Clinical Electrocardiographic and Echocardiographic Features of ...

African Journals Online (AJOL)

Clinical Electrocardiographic and Echocardiographic Features of Atrial Fibrillation in Nigerians: An Analysis of 39 Patients Seen at the Lagos University Teaching Hospital. ... Congestive cardiac failure was present in 74% of the subjects with a mean NYHA class of about III. Embolic phenomenon was observed in 15% of the ...

Bladder cancer treatment response assessment with radiomic, clinical, and radiologist semantic features

Science.gov (United States)

Gordon, Marshall N.; Cha, Kenny H.; Hadjiiski, Lubomir M.; Chan, Heang-Ping; Cohan, Richard H.; Caoili, Elaine M.; Paramagul, Chintana; Alva, Ajjai; Weizer, Alon Z.

2018-02-01

We are developing a decision support system for assisting clinicians in assessment of response to neoadjuvant chemotherapy for bladder cancer. Accurate treatment response assessment is crucial for identifying responders and improving quality of life for non-responders. An objective machine learning decision support system may help reduce variability and inaccuracy in treatment response assessment. We developed a predictive model to assess the likelihood that a patient will respond based on image and clinical features. With IRB approval, we retrospectively collected a data set of pre- and post- treatment CT scans along with clinical information from surgical pathology from 98 patients. A linear discriminant analysis (LDA) classifier was used to predict the likelihood that a patient would respond to treatment based on radiomic features extracted from CT urography (CTU), a radiologist's semantic feature, and a clinical feature extracted from surgical and pathology reports. The classification accuracy was evaluated using the area under the ROC curve (AUC) with a leave-one-case-out cross validation. The classification accuracy was compared for the systems based on radiomic features, clinical feature, and radiologist's semantic feature. For the system based on only radiomic features the AUC was 0.75. With the addition of clinical information from examination under anesthesia (EUA) the AUC was improved to 0.78. Our study demonstrated the potential of designing a decision support system to assist in treatment response assessment. The combination of clinical features, radiologist semantic features and CTU radiomic features improved the performance of the classifier and the accuracy of treatment response assessment.

Clinical features in accelerated phase of chronic myeloid leukemia

International Nuclear Information System (INIS)

Naqi, N.; Ayub, M.

2001-01-01

Objective: To identify the clinical indicators of accelerated phase in chronic myeloid leukemia (CML) diagnosed on hematological findings. Design: An observational and prospective study. Place and Duration of Study: The study was conducted at Oncology department of Combined Military Hospital, Rawalpindi and Armed Forces Institute of Pathology from April 1998 to April 1999. Subjects and Methods: The study on 51 patients of Philadelphia positive CML in chronic phase and on hydroxyurea therapy were carried out. Clinical features and hematological parameters in the peripheral blood examination were recorded and statistical analysis carried out to document reliable clinically indicators of accelerated phase of CML in reference to those reported in the literature. Results: Clinical, presence of unexplained fever, re-enlargement of spleen after successful regression with hydroxyurea therapy, and bleeding diathesis were found to be statistically significant pointers of progression into accelerated phase of CML. In the hematological features, with the exception of peripheral basophilia, the findings in the peripheral blood were consistent with those reported in the literature. Conclusion: It is concluded that the occurrences of the clinical features in the follow-up of chronic myeloid leukemia patients herald the accelerated phase of the disease. (author)

Juvenile myoclonic epilepsy: clinical and EEG features

DEFF Research Database (Denmark)

Pedersen, S B; Petersen, K A

1998-01-01

We aimed to characterize the clinical profile and EEG features of 43 patients with juvenile myoclonic epilepsy. In a retrospective design we studied the records of, and re-interviewed, 43 patients diagnosed with JME from the epilepsy clinic data base. Furthermore, available EEGs were re...... were sleep deprivation (84%), stress (70%), and alcohol consumption (51%). EEG findings included rapid spike-wave and polyspike-wave....

Juvenile myoclonic epilepsy: clinical and EEG features

DEFF Research Database (Denmark)

Pedersen, S B; Petersen, K A

1998-01-01

We aimed to characterize the clinical profile and EEG features of 43 patients with juvenile myoclonic epilepsy. In a retrospective design we studied the records of, and re-interviewed, 43 patients diagnosed with JME from the epilepsy clinic data base. Furthermore, available EEGs were re-evaluated...... were sleep deprivation (84%), stress (70%), and alcohol consumption (51%). EEG findings included rapid spike-wave and polyspike-wave....

[Clinical features of a Chinese pedigree with Waardenburg syndrome type 2].

Science.gov (United States)

Yang, Shu-zhi; Yuan, Hui-jun; Bai, Lin-na; Cao, Ju-yang; Xu, Ye; Shen, Wei-dong; Ji, Fei; Yang, Wei-yan

2005-10-12

To investigate detailed clinical features of a Chinese pedigree with Waardenburg syndrome type 2. Members of this pedigree were interviewed to identify personal or family medical histories of hearing loss, the use of aminoglycosides, and other clinical abnormalities by filling questionnaire. The audiological and other clinical evaluations of the proband and other members of this family were conducted, including pure-tone audiometry, immittance and auditory brain-stem response and ophthalmological, dermatologic, hair, temporal bone CT examinations. This family is categorized as Waardenburg syndrome type 2 according to its clinical features. It's an autosomal dominant disorder with incomplete penetrance. The clinical features varied greatly among family members and characterized by sensorineural hearing loss, heterochromia irides, freckle on the face and premature gray hair. Hearing loss can be unilateral or bilateral, congenital or late onset in this family. This Chinese family has some unique clinical features comparing with the international diagnostic criteria for Waardenburg syndrome. This study may provide some evidences to amend the diagnostic criteria for Waardenburg syndrome in Chinese population.

Relationship between ionospheric plasma bubble occurrence and lightning strikes over the Amazon region

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J. Sousasantos

2018-03-01

Full Text Available The vertical coupling between the troposphere and the ionosphere presents some remarkable features. Under intense tropospheric convection, gravity waves may be generated, and once they reach the ionosphere, these waves may seed instabilities and spread F and equatorial plasma bubble events may take place. Additionally, there is a close association between severe tropospheric convection and lightning strikes. In this work an investigation covering an equinox period (September–October during the deep solar minimum (2009 presents the relation between lightning strike activity and spread F (equatorial plasma bubble detected over a low-latitude Brazilian region. The results show a considerable correlation between these two phenomena. The common element in the center of this conformity seems to be the gravity waves. Once gravity waves and lightning strikes share the same source (intense tropospheric convection and the effects of such gravity waves in the ionosphere include the seeding of instabilities according to the gravity waves magnitude, the monitoring of the lightning strike activity seems to offer some information about the subsequent development of spread F over the equatorial region.

Relationship between ionospheric plasma bubble occurrence and lightning strikes over the Amazon region

Science.gov (United States)

Sousasantos, Jonas; Sobral, José Humberto Andrade; Alam Kherani, Esfhan; Magalhães Fares Saba, Marcelo; Rodolfo de Campos, Diovane

2018-03-01

The vertical coupling between the troposphere and the ionosphere presents some remarkable features. Under intense tropospheric convection, gravity waves may be generated, and once they reach the ionosphere, these waves may seed instabilities and spread F and equatorial plasma bubble events may take place. Additionally, there is a close association between severe tropospheric convection and lightning strikes. In this work an investigation covering an equinox period (September-October) during the deep solar minimum (2009) presents the relation between lightning strike activity and spread F (equatorial plasma bubble) detected over a low-latitude Brazilian region. The results show a considerable correlation between these two phenomena. The common element in the center of this conformity seems to be the gravity waves. Once gravity waves and lightning strikes share the same source (intense tropospheric convection) and the effects of such gravity waves in the ionosphere include the seeding of instabilities according to the gravity waves magnitude, the monitoring of the lightning strike activity seems to offer some information about the subsequent development of spread F over the equatorial region.

Women, transition and strikes in Serbia

OpenAIRE

Novaković, Nada G.

2014-01-01

The author, in a sociological way, describes and analyzes the concepts of transition, privatization and strikes in Serbia, particularly the place of women in it. It examines the most important economic and social causes and consequences of these phenomena. The main hypothesis is: women's strikes in the Serbian transition are less efficient than strikes and public protests of women in the developed world and the second Yugoslavia. A strike is a class conflict, in which the workers are fighting...

Acute transient hemiparesis induced by lightning strike.

Science.gov (United States)

Rahmani, Seyed Hesam; Faridaalaee, Gholamreza; Jahangard, Samira

2015-07-01

According to data from the National Oceanic and Atmospheric Administration,in the years from 1959 to 1994, lightning was responsible for more than 3000 deaths and nearly 10,000 casualties. The most important characteristic features of lightning injuries are multisystem involvement and widely variable severity. Lightning strikes are primarily a neurologic injury that affects all 3 components of the nervous system: central, autonomic,and peripheral. Neurologic complications of lightning strikes vary from transient benign symptoms to permanent disability. Many patients experience a temporary paralysis called keraunoparalysis. Here we reported a 22-year-old mountaineer man with complaining of left sided hemiparesis after being hit by a lightning strike in the mountain 3 hours ago. There was no loss of consciousness at hitting time. On arrival the patient was alert, awake and hemodynamically stable. In neurologic examination cranial nerves were intact, left sided upper and lower extremity muscle force was I/V with a combination of complete sensory loss, and right-sided muscle force and sensory examination were normal. There is not any evidence of significant vascular impairment in the affected extremities. Brain MRI and CT scan and cervical MRI were normal. During 2 days of admission, with intravenous hydration, heparin 5000 unit SC q12hr and physical therapy of the affected limbs, motor and sensory function improved and was normal except mild paresthesia. He was discharged 1 day later for outpatient follow up while vitamin B1 100mg orally was prescribed.Paresthesia improved after 3 days without further sequels.

[Clinical and histopathological features of myositis associated with anti-mitochondrial antibodies].

Science.gov (United States)

Shimizu, Jun

2013-01-01

Anti-mitochondrial antibodies (AMA) are known to be characteristic markers of primary biliary cirrhosis (PBC). The association of PBC with myositis has been reported mainly as case reports, and comprehensive studies of the clinical and histopathological features of patients with myositis and AMAs or PBC have not been conducted thus far. We retrospectively reviewed 212 patients with inflammatory myopathies in our laboratory and found 24 patients with AMA-positive myositis (11%) (seven patients with PBC and 17 patients without PBC). The analysis of clinical and histopathological features revealed that myositis associated with AMAs frequently include patients with a clinically chronic disease course, muscle atrophy, cardiopulmonary involvement and granulomatous inflammation, regardless of the presence or absence of PBC. We also reviewed and analyzed the clinical features of previously reported patients. The analysis of 75 patients, which have been described in previous case reports including the ones of meeting abstracts, also showed the similar results about clinical features of myositis associated with AMAs and supported our findings. Our study suggests that myositis associated with AMAs form a characteristic subgroup.

Stress distribution of metatarsals during forefoot strike versus rearfoot strike: A finite element study.

Science.gov (United States)

Li, Shudong; Zhang, Yan; Gu, Yaodong; Ren, James

2017-12-01

Due to the limitations of experimental approaches, comparison of the internal deformation and stresses of the human man foot between forefoot and rearfoot landing is not fully established. The objective of this work is to develop an effective FE modelling approach to comparatively study the stresses and energy in the foot during forefoot strike (FS) and rearfoot strike (RS). The stress level and rate of stress increase in the Metatarsals are established and the injury risk between these two landing styles is evaluated and discussed. A detailed subject specific FE foot model is developed and validated. A hexahedral dominated meshing scheme was applied on the surface of the foot bones and skin. An explicit solver (Abaqus/Explicit) was used to stimulate the transient landing process. The deformation and internal energy of the foot and stresses in the metatarsals are comparatively investigated. The results for forefoot strike tests showed an overall higher average stress level in the metatarsals during the entire landing cycle than that for rearfoot strike. The increase rate of the metatarsal stress from the 0.5 body weight (BW) to 2 BW load point is 30.76% for forefoot strike and 21.39% for rearfoot strike. The maximum rate of stress increase among the five metatarsals is observed on the 1st metatarsal in both landing modes. The results indicate that high stress level during forefoot landing phase may increase potential of metatarsal injuries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Foot-strike pattern and performance in a marathon.

Science.gov (United States)

Kasmer, Mark E; Liu, Xue-Cheng; Roberts, Kyle G; Valadao, Jason M

2013-05-01

To determine prevalence of heel strike in a midsize city marathon, if there is an association between foot-strike classification and race performance, and if there is an association between foot-strike classification and gender. Foot-strike classification (forefoot, midfoot, heel, or split strike), gender, and rank (position in race) were recorded at the 8.1-km mark for 2112 runners at the 2011 Milwaukee Lakefront Marathon. 1991 runners were classified by foot-strike pattern, revealing a heel-strike prevalence of 93.67% (n = 1865). A significant difference between foot-strike classification and performance was found using a Kruskal-Wallis test (P strike. No significant difference between foot-strike classification and gender was found using a Fisher exact test. In addition, subgroup analysis of the 126 non-heel strikers found no significant difference between shoe wear and performance using a Kruskal-Wallis test. The high prevalence of heel striking observed in this study reflects the foot-strike pattern of most mid-distance to long-distance runners and, more important, may predict their injury profile based on the biomechanics of a heel-strike running pattern. This knowledge can help clinicians appropriately diagnose, manage, and train modifications of injured runners.

Clinical, biochemical and ultrasonographic features of infertile women with polycystic ovarian syndrome

International Nuclear Information System (INIS)

Haq, F.; Rizvi, J.

2007-01-01

To evaluate and compare the clinical, biochemical and ultrasonic features of infertile women with PCOS from the two infertility centers of Karachi, The Aga Khan University Hospital and Concept Fertility Centre. Patients attending the Infertility Clinics of Aga Khan University Hospital, Karachi and Concept Fertility Centre, Karachi, were evaluated for their clinical features. Complete biochemical evaluation was performed by day 2 FSH, LH, serum prolactin, serum testosterone and fasting serum insulin determination. These results were recorded on the data collection form. Ultrasonic evaluation was performed with transvaginal ultrasound to check the morphological appearance of ovaries. A total of 508 patients were evaluated for epidemiological features of PCOS. Frequency of PCOS in the infertility clinic was 17.6% with high rate of obesity (68.5%) and hyperinsulinemia (59%). The highest rate of abnormal clinical, biochemical features were seen above BMI of 30. High rates of obesity, hyperinsulinemia and impaired glycemic control were seen in this series. It was demonstrated that high BMI had an association and correlation with abnormal clinical and biochemical features. Obese women with PCOS need more attention for their appropriate management. (author)

Perinatal clinical and imaging features of CLOVES syndrome

Energy Technology Data Exchange (ETDEWEB)

Fernandez-Pineda, Israel [Virgen del Rocio Children' s Hospital, Department of Pediatric Surgery, Seville (Spain); Fajardo, Manuel [Virgen del Rocio Children' s Hospital, Department of Pediatric Radiology, Seville (Spain); Chaudry, Gulraiz; Alomari, Ahmad I. [Children' s Hospital Boston and Harvard Medical School, Division of Vascular and Interventional Radiology, Boston, MA (United States)

2010-08-15

We report a neonate with antenatal imaging features suggestive of CLOVES syndrome. Postnatal clinical and imaging findings confirmed the diagnosis, with the constellation of truncal overgrowth, cutaneous capillary malformation, lymphatic and musculoskeletal anomalies. The clinical, radiological and histopathological findings noted in this particular phenotype help differentiate it from other overgrowth syndromes with complex vascular anomalies. (orig.)

Novel clinical features of nonconvulsive status epilepticus

Science.gov (United States)

Nagayama, Masao; Yang, Sunghoon; Geocadin, Romergryko G.; Kaplan, Peter W.; Hoshiyama, Eisei; Shiromaru-Sugimoto, Azusa; Kawamura, Mitsuru

2017-01-01

Nonconvulsive status epilepticus (NCSE) has rapidly expanded from classical features such as staring, repetitive blinking, chewing, swallowing, and automatism to include coma, prolonged apnea, cardiac arrest, dementia, and higher brain dysfunction, which were demonstrated mainly after the 2000s by us and other groups. This review details novel clinical features of NCSE as a manifestation of epilepsy, but one that is underdiagnosed, with the best available evidence. Also, we describe the new concept of epilepsy-related organ dysfunction (Epi-ROD) and a novel electrode and headset which enables prompt electroencephalography. PMID:28979770

14 CFR 35.38 - Lightning strike.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Lightning strike. 35.38 Section 35.38... STANDARDS: PROPELLERS Tests and Inspections § 35.38 Lightning strike. The applicant must demonstrate, by... lightning strike without causing a major or hazardous propeller effect. The limit to which the propeller has...

Strikes in Serbia since 2000 to 2005

OpenAIRE

Novaković Nada

2005-01-01

In this article author deals with main characteristics of strikes in Serbia within the period 2000–2005. Analysis starts with thesis that strike is open class conflict within class divided society. Therefore strike is radical form of trade union struggle for workers rights. Main questions in the analysis were: on social structure as a background of strikes, on organizations and trade unions included in it, on effects of strikes in Serbia in the given period. Main thesis of the article is that...

Options with Extreme Strikes

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Lingjiong Zhu

2015-07-01

Full Text Available In this short paper, we study the asymptotics for the price of call options for very large strikes and put options for very small strikes. The stock price is assumed to follow the Black–Scholes models. We analyze European, Asian, American, Parisian and perpetual options and conclude that the tail asymptotics for these option types fall into four scenarios.

Management of patients during hunger strike and refeeding phase.

Science.gov (United States)

Eichelberger, M; Joray, M L; Perrig, M; Bodmer, M; Stanga, Z

2014-01-01

Hunger strikers resuming nutritional intake may develop a life-threatening refeeding syndrome (RFS). Consequently, hunger strikers represent a core challenge for the medical staff. The objective of the study was to test the effectiveness and safety of evidence-based recommendations for prevention and management of RFS during the refeeding phase. This was a retrospective, observational data analysis of 37 consecutive, unselected cases of prisoners on a hunger strike during a 5-y period. The sample consisted of 37 cases representing 33 individual patients. In seven cases (18.9%), the hunger strike was continued during the hospital stay, in 16 episodes (43.2%) cessation of the hunger strike occurred immediately after admission to the security ward, and in 14 episodes (37.9%) during hospital stay. In the refeed cases (n = 30), nutritional replenishment occurred orally, and in 25 (83.3%) micronutrients substitutions were made based on the recommendations. The gradual refeeding with fluid restriction occurred over 10 d. Uncomplicated dyselectrolytemia was documented in 12 cases (40%) within the refeeding phase. One case (3.3%) presented bilateral ankle edemas as a clinical manifestation of moderate RFS. Intensive medical treatment was not necessary and none of the patients died. Seven episodes of continued hunger strike were observed during the entire hospital stay without medical complications. Our data suggested that seriousness and rate of medical complications during the refeeding phase can be kept at a minimum in a hunger strike population. This study supported use of recommendations to optimize risk management and to improve treatment quality and patient safety in this vulnerable population. Copyright © 2014 Elsevier Inc. All rights reserved.

Women, transition and strikes in Serbia

Directory of Open Access Journals (Sweden)

Novaković Nada G.

2014-01-01

Full Text Available The author, in a sociological way, describes and analyzes the concepts of transition, privatization and strikes in Serbia, particularly the place of women in it. It examines the most important economic and social causes and consequences of these phenomena. The main hypothesis is: women's strikes in the Serbian transition are less efficient than strikes and public protests of women in the developed world and the second Yugoslavia. A strike is a class conflict, in which the workers are fighting for their social and economic rights, threatened by the capitalist class. Elites in government and state authorities protect the interests of big capital at the detriment of the interests of the majority of workers. Exploring women's strikes in transition reveals the nature of the social and political system. Their strikes in enterprises, the blocking of public spaces and public protests are systemic, ie. class determined. As the transition was very fast, the resistance of the strikers was inefficient, and the protests of women became an expression of desperation against the loss of jobs and basic resources for lifehood. In short, this research is about the main causes, the organizational forms and the consequences of strikes in which the majority were women. For this purpose, the author chose to describe an array of strikes in the industries and the companies where women are most employed. The choice of strikes in the economic sector is not accidental, but a consequence of the fact that the women there were the most vulnerable. Women in public institutions and companies had much higher financial and social position. They are less likely to strike and publicly protested. After 2000, these strikes were more successful than worker's strikes in textile, food processing, manufacturing and trade. Relationship between the government and the public towards them was tainted by self-interest and selective. The main criterion for the selection of companies and

Clinical Features of Osteogenesis Imperfecta in Taiwan

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Hsiang-Yu Lin

2009-07-01

Conclusion: Nine of the 11 clinical features examined—height, weight, BMD, dentinogenesis imperfecta, bone deformity, scoliosis, walking ability, fracture rate, and family history—were significantly different among the three types of OI patients. This finding may be of help in evaluating patients and establishing their prognosis.

Barrett's esophagus: clinical features, obesity, and imaging.

LENUS (Irish Health Repository)

Quigley, Eamonn M M

2011-09-01

The following includes commentaries on clinical features and imaging of Barrett\\'s esophagus (BE); the clinical factors that influence the development of BE; the influence of body fat distribution and central obesity; the role of adipocytokines and proinflammatory markers in carcinogenesis; the role of body mass index (BMI) in healing of Barrett\\'s epithelium; the role of surgery in prevention of carcinogenesis in BE; the importance of double-contrast esophagography and cross-sectional images of the esophagus; and the value of positron emission tomography\\/computed tomography.

[Physicians' strikes--ethical considerations].

Science.gov (United States)

Glick, Shimon; Schwarzfuchs, Dan

2012-01-01

Strikes in general represent a solution based on a form of coercion. Historically, the striker caused direct damage to his employer, who was responsible for the perceived unfair treatment of the employee. In the case of strikes in the public sector, the employer is generally not harmed, but innocent citizens suffer in order to pressure the government agencies, a questionable practice from an ethical viewpoint. Physicians' strikes have more serious ethical problems. They cause suffering and death to innocent citizens. They violate the ethical codes to which physicians have committed themselves as professionals, and they seriously impair the trust of the public in physicians. Better and more ethical ways to provide fair compensation for physicians must be employed, perhaps like those used for judges and members of the IDF.

Clinical features and outcome analysis of intracranial hydatid cysts

International Nuclear Information System (INIS)

Khan, M.M.; Shah, M.; Ayub, S.; Ahmad, A.; Aman, A.; Shah, M.A.; Rehman, R.U.

2016-01-01

Background: Hydatid cyst of the brain is a serious zoonotic parasitic infection which have profound health consequences if left untreated. The surgical excision of the cysts are rewarding for both the patient the neurosurgeon. Methods: The study was conducted prospectively at Department of Neurosurgery Hayatabad Medical Complex Peshawar from January 2013 to December 2014. Patients with a diagnosis of intracranial hydatid cysts were included, clinical and radiological features recorded, intervention and postoperative outcome were analysed. Results: Eleven patients with a male to female ratio of 1.7:1. Mean age was 12.4 (SD±6.5) years with median GCS on arrival of 10 (SD±2.5). Clinical features were headache (81.8 percentage), vomiting (90.9 percentage), seizures (36.4 percentage), focal deficits (54.5 percentage) and papilloedema (72.7 percentage). The median GCS on discharge was 13 (SD±1.1) while GOS at 1 month follow up was 4 (SD±0.7). The bivariate analysis showed inverse correlation (R2=-0.68; p=0.02) between duration of symptoms and outcome while GCS on admission was positively correlated (rs=0.75; p=0.007) with the outcome. There was no mortality. Conclusion: Despite its rarity the clinical features are non-specific while radiological features help in establishing diagnosis. Earlier diagnosis and prompt intervention is the key to favourable outcome. (author)

Autoimmune Thyroiditis: Clinical Course Features and Principles of Differential Therapy

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L.Ye. Bobyryova

2014-02-01

Full Text Available Constant increase in the incidence of autoimmune thyroiditis (AIT in different regions of Ukraine puts this problem in actual number that determines the need to identify features of the clinical course of AIT, the principles of differentiated treatment depending on the nature of the metabolic changes and taking into account regional differences in thyroid pathology, particularly AIT. The paper presents data on the study of features of clinical course and complex treatment of AIT.

Preemptive strikes: Fear, hope, and defensive aggression.

Science.gov (United States)

Halevy, Nir

2017-02-01

Preemptive strikes are costly and harmful. Existing models of defensive aggression focus narrowly on the role fear plays in motivating preemptive strikes. Theoretically integrating the literatures on conflict, decision making, and emotion, the current research investigated how specific emotions associated with certainty or uncertainty, including fear, anger, disgust, hope, and happiness, influence preemptive strikes. Study 1 demonstrated that hope negatively predicts defensive exits from relationships in choice dilemmas. Studies 2 and 3 experimentally manipulated risk of being attacked in an incentivized, interactive decision making task-the Preemptive Strike Game. Risk of being attacked fueled preemptive strikes; reduced feelings of hope partially mediated this effect in Study 3. Studies 4 and 5 investigated preemptive strikes under uncertainty (rather than risk). In Study 4, reasoning about the factors that make one trustful of others curbed preemptive strikes; cogitating about the factors that underlie discrete emotions, however, did not influence defensive aggression. Study 5 demonstrated that the valence and uncertainty appraisals of incidental emotions interact in shaping preemptive strikes. Specifically, recalling an autobiographical emotional experience that produced hope significantly decreased attack rates relative to fear, happiness, and a control condition. Fear, anger, disgust, and happiness were either unrelated to preemptive strikes or showed inconsistent relationships with preemptive strikes across the 5 studies. These findings shed light on how emotions shape defensive aggression, advance knowledge on strategic choice under risk and uncertainty, and demonstrate hope's positive effects on social interactions and relationships. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Ebola outbreak in Conakry, Guinea: Epidemiological, clinical, and outcome features

OpenAIRE

Barry, M; Traoré, F A; Sako, F B; Kpamy, D O; Bah, E I; Poncin, M; Keita, S; Cisse, M; Touré, A

2014-01-01

The authors studied the epidemiological, clinical, and outcome features of the Ebola virus disease in patients hospitalized at the Ebola treatment center (ETC) in Conakry to identify clinical factors associated with death.

Multifocal dystonia, Clinical feature of Hallervorden-Spatz

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Ghelichkhani H

1998-09-01

Full Text Available Hallervorden-spatz disease is an inherited metabolic disorder with autosomal recessive trait. Onset is in late childhood or early adolescence. Clinical manifestation is variable but pyramidal and extrapyramidal signs are often prominent. Many of patients show progressive dementia and extrapyramidal symptoms. Ataxia or myoclonus is reported in the course of the disease in individual cases. Focal dystonias including tongue, eyelids (blepharospasm and optic atrophy, retinitis pigmentosa, rarely familial parkinsonism are also reported. Pathologically pigmentary degeneration of globus pallidus, substantia nigra (pars reticular and red nucleus is characteristic. In our case the main clinical feature was multifocal dystonia without obvious pyramidal or other extrapyramidal symptoms, and diagnosis was based on clinical and MRI findings.

Features of the Clinical Course of Adrenal Incidentalomas

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G.A. Alimukhamedova

2014-03-01

Full Text Available The objective of the study was to examine the clinical features of adrenal incidentalomas. 98 clinical observations of patients with adrenal incidentalomas receiving in- and out-patient treatment in the clinic of Republican Specialized Scientific and Practical Medical Centre of Endocrinology of Ministry of Healthcare of Republic of Uzbekistan were analyzed. Of them, 51 % — males, 49 % — females. General clinical observation included: thorough gaining of complaints; anamnesis morbi and vitae; assessment of somatic and endocrine statuses; clinical examination with measurement of blood pressure and body mass index; urinalysis; biochemical blood analysis. In addition, all patients underwent complete blood count with determination of blood potassium, sodium, chlorine, lipid profile, fasting blood glucose and oral glucose tolerance test, creatinine and urea; hormonal blood tests, including studies of plasma aldosterone and plasma renin activity in a horizontal position, adrenocorticotropic hormone, blood cortisol, as well as the daily excretion of catecholamines with urine. For topical diagnosis we used ultrasound, CT of adrenals. It was found that adrenal incidentalomas were detected in 37.8 % as a result of searching for the reason of arterial hypertension, in 23.5 % — of obesity and hypothalamus dysfunction, in 14.2 % — in abdominal pathology, in 12.2 % — of non-specific complaints, in 8.1 % — in exclusion of adrenal diseases, and in 4 % — in clinical supervision. Clinically they are characterized with nonspecific features with predominance of arterial hypertension (76.5 %, which is associated with adrenal pathology only 18.4 % of cases. Analysis of metabolic disorders revealed clinically significant changes as well. Of 98 examined patients, 70 % had metabolic disorders.

Clinical Features Indicating Nigrostriatal Dopaminergic Degeneration in Drug-Induced Parkinsonism

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Seung Ha Lee

2017-01-01

Full Text Available Objective Patients with drug-induced parkinsonism (DIP may have nigrostriatal dopaminergic degeneration. We studied the clinical features that may indicate nigrostriatal dopaminergic degeneration in patients with DIP. Methods Forty-one DIP patients were classified into normal and abnormal [18F] FP-CIT scan groups. Differences in 32 clinical features and drug withdrawal effects were studied. Results Twenty-eight patients had normal (Group I and 13 patients had abnormal (Group II scans. Eight patients of Group I, but none of Group II, had taken calcium channel blockers (p = 0.040. Three patients of Group I and six of Group II had hyposmia (p = 0.018. After drug withdrawal, Group I showed greater improvement in Unified Parkinson’s Disease Rating Scale total motor scores and subscores for bradykinesia and tremors than Group II. Only hyposmia was an independent factor associated with abnormal scans, but it had suboptimal sensitivity. Conclusion None of the clinical features were practical indicators of nigrostriatal dopaminergic degeneration in patients with DIP.

Clinical and MRI features of prostate sarcoma: comparison with prostate adenocarcinoma

International Nuclear Information System (INIS)

Ding Jianping; Wang Xiaoying; Wang Zhenzhong; Zhou Liangping; Jiang Xuexiang

2004-01-01

Objective: To summarize the clinical and imaging features of prostate sarcoma, and to compare the features with those of prostate adenocarcinoma (PCa). Method: Six cases of prostate sarcoma proved pathologically were enrolled in this study. The clinical material and imaging features were compared with those of the PCa. Results: (1) Pathological result: Among the 6 prostate sarcomas, 3 were rhabdomyosarcoma, 1 was leiomyosarcoma, and 2 were sarcoma originated from interstitial tissue that could not be classified. (2) Clinical result: The 6 patients of sarcoma were younger (median age 36.5, 15-71 years) than the patients of PCa (median age 72, 50-78 years) (P -3 ng/L] was normal and lower than that of the PCa patients [median 27.80, (1.55-352.00) x 10 -3 ng/ L] (P 3 ) was larger than that of PCa (median 41.57, 17.16-179.44 cm 3 ) (P 2 -weighted images, with grossly normal structure of the prostate. Excapsular extension was more common in the sarcomas than in the PCa (83.3% vs 66.7%). Conclusion: The clinical and imaging features of prostate sarcoma are different from those of prostate adenocarcinoma

Epidemiology and clinical features of patients with hepatocellular ...

African Journals Online (AJOL)

2016-02-28

Feb 28, 2016 ... deaths worldwide.[1] It is the fifth most common type ... Qari and Mosli: Epidemiological and clinical features of liver cancer. 44. Nigerian Journal of ... Package for the Social Sciences (SPSS Inc., Chicago, IL,. USA), version 16.

Identifying ideology: media representations of the Irving Oil Refinery strike, 1994-1996

Energy Technology Data Exchange (ETDEWEB)

Steuter, E.C.

1998-07-01

Media coverage of a strike at the Irving Oil Refinery in Saint John, New Brunswick which began in 1994 and lasted until 1996 is used as a background for the examination of ideology, used here in the more inclusive sense, one in which the term suggests a frame of mind without the coherence and easily recognized label usually associated with political ideology. Central issues such as monopoly ownership of the New Brunswick media by the Irving Group of Companies (also owners of the refinery) , the ideological presentation of strikes in general, and the representation of changing labour relations in a post-industrial, globally-oriented society are analyzed to show how these issues influenced media coverage. Four New Brunswick dailies as well as selected English-language dailies from other parts of Canada have been scrutinized in an effort to determine their ideological stand. It was found that restrictive ideologies such as liberalism or conservatism are on the decline; instead, more inclusive ideologies like defeatism and individualism were prominently featured especially by the St. John Telegraph-Journal in New Brunswick and other papers outside the province. The most striking finding was that if the media coverage of the Irving Refinery strike is representative of public opinion, the current organization of the provincial political economy is accepted as 'natural' by a majority of New Brunswickers.

Pneumatosis intestinalis: CT findings and clinical features

Energy Technology Data Exchange (ETDEWEB)

Kim, Hye Lin; Lee, Hae Kyung; Park, Seong Jin; Yi, Boem Ha; Ko, Bong Min; Hong, Hyun Sook; Paik, Sang Hyun [Soonchunhyang University Hospital Bucheon, Bucheon (Korea, Republic of)

2008-02-15

The purpose of this study is to evaluate the CT findings and clinical features of patients with pneumatosis intestinalis. From January 2001 to October 2007, 15 patients with pneumatosis intestinalis were diagnosed by the use of CT. We analyzed the clinical features and CT findings to assess the involvement site, the presence of portal and mesenteric vein gas, and the existence of accompanied ischemic change. Of the 15 patients, five patients had end stage renal disease (33.3%), two patients underwent a gastrectomy, one patient underwent a laminectomy, one patient had tuberculous enteritis, one patient had lung cancer and one patient had pneumonia. Four patients presented with no specific disease. There was portal or mesenteric venous gas in six cases, and strangulation or an ischemic change of the bowel in five cases. Otherwise, pneumatosis intestinalis was associated with hydropneumoperitoneum in two cases, pneumoperitoneum in one case and a single case of perforated appendicitis. Nine patients underwent surgery for ischemic change of the bowel, pneumoperitoneum, appendicitis, and a clinical sign of panperitonitis. Among the remaining six patients, three patients recovered and were discharged, and three patients expired during progression of the disease. End stage renal disease is the most common condition associated with pneumatosis intestinalis. The presence of portomesenteric venous gas, ischemic change of the bowel, and linear pneumatosis intestinalis are indicative of a poor prognosis.

Psychiatric Illness in Mentally Retarded Adolescents: Clinical Features.

Science.gov (United States)

Masi, Gabriele

1998-01-01

Describes the clinical features of the most important psychiatric disorders in mentally retarded adolescents: mood disorders, psychotic disorders, severe behavioral disorders, personality disorders, anxiety disorders, and attention-deficit The impact of mental retardation on personality development is confirmed by the high psychopathological…

What causes an icy fault to slip? Investigating strike-slip failure conditions on Ganymede at Dardanus and Tiamat Sulcus.

Science.gov (United States)

Cameron, M. E.; Smith-Konter, B. R.; Burkhard, L. M.; Collins, G. C.; Seifert, F.; Pappalardo, R. T.

2015-12-01

Ganymede exhibits two geologically distinct terrains known as dark and light (grooved) terrain. The mechanism for a transition from dark to light terrain remains unclear; however, inferences of strike-slip faulting and distributed shear zones suggest that strike-slip tectonism may be important to the structural development of Ganymede's surface and in this transition. Here we investigate the role of tidal stresses on Ganymede in the formation and evolution of strike-slip structures in both dark and grooved terrains. Using numerical code SatStress, we calculate both diurnal and non-synchronous rotation (NSR) tidal stresses at Ganymede's surface. Specifically, we investigate the role of fault friction and orbital eccentricity in the development of ~45 km of right-lateral offset at Dardanus Sulcus and a possible case of study with a detailed morphological mapping of strike-slip morphologies (en echelon structures, strike-slip duplexes, laterally offset pre-existing features, and possible strained craters) at Nun Sulcus and several other locations. These structures serve as example regions to provide improved constraints for global stress mechanisms responsible for strike-slip fault evolution on Ganymede.

Clinical mastitis in ewes; bacteriology, epidemiology and clinical features

Directory of Open Access Journals (Sweden)

Kvitle Bjørg

2007-09-01

Full Text Available Abstract Background Clinical mastitis is an important disease in sheep. The objective of this work was to identify causal bacteria and study certain epidemiological and clinical features of clinical mastitis in ewes kept for meat and wool production. Methods The study included 509 ewes with clinical mastitis from 353 flocks located in 14 of the 19 counties in Norway. Clinical examination and collection of udder secretions were carried out by veterinarians. Pulsed-field gel electrophoresis (PFGE was performed on 92 Staphylococcus aureus isolates from 64 ewes. Results and conclusion S. aureus was recovered from 65.3% of 547 clinically affected mammary glands, coagulase-negative staphylococci from 2.9%, enterobacteria, mainly Escherichia coli, from 7.3%, Streptococcus spp. from 4.6%, Mannheimia haemolytica from 1.8% and various other bacteria from 4.9%, while no bacteria were cultured from 13.2% of the samples. Forty percent of the ewes with unilateral clinical S. aureus mastitis also had a subclinical S. aureus infection in the other mammary gland. Twenty-four of 28 (86% pairs of S. aureus isolates obtained from clinically and subclinically affected mammary glands of the same ewe were indistinguishable by PFGE. The number of identical pairs was significantly greater than expected, based on the distribution of different S. aureus types within the flocks. One-third of the cases occurred during the first week after lambing, while a second peak was observed in the third week of lactation. Gangrene was present in 8.8% of the clinically affected glands; S. aureus was recovered from 72.9%, Clostridium perfringens from 6.3% and E. coli from 6.3% of the secretions from such glands. This study shows that S. aureus predominates as a cause of clinical ovine mastitis in Norway, also in very severe cases. Results also indicate that S. aureus is frequently spread between udder halves of infected ewes.

Polycystic ovaries and associated clinical and biochemical features ...

African Journals Online (AJOL)

The aim of this study was to determine prevalence of polycystic ovaries (PCO) and associated clinical and biochemical features among women with infertility attending gynaecological outpatient department (GOPD) at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. All women with infertility attending the ...

A bird strike handbook for base-level managers

Science.gov (United States)

Payson, R. P.; Vance, J. D.

1984-09-01

To help develop more awareness about bird strikes and bird strike reduction techniques, this thesis compiled all relevant information through an extensive literature search, review of base-level documents, and personal interviews. The final product--A Bird Strike Handbook for Base-Level Managers--provides information on bird strike statistics, methods to reduce the strike hazards, and means to obtain additional assistance. The handbook is organized for use by six major base agencies: Maintenance, Civil Engineering, Operations, Air Field Management, Safety, and Air Traffic Control. An appendix follows at the end.

Idiopathic granulomatous mastitis; Clinical presentation, radiological features and treatmant

International Nuclear Information System (INIS)

Aldaqal, Saleh M.

2004-01-01

To determine the clinical characteristic, clinical presentations and radiological features of diopathic granulomatous mastitis, and the best treatment approaches of this clinical entity. Between 1996 and 2003 the files and histopathology reports of 25 patients with granulomatous mastitis at King Abdul-Aziz University Hospital Jeddah, Kindom of Saudi Arabia were reviewed. The data were analyzed and a Medline search was carried out from 1970 to 2003 to review relevant cases. The age of patients ranged from 24-66 years and the mean age was 36.6+-9.43 years. All patients were females. The most common clinical presentation was palpable tender mass. The most common mammographic finding was ill-defined mass. However, mixed hypo- and hyper-echogenic lesions with tubular connections were the common ultrasonic findings. Treatment approaches were conservative or surgical excision or steroid. Conservative treatment associated with the higher rate of complications, while treatment with steroid showed complete remission of disease. Idiopathic granulomatous mastitis is a rare, benign breast disease that is usually underestimated or misdiagnosed. The clinical and radiological features resemble those of infectious mastitis or breast carcinoma. Early recognition and initiation of steroid treatment will result in complete remission of the disease and prevent complications. (author)

Desmoid tumors: clinical features and treatment options: a case ...

African Journals Online (AJOL)

Desmoid tumors: clinical features and treatment options: a case report and a review of literature. Amel Achour Jenayah, Hajer Bettaieb, Sarra Saoudi, Anissa Gharsa, Ezzeddine Sfar, Fethia Boudaya, Dalenda Chelli ...

Clinical features and respiratory complications in Myhre syndrome

NARCIS (Netherlands)

McGowan, Ruth; Gulati, Ramkumar; McHenry, Pamela; Cooke, Alexander; Butler, Sandra; Keng, Wee Teik; Murday, Victoria; Whiteford, Margo; Dikkers, Frederik G.; Sikkema-Raddatz, Brigit; van Essen, Ton; Tolmie, John

2011-01-01

We describe the clinical characteristics of 4 singleton cases, 3 males and 1 female, with Myhre Syndrome (OMIM 139210), who were born to non-consanguineous parents. Three cases had no family history of similarly affected individuals but 1 male's mother had short stature, some facial features

Clinical and radiological features of hypertensive brainstem encephalopathy

Directory of Open Access Journals (Sweden)

Xiao-qiu LI

2015-07-01

Full Text Available Objective　To discuss the diagnosis and treatment of hypertensive brainstem encephalopathy. Methods　 The clinical and imaging data of 3 cases of hypertensive brainstem encephalopathy were summarized and analyzed for the purpose of improving the acumen in diagnosis and treatment. Results　All the 3 patients showed relatively mild clinical symptoms, and they were misdiagnosed in different degrees during the treatment, but their clinical symptoms were improved by rapid and effective antihypertensive therapy. Cerebral CT and MRI scans revealed extensive abnormal signals in brain stem, with or without supratentorial lesions and brain stem hemorrhage. The lesions as revealed by imaging were improved significantly after treatment. Conclusions　Clinical-radiographic dissociation is the classic feature of hypertensive brainstem encephalopathy. The clinical symptoms and lesions as shown by imaging could be improved after active treatment. DOI: 10.11855/j.issn.0577-7402.2015.06.03

Clinical features and management of hereditary spastic paraplegia

Directory of Open Access Journals (Sweden)

Ingrid Faber

2014-03-01

Full Text Available Hereditary spastic paraplegia (HSP is a group of genetically-determined disorders characterized by progressive spasticity and weakness of lower limbs. An apparently sporadic case of adult-onset spastic paraplegia is a frequent clinical problem and a significant proportion of cases are likely to be of genetic origin. HSP is clinically divided into pure and complicated forms. The later present with a wide range of additional neurological and systemic features. To date, there are up to 60 genetic subtypes described. All modes of monogenic inheritance have been described: autosomal dominant, autosomal recessive, X-linked and mitochondrial traits. Recent advances point to abnormal axonal transport as a key mechanism leading to the degeneration of the long motor neuron axons in the central nervous system in HSP. In this review we aim to address recent advances in the field, placing emphasis on key diagnostic features that will help practicing neurologists to identify and manage these conditions.

Oropharyngeal Dysphagia in Dermatomyositis: Associations with Clinical and Laboratory Features Including Autoantibodies

OpenAIRE

Mugii, Naoki; Hasegawa, Minoru; Matsushita, Takashi; Hamaguchi, Yasuhito; Oohata, Sacihe; Okita, Hirokazu; Yahata, Tetsutarou; Someya, Fujiko; Inoue, Katsumi; Murono, Shigeyuki; Fujimoto, Manabu; Takehara, Kazuhiko

2016-01-01

Objective Dysphagia develops with low frequency in patients with dermatomyositis. Our objective was to determine the clinical and laboratory features that can estimate the development of dysphagia in dermatomyositis. Methods This study included 92 Japanese patients with adult-onset dermatomyositis. The associations between dysphagia and clinical and laboratory features including disease-specific autoantibodies determined by immunoprecipitation assays were analyzed. Results Videofluoroscopy sw...

Clinical features of emergency department patients with depression ...

African Journals Online (AJOL)

Clinical features of emergency department patients with depression who had attempted to commit suicide by poisoning. ... MDD patients. Conclusion: In poisoning patients with MDD, physicians in the ED must consider that they have a higher tendency to show suicidal behavior and to have ingested multiple types of drugs.

Self-Reported Visual Perceptual Abnormalities Are Strongly Associated with Core Clinical Features in Psychotic Disorders

Directory of Open Access Journals (Sweden)

Brian P. Keane

2018-03-01

Full Text Available BackgroundPast studies using the Bonn Scale for the Assessment of Basic Symptoms (hereafter, Bonn Scale have shown that self-reported perceptual/cognitive disturbances reveal which persons have or will soon develop schizophrenia. Here, we focused specifically on the clinical value of self-reported visual perceptual abnormalities (VPAs since they are underexplored and have been associated with suicidal ideation, negative symptoms, and objective visual dysfunction.MethodUsing the 17 Bonn Scale vision items, we cross-sectionally investigated lifetime occurrence of VPAs in 21 first-episode psychosis and 22 chronic schizophrenia/schizoaffective disorder (SZ/SA patients. Relationships were probed between VPAs and illness duration, symptom severity, current functioning, premorbid functioning, diagnosis, and age of onset.ResultsIncreased VPAs were associated with: earlier age of onset; more delusions, hallucinations, bizarre behavior, and depressive symptoms; and worse premorbid social functioning, especially in the childhood and early adolescent phases. SZ/SA participants endorsed more VPAs as compared to those with schizophreniform or psychotic disorder-NOS, especially in the perception of color, bodies, faces, object movement, and double/reversed vision. The range of self-reported VPAs was strikingly similar between first-episode and chronic patients and did not depend on the type or amount of antipsychotic medication. As a comparative benchmark, lifetime occurrence of visual hallucinations did not depend on diagnosis and was linked only to poor premorbid social functioning.ConclusionA brief 17-item interview derived from the Bonn Scale is strongly associated with core clinical features in schizophrenia. VPAs hold promise for clarifying diagnosis, predicting outcome, and guiding neurocognitive investigations.

Clinical Features and Pattern of Presentation of Breast Diseases in ...

African Journals Online (AJOL)

Objective: To characterize the clinical features and pattern of presentation of breast diseases as observed in our practice. Materials and Methods: A prospective study of 121 consecutive patients with breast complaints presenting in our Surgical Outpatient Clinics. The relevant data were collected by two surgeons using the ...

Clinical and ultrasonographic features of amoebic liver abscess In a ...

African Journals Online (AJOL)

Background: Amoebic Liver abscess is a tropical disease with a wide spectrum of clinical presentation. This study describes its clinical and ultrasonographic features in a teaching hospital setting. Methods: Records of all patients aged 18 years and above with amoebic liver abscess admitted in the medical wards of ...

Classification and clinical features of primary headache in Akaki ...

African Journals Online (AJOL)

Classification and clinical features of primary headache in Akaki Textile Mill workers, ... study wherein data collection and examination of cases using a structured and ... like pressure or tightness with a mild to moderate intensity and anorexia.

Evaluation of features to support safety and quality in general practice clinical software

Science.gov (United States)

2011-01-01

Background Electronic prescribing is now the norm in many countries. We wished to find out if clinical software systems used by general practitioners in Australia include features (functional capabilities and other characteristics) that facilitate improved patient safety and care, with a focus on quality use of medicines. Methods Seven clinical software systems used in general practice were evaluated. Fifty software features that were previously rated as likely to have a high impact on safety and/or quality of care in general practice were tested and are reported here. Results The range of results for the implementation of 50 features across the 7 clinical software systems was as follows: 17-31 features (34-62%) were fully implemented, 9-13 (18-26%) partially implemented, and 9-20 (18-40%) not implemented. Key findings included: Access to evidence based drug and therapeutic information was limited. Decision support for prescribing was available but varied markedly between systems. During prescribing there was potential for medicine mis-selection in some systems, and linking a medicine with its indication was optional. The definition of 'current medicines' versus 'past medicines' was not always clear. There were limited resources for patients, and some medicines lists for patients were suboptimal. Results were provided to the software vendors, who were keen to improve their systems. Conclusions The clinical systems tested lack some of the features expected to support patient safety and quality of care. Standards and certification for clinical software would ensure that safety features are present and that there is a minimum level of clinical functionality that clinicians could expect to find in any system.

[The historical aspects of the notion of "self-striking" in the Russian- and foreign-language literature].

Science.gov (United States)

Ivanov, I N

2015-01-01

This article was designed to illustrate specific features of the injuries inflicted by the sharp objects as a result of the so-called self-striking based on the examples from the historical and literary works. The forensic medical characteristics of such cases are provided.

Foot strike patterns after obstacle clearance during running.

Science.gov (United States)

Scholten, Shane D; Stergiou, Nicholas; Hreljac, Alan; Houser, Jeremy; Blanke, Daniel; Alberts, L Russell

2002-01-01

Running over obstacles of sufficient height requires heel strike (HS) runners to make a transition in landing strategy to a forefoot (FF) strike, resulting in similar ground reaction force patterns to those observed while landing from a jump. Identification of the biomechanical variables that distinguish between the landing strategies may offer some insight into the reasons that the transition occurs. The purpose of this study was to investigate the difference in foot strike patterns and kinetic parameters of heel strike runners between level running and running over obstacles of various heights. Ten heel strike subjects ran at their self-selected pace under seven different conditions: unperturbed running (no obstacle) and over obstacles of six different heights (10%, 12.5%, 15%, 17.5%, 20%, and 22.5% of their standing height). The obstacle was placed directly before a Kistler force platform. Repeated measures ANOVAs were performed on the subject means of selected kinetic parameters. The statistical analysis revealed significant differences (P strike patterns were affected by the increased obstacle height. Between the 12.5% and 15% obstacle conditions, the group response changed from a heel strike to a forefoot strike pattern. At height > 15%, the pattern was more closely related to the foot strike patterns found in jumping activities. This strategy change may represent a gait transition effected as a mechanism to protect against increased impact forces. Greater involvement of the ankle and the calf muscles could have assisted in attenuating the increased impact forces while maintaining speed after clearing the obstacle.

Ombuds’ corner: Two striking features from last year

CERN Multimedia

Vincent Vuillemin

2012-01-01

In this series, the Bulletin aims to explain the role of the Ombuds at CERN by presenting practical examples of misunderstandings that could have been resolved by the Ombuds if he had been contacted earlier. Please note that, in all the situations we present, the names are fictitious and used only to improve clarity.   Happy New Year 2012 to all! At the beginning of this New Year, I would like to draw your attention to two important features that appeared from the statistics on the numbers and classes of visitors who came to the Ombuds during the first year of operations. The number of women was by far superior to the number of men who visited the Ombuds, when compared to the actual CERN percentage in such categories. The number of people visiting the Ombuds holding a Limited Duration contract was surprisingly lower than the number of visitors with an Indefinite appointment. In terms of pure number of visitors, the Ombuds met around the same number of men and women. However these numbers sh...

Strikes and solidarity: coalfield conflict in Britain, 1889-1966

Energy Technology Data Exchange (ETDEWEB)

Roy Church; Quentin Outram [University of East Anglia, Norwich (United Kingdom)

2002-05-01

This book investigates the history of strike activity in the British coal mining industry, a byword for industrial militancy since the late nineteenth century. Contents: 1. Interpreting coalfield conflict: focus and formulations; 2. Tradition and modernity: the mining industry 1889-1940; 3. Employers and workers: organizations and strategies; 4. Employers and workers: ideologies, attitudes and political orientations; 5. Configurations of strike activity; 6. Strike participation and solidarity before 1912; 7. Strikes, organization and consciousness in 1912 and after; 8. Conflictual context? The 'isolated mass' revisited; 9. Mining and modernity: size, sectionalism and solidarity; 10. The foundations of strike propensity; 11. Miners and management: agency and action; 12. Industrial relations and strikes after nationalization; 13. International perspectives; 14. Myths and realities: strikes, solidarity and 'militant miners'.

Estimating the Impact of Bird Strikes

NARCIS (Netherlands)

Metz, I.C.; Muhlhausen, Thorsten; Ellerbroek, J.; Hoekstra, J.M.

2018-01-01

Bird strikes have the potential to cause severe damage to aircraft. Therefore, measures to reduce the risk of bird strikes are performed at airports. However, this risk is not limited to the airport but is increased in the arrival and departure corridors as well. Consequently, a significant amount

[Rocky Mountain spotted fever in children: clinical and epidemiological features].

Science.gov (United States)

Martínez-Medina, Miguel Angel; Alvarez-Hernández, Gerardo; Padilla-Zamudioa, José Guillermo; Rojas-Guerra, Maria Guadalupe

2007-01-01

To report the clinical features of the Rocky Mountain spotted fever (RMSF) in children of southern Sonora, Mexico. Nine cases were studied at the Sonora State Children's Hospital. One case was defined by clinical features and positive serological tests (indirect immunofluorescence assay or reaction to Proteus OX 19). Demographic and clinical characteristics of the patients were registered. The study subjects were children from two to twelve years ofage. All patients have had contact with tick-infested dogs and had fever, as well as petechial rash. Laboratory findings included high levels of hepatic aminotransferase, hyponatremia and thrombocytopenia. Therapy with chloramphenicol and doxyciclyne was administered after the first seven days of the onset of illness. The mortality rate was 22%. This study supports the presence of RMSF in the state of Sonora, Mexico, which should be considered as a public health hazard, requiring immediate actions for prevention and control.

The effect of hand dominance on martial arts strikes.

Science.gov (United States)

Neto, Osmar Pinto; Silva, Jansen Henrique; Marzullo, Ana Carolina de Miranda; Bolander, Richard P; Bir, Cynthia A

2012-08-01

The main goal of this study was to compare dominant and non-dominant martial arts palm strikes under different circumstances that usually happen during martial arts and combative sports applications. Seven highly experienced (10±5 years) right hand dominant Kung Fu practitioners performed strikes with both hands, stances with left or right lead legs, and with the possibility or not of stepping towards the target (moving stance). Peak force was greater for the dominant hand strikes (1593.76±703.45 N vs. 1042.28±374.16 N; p<.001), whereas no difference was found in accuracy between the hands (p=.141). Additionally, peak force was greater for the strikes with moving stance (1448.75±686.01 N vs. 1201.80±547.98 N; p=.002) and left lead leg stance (1378.06±705.48 N vs. 1269.96±547.08 N). Furthermore, the difference in peak force between strikes with moving and stationary stances was statistically significant only for the strikes performed with a left lead leg stance (p=.007). Hand speed was higher for the dominant hand strikes (5.82±1.08 m/s vs. 5.24±0.78 m/s; p=.001) and for the strikes with moving stance (5.79±1.01 m/s vs. 5.29±0.90 m/s; p<.001). The difference in hand speed between right and left hand strikes was only significant for strikes with moving stance. In summary, our results suggest that the stronger palm strike for a right-handed practitioner is a right hand strike on a left lead leg stance moving towards the target. Copyright © 2011 Elsevier B.V. All rights reserved.

Single and Combined Diagnostic Value of Clinical Features and Laboratory Tests in Acute Appendicitis

NARCIS (Netherlands)

Laméris, Wytze; van Randen, Adrienne; Go, Peter M. N. Y. H.; Bouma, Wim H.; Donkervoort, Sandra C.; Bossuyt, Patrick M. M.; Stoker, Jaap; Boermeester, Marja A.

2009-01-01

Objectives: The objective was to evaluate the diagnostic accuracy of clinical features and laboratory test results in detecting acute appendicitis. Methods: Clinical features and laboratory test results were prospectively recorded in a consecutive series of 1,101 patients presenting with abdominal

Malignant round cell tumours of bone: atypical clinical and imaging features

International Nuclear Information System (INIS)

Saifuddin, A.; Whelan, J.; Pringle, J.A.S.; Cannon, S.R.

2000-01-01

Objective. To describe the clinical, radiological and MRI features of six atypical cases of histologically proven appendicular Ewing sarcoma/ primitive neuroectodermal tumour (PNET). Design. Retrospective review of case notes and available imaging was carried out. Patients. Six patients (4 male, 2 female; mean age 27 years, range 19-44 years), presenting over a 77-month period, were identified from the Bone Tumour Register. All had unusual clinical and imaging features for Ewing sarcoma/PNET.Results and conclusions. Four tumours were centred on the distal femoral metaphysis, one in the proximal tibial metaphysis and one in the distal tibial metaphysis. Plain radiographs were available in four cases and showed minor cortical changes. MRI demonstrated a relatively small, eccentrically located intraosseous component with a large, eccentric extraosseous component. Extension into the epiphysis was seen in three cases and into the adjacent joint in two cases. Intraosseous ''skip'' metastases were present in three cases. The clinical and imaging features were atypical for conventional intraosseous Ewing sarcoma/PNET and the exact site of origin (intraosseous, periosteal or soft-tissue) was unclear. (orig.)

BIRD/WILDLIFE STRIKE CONTROL FOR SAFER AIR ...

African Journals Online (AJOL)

Osondu

2012-06-05

Jun 5, 2012 ... Keywords: bird/wildlife, strike, aviation, hazard, control. Introduction ... Ethiopian Journal of Environmental Studies and Management EJESM Vol. 5 No. 3 2012 .... Aircraft Bird. Strike Avoidance Rader System (ABARS) and.

Clinical Significance of Histological Features of Thrombi in Patients with Myocardial Infarction

Energy Technology Data Exchange (ETDEWEB)

Sebben, Juliana Canedo; Cambruzzi, Eduardo; Avena, Luisa Martins; Gazeta, Cristina do Amaral; Gottschall, Carlos Antonio Mascia; Quadros, Alexandre Schaan de, E-mail: quadros.pesquisa@gmail.com [Instituto de Cardiologia / Fundação Universitária de Cardiologia - IC/FUC, Porto Alegre, RS (Brazil)

2013-12-15

Percutaneous Coronary Intervention (PCI) is the most common strategy for the treatment of Acute ST segment elevation Myocardial Infarction (STEMI), and thromboaspiration has been increasingly utilized for removal of occlusive thrombi. To analyze the influence of histopathological features of coronary thrombi in clinical outcomes of patients with STEMI, and the association of these variables with clinical, angiographic, and laboratory features and medications used in hospitalization. Prospective cohort study. All patients were monitored during hospitalization and thirty days after the event. Aspirated thrombi were preserved in formalin and subsequently stained with hematoxylin-eosin and embedded in paraffin. Thrombi were classified as recent and old. The primary outcome was the occurrence of major cardiovascular events within thirty days. During the study period, 1,149 patients were evaluated with STEMI, and 331 patients underwent thrombi aspiration, leaving 199 patients available for analysis. It was identified recent thrombi in 116 patients (58%) and old thrombi in 83 patients (42%). Recent thrombi have greater infiltration of red blood cells than old thrombi (p = 0.02), but there were no statistically significant differences between other clinical, angiographic, laboratory, and histopathological features and medications in both group of patients. The rates of clinical outcomes were similar in both groups. Recent thrombi were identified in 58% of patients with STEMI and it was observed an association with infiltration of red blood cells. There was no association between histopathological features of thrombi and clinical variables and cardiovascular outcomes.

A decade of U.S. Air Force bat strikes

Science.gov (United States)

Peurach, Suzanne C.; Dove, Carla J.; Stepko, Laura

2009-01-01

From 1997 through 2007, 821 bat strikes were reported to the U.S. Air Force (USAF) Safety Center by aircraft personnel or ground crew and sent to the National Museum of Natural History, Smithsonian Institution, for identification. Many samples were identified by macroscopic and or microscopic comparisons with bat specimens housed in the museum and augmented during the last 2 years by DNA analysis. Bat remains from USAF strikes during this period were received at the museum from 40 states in the United States and from 20 countries. We confirmed that 46% of the strikes were caused by bats, but we did not identify them further; we identified 5% only to the family or genus level, and 49% to the species level. Fifty-five of the 101 bat-strike samples submitted for DNA analysis have been identified to the species level. Twenty-five bat species have been recorded striking USAF planes worldwide. The Brazilian free-tailed bat (Tadarida brasiliensis; n = 173) is the species most commonly identified in USAF strike impacts, followed by the red bat (Lasiurus borealis; n = 83). Bat strikes peak during the spring and fall, with >57% occurring from August through October; 82% of the reports that included time of strike were recorded between 2100 and 0900 hours. More than 12% of the bat strikes were reported at >300 m above ground level (AGL). Although $825,000 and >50% of this sum was attributable to 5 bat-strike incidents. Only 5 bats from the 10 most damaging bat strikes were identified to the species level, either because we did not receive remains with the reports or the sample was insufficient for identification.

2002 Bird Strike Committee USA/Canada Conference

National Research Council Canada - National Science Library

Dolbeer, Richard

2002-01-01

Over 380 people from 20 countries and 17 exhibitors attended the 4th annual joint meeting of Bird Strike Committee-USA and Bird Strike Committee Canada in Sacramento, California on October 21-24, 2002...

The clinical and mammographic features of plasma cell mastitis

International Nuclear Information System (INIS)

Wu Xiurong; Luo Xiaohua; Yu Xuming; Zhong Shan; Huang Yufan; Wu Xinyi; Lin Yubin

2007-01-01

Objective: To investigate the clinical and mammographic features of plasma cell mastitis. Methods: Twenty-five patients (28 lesions) with histologically confirmed plasma cell mastitis, aged from 26 to 70 years (mean age 41 years), were examined with X-ray mammography. The clinical manifestations and imaging features were retrospectively reviewed. Results: No case was in lactation. The painful irregular masses, ranged from 1.3 to 8cm in size, were found in 22 patients, while 3 patients with acute episode. Recurrent episodes of breast masses were noted in 4 patients. Based on the mammographic appearances, the plasma cell mastitis were classified as the following four types: inflammation-like type (2/28), ductal ectasia type (3/28), focal infiltration type (10/28) and nodular type (13/28). The valuable radiographic signs: (1) An asymmetrically increased density along the lactiferous duct with a flame-like appearance, inhomogeneous low density tubular structures and scattered stick-shape calcifications. (2) Architectural distortion and oil cysts formation in adjacent area, (3) Subareolar ductal ectasia. Conclusions: The clinical and mammographic characteristics of plasma cell mastitis are critical to avoiding unnecessary surgery. Histopathological result is needed for the diagnosis in patients highly suspected of malignancy. (authors)

Clinical features and pharmacotherapy of childhood monoamine neurotransmitter disorders.

Science.gov (United States)

Ng, J; Heales, S J R; Kurian, M A

2014-08-01

Childhood neurotransmitter disorders are increasingly recognised as an expanding group of inherited neurometabolic syndromes. They are caused by disturbance in synthesis, metabolism, and homeostasis of the monoamine neurotransmitters, including the catecholamines (dopamine, norepinephrine, and epinephrine) and serotonin. Disturbances in monoamine neurotransmission will lead to neurological symptoms that often overlap with clinical features of other childhood neurological disorders (such as hypoxic ischaemic encephalopathy, cerebral palsy, other movement disorders, and paroxysmal conditions); consequently, neurotransmitter disorders are frequently misdiagnosed. The diagnosis of neurotransmitter disorders is made through detailed clinical assessment, analysis of cerebrospinal fluid neurotransmitters, and further supportive diagnostic investigations. Early and accurate diagnosis of neurotransmitter disorders is important, as many are amenable to therapeutic intervention. The principles of treatment for monoamine neurotransmitter disorders are mainly directly derived from understanding these metabolic pathways. In disorders characterized by enzyme deficiency, we aim to increase monoamine substrate availability, boost enzyme co-factor levels, reduce monoamine breakdown, and replace depleted levels of monoamines with pharmacological analogs as clinically indicated. Most monoamine neurotransmitter disorders lead to reduced levels of central dopamine and/or serotonin. Complete amelioration of motor symptoms is achievable in some disorders, such as Segawa's syndrome, and, in other conditions, significant improvement in quality of life can be attained with pharmacotherapy. In this review, we provide an overview of the clinical features and current treatment strategies for childhood monoamine neurotransmitter disorders.

Wavelet transform analysis of electromyography kung fu strikes data.

Science.gov (United States)

Neto, Osmar Pinto; Marzullo, Ana Carolina de Miranda

2009-11-01

In martial arts and contact sports strikes are performed at near maximum speeds. For that reason, electromyography (EMG) analysis of such movements is non-trivial. This paper has three main goals: firstly, to investigate the differences in the EMG activity of muscles during strikes performed with and without impacts; secondly, to assess the advantages of using Sum of Significant Power (SSP) values instead of root mean square (rms) values when analyzing EMG data; and lastly to introduce a new method of calculating median frequency values using wavelet transforms (WMDF). EMG data of the deltoid anterior (DA), triceps brachii (TB) and brachioradialis (BR) muscles were collected from eight Kung Fu practitioners during strikes performed with and without impacts. SSP results indicated significant higher muscle activity (p = 0.023) for the strikes with impact. WMDF results, on the other hand, indicated significant lower values (p = 0. 007) for the strikes with impact. SSP results presented higher sensitivity than rms to quantify important signal differences and, at the same time, presented lower inter-subject coefficient of variations. The result of increase in SSP values and decrease in WMDF may suggest better synchronization of motor units for the strikes with impact performed by the experienced Kung Fu practitioners. Key PointsThe results show higher muscle activity and lower electromyography median frequencies for strikes with impact compared to strikes without.SSP results presented higher sensitivity and lower inter-subject coefficient of variations than rms results.Kung Fu palm strikes with impact may present better motor units' synchronization than strikes without.

When Push Comes to Shove: Strikes in Higher Education.

Science.gov (United States)

Magney, John

2002-01-01

To provide a better sense of how academic unions handle a strike situation, examines six unions who, between 1996 and 2000, went through strikes. Discusses the key issues and outcomes of the strikes. (EV)

Lower limb joint angles and ground reaction forces in forefoot strike and rearfoot strike runners during overground downhill and uphill running.

Science.gov (United States)

Kowalski, Erik; Li, Jing Xian

2016-11-01

This study investigated the normal and parallel ground reaction forces during downhill and uphill running in habitual forefoot strike and habitual rearfoot strike (RFS) runners. Fifteen habitual forefoot strike and 15 habitual RFS recreational male runners ran at 3 m/s ± 5% during level, uphill and downhill overground running on a ramp mounted at 6° and 9°. Results showed that forefoot strike runners had no visible impact peak in all running conditions, while the impact peaks only decreased during the uphill conditions in RFS runners. Active peaks decreased during the downhill conditions in forefoot strike runners while active loading rates increased during downhill conditions in RFS runners. Compared to the level condition, parallel braking peaks were larger during downhill conditions and parallel propulsive peaks were larger during uphill conditions. Combined with previous biomechanics studies, our findings suggest that forefoot strike running may be an effective strategy to reduce impacts, especially during downhill running. These findings may have further implications towards injury management and prevention.

Clinical features analysis of elderly patients with malignant tumor before dying

International Nuclear Information System (INIS)

Tang Haiying

2010-01-01

Objective: To analyse the clinical features of elderly patients with malignant tumor before death. Method: Fifty-two elderly patients with malignant tumor were retrospectively analyzed respectively from sputum culture and plasma FIB, D-dimer, albumin, hemoglobin aspects. Result: Results of sputum cultures showed the percentage of gram-negative bacteria was 56. 6%, gram-positive bacteria was 24. 5% and fungus was 18. 8%. The level of plasma FIB and D-dimer in the tumor group significantly higher than those in the control (P < 0. 05). The level of plasma albumin and hemoglobin in the tumor group were significantly lower than those in the control (P < 0. 01). Conclusion: Elderly patients with malignant tumor has obvious clinical features before death. Understanding them has important significance for guidelines of clinical treatment and judgement of prognosis. (authors)

The Diagnostic importance of clinical and radiologic features of the Multiple Cemento-osseous dysplasia

International Nuclear Information System (INIS)

Han, M. R.; Kim, Y. H.; Kang, B. C.

1998-01-01

This case was diagnosed as multiple cementoosseous dysplasia on the basis of clinical and radiological features but was diagnosed as ossifying fibroma on the basis of histopathological feature. The histopathologic features of the multiple cementoosseous dysplasia and cementoossifying fibroma have common features of cementum, fibrous network and bone. Multiple cementoosseous dysplasia is reactive lesion and shows restricted lesion size, occurred on anterior and posterior tooth of the mandible and needs no treatment except periodic follow up. But Cementoossifying fibroma is the true neoplasm and grows continuously and needs surgical removal. The final diagnosis of the multiple cementoosseous dysplasia requires good correlation of the clinical histopathological, and radiological features.

Main clinical epidemiological features of lung cancer

International Nuclear Information System (INIS)

Costa Montane, Daniel Marino; Prado Lage, Yulien; Lozano Salazar; Jorge Luis

2011-01-01

A descriptive and cross-sectional study of 95 patients with lung cancer, discharged from Neumology Service at 'Dr Juan Bruno Zayas Alfonso' General Hospital in Santiago de Cuba, was carried out from January, 2008 to December, 2008 in order to identify the main clinical epidemiological features of the aforementioned disease. A malignancy predominance among men aged between 56 and 65 years old, belonging to urban areas and being heavy smoker (out of 30 cigarettes per day over 30 years ), was found. Those affected without a confirmed histological type and IV clinical stage epidermoid carcinoma were predominant. Most of them had the opportunity to be treated. Increasing and intensifying health promotion and disease prevention campaigns were recommended so as to achieve the population to avoid or quit the smoking habit. (author)

Clinical features of Friedreich's ataxia: classical and atypical phenotypes.

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Parkinson, Michael H; Boesch, Sylvia; Nachbauer, Wolfgang; Mariotti, Caterina; Giunti, Paola

2013-08-01

One hundred and fifty years since Nikolaus Friedreich's first description of the degenerative ataxic syndrome which bears his name, his description remains at the core of the classical clinical phenotype of gait and limb ataxia, poor balance and coordination, leg weakness, sensory loss, areflexia, impaired walking, dysarthria, dysphagia, eye movement abnormalities, scoliosis, foot deformities, cardiomyopathy and diabetes. Onset is typically around puberty with slow progression and shortened life-span often related to cardiac complications. Inheritance is autosomal recessive with the vast majority of cases showing an unstable intronic GAA expansion in both alleles of the frataxin gene on chromosome 9q13. A small number of cases are caused by a compound heterozygous expansion with a point mutation or deletion. Understanding of the underlying molecular biology has enabled identification of atypical phenotypes with late onset, or atypical features such as retained reflexes. Late-onset cases tend to have slower progression and are associated with smaller GAA expansions. Early-onset cases tend to have more rapid progression and a higher frequency of non-neurological features such as diabetes, cardiomyopathy, scoliosis and pes cavus. Compound heterozygotes, including those with large deletions, often have atypical features. In this paper, we review the classical and atypical clinical phenotypes of Friedreich's ataxia. © 2013 International Society for Neurochemistry.

Patellofemoral joint stress during running with alterations in foot strike pattern.

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Vannatta, Charles Nathan; Kernozek, Thomas W

2015-05-01

This study aimed to quantify differences in patellofemoral joint stress that may occur when healthy runners alter their foot strike pattern from their habitual rearfoot strike to a forefoot strike to gain insight on the potential etiology and treatment methods of patellofemoral pain. Sixteen healthy female runners completed 20 running trials in a controlled laboratory setting under rearfoot strike and forefoot strike conditions. Kinetic and kinematic data were used to drive a static optimization technique to estimate individual muscle forces to input into a model of the patellofemoral joint to estimate joint stress during running. Peak patellofemoral joint stress and the stress-time integral over stance phase decreased by 27% and 12%, respectively, in the forefoot strike condition (P forefoot strike condition (P forefoot strike (P forefoot strike condition (P strike pattern to a forefoot strike results in consistent reductions in patellofemoral joint stress independent of changes in step length. Thus, implementation of forefoot strike training programs may be warranted in the treatment of runners with patellofemoral pain. However, it is suggested that the transition to a forefoot strike pattern should be completed in a graduated manner.

Frank-ter Haar syndrome with unusual clinical features.

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Dundar, Munis; Saatci, Cetin; Tasdemir, Sener; Akcakus, Mustafa; Caglayan, Ahmet Okay; Ozkul, Yusuf

2009-01-01

Frank-ter Haar syndrome first recognized by Frank et al. [Y. Frank, M. Ziprkowski, A. Romano, R. Stein, M.B. Katznelson, B. Cohen, R.M. Goodman, Megalocornea associated with multiple skeletal anomalies: a new genetic syndrome?, J. Genet. Hum. 21 (1973) 67-72.] and subsequently confirmed by ter Haar et al. [B. Ter Haar, B. Hamel, J. Hendriks, J. de Jager, Melnick-Needles syndrome: indication for an autosomal recessive form, Am. J. Med. Genet. 13 (1982) 469-477.]. The main clinical features of the syndrome are brachycephaly, wide fontanels, prominent forehead, hypertelorism, prominent eyes, macro cornea with or without glaucoma, full cheeks, small chin, bowing of the long bones, and flexion deformity of the fingers [S.M. Maas, H. Kayserili, J. Lam, M.Y. Apak, R.C. Hennekam, Further delineation of Frank-ter Haar syndrome, Am. J. Med. Genet. 131 (2004) 127-133.]. We report a child with Frank-ter Haar syndrome presenting unusual clinical features. Hypopigmented areas in hair, bilateral adducted thumb, bilateral contractures in elbows and pelvic limb, atrial septal defect have not been described previously in the literature. Our patient also had double-outlet right ventricle.

Martial arts striking hand peak acceleration, accuracy and consistency.

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Neto, Osmar Pinto; Marzullo, Ana Carolina De Miranda; Bolander, Richard P; Bir, Cynthia A

2013-01-01

The goal of this paper was to investigate the possible trade-off between peak hand acceleration and accuracy and consistency of hand strikes performed by martial artists of different training experiences. Ten male martial artists with training experience ranging from one to nine years volunteered to participate in the experiment. Each participant performed 12 maximum effort goal-directed strikes. Hand acceleration during the strikes was obtained using a tri-axial accelerometer block. A pressure sensor matrix was used to determine the accuracy and consistency of the strikes. Accuracy was estimated by the radial distance between the centroid of each subject's 12 strikes and the target, whereas consistency was estimated by the square root of the 12 strikes mean squared distance from their centroid. We found that training experience was significantly correlated to hand peak acceleration prior to impact (r(2)=0.456, p =0.032) and accuracy (r(2)=0. 621, p=0.012). These correlations suggest that more experienced participants exhibited higher hand peak accelerations and at the same time were more accurate. Training experience, however, was not correlated to consistency (r(2)=0.085, p=0.413). Overall, our results suggest that martial arts training may lead practitioners to achieve higher striking hand accelerations with better accuracy and no change in striking consistency.

Orthotic intervention in forefoot and rearfoot strike running patterns.

Science.gov (United States)

Stackhouse, Carrie Laughton; Davis, Irene McClay; Hamill, Joseph

2004-01-01

To compare the differential effect of custom orthoses on the lower extremity mechanics of a forefoot and rearfoot strike pattern. Fifteen subjects ran with both a forefoot and a rearfoot strike pattern with and without orthoses. Lower extremity kinematic and kinetic variables were compared between strike pattern and orthotic conditions. Foot orthoses have been shown to be effective in controlling excessive rearfoot motion in rearfoot strikers. The effect of orthotic intervention on rearfoot motion in forefoot strikers has not been previously reported. Five trials were collected for each condition. Peak rearfoot eversion, eversion excursion, eversion velocity, peak inversion moment, and inversion work were compared between conditions. Kinematic variables in the sagittal plane of the rearfoot and in the frontal and sagittal plane of the knee were also determined. Increased rearfoot excursions and velocities and decreased peak eversion were noted in the forefoot strike pattern compared to the rearfoot strike pattern. Orthotic intervention, however,did not significantly change rearfoot motion in either strike pattern. Reductions in internal rotation and abduction of the knee were noted with orthotic intervention. Foot orthoses do not differentially effect rearfoot motion of a rearfoot strike and a forefoot strike running pattern. Orthotic intervention has a larger and more systematic effect on rearfoot kinetics compared to rearfoot kinematics.

VARIATION OF STRIKE INCENTIVES IN DEEP REDUCTIONS; FINAL

International Nuclear Information System (INIS)

G.H. CANAVAN

2001-01-01

This note studies the sensitivity of strike incentives to deep offensive force reductions using exchange, cost, and game theoretic decision models derived and discussed in companion reports. As forces fall, weapon allocations shift from military to high value targets, with the shift being half complete at about 1,000 weapons. By 500 weapons, the first and second strikes are almost totally on high value. The dominant cost for striking first is that of damage to one's high value, which is near total absent other constraints, and hence proportional to preferences for survival of high value. Changes in military costs are largely offsetting, so total first strike costs change little. The resulting costs at decision nodes are well above the costs of inaction, so the preferred course is inaction for all offensive reductions studied. As the dominant cost for striking first is proportional to the preference for survival of high value. There is a wide gap between the first strike cost and that of inaction for the parameters studied here. These conclusions should be insensitive to significant reductions in the preference for survival of high value, which is the most sensitive parameter

Clinical features and endocrine profile of Laron syndrome in Indian children.

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Phanse-Gupte, Supriya R; Khadilkar, Vaman V; Khadilkar, Anuradha V

2014-11-01

Patients with growth hormone (GH) insensitivity (also known as Laron syndome) have been reported from the Mediterranean region and Southern Eucador, with few case reports from India. We present here the clinical and endocrine profile of 9 children with Laron syndrome from India. Nine children diagnosed with Laron syndrome based on clinical features of GH deficiency and biochemical profile suggestive of GH resistance were studied over a period of 5 years from January 2008 to January 2013. Age of presentation was between 2.5-11.5 years. All children were considerably short on contemporary Indian charts with mean (SD) height Z score -5.2 (1.6). However, they were within ± 2 SD on Laron charts. No child was overweight [mean (SD) BMI Z score 0.92 (1.1)]. All children had characteristic facies of GH deficiency with an added feature of prominent eyes. Three boys had micropenis and 1 had unilateral undescended testis. All children had low IGF-1 (Laron syndrome should be suspected in children with clinical features of GH deficiency, high GH levels and low IGF-1/IGFBP-3. These children are in a state of GH resistance and need IGF-1 therapy.

Clinical and imaging features of neonatal chlamydial pneumonia

International Nuclear Information System (INIS)

Cao Yongli; Peng Yun; Sun Guoqiang

2012-01-01

Objective: To study the clinical and imaging features of chlamydial pneumonia in newborns. Methods: Medical records,chest X-Ray and CT findings of 17 neonates with chlamydia pneumonia were reviewed. The age was ranged from 9.0 to 28.0 days with mean of (16.8 ± 5.8) days. There were 11 males and 6 females. Sixteen were full term infants and one was born post term. All babies were examined with chest X-ray film, and 13 patients also underwent chest CT scan. Serologic test using immunofluorescence method for Chlamydia IgG and IgM antibodies were performed in all patients. Results: All newborns presented with cough but without fever. Positive results of the serologic tests were demonstrated. Chest films showed bilateral hyperventilation in 10 patients, diffuse reticular nodules in 10 patients including nodules mimicking military tuberculosis in 7 patients, and accompanying consolidation in 9 patients. CT features included interstitial reticular nodules in 13 patients with size, density, and distribution varied. Subpleural nodules (11 patients) and fusion of nodules (10 patients) predominated. Bilateral hyperinflation was found in 10 patients, which combined with infiltration in 12 patients, thickening of bronchovascular bundles in 10 patients, and ground glass sign in 5 patients. No pleural effusion and lymphadenopathy was detected in any patient. Conclusions: Bilateral hyperinflation and diffuse interstitial reticular nodules were the most common imaging features of neonatal chlamydial pneumonia. The main clinical characteristic of neonatal chlamydial pneumonia is respiratory symptoms without fever, which is helpful to its diagnosis. (authors)

When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence.

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Mutsaers, Brittany; Jones, Georden; Rutkowski, Nicole; Tomei, Christina; Séguin Leclair, Caroline; Petricone-Westwood, Danielle; Simard, Sébastien; Lebel, Sophie

2016-10-01

Fear of cancer recurrence (FCR) is a common experience for cancer survivors. However, it remains unclear what characteristics differentiate non-clinical from clinical levels of FCR. The goal of this study was to investigate the potential hallmarks of clinical FCR. A convenience sample of 40 participants (n = 19 female) was drawn from another study (Lebel et al. in Qual Life Res 25:311-321. doi: 10.1007/s11136-015-1088-2 , 2016). The semi-structured interview for fear of cancer recurrence (Simard and Savard in J Cancer Surviv 9:481-491. doi: 10.1007/s11764-015-0424-4 , 2015) was used to identify participants with non-clinical and clinical FCR and qualitative analysis of these interviews was performed. Individuals with clinical FCR reported the following features: death-related thoughts, feeling alone, belief that the cancer would return, experiencing intolerance of uncertainty, having cancer-related thoughts and imagery that were difficult to control, daily and recurrent, lasted 30 minutes or more, increased over time, caused distress and impacted their daily life. Triggers of FCR and coping strategies did not appear to be features of clinical FCR as they were reported by participants with a range of FCR scores. While features of clinical FCR found in this analysis such as intrusive thoughts, distress and impact on functioning confirmed previous FCR research, other features spontaneously emerged from the interviews including "death-related thoughts," "feeling alone," and "belief that the cancer will return." The participants' descriptions of cancer-specific fear and worry suggest that FCR is a distinct phenomenon related to cancer survivorship, despite similarities with psychological disorders (e.g., Anxiety Disorders). Future research investigating the construct of FCR, and the distinguishing features of clinical FCR across a range of cancer types and gender is required.

Clinical Features of Fatal Asthma

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Chiung-Zuei Chen

2006-05-01

Full Text Available To characterize the clinical features of fatal asthma, we retrospectively analyzed the clinical characteristics of patients who died of an acute asthma attack in our hospital during a 15-year period from 1989 to 2003. Twelve patients had fatal asthma during this period, including eight who were dead on arrival in the emergency room (ER and three who died within 1 hour of admission to the ER. Patients were categorized into three groups according to the clinical presentations during the fatal attack: (1 rapid (< 3 hours decompensation in four patients; (2 gradual development of respiratory failure over several days in two patients; and (3 acute deterioration after unstable asthma lasting several days in six patients. All patients in groups 1 and 2 had reported previous near-fatal attacks. The proportion of young patients was highest in group 3, with half of them (3/6 younger than 35 years of age. Only one patient in group 3 had had a previous near-fatal attack. Five of the seven patients, with previous near-fatal attacks, had a pattern of decompensation during their fatal attack that was similar to their previous attacks. In conclusion, nearly all patients with fatal asthma in this study died outside of the hospital or within 1 hour after admission to the ER. Patients had patterns of decompensation during the fatal attack that were similar to those of their previous attacks. Early detection of warning signs, early admission to the ER, adequate treatment, and extremely close observation of patients, especially within 1 hour after ER arrival, may prevent or decrease the incidence of fatal asthmatic attack.

Pilonidal sinus disease - Etiological factors, pathogenesis and clinical features

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Kazim Duman

2016-12-01

Full Text Available and lsquo;Pilonidal sinus' disease, which is most commonly seen in reproductive populations, such as young adults - mostly in males who are in their twenties - is actually a controversial disease in that there is no consensus on its many facets. It is sometimes seen as an infected abscess draining from an opening or a lesion extending to the perineum. It may also present as a draining fistula opening to skin. In terms of etiological factors, various theories (main theories being congenital and acquired have been established since it was first described, no universal understanding achieved. A long and significant post-operative care period with different lengths of recovery depending on the type of operation are quite prevalent with regards to recurrence and complication status. In order to prevent recurrence and improve the quality of life, etiological and predisposing factors as well as clinical features of sacrococcygeal pilonidal disease should be well known, a detailed differential diagnosis should be made, and a suitable and timely intervention should be performed. It was aimed here to explain the etiological factors, pathogenesis and clinical features of the disease that may present with various clinical symptoms. [Arch Clin Exp Surg 2016; 5(4.000: 228-232

Colonic duplications: Clinical presentation and radiologic features of five cases

International Nuclear Information System (INIS)

Blickman, J.G.; Rieu, P.H.M.; Buonomo, C.; Hoogeveen, Y.L.; Boetes, C.

2006-01-01

Diagnosis of colonic duplication can pose a potential problem even for those familiar with gastro-intestinal tract duplications in general but unaware of the condition due to its rarity and its apparently bimodal clinical presentation. In this report of five cases of surgically proven pediatric colonic duplication, we illustrate how the condition manifests clinically and describe the imaging features in an attempt to illustrate this bimodal presentation of the condition. The possible etiology, associated congenital anomalies and modes of clinical presentation are reviewed based on literature review as well as on our own experience

Understanding the Limitations to the Right to Strike in Essential and Public Services in the SADC Region

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Rochelle le Roux

2016-05-01

Full Text Available The nature of the limitations to the right to strike in essential and public services in the nine sub-regional countries of Southern Africa – South Africa, Botswana, Lesotho, Namibia, Swaziland, Malawi, Mozambique, Zambia and Zimbabwe – is examined in this contribution. While all of these countries share common influences and face common challenges, there appears to be a vast disparity in the approaches taken to the right to strike in public and essential services in the region. A brief overview of the demographics and labour markets in the countries under discussion is sketched, the salient features of the ILO's approach to strike in essential and public services is highlighted, and a broad overview of the contrasting and disparate approaches to essential and public services in the region is provided. The focus is, however, on the legislative approach taken to essential service employees in South Africa. It is concluded that – with the exception of South Africa and Namibia – the limitations to the right to strike of public sector employees exceed those endorsed by international conventions, and the broad definition of essential services generally relied upon effectively

[Genetic mutation and clinical features of osteogenesis imperfecta type V].

Science.gov (United States)

Guan, Shizhen; Bai, Xue; Wang, Yi; Liu, Zhigang; Ren, Xiuzhi; Zhang, Tianke; Ju, Mingyan; Li, Keqiu; Li, Guang

2017-12-10

To explore genetic mutations and clinical features of osteogenesis imperfecta type V. Clinical record of five patients (including one familial case) with osteogenesis imperfecta type V were retrospectively analyzed. Peripheral blood samples of the patients, one family member, as well as healthy controls were collected. Mutation of IFITM5 gene was identified by PCR amplification and Sanger sequencing. A heterozygous mutation (c.-14C>T) in the 5-UTR of the IFITM5 gene was identified in all of the patients and one mother. The clinical findings included frequent fractures and spine and/or extremities deformities, absence of dentinogenesis imperfecta, absence of hearing impairment, and blue sclera in 1 case. Radiographic findings revealed calcification of the interosseous membrane between the radius-ulna in all cases. Hyperplastic callus formation was found in 3 cases. Four had radial-head dislocation. A single heterozygous mutation c.-14C>T was found in the 5-UTR of the IFITM5 gene in 5 patients with osteogensis imperfecta type V. The patients showed specific radiological features including calcification of interosseous membrane, hyperplastic callus formation, and radial-head dislocation.

Early-Onset Psychoses: Comparison of Clinical Features and Adult Outcome in 3 Diagnostic Groups

Science.gov (United States)

Ledda, Maria Giuseppina; Fratta, Anna Lisa; Pintor, Manuela; Zuddas, Alessandro; Cianchetti, Carlo

2009-01-01

A comparison of clinical features and adult outcome in adolescents with three types of psychotic disorders: schizophrenic (SPh), schizoaffective (SA) and bipolar with psychotic features (BPP). Subjects (n = 41) were finally diagnosed (DSM-IV criteria) with SPh (n = 17), SA (n = 11) or BPP (n = 13). Clinical evaluation took place at onset and at a…

The Clinical Features of Myositis-Associated Autoantibodies: a Review.

Science.gov (United States)

Gunawardena, Harsha

2017-02-01

The idiopathic inflammatory myopathies (IIM) are a group of autoimmune diseases traditionally defined by clinical manifestations including skeletal muscle weakness, skin rashes, elevated skeletal muscle enzymes, and neurophysiological and/or histological evidence of muscle inflammation. Patients with myositis overlap can develop other features including parenchymal lung disease, inflammatory arthritis, gastrointestinal manifestations and marked constitutional symptoms. Although patients may be diagnosed as having polymyositis (PM) or dermatomyositis (DM) under the IIM spectrum, it is quite clear that disease course between subgroups of patients is different. For example, interstitial lung disease may predominate in some, whereas cutaneous complications, cancer risk, or severe refractory myopathy may be a significant feature in others. Therefore, tools that facilitate diagnosis and indicate which patients require more detailed investigation for disease complications are invaluable in clinical practice. The expanding field of autoantibodies (autoAbs) associated with connective tissue disease (CTD)-myositis overlap has generated considerable interest over the last few years. Using an immunological diagnostic approach, this group of heterogeneous conditions can be separated into a number of distinct clinical phenotypes. Rather than diagnose a patient as simply having PM, DM or overlap CTD, we can define syndromes to differentiate disease subsets that emphasise clinical outcomes and guide management. There are now over 15 CTD-myositis overlap autoAbs found in patients with a range of clinical manifestations including interstitial pneumonia, cutaneous disease, cancer-associated myositis and autoimmune-mediated necrotising myopathy. This review describes their diagnostic utility, potential role in disease monitoring and response to treatment. In the future, routine use of these autoAb will allow a stratified approach to managing this complex set of conditions.

Clinical features of paralytic strabismus

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Xin-Ling Wang

2013-09-01

Full Text Available AIM: To observe the clinical features of paralytic strabismus and analyze its etiology.METHODS: Eighty-nine cases(97 eyeswere diagnosed with paralytic strabismus and recruited in this study in the Department of Ophthalmology, the Fourth Affiliated Hospital, China Medical University between July 2008 and February 2013. The clinical data were recorded including the general and ophthalmic history, symptom, visual acuity, fundus, pupil, eyelid, visual field, eye movement, synoptophore, acting countervail head, ultrasound of eyeball and ocular muscle, color Doppler ultrasonography of the carotid artery, orbital computed tomography(CT, brain magnetic resonance imaging(MRI, blood biochemistry and immunologic tests.RESULTS: The medical history disclosed that among these cases, hypertension in 36 cases, diabetic mellitus in 28 cases, hyperlipidemia in 19 cases, heart diseases in 17 cases, ischemic cerebrovascular disease in 12 cases and hyperthyroidism in 3 cases. Symptoms included vertigo in 47 cases and binocular temporal amaurosis in 36 cases. The horizontal restriction was manifested in 38 cases 45 eyes, vertical restriction in 42 cases with 42 eyes, and horizontal-and-vertical restriction in 9 cases with 10 eyes. CONCLUSION: Brain vascular ischemic disease is one of the top reasons causing paralytic strabismus. Systemic disease history was found in a high proportion of the cases. It is of great essence to detect the life-threatening ischemia of vertebrobasilar artery system and take priority for treatment.

Joint stiffness and running economy during imposed forefoot strike before and after a long run in rearfoot strike runners.

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Melcher, Daniel A; Paquette, Max R; Schilling, Brian K; Bloomer, Richard J

2017-12-01

Research has focused on the effects of acute strike pattern modifications on lower extremity joint stiffness and running economy (RE). Strike pattern modifications on running biomechanics have mostly been studied while runners complete short running bouts. This study examined the effects of an imposed forefoot strike (FFS) on RE and ankle and knee joint stiffness before and after a long run in habitual rearfoot strike (RFS) runners. Joint kinetics and RE were collected before and after a long run. Sagittal joint kinetics were computed from kinematic and ground reaction force data that were collected during over-ground running trials in 13 male runners. RE was measured during treadmill running. Knee flexion range of motion, knee extensor moment and ankle joint stiffness were lower while plantarflexor moment and knee joint stiffness were greater during imposed FFS compared with RFS. The long run did not influence the difference in ankle and knee joint stiffness between strike patterns. Runners were more economical during RFS than imposed FFS and RE was not influenced by the long run. These findings suggest that using a FFS pattern towards the end of a long run may not be mechanically or metabolically beneficial for well-trained male RFS runners.

Evaluating the Effects of a Bird Strike Advisory System

NARCIS (Netherlands)

Metz, I.C.; Mühlhausen, T; Ellerbroek, J.; Hoekstra, J.M.

2016-01-01

Bird strikes have operational impacts and cause economic loss to the aviation industry. In the worst case, the damages resulting from bird strikes lead to crashes. The highest risk for bird strikes lies in the area below 3000 ft and thus mainly in airport environments. Despite intense efforts from

[FEATURES OF CLINICAL COURSE OF INFECTIOUS MONONUCLEOSIS IN CHILDREN DEPENDENT ON ETIOLOGY].

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Kharchenko, Iu P; Zarets'ka, A V; Slobodnichenko, L M; Iurchenko, I V

2015-01-01

The article highlights the clinical features of infectious mononucleosis in children (based on the analysis of the data for children of different ages treated in Odessa clinical hospital of infectious diseases in connection with infectious mononucleosis) based on etiological factors.

Debunking the viper's strike: harmless snakes kill a common assumption.

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Penning, David A; Sawvel, Baxter; Moon, Brad R

2016-03-01

To survive, organisms must avoid predation and acquire nutrients and energy. Sensory systems must correctly differentiate between potential predators and prey, and elicit behaviours that adjust distances accordingly. For snakes, strikes can serve both purposes. Vipers are thought to have the fastest strikes among snakes. However, strike performance has been measured in very few species, especially non-vipers. We measured defensive strike performance in harmless Texas ratsnakes and two species of vipers, western cottonmouths and western diamond-backed rattlesnakes, using high-speed video recordings. We show that ratsnake strike performance matches or exceeds that of vipers. In contrast with the literature over the past century, vipers do not represent the pinnacle of strike performance in snakes. Both harmless and venomous snakes can strike with very high accelerations that have two key consequences: the accelerations exceed values that can cause loss of consciousness in other animals, such as the accelerations experienced by jet pilots during extreme manoeuvres, and they make the strikes faster than the sensory and motor responses of mammalian prey and predators. Both harmless and venomous snakes can strike faster than the blink of an eye and often reach a target before it can move. © 2016 The Author(s).

Clinical and electrophysiological findings in patients with phenylketonuria and epilepsy: Reflex features.

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Yildiz Celik, Senay; Bebek, Nerses; Gurses, Candan; Baykan, Betul; Gokyigit, Aysen

2018-03-23

Phenylketonuria (PKU) is the most common form of amino acid metabolism disorders with autosomal recessive inheritance. The brain damage can be prevented by early diagnosis and a phenylalanine-restricted diet. Untreated or late-treated patients may show mental retardation and other cognitive dysfunctions, as well as motor disability and/or epilepsy. Three patients with PKU and epilepsy were recognized to have reflex epileptic features, and there were ten consecutive adult patients with PKU and epilepsy who were evaluated retrospectively. Medical history, ages at diagnosis and therapy onset, age at seizure onset, seizure types and reflex features, neurological findings, cranial imaging, electroencephalography (EEG) findings, and final clinical condition were evaluated. Reflex epilepsy features were examined in detail. The cases (6 females, 4 males) were diagnosed at ages between 3.5months and 12years. All patients had various degrees of mental-motor retardation and focal or generalized seizures with age at seizure onset varied between neonatal period and 15years. Three patients had febrile seizure, 3 patients had myoclonia, and 3 patients had status epilepticus. All patients had abnormal EEG findings except one. There was a slowing of background activity, and generalized discharges were observed in 7 patients; 3 of them had asymmetrical discharges. One patient had right hippocampal sclerosis (HS), and another patient had hypointensities in the basal ganglia and corpus callosum. Reflex features were clinically observed in 3 of the patients; however, EEG results did not show any related findings. One patient had reflex seizures triggered by photic stimuli, hot water, and startling; one by photic stimuli; and the other one by startling. Reports on the clinical and electrophysiological features of adult patients with PKU were scant. We emphasized that reflex clinical features may be observed in this metabolic disease, and focal epileptiform abnormalities and asymmetry

Intraductal papillary mucinous neoplasms of the pancreas: reporting clinically relevant features.

Science.gov (United States)

Del Chiaro, Marco; Verbeke, Caroline

2017-05-01

Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas can exhibit a wide spectrum of macroscopic and microscopic appearances. This not only causes occasional difficulties for the reporting pathologist in distinguishing these tumours from other lesions, but is also relevant clinically. As evidence accumulates, it becomes clear that multiple macroscopic and histological features of these neoplasms are relevant to the risk for malignant transformation and, consequently, of prime importance for clinical patient management. The need for detailed reporting is therefore increasing. This review discusses the panoply of gross and microscopic features of IPMN as well as the recommendations from recent consensus meetings regarding the pathology reporting on this tumour entity. © 2016 John Wiley & Sons Ltd.

Genetic Epidemiology, Hematological and Clinical Features of Hemoglobinopathies in Iran

OpenAIRE

Rahimi, Zohreh

2013-01-01

There is large variation in the molecular genetics and clinical features of hemoglobinopathies in Iran. Studying structural variants of hemoglobin demonstrated that the ?-chain variants of hemoglobin S and D-Punjab are more prevalent in the Fars (southwestern Iran) and Kermanshah (western Iran) provinces, respectively. Also, ? -chain variants of Hb Q-Iran and Hb Setif are prevalent in western Iran. The molecular basis and clinical severity of thalassemias are extremely heterogenous among Iran...

Foot strike and injury rates in endurance runners: a retrospective study.

Science.gov (United States)

Daoud, Adam I; Geissler, Gary J; Wang, Frank; Saretsky, Jason; Daoud, Yahya A; Lieberman, Daniel E

2012-07-01

This retrospective study tests if runners who habitually forefoot strike have different rates of injury than runners who habitually rearfoot strike. We measured the strike characteristics of middle- and long-distance runners from a collegiate cross-country team and quantified their history of injury, including the incidence and rate of specific injuries, the severity of each injury, and the rate of mild, moderate, and severe injuries per mile run. Of the 52 runners studied, 36 (69%) primarily used a rearfoot strike and 16 (31%) primarily used a forefoot strike. Approximately 74% of runners experienced a moderate or severe injury each year, but those who habitually rearfoot strike had approximately twice the rate of repetitive stress injuries than individuals who habitually forefoot strike. Traumatic injury rates were not significantly different between the two groups. A generalized linear model showed that strike type, sex, race distance, and average miles per week each correlate significantly (P strike have significantly higher rates of repetitive stress injury than those who mostly forefoot strike. This study does not test the causal bases for this general difference. One hypothesis, which requires further research, is that the absence of a marked impact peak in the ground reaction force during a forefoot strike compared with a rearfoot strike may contribute to lower rates of injuries in habitual forefoot strikers.

Lightning Strike in Pregnancy With Fetal Injury.

Science.gov (United States)

Galster, Kellen; Hodnick, Ryan; Berkeley, Ross P

2016-06-01

Injuries from lightning strikes are an infrequent occurrence, and are only rarely noted to involve pregnant victims. Only 13 cases of lightning strike in pregnancy have been previously described in the medical literature, along with 7 additional cases discovered within news media reports. This case report presents a novel case of lightning-associated injury in a patient in the third trimester of pregnancy, resulting in fetal ischemic brain injury and long-term morbidity, and reviews the mechanics of lightning strikes along with common injury patterns of which emergency providers should be aware. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Clinical and Anamnestic Features of Hepatic Steatosis in Children

Directory of Open Access Journals (Sweden)

N.Yu. Zavgorodnia

2015-11-01

Full Text Available The article is devoted to the study of clinical and anamnestic features of hepatic steatosis in children. The results of a comparative analysis of survey data of patients with evidence of hepatic steatosis and patients without steatosis were shown. The presence and degree of hepatic steatosis was found using FibroScan-touch-502 by measuring controlled attenuation parameter (CAP. The features of lifestyle and nutrition of children with steatosis were determined: hypodynamic lifestyle, the prevalence of fast food habits, insufficient consumption of liquid. It was established that hepatic steatosis is closely associated with obesity and hypothalamic disorders, increased both blood pressure and serum levels of atherogenic lipids.

Clinical features of measles pneumonia in adults

International Nuclear Information System (INIS)

Tanaka, Hiroshi; Honma, Shin-ichi; Yamagishi, Masahiko; Honda, Yasuhito; Abe, Shosaku; Igarashi, Tomofumi; Sekine, Kyuichiro.

1993-01-01

The clinical features, chest radiographs and computed tomographic (CT) images were evaluated in 11 cases of serologically proved adult measles complicated with pneumonia (10 were previously healthy and one had sarcoidosis). Pneumonia appeared during the rash period in all cases. Respiratory symptoms were cough (9/11), dyspnea (3/11), and hypoxemia (10/11). Pneumonia manifestations were detected in only 4 cases by chest radiograph; on the other hand, they were seen in all cases by CT scan and consisted of ground-glass opacities (73%), nodular opacities (64%) and consolidation (27%). CT seems to be useful method to detect measles pneumonia if it is suspected. Measles pneumonia in previously healthy patients had a good prognosis, as the hypoxemia disappeared within 6 days in all cases. The sarcoidosis patient showed prolonged pneumonic shadows and period of hypoxemia. Measles pneumonia occurring in a host with cellular immunodeficiency may have a severe clinical course. (author)

effects of strike cost on economic development in nigeria

African Journals Online (AJOL)

USER

same firm, in other firms even in other industries (Kempner, 1980). For example ... The main purpose of this paper is to examine the strike cost and productivity in. Nigeria. ... Obnoxious Policies: Workers do go on strike when management makes obnoxious ... ASUU had to go on strike; the FGN had rescinded the decision.

Forward to the Past: Strikes and Striking as Dialogue by other ...

African Journals Online (AJOL)

In Nigeria, from the colonial period to the present, the employment of strikes and protests by nationalists, Nigerian workers and civil society groups has been established as one of the potent means of conveying viewpoints, positions as well as the demand for equality, fairness, social justice and reforms. It has been used as ...

Acromegaly: clinical features at diagnosis.

Science.gov (United States)

Vilar, Lucio; Vilar, Clarice Freitas; Lyra, Ruy; Lyra, Raissa; Naves, Luciana A

2017-02-01

Acromegaly is a rare and underdiagnosed disorder caused, in more than 95% of cases, by a growth hormone (GH)-secreting pituitary adenoma. The GH hypersecretion leads to overproduction of insulin-like growth factor 1 (IGF-1) which results in a multisystem disease characterized by somatic overgrowth, multiple comorbidities, physical disfigurement, and increased mortality. This article aims to review the clinical features of acromegaly at diagnosis. Acromegaly affects both males and females equally and the average age at diagnosis ranges from 40 to 50 years (up to 5% of cases acromegaly is often diagnosed five to more than ten years after its onset. The typical coarsening of facial features include furrowing of fronthead, pronounced brow protrusion, enlargement of the nose and the ears, thickening of the lips, skin wrinkles and nasolabial folds, as well as mandibular prognathism that leads to dental malocclusion and increased interdental spacing. Excessive growth of hands and feet (predominantly due to soft tissue swelling) is present in the vast majority of acromegalic patients. Gigantism accounts for up to 5% of cases and occurs when the excess of GH becomes manifest in the young, before the epiphyseal fusion. The disease also has rheumatologic, cardiovascular, respiratory, neoplastic, neurological, and metabolic manifestations which negatively impact its prognosis and patients quality of life. Less than 15% of acromegalic patients actively seek medical attention for change in appearance or enlargement of the extremities. The presentation of acromegaly is more often related to its systemic comorbidities or to local tumor effects.

Cockayne's syndrome: correlation of clinical features with cellular sensitivity of RNA synthesis to UV irradiation

International Nuclear Information System (INIS)

Lehmann, A.R.; Thompson, A.F.; Harcourt, S.A.

1993-01-01

Cockayne's syndrome (CS) is a rare autosomal recessive disorder with dwarfism, mental retardation, and otherwise clinically heterogeneous features. In cultured CS fibroblasts, the failure of RNA synthesis to recover to normal rates after UV-C irradiation provides a useful and relatively simple diagnostic test. We have measured post-UV-C RNA synthesis in 52 patients for whom a clinical diagnosis of CS was considered a possibility. Twenty-nine patients showed the defect characteristic of CS cells, and 23 had a normal response. We have attempted to correlate the cellular diagnosis with the different clinical features of the disorder. Clinical details of the patients were obtained from referring clinicians in the form of a questionnaire. Our results show that, apart from the cardinal features of dwarfism and mental retardation, sun sensitivity correlated best with a positive cellular diagnosis. Pigmentary retinopathy, gait defects, and dental caries were also good positive indicators, although several patients with a positive cellular diagnosis did not have these features. (Author)

Prediction models for solitary pulmonary nodules based on curvelet textural features and clinical parameters.

Science.gov (United States)

Wang, Jing-Jing; Wu, Hai-Feng; Sun, Tao; Li, Xia; Wang, Wei; Tao, Li-Xin; Huo, Da; Lv, Ping-Xin; He, Wen; Guo, Xiu-Hua

2013-01-01

Lung cancer, one of the leading causes of cancer-related deaths, usually appears as solitary pulmonary nodules (SPNs) which are hard to diagnose using the naked eye. In this paper, curvelet-based textural features and clinical parameters are used with three prediction models [a multilevel model, a least absolute shrinkage and selection operator (LASSO) regression method, and a support vector machine (SVM)] to improve the diagnosis of benign and malignant SPNs. Dimensionality reduction of the original curvelet-based textural features was achieved using principal component analysis. In addition, non-conditional logistical regression was used to find clinical predictors among demographic parameters and morphological features. The results showed that, combined with 11 clinical predictors, the accuracy rates using 12 principal components were higher than those using the original curvelet-based textural features. To evaluate the models, 10-fold cross validation and back substitution were applied. The results obtained, respectively, were 0.8549 and 0.9221 for the LASSO method, 0.9443 and 0.9831 for SVM, and 0.8722 and 0.9722 for the multilevel model. All in all, it was found that using curvelet-based textural features after dimensionality reduction and using clinical predictors, the highest accuracy rate was achieved with SVM. The method may be used as an auxiliary tool to differentiate between benign and malignant SPNs in CT images.

"Thunderstruck": penetrating thoracic injury from lightning strike.

Science.gov (United States)

van Waes, Oscar J F; van de Woestijne, Pieter C; Halm, Jens A

2014-04-01

Lightning strike victims are rarely presented at an emergency department. Burns are often the primary focus. This case report describes the improvised explosive device like-injury to the thorax due to lightning strike and its treatment, which has not been described prior in (kerauno)medicine. Penetrating injury due to blast from lightning strike is extremely rare. These "shrapnel" injuries should however be ruled out in all patients struck by lightning. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Option Strike Price and Managerial Investment Decisions

Institute of Scientific and Technical Information of China (English)

刘鸿雁; 张维

2003-01-01

The manager′s investment decisions is modeled when the manager is risk-averse and has stock options as compensation. It is found that the strike price of options is crucial to the investment incentives of managers, and that the correct value, or interval of values, of managerial stock option strike price can bring stockholder and manager interests in agreement.

Neuromyelitis optica: clinical features, immunopathogenesis and treatment

Science.gov (United States)

Jarius, S; Wildemann, B; Paul, F

2014-01-01

The term ‘neuromyelitis optica’ (‘Devic's syndrome’, NMO) refers to a syndrome characterized by optic neuritis and myelitis. In recent years, the condition has raised enormous interest among scientists and clinical neurologists, fuelled by the detection of a specific serum immunoglobulin (Ig)G reactivity (NMO-IgG) in up to 80% of patients with NMO. These autoantibodies were later shown to target aquaporin-4 (AQP4), the most abundant water channel in the central nervous system (CNS). Here we give an up-to-date overview of the clinical and paraclinical features, immunopathogenesis and treatment of NMO. We discuss the widening clinical spectrum of AQP4-related autoimmunity, the role of magnetic resonance imaging (MRI) and new diagnostic means such as optical coherence tomography in the diagnosis of NMO, the role of NMO-IgG, T cells and granulocytes in the pathophysiology of NMO, and outline prospects for new and emerging therapies for this rare, but often devastating condition. Other Articles published in this series Paraneoplastic neurological syndromes. Clinical and Experimental Immunology 2014, 175: 336–48. Disease-modifying therapy in multiple sclerosis and chronic inflammatory demyelinating polyradiculoneuropathy: common and divergent current and future strategies. Clinical and Experimental Immunology 2014, 175: 359–72. Monoclonal antibodies in treatment of multiple sclerosis. Clinical and Experimental Immunology 2014, 175: 373–84. CLIPPERS: chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. Review of an increasingly recognized entity within the spectrum of inflammatory central nervous system disorders. Clinical and Experimental Immunology 2014, 175: 385–96. Requirement for safety monitoring for approved multiple sclerosis therapies: an overview. Clinical and Experimental Immunology 2014, 175: 397–407. Myasthenia gravis: an update for the clinician. Clinical and Experimental Immunology 2014, 175: 408�

The neurocognitive basis of feature integration

NARCIS (Netherlands)

Keizer, André Willem

2010-01-01

One of the most striking features of the brain is that it is modular; it consists of often highly specialized areas. This modular organization requires efficient communication in order to integrate the information that is represented in distinct brain areas. In my thesis, I studied the neural basis

Clinical Features and the Factors Associated with Poor Outcome of ...

African Journals Online (AJOL)

Clinical Features and the Factors Associated with Poor Outcome of. Measles Patients at Queen Elizabeth Central Hospital. Robin L Broadhead. Paul Courtright. Lincy Misoya. Affiliation: 1. Department of Paediatrics College of. Medicine University of Malawi. 2. International Eye FoundatiQn. 3. Department of Paediatrics ...

Clinical features and course of ocular toxocariasis in adults.

Directory of Open Access Journals (Sweden)

Seong Joon Ahn

2014-06-01

Full Text Available PURPOSE: To investigate the clinical features, clinical course of granuloma, serologic findings, treatment outcome, and probable infection sources in adult patients with ocular toxocariasis (OT. METHODS: In this retrospective cohort study, we examined 101 adult patients diagnosed clinically and serologically with OT. Serial fundus photographs and spectral domain optical coherence tomography images of all the patients were reviewed. A clinic-based case-control study on pet ownership, occupation, and raw meat ingestion history was performed to investigate the possible infection sources. RESULTS: Among the patients diagnosed clinically and serologically with OT, 69.6% showed elevated immunoglobulin E (IgE levels. Granuloma in OT involved all retinal layers and several vitreoretinal comorbidities were noted depending on the location of granuloma: posterior pole granuloma was associated with epiretinal membrane and retinal nerve fiber layer defects, whereas peripheral granuloma was associated with vitreous opacity. Intraocular migration of granuloma was observed in 15 of 93 patients (16.1%. Treatment with albendazole (400 mg twice a day for 2 weeks and corticosteroids (oral prednisolone; 0.5-1 mg/kg/day resulted in comparable outcomes to patients on corticosteroid monotherapy; however, the 6-month recurrence rate in patients treated with combined therapy (17.4% was significantly lower than that in patients treated with corticosteroid monotherapy (54.5%, P=0.045. Ingestion of raw cow liver (80.8% or meat (71.2% was significantly more common in OT patients than healthy controls. CONCLUSIONS: Our study discusses the diagnosis, treatment, and prevention strategies for OT. Evaluation of total IgE, in addition to anti-toxocara antibody, can assist in the serologic diagnosis of OT. Combined albendazole and corticosteroid therapy may reduce intraocular inflammation and recurrence. Migrating feature of granuloma is clinically important and may further suggest

The morphology of strike-slip faults - Examples from the San Andreas Fault, California

Science.gov (United States)

Bilham, Roger; King, Geoffrey

1989-01-01

The dilatational strains associated with vertical faults embedded in a horizontal plate are examined in the framework of fault kinematics and simple displacement boundary conditions. Using boundary element methods, a sequence of examples of dilatational strain fields associated with commonly occurring strike-slip fault zone features (bends, offsets, finite rupture lengths, and nonuniform slip distributions) is derived. The combinations of these strain fields are then used to examine the Parkfield region of the San Andreas fault system in central California.

Effects of footwear and strike type on running economy.

Science.gov (United States)

Perl, Daniel P; Daoud, Adam I; Lieberman, Daniel E

2012-07-01

This study tests if running economy differs in minimal shoes versus standard running shoes with cushioned elevated heels and arch supports and in forefoot versus rearfoot strike gaits. We measured the cost of transport (mL O(2)·kg(-1)·m(-1)) in subjects who habitually run in minimal shoes or barefoot while they were running at 3.0 m·s(-1) on a treadmill during forefoot and rearfoot striking while wearing minimal and standard shoes, controlling for shoe mass and stride frequency. Force and kinematic data were collected when subjects were shod and barefoot to quantify differences in knee flexion, arch strain, plantar flexor force production, and Achilles tendon-triceps surae strain. After controlling for stride frequency and shoe mass, runners were 2.41% more economical in the minimal-shoe condition when forefoot striking and 3.32% more economical in the minimal-shoe condition when rearfoot striking (P forefoot and rearfoot striking did not differ significantly in cost for either minimal- or standard-shoe running. Arch strain was not measured in the shod condition but was significantly greater during forefoot than rearfoot striking when barefoot. Plantar flexor force output was significantly higher in forefoot than in rearfoot striking and in barefoot than in shod running. Achilles tendon-triceps surae strain and knee flexion were also lower in barefoot than in standard-shoe running. Minimally shod runners are modestly but significantly more economical than traditionally shod runners regardless of strike type, after controlling for shoe mass and stride frequency. The likely cause of this difference is more elastic energy storage and release in the lower extremity during minimal-shoe running.

BRIEF REPORT: Beyond Clinical Experience: Features of Data Collection and Interpretation That Contribute to Diagnostic Accuracy

Science.gov (United States)

Nendaz, Mathieu R; Gut, Anne M; Perrier, Arnaud; Louis-Simonet, Martine; Blondon-Choa, Katherine; Herrmann, François R; Junod, Alain F; Vu, Nu V

2006-01-01

BACKGROUND Clinical experience, features of data collection process, or both, affect diagnostic accuracy, but their respective role is unclear. OBJECTIVE, DESIGN Prospective, observational study, to determine the respective contribution of clinical experience and data collection features to diagnostic accuracy. METHODS Six Internists, 6 second year internal medicine residents, and 6 senior medical students worked up the same 7 cases with a standardized patient. Each encounter was audiotaped and immediately assessed by the subjects who indicated the reasons underlying their data collection. We analyzed the encounters according to diagnostic accuracy, information collected, organ systems explored, diagnoses evaluated, and final decisions made, and we determined predictors of diagnostic accuracy by logistic regression models. RESULTS Several features significantly predicted diagnostic accuracy after correction for clinical experience: early exploration of correct diagnosis (odds ratio [OR] 24.35) or of relevant diagnostic hypotheses (OR 2.22) to frame clinical data collection, larger number of diagnostic hypotheses evaluated (OR 1.08), and collection of relevant clinical data (OR 1.19). CONCLUSION Some features of data collection and interpretation are related to diagnostic accuracy beyond clinical experience and should be explicitly included in clinical training and modeled by clinical teachers. Thoroughness in data collection should not be considered a privileged way to diagnostic success. PMID:17105525

Clinical features, diagnostic criteria, and management of Coffin-Siris syndrome.

Science.gov (United States)

Vergano, Samantha S; Deardorff, Matthew A

2014-09-01

Coffin-Siris syndrome (OMIM#135900) is a multiple congenital anomaly syndrome classically characterized by hypo- or aplasia of the fifth digit nails or phalanges, as well as coarse facial features, sparse scalp hair, and moderate to severe cognitive and/or developmental delay. The recent identification of molecular etiologies has served to effectively characterize a large set of patients who have been described with Coffin-Siris between the time of its initial description and the present. However, despite recent advances, a number of patients who traditionally fit the diagnosis have yet to have identified causes. This could be due to patients who lie outside the defined phenotype, or alternatively, to additional as yet unidentified genes which may play roles. Here we outline the range of clinical features described in the broader diagnostic category, review the continuing phenotypic challenges and note those subsets of patients for whom molecular causes have yet to be clarified. Finally, we discuss recommendations for clinical management of these individuals. © 2014 Wiley Periodicals, Inc.

Strike Point Control on EAST Using an Isoflux Control Method

International Nuclear Information System (INIS)

Xing Zhe; Xiao Bingjia; Luo Zhengping; Walker, M. L.; Humphreys, D. A.

2015-01-01

For the advanced tokamak, the particle deposition and thermal load on the divertor is a big challenge. By moving the strike points on divertor target plates, the position of particle deposition and thermal load can be shifted. We could adjust the Poloidal Field (PF) coil current to achieve the strike point position feedback control. Using isoflux control method, the strike point position can be controlled by controlling the X point position. On the basis of experimental data, we establish relational expressions between X point position and strike point position. Benchmark experiments are carried out to validate the correctness and robustness of the control methods. The strike point position is successfully controlled following our command in the EAST operation. (paper)

The clinical features of late onset anorexia nervosa.

OpenAIRE

Joughin, N. A.; Crisp, A. H.; Gowers, S. G.; Bhat, A. V.

1991-01-01

This study examines clinical features of late onset anorexia nervosa. This involved the scrutiny of a large database of patients with anorexia nervosa comprising data gathered at standardized initial assessments over the period 1960-1990. Patients with a late onset were compared to other selected patient samples. The population comprised 12 patients with a first onset of anorexia nervosa at or after the age of 30, 415 patients with an onset after 15 but before 20 and 9 patients with an onset ...

Clinical feature and imaging findings of juvenile ankylosing spondylitis

International Nuclear Information System (INIS)

Zeng Hui; Liang Hongchang; Wang Weigang; Liu Hui; Huang Meiping; Zheng Junhui

2003-01-01

Objective: To analyze the clinical features and imaging findings of juvenile ankylosing spondylitis (JAS) in order to improve the diagnosis and the prognosis of JAS. Methods: Twelve cases were analyzed retrospectively and 14 cases, who were followed-up averagely for 2.3 years, were analyzed prospectively. Initially 10 were diagnosed as Still's disease and four were diagnosed as rheumatoid arthritis. Photography was performed in all cases, CT scan was done in 18 cases, and MRI in 8 cases. Lower extremity big joint disorders were observed in all cases and the small joints were reserved. The abnormalities of the sacroiliac joint were revealed in the early stage in 12 cases. The results were analyzed statistically. Results: The age of preliminary diagnosis was 9.3 years in average. There were statistical correlation between the age of the first episode and severity of the disease. And there were statistical correlation between the course of the illness and severity of the disease. The large joints of the lower extremities were most commonly involved. Conclusion: There were characteristic clinical features and imaging findings in the JAS. Early diagnosis and treatment improve the prognosis

Comparison of force, power, and striking efficiency for a Kung Fu strike performed by novice and experienced practitioners: preliminary analysis.

Science.gov (United States)

Neto, Osmar Pinto; Magini, Marcio; Saba, Marcelo M F; Pacheco, Marcos Tadeu Tavares

2008-02-01

This paper presents a comparison of force, power, and efficiency values calculated from Kung Fu Yau-Man palm strikes, when performed by 7 experienced and 6 novice men. They performed 5 palm strikes to a freestanding basketball, recorded by high-speed camera at 1000 Hz. Nonparametric comparisons and correlations showed experienced practitioners presented larger values of mean muscle force, mean impact force, mean muscle power, mean impact power, and mean striking efficiency, as is noted in evidence obtained for other martial arts. Also, an interesting result was that for experienced Kung Fu practitioners, muscle power was linearly correlated with impact power (p = .98) but not for the novice practitioners (p = .46).

Cognitive impairment and dementia in Parkinson’s disease: clinical features, diagnosis, and management

Directory of Open Access Journals (Sweden)

Joana eMeireles

2012-05-01

Full Text Available Parkinson’s disease (PD is a common, disabling, neurodegenerative disorder. In addition to classical motor symptoms, nonmotor features are now widely accepted as part of the clinical picture, and cognitive decline is a very important aspect of the disease, as it brings an additional significant burden for the patient and caregivers. The diagnosis of cognitive decline in PD, namely mild cognitive impairment and dementia, can be extremely challenging, remaining largely based on clinical and cognitive assessments. Diagnostic criteria and methods for PD dementia and mild cognitive impairment have been recently issued by expert work groups. This manuscript has synthesized relevant data in order to obtain a pragmatic and updated review regarding cognitive decline in PD, from milder stages to dementia. This text will summarize clinical features, diagnostic methodology, and therapeutic issues of clinical decline in Parkinson’s disease. Relevant clinical genetic issues, including recent advances, will also be approached.

The place of clinical features and standard chest radiography in ...

African Journals Online (AJOL)

One hundred and five primary mediastinal masses were seen between 1975 and 1998, at the Cardiothoracic surgical Unit of the University College Hospital Ibadan. These were studied to establish the importance of clinical features and plain chest radiography in preoperative evaluation of these masses. The sources of ...

Underestimated clinical features of postadolescent acne.

Science.gov (United States)

Capitanio, Bruno; Sinagra, Jo Linda; Bordignon, Valentina; Cordiali Fei, Paola; Picardo, Mauro; Zouboulis, Christos C

2010-11-01

Postadolescent acne is usually described as an inflammatory, mild-to-moderate dermatosis, frequently involving the lower third of the face, the jawline, and the neck. However, we have also frequently observed a clinical form predominantly characterized by retention lesions (microcomedones and macrocomedones), with few inflammatory lesions (comedonal postadolescent acne [CPAA]), which appears significantly correlated with cigarette smoking. We sought to investigate the clinical features of postadolescent acne in a group of female patients affected by acne and its relationship with cigarette smoking. A total of 226 women with acne (25-50 years) attending our department were examined by a team of 3 dermatologists, to assess the age of onset of the disease, and the number, type, and distribution of acne lesions. In all, 192 of 226 patients (85.0%) were classified as having CPAA and 34 as having papulopustular postadolescent acne. A smoking habit was confirmed in 150 of 226 (66.3%). Remarkably, 72.9% of patients with CPAA were smokers as compared with only 29.4% of those with papulopustular postadolescent acne (P < .0001). Possible limitations are related to geographic area or to the prevalence of darker skin types (III and IV) (data about skin types have not been collected). Other possible aggravating factors (ie, stress and diet) have not been investigated. According to our results, CPAA appears as the most frequent clinical form of postadolescent acne and seems to be strictly correlated with cigarette smoking. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Preventive strike vs. false targets and protection in defense strategy

International Nuclear Information System (INIS)

Levitin, Gregory; Hausken, Kjell

2011-01-01

A defender allocates its resource between defending an object passively and striking preventively against an attacker seeking to destroy the object. With no preventive strike the defender distributes its entire resource between deploying false targets, which the attacker cannot distinguish from the genuine object, and protecting the object. If the defender strikes preventively, the attacker's vulnerability depends on its protection and on the defender's resource allocated to the strike. If the attacker survives, the object's vulnerability depends on the attacker's revenge attack resource allocated to the attacked object. The optimal defense resource distribution between striking preventively, deploying the false targets and protecting the object is analyzed. Two cases of the attacker strategy are considered: when the attacker attacks all of the targets and when it chooses a number of targets to attack. An optimization model is presented for making a decision about the efficiency of the preventive strike based on the estimated attack probability, dependent on a variety of model parameters.

Clinical features in patients with long-lasting macrophagic myofasciitis

OpenAIRE

Muriel eRIGOLET; Jessie eAOUIZERATE; Jessie eAOUIZERATE; Maryline eCOUETTE; Nilusha eTHANGARAJAH; Nilusha eTHANGARAJAH; Mehdi eAOUN-SEBAITI; Romain Kroum GHERARDI; Romain Kroum GHERARDI; Romain Kroum GHERARDI; Josette eCADUSSEAU; Josette eCADUSSEAU; Francois Jerome eAUTHIER; Francois Jerome eAUTHIER; Francois Jerome eAUTHIER

2014-01-01

Macrophagic myofasciitis (MMF) is an emerging condition characterized by specific muscle lesions assessing abnormal long-term persistence of aluminium hydroxide within macrophages at the site of previous immunization. Affected patients usually are middle-aged adults, mainly presenting with diffuse arthromyalgias, chronic fatigue, and marked cognitive deficits, not related to pain, fatigue or depression. Clinical features usually correspond to that observed in chronic fatigue syndrome/myalgic ...

Clinical Features in Patients with Long-Lasting Macrophagic Myofasciitis

OpenAIRE

Rigolet, Muriel; Aouizerate, Jessie; Couette, Maryline; Ragunathan-Thangarajah, Nilusha; Aoun-Sebaiti, Mehdi; Gherardi, Romain Kroum; Cadusseau, Josette; Authier, François Jérôme

2014-01-01

Macrophagic myofasciitis (MMF) is an emerging condition characterized by specific muscle lesions assessing abnormal long-term persistence of aluminum hydroxide within macrophages at the site of previous immunization. Affected patients usually are middle-aged adults, mainly presenting with diffuse arthromyalgias, chronic fatigue, and marked cognitive deficits, not related to pain, fatigue, or depression. Clinical features usually correspond to that observed in chronic fatigue syndrome/myalgic ...

Clinical and laboratory features of patients of Vietnamese descent with systemic lupus erythematosus.

Science.gov (United States)

Phan, J C; Bush, T M; Donald, F; Ward, M

1999-01-01

The prevalence rate and disease manifestations of systemic lupus erythematosus (SLE) have been noted to vary among different ethnic groups. There has been no description in the English literature of SLE in the Vietnamese population. This is the first report, which details the clinical and laboratory features as well as an estimation of the prevalence of SLE in patients with a Vietnamese ancestry living in the United States. We performed a retrospective chart review of clinical and laboratory features of patients of Vietnamese descent with SLE. The case finding was performed by a review of the rheumatology clinic records at two large teaching hospitals in Santa Clara County searching for patients with SLE with a Vietnamese surname. In addition, we recruited patients by contacting all of the rheumatologists practicing in the county. Twenty-three patients of Vietnamese descent were identified with SLE in Santa Clara County. The estimated prevalence of SLE in the patients of Vietnamese descent was 42 cases per 100 000 persons. Eighty-seven per cent of the cases were born in Vietnam. The clinical and laboratory features of SLE were similar to prior published reviews except for a relatively high prevalence of anti-RNP antibody (54%). The patients with anti-RNP antibody exhibited features of overlap syndrome. There was a high rate of exposure to tuberculosis (TB). Fifty-eight per cent of patients had a positive purified protein derivative (PPD) skin test and 27% of patients had a history of clinical TB. Forty-four per cent of patients had evidence of hepatitis B exposure. The prevalence of SLE in the Vietnamese population in Santa Clara County is similar to that of other Asian populations. There was a relatively high prevalence of anti-RNP antibody in our patient group which was associated with overlap features. As expected in an immigrant population from Southeast Asia, there was a high rate of prior exposure to tuberculosis and hepatitis B. Clinicians should diligently

Does the concept of borderline personality features have clinical utility in childhood?

Science.gov (United States)

Hawes, David J

2014-01-01

Phenotypic features of borderline personality disorder may first emerge during childhood, alongside symptoms of common externalizing and internalizing disorders. Children with these borderline personality features (BPF) are, therefore, likely to come into contact with clinical services prior to adolescence. This raises the question of whether BPF may be clinically informative with respect to the formulation and treatment of childhood psychopathology. BPF in late childhood appear to be highly heritable, while also predicted by environmental risk factors that overlap with those related to both externalizing and internalizing disorders. These risk factors include hostile parenting, maternal insensitivity to infant attachment cues, and early peer victimization, thereby implicating both family and peer processes that play out across early development. Children with BPF appear to be further characterized by social-cognitive factors including social perspective coordination deficits, a shame-prone self-concept, and hypermentalizing, which may represent potential therapeutic targets. Clinical research into the implications of BPF for the treatment of childhood psychopathology is a current priority. It is proposed that the research designs that have contributed to recent evidence for the clinical utility of childhood psychopathic traits may likewise aid in understanding the potential clinical utility of BPF in children.

WAVELET TRANSFORM ANALYSIS OF ELECTROMYOGRAPHY KUNG FU STRIKES DATA

Directory of Open Access Journals (Sweden)

Ana Carolina de Miranda Marzullo

2009-11-01

Full Text Available In martial arts and contact sports strikes are performed at near maximum speeds. For that reason, electromyography (EMG analysis of such movements is non-trivial. This paper has three main goals: firstly, to investigate the differences in the EMG activity of muscles during strikes performed with and without impacts; secondly, to assess the advantages of using Sum of Significant Power (SSP values instead of root mean square (rms values when analyzing EMG data; and lastly to introduce a new method of calculating median frequency values using wavelet transforms (WMDF. EMG data of the deltoid anterior (DA, triceps brachii (TB and brachioradialis (BR muscles were collected from eight Kung Fu practitioners during strikes performed with and without impacts. SSP results indicated significant higher muscle activity (p = 0.023 for the strikes with impact. WMDF results, on the other hand, indicated significant lower values (p = 0. 007 for the strikes with impact. SSP results presented higher sensitivity than rms to quantify important signal differences and, at the same time, presented lower inter-subject coefficient of variations. The result of increase in SSP values and decrease in WMDF may suggest better synchronization of motor units for the strikes with impact performed by the experienced Kung Fu practitioners

Review of the Lightning Strike Incident at Launch Complex 37 on July 27, 1967, and Comparison to a Gemini Lightning Strike

Science.gov (United States)

Llewellyn, J. A.

1967-01-01

The Launch Complex 37 lightning strike of July 27, 1967, was reviewed and compared to a similar incident on the Gemini Program. Available data indicate little likelihood of damaging currents having been present in SA-204 Launch Vehicle or the ground equipment during the July 27th incident. Based on the results of subsystem and system testing after the strike, anticipated results of future testing, the six months elapsed time between the strike-and launch, and the fact that much of the critical airborne electrical/electronic equipment has been removed since the strike for other reasons, no new actions are considered necessary at this time in the Gemini case, significant failures occurred in both airborne and ground circuits. Due to the resultant semi, condlictor uncertainty, and the relatively' short time prior to planned launch, all critical airborne components containing semiconduetors were replaced, and a sophisticated data comparison task was implemented.

Update on Clinical Features and Brain Abnormalities in Neurogenetics Syndromes

Science.gov (United States)

Jackowski, Andrea Parolin; Laureano, Maura Regina; Del'Aquilla, Marco Antonio; de Moura, Luciana Monteiro; Assuncao, Idaiane; Silva, Ivaldo; Schwartzman, Jose Salomao

2011-01-01

Neuroimaging methods represent a critical tool in efforts to join the study of the neurobiology of genes with the neurobiology of behaviour, and to understand the neurodevelopmental pathways that give rise to cognitive and behavioural impairments. This article reviews the clinical features and highlights studies with a focus on the relevant…

Clinical Features Of Malaria And Typhoid Fever | Mba | Journal of ...

African Journals Online (AJOL)

Features to distinguish Malaria from Typhoid fever. These can be discerned from a good and detailed clinical history, in addition to a thorough physical examination. The following would help. The paroxysms of malaria fever as against the step ladder pattern fever of typhoid fever. The prominence of headaches in typhoid ...

Autoimmune hepatitis: diagnostic criteria, subclassifications, and clinical features.

Science.gov (United States)

McFarlane, Ian G

2002-08-01

The diagnosis of AIH depends on the finding of several suggestive features together with careful exclusion of liver diseases of other etiologies. Wherever possible, the diagnosis should be confirmed histologically by an experienced hepatopathologist. Seronegativity for the conventional autoantibodies at presentation does not exclude a diagnosis of AIH. It is important to test for anti-LKM1 antibodies to avoid missing a diagnosis of type 2 AIH, with potentially serious consequences. Although the syndrome is associated with characteristic biochemical abnormalities, and biochemical parameters are commonly used for monitoring response to therapy, it should be borne in mind that neither these nor autoantibody titers are completely reliable indices of disease activity. Although the various systems that have been promulgated for classification of the disease may identify different groups of patients on pathogenetic or clinical criteria and are useful for research purposes, none is yet sufficiently exclusive in terms of defining prognosis or planning treatment strategies to be applicable to the individual patient seen in the clinic. Clinical management should therefore continue to be individually tailored.

Strike action by nurses in South Africa: A value clarification

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Marie Muller

2001-09-01

Full Text Available The Labour Relations Act (South Africa, 1991 made provision for protected strike action by employees, subject to certain conditions, procedures and negotiated agreements. This led to the removal of the strike clause in the Nursing Act (South Africa, 1992. The labour rights of all citizens are entrenched in the Constitution of the country (South Africa, 1996. Participation in strike action by the nurse/ midwife, regardless of the legal requirements and specifications, does, however, pose an ethical question. It is therefore necessary to conduct a value clarification on strike action by nurses in South Africa. The purpose of this research is to explore and describe the perceived values of participants from an accessible population on this phenomenon. A qualitative, exploratory and descriptive research design was deployed. The perceived values of nurses on strike action were collected by means of an openended questionnaire/sketch. Over a period of three years a purposive and convenient sampling method was used, involving all the enrolled post basic nursing/midwifery students/ learners at a particular Nursing Education Institution. The justification of the sample was further enhanced by also collecting data on the participants’ age and provincial distribution location. Although a 63% sample realisation (of the accessible population was achieved, this represents only 1,5% of the registered nursing/midwifery population in the country. A descriptive analysis of the participants’ age and provincial distribution was undertaken, as well as a content analysis of their perceived values on strike action. The mean age of the participants was 48 years, which could be attributed to the fact that most of them were enrolled for a post-basic Diploma in Community Nursing Science. Most of the responses (52,7% were against strike action and 32,5% supported strike action by nurses as a constitutional and legal right. A fairly substantial number of participants (14

The Teacher Strike: School District Protection Procedures. A Manual for School District Officials on How to Handle a Teachers' Strike.

Science.gov (United States)

Igoe, Joseph A.; DiRocco, Anthony P.

This booklet is designed to give practical and realistic advice to school district officials faced with the possibility of a teachers' strike. It is intended for use both by school district administrators and school board members. The booklet is organized into four sections that focus in turn on signs of a pending teachers' strike, union…

The cenozoic strike-slip faults and TTHE regional crust stability of Beishan area

International Nuclear Information System (INIS)

Guo Zhaojie; Zhang Zhicheng; Zhang Chen; Liu Chang; Zhang Yu; Wang Ju; Chen Weiming

2008-01-01

The remote sensing images and geological features of Beishan area indicate that the Altyn Tagh fault, Sanweishan-Shuangta fault, Daquan fault and Hongliuhe fault are distributed in Beishan area from south to north. The faults are all left-lateral strike-slip faults with trending of NE40-50°, displaying similar distribution pattern. The secondary branch faults are developed at the end of each main strike-slip fault with nearly east to west trending form dendritic oblique crossings at the angle of 30-50°. Because of the left-lateral slip of the branch faults, the granites or the blocks exposed within the branch faults rotate clockwisely, forming 'Domino' structures. So the structural style of Beishan area consists of the Altyn Tagh fault, Sanweishan-Shuangta fault, Daquan fault, Hongliuhe fault and their branch faults and rotational structures between different faults. Sedimentary analysis on the fault valleys in the study area and ESR chronological test of fault clay exhibit that the Sanweishan-Shuangta fault form in the late Pliocene (N2), while the Daquan fault displays formation age of l.5-1.2 Ma, and the activity age of the relevant branch faults is Late Pleistocene (400 ka). The ages become younger from the Altyn Tagh fault to the Daquan fault and strike-slip faults display NW trending extension, further revealing the lateral growth process of the strike-slip boundary at the northern margin during the Cenozoic uplift of Tibetan Plateau. The displacement amounts on several secondary faults caused by the activities of the faults are slight due to the above-mentioned structural distribution characteristics of Beishan area, which means that this area is the most stable active area with few seismic activities. We propose the main granitic bodies in Beishan area could be favorable preselected locations for China's high level radioactive waste repository. (authors)

‘The Nairobi General Strike [1950]: from protest to insurgency’

OpenAIRE

Hyde, David

2002-01-01

The Nairobi General Strike [1950] was the culmination of Kenya’s post war strike wave and urban upheaval. An unprecedented upsurge occurred with the general strikes in Mombasa [1947] led by the African Workers Federation [A.W.F.] and in Nairobi by the East African Trades Union Congress [E.A.T.U.C.]. While this has been termed and treated as a city wide strike, there is enough evidence to suggest a movement that went some way beyond Nairobi. The extent of the cohesion and reciprocal impacts am...

Clinical and radiological features of bronchiolitis obliterans in children

International Nuclear Information System (INIS)

Peng Yun; Sun Guoqiang; Zeng Jinjin; Ma Daqing

2006-01-01

Objective: To study the value of chest radiograph and thin-section computed tomography (CT) in diagnosis bronchiolitis obliterans in children, and to determine clinical view of obliterative bronchiolitis in children. Methods: We identified 12 infants, 10 boys, and 2 girls (age range, 5 month to 11 years) with clinical confirmation of bronchiolitis obliterans. Three cases were after Steven-Johnson syndrome, 8 were post-infection (2 adenovirus, 2 measles and 1 Pseudomonas aeruginosa infection, 3 cases were unknown etiology infection); The symptoms lasted for at least 6 weeks. One case had lung ventilation nuclear scan. We evaluated individual bronchoscopy, pulmonary function test, chest radiograph and thin- section CT features and their characteristic appearance. Results: All cases had typical clinical characteristics and pulmonary function testing results that were consistent with nonreversible small airways obstruction. One case had lung ventilation nuclear scan illustrated absent and reduced ventilation of the right lower lobe. Nine cases who underwent bronchoscopy were chronic endobronchial inflammation. Three children had transbronchial biopsy and 1 patient who underwent open pulmonary biopsies were uncertain of histological diagnosis. Chest radiography showed hyperinflation in 8 cases; peribronchial thickening in 6 cases; consolidation/atelectasia in 6 cases; unilateral hyperlucency of a small/normal-sized lung in 4 cases. Thin-section CT/HRCT features included: mosaic perfusion pattern, decreased lung attenuation in 11 cases, pulmonary vascular attenuation in 10 cases; bronchial dilatation in 7 cases; bronchial wall thickening in 9 cases; unilateral hyperlucency of a small/normal-sized lung in 5 cases; consolidation in 6 cases; nodular in 3 cases; mucoid impaction in 5 cases. Conclusions: In our study, correct diagnoses of bronchiolitis obliterans in children were made more special with thin-section CT than with chest radiographs. The diagnosis of BO in

Clinical Features of Patients with Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

Directory of Open Access Journals (Sweden)

Hai Chen

2016-01-01

Conclusion: The different CSF features combined with clinical, magnetic resonance imaging, and serum characteristics between Chinese patients with MS and NMOSD could assist in the differential diagnosis.

Children on hunger strike: child abuse or legitimate protest?

OpenAIRE

Mok, A.; Nelson, E. A.; Murphy, J.; Hampson, A.; Hendriks, J. H.

1996-01-01

The issue of children on hunger strike (voluntary total fasting) has not been reported before. The World Medical Association Declaration of Tokyo 1975 and the Declaration of Malta 1991 (revised 1992) provide clinicians with guidelines for the management of adult patients on hunger strike but do not mention children. We report the management of 14 Vietnamese children, aged 1 to 12 years, who took part in a hunger strike at a refugee detention centre in Hong Kong.

Expertise of using striking techniques for power stroke in badminton.

Science.gov (United States)

Zhu, Qin

2013-10-01

Two striking techniques (fast swing and angled striking) were examined to see if they allowed effective use of string tension for the power stroke in badminton. 12 participants (4 novices, 4 recreational, and 4 expert badminton players) were recorded by a fast-speed camera while striking a shuttlecock with racquets of 8 different string tensions. The peak speed of the shuttlecock, the racquet angle and the shuttlecock angle were analyzed. The results showed that expert players succeeded in using both striking techniques to overcome the constraint of string tension and produce a consistently superior stroke. Failure to use either striking technique resulted in inferior performance that was constrained by string tension. Expertise in badminton allows the necessary motor adjustments based on the affordance perception of the string tension.

Developing personal values: trainees' attitudes toward strikes by health care providers.

Science.gov (United States)

Li, Su-Ting T; Srinivasan, Malathi; Der-Martirosian, Claudia; Kravitz, Richard L; Wilkes, Michael S

2011-05-01

Worldwide, health care providers use strikes and job actions to influence policy. For health care providers, especially physicians, strikes create an ethical tension between an obligation to care for current patients (e.g., to provide care and avoid abandonment) and an obligation to better care for future patients by seeking system improvements (e.g., improvements in safety, to access, and in the composition and strength of the health care workforce). This tension is further intensified when the potential benefit of a strike involves professional self-interest and the potential risk involves patient harm or death. By definition, trainees are still forming their professional identities and values, including their opinions on fair wages, health policy, employee benefits, professionalism, and strikes. In this article, the authors explore these ethical tensions, beginning with a discussion of reactions to a potential 2005 nursing strike at the University of California, Davis, Medical Center. The authors then propose a conceptual model describing factors that may influence health care providers' decisions to strike (including personal ethics, personal agency, and strike-related context). In particular, the authors explore the relationship between training level and attitudes toward taking a job action, such as going on strike. Because trainees' attitudes toward strikes continue to evolve during training, the authors maintain that open discussion around the ethics of health care professionals' strikes and other methods of conflict resolution should be included in medical education to enhance professionalism and systems-based practice training. The authors include sample case vignettes to help initiate these important discussions. Copyright © by the Association of American medical Colleges.

Clinical and epidemiological features of AIDS/tuberculosis comorbidity

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Song Alice Tung Wan

2003-01-01

Full Text Available Considering the relevance of AIDS/tuberculosis comorbidity worldwide, especially in Brazil, this study was developed to describe the clinical and epidemiological features of the comorbid cases identified from 1989 to 1997 by the epidemiology service of the Hospital das Clínicas of the Universidade de São Paulo. METHODS: Databases containing information on all identified AIDS/tuberculosis cases cared for at the hospital were used to gather information on comorbid cases. RESULTS: During the period, 559 patients were identified as presenting with AIDS/tuberculosis comorbidity. Risk behavior for AIDS was primarily heterosexual contact (38.9%, followed by intravenous drug use (29.3% and homosexual/bisexual contact (23.2%. Regarding clinical features, there were higher rates of extrapulmonary tuberculosis when compared to tuberculosis without comorbidity. There was an increase in reporting of AIDS by ambulatory units during the period. Epidemiologically, there was a decrease in the male/female ratio, a predominance in the 20 to 39 year-old age group, and a majority of individuals who had less than 8 years of schooling and had low professional qualifications. CONCLUSIONS: High rates of AIDS/tuberculosis cases at our hospital indicate the need for better attention towards early detection of tuberculosis, especially in its extrapulmonary form. Since the population that attends this hospital tends to be of a lower socioeconomic status, better management of AIDS and tuberculosis is required to increase the rates of treatment adherence and thus lower the social costs.

Clinical Features and Differential Diagnoses in Laryngeal Mucoepidermoid Carcinoma

OpenAIRE

Mokhtari, Sepideh; Mokhtari, Saeedeh

2011-01-01

Mucoepidermoid carcinoma is the most common malignant tumor of salivary glands. However, it is a rare entity in larynx. Laryngeal cases are frequently misdiagnosed with other malignancies and they are under-reported. So, recognizing the clinical and histological features of this tumor is essential. Laryngeal mucoepidermoid carcinoma can arise in supraglottis, glottis and subglottis. Generally, it presents as a submucosal mass; therefore, progressive symptoms without any identifiable lesion in...

Effect of public transport strikes on air pollution levels in Barcelona (Spain).

Science.gov (United States)

Basagaña, Xavier; Triguero-Mas, Margarita; Agis, David; Pérez, Noemí; Reche, Cristina; Alastuey, Andrés; Querol, Xavier

2018-01-01

Public transport strikes can lead to an increase of the number of private vehicle trips, which in turn can increase air pollution levels. We aimed to estimate the change in air pollution concentrations during public transport strikes in the city of Barcelona (Spain). Data on strikes of the metro, train or bus systems were collected from government records (2005-2016). We collected daily concentrations of NOx; particulate matter with an aerodynamic diameter smaller than 10μm (PM10), 2.5μm (PM2.5), and 1μm (PM1); particle number concentration (N); black carbon (BC) and CO from research and official monitoring stations. We fitted linear regression models for each pollutant with the strike indicator as an independent variable, and models were adjusted for day of the week, month, year, and holiday periods. During the study period, there were 208days affected by a strike of the metro (28), train (106) or bus (91) systems. Half of the strikes were partial, most of them were single-day strikes, there was little overlap between strikes of the different transport systems, and all strikes had to comply with mandatory minimal services. When pooling all types of strikes, NOx and BC showed higher levels during strike days in comparison with non-strike days (increase between 4.1% and 7.7%, with higher increases for NO). The increases in these concentrations were more evident during full day and multiday metro strikes. In conclusion, alterations in public transport have consequences on air quality. This highlights the importance of public transport in reducing air pollution concentrations in cities. Copyright © 2017 Elsevier B.V. All rights reserved.

Impact of lightning strikes on hospital functions.

Science.gov (United States)

Mortelmans, Luc J M; Van Springel, Gert L J; Van Boxstael, Sam; Herrijgers, Jan; Hoflacks, Stefaan

2009-01-01

Two regional hospitals were struck by lightning during a one-month period. The first hospital, which had 236 beds, suffered a direct strike to the building. This resulted in a direct spread of the power peak and temporary failure of the standard power supply. The principle problems, after restoring standard power supply, were with the fire alarm system and peripheral network connections in the digital radiology systems. No direct impact on the hardware could be found. Restarting the servers resolved all problems. The second hospital, which had 436 beds, had a lightning strike on the premises and mainly experienced problems due to induction. All affected installations had a cable connection from outside in one way or another. The power supplies never were endangered. The main problem was the failure of different communication systems (telephone, radio, intercom, fire alarm system). Also, the electronic entrance control went out. During the days after the lightening strike, multiple software problems became apparent, as well as failures of the network connections controlling the technical support systems. There are very few ways to prepare for induction problems. The use of fiber-optic networks can limit damage. To the knowledge of the authors, these are the first cases of lightning striking hospitals in medical literature.

Clinical and microbiological features of melioidosis in northern Vietnam.

Science.gov (United States)

Phuong, Doan Mai; Trung, Trinh Thanh; Breitbach, Katrin; Tuan, Nguyen Quang; Nübel, Ulrich; Flunker, Gisela; Khang, Dinh Duy; Quang, Nguyen Xuan; Steinmetz, Ivo

2008-12-01

Sporadic cases of melioidosis have been reported from Vietnam for decades, but clinical and epidemiological data for the indigenous population are still scarce. In this study, we reviewed clinical and demographic data of patients with culture-proven melioidosis diagnosed at a single large referral hospital in Hanoi between November 1997 and December 2005. We found that the clinical manifestations of melioidosis (with fatal septicaemia as the most common presentation), a high rate of underlying diseases, and a peak of cases admitted during the wet season, were similar to studies from other endemic areas. The geographical origin of patients with melioidosis showed that melioidosis existed in at least 18 northern provinces. The characterization of clinical Burkholderia pseudomallei strains by multilocus sequence typing identified 17 different sequence types (STs), 11 of which have (as yet) not been found outside Vietnam. Several of these STs presumably were generated through recent evolutionary events in this rapidly diversifying bacterial species, and thus, restricted geographic distribution may be a consequence of limited time passed since emergence. To our knowledge, this is the first report on a series of cases describing clinical and epidemiological features of melioidosis and corresponding B. pseudomallei strains from northern Vietnam.

[Force-feeding of hunger-striking prisoners].

Science.gov (United States)

Glick, Shimon

2014-09-01

In contrast to the position of the World Medical Association and the Ethics Council of the Israel Medical Association, the author argues for forced-feeding of hunger-striking prisoners when their condition reaches a stage of danger of death or permanent injury. This position is based on the priority of human life over autonomy, and of a communitarian ethic. This position is supported by a District Court decision ordering the feeding of a hunger-striking prisoner, by a Supreme Court decision imposing surgery on a non-consenting prisoner, and in line with Israel's Patient's Right Law.

Strike-slip linked core complexes: A new kinematic model of basement rock exhumation in a crustal-scale fault system

Science.gov (United States)

Meyer, Sven Erik; Passchier, Cees; Abu-Alam, Tamer; Stüwe, Kurt

2014-05-01

Metamorphic core complexes usually develop as extensional features during continental crustal thinning, such as the Basin and Range and the Aegean Terrane. The Najd fault system in Saudi Arabia is a 2000 km-long and 400 km-wide complex network of crustal-scale strike-slip shear zones in a Neoproterozoic collision zone. Locally, the anastomosing shear zones lead to exhumation of lower crustal segments and represent a new kinematic model for the development of core complexes. We report on two such structures: the Qazaz complex in Saudi Arabia and the Hafafit complex in Egypt. The 15 km-wide Qazaz complex is a triangular dome of gently dipping mylonitic foliations within the 140 km-long sinistral strike-slip Qazaz mylonite zone. The gneissic dome consists of high-grade rocks, surrounded by low-grade metasediments and metavolcanics. The main SE-trending strike-slip Qazaz shear zone splits southwards into two branches around the gneiss dome: the western branch is continuous with the shallow dipping mylonites of the dome core, without overprinting, and changes by more than 90 degrees from a NS-trending strike-slip zone to an EW-trending 40 degree south-dipping detachment that bounds the gneiss dome to the south. The eastern SE-trending sinistral strike-slip shear zone branch is slightly younger and transects the central dome fabrics. The gneiss dome appears to have formed along a jog in the strike-slip shear zone during 40 km of horizontal strike-slip motion, which caused local exhumation of lower crustal rocks by 25 km along the detachment. The eastern shear zone branch formed later during exhumation, transacted the gneiss dome and offset the two parts by another 70 km. The Hafafit core complex in Egypt is of similar shape and size to the Qazaz structure, but forms the northern termination of a sinistral strike-slip zone that is at least 100 km in length. This zone may continue into Saudi Arabia as the Ajjaj shear zone for another 100 km. The NW trending strike slip

Strike kinematics and performance in juvenile ball pythons (Python regius).

Science.gov (United States)

Ryerson, William G; Tan, Weimin

2017-08-01

The rapid strike of snakes has interested researchers for decades. Although most work has focused on the strike performance of vipers, recent work has shown that other snakes outside of the Viperidae can strike with the same velocities and accelerations. However, to date all of these examples focus on performance in adult snakes. Here, we use high-speed video to measure the strike kinematics and performance of 10 juvenile (pythons, Python regius. We find that juvenile P. regius strike at levels comparable to larger snakes, but with shorter durations and over shorter distances. We conclude that the juvenile P. regius maintain performance likely through manipulation of the axial musculature and accompanying elastic tissues, and that this is a first step to understanding ontogenetic changes in behavior and a potential avenue for understanding how captivity may also impact behavior. © 2017 Wiley Periodicals, Inc.

effect of strikes on management and planning of educational ...

African Journals Online (AJOL)

Global Journal

Strike is an event that consumes and waste a lot of time which implies that ... from this paper. KEYWORDS: Strikes, Management, Planning, Educational, Activities, Universities ..... employers; and Introduction of new technology which affect the ...

Mechanical and geometric features of endodontic instruments and its clinical effect

OpenAIRE

Hyeon-Cheol Kim

2011-01-01

Introduction The aim of this paper is to discuss the mechanical and geometric features of Nickel-titanium (NiTi) rotary files and its clinical effects. NiTi rotary files have been introduced to the markets with their own geometries and claims that they have better ability for the root canal shaping than their competitors. The contents of this paper include the (possible) interrelationship between the geometries of NiTi file (eg. tip, taper, helical angle, etc) and clinical performance ...

Clinical features and endocrine profile of Laron syndrome in Indian children

OpenAIRE

Supriya R Phanse-Gupte; Vaman V Khadilkar; Anuradha V Khadilkar

2014-01-01

Introduction: Patients with growth hormone (GH) insensitivity (also known as Laron syndome) have been reported from the Mediterranean region and Southern Eucador, with few case reports from India. We present here the clinical and endocrine profile of 9 children with Laron syndrome from India. Material and Methods: Nine children diagnosed with Laron syndrome based on clinical features of GH deficiency and biochemical profile suggestive of GH resistance were studied over a period of 5 years fro...

Differential clinical features and stool findings in shigellosis and amoebic dysentery

NARCIS (Netherlands)

Speelman, P.; McGlaughlin, R.; Kabir, I.; Butler, T.

1987-01-01

To obtain information that could assist the clinician to differentiate between shigellosis and amoebic dysentery, we compared clinical features and stool findings in 58 adult male patients in Bangladesh. Mean values indicated that patients with invasive amoebiasis were older and had a longer

clinical features of malaria parasiteamia among children in parts of ...

African Journals Online (AJOL)

LUCY

This study was carried out to investigate the prevalence of malaria parasitamiae and its clinical features in children aged 0-5 years in parts of Delta State of Nigeria. Blood samples were randomly collected from the thumb of each child using the finger prick method. A total of 600 blood samples (360 males and 240 females) ...

MEVTV workshop on tectonic features on Mars

International Nuclear Information System (INIS)

Watters, T.R.; Golombek, M.P.

1989-01-01

The state of knowledge of tectonic features on Mars was determined and kinematic and mechanical models were assessed for their origin. Three sessions were held: wrinkle ridges and compressional structure; strike-slip faults; and extensional structures. Each session began with an overview of the features under discussion. In the case of wrinkle ridges and extensional structures, the overview was followed by keynote addresses by specialists working on similar structures on the Earth. The first session of the workshop focused on the controversy over the relative importance of folding, faulting, and intrusive volcanism in the origin of wrinkle ridges. The session ended with discussions of the origin of compressional flank structures associated with Martian volcanoes and the relationship between the volcanic complexes and the inferred regional stress field. The second day of the workshop began with the presentation and discussion of evidence for strike-slip faults on Mars at various scales. In the last session, the discussion of extensional structures ranged from the origin of grabens, tension cracks, and pit-crater chains to the origin of Valles Marineris canyons. Shear and tensile modes of brittle failure in the formation of extensional features and the role of these failure modes in the formation of pit-crater chains and the canyons of Valles Marineris were debated. The relationship of extensional features to other surface processes, such as carbonate dissolution (karst) were also discussed

Noonan syndrome: clinical features, diagnosis, and management guidelines.

Science.gov (United States)

Romano, Alicia A; Allanson, Judith E; Dahlgren, Jovanna; Gelb, Bruce D; Hall, Bryan; Pierpont, Mary Ella; Roberts, Amy E; Robinson, Wanda; Takemoto, Clifford M; Noonan, Jacqueline A

2010-10-01

Noonan syndrome (NS) is a common, clinically and genetically heterogeneous condition characterized by distinctive facial features, short stature, chest deformity, congenital heart disease, and other comorbidities. Gene mutations identified in individuals with the NS phenotype are involved in the Ras/MAPK (mitogen-activated protein kinase) signal transduction pathway and currently explain ∼61% of NS cases. Thus, NS frequently remains a clinical diagnosis. Because of the variability in presentation and the need for multidisciplinary care, it is essential that the condition be identified and managed comprehensively. The Noonan Syndrome Support Group (NSSG) is a nonprofit organization committed to providing support, current information, and understanding to those affected by NS. The NSSG convened a conference of health care providers, all involved in various aspects of NS, to develop these guidelines for use by pediatricians in the diagnosis and management of individuals with NS and to provide updated genetic findings.

Clinical features and endocrine profile of Laron syndrome in Indian children

Directory of Open Access Journals (Sweden)

Supriya R Phanse-Gupte

2014-01-01

Full Text Available Introduction: Patients with growth hormone (GH insensitivity (also known as Laron syndome have been reported from the Mediterranean region and Southern Eucador, with few case reports from India. We present here the clinical and endocrine profile of 9 children with Laron syndrome from India. Material and Methods: Nine children diagnosed with Laron syndrome based on clinical features of GH deficiency and biochemical profile suggestive of GH resistance were studied over a period of 5 years from January 2008 to January 2013. Results and Discussion: Age of presentation was between 2.5-11.5 years. All children were considerably short on contemporary Indian charts with mean (SD height Z score -5.2 (1.6. However, they were within ± 2 SD on Laron charts. No child was overweight [mean (SD BMI Z score 0.92 (1.1]. All children had characteristic facies of GH deficiency with an added feature of prominent eyes. Three boys had micropenis and 1 had unilateral undescended testis. All children had low IGF-1 (<5 percentile and IGFP-3 (<0.1 percentile with high basal and stimulated GH [Basal GH mean (SD = 13.78 (12.75 ng/ml, 1-h stimulated GH mean (SD = 46.29 (25.68 ng/ml]. All children showed poor response to IGF generation test. Conclusion: Laron syndrome should be suspected in children with clinical features of GH deficiency, high GH levels and low IGF-1/IGFBP-3. These children are in a state of GH resistance and need IGF-1 therapy.

When strike comes to town... anticipated and actual behavioural reactions to a one-day, pre-announced, complete rail strike in the Netherlands

NARCIS (Netherlands)

Rietveld, P.; Exel, N.J.A.

2009-01-01

We conducted secondary analysis on data collected among rail users, days before and after a national rail strike in the Netherlands. Our aim was to compare anticipated and actual behavioural reactions to the rail strike, investigate associations with traveller and trip characteristics, and perceived

Continental United States Hurricane Strikes

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Continental U.S. Hurricane Strikes Poster is our most popular poster which is updated annually. The poster includes all hurricanes that affected the U.S. since...

Radiologic and clinical features of idiopathic granulomatous lobular mastitis mimicking advanced breast cancer.

Science.gov (United States)

Lee, Jei Hee; Oh, Ki Keun; Kim, Eun-kyung; Kwack, Kyu Sung; Jung, Woo Hee; Lee, Han Kyung

2006-02-28

Idiopathic granulomatous lobular mastitis (IGLM), also known as idiopathic granulomatous mastitis, is a rare chronic inflammatory lesion of the breast that can clinically and radiographically mimic breast carcinoma. The aim of this study was to describe the radiological imaging and clinical features of IGLM in order to better differentiate this disorder from breast cancer. We performed a retrospective analysis of the clinical and radiographic features of 11 women with a total of 12 IGLM lesions. The ages of these women ranged between 29 and 42 years, with a mean age of 34.8 years. Ten patients were examined by both mammography and sonography and one by sonography alone. The sites that were the most frequently involved were the peripheral (6/12), diffuse, (3/12), and subareolar (3/12) regions of the breast. The patient mammograms showed irregular ill-defined masses (7/11), diffuse increased densities (3/11), and one oval obscured mass. In addition, patient sonograms showed irregular tubular lesions (7/12) or lobulated masses with minimal parenchymal distortion (2/12), parenchymal distortion without definite mass lesions (2/12), and one oval mass. Subcutaneous fat obliteration (12/12) and skin thickening (11/12) were also observed in these patients. Contrary to previous reports, skin changes and subareolar involvement were not rare occurrences in IGLM. In conclusion, the sonographic features of IGLM show irregular or tubular hypoechoic masses with minimal parenchymal distortion. Both clinical information and the description of radiographic features of IGLM may aid in the differentiation between IGLM and breast cancer, however histological confirmation is still required for the proper diagnosis and treatment of the disorder.

Diagnosis of Hair Loss: Clinical features of common causes of hair loss

OpenAIRE

Coupe, Robert L.M.

1992-01-01

Common causes of hair loss include androgenic hair loss, alopecia areata, trichotillomania, tinea capitis, telogen effluvium, and traction alopecia. The author discusses their distinguishing clinical features and those of less common alopecias.

Strike-Slip Fault Deformation and Its Control in Hydrocarbon Trapping in Ketaling Area, Jambi Subbasin, Indonesia

Science.gov (United States)

Ramadhan, Aldis; Badai Samudra, Alexis; Jaenudin; Puji Lestari, Enik; Saputro, Julian; Sugiono; Hirosiadi, Yosi; Amrullah, Indi

2018-03-01

Geologically, Ketaling area consists of a local high considered as flexure margin of Tempino-Kenali Asam Deep in west part and graben in east part also known as East Ketaling Deep. Numerous proven plays were established in Ketaling area with reservoir in early Miocene carbonate and middle Miocene sand. This area underwent several major deformations. Faults are developed widely, yet their geometrical features and mechanisms of formation remained so far indistinct, which limited exploration activities. With new three-dimensional seismic data acquired in 2014, this area evidently interpreted as having strike-slip mechanism. The objective of this study is to examine characteristic of strike slip fault and its affect to hydrocarbon trapping in Ketaling Area. Structural pattern and characteristic of strike slip fault deformation was examined with integration of normal seismic with variance seismic attribute analysis and the mapping of Syn-rift to Post-rift horizon. Seismic flattening on 2D seismic cross section with NW-SE direction is done to see the structural pattern related to horst (paleohigh) and graben. Typical flower structure, branching strike-slip fault system and normal fault in synrift sediment clearly showed in section. An echelon pattern identified from map view as the result of strike slip mechanism. Detail structural geology analysis show the normal fault development which has main border fault in the southern of Ketaling area dipping to the Southeast-East with NE-SW lineament. These faults related to rift system in Ketaling area. NW-SE folds with reactive NE-SW fault which act as hydrocarbon trapping in the shallow zone. This polyphase tectonic formed local graben, horst and inverted structure developed a good kitchen area (graben) and traps (horst, inverted structure). Subsequently, hydrocarbon accumulation potentials such as basement fractures, inverted syn-rift deposit and shallow zone are very interesting to explore in this area.

Surgery planning and navigation by laser lithography plastic replica. Features, clinical applications, and advantages

International Nuclear Information System (INIS)

Kihara, Tomohiko; Tanaka, Yuuko; Furuhata, Kentaro

1995-01-01

The use of three-dimensional replicas created using laserlithography has recently become popular for surgical planning and intraoperative navigation in plastic surgery and oral maxillofacial surgery. In this study, we investigated many clinical applications that we have been involved in regarding the production of three-dimensional replicas. We have also analyzed the features, application classes, and advantages of this method. As a result, clinical applications are categorized into three classes, which are 'three-dimensional shape recognition', 'simulated surgery', and 'template'. The distinct features of three-dimensional replicas are 'direct recognition', 'fast manipulation', and 'free availability'. Meeting the requirements of surgical planning and intraoperative navigation, they have produced satisfactory results in clinical applications. (author)

Stargardt disease: clinical features, molecular genetics, animal models and therapeutic options

OpenAIRE

Tanna, P.; Strauss, R. W.; Fujinami, K.; Michaelides, M.

2017-01-01

Stargardt disease (STGD1; MIM 248200) is the most prevalent inherited macular dystrophy and is associated with disease-causing sequence variants in the gene ABCA4 Significant advances have been made over the last 10 years in our understanding of both the clinical and molecular features of STGD1, and also the underlying pathophysiology, which has culminated in ongoing and planned human clinical trials of novel therapies. The aims of this review are to describe the detailed phenotypic and genot...

Stargardt disease: clinical features, molecular genetics, animal models and therapeutic options

OpenAIRE

Tanna, Preena; Strauss, Rupert W; Fujinami, Kaoru; Michaelides, Michel

2016-01-01

Stargardt disease (STGD1; MIM 248200) is the most prevalent inherited macular dystrophy and is associated with disease-causing sequence variants in the gene ABCA4. Significant advances have been made over the last 10?years in our understanding of both the clinical and molecular features of STGD1, and also the underlying pathophysiology, which has culminated in ongoing and planned human clinical trials of novel therapies. The aims of this review are to describe the detailed phenotypic and geno...

Eccrine Porocarcinoma: Patient Characteristics, Clinical and Histopathologic Features, and Treatment in 7 Cases.

Science.gov (United States)

Gómez-Zubiaur, A; Medina-Montalvo, S; Vélez-Velázquez, M D; Polo-Rodríguez, I

2017-05-01

Eccrine porocarcinoma is a rare, malignant cutaneous adnexal tumor that arises from the ducts of sweat glands. Found mainly in patients of advanced age, this tumor has diverse clinical presentations. Histology confirms the diagnosis, detects features relevant to prognosis, and guides treatment. Growth is slow, but the prognosis is poor if the tumor metastasizes to lymph nodes or visceral organs. We report 7 cases of eccrine porocarcinoma, describing patient characteristics, the clinical and histopathologic features of the tumors, and treatments used. Our observations were similar to those of other published case series. Given the lack of therapeutic algorithms or protocols for this carcinoma, we propose a decision-making schema based on our review of the literature and our experience with this case series. The algorithm centers on sentinel lymph node biopsy and histologic features. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Clinical and genetic features of ataxia-telangiectasia

International Nuclear Information System (INIS)

Bundey, S.

1994-01-01

There are several variants of ataxia-telangiectasia (A-T): classical A-T with marked radiation sensitivity; classical A-T with intermediate levels of radiation sensitivity; mild A-T with intermediate levels of radiation sensitivity; A-T without telangiectasia; A-T without oculomoto apraxia; and A-T with microcephaly. These disorders are probably caused by different allelic mutations, because affected sibs resemble the index patients, and because there is an association of certain haplo-types of 11q22-23 with specific phenotypes. The Nijmegen Breakage Syndrome, with its lack of ataxia, seems on clinical grounds to be a different disorder. Although A-T is almost always inherited as an autosomal recessive, there are some unusual features; an unexpectedly low parental consanguinity rate, an incidence in sibs that is < 0.25, and occurrence of disease in many different races and in the offspring of mixed race unions. Moreover, looking at haplotypes from 63 UK patients, there is a remarkably low incidence of homozygosity. An autosomal recessive condition that is deficient in parental consanguinity, and in homozygosity for the region around the gene, can be explained by J.H. Edwards' hypothesis that homozygosity for alleles at a neighbouring locus are lethal early in embryogenesis. Other possible mechanisms to explain the unusual genetic features are discussed. (author)

Miners' strike 1984-85

Energy Technology Data Exchange (ETDEWEB)

Brown, L; Salter, S [comps.

1985-01-01

References relating to the 1984-85 UK miners strike are listed under the following subject headings: events and analysis - a chronological record; short term effects - coal stocks and supplies, electricity supplies, financial, industrial and economic; the miners and their leadership; social aspects - civil liberties, media coverage, mining communities, picketing, policing, the future; pit closures. 240 references.

Cardiovascular Disease and 10-Year Mortality in Postmenopausal Women with Clinical Features of Polycystic Ovary Syndrome.

Science.gov (United States)

Merz, C Noel Bairey; Shaw, Leslee J; Azziz, Ricardo; Stanczyk, Frank Z; Sopko, George; Braunstein, Glenn D; Kelsey, Sheryl F; Kip, Kevin E; Cooper-DeHoff, Rhonda M; Johnson, B Delia; Vaccarino, Viola; Reis, Steven E; Bittner, Vera; Hodgson, T Keta; Rogers, William; Pepine, Carl J

2016-09-01

Women with polycystic ovary syndrome (PCOS) have greater cardiac risk factor clustering but the link with mortality is incompletely described. To evaluate outcomes in 295 postmenopausal women enrolled in the National Institutes of Health-National Heart, Lung, and Blood Institute (NIH-NHLBI) sponsored Women's Ischemia Syndrome Evaluation (WISE) study according to clinical features of PCOS. A total of 25/295 (8%) women had clinical features of PCOS defined by a premenopausal history of irregular menses and current biochemical evidence of hyperandrogenemia, defined as the top quartile of androstenedione (≥701 pg/mL), testosterone (≥30.9 ng/dL), or free testosterone (≥4.5 pg/mL). Cox proportional hazard model estimated death (n = 80). Women with clinical features of PCOS had an earlier menopause (p = 0.01), were more often smokers (p PCOS (n = 270) (p = 0.85). PCOS was not a significant predictor (p = NS) in prognostic models including diabetes, waist circumference, hypertension, and angiographic CAD. From this longer-term follow up of a relatively small cohort of postmenopausal women with suspected ischemia, the prevalence of PCOS is similar to the general population, and clinical features of PCOS are not associated with CAD or mortality. These findings question whether identification of clinical features of PCOS in postmenopausal women who already have known cardiovascular disease provides any additional opportunity for risk factor intervention.

Clinical Features in a Danish Population-Based Cohort of Probable Multiple System Atrophy Patients

DEFF Research Database (Denmark)

Starhof, Charlotte; Korbo, Lise; Lassen, Christina Funch

2016-01-01

Background: Multiple system atrophy (MSA) is a rare, sporadic and progressive neurodegenerative disorder. We aimed to describe the clinical features of Danish probable MSA patients, evaluate their initial response to dopaminergic therapy and examine mortality. Methods: From the Danish National...... the criteria for probable MSA. We recorded clinical features, examined differences by MSA subtype and used Kaplan-Meier survival analysis to examine mortality. Results: The mean age at onset of patients with probable MSA was 60.2 years (range 36-75 years) and mean time to wheelchair dependency was 4.7 years...

Incidence, epidemiology and clinical features of Kawasaki disease in Catalonia, Spain.

Science.gov (United States)

Sánchez-Manubens, Judith; Antón, Jordi; Bou, Rosa; Iglesias, Estíbaliz; Calzada-Hernandez, Joan

2016-01-01

To assess the incidence, epidemiology and clinical features of Kawasaki disease (KD) in Catalonia (northeast region of Spain). This was an observational population-based study including all Paediatric Units in Catalonia, under both public and private management. Retrospective data retrieval was performed for 10 years (2004-2013). A 12-month (March 2013 to March 2014) prospective collection of new cases of KD was carried out to determine the incidence of KD. Data from 399 patients over the 10-year study period was analysed, revealing that 233 (58.4%) had complete KD, 159 (39.8) incomplete KD and 7 (1.7%) were considered atypical KD. Mean annual incidence was 3.5/105 children 10(th) day of illness, ages 8 yo and the presence of sterile piuria, aseptic meningitis, abdominal pain and uveitis at diagnosis were found to have higher risk of coronary aneurisms (CAA) (pIncidence, clinical features and treatment plans in our cohort are similar to those described in other European studies.

Addison's disease due to adrenal tuberculosis: Contrast-enhanced CT features and clinical duration correlation

International Nuclear Information System (INIS)

Guo Yingkun; Yang Zhigang; Li Yuan; Ma Ensen; Deng Yuping; Min Pengqiu; Yin Longlin; Hu Jian; Zhang Xiaochun; Chen Tianwu

2007-01-01

Purpose: To describe CT morphology of untreated adrenal tuberculosis during the different stages of the natural history of the disease and to evaluate the diagnostic implications of CT features. Materials and methods: We retrospectively evaluated CT features in 42 patients with documented adrenal tuberculosis for the location, size, morphology, and enhancement patterns shown on CT images. The clinical duration were correlated with the CT features. Results: Of the 42 patients with untreated adrenal tuberculosis, bilaterally enlarged adrenal glands were revealed in 38 cases (91%), unilaterally enlarged in 3 cases (7%), and normal size in 1 case (2%). Of the 41 cases (98%) with enlargement, mass-like enlargement was seen in 20 cases (49%) and enlargement with preserved contours in 21 cases (51%). Peripheral rim enhancement presented in 22 cases (52%) on contrast-enhanced CT. Non-enhanced CT scan revealed calcification in 21 cases (50%). As the duration of Addison's disease increased, the presence of calcification and contour preservation increased concomitantly (p < 0.001), whereas peripheral rim enhancement and mass-like enlargement decreased concomitantly on CT images (p < 0.001). Conclusion: CT may be helpful in diagnosing adrenal tuberculosis when clinically suspected, and CT features are correlated to the clinical duration of Addison's disease

Analysis of clinical features and risk factors for infective endocarditis

International Nuclear Information System (INIS)

Wang Li; Zhao Liangping; Xu Weiting; Chen Jianchang; Tong Guangming; Hong Xiaosu

2012-01-01

Objective: To analyze the clinical features of infective endocarditis (IE) and explore the risk factors for it's prognosis. Methods: Clinical data of 65 patients with IE were acquired retrospectively, and its causes, clinical characteristics, pathogenic microorganism, clinical outcomes were analyzed. Results: The major occurring heart diseases for IE in all patients were rheumatic heart disease, congenital heart disease, and there was no any previously known heart disease. The major clinical manifestations included fever and anemia. The major pathogenic bacteria is streptococcus, but percentage of other bacteria increased gradually. Thirteen patients were refractory, in hospital. Haematoglobin and seralbumin were significantly lower, and leucocyte, hsCRP, erythrocyte sedimentation were significantly higher in refractory group. Anaemia, lower seralbumin, higher hsCRP were independent predictors for bad prognosis. Conclusion: The proportion of rheumatic heart disease is decreasing as one of the risk factors for IE in recent years. Streptococcus is major pathogen of IE, and the mortality of IE is still very high. Anaemia, lower seralbumin, higher hsCRP are independent predictors for bad prognosis. (authors)

Clinical features, proximate causes, and consequences of active convulsive epilepsy in Africa

Science.gov (United States)

Kariuki, Symon M; Matuja, William; Akpalu, Albert; Kakooza-Mwesige, Angelina; Chabi, Martin; Wagner, Ryan G; Connor, Myles; Chengo, Eddie; Ngugi, Anthony K; Odhiambo, Rachael; Bottomley, Christian; White, Steven; Sander, Josemir W; Neville, Brian G R; Newton, Charles R J C

2014-01-01

Purpose Epilepsy is common in sub-Saharan Africa (SSA), but the clinical features and consequences are poorly characterized. Most studies are hospital-based, and few studies have compared different ecological sites in SSA. We described active convulsive epilepsy (ACE) identified in cross-sectional community-based surveys in SSA, to understand the proximate causes, features, and consequences. Methods We performed a detailed clinical and neurophysiologic description of ACE cases identified from a community survey of 584,586 people using medical history, neurologic examination, and electroencephalography (EEG) data from five sites in Africa: South Africa; Tanzania; Uganda; Kenya; and Ghana. The cases were examined by clinicians to discover risk factors, clinical features, and consequences of epilepsy. We used logistic regression to determine the epilepsy factors associated with medical comorbidities. Key Findings Half (51%) of the 2,170 people with ACE were children and 69% of seizures began in childhood. Focal features (EEG, seizure types, and neurologic deficits) were present in 58% of ACE cases, and these varied significantly with site. Status epilepticus occurred in 25% of people with ACE. Only 36% received antiepileptic drugs (phenobarbital was the most common drug [95%]), and the proportion varied significantly with the site. Proximate causes of ACE were adverse perinatal events (11%) for onset of seizures before 18 years; and acute encephalopathy (10%) and head injury prior to seizure onset (3%). Important comorbidities were malnutrition (15%), cognitive impairment (23%), and neurologic deficits (15%). The consequences of ACE were burns (16%), head injuries (postseizure) (1%), lack of education (43%), and being unmarried (67%) or unemployed (57%) in adults, all significantly more common than in those without epilepsy. Significance There were significant differences in the comorbidities across sites. Focal features are common in ACE, suggesting identifiable and

Cockayne's syndrome: correlation of clinical features with cellular sensitivity of RNA synthesis to UV irradiation

Energy Technology Data Exchange (ETDEWEB)

Lehmann, A.R.; Thompson, A.F.; Harcourt, S.A. (Medical Research Council, Brighton (United Kingdom). Cell Mutation Unit); Stefanini, Miria (Consiglio Nazionale delle Ricerche, Pavia (Italy). Ist. di Genetica Biochimica ed Evoluzionistica); Norris, P.G. (Addenbrooke' s Hospital, Cambridge (United Kingdom))

1993-08-01

Cockayne's syndrome (CS) is a rare autosomal recessive disorder with dwarfism, mental retardation, and otherwise clinically heterogeneous features. In cultured CS fibroblasts, the failure of RNA synthesis to recover to normal rates after UV-C irradiation provides a useful and relatively simple diagnostic test. We have measured post-UV-C RNA synthesis in 52 patients for whom a clinical diagnosis of CS was considered a possibility. Twenty-nine patients showed the defect characteristic of CS cells, and 23 had a normal response. We have attempted to correlate the cellular diagnosis with the different clinical features of the disorder. Clinical details of the patients were obtained from referring clinicians in the form of a questionnaire. Our results show that, apart from the cardinal features of dwarfism and mental retardation, sun sensitivity correlated best with a positive cellular diagnosis. Pigmentary retinopathy, gait defects, and dental caries were also good positive indicators, although several patients with a positive cellular diagnosis did not have these features. (Author).

Prediction of renal mass aggressiveness using clinical and radiographic features: a global, multicentre prospective study

NARCIS (Netherlands)

Golan, Shay; Eggener, Scott; Subotic, Svetozar; Barret, Eric; Cormio, Luigi; Naito, Seiji; Tefekli, Ahmet; Pilar Laguna Pes, M.

2016-01-01

To examine the ability of preoperative clinical characteristics to predict histological features of renal masses (RMs). Data from consecutive patients with clinical stage I RMs treated surgically between 2010 and 2011 in the Clinical Research Office of Endourology Society (CROES) Renal Mass Registry

Variation in foot strike patterns during running among habitually barefoot populations.

Science.gov (United States)

Hatala, Kevin G; Dingwall, Heather L; Wunderlich, Roshna E; Richmond, Brian G

2013-01-01

Endurance running may have a long evolutionary history in the hominin clade but it was not until very recently that humans ran wearing shoes. Research on modern habitually unshod runners has suggested that they utilize a different biomechanical strategy than runners who wear shoes, namely that barefoot runners typically use a forefoot strike in order to avoid generating the high impact forces that would be experienced if they were to strike the ground with their heels first. This finding suggests that our habitually unshod ancestors may have run in a similar way. However, this research was conducted on a single population and we know little about variation in running form among habitually barefoot people, including the effects of running speed, which has been shown to affect strike patterns in shod runners. Here, we present the results of our investigation into the selection of running foot strike patterns among another modern habitually unshod group, the Daasanach of northern Kenya. Data were collected from 38 consenting adults as they ran along a trackway with a plantar pressure pad placed midway along its length. Subjects ran at self-selected endurance running and sprinting speeds. Our data support the hypothesis that a forefoot strike reduces the magnitude of impact loading, but the majority of subjects instead used a rearfoot strike at endurance running speeds. Their percentages of midfoot and forefoot strikes increased significantly with speed. These results indicate that not all habitually barefoot people prefer running with a forefoot strike, and suggest that other factors such as running speed, training level, substrate mechanical properties, running distance, and running frequency, influence the selection of foot strike patterns.

Variation in foot strike patterns during running among habitually barefoot populations.

Directory of Open Access Journals (Sweden)

Kevin G Hatala

Full Text Available Endurance running may have a long evolutionary history in the hominin clade but it was not until very recently that humans ran wearing shoes. Research on modern habitually unshod runners has suggested that they utilize a different biomechanical strategy than runners who wear shoes, namely that barefoot runners typically use a forefoot strike in order to avoid generating the high impact forces that would be experienced if they were to strike the ground with their heels first. This finding suggests that our habitually unshod ancestors may have run in a similar way. However, this research was conducted on a single population and we know little about variation in running form among habitually barefoot people, including the effects of running speed, which has been shown to affect strike patterns in shod runners. Here, we present the results of our investigation into the selection of running foot strike patterns among another modern habitually unshod group, the Daasanach of northern Kenya. Data were collected from 38 consenting adults as they ran along a trackway with a plantar pressure pad placed midway along its length. Subjects ran at self-selected endurance running and sprinting speeds. Our data support the hypothesis that a forefoot strike reduces the magnitude of impact loading, but the majority of subjects instead used a rearfoot strike at endurance running speeds. Their percentages of midfoot and forefoot strikes increased significantly with speed. These results indicate that not all habitually barefoot people prefer running with a forefoot strike, and suggest that other factors such as running speed, training level, substrate mechanical properties, running distance, and running frequency, influence the selection of foot strike patterns.

Hypertrophic cardiomyopathy in infants: clinical features and natural history

International Nuclear Information System (INIS)

Maron, B.J.; Tajik, A.J.; Ruttenberg, H.D.; Graham, T.P.; Atwood, G.F.; Victorica, B.E.; Lie, J.T.; Roberts, W.C.

1982-01-01

The clinical and morphologic features of hypertrophic cardiomyopathy in 20 patients recognized as having cardiac disease in the first year of life are described. Fourteen of these 20 infants were initially suspected of having heart disease solely because a heart murmur was identified. However, the infants showed a variety of clinical findings, including signs of marked congestive heart failure (in the presence of nondilated ventricular cavities and normal or increased left ventricular contractility) and substantial cardiac enlargement on chest radiograph. Other findings were markedly different from those usually present in older children and adults with hypertrophic cardiomyopathy (e.g., right ventricular hypertrophy on the ECG and cyanosis). Consequently, in 14 infants, the initial clinical diagnosis was congenital cardiac malformation other than hypertrophic cardiomyopathy. The clinical course was variable in these patients, but the onset of marked congestive heart failure in the first year of life appeared to be an unfavorable prognostic sign; nine of the 11 infants with congestive heart failure died within the first year of life. In infants with hypertrophic cardiomyopathy, unlike older children and adults with this condition, sudden death was less common (two patients) than death due to progressive congestive heart failure

Clinical and laboratory features of 48 feline hyperthyroidism cases in Japan

Directory of Open Access Journals (Sweden)

Shinichi Namba

2014-02-01

Full Text Available Feline hyperthyroidism (HT is a common endocrine disorder worldwide, but clinical and laboratory features might vary geographically. The aim of this retrospective study was to evaluate feline HT in Japan, and compare results to those of previous study for feline HT. We evaluated 48 feline HT cases clinical and laboratory features. Surprisingly, the youngest patient was 32 months of age (2 year 9 months. There was no significant difference among the study subjects in sex, but frequency of spayed/castrated cats was high (85.4%. Median age was 186 months (32-272 months. 91.3% (n=42 of subjects were over 10 years of age, and 8.7% (n=4 were under 10 years of age. Clinical symptoms included vomiting, 56.3% (n=27; diarrhea, 2.1% (n=1; hyperactivity, 12.5% (n=6; emaciation, 41.7% (n=20; polyuria and polydipsia, 22.9% (n=11; chronic weight loss, 60.4% (n=29; and palpated enlarged thyroid, 2.1% (n=1. Concurrent findings included chronic kidney disease, 20.8% (n=10; congestive heart failure, 20.8% (n=10; tachycardia (over 240 beats/min, 18.8% (n=9; gallop rhythm, 31.3% (n=15; neurological disorders such as hind-limb paralysis, 14.6% (n=7; cystitis, 8.7% (n=4; gingivitis, 4.2% (n=2; diabetes mellitus, 4.2% (n=2; and arterial thromboembolism, 6.3% (n=3. In addition, laboratory features (complete blood counts and biochemistry differed from those of previous reports in certain respects. Our results show that it might be important for practitioners to comprehend epidemiologic differences regarding feline HT worldwide.

[Study on computed tomography features of nasal septum cellule and its clinical significance].

Science.gov (United States)

Huang, Dingqiang; Li, Wanrong; Gao, Liming; Xu, Guanqiang; Ou, Xiaoyi; Tang, Guangcai

2008-03-01

To investigate the features of nasal septum cellule in computed tomographic (CT) images and its clinical significance. CT scans data of nasal septum in 173 patients were randomly obtained from January 2001 to June 2005. Prevalence and clinical features were summarized in the data of 19 patients with nasal septum cellule retrospectively. (1) Nineteen cases with nasal septum cellule were found in 173 patients. (2) All nasal septum cellule of 19 cases located in perpendicular plate of the ethmoid bone, in which 8 cases located in upper part of nasal septum and 11 located in middle. (3) There were totally seven patients with nasal diseases related to nasal septum cellule, in which 3 cases with inflammation, 2 cases with bone fracture, 1 case with cholesterol granuloma, 1 case with mucocele. Nasal septum cellule is an anatomic variation of nasal septum bone, and its features can provide further understanding of some diseases related to nasal septum cellule.

Algab õppus "Saber Strike"

Index Scriptorium Estoniae

2014-01-01

Täna algab Eestis, Lätis ja Leedus Ameerika Ühendriikide Euroopa väekoondise õppus "Saber Strike", mille eesmärk on maaväeüksuste koostöö harjutamine. Õppusest võtab osa üle 2000 kaitseväelase Baltimaadest, USAst, Ühendkuningriigist, Taanist, Norrast, Soomest ja Saksamaalt. Eestist osaleb õppusel ligi 400 kaitseväelast

Central hyperadrenergic state after lightning strike.

Science.gov (United States)

Parsaik, Ajay K; Ahlskog, J Eric; Singer, Wolfgang; Gelfman, Russell; Sheldon, Seth H; Seime, Richard J; Craft, Jennifer M; Staab, Jeffrey P; Kantor, Birgit; Low, Phillip A

2013-08-01

To describe and review autonomic complications of lightning strike. Case report and laboratory data including autonomic function tests in a subject who was struck by lightning. A 24-year-old man was struck by lightning. Following that, he developed dysautonomia, with persistent inappropriate sinus tachycardia and autonomic storms, as well as posttraumatic stress disorder (PTSD) and functional neurologic problems. The combination of persistent sinus tachycardia and episodic exacerbations associated with hypertension, diaphoresis, and agitation was highly suggestive of a central hyperadrenergic state with superimposed autonomic storms. Whether the additional PTSD and functional neurologic deficits were due to a direct effect of the lightning strike on the central nervous system or a secondary response is open to speculation.

Acne severity grading: determining essential clinical components and features using a Delphi consensus.

Science.gov (United States)

Tan, Jerry; Wolfe, Barat; Weiss, Jonathan; Stein-Gold, Linda; Bikowski, Joseph; Del Rosso, James; Webster, Guy F; Lucky, Anne; Thiboutot, Diane; Wilkin, Jonathan; Leyden, James; Chren, Mary-Margaret

2012-08-01

There are multiple global scales for acne severity grading but no singular standard. Our objective was to determine the essential clinical components (content items) and features (property-related items) for an acne global grading scale for use in research and clinical practice using an iterative method, the Delphi process. Ten acne experts were invited to participate in a Web-based Delphi survey comprising 3 iterative rounds of questions. In round 1, the experts identified the following clinical components (primary acne lesions, number of lesions, extent, regional involvement, secondary lesions, and patient experiences) and features (clinimetric properties, ease of use, categorization of severity based on photographs or text, and acceptance by all stakeholders). In round 2, consensus for inclusion in the scale was established for primary lesions, number, sites, and extent; as well as clinimetric properties and ease of use. In round 3, consensus for inclusion was further established for categorization and acceptance. Patient experiences were excluded and no consensus was achieved for secondary lesions. The Delphi panel consisted solely of the United States (U.S.)-based acne experts. Using an established method for achieving consensus, experts in acne vulgaris concluded that an ideal acne global grading scale would comprise the essential clinical components of primary acne lesions, their quantity, extent, and facial and extrafacial sites of involvement; with features of clinimetric properties, categorization, efficiency, and acceptance. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

VARIATION OF STRIKE INCENTIVES WITH DAMAGE PREFERENCES; FINAL

International Nuclear Information System (INIS)

G. CANAVAN

2001-01-01

For START III level forces, strike allocations and magnitudes vary little with L, but first strike costs vary directly with L, which means that for K reflecting a preference for the survival of high value targets over their destruction and a preference for high value over military targets, the costs of action are far greater than those of inaction for a wide range of values of damage preference L. Thus, if both sides have much greater preferences for the survival of their high value targets than for military targets or destruction, they do not see a net incentive to strike, and crises are terminated by inaction. Recent decades suggest strong preferences for the survival of high value and that this has contributed to the lack of direct conflict during that period

Laterality of repetitive finger movement performance and clinical features of Parkinson's disease.

Science.gov (United States)

Stegemöller, Elizabeth; Zaman, Andrew; MacKinnon, Colum D; Tillman, Mark D; Hass, Chris J; Okun, Michael S

2016-10-01

Impairments in acoustically cued repetitive finger movement often emerge at rates near to and above 2Hz in persons with Parkinson's Disease (PD) in which some patients move faster (hastening) and others move slower (bradykinetic). The clinical features impacting this differential performance of repetitive finger movement remain unknown. The purpose of this study was to compare repetitive finger movement performance between the more and less affected side, and the difference in clinical ratings among performance groups. Forty-one participants diagnosed with idiopathic PD completed an acoustically cued repetitive finger movement task while "on" medication. Eighteen participants moved faster, 10 moved slower, and 13 were able to maintain the appropriate rate at rates above 2Hz. Clinical measures of laterality, disease severity, and the UPDRS were obtained. There were no significant differences between the more and less affected sides regardless of performance group. Comparison of disease severity, tremor, and rigidity among performance groups revealed no significant differences. Comparison of posture and postural instability scores revealed that the participants that demonstrated hastening had worse posture and postural instability scores. Consideration of movement rate during the clinical evaluation of repetitive finger movement may provide additional insight into varying disease features in persons with PD. Copyright © 2016 Elsevier B.V. All rights reserved.

Clinical and MRI features in pediatric multiple sclerosis

International Nuclear Information System (INIS)

Zhao Cailei; Xie Sheng; Xiao Jiangxi; Wang Shuang

2011-01-01

Objective: To investigate the clinical and MRI features of multiple sclerosis in children, including the clinically isolated syndrome (CIS) and relapse. Methods: In total, 16 cases of pediatric multiple sclerosis were included in this study. Of them, 11 patients were female and 5 were male, with the mean onset age of 10.1 years. They were followed up for 4 months to 7 years and found to have 1- 5 relapses. The clinical manifestations of CIS and relapse were analyzed by a pediatric neurologist. An experienced neuroradiologist reviewed the MRI images of CIS and relapse. Information on the location, size, and pattern of the lesions was gathered. The location of lesions included subcortical, central, and periventricular white matter, cortex, deep gray matter, brain stem, and cerebellum. Results: CIS episode presented acute onsets in 13/16 cases, with symptoms of cortices in 10 cases and visual impairment in 6 cases. Relapse occurred in 14/16 cases within one year. The incidence of symptoms of cortices was less frequent and severe in the second episode of MS, whereas the visual impairment had a high incidence. All patients had full recovery after the last episode. MRI of CIS showed confluent subcortical white matter lesions in 13/16 cases, abutting on central white matter lesions. The most frequently involved brain part was the frontal lobe, followed by the parietal lobe. Cortical involvement was observed in 9/16 cases. In 6 cases, periventricular white matter lesions were detected. Bilateral deep gray matter was abnormal in 4 cases. Other abnormalities included brain stem lesions in 5 cases, cerebellum lesions in 3 cases, optic nerve involvement in 3 cases, and pyramidal tract lesions in 2 cases. MRI of relapse revealed more small lesions in the subcortical and periventricular white matter in the patients. In the second episode, only 2 cases presented cortical involvement. Lesions were found in the brain stem in 4 cases and in the cerebellum in 5 cases. Pyramidal tract

Foot-strike haemolysis in an ultramarathon runner.

Science.gov (United States)

Fazal, Abid A; Whittemore, Mary S; DeGeorge, Katharine C

2017-12-13

This case report describes mild anaemia and intravascular haemolysis in an otherwise healthy 41-year-old ultramarathon runner. In long-distance endurance athletes, trace gastrointestinal bleeding and plasma volume expansion are recognised sources of mild anaemia, often found incidentally. However, repetitive forceful foot striking can lead to blood cell lysis in the feet, resulting in a mild macrocytic anaemia and intravascular haemolysis, as was demonstrated in the patient described herein. Mild anaemia in runners, often called 'runner's pseudoanaemia', is typically clinically insignificant and does not require intervention. However, an unexplained anaemia can cause undue worry for otherwise healthy patients and lead to costly further testing, providing an argument against routine testing with complete blood counts in healthy, asymptomatic patients. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Canavan disease - unusual imaging features in a child with mild clinical presentation

International Nuclear Information System (INIS)

Nguyen, Ho V.; Ishak, Gisele E.

2015-01-01

Canavan disease is a rare hereditary leukodystrophy that manifests in early childhood. Associated with rapidly progressive clinical deterioration, it usually results in death by the third year of life. The predominant MRI appearance is diffuse and symmetrical white matter disease. We discuss an atypical, late presentation of Canavan disease with a benign clinical course and uncharacteristic imaging features. This case introduces a previously unreported pattern of diffuse cortical abnormality without significant white matter involvement. (orig.)

Canavan disease - unusual imaging features in a child with mild clinical presentation

Energy Technology Data Exchange (ETDEWEB)

Nguyen, Ho V.; Ishak, Gisele E. [University of Washington, Department of Radiology, Seattle Children' s Hospital, Seattle, WA (United States)

2015-03-01

Canavan disease is a rare hereditary leukodystrophy that manifests in early childhood. Associated with rapidly progressive clinical deterioration, it usually results in death by the third year of life. The predominant MRI appearance is diffuse and symmetrical white matter disease. We discuss an atypical, late presentation of Canavan disease with a benign clinical course and uncharacteristic imaging features. This case introduces a previously unreported pattern of diffuse cortical abnormality without significant white matter involvement. (orig.)

Is the foot striking pattern more important than barefoot or shod conditions in running?

Science.gov (United States)

Shih, Yo; Lin, Kuan-Lun; Shiang, Tzyy-Yuang

2013-07-01

People have advocated barefoot running, claiming that it is better suited to human nature. Humans usually run barefoot using a forefoot strike and run shod using a heel strike. The striking pattern was thought to be a key factor that contributes to the benefit of barefoot running. The purpose of this study is to use scientific data to prove that the striking pattern is more important than barefoot or shod conditions for runners on running injuries prevention. Twelve habitually male shod runners were recruited to run under four varying conditions: barefoot running with a forefoot strike, barefoot running with a heel strike, shod running with a forefoot strike, and shod running with a heel strike. Kinetic and kinematic data and electromyography signals were recorded during the experiments. The results showed that the lower extremity can gain more compliance when running with a forefoot strike. Habitually shod runners can gain more shock absorption by changing the striking pattern to a forefoot strike when running with shoes and barefoot conditions. Habitually shod runners may be subject to injuries more easily when they run barefoot while maintaining their heel strike pattern. Higher muscle activity in the gastrocnemius was observed when running with a forefoot strike, which may imply a greater training load on the muscle and a tendency for injury. Copyright © 2013 Elsevier B.V. All rights reserved.

A comparison of the clinical features of depression in hiv-positive ...

African Journals Online (AJOL)

by far the worst affected region in the world with a continental prevalence of around ... This study compared the clinical features of major depression between .... programme Statistical Package for Social Scientists (SPSS), version 11.5. ... HIV-Positive N=64 n(%) HIV-Negative N=66 n(%) X2. OR (95%CI). P-Value. Gender.

Evidence of extensional and strike-slip deformation in the offshore Gökova-Kos area affected by the July 2017 Mw6.6 Bodrum-Kos earthquake, eastern Aegean Sea

Science.gov (United States)

Ocakoğlu, Neslihan; Nomikou, Paraskevi; İşcan, Yeliz; Loreto, Maria Filomena; Lampridou, Danai

2018-01-01

The interpretation of new multichannel seismic profiles and previously published high-resolution swath and seismic reflection data from the Gökova Gulf and southeast of Kos Island in the eastern Aegean Sea revealed new morphotectonic features related to the July 20, 2017 Mw6.6 Bodrum-Kos earthquake offshore between Kos Island and the Bodrum Peninsula. The seafloor morphology in the northern part of the gulf is characterized by south-dipping E-W-oriented listric normal faults. These faults bend to a ENE-WSW direction towards Kos Island, and then extend parallel to the southern coastline. A left-lateral SW-NE strike-slip fault zone is mapped with segments crossing the Gökova Gulf from its northern part to south of Kos Island. This fault zone intersects and displaces the deep basins in the gulf. The basins are thus interpreted as the youngest deformed features in the study area. The strike-slip faults also produce E-W-oriented ridges between the basin segments, and the ridge-related vertical faults are interpreted as reverse faults. This offshore study reveals that the normal and strike-slip faults are well correlated with the focal mechanism solutions of the recent earthquake and general seismicity of the Gökova Gulf. Although the complex morphotectonic features could suggest that the area is under a transtensional regime, kinematic elements normally associated with a transtensional system are missing. At present, the Gökova Gulf is experiencing strike-slip motion with dominant extensional deformation, rather than transtensional deformation.

Evidence of extensional and strike-slip deformation in the offshore Gökova-Kos area affected by the July 2017 Mw6.6 Bodrum-Kos earthquake, eastern Aegean Sea

Science.gov (United States)

Ocakoğlu, Neslihan; Nomikou, Paraskevi; İşcan, Yeliz; Loreto, Maria Filomena; Lampridou, Danai

2018-06-01

The interpretation of new multichannel seismic profiles and previously published high-resolution swath and seismic reflection data from the Gökova Gulf and southeast of Kos Island in the eastern Aegean Sea revealed new morphotectonic features related to the July 20, 2017 Mw6.6 Bodrum-Kos earthquake offshore between Kos Island and the Bodrum Peninsula. The seafloor morphology in the northern part of the gulf is characterized by south-dipping E-W-oriented listric normal faults. These faults bend to a ENE-WSW direction towards Kos Island, and then extend parallel to the southern coastline. A left-lateral SW-NE strike-slip fault zone is mapped with segments crossing the Gökova Gulf from its northern part to south of Kos Island. This fault zone intersects and displaces the deep basins in the gulf. The basins are thus interpreted as the youngest deformed features in the study area. The strike-slip faults also produce E-W-oriented ridges between the basin segments, and the ridge-related vertical faults are interpreted as reverse faults. This offshore study reveals that the normal and strike-slip faults are well correlated with the focal mechanism solutions of the recent earthquake and general seismicity of the Gökova Gulf. Although the complex morphotectonic features could suggest that the area is under a transtensional regime, kinematic elements normally associated with a transtensional system are missing. At present, the Gökova Gulf is experiencing strike-slip motion with dominant extensional deformation, rather than transtensional deformation.

Clinical and Biological Features of Interval Colorectal Cancer

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Yu Mi Lee

2017-05-01

Full Text Available Interval colorectal cancer (I-CRC is defined as a CRC diagnosed within 60 months after a negative colonoscopy, taking into account that 5 years is the “mean sojourn time.” It is important to prevent the development of interval cancer. The development of interval colon cancer is associated with female sex, old age, family history of CRC, comorbidities, diverticulosis, and the skill of the endoscopist. During carcinogenesis, sessile serrated adenomas/polyps (SSA/Ps share many genomic and colonic site characteristics with I-CRCs. The clinical and biological features of I-CRC should be elucidated to prevent the development of interval colon cancer.

Cauda equina syndrome as the initial presenting clinical feature of medulloblastoma: a case report

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Al-Otaibi Faisal

2012-05-01

Full Text Available Abstract Introduction Medulloblastoma is one of the most common pediatric brain malignancies. The usual presenting clinical features are related to posterior fossa syndrome or/and hydrocephalus. Cauda equina syndrome is a very rare presentation for this disease. Case presentation We describe the case of a three-year-old boy with cauda equina syndrome as the initial presenting clinical feature for medulloblastoma. He was initially diagnosed as having a spinal tumor by magnetic resonance imaging scan. Subsequently, a cranial magnetic resonance imaging scan revealed a posterior fossa tumor with features of dissemination. He had substantial improvement after treatment. This case report is complemented by a literature review related to this unusual presentation. Conclusions Medulloblastoma primarily presenting with cauda equina syndrome is very rare. However, spinal drop metastasis should be considered in the pediatric age group to avoid suboptimal management.

Clinical features of autoimmune hepatitis with acute presentation: a Japanese nationwide survey.

Science.gov (United States)

Joshita, Satoru; Yoshizawa, Kaname; Umemura, Takeji; Ohira, Hiromasa; Takahashi, Atsushi; Harada, Kenichi; Hiep, Nguyen Canh; Tsuneyama, Koichi; Kage, Masayoshi; Nakano, Masayuki; Kang, Jong-Hon; Koike, Kazuhiko; Zeniya, Mikio; Yasunaka, Tetsuya; Takaki, Akinobu; Torimura, Takuji; Abe, Masanori; Yokosuka, Osamu; Tanaka, Atsushi; Takikawa, Hajime

2018-02-23

Autoimmune hepatitis (AIH) is characterized by progressive inflammation and necrosis of hepatocytes and eventually leads to a variety of phenotypes, including acute liver dysfunction, chronic progressive liver disease, and fulminant hepatic failure. Although the precise mechanisms of AIH are unknown, environmental factors may trigger disease onset in genetically predisposed individuals. Patients with the recently established entity of AIH with acute presentation often display atypical clinical features that mimic those of acute hepatitis forms even though AIH is categorized as a chronic liver disease. The aim of this study was to identify the precise clinical features of AIH with acute presentation. Eighty-six AIH patients with acute presentation were retrospectively enrolled from facilities across Japan and analyzed for clinical features, histopathological findings, and disease outcomes. Seventy-five patients were female and 11 were male. Patient age ranged from adolescent to over 80 years old, with a median age of 55 years. Median alanine transaminase (ALT) was 776 U/L and median immunoglobulin G (IgG) was 1671 mg/dL. There were no significant differences between genders in terms of ALT (P = 0.27) or IgG (P = 0.51). The number of patients without and with histopathological fibrosis was 29 and 57, respectively. The patients with fibrosis were significantly older than those without (P = 0.015), but no other differences in clinical or histopathological findings were observed. Moreover, antinuclear antibody (ANA)-positive (defined as × 40, N = 63) and -negative (N = 23) patients showed no significant differences in clinical or histopathological findings or disease outcomes. Twenty-five patients experienced disease relapse and two patients died during the study period. ALP ≥ 500 U/L [odds ratio (OR) 3.20; 95% confidence interval (CI) 1.12-9.10; P presentation is a newly recognized disease entity for which diagnostic hallmarks, such as ALT

Clinical and epidemiological features of coryneform skin infections at a tertiary hospital

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Malcolm Pinto

2016-01-01

Full Text Available Background: Skin infections caused by coryneform bacteria are common dermatological conditions. However, to the best of our knowledge, no studies are available on the clinical characteristics and epidemiological features of this group of disorders as one entity from India and abroad. Aims: To study the clinical and epidemiological features of coryneform skin infections Methods: A total of 75 patients presenting with clinically distinctive lesions of pitted keratolysis, erythrasma and trichobacteriosis to our hospital were included in the study. Cases were interviewed with particular emphasis on epidemiological features and the various clinical findings were recorded. Investigations like Gram's stain, Wood's light examination, 10% KOH scrapings, were done in selected cases to ascertain the diagnosis. Results: Pitted keratolysis was more common in the age group of 31-40 years (40% with a male preponderance (76.7%, most commonly affecting pressure bearing areas of the soles with malodour (86.7% and frequent contact with water (58.3% constituting the most important presenting symptom and provocating factor respectively. Erythrasma affected both male and female patients equally and was more commonly detected in patients with a BMI > 23kg/m2 (62.5% and in diabetics (50%. All patients with trichobacteriosis presented with yellow coloured concretions in the axillae. Bromhidrosis (71.4% and failure to regularly use an axillary deodorant (71.4% were the most common presenting symptom and predisposing factor respectively. Conclusion: Coryneform skin infections are common dermatological conditions, though epidemiological data are fragmentary. Hyperhidrosis is a common predisposing factor to all three coryneform skin infections. Asymmetrical distribution of pits has been reported in our study. Diabetic status needs to be evaluated in all patients with erythrasma. Woods lamp examination forms an indispensible tool to diagnose erythrasma and trichobacteriosis.

Causes of falls of hangingwall over gullies adjacent to stabilizing strike pillars

CSIR Research Space (South Africa)

Turner, PA

1987-08-01

Full Text Available This report discusses the occurrence of falls of ground in strike gullies. Falls of hangingwall over strike gullies on the up-dip side of strike stabilizing pillars in longwall mining systems were investigated. Gullies were examined in both...

["Bell-striking" Saying of Acupuncture Therapy].

Science.gov (United States)

Zhao, Jing-Sheng

2017-04-25

As an analogy, a prototype of "bell-striking" is proposed in the present paper for exploring the basic properties, major elements, and potential mechanisms of acupuncture stimulation. On the strength of analysis on the physiological basis of acupuncture effect, several fundamental aspects of acupuncture are summarized as a) the body-surface stimulating characters, b) general and local effects, and c) triggering the auto-regulative function of the organism, which mimics the "bell-striking" response. Namely, when stroke, bell will chime, otherwise, chiming will not be heard. During analyzing special contents of acupuncture theory, its formative background should not be separated, and it is improper to take, modern medical theory of the human body as the guiding thinking way for researching the ancient Chinese medical literature.

Mechanical and geometric features of endodontic instruments and its clinical effect

Directory of Open Access Journals (Sweden)

Hyeon-Cheol Kim

2011-01-01

Full Text Available Introduction The aim of this paper is to discuss the mechanical and geometric features of Nickel-titanium (NiTi rotary files and its clinical effects. NiTi rotary files have been introduced to the markets with their own geometries and claims that they have better ability for the root canal shaping than their competitors. The contents of this paper include the (possible interrelationship between the geometries of NiTi file (eg. tip, taper, helical angle, etc and clinical performance of the files as follows; - Fracture modes of NiTi rotary files - Non-cutting guiding tip and glide path - Taper and clinical effects - Cross-sectional area and clinical effects - Heat treatments and surface characteristics - Screw-in effect and preservation of root dentin integrity - Designs for reducing screw-in effect Conclusions Based on the reviewed contents, clinicians may have an advice to use various brands of NiTi rotary instruments regarding their advantages which would fit for clinical situation.

Respecting the right to strike

CERN Multimedia

Staff Association

2015-01-01

Since two years the representatives of the employers in the ILO, a tripartite multilateral body responsible for guaranteeing the correct application of an international labour code, try to weaken the global work regulations. On the occasion of the Global Day of Action for the right to strike at the invitation of the Geneva community of Union action (Communauté genevoise d’action syndicale) and the Swiss Trade Union Association (Union syndicale suisse) around noon on Wednesday 18th February some fifty staff representatives of international organizations gathered on the place des Nations in Geneva to reaffirm the importance of this fundamental right, too often flouted. A delegation of the CERN Staff Association was also present. In a short speech, the Staff Association said that, while being one of the fundamental human rights, to be efficient the right to strike must be used intelligently. It must be implemented taking into account the sensitivities of the professional environment and r...

The effects of preferred and non-preferred running strike patterns on tissue vibration properties.

Science.gov (United States)

Enders, Hendrik; von Tscharner, Vinzenz; Nigg, Benno M

2014-03-01

To characterize soft tissue vibrations during running with a preferred and a non-preferred strike pattern in shoes and barefoot. Cross-sectional study. Participants ran at 3.5 m s(-1) on a treadmill in shoes and barefoot using a rearfoot and a forefoot strike for each footwear condition. The preferred strike patterns for the subjects were a rearfoot strike and a forefoot strike for shod and barefoot running, respectively. Vibrations were recorded with an accelerometer overlying the belly of the medial gastrocnemius. Thirteen non-linearly scaled wavelets were used for the analysis. Damping was calculated as the overall decay of power in the acceleration signal post ground contact. A higher damping coefficient indicates higher damping capacities of the soft tissue. The shod rearfoot strike showed a 93% lower damping coefficient than the shod forefoot strike (pforefoot strike showed a trend toward a lower damping coefficient compared to a barefoot rearfoot strike. Running barefoot with a forefoot strike resulted in a significantly lower damping coefficient than a forefoot strike when wearing shoes (pstrike showed lower damping compared to a barefoot rearfoot strike (p<0.001). While rearfoot striking showed lower vibration frequencies in shod and barefoot running, it did not consistently result in lower damping coefficients. This study showed that the use of a preferred movement resulted in lower damping coefficients of running related soft tissue vibrations. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

THE EFFECT OF STEP RATE MANIPULATION ON FOOT STRIKE PATTERN OF LONG DISTANCE RUNNERS.

Science.gov (United States)

Allen, Darrell J; Heisler, Hollie; Mooney, Jennifer; Kring, Richard

2016-02-01

Running gait retraining to change foot strike pattern in runners from a heel strike pattern to a non heel- strike pattern has been shown to reduce impact forces and may help to reduce running related injuries. Step rate manipulation above preferred is known to help decrease step length, foot inclination angle, and vertical mass excursion, but has not yet been evaluated as a method to change foot strike pattern. The purpose of this study was to investigate the effect of step rate manipulation on foot strike pattern in shod recreational runners who run with a heel strike pattern. A secondary purpose was to describe the effect of step rate manipulation at specific percentages above preferred on foot inclination angle at initial contact. Forty volunteer runners, who were self-reported heel strikers and had a weekly running mileage of at least 10 miles, were recruited. Runners were confirmed to be heel strikers during the warm up period on the treadmill. The subject's step rate was determined at their preferred running pace. A metronome was used to increase step rate above the preferred step rate by 5%, 10% and 15%. 2D video motion analysis was utilized to determine foot strike pattern and to measure foot inclination angle at initial contact for each step rate condition. There was a statistically significant change in foot strike pattern from a heel strike pattern to a mid-foot or forefoot strike pattern at both 10% and 15% step rates above preferred. Seven of the 40 subjects (17.5%) changed from a heel- strike pattern to a non- heel strike pattern at +10% and 12 of the 40 subjects (30%) changed to a non-heel strike pattern at +15%. Mean foot inclination angle at initial contact showed a statistically significant change (reduction) as step rate increased. Step rate manipulation of 10% or greater may be enough to change foot strike pattern from a heel strike to a mid-foot or forefoot strike pattern in a small percentage of recreational runners who run in traditional

Clinical Features and Outcomes of Fusobacterium Species Infections in a Ten-Year Follow-up

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Garcia-Carretero Rafael

2017-10-01

Full Text Available Objective: Although uncommon, Fusobacterium infections have a wide clinical spectrum, ranging from local pharyngeal infections to septic shock. Our aim was to characterize and analyze the clinical features and outcomes in patients with Fusobacterium infections, and determine which variables were able to predict a poor outcome.

Male non-gonococcal urethritis: From microbiological etiologies to demographic and clinical features.

Science.gov (United States)

Ito, Shin; Hanaoka, Nozomu; Shimuta, Ken; Seike, Kensaku; Tsuchiya, Tomohiro; Yasuda, Mitsuru; Yokoi, Shigeaki; Nakano, Masahiro; Ohnishi, Makoto; Deguchi, Takashi

2016-04-01

To detect microorganisms responsible for male acute urethritis and to define the microbiology of non-gonococcal urethritis. The present study comprised 424 men with symptoms and signs compatible with acute urethritis. Their urethral swabs and first-voided urine underwent detection of the microorganisms. Demographic characteristics and clinical features of Mycoplasma genitalium-, Ureaplasma urealyticum-, Haemophilus influenza-, adenovirus- or Herpes simplex virus-positive monomicrobial non-gonococcal urethritis, or all-examined microorganism-negative urethritis in heterosexual men were compared with urethritis positive only for Chlamydia trachomatis. Neisseria gonorrhoeae was detected in 127 men (30.0%). In 297 men with non-gonococcal urethritis, C. trachomatis was detected in 143 (48.1%). In 154 men with non-chlamydial non-gonococcal urethritis, M. genitalium (22.7%), M. hominis (5.8%), Ureaplasma parvum (9.1%), U. urealyticum (19.5%), H. influenzae (14.3%), Neisseria meningitidis (3.9%), Trichomonas vaginalis (1.3%), human adenovirus (16.2%), and Herpes simplex virus types 1 (7.1%) and 2 (2.6%) were detected. Although some features of monomicrobial non-chlamydial non-gonococcal urethritis or all-examined microorganism-negative urethritis were significantly different from those of monomicrobial chlamydial non-gonococcal urethritis, most features were superimposed. Predicting causative microorganisms in men with non-gonococcal urethritis based on demographic and clinical features is difficult. However, the present study provides useful information to better understand the microbiological diversity in non-gonococcal urethritis, and to manage patients with non-gonococcal urethritis appropriately. © 2016 The Japanese Urological Association.

Gambling disorder in financial markets: Clinical and treatment-related features.

Science.gov (United States)

Shin, Young-Chul; Choi, Sam-Wook; Ha, Juwon; Choi, Jung-Seok; Kim, Dai-Jin

2015-12-01

To date, few studies have examined the clinical manifestation of disordered gamblers in financial markets. This study examined the differences in the clinical and treatment-related features of gambling disorder between financial markets and horse races. Subjects who met the DSM-IV criteria for pathological gambling (PG) and who sought treatment were assessed by retrospective chart review. One hundred forty-four subjects were included in this sample, which consisted of the following groups: financial markets (n = 45; 28.6%) and horse races (n = 99; 71.4%). Multiple similar manifestations were found between the groups, including severity of PG, age of PG onset, amounts of gambling debts, drinking days per week, depressive mood, duration of seeking treatment after the onset of PG, and treatment follow-up duration. However, disordered gamblers who invested in the financial market were significantly more likely to be educated (p = 0.003), live with their spouses (p = 0.007), have full-time jobs (p = 0.006), and they were more likely to participate in the first type of gambling than the horse races group (pfinancial markets group received the anti-craving medication less often than the horse races group (p = 0.04). These findings suggest that disordered gamblers in financial markets show different socio-demographic, clinical and treatment-related features compared with the horse race gamblers, despite a similar severity of gambling disorder. Understanding these differential manifestations may provide insight into prevention and treatment development for specific types of gambling.

Gender effect on clinical features of achalasia: a prospective study

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Mahdavinia Mahboobeh

2006-04-01

Full Text Available Abstract Background Achalasia is a well-characterized esophageal motor disorder but the rarity of the disease limits performing large studies on its demographic and clinical features. Methods Prospectively, 213 achalasia patients (110 men and 103 women were enrolled in the study. The diagnosis established by clinical, radiographic, and endoscopic as well as manometry criteria. All patients underwent a pre-designed clinical evaluation before and within 6 months after the treatment. Results Solid dysphagia was the most common clinical symptom in men and women. Chest pain was the only symptom which was significantly different between two groups and was more complained by women than men (70.9% vs. 54.5% P value= 0.03. Although the occurrence of chest pain significantly reduced after treatment in both groups (P Conclusion It seems that chest pain is the distinct symptom of achalasia which is affected by sex as well as age and does not relate to the duration of illness, LESP and the type of treatment achalasia patients receive.

Manipulation of Foot Strike and Footwear Increases Achilles Tendon Loading During Running.

Science.gov (United States)

Rice, Hannah; Patel, Mubarak

2017-08-01

The Achilles tendon is the most common site of tendon overuse injury in humans. Running with a forefoot strike pattern and in minimal shoes is a topic of recent interest, yet evidence is currently limited regarding the combined influence of foot strike and footwear on Achilles tendon loading. To investigate the influence of both foot strike and footwear on Achilles tendon loading in habitual rearfoot strike runners. Controlled laboratory study. Synchronized kinematic and force data were collected from 22 habitual rearfoot strikers (11 male), who habitually ran in nonminimal running shoes, during overground running at 3.6 m·s -1 . Participants ran in 3 different footwear conditions (standard running shoe, minimal running shoe, and barefoot) with both a rearfoot strike (RFS) and an imposed forefoot strike (FFS) in each footwear condition. Achilles tendon loading was estimated by use of inverse dynamics, where the Achilles tendon moment arm was determined with a regression equation. A 2-way, repeated-measures analysis of variance was used to compare conditions. Achilles tendon impulse was greater when subjects ran with an FFS rather than an RFS in minimal shoes. Achilles tendon loading rates were higher when subjects ran either in minimal shoes or barefoot than in standard shoes, regardless of foot strike. In runners who habitually rearfoot strike in standard running shoes, running in minimal shoes or barefoot increased the rate of tendon loading, and running with a forefoot strike in minimal shoes increased the magnitude of tendon loading. Transitioning to these running conditions may increase the risk of tendinopathy.

Clinical Features of Herpes Zoster Infections in Childhood

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Emine Çölgeçen

2012-03-01

Full Text Available Background and Design: Herpes zoster (HZ is a rare disease in childhood and encountered especially in immunosuppressed patients. The aim of this study was to determine the clinical features of HZ in children. Materials and methods: Records of 24 children, who had a diagnosis of HZ and were referred to the dermatology and pediatric outpatient clinic during February 2009-February 2011, were evaluated retrospectively. Results: Twenty-four patients, - 14 female (58.3%, 10 male (41.7% -, aged between 4 and 16 years were assessed. The mean age of the patients was 10.6±3.7 years. The most frequent complaint was pruritus (54.2%. Sixteen patients had thoracic involvement, whilst the rest had lumbar (n: 4, trigeminal (n: 3 and sacral (n: 1 involvements, respectively. Eleven children were distressed and 2 children had physical trauma. Ten patients were treated with acyclovir orally, 3 were given valacyclovir orally and the rest had only local treatment. No complications were reported. Conclusion: HZ may be seen in healthy children with no immunosuppresion and the infection in these patients has a favorable course.

Precision Strike Training in Lean Manufacturing: A Workplace Literacy Guidebook [and] Final Report on Precision Strike Workplace Literacy Training at CertainTeed Corporation.

Science.gov (United States)

National Alliance of Business, Inc., Washington, DC.

CertainTeed's Precision Strike training program was designed to close the gaps between the current status of its workplace and where that work force needed to be to compete successfully in global markets. Precision Strike included Skills and Knowledge in Lifelong Learning (SKILL) customized, computerized lessons in basic skills, one-on-one…

Effects of Foot Strike and Step Frequency on Achilles Tendon Stress During Running.

Science.gov (United States)

Lyght, Michael; Nockerts, Matthew; Kernozek, Thomas W; Ragan, Robert

2016-08-01

Achilles tendon (AT) injuries are common in runners. The AT withstands high magnitudes of stress during running which may contribute to injury. Our purpose was to examine the effects of foot strike pattern and step frequency on AT stress and strain during running utilizing muscle forces based on a musculoskeletal model and subject-specific ultrasound-derived AT cross-sectional area. Nineteen female runners performed running trials under 6 conditions, including rearfoot strike and forefoot strike patterns at their preferred cadence, +5%, and -5% preferred cadence. Rearfoot strike patterns had less peak AT stress (P forefoot strike pattern. A reduction in peak AT stress and strain were exhibited with a +5% preferred step frequency relative to the preferred condition using a rearfoot (P forefoot (P=.005) strike pattern. Strain rate was not different (P > .05) between step frequencies within each foot strike condition. Our results suggest that a rearfoot pattern may reduce AT stress, strain, and strain rate. Increases in step frequency of 5% above preferred frequency, regardless of foot strike pattern, may also lower peak AT stress and strain.

Force, reaction time, and precision of Kung Fu strikes.

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Neto, Osmar Pinto; Bolander, Richard; Pacheco, Marcos Tadeu Tavares; Bir, Cynthia

2009-08-01

The goal was to compare values of force, precision, and reaction time of several martial arts punches and palm strikes performed by advanced and intermediate Kung Fu practitioners, both men and women. 13 Kung Fu practitioners, 10 men and three women, participated. Only the men, three advanced and seven intermediate, were considered for comparisons between levels. Reaction time values were obtained using two high speed cameras that recorded each strike at 2500 Hz. Force of impact was measured by a load cell. For comparisons of groups, force data were normalized by participant's body mass and height. Precision of the strikes was determined by a high speed pressure sensor. The results show that palm strikes were stronger than punches. Women in the study presented, on average, lower values of reaction time and force but higher values of precision than men. Advanced participants presented higher forces than intermediate participants. Significant negative correlations between the values of force and precision and the values of force and reaction time were also found.

Clinical features, proximate causes, and consequences of active convulsive epilepsy in Africa.

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Kariuki, Symon M; Matuja, William; Akpalu, Albert; Kakooza-Mwesige, Angelina; Chabi, Martin; Wagner, Ryan G; Connor, Myles; Chengo, Eddie; Ngugi, Anthony K; Odhiambo, Rachael; Bottomley, Christian; White, Steven; Sander, Josemir W; Neville, Brian G R; Newton, Charles R J C; Twine, Rhian; Gómez Olivé, F Xavier; Collinson, Mark; Kahn, Kathleen; Tollman, Stephen; Masanja, Honratio; Mathew, Alexander; Pariyo, George; Peterson, Stefan; Ndyomughenyi, Donald; Bauni, Evasius; Kamuyu, Gathoni; Odera, Victor Mung'ala; Mageto, James O; Ae-Ngibise, Ken; Akpalu, Bright; Agbokey, Francis; Adjei, Patrick; Owusu-Agyei, Seth; Kleinschmidt, Immo; Doku, Victor C K; Odermatt, Peter; Nutman, Thomas; Wilkins, Patricia; Noh, John

2014-01-01

Epilepsy is common in sub-Saharan Africa (SSA), but the clinical features and consequences are poorly characterized. Most studies are hospital-based, and few studies have compared different ecological sites in SSA. We described active convulsive epilepsy (ACE) identified in cross-sectional community-based surveys in SSA, to understand the proximate causes, features, and consequences. We performed a detailed clinical and neurophysiologic description of ACE cases identified from a community survey of 584,586 people using medical history, neurologic examination, and electroencephalography (EEG) data from five sites in Africa: South Africa; Tanzania; Uganda; Kenya; and Ghana. The cases were examined by clinicians to discover risk factors, clinical features, and consequences of epilepsy. We used logistic regression to determine the epilepsy factors associated with medical comorbidities. Half (51%) of the 2,170 people with ACE were children and 69% of seizures began in childhood. Focal features (EEG, seizure types, and neurologic deficits) were present in 58% of ACE cases, and these varied significantly with site. Status epilepticus occurred in 25% of people with ACE. Only 36% received antiepileptic drugs (phenobarbital was the most common drug [95%]), and the proportion varied significantly with the site. Proximate causes of ACE were adverse perinatal events (11%) for onset of seizures before 18 years; and acute encephalopathy (10%) and head injury prior to seizure onset (3%). Important comorbidities were malnutrition (15%), cognitive impairment (23%), and neurologic deficits (15%). The consequences of ACE were burns (16%), head injuries (postseizure) (1%), lack of education (43%), and being unmarried (67%) or unemployed (57%) in adults, all significantly more common than in those without epilepsy. There were significant differences in the comorbidities across sites. Focal features are common in ACE, suggesting identifiable and preventable causes. Malnutrition and

Ethical and legal consideration of prisoner's hunger strike in Serbia.

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Alempijevic, Djordje; Pavlekic, Snezana; Jecmenica, Dragan; Nedeljkov, Aleksandra; Jankovic, Milos

2011-03-01

Hunger strike of prisoners and detainees remains a major human rights and ethical issue for medical professionals. We are reporting on a case of a 48-year-old male sentenced prisoner, intravenous heroin user, who went on a hunger strike and died 15 days later. Throughout the fasting period, the prisoner, who was capable of decision making, refused any medical examination. Autopsy findings were not supporting prolonged starvation, while toxicology revealed benzodiazepines and opiates in blood and urine. Cause of death was given as "heroin intoxication" in keeping with detection of 6-MAM. Legal and ethical issues pertinent to medical examination and treatment of prisoners on hunger strike are explored in accordance with legislation and professional ethical standards in Serbia. A recommendation for the best autopsy practice in deaths following hunger strike has been made. © 2011 American Academy of Forensic Sciences.

Clinical and pathological features of dense deposit disease in Chinese patients.

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Wang, Jinquan; Tang, Zheng; Luo, Chunlei; Hu, Yanglin; Zeng, Caihong; Chen, Huiping; Liu, Zhihong

2012-09-01

Dense deposit disease (DDD) is a rare disease that has no universally effective treatment. Herein we explore the clinical and pathological features of DDD in Chinese patients and the therapeutic effect of Tripterygium wilfordii (TW). Clinical and pathological data of 10 Chinese patients with biopsy-proved DDD were collected and analyzed retrospectively. The patients consisted of 6 males and 4 females. All of them had heavy proteinuria and microscopic hematuria. Gross hematuria, renal insufficiency, anemia, hypertension and low serum complement 3 (C3) occurred in 3, 3, 5, 6 and 8 cases, respectively. Under light microscopy (LM), 8 cases exhibited membranoproliferative glomerulonephritis (MPGN). Periodic acid-Schiff (PAS) stain disclosed intense PAS-positive bright ribbon-like thickening of glomerular basement membranes (GBM). Immunofluorescence mainly showed diffuse fine granular and short linear deposition of C3 along the glomerular capillary wall. Under electron microscopy, ribbon-like electrondense intramembranous deposits were identified in the lamina densa of the GBM, along the tubule basement membranes (TBM) and wall of Bowman's capsule. Before admission, 6 cases were treated with prednisone, cyclophosphamide and/or cyclosporin A with no response. Proteinuria in 8 cases who received TW during the course decreased at different degrees. The clinical and pathological features in DDD patients were various. The effect of TW in patients with DDD merits further investigation.

Teaching Striking Skills in Elementary Physical Education Using Woodball

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Chang, Seung Ho; Lee, Jihyun

2017-01-01

Object control (OC) skills are a part of fundamental motor skills and basic functional skills, which work as a prerequisite to becoming a skilled performer in many sports. Of various OC skills, striking is one of the most difficult to master due to a variety of interrelated movement components. A form of vertical or underarm striking is a more…

[Hunger strike and forced feeding: a historical look at medical practices].

Science.gov (United States)

Rieder, Jean-Pierre; Huber-Giseke, Tina; Getaz, Laurent; Kramer-Gauchat, Marie-Claire; Nyffenegger, Laurent; Gaspoz, Jean-Michel; Wolff, Hans

2010-12-01

Hunger strike is not a disease but a common situation in prisons. This article takes a historical look at medical practices in connection with the forced feeding of hunger strikers. We now know the fate of the strikers who were subjected to forced feeding. Depending on the context and the political situation in the country, the fate of these people, mostly political prisoners, is described as humiliating and abominable frequently ending in death or irreparable consequences. Particularly difficult for health professionals, this act raises clinical, ethical and legal questions and refers to the fundamental principles of medicine.

Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis

NARCIS (Netherlands)

Visser, L.H.; Nijssen, P.G.; Tijssen, C.C.; Middendorp, J.J. van; Schieving, J.H.

2013-01-01

PURPOSE: To compare the clinical features of patients with sacroiliac joint (SIJ)-related sciatica-like symptoms to those with sciatica from nerve root compression and to investigate the necessity to perform radiological imaging in patients with sciatica-like symptoms derived from the SIJ. METHODS:

The significance of strike-slip faulting in the basement of the Zagros fold and thrust belt

Energy Technology Data Exchange (ETDEWEB)

Hessami, K.; Koyi, H.A.; Talbot, C.J. [Uppsala University (Sweden). Institute of Earth Sciences

2000-01-01

Lateral offsets in the pattern of seismicity along the Zagros fold and thrust belt indicate that transverse faults segmenting the Arabian basement are active deep-seated strike-slip faults. The dominant NW-SE trending features of the belt have undergone repeated horizontal displacements along these transverse faults. These reactivated basement faults, which are inherited from the Pan-African construction phase, controlled both deposition of the Phanerozoic cover before Tertiary-Recent deformation of the Zagros and probably the entrapment of hydrocarbons on the NE margin of Arabia and in the Zagros area. We have used observations of faulting recognized on Landsat satellite images, in conjunction with the spatial distribution of earthquakes and their focal mechanism solutions, to infer a tectonic model for the Zagros basement. Deformation in the NW Zagros appears to be concentrated on basement thrusts and a few widely-spaced north-south trending strike-slip faults which separate major structural segments. In the SE Zagros, two main structural domains can be distinguished. A domain of NNW-trending right-lateral faults in the northern part of the SE Zagros implies that fault-bounded blocks are likely to have rotated anticlockwise about vertical axes relative to both Arabia and Central Iran. In contrast, the predominance of NNE-trending left-lateral faults in the southern part of the SE Zagros implies that fault-bounded blocks may have rotated clockwise about vertical axes. We propose a tectonic model in which crustal blocks bounded by strike-slip faults in a zone of simple shear rotate about vertical axes relative to both Arabia and Central Iran. The presence of domains of strike-slip and thrust faulting in the Zagros basement suggest that some of the convergence between Arabia and Central Iran is accommodated by rotation and possible lateral movement of crust along the belt by strike-slip faults, as well as by obvious crustal shortening and thickening along thrust

Clinical and microbiological features of cryptococcal meningitis

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Lucia Kioko Hasimoto e Souza

2013-06-01

Full Text Available Introduction In this study, the clinical features, underlying diseases and clinical outcomes of patients with cryptococcosis were investigated. In addition, a molecular analysis of the Cryptococcus neoformans species complex isolated from these patients was performed. Methods A prospective study of 62 cases of patients with cryptococcal infection was conducted at the Hospital de Doenças Tropicais de Goiás Dr. Anuar Auad from 2009-2010. Cryptococcal meningitis cases were diagnosed by direct examination and cerebrospinal fluid (CSF sample culture. The profiling of these patients was assessed. The CSF samples were submitted to India ink preparation and cultured on Sabouraud dextrose agar, and C. neoformans was identified by the production of urease, a positive phenoloxidase test and assimilation of carbohydrates. C. neoformans and C. gattii isolates were distinguished by growth on L-canavanine-glycine-bromothymol blue medium, and molecular analysis was conducted via PCR fingerprinting reactions using M13 and (GACA4 primers. Results From the 62 patients with cryptococcosis, 71 isolates of CSF were obtained; 67 (94.4% isolates were identified as C. neoformans var. grubii/VNI, and 4 (5.6% were identified as C. gattii/VGII. Of these patients, 53 had an HIV diagnosis. The incidence of cryptococcosis was higher among patients 20-40 years of age, with 74.2% of the cases reported in males. Cryptococcus-related mortality was noted in 48.4% of the patients, and the symptoms were altered sensorium, headache, fever and stiff neck. Conclusions The high morbidity and mortality observed among patients with cryptococcosis demonstrate the importance of obtaining information regarding the epidemiological profile and clinical course of the disease in the State of Goiás, Brazil.

[Clinical and pathogenetic features of esophageal spasm].

Science.gov (United States)

Firsova, L D; Pichugina, I M; Yanova, O B; Berezina, O I; Bordin, D S

2015-01-01

To comparatively analyze clinical manifestations in patients with primary esophageal spasm (ES) and its concurrence with gastroesophageal reflux disease (GERD) and the results of their instrumental examinations and psychodiagnostic tests. A total of 104 patients with the clinical and manometric signs of ES were examined and divided into two groups: 1) 42 patients with primary ES; 2) 62 patients with ES concurrent with GERD. The examination encompassed esophageal manometry, esophagogastroduodenoscopy, 24-hour pH metry, and an interview using a questionnaire to identify autonomic disorders, and the Mini-Mult test. The patients with primary ES compared to those with ES concurrent with GERD significantly more frequently showed severe pain syndrome (p = 0.009) and a paradoxical dysphagia pattern (p = 0.03); manometry revealed an incoordination in the motility of the entire esophagus (p = 0.001). Comparison of the statistical series of values for contraction amplitude and duration in the distal esophagus found no significant difference in the patients of both groups. Autonomic disturbances were detected in 76.0% of the patients with ES; but the intergroup differences were insignificant. Mental maladaptation was observed in 81.7% of the patients in the absence of intergroup differences. The etiopathogenetic factor of ES is a psychoautonomic response to chronic stress in both primary ES and its concurrence with GERD. The reflux of gastric contents into the esophagus does not appear to be one of the leading causes of ES. In primary ES, esophageal motor function is generally impaired to a much greater extent than that in ES concurrent with GERD. The degree of motor disorders is embodied in the specific clinical features of the disease.

[Clinical features of strabismus in psychomotor retardation].

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Arias-Cabello, Belina; Arroyo-Yllanes, María Estela; Pérez-Pérez, José Fernando; Fonte-Vázquez, Anselmo

2016-01-01

In psychomotor retardation there is an abnormal development of mental, sensory and motor skills associated with ocular manifestations. There are biological and psychosocial risk factors that predispose an individual to neurological damage. From 50% to 80% of patients with strabismus retardation have special features that differentiate it from the rest of strabismus in healthy patients. To determine the most common type of strabismus in patients with psychomotor retardation and their clinical features. Patients with psychomotor retardation and strabismus were included. An ophthalmological examination was performed, as well as an evaluation of the characteristics of strabismus, including perinatal and post-natal history. Esotropia was the most frequent squint with 65.3%, followed by exotropia with 32.7%. The variability in the squint magnitude was 60% in both types, and 6 patients had dissociated vertical deviation. Most of the patients started to present strabismus since they were born. The most frequent perinatal risk factors were threatened miscarriage, pre-eclampsia, foetal distress, and hypoxia. Esotropia is the most common type of strabismus in psychomotor retardation. The variability of squint magnitude is a characteristic in these patients. The moderate variability is the most frequent in both esotropia and exotropia. The most common refractive error is hyperopic astigmatism in esotropia and the myopic kind in exotropia. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Negative ion beam characterisation in BATMAN by mini-STRIKE: Improved design and new measurements

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Serianni, G.; Bonomo, F.; Brombin, M.; Cervaro, V.; Chitarin, G.; Cristofaro, S.; Delogu, R.; De Muri, M.; Fasolo, D.; Fonnesu, N.; Franchin, L.; Franzen, P.; Ghiraldelli, R.; Molon, F.; Muraro, A.; Pasqualotto, R.; Ruf, B.; Schiesko, L.; Tollin, M.; Veltri, P.

2015-04-01

The ITER project requires additional heating provided by two injectors of neutral beams resulting from the neutralisation of accelerated negative ions. To study and optimise negative ion production, the SPIDER test facility (particle energy 100keV; beam current 50A) is under construction in Padova, with the aim of testing beam characteristics and to verify the source proper operation. The SPIDER beam will be characterised by the instrumented calorimeter STRIKE, whose main components are one-directional carbon fibre carbon composite tiles. Some prototype tiles have been employed in 2012 as a small-scale version (mini-STRIKE) of the entire system to investigate the features of the beam from BATMAN at IPP-Garching. As the BATMAN beamlets are superposed at the measurement position, about 1m from the grounded grid, an actively cooled copper mask is located in front of the tiles; holes in the mask create an artificial beamlet structure. Recently the mini-STRIKE has been updated, taking into account the results obtained in the first campaign. In particular the spatial resolution of the system has been improved by increasing the number of the copper mask holes. Moreover a custom measurement system has been realized for the thermocouple signals and employed in BATMAN in view of its use in SPIDER. The present contribution gives a description of the new design of the system as well as of the thermocouple measurements system and its field test. A new series of measurements has been carried out in BATMAN. The BATMAN beam characterisation in different experimental conditions is presented.

Negative ion beam characterisation in BATMAN by mini-STRIKE: Improved design and new measurements

International Nuclear Information System (INIS)

Serianni, G.; Brombin, M.; Cervaro, V.; Chitarin, G.; Delogu, R.; Fasolo, D.; Fonnesu, N.; Franchin, L.; Ghiraldelli, R.; Molon, F.; Pasqualotto, R.; Tollin, M.; Veltri, P.; Bonomo, F.; Cristofaro, S.; De Muri, M.; Franzen, P.; Ruf, B.; Schiesko, L.; Muraro, A.

2015-01-01

The ITER project requires additional heating provided by two injectors of neutral beams resulting from the neutralisation of accelerated negative ions. To study and optimise negative ion production, the SPIDER test facility (particle energy 100keV; beam current 50A) is under construction in Padova, with the aim of testing beam characteristics and to verify the source proper operation. The SPIDER beam will be characterised by the instrumented calorimeter STRIKE, whose main components are one-directional carbon fibre carbon composite tiles. Some prototype tiles have been employed in 2012 as a small-scale version (mini-STRIKE) of the entire system to investigate the features of the beam from BATMAN at IPP-Garching. As the BATMAN beamlets are superposed at the measurement position, about 1m from the grounded grid, an actively cooled copper mask is located in front of the tiles; holes in the mask create an artificial beamlet structure. Recently the mini-STRIKE has been updated, taking into account the results obtained in the first campaign. In particular the spatial resolution of the system has been improved by increasing the number of the copper mask holes. Moreover a custom measurement system has been realized for the thermocouple signals and employed in BATMAN in view of its use in SPIDER. The present contribution gives a description of the new design of the system as well as of the thermocouple measurements system and its field test. A new series of measurements has been carried out in BATMAN. The BATMAN beam characterisation in different experimental conditions is presented

Clinical features and multidisciplinary approaches to dementia care

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Gr

2011-05-01

pathological burden. Future research goals are outlined, with a call to action for social policy initiatives that promote preventive lifestyle behaviors, and healthcare programs that will support the growing number of individuals affected by dementia.Keywords: dementia, Alzheimer’s disease, clinical features, multidisciplinary care, BPSD, prodromal dementia

Overlapping Clinical Features Between NAFLD and Metabolic Syndrome in Children

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Anna Alisi

2014-05-01

Full Text Available Non-alcoholic fatty liver disease (NAFLD is a cluster of pathological liver conditions of emerging importance in overweight and obese children. NAFLD is associated with central obesity, insulin resistance, and dyslipidaemia, which are considered to be the main features of metabolic syndrome (MetS. Prevention of the adverse outcomes of NAFLD, as well as the risk of MetS, depends on the identification of genetic background and environmental factors that modulate susceptibility to these diseases. However, several lines of evidence highlight the strong correlation and co-currency of these two chronic diseases, both in children and in adults. In the present review, we provide an overview of the current clinical proofs on the link between NAFLD and MetS in children, with particular focus on all the possible overlapping features that connect them at paediatric age.

Physicians' strikes and the competing bases of physicians' moral obligations.

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MacDougall, D Robert

2013-09-01

Many authors have addressed the morality of physicians' strikes on the assumption that medical practice is morally different from other kinds of occupations. This article analyzes three prominent theoretical accounts that attempt to ground such special moral obligations for physicians--practice-based accounts, utilitarian accounts, and social contract accounts--and assesses their applicability to the problem of the morality of strikes. After critiquing these views, it offers a fourth view grounding special moral obligations in voluntary commitments, and explains why this is a preferable basis for understanding physicians' moral obligations in general and especially as pertaining to strikes.

[Clinical features and COMP gene mutation in a family with a pseudoachondroplasia child].

Science.gov (United States)

Lu, Chun-Ting; Guo, Li; Zahng, Zhan-Hui; Lin, Wei-Xia; Song, Yuan-Zong; Feng, Lie

2013-11-01

This study aimed to report the clinical characteristics and COMP gene mutation of a family with pseudoachondroplasia (PSACH), a relatively rare spinal and epiphyseal dysplasia that is inherited as an autosomal dominant trait. Clinical information on a 5-year-2-month-old PSACH child and his parents was collected and analyzed. Diagnosis was confirmed by PCR amplification and direct sequencing of all the 19 exons and their flanking sequences of COMP gene, and the mutation was further ascertained by cloning analysis of exon 10. The child presented with short and stubby fingers, bow leg, short limb dwarfism and metaphysic broadening in long bone as well as lumbar lordosis. A mutation c.1048_1116del (p.Asn350_Asp372del) in exon 10, inherited from his father who did not demonstrate any phenotypic feature of PSACH, was detected in the child. PSACH was diagnosed definitively by means of COMP mutation analysis, on the basis of the child's clinical and imaging features. The non-penetrance phenomenon of COMP mutation was described for the first time in PSACH.

[Clinical feature of chronic compressive optic neuropathy without optic atrophy].

Science.gov (United States)

Jiang, Libin; Shi, Jitong; Liu, Wendong; Kang, Jun; Wang, Ningli

2014-12-01

To investigate the clinical feature of the chronic compressive optic neuropathy without optic atrophy. Retrospective cases series study. The clinical data of 25 patients (37 eyes) with chronic compressive optic neuropathy without optic atrophy, treated in Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, from October, 2005 to March, 2014, were collected. Those patients had been showing visual symptoms for 6 months or longer, but missed diagnosed or misdiagnosed as other eye diseases due to their normal or slightly changed fundi. The collected data including visual acuities, visual fields, neuroimaging and/or pathologic diagnosis were analyzed. Among the 25 patients, there were 5 males and 20 females, and their ages range from 9 to 74 years [average (47.5 ± 13.4) years]. All patients suffered progressive impaired vision in single eye or both eyes, without exophthalmos or abnormal eye movements. Except one patient had a headache, other patients did not show systemic symptoms. The corrected visual acuities were between HM to 1.0, and their appearances of optic discs and colors of fundi were normal. After neuroimaging and/or pathological examination, it was proven that 14 patients suffered tuberculum sellae meningiomas, 5 patients with hypophysoma, 3 patient with optic nerve sheath meningioma in orbital apex, 1 patient with cavernous hemangioma, 1 patient with vascular malformation in orbital apex and 1 patient with optic nerve glioma. Among the 19 patients whose suffered occupied lesions of saddle area, 14 patients underwent visual field examinations, and only 4 patients showed classic visual field defects caused by optic chiasmal lesions. Occult progressive visual loss was the most important clinical feature of the disease.

Eosinophilic Esophagitis: Clinical Features, Endoscopic Findings and Response to Treatment

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Robert Enns

2010-01-01

Full Text Available Eosinophilic esophagitis (EE is a motility disorder of the esophagus that typically presents with dysphagia. The objective of the present study was to explore patient characteristics, clinical and endoscopic features, and response to treatment of patients with EE. Patients were selected retrospectively based on a review of biopsy results from previous endoscopies performed between 2004 and 2008. A total of 54 patients (41 men and 13 women with biopsy-proven EE were included in the study. Further information regarding the patients’ clinical and endoscopic features, and response to treatment were obtained through chart reviews and patient telephone interviews. The mean age of the patients at symptom onset was 30 years. All patients complained of dysphagia, 81% had a history of bolus obstruction, 43% had a history of asthma and 70% had a history of environmental allergies. Thirty-three per cent had a family history of asthma, while 52% had a family history of food or seasonal allergies. The most common endoscopic findings were rings and/or corrugations, which were found in 63% of patients. Swallowed fluticasone therapy resulted in symptom resolution in 74% of patients; however, 79% of these patients relapsed after discontinuing fluticasone therapy and required repeat treatments. Esophageal dilation was complication free and resulted in improvement in 80% of patients. However, 83% of those reporting improvement relapsed within one year. The clinical and endoscopic findings were similar to those found in the literature, with most patients requiring ongoing, repeated therapies. Further studies are needed to assess the safety and efficacy of treatment modalities ideally suited to patients with EE.

Clinical features of multiple spontaneous intracerebral hemorrhages

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Tao CHANG

2016-01-01

Full Text Available Objective To analyze the clinical features of multiple spontaneous intracerebral hemorrhages (MICH. Methods Conservative therapy, puncture and drainage, hematoma removal and/or decompressive craniectomy were used in the treatment of 630 intracerebral hemorrhage (ICH patients, who were divided into 2 groups: 30 cases with MICH and another 600 cases with solitary intracerebral hemorrhage (SICH. Three months after onset, modified Rankin Scale (mRS was used to evaluate the prognosis of all cases. Results Compared with patients in SICH group, the occurrence rate of hypertension > 5 years (P = 0.008, diabetes mellitus (P = 0.024, hypercholesterolemia (P = 0.050 and previous ischemic stroke (P = 0.026 were all significantly higher in MICH group. The mean arterial pressure (MAP level (P = 0.002 and the incidence of limb movement disorder (P = 0.000 were significantly higher in patients with MICH than those with SICH. Basal ganglia and thalamus were the predilection sites of hematoma (P = 0.001. Patients with MICH had worse prognosis compared to those with SICH 3 months after onset (P = 0.006. Conclusions Hypertension > 5 years, diabetes mellitus, hypercholesterolemia and ischemic stroke were identified to be the pathophysiological basis of MICH in this study. All patients with MICH had more serious clinical manifestations after onset and worse prognosis. DOI: 10.3969/j.issn.1672-6731.2016.01.008

Clinical features and surgical treatment of cauda equina schwannoma

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Jun-jun HUANG

2011-03-01

Full Text Available Objective To investigate the clinical features and surgical treatment method of cauda equina schwannoma.Methods Clinical symptoms,imaging characteristics and functional outcomes after surgical treatment of 32 patients with cauda equina schwannoma from June 2007 to March 2009 were retrospectively reviewed.Results Most patients(30 cases suffered lower extremity numbness/pain before operations and 18 of them suffered in both lower extremities.Physical examination showed bilateral nerve damage or unilateral multiple nerve damage in 25 cases.The initial symptom of 12 cases was simple lumbago.Ten cases were misdiagnosed as lumbar disc herniation.Six patients were scanned by computed tomography but none of them was diagnosed correctly.All the patients were definitely diagnosed by magnetic resonance imaging(MRI,the typical appearance of the schwannoma was a round or ovoid mass with isointense or slightly hyperintense on T1-weighted images,while on T2-weighted images with heterogeneous hyperintense in 25 cases,slightly hyperintense in 2,and homogeneous hyperintense in 5.Gadolinium-enhanced MRI was performed in 13 patients,of whom 10 cases showed heterogeneous or annular enhancing.In all patients,the tumor was resected completely,the functional outcomes were satisfactory except one with a giant tumor,in whom the neurological symptom was aggravated,and no recurrence was found during a short-term follow-up.Conclusions The characteristic features of cauda equina schwannoma were lower extremities numbness/pain and bi-or unilateral polyradiculopathy in physical examination.MRI is helpful for early diagnosis and recommended as the first choice.Functional outcomes are satisfactory in patients with tumor completely resected.

Etiology, clinical features and management of acute recurrent pancreatitis.

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Deng, Yi Yun; Wang, Rui; Wu, Hao; Tang, Cheng Wei; Chen, Xin Zu

2014-10-01

To study the etiology and clinical features of acute recurrent pancreatitis (ARP) and to determine its optimal management and outcomes. ARP cases among acute pancreatitis patients who were admitted to the West China Hospital, Sichuan University from January 2008 to December 2012 were retrospectively collected. Their etiology, clinical features, treatments and outcomes were analyzed. Of all pancreatitis patients, 8.9% were classified as ARP. The proportions of mild and severe diseases were 85.7% and 14.3%, respectively. The common etiological factors were biliogenic (31.0%), alcohol (26.2%), hyperlipidemia (21.4%) and pancreaticobiliary malformation (15.4%). At first 46 cases were cryptogenic and among them 36 were subsequently confirmed by endoscopic retrograde cholangiopancreatography (ERCP). Among the hyperlipidemic ARP patients, 72.2% failed to routinely monitor and control serum lipids. ERCP was performed in 88 cases, and 48 also required an endoscopic sphincterotomy or calculus removal. Twenty-two patients underwent cholangiopancreatic duct stent placement, and pancreatic necrosectomy was performed on eight severe cases. The overall outcomes indicate that 8.3% of the cases progressed to chronic pancreatitis and 33.3% of the cases receiving etiological treatment were recurrence-free. There were no deaths in this study. The etiological factors of ARP are similar to those of acute pancreatitis at the first attack. The management of ARP should be fully considered based on etiological investigation. © 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

HYPERPHAGIA REACTIONS WITHIN EATING DISORDERS. CLINICAL FEATURES AND THERAPY

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O. A. Gladyshev

2014-01-01

Full Text Available Aim. To evaluate clinical features of hyperphagia reactions, their significance in attraction abnormities within eating disorders and treatment options for these conditions with escitalopram.Material and methods. Mental state of 39 women (age 19-50 years with psychogenic overeating and obesity (body mass index of 30 to 53 kg/m2 was studied. Patients were admitted to the Institute of Nutrition of the Russian Academy of Medical Sciences. Diagnostic criteria for International Classification of Diseases, 10th edition, as well as Eating Disorder Inventory (EDI, Hospital Anxiety and Depression Scale (HADS and Ferreri Anxiety Rating Diagram (FARD were used for syndrome qualifications. Patient Global Impression of Change was also studied using a 4-point scale of results (excellent, good, fair, and negative.Results. Clinical features of hyperphagic reactions were found. Escitalopram treatment course was completed with excellent and good results in 80% of patients. 50%-reduction in HADS score for anxiety was found in 74% of patients, for depression – in 63%, and for Ferreri scale – in 68% of patients. Escitalopram promoted more intensive body weight loss: 11% vs 8% of baseline weight in active and control groups, respectively. Adverse events occurred only in 7 (36% patients; they were transient and did not require therapy discontinuation.Conclusion: Significant differences of premanifest disorders were often observed in patients history. Escitalopram in these patients showed efficacy in improvement of both mental and somatic symptoms of anxiety. It decreased dependence on food as a factor mitigating affect and stress, thus provided better results in body weight reduction.

HYPERPHAGIA REACTIONS WITHIN EATING DISORDERS. CLINICAL FEATURES AND THERAPY

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O. A. Gladyshev

2015-09-01

Full Text Available Aim. To evaluate clinical features of hyperphagia reactions, their significance in attraction abnormities within eating disorders and treatment options for these conditions with escitalopram.Material and methods. Mental state of 39 women (age 19-50 years with psychogenic overeating and obesity (body mass index of 30 to 53 kg/m2 was studied. Patients were admitted to the Institute of Nutrition of the Russian Academy of Medical Sciences. Diagnostic criteria for International Classification of Diseases, 10th edition, as well as Eating Disorder Inventory (EDI, Hospital Anxiety and Depression Scale (HADS and Ferreri Anxiety Rating Diagram (FARD were used for syndrome qualifications. Patient Global Impression of Change was also studied using a 4-point scale of results (excellent, good, fair, and negative.Results. Clinical features of hyperphagic reactions were found. Escitalopram treatment course was completed with excellent and good results in 80% of patients. 50%-reduction in HADS score for anxiety was found in 74% of patients, for depression – in 63%, and for Ferreri scale – in 68% of patients. Escitalopram promoted more intensive body weight loss: 11% vs 8% of baseline weight in active and control groups, respectively. Adverse events occurred only in 7 (36% patients; they were transient and did not require therapy discontinuation.Conclusion: Significant differences of premanifest disorders were often observed in patients history. Escitalopram in these patients showed efficacy in improvement of both mental and somatic symptoms of anxiety. It decreased dependence on food as a factor mitigating affect and stress, thus provided better results in body weight reduction.

Clinical manifestations and pulmonary radiological features in patients with triphosgene poisoning

International Nuclear Information System (INIS)

Ye Caier, Chen Weijian; Wu Enfu; Yang Yunjun; Ye Min; Liu Zaiyi

2007-01-01

Objective: To examine the clinical manifestations and pulmonary radiological features in patients with triphosgene poisoning. Methods: Clinical manifestations, laboratory tests and CT scans were analyzed retrospectively in 17 patients with triphosgene poisoning. We focused on the severity, development and repair of pulmonary impairment. Results: Plain film and CT scans in five mild cases demonstrated bilateral scattered pulmonary patchy shadows. Of 12 cases with moderate to severe diseases, three showed bilateral multiple pulmonary patchy shadows and nodules with confluence of part of the lesions on plain film and CT scans; bilateral lungs were involved in nine cases with imaging findings of bilateral disseminated pulmonary round or ovary nodules with different size, ill-defined and partly-confluent patchy shadows and thickening of both interlobular septum and the wall of bronchus. Of clinical interests, imaging findings were closely correlated with clinical course and laboratory results. Conclusion: Radiological examinations with plain films and CT scans could reveal the severity, evolvement of pulmonary edema in patients with triphosgene poisoning, and these are of clinical benefit in the early management and prognostic evaluation of patients with triphosgene poisoning. (authors)

[Clinical and pathological features of breast cancer in a population of Mexico].

Science.gov (United States)

Maffuz-Aziz, Antonio; Labastida-Almendaro, Sonia; Espejo-Fonseca, Aura; Rodríguez-Cuevas, Sergio

Breast cancer is the most common among women in our country, and its treatment is based on prognostic factors to categorize patients into different risk groups. In this study, the clinical and pathological features that play a role as a prognostic factor in a representative population with breast cancer in México are described. A descriptive analysis of the clinical and pathological features of women diagnosed with breast cancer, in a period from June 2005 to May 2014; registered in a database and calculated by simple frequencies. A total of 4,411 patients were included, the average age at diagnosis was 53 years, 19.7% were diagnosed by mammography screening program and 80.3% derived from any signs or symptoms. Regarding the stages at diagnosis, 6.8% were carcinoma in situ, 36% at early stages (I and IIA), 45% locally advanced (IIB to IIIC), 7.7% metastatic and 3.9% unclassifiable. A 79% were ductal histology, lobular 7.8% and the rest, other types. Of ductal carcinomas, 9.1% were grade I, 54.1% grade II, and 34.6% grade III. Regarding the biological subtypes, 65.7% were luminal, 10.9% luminal Her positive, 8.7% pure Her 2 positive and 14.6% triple negative. In the present study, we described the clinical and pathologic features of a group of Mexican women with breast cancer that might reflect a national landscape, and represent the prognostic factors to determine groups of risk and treatment decisions. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Stargardt disease: clinical features, molecular genetics, animal models and therapeutic options

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Tanna, Preena; Strauss, Rupert W; Fujinami, Kaoru; Michaelides, Michel

2017-01-01

Stargardt disease (STGD1; MIM 248200) is the most prevalent inherited macular dystrophy and is associated with disease-causing sequence variants in the gene ABCA4. Significant advances have been made over the last 10 years in our understanding of both the clinical and molecular features of STGD1, and also the underlying pathophysiology, which has culminated in ongoing and planned human clinical trials of novel therapies. The aims of this review are to describe the detailed phenotypic and genotypic characteristics of the disease, conventional and novel imaging findings, current knowledge of animal models and pathogenesis, and the multiple avenues of intervention being explored. PMID:27491360

Uncovering Clinical Features of De Novo Philadelphia Positive Myelodysplasia.

Science.gov (United States)

Armas, Aristides; Chen, Chen; Mims, Martha; Rivero, Gustavo

2017-01-01

Myelodysplastic syndrome (MDS) is cytogenetically heterogeneous and retains variable risk for acute myeloid leukemia transformation. Though not yet fully understood, there is an association between genetic abnormalities and defects in gene expression. The functional role for infrequent cytogenetic alteration remains unclear. An uncommon chromosomic abnormality is the presence of the Philadelphia (Ph) chromosome. Here, we report a patient with Ph+ MDS treated with low dose Dasatinib who achieved hematologic response for 7 months. In addition, we also examined the English literature on all de novo Ph + MDS cases between 1996 and 2015 to gain insight into clinical features and outcome.

The Left Labourites and the General Strike of 1926 in the UK

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Evgeniya G. Blosfeld

2017-12-01

Full Text Available The author analyses the left labourites’ attitude to the interaction of the Labour Party and trade unions and use of general strike as a means of the social struggle. Besides the article analyses the left labourites’ estimation of 1926 general strike and the causes of the defeat, and the strike of the miners who decided to continue it. The left labourites defended the branch principle of the trade unions’ organization based on the shopstewards’ model which was better adopted for the strike struggle. The left labourites took into account that the general structure of the labour movement would remain the same, but the Labour Party would take over the leadership from trade unions. The left labourites supported the peaceful way of transition to socialism and they considered the general strike to be analogy of social revolution or a means of pressure of the government for nationalization of the main economic branches and the improvement of the workers’ life conditions. Under extreme circumstances, the general strike was considered to be a means to prevent antidemocratic revolution. Evaluating the general strike of 1926, the author marks the absence of unity in the leadership, hesitations and inconsistency of the left labourites themselves. They didn’t give a single proposal about the improvement of the working-class movement organization except of state British Trade Unions Congress. As a result, the criticism of the General Council’s renegade position was bestowed upon the leadership of the Miners Federation who didn’t submit to the General Council order to stop the strike.

Clinical features of pedophilia and implications for treatment.

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Cohen, Lisa J; Galynker, Igor I

2002-09-01

The authors discuss the diagnostic criteria for pedophilia and review the literature on its clinical features, including data on prevalence, gender, age of onset, number of victims, frequency and type of acts, violence, impulsivity, and insight. Findings concerning the characteristics of victims (e.g., sex, age, relationship to the pedophile) and research on pedophilic subtypes-exclusive versus nonexclusive; incestuous versus nonincestuous; heterosexual, homosexual, or bisexual-are reviewed. Studies have shown that pedophiles may share many psychiatric features beyond deviant sexual desire, including high rates of comorbid axis I disorders (affective disorders, substance use disorders, impulse control disorders, other paraphilias) as well as severe axis II psychopathology (especially antisocial and Cluster C personality disorders). The authors present several possible etiological models for pedophilia and conclude that further research is needed concerning the etiological role of a childhood history of sexual abuse as well as the underlying neurobiology of deviant sexual arousal and decreased erotic differentiation. Finally, findings concerning pharmacological and cognitive-behavioral treatments for pedophilia are briefly reviewed. Recidivism, drop-out, and noncompliance are significant problems in the treatment of pedophilia. The authors review predictors of treatment outcome and conclude that pedophilia is extremely difficult to treat and that effective treatment needs to be intensive, long-term, and comprehensive, possibly with lifetime follow-up.

Factors affecting defensive strike behavior in Brown Treesnakes (Boiga irregularis) provoked by humans

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Spencer, McKayka M.; Lardner, Bjorn; Mazurek, M.J.; Reed, Robert N.

2015-01-01

Striking is a typical antipredator defense exhibited by many species of snakes. While trapping Brown Treesnakes (Boiga irregularis) on Guam, we observed that snakes most frequently struck at an approaching person at a site where snakes had been trapped, marked, and handled in the past. Using a combination of between-sites and within-site comparisons, we assessed if the propensity to strike was correlated with capture histories (both recent and long-term), snake size, body condition (a proxy to nutritional stress), sex, or tail condition (broken or intact), while controlling for confounding variables. We confirmed that propensity to strike was higher at the site where we had been conducting capture-mark-recapture for several years. However, we were unable to demonstrate a correlation between striking tendencies and individual recent or long-term capture histories. The only morphological covariate that had an effect on strike propensity was sex, with females striking more often than males. After removing the site effect from our model, we found that snakes missing parts of their tails were more likely to strike than snakes with intact tails. We have yet to identify the factor(s) that cause the pronounced difference across sites in snake propensity to strike, and data from additional sites might help elucidate any geographical patterns.

Footwear Matters: Influence of Footwear and Foot Strike on Load Rates during Running.

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Rice, Hannah M; Jamison, Steve T; Davis, Irene S

2016-12-01

Running with a forefoot strike (FFS) pattern has been suggested to reduce the risk of overuse running injuries, due to a reduced vertical load rate compared with rearfoot strike (RFS) running. However, resultant load rate has been reported to be similar between foot strikes when running in traditional shoes, leading to questions regarding the value of running with a FFS. The influence of minimal footwear on the resultant load rate has not been considered. This study aimed to compare component and resultant instantaneous loading rate (ILR) between runners with different foot strike patterns in their habitual footwear conditions. Twenty-nine injury-free participants (22 men, seven women) ran at 3.13 m·s along a 30-m runway, with their habitual foot strike and footwear condition. Ground reaction force data were collected. Peak ILR values were compared between three conditions; those who habitually run with an RFS in standard shoes, with an FFS in standard shoes, and with an FFS in minimal shoes. Peak resultant, vertical, lateral, and medial ILR were lower (P strike. When running with an FFS, peak posterior ILR were lower (P strike. Therefore, it appears that footwear alters the load rates during running, even with similar foot strike patterns.

Relationship between foot strike pattern, running speed, and footwear condition in recreational distance runners.

Science.gov (United States)

Cheung, Roy T H; Wong, Rodney Y L; Chung, Tim K W; Choi, R T; Leung, Wendy W Y; Shek, Diana H Y

2017-06-01

Compared to competitive runners, recreational runners appear to be more prone to injuries, which have been associated with foot strike patterns. Surprisingly, only few studies had examined the foot strike patterns outside laboratories. Therefore, this study compared the foot strike patterns in recreational runners at outdoor tracks with previously reported data. We also investigated the relationship between foot strike pattern, speed, and footwear in this cohort. Among 434 recreational runners analysed, 89.6% of them landed with rearfoot strike (RFS). Only 6.9 and 3.5% landed with midfoot and forefoot, respectively. A significant shift towards non-RFS was observed in our cohort, when compared with previously reported data. When speed increased by 1 m/s, the odds of having forefoot strike and midfoot strike relative to RFS increased by 2.3 times and 2.6 times, respectively. Runners were 9.2 times more likely to run with a forefoot strike in minimalists compared to regular running shoes, although 70% of runners in minimalists continued to use a RFS. These findings suggest that foot strike pattern may differ across running conditions and runners should consider these factors in order to mitigate potential injury.

Association of systemic lupus erythematosus clinical features with European population genetic substructure.

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Elisa Alonso-Perez

Full Text Available Systemic Lupus Erythematosus (SLE is an autoimmune disease with a very varied spectrum of clinical manifestations that could be partly determined by genetic factors. We aimed to determine the relationship between prevalence of 11 clinical features and age of disease onset with European population genetic substructure. Data from 1413 patients of European ancestry recruited in nine countries was tested for association with genotypes of top ancestry informative markers. This analysis was done with logistic regression between phenotypes and genotypes or principal components extracted from them. We used a genetic additive model and adjusted for gender and disease duration. Three clinical features showed association with ancestry informative markers: autoantibody production defined as immunologic disorder (P = 6.8×10(-4, oral ulcers (P = 6.9×10(-4 and photosensitivity (P = 0.002. Immunologic disorder was associated with genotypes more common in Southern European ancestries, whereas the opposite trend was observed for photosensitivity. Oral ulcers were specifically more common in patients of Spanish and Portuguese self-reported ancestry. These results should be taken into account in future research and suggest new hypotheses and possible underlying mechanisms to be investigated. A first hypothesis linking photosensitivity with variation in skin pigmentation is suggested.

Association of Systemic Lupus Erythematosus Clinical Features with European Population Genetic Substructure

Science.gov (United States)

Calaza, Manuel; Witte, Torsten; Papasteriades, Chryssa; Marchini, Maurizio; Migliaresi, Sergio; Kovacs, Attila; Ordi-Ros, Josep; Bijl, Marc; Santos, Maria Jose; Ruzickova, Sarka; Pullmann, Rudolf; Carreira, Patricia; Skopouli, Fotini N.; D'Alfonso, Sandra; Sebastiani, Gian Domenico; Suarez, Ana; Blanco, Francisco J.; Gomez-Reino, Juan J.; Gonzalez, Antonio

2011-01-01

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with a very varied spectrum of clinical manifestations that could be partly determined by genetic factors. We aimed to determine the relationship between prevalence of 11 clinical features and age of disease onset with European population genetic substructure. Data from 1413 patients of European ancestry recruited in nine countries was tested for association with genotypes of top ancestry informative markers. This analysis was done with logistic regression between phenotypes and genotypes or principal components extracted from them. We used a genetic additive model and adjusted for gender and disease duration. Three clinical features showed association with ancestry informative markers: autoantibody production defined as immunologic disorder (P = 6.8×10−4), oral ulcers (P = 6.9×10−4) and photosensitivity (P = 0.002). Immunologic disorder was associated with genotypes more common in Southern European ancestries, whereas the opposite trend was observed for photosensitivity. Oral ulcers were specifically more common in patients of Spanish and Portuguese self-reported ancestry. These results should be taken into account in future research and suggest new hypotheses and possible underlying mechanisms to be investigated. A first hypothesis linking photosensitivity with variation in skin pigmentation is suggested. PMID:22194982

Clinical-Diagnostic Features of Duchenne Muscular Dystrophy in Children

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Umida T. Omonova

2013-12-01

Full Text Available Duchenne Muscular Dystrophy (DMD is a severe, progressive disease that affects about 1 out of every 5,000 male infants; this is the most destructive of all muscular dystrophies, which worsens rapidly. In this study, we performed a clinical analysis of 37 children with DMD. They ranged in age from 3 to 15 years, mean age being 7.8±0.48 years. The mean age at onset was 4.3±0.36 years and ranged from birth to 8 years. The biochemical examination included the determination of the serum levels of the following enzymes, AST, ALT, CPK-MM, and LDH. A genealogical analysis was conducted among 240 first-degree relatives of children with DMD. Electroneuromyography examination included registration of the biopotentials of the hand and foot muscles, measurement of the muscle response (M-wave and the late-evoked responses. The clinical-diagnostic features of DMD in children were characterized.

Differences in clinical features according to Boryoung and Karp genotypes of Orientia tsutsugamushi.

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Dong-Min Kim

Full Text Available Scrub typhus is an infectious disease caused by Orientia tsutsugamushi. The differences in virulence of O. tsutsugamushi prototypes in humans are still unknown. We investigated whether there are any differences in the clinical features of the Boryoung and Karp genotypes.Patients infected with O. tsutsugamushi, as Boryoung and Karp clusters, who had visited 6 different hospitals in southwestern Korea were prospectively compared for clinical features, complications, laboratory parameters, and treatment responses. Infected patients in the Boryoung cluster had significantly more generalized weakness, eschars, skin rashes, conjunctival injection, high albumin levels, and greater ESR and fibrinogen levels compared to the Karp cluster. The treatment response to current antibiotics was significantly slower in the Karp cluster as compared to the Boryoung cluster.The frequency of occurrence of eschars and rashes may depend on the genotype of O. tsutsugamushi.

Clinical features and differential diagnosis of type 2 diabetes mellitus in children

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Tamara Leonidovna Kuraeva

2009-09-01

Full Text Available This review was designed to evaluate prevalence, specific clinical features, and differential diagnosis of type 2 diabetes mellitus (DM2 in childrenand adolescents. Special emphasis is laid on the importance of immunological and molecular-genetic studies for the verification of diagnosis and activecase detection in h groups.

Late-onset hypogonadism: etiology, clinical features, diagnostics, treatment

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E. Yu. Pashkova

2015-04-01

Full Text Available In a critical review of the literature current data concerning etiology, clinical features, diagnostics, treatment of late-onset hypogonadism (LOH are given. LOH is a multidisciplinary problem, because a patient with LOH can have osteoporosis, anemia, depression, obesity, diabetes mellitus, erectile dysfunction. Sometimes it is hard to realize that all this complaints are symptoms of LOH. LOH has a negative impact on a patient,s quality of life and it,s impossible to help without androgen replacement therapy. Furthermore doctors often have doubts about testosterone replacement therapy safety because of lack of accurate information. In a convenient for medical practitioners form clinical and laboratory diagnostic criteria of LOH are presented together with formulas for conversion from one measurement unit of main sex hormones into another. Based on latest ISSAM guidelines (International Society for the Study of the Aging Male modern treatment options of LOH are summarized, full information about available testosterone preparations (oral, transdermal, injectable with comparative analysis of advantages and disadvantages of each is given. A full description of indications and contraindications for androgen replacement treatment is presented, also treatment regimen and medical supervision algorithm during treatment are described. 

Late-onset hypogonadism: etiology, clinical features, diagnostics, treatment

Directory of Open Access Journals (Sweden)

E. Yu. Pashkova

2015-01-01

Full Text Available In a critical review of the literature current data concerning etiology, clinical features, diagnostics, treatment of late-onset hypogonadism (LOH are given. LOH is a multidisciplinary problem, because a patient with LOH can have osteoporosis, anemia, depression, obesity, diabetes mellitus, erectile dysfunction. Sometimes it is hard to realize that all this complaints are symptoms of LOH. LOH has a negative impact on a patient,s quality of life and it,s impossible to help without androgen replacement therapy. Furthermore doctors often have doubts about testosterone replacement therapy safety because of lack of accurate information. In a convenient for medical practitioners form clinical and laboratory diagnostic criteria of LOH are presented together with formulas for conversion from one measurement unit of main sex hormones into another. Based on latest ISSAM guidelines (International Society for the Study of the Aging Male modern treatment options of LOH are summarized, full information about available testosterone preparations (oral, transdermal, injectable with comparative analysis of advantages and disadvantages of each is given. A full description of indications and contraindications for androgen replacement treatment is presented, also treatment regimen and medical supervision algorithm during treatment are described. 

Key clinical features to identify girls with CDKL5 mutations.

Science.gov (United States)

Bahi-Buisson, Nadia; Nectoux, Juliette; Rosas-Vargas, Haydeé; Milh, Mathieu; Boddaert, Nathalie; Girard, Benoit; Cances, Claude; Ville, Dorothée; Afenjar, Alexandra; Rio, Marlène; Héron, Delphine; N'guyen Morel, Marie Ange; Arzimanoglou, Alexis; Philippe, Christophe; Jonveaux, Philippe; Chelly, Jamel; Bienvenu, Thierry

2008-10-01

Mutations in the human X-linked cyclin-dependent kinase-like 5 (CDKL5) gene have been shown to cause infantile spasms as well as Rett syndrome (RTT)-like phenotype. To date, less than 25 different mutations have been reported. So far, there are still little data on the key clinical diagnosis criteria and on the natural history of CDKL5-associated encephalopathy. We screened the entire coding region of CDKL5 for mutations in 183 females with encephalopathy with early seizures by denaturing high liquid performance chromatography and direct sequencing, and we identified in 20 unrelated girls, 18 different mutations including 7 novel mutations. These mutations were identified in eight patients with encephalopathy with RTT-like features, five with infantile spasms and seven with encephalopathy with refractory epilepsy. Early epilepsy with normal interictal EEG and severe hypotonia are the key clinical features in identifying patients likely to have CDKL5 mutations. Our study also indicates that these patients clearly exhibit some RTT features such as deceleration of head growth, stereotypies and hand apraxia and that these RTT features become more evident in older and ambulatory patients. However, some RTT signs are clearly absent such as the so called RTT disease profile (period of nearly normal development followed by regression with loss of acquired fine finger skill in early childhood and characteristic intensive eye communication) and the characteristic evolution of the RTT electroencephalogram. Interestingly, in addition to the overall stereotypical symptomatology (age of onset and evolution of the disease) resulting from CDKL5 mutations, atypical forms of CDKL5-related conditions have also been observed. Our data suggest that phenotypic heterogeneity does not correlate with the nature or the position of the mutations or with the pattern of X-chromosome inactivation, but most probably with the functional transcriptional and/or translational consequences of CDKL5

The early clinical features of dengue in adults: challenges for early clinical diagnosis.

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Jenny G H Low

Full Text Available BACKGROUND: The emergence of dengue throughout the tropical world is affecting an increasing proportion of adult cases. The clinical features of dengue in different age groups have not been well examined, especially in the context of early clinical diagnosis. METHODOLOGY/PRINCIPAL FINDINGS: We structured a prospective study of adults (≥ 18 years of age presenting with acute febrile illness within 72 hours from illness onset upon informed consent. Patients were followed up over a 3-4 week period to determine the clinical outcome. A total of 2,129 adults were enrolled in the study, of which 250 (11.7% had dengue. Differences in the rates of dengue-associated symptoms resulted in high sensitivities when the WHO 1997 or 2009 classification schemes for probable dengue fever were applied to the cohort. However, when the cases were stratified into age groups, fewer older adults reported symptoms such as myalgia, arthralgia, retro-orbital pain and mucosal bleeding, resulting in reduced sensitivity of the WHO classification schemes. On the other hand, the risks of severe dengue and hospitalization were not diminished in older adults, indicating that this group of patients can benefit from early diagnosis, especially when an antiviral drug becomes available. Our data also suggests that older adults who present with fever and leukopenia should be tested for dengue, even in the absence of other symptoms. CONCLUSION: Early clinical diagnosis based on previously defined symptoms that are associated with dengue, even when used in the schematics of both the WHO 1997 and 2009 classifications, is difficult in older adults.

Is Early-onset in Major Depression a Predictor of Specific Clinical Features with More Impaired Social Function?

Institute of Scientific and Technical Information of China (English)

Yan-Hong Liu; Lin Chen; Yun-Ai Su; Yi-Ru Fang; Manit Srisurapanont; Jin Pyo Hong; Ahmad Hatim

2015-01-01

Background:Early-onset major depressive disorder (MDD) (EOD) is often particularly malignant due to its special clinical features,accompanying impaired social function,protracted recovery time,and frequent recurrence.This study aimed to observe the effects of age onset on clinical characteristics and social function in MDD patients in Asia.Methods:In total,547 out-patients aged 18-65 years who were from 13 study sites in five Asian countries were included.These patients had MDD diagnose according to the Diagnostic and Statistical Manual of Mental Disorders,4th Edition criteria.Clinical features and social function were assessed using Symptom Checklist-90-revised (SCL-90-R) and Sheehan Disability Scale (SDS).Quality of life was assessed by a 36-item Short-form Health Survey (SF-36).Analyses were performed using a continuous or dichotomous (cut-off:30 years)age-of-onset indicator.Results:Early-onset MDD (EOD,＜30 years) was associated with longer illness (P =0.003),unmarried status (P ＜ 0.001),higher neuroticism (P ≤ 0.002) based on the SCL-90-R,and more limited social function and mental health (P =0.006,P =0.007) based on the SF-36 and SDS.The impairment of social function and clinical severity were more prominent at in-patients with younger onset ages.Special clinical features and more impaired social function and quality of life were associated with EOD,as in western studies.Conclusions:EOD often follows higher levels of neuroticism.Age of onset of MDD may be a predictor of clinical features and impaired social function,allowing earlier diagnosis and treatment.

Implications of Incessant Strike Actions on the Implementation of Technical Education Programme in Nigeria

Science.gov (United States)

Adavbiele, J. A.

2015-01-01

This paper was designed to x-ray the implications of incessant strike actions on the implementation of Technical education programme in Nigeria. The paper took an exploratory view on the concept of strike actions in Nigeria with particular references on notable strike actions that have occurred in Nigeria. The types of strike were explained and…

Feature Issue Introduction: Bio-Optics in Clinical Applications, Nanotechnology, and Drug Discovery

OpenAIRE

Nordstrom, Robert J.; Almutairi, Adah; Hillman, Elizabeth M.C.

2010-01-01

The editors introduce the Biomedical Optics Express feature issue, “Bio-Optics in Clinical Applications, Nanotechnology, and Drug Discovery,” which combines three technical areas from the 2010 Optical Society of America (OSA), Biomedical Optics (BIOMED) Topical Meeting held on 11–14 April in Miami, FL and includes contributions from conference attendees.

Variation in Foot Strike Patterns among Habitually Barefoot and Shod Runners in Kenya.

Science.gov (United States)

Lieberman, Daniel E; Castillo, Eric R; Otarola-Castillo, Erik; Sang, Meshack K; Sigei, Timothy K; Ojiambo, Robert; Okutoyi, Paul; Pitsiladis, Yannis

2015-01-01

Runners are often categorized as forefoot, midfoot or rearfoot strikers, but how much and why do individuals vary in foot strike patterns when running on level terrain? This study used general linear mixed-effects models to explore both intra- and inter-individual variations in foot strike pattern among 48 Kalenjin-speaking participants from Kenya who varied in age, sex, body mass, height, running history, and habitual use of footwear. High speed video was used to measure lower extremity kinematics at ground contact in the sagittal plane while participants ran down 13 meter-long tracks with three variables independently controlled: speed, track stiffness, and step frequency. 72% of the habitually barefoot and 32% of the habitually shod participants used multiple strike types, with significantly higher levels of foot strike variation among individuals who ran less frequently and who used lower step frequencies. There was no effect of sex, age, height or weight on foot strike angle, but individuals were more likely to midfoot or forefoot strike when they ran on a stiff surface, had a high preferred stride frequency, were habitually barefoot, and had more experience running. It is hypothesized that strike type variation during running, including a more frequent use of forefoot and midfoot strikes, used to be greater before the introduction of cushioned shoes and paved surfaces.

Variation in Foot Strike Patterns among Habitually Barefoot and Shod Runners in Kenya.

Directory of Open Access Journals (Sweden)

Daniel E Lieberman

Full Text Available Runners are often categorized as forefoot, midfoot or rearfoot strikers, but how much and why do individuals vary in foot strike patterns when running on level terrain? This study used general linear mixed-effects models to explore both intra- and inter-individual variations in foot strike pattern among 48 Kalenjin-speaking participants from Kenya who varied in age, sex, body mass, height, running history, and habitual use of footwear. High speed video was used to measure lower extremity kinematics at ground contact in the sagittal plane while participants ran down 13 meter-long tracks with three variables independently controlled: speed, track stiffness, and step frequency. 72% of the habitually barefoot and 32% of the habitually shod participants used multiple strike types, with significantly higher levels of foot strike variation among individuals who ran less frequently and who used lower step frequencies. There was no effect of sex, age, height or weight on foot strike angle, but individuals were more likely to midfoot or forefoot strike when they ran on a stiff surface, had a high preferred stride frequency, were habitually barefoot, and had more experience running. It is hypothesized that strike type variation during running, including a more frequent use of forefoot and midfoot strikes, used to be greater before the introduction of cushioned shoes and paved surfaces.

[Clinical and endoscopic features of a selected population with serrated colorectal adenomas in a private clinic in Lima - Peru].

Science.gov (United States)

Castillo, Ofelia; Barreda, Carlos; Recavarren, Sixto; Barriga, José A; Salazar M, Fernando; Yriberry, Simón; Barriga, Eduardo; Salazar C, Fernando

2013-01-01

To describe the clinical and endoscopic caracteristics of a population that has only serrated polyps of colon (mainly sessile serrated adenomas) in a private clinic in Lima, Perú, from 2009-2011. Retrospective study conducted at the endoscopy center of Clinic Ricardo Palma, Lima, Peru. Olympus colonoscope was used with high definition, including NBI (narrow band imaging) and electronic magnification. Patients had pathologic diagnosis of “polyps and / or colorectal serrated adenomas” and excluded those with synchronous tubular or villous adenomas. Images were evaluated by two endoscopists and then by a third gastroenterologist. We found 201 serrated polyps in 108 patients. Women were 60.2% and overweight predominated. Eighty (74.1%) had only one serrated adenoma and 23 (21.3%) with at least one synchronous hyperplastic polyp. The average size of sessile serrated adenomas was 5.12 mm (± 3.87 DS) and the flat type was 91 (58.7%). There were significant differences in the diameter of sessile serrated adenomas between the distal and proximal colon (4.47 mm ± 2.23 vs. 6.90 mm ± 6.25; p<0.000). The common features of sessile serrated adenomas were: White (31/36, 86.1%), smooth (28/36, 77.8%) and regular margins (26/36, 72.2%). There was a relationship between vascular pattern according NBI and serrated polyp histology (p=0.024). The endoscopic features of sessile serrated adenomas can evade detection to white light. NBI is a useful tool to define some features of these lesions.

Clinical features, management and outcomes of progressive outer retinal necrosis (PORN) in southern Thailand.

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Sittivarakul, Wantanee; Aui-aree, Nipat

2009-03-01

To study the demographics, clinical features, treatment, and visual outcomes of progressive outer retinal necrosis (PORN) in a group of Thai patients. All cases of AIDS with a clinical diagnosis of PORN in a major tertiary referral hospital in southern Thailand between January 2003 and June 2007 were retrospectively reviewed. Demographic data, clinical features, treatment regimens, and visual outcomes were analyzed. Seven patients (11 eyes) were studied. The mean age was 44.7 years. The median CD4 count was 12 cells/mm3. A known history of cutaneous zoster was documented in 57% of cases. The median follow-up period was 17 weeks. Fifty-seven percent of the patients had bilateral disease. A majority of eyes (45.4%) had initial visual acuity of less than 20/50 to equal to or better than 20/200. About two-thirds of the eyes had anterior chamber cells. Vitritis and retinal lesions scattered throughout both posterior pole and peripheral retina were found in 72.7%. Either intravenous acyclovir in combination with intravitreal ganciclovir injections or intravenous aclyclovir alone was used for initial treatment. Retinal detachment occurred in 54.5%. Final visual acuity worsened (loss of 3 lines on the ETDRS chart or more) in 60%. Visual acuity was no light perception in 45.5% at the final recorded follow-up. Demographics, clinical features and treatment outcomes of PORN in this group of Thai patients were comparable with studies from other countries. Visual prognosis is still poor with current treatment regimens.

Fractographic features of glass-ceramic and zirconia-based dental restorations fractured during clinical function.

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Oilo, Marit; Hardang, Anne D; Ulsund, Amanda H; Gjerdet, Nils R

2014-06-01

Fractures during clinical function have been reported as the major concern associated with all-ceramic dental restorations. The aim of this study was to analyze the fracture features of glass-ceramic and zirconia-based restorations fractured during clinical use. Twenty-seven crowns and onlays were supplied by dentists and dental technicians with information about type of cement and time in function, if available. Fourteen lithium disilicate glass-ceramic restorations and 13 zirconia-based restorations were retrieved and analyzed. Fractographic features were examined using optical microscopy to determine crack initiation and crack propagation of the restorations. The material comprised fractured restorations from one canine, 10 incisors, four premolars, and 11 molars. One crown was not categorized because of difficulty in orientation of the fragments. The results revealed that all core and veneer fractures initiated in the cervical margin and usually from the approximal area close to the most coronally placed curvature of the margin. Three cases of occlusal chipping were found. The margin of dental all-ceramic single-tooth restorations was the area of fracture origin. The fracture features were similar for zirconia, glass-ceramic, and alumina single-tooth restorations. Design features seem to be of great importance for fracture initiation. © 2014 Eur J Oral Sci.

Clinical features and 123I-FP-CIT SPECT imaging in drug-induced parkinsonism and Parkinson's disease

International Nuclear Information System (INIS)

Diaz-Corrales, Francisco J.; Escobar-Delgado, Teresa; Sanz-Viedma, Salome; Garcia-Solis, David; Mir, Pablo

2010-01-01

To determine clinical predictors and accuracy of 123 I-FP-CIT SPECT imaging in the differentiation of drug-induced parkinsonism (DIP) and Parkinson's disease (PD). Several clinical features and 123 I-FP-CIT SPECT images in 32 patients with DIP, 25 patients with PD unmasked by antidopaminergic drugs (PDu) and 22 patients with PD without a previous history of antidopaminergic treatment (PDc) were retrospectively evaluated. DIP and PD shared all clinical features except symmetry of parkinsonian signs which was more frequently observed in patients with DIP (46.9%) than in patients with PDu (16.0%, p 123 I-FP-CIT SPECT images were normal in 29 patients with DIP (90.6%) and abnormal in all patients with PD, and this imaging technique showed high levels of accuracy. DIP and PD are difficult to differentiate based on clinical signs. The precision of clinical diagnosis could be reliably enhanced by 123 I-FP-CIT SPECT imaging. (orig.)

High-Resolution Anoscopy: Clinical Features of Anal Intraepithelial Neoplasia in HIV-positive Men

NARCIS (Netherlands)

Richel, Olivier; Hallensleben, Nora D. L.; Kreuter, Alexander; van Noesel, Carel J. M.; Prins, Jan M.; de Vries, Henry J. C.

2013-01-01

BACKGROUND: High-resolution anoscopy is increasingly advocated to screen HIV+ men who have sex with men for anal cancer and its precursor lesions, anal intraepithelial neoplasia. A systematic comparison between clinical features and the histopathology of suspect lesions is lacking. OBJECTIVE: This

Small deletions of SATB2 cause some of the clinical features of the 2q33.1 microdeletion syndrome.

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Jill A Rosenfeld

Full Text Available Recurrent deletions of 2q32q33 have recently been reported as a new microdeletion syndrome. Clinical features of this syndrome include severe mental retardation, growth retardation, dysmorphic features, thin and sparse hair, feeding difficulties and cleft or high palate. The commonly deleted region contains at least seven genes. Haploinsufficiency of one of these genes, SATB2, a DNA-binding protein that regulates gene expression, has been implicated as causative in the cleft or high palate of individuals with 2q32q33 microdeletion syndrome. In this study we describe three individuals with smaller microdeletions of this region, within 2q33.1. The deletions ranged in size from 173.1 kb to 185.2 kb and spanned part of SATB2. Review of clinical records showed similar clinical features among these individuals, including severe developmental delay and tooth abnormalities. Two of the individuals had behavioral problems. Only one of the subjects presented here had a cleft palate, suggesting reduced penetrance for this feature. Our results suggest that deletion of SATB2 is responsible for several of the clinical features associated with 2q32q33 microdeletion syndrome.

Severe hyperthyroidism: aetiology, clinical features and treatment outcome.

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Iglesias, P; Dévora, O; García, J; Tajada, P; García-Arévalo, C; Díez, J J

2010-04-01

Severe hyperthyroidism (SH) is a serious medical disorder that can compromise life. There have not been systematic studies in which SH has been evaluated in detail. Here, our aims were: (1) to analyse both clinical and analytical features and outcome in patients with SH and (2) to compare these data with those found in more usual forms of hyperthyroidism. Patients and methods All patients diagnosed of SH (free thyroxine, FT4 > 100 pmol/l, NR: 11-23) seen in our endocrinology clinic in the last 15 years were studied and compared with a sample of patients with mild (mH; FT4, 23-50 pmol/l) and moderate (MH; FT4, 51-100 pmol/l) hyperthyroidism. Aetiology, clinical analytical and imaging data at diagnosis, therapeutic response and outcome were registered. Results A total of 107 patients with overt hyperthyroidism (81 females, mean age +/- SD 46.9 +/- 16.1 years) were evaluated. We studied a historic group with SH (n = 21; 14 females, 40.9 +/- 17.2 years) and, as a comparator group, we analyszed the data of 86 hyperthyroid patients (67 females, 48.4 +/- 15.5.6 years, NS) comparable in age and gender. The comparator group was classified in MH (n = 37, 26 females, 47.2 +/- 16.6 years) and mH (n = 49, 41 females, 49.4 +/- 14.8 years). In comparison with mH group, SH patients were significantly (P hyperthyroidism. FT4 was the only independent predictor of cure [OR 0.98 (CI 95%, 0.97-0.99), P hyperthyroidism is usually de novo and is accompanied by more clinical signs, symptoms, and analytical derangements, as well as higher titres of TRAb at diagnosis than milder forms of hyperthyroidism. The present data are not able to show differences in treatment modality, time to achieve cure, and remission rate among patients with mild, moderate and severe hyperthyroidism.

A simple field method to identify foot strike pattern during running.

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Giandolini, Marlène; Poupard, Thibaut; Gimenez, Philippe; Horvais, Nicolas; Millet, Guillaume Y; Morin, Jean-Benoît; Samozino, Pierre

2014-05-07

Identifying foot strike patterns in running is an important issue for sport clinicians, coaches and footwear industrials. Current methods allow the monitoring of either many steps in laboratory conditions or only a few steps in the field. Because measuring running biomechanics during actual practice is critical, our purpose is to validate a method aiming at identifying foot strike patterns during continuous field measurements. Based on heel and metatarsal accelerations, this method requires two uniaxial accelerometers. The time between heel and metatarsal acceleration peaks (THM) was compared to the foot strike angle in the sagittal plane (αfoot) obtained by 2D video analysis for various conditions of speed, slope, footwear, foot strike and state of fatigue. Acceleration and kinematic measurements were performed at 1000Hz and 120Hz, respectively, during 2-min treadmill running bouts. Significant correlations were observed between THM and αfoot for 14 out of 15 conditions. The overall correlation coefficient was r=0.916 (Pstrike except for extreme forefoot strike during which the heel rarely or never strikes the ground, and for different footwears and states of fatigue. We proposed a classification based on THM: FFS<-5.49ms

Basal Cell Carcinoma: Pathogenesis, Epidemiology, Clinical Features, Diagnosis, Histopathology, and Management

Science.gov (United States)

Marzuka, Alexander G.; Book, Samuel E.

2015-01-01

Basal cell carcinoma (BCC) is the most common malignancy. Exposure to sunlight is the most important risk factor. Most, if not all, cases of BCC demonstrate overactive Hedgehog signaling. A variety of treatment modalities exist and are selected based on recurrence risk, importance of tissue preservation, patient preference, and extent of disease. The pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management of BCC will be discussed in this review. PMID:26029015

Capgras syndrome: a review of the neurophysiological correlates and presenting clinical features in cases involving physical violence.

Science.gov (United States)

Bourget, Dominique; Whitehurst, Laurie

2004-11-01

Acts of violence have been frequently reported in cases of Capgras syndrome (CS), a misidentification syndrome characterized by the delusional belief that imposters have replaced people familiar to the individual. CS has been observed in many neuropsychiatric and organic disorders, and neuroimaging studies indicate an association between CS and right hemisphere abnormalities. However, CS has received limited attention from a forensic psychiatric perspective. We propose that elucidating demographic and clinical features noted in cases of violence secondary to CS may highlight important factors in the progression of CS to violence. We review the neurophysiological correlates and clinical factors observed in CS and present characteristics of a series of cases that demonstrate the potential of CS patients for severe physical violence toward the misidentified person. For patients with CS involving assault, we present and discuss commonly reported demographic and clinical features that may contribute to an increased risk for violence. An understanding of the presenting clinical features of CS resulting in aggressive acts may assist clinicians to assess the potential for violence in these patients.

Foot strike patterns of recreational and sub-elite runners in a long-distance road race.

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Larson, Peter; Higgins, Erin; Kaminski, Justin; Decker, Tamara; Preble, Janine; Lyons, Daniela; McIntyre, Kevin; Normile, Adam

2011-12-01

Although the biomechanical properties of the various types of running foot strike (rearfoot, midfoot, and forefoot) have been studied extensively in the laboratory, only a few studies have attempted to quantify the frequency of running foot strike variants among runners in competitive road races. We classified the left and right foot strike patterns of 936 distance runners, most of whom would be considered of recreational or sub-elite ability, at the 10 km point of a half-marathon/marathon road race. We classified 88.9% of runners at the 10 km point as rearfoot strikers, 3.4% as midfoot strikers, 1.8% as forefoot strikers, and 5.9% of runners exhibited discrete foot strike asymmetry. Rearfoot striking was more common among our sample of mostly recreational distance runners than has been previously reported for samples of faster runners. We also compared foot strike patterns of 286 individual marathon runners between the 10 km and 32 km race locations and observed increased frequency of rearfoot striking at 32 km. A large percentage of runners switched from midfoot and forefoot foot strikes at 10 km to rearfoot strikes at 32 km. The frequency of discrete foot strike asymmetry declined from the 10 km to the 32 km location. Among marathon runners, we found no significant relationship between foot strike patterns and race times.

Association between traditional clinical high-risk features and gene expression profile classification in uveal melanoma.

Science.gov (United States)

Nguyen, Brandon T; Kim, Ryan S; Bretana, Maria E; Kegley, Eric; Schefler, Amy C

2018-02-01

To evaluate the association between traditional clinical high-risk features of uveal melanoma patients and gene expression profile (GEP). This was a retrospective, single-center, case series of patients with uveal melanoma. Eighty-three patients met inclusion criteria for the study. Patients were examined for the following clinical risk factors: drusen/retinal pigment epithelium (RPE) changes, vascularity on B-scan, internal reflectivity on A-scan, subretinal fluid (SRF), orange pigment, apical tumor height/thickness, and largest basal dimensions (LBD). A novel point system was created to grade the high-risk clinical features of each tumor. Further analyses were performed to assess the degree of association between GEP and each individual risk factor, total clinical risk score, vascularity, internal reflectivity, American Joint Committee on Cancer (AJCC) tumor stage classification, apical tumor height/thickness, and LBD. Of the 83 total patients, 41 were classified as GEP class 1A, 17 as class 1B, and 25 as class 2. The presence of orange pigment, SRF, low internal reflectivity and vascularity on ultrasound, and apical tumor height/thickness ≥ 2 mm were not statistically significantly associated with GEP class. Lack of drusen/RPE changes demonstrated a trend toward statistical association with GEP class 2 compared to class 1A/1B. LBD and advancing AJCC stage was statistically associated with higher GEP class. In this cohort, AJCC stage classification and LBD were the only clinical features statistically associated with GEP class. Clinicians should use caution when inferring the growth potential of melanocytic lesions solely from traditional funduscopic and ultrasonographic risk factors without GEP data.

Traumatic neuralgia from pressure-point strikes in the martial arts: results from a retrospective online survey.

Science.gov (United States)

Kelly, Michael D

2008-06-01

Many techniques in Asian martial arts hand-to-hand combat systems emphasize hitting or striking specific sites on the body that correlate with exposed portions of peripheral nerves. To evaluate the prevalence and clinical effects of this unique sports-related injury. An anonymous self-administered retrospective 20-question electronic survey was posted on a high-traffic martial arts Web site. Primary outcome measures were demographic and medical history data, including martial arts experience and neuropathic symptoms associated with injury from this form of combat. Risk of symptoms was calculated by dividing the number of individuals with symptoms in each pressure-point area by the number of individuals who were struck in these areas during martial arts training. Of the 651 survey responses received, 605 met inclusion criteria. Neuropathic symptoms were reported by 291 subjects. Most symptoms occurred in individuals aged between 20 and 30 years as well as in individuals with less than 1 year of martial arts training. The majority of respondents with neuropathic symptoms reported a symptom duration of less than 1 year (207 [71%]). Individuals with more than 5 years of combat training experience had a greater risk of chronic symptoms than individuals with less experience. Strikes to pressure points on the back had the greatest risk of inducing neuropathic symptoms. Symptoms of neurapraxia can occur in individuals as a result of practicing martial arts involving strikes on pressure points. Although the majority of symptoms resolve within 1 year, individuals with prolonged exposure to pressure-point strikes may be more likely to have chronic symptoms.

Parieto-occipital encephalomalacia in children; clinical and electrophysiological features of twenty-seven cases.

Science.gov (United States)

Karaoğlu, Pakize; Polat, Ayşe İpek; Yiş, Uluç; Hız, Semra

2015-01-01

Brain injuries occurring at a particular time may cause damages in well-defined regions of brain. Perinatal hypoxic ischemic encephalopathy and hypoglycemia are some of the most common types of brain injuries. Neonatal hypoglycemia can cause abnormal myelination in parietal and occipital lobes resulting in parieto-occipital encephalomalacia. There is a small number of studies about clinical and electroencephalographic (EEG) features of children with parieto-occipital encephalomalacia. They might have important neurologic sequelae such as cortical visual loss, seizures, and psychomotor retardation. We aimed to evaluate the causes of parieto-occipital encephalomalacia and evaluate the clinical and electrophysiological features of children with parieto-occipital encephalomalacia. We evaluated clinical features and EEGs of 27 children with parieto-occipital encephalomalacia. Descriptive statistics were used. Hospitalization during the neonatal period was the most common cause (88.9%) of parieto-occipital brain injury. Eleven patients (40.7%) had a history of neonatal hypoglycemia. Twenty-three patients (85.2%) had epilepsy and nine of the epileptic patients (39%) had refractory seizures. Most of the patients had bilateral (50%) epileptic discharges originating from temporal, parietal, and occipital lobes (56.2%). However, some patients had frontal sharp waves and some had continuous spike and wave discharges during sleep. Visual abnormalities were evident in 15 (55.6%) patients. Twenty-two (81.5%) had psychomotor retardation. Fine motor skills, social contact and language development were impaired more than gross motor skills. In our study, most of the patients with parieto-occipital encephalomalacia had an eventful perinatal history. Epilepsy, psychomotor retardation, and visual problems were common neurologic complications.

Statistical methods for detecting differentially abundant features in clinical metagenomic samples.

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James Robert White

2009-04-01

Full Text Available Numerous studies are currently underway to characterize the microbial communities inhabiting our world. These studies aim to dramatically expand our understanding of the microbial biosphere and, more importantly, hope to reveal the secrets of the complex symbiotic relationship between us and our commensal bacterial microflora. An important prerequisite for such discoveries are computational tools that are able to rapidly and accurately compare large datasets generated from complex bacterial communities to identify features that distinguish them.We present a statistical method for comparing clinical metagenomic samples from two treatment populations on the basis of count data (e.g. as obtained through sequencing to detect differentially abundant features. Our method, Metastats, employs the false discovery rate to improve specificity in high-complexity environments, and separately handles sparsely-sampled features using Fisher's exact test. Under a variety of simulations, we show that Metastats performs well compared to previously used methods, and significantly outperforms other methods for features with sparse counts. We demonstrate the utility of our method on several datasets including a 16S rRNA survey of obese and lean human gut microbiomes, COG functional profiles of infant and mature gut microbiomes, and bacterial and viral metabolic subsystem data inferred from random sequencing of 85 metagenomes. The application of our method to the obesity dataset reveals differences between obese and lean subjects not reported in the original study. For the COG and subsystem datasets, we provide the first statistically rigorous assessment of the differences between these populations. The methods described in this paper are the first to address clinical metagenomic datasets comprising samples from multiple subjects. Our methods are robust across datasets of varied complexity and sampling level. While designed for metagenomic applications, our software

Variability in anatomical features of human clavicle: Its forensic anthropological and clinical significance

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Jagmahender Singh Sehrawat

2016-06-01

Full Text Available Bones can reflect the basic framework of human body and may provide valuable information about the biological identity of the deceased. They, often, survive the morphological alterations, taphonomic destructions, decay/mutilation and decomposition insults. In-depth knowledge of variations in clavicular shape, size and its dimensions is very important from both clinical (fixation of clavicular fractures using external or inter-medullary devices, designing orthopedic fixation devices as well as forensic anthropological perspectives. Human clavicle is the most frequently fractured bone of human skeleton, possessing high degree of variability in its anatomical, biomechanical and morphological features. Extended period of skeletal growth (up to third decade in clavicle imparts it an additional advantage for forensic identification purposes. In present study, five categories of clavicular features like lengths, diameters, angles, indices and robustness were examined to explore the suitability of collarbone for forensic and clinical purposes. For this purpose, 263 pairs of adult clavicles (195 Males and 68 Females were collected from autopsied cadavers and were studied for 13 anatomical features. Gender and occupational affiliations of cadavers were found to have significant influences on anatomical dimensions of their clavicles. Product index, weight and circumference of collarbone were found the best univariate variables, discriminating sex of more than 80% individuals. The best multivariate Function-I (DF: -17.315 + 0.054 CL-L+0.196 CC-R+0.184 DM-L could identify sex and occupation of 89.4% (89.2% Male and 89.7% Female and 65.4% individuals, respectively. All clavicular variables were found bilaterally asymmetric; left clavicles being significantly longer in length, lighter in weight, smooth in texture and less curved than the right side bones. Among non-metric traits, sub-clavian groove, nutrient foramina and ‘type’ of clavicle exhibited

Expeditionary Strike Group: Command Structure Design Support

National Research Council Canada - National Science Library

Hutchins, Susan G; Kemple, William G; Kleinman, David L; Hocevar, Susan P

2005-01-01

An Expeditionary Strike Group (ESG) is a new capability mix that combines the combat power of three surface combatants and one submarine with an Amphibious Readiness Group/ Marine Expeditionary Unit...

The Noonan Syndrome--A Review of the Clinical and Genetic Features of 27 Cases

Science.gov (United States)

Collins, Edith; Turner, Gillian

1973-01-01

Reviewed were clinical and genetic features of 27 cases of the Noonan Syndrome, a condition with characteristics such as webbing of the neck, short stature, frequent congential heart lesions, and chromosomal irregularities. (DB)

Is Early-onset in Major Depression a Predictor of Specific Clinical Features with More Impaired Social Function?

Science.gov (United States)

Liu, Yan-Hong; Chen, Lin; Su, Yun-Ai; Fang, Yi-Ru; Srisurapanont, Manit; Hong, Jin Pyo; Hatim, Ahmad; Chua, Hong Choon; Bautista, Dianne; Si, Tian-Mei

2015-01-01

Background: Early-onset major depressive disorder (MDD) (EOD) is often particularly malignant due to its special clinical features, accompanying impaired social function, protracted recovery time, and frequent recurrence. This study aimed to observe the effects of age onset on clinical characteristics and social function in MDD patients in Asia. Methods: In total, 547 out-patients aged 18–65 years who were from 13 study sites in five Asian countries were included. These patients had MDD diagnose according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria. Clinical features and social function were assessed using Symptom Checklist-90-revised (SCL-90-R) and Sheehan Disability Scale (SDS). Quality of life was assessed by a 36-item Short-form Health Survey (SF-36). Analyses were performed using a continuous or dichotomous (cut-off: 30 years) age-of-onset indicator. Results: Early-onset MDD (EOD, <30 years) was associated with longer illness (P = 0.003), unmarried status (P < 0.001), higher neuroticism (P ≤ 0.002) based on the SCL-90-R, and more limited social function and mental health (P = 0.006, P = 0.007) based on the SF-36 and SDS. The impairment of social function and clinical severity were more prominent at in-patients with younger onset ages. Special clinical features and more impaired social function and quality of life were associated with EOD, as in western studies. Conclusions: EOD often follows higher levels of neuroticism. Age of onset of MDD may be a predictor of clinical features and impaired social function, allowing earlier diagnosis and treatment. PMID:25758278

Oropharyngeal Dysphagia in Dermatomyositis: Associations with Clinical and Laboratory Features Including Autoantibodies.

Science.gov (United States)

Mugii, Naoki; Hasegawa, Minoru; Matsushita, Takashi; Hamaguchi, Yasuhito; Oohata, Sacihe; Okita, Hirokazu; Yahata, Tetsutarou; Someya, Fujiko; Inoue, Katsumi; Murono, Shigeyuki; Fujimoto, Manabu; Takehara, Kazuhiko

2016-01-01

Dysphagia develops with low frequency in patients with dermatomyositis. Our objective was to determine the clinical and laboratory features that can estimate the development of dysphagia in dermatomyositis. This study included 92 Japanese patients with adult-onset dermatomyositis. The associations between dysphagia and clinical and laboratory features including disease-specific autoantibodies determined by immunoprecipitation assays were analyzed. Videofluoroscopy swallow study (VFSS) was performed for all patients with clinical dysphagia (n = 13, 14.1%) but not for patients without clinical dysphagia. Typical findings of dysphagia (pharyngeal pooling, n = 11 and/or nasal regurgitation, n = 4) was detected by VFSS in all patients with clinical dysphagia. Eleven patients with dysphagia (84.6%) had anti-transcription intermediary factor 1γ (TIF-1γ) antibody. By univariate analysis, the average age and the male to female ratio, internal malignancy, and anti-TIF-1γ antibody were significantly higher and the frequency of interstitial lung diseases and manual muscle testing (MMT) scores of sternomastoid and dertoid muscles were significantly lower in patients with dysphagia than in patients without dysphagia. Among patients with anti-TIF-1γ antibody, the mean age, the ratios of male to female and internal malignancy were significantly higher and mean MMT scores of sternomastoid muscle were significantly lower in patients with dysphagia compared with patients without dysphagia. By multivariable analysis, the risk of dysphagia was strongly associated with the existence of internal malignancy and ant-TIF-1γ antibody and was also associated with reduced scores of manual muscle test of sternomastoid muscle. Dysphagia was markedly improved after the treatment against myositis in all 13 patients. These findings indicate that dysphagia can develop frequently in patients with internal malignancy, anti-TIF-1γ antibody, or severe muscle weakness of sternomastoid muscle.

Clinical features and management of non-HIV related lipodystrophy in children: A systematic review

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Lipodystrophy syndromes are characterized by generalized or partial absence of adipose tissue. We conducted a systematic review to synthesize data on clinical and metabolic features of lipodystrophy (age at onset, Scopus and Non-Indexe...

Proportion and clinical features of never-smokers with non-small cell lung cancer

OpenAIRE

Cho, Jaeyoung; Choi, Sun Mi; Lee, Jinwoo; Lee, Chang-Hoon; Lee, Sang-Min; Kim, Dong-Wan; Yim, Jae-Joon; Kim, Young Tae; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Park, Young Sik

2017-01-01

Background The proportion of never-smokers with non-small cell lung cancer (NSCLC) is increasing, but that in Korea has not been well addressed in a large population. We aimed to evaluate the proportion and clinical features of never-smokers with NSCLC in a large single institution. Methods We analyzed clinical data of 1860 consecutive patients who were newly diagnosed with NSCLC between June 2011 and December 2014. Results Of the 1860 NSCLC patients, 707 (38.0%) were never-smokers. The propo...

Electric converters of electromagnetic strike machine with battery power

Science.gov (United States)

Usanov, K. M.; Volgin, A. V.; Kargin, V. A.; Moiseev, A. P.; Chetverikov, E. A.

2018-03-01

At present, the application of pulse linear electromagnetic engines to drive strike machines for immersion of rod elements into the soil, strike drilling of shallow wells, dynamic probing of soils is recognized as quite effective. The pulse linear electromagnetic engine performs discrete consumption and conversion of electrical energy into mechanical work. Pulse dosing of a stream transmitted by the battery source to the pulse linear electromagnetic engine of the energy is provided by the electrical converter. The electric converters with the control of an electromagnetic strike machine as functions of time and armature movement, which form the unipolar supply pulses of voltage and current necessary for the normal operation of a pulse linear electromagnetic engine, are proposed. Electric converters are stable in operation, implement the necessary range of output parameters control determined by the technological process conditions, have noise immunity and automatic disconnection of power supply in emergency modes.

Childhood sarcoidosis in Denmark 1979-1994: incidence, clinical features and laboratory results at presentation in 48 children

DEFF Research Database (Denmark)

Hoffmann, A L; Milman, N; Byg, K E

2004-01-01

AIM: To describe the incidence, clinical presentation and paraclinical findings in childhood sarcoidosis in Denmark, 1979-1994. METHODS: Patients (n = 5536) with a diagnosis of sarcoidosis were drawn from the nationwide Patient Registry; 81 patients were ... examination (glucose, albumin, haemoglobin) was normal in 96% of the patients; the patient with nephrocalcinosis had albuminuria and haematuria. CONCLUSION: The incidence of sarcoidosis in Danish children is low and increases with age. Sarcoidosis in young children may present clinical features...... that are different from the appearance of those in older children and often constitute a diagnostic challenge. In older children, the clinical appearance has many features in common with the presentation in adults....

Strike-slip tectonics during rift linkage

Science.gov (United States)

Pagli, C.; Yun, S. H.; Ebinger, C.; Keir, D.; Wang, H.

2017-12-01

The kinematics of triple junction linkage and the initiation of transforms in magmatic rifts remain debated. Strain patterns from the Afar triple junction provide tests of current models of how rifts grow to link in area of incipient oceanic spreading. Here we present a combined analysis of seismicity, InSAR and GPS derived strain rate maps to reveal that the plate boundary deformation in Afar is accommodated primarily by extensional tectonics in the Red Sea and Gulf of Aden rifts, and does not require large rotations about vertical axes (bookshelf faulting). Additionally, models of stress changes and seismicity induced by recent dykes in one sector of the Afar triple junction provide poor fit to the observed strike-slip earthquakes. Instead we explain these patterns as rift-perpendicular shearing at the tips of spreading rifts where extensional strains terminate against less stretched lithosphere. Our results demonstrate that rift-perpendicular strike-slip faulting between rift segments achieves plate boundary linkage during incipient seafloor spreading.

Recurrent Wernicke s Encephalopathy in a 16-Year-Old Girl with Atypical Clinical and Radiological Features

Directory of Open Access Journals (Sweden)

S. Lamdhade

2014-01-01

Full Text Available Background. Wernicke’s Encephalopathy (WE is a clinical diagnosis with serious neurological consequences. Its occurrence is underestimated in nonalcoholics and is uncommon in adolescents. We aim to draw the attention to a rare case, which had additional clinical and radiological features. Case. A 16-year-old girl presented with three-week history of vomiting secondary to intestinal obstruction. She developed diplopia soon after hospitalization. Neurological evaluation revealed restriction of bilateral lateral recti with horizontal nystagmus, and bilateral limb dysmetria. Brain MRI was normal. She had prompt improvement to thiamine. Four months later, she presented with headache, bilateral severe deafness, and tinnitus. Clinically, she had severe sensorineural hearing loss, bilateral lateral recti paresis, and gait ataxia. CT head showed bilateral caudate nucleus hypodensities. MRI brain revealed gadolinium enhancement of mamillary bodies and vermis. She had significant improvement after IV thiamine. Headache completely resolved while the ocular movements, hearing, and tinnitus improved partially in 72 hours. Conclusions. Recurrent WE in adolescence is uncommon. Headache, tinnitus, and deafness are rare clinical features. Although MRI study shows typical features of WE, the presence of bilateral caudate nuclei hypodensities on CT scan is uncommon. Prompt treatment with thiamine is warranted in suspected cases to prevent permanent neurological sequelae.

Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis.

Science.gov (United States)

Wei, Diana Yi-Ting; Yuan Ong, Jonathan Jia; Goadsby, Peter James

2018-04-01

Cluster headache is a primary headache disorder affecting up to 0.1% of the population. Patients suffer from cluster headache attacks lasting from 15 to 180 min up to 8 times a day. The attacks are characterized by the severe unilateral pain mainly in the first division of the trigeminal nerve, with associated prominent unilateral cranial autonomic symptoms and a sense of agitation and restlessness during the attacks. The male-to-female ratio is approximately 2.5:1. Experimental, clinical, and neuroimaging studies have advanced our understanding of the pathogenesis of cluster headache. The pathophysiology involves activation of the trigeminovascular complex and the trigeminal-autonomic reflex and accounts for the unilateral severe headache, the prominent ipsilateral cranial autonomic symptoms. In addition, the circadian and circannual rhythmicity unique to this condition is postulated to involve the hypothalamus and suprachiasmatic nucleus. Although the clinical features are distinct, it may be misdiagnosed, with patients often presenting to the otolaryngologist or dentist with symptoms. The prognosis of cluster headache remains difficult to predict. Patients with episodic cluster headache can shift to chronic cluster headache and vice versa. Longitudinally, cluster headache tends to remit with age with less frequent bouts and more prolonged periods of remission in between bouts.

Further delineation of cardio-facio-cutaneous syndrome: clinical features of 38 individuals with proven mutations.

Science.gov (United States)

Armour, C M; Allanson, J E

2008-04-01

Cardio-facio-cutaneous syndrome (CFC) is a multiple congenital anomaly/mental retardation syndrome named because of a characteristic facies, cardiac anomalies, and ectodermal abnormalities. While considerable literature describes the main features, few studies have documented the frequencies of less common features allowing a greater appreciation of the full phenotype. We have analysed clinical data on 38 individuals with CFC and a confirmed mutation in one of the genes known to cause the condition. We provide data on well-established features, and those that are less often described. Polyhydramnios (77%) and prematurity (49%) were common perinatal issues. 71% of individuals had a cardiac anomaly, the most common being pulmonary valve stenosis (42%), hypertrophic cardiomyopathy (39%), and atrial septal defect (28%). Hair anomalies were also typical: 92% had curly hair, 84% sparse hair, and 86% absent or sparse eyebrows. The most frequent cutaneous features were keratosis pilaris (73%), hyperkeratosis (61%) and nevi (76%). Significant and long lived gastrointestinal dysmotility (71%), seizures (49%), optic nerve hypoplasia (30%) and renal anomalies, chiefly hydronephrosis (20%), were among the less well known issues reported. This study reports a broad range of clinical issues in a large cohort of individuals with molecular confirmation of CFC.

Alteration of Occlusal Plane in Orthognathic Surgery: Clinical Features to Help Treatment Planning on Class III Patients

Directory of Open Access Journals (Sweden)

Daniel Amaral Alves Marlière

2018-01-01

Full Text Available Dentofacial deformities (DFD presenting mainly as Class III malocclusions that require orthognathic surgery as a part of definitive treatment. Class III patients can have obvious signs such as increasing the chin projection and chin throat length, nasolabial folds, reverse overjet, and lack of upper lip support. However, Class III patients can present different facial patterns depending on the angulation of occlusal plane (OP, and only bite correction does not always lead to the improvement of the facial esthetic. We described two Class III patients with different clinical features and inclination of OP and had undergone different treatment planning based on 6 clinical features: (I facial type; (II upper incisor display at rest; (III dental and gingival display on smile; (IV soft tissue support; (V chin projection; and (VI lower lip projection. These patients were submitted to orthognathic surgery with different treatment plannings: a clockwise rotation and counterclockwise rotation of OP according to their facial features. The clinical features and OP inclination helped to define treatment planning by clockwise and counterclockwise rotations of the maxillomandibular complex, and two patients undergone to bimaxillary orthognathic surgery showed harmonic outcomes and stables after 2 years of follow-up.

Clinical features for diagnosis and management of patients with PRDM12 congenital insensitivity to pain.

Science.gov (United States)

Zhang, Stella; Malik Sharif, Saghira; Chen, Ya-Chun; Valente, Enza-Maria; Ahmed, Mushtaq; Sheridan, Eamonn; Bennett, Christopher; Woods, Geoffrey

2016-08-01

Congenital insensitivity to pain (CIP) is a rare extreme phenotype characterised by an inability to perceive pain present from birth due to lack of, or malfunction of, nociceptors. PRDM12 has recently been identified as a new gene that can cause CIP. The full phenotype and natural history have not yet been reported. We have ascertained five adult patients and report their clinical features. Based on our findings, and those of previous patients, we describe the natural history of the PRDM12-CIP disorder, and derive diagnostic and management features to guide the clinical management of patients. PRDM12-CIP is a distinct and diagnosable disorder, and requires specific clinical management to minimise predictable complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

BLINCK?A diagnostic algorithm for skin cancer diagnosis combining clinical features with dermatoscopy findings

OpenAIRE

Bourne, Peter; Rosendahl, Cliff; Keir, Jeff; Cameron, Alan

2012-01-01

Background: Deciding whether a skin lesion requires biopsy to exclude skin cancer is often challenging for primary care clinicians in Australia. There are several published algorithms designed to assist with the diagnosis of skin cancer but apart from the clinical ABCD rule, these algorithms only evaluate the dermatoscopic features of a lesion. Objectives: The BLINCK algorithm explores the effect of combining clinical history and examination with fundamental dermatoscopic assessment in primar...

Evaluation of a web based informatics system with data mining tools for predicting outcomes with quantitative imaging features in stroke rehabilitation clinical trials

Science.gov (United States)

Wang, Ximing; Kim, Bokkyu; Park, Ji Hoon; Wang, Erik; Forsyth, Sydney; Lim, Cody; Ravi, Ragini; Karibyan, Sarkis; Sanchez, Alexander; Liu, Brent

2017-03-01

Quantitative imaging biomarkers are used widely in clinical trials for tracking and evaluation of medical interventions. Previously, we have presented a web based informatics system utilizing quantitative imaging features for predicting outcomes in stroke rehabilitation clinical trials. The system integrates imaging features extraction tools and a web-based statistical analysis tool. The tools include a generalized linear mixed model(GLMM) that can investigate potential significance and correlation based on features extracted from clinical data and quantitative biomarkers. The imaging features extraction tools allow the user to collect imaging features and the GLMM module allows the user to select clinical data and imaging features such as stroke lesion characteristics from the database as regressors and regressands. This paper discusses the application scenario and evaluation results of the system in a stroke rehabilitation clinical trial. The system was utilized to manage clinical data and extract imaging biomarkers including stroke lesion volume, location and ventricle/brain ratio. The GLMM module was validated and the efficiency of data analysis was also evaluated.

BIRD/WILDLIFE STRIKE CONTROL FOR SAFER AIR ...

African Journals Online (AJOL)

Osondu

2012-06-05

Jun 5, 2012 ... Several factors including lack of adequate data, shortage of funds, inadequate training of staff and lack of ... Keywords: bird/wildlife, strike, aviation, hazard, control. Introduction ..... implications of some human activities within.

Different Clinical Features and Lower Scores in Clinical Scoring Systems for Appendicitis in Preschool Children: Comparison with School Age Onset

OpenAIRE

Song, Chun Woo; Kang, Joon Won; Kim, Jae Young

2018-01-01

Purpose To clarify the clinical features of appendicitis in preschool children and to explore clinical appendicitis scoring systems in this age group. Methods We retrospectively collected data on 142 children, aged 10 years or younger, with confirmed diagnosis of appendicitis based on surgical and pathologic findings. Enrolled subjects were divided into two groups: Group 1 (preschool children aged ≤5 years, n=41) and Group 2 (school children aged >5 to ≤10 years, n=101). Data analyzed include...

Late-onset Becker muscular dystrophy: Refining the clinical features and electrophysiological findings.

Science.gov (United States)

Beltran Papsdorf, Tania; Howard, James F; Chahin, Nizar

2015-11-01

The aim of this study was to characterize a unique distribution of muscle involvement in sporadic Becker muscle dystrophy (BMD). Retrospective chart review, clinical examination, electrophysiological studies, cardiac testing, and genetic testing were performed in 5 patients. Predominant weakness and atrophy of biceps brachii, hip adduction, and quadriceps muscles was noted along with calf and extensor forearm hypertrophy. Finger flexor muscles were severely weak in 3 of 5 patients, a feature that could lead to a misdiagnosis of inclusion body myositis. Creatinine kinase was only mildly elevated in most patients. Electromyography was abnormal in all patients. Muscle biopsy in 1 patient demonstrated normal immunostaining for dystrophin. We found a unique and uniform distribution of muscle involvement in 5 sporadic cases of BMD. Recognizing these features is important for differentiating it from other myopathies that may have similar features and avoids unnecessary invasive procedures such as muscle biopsy. © 2015 Wiley Periodicals, Inc.

Gilbert’s syndrome: clinical features, diagnostics, differential diagnosis and treatment (part 2

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T.V. Sorokman

2017-02-01

discoloration of the skin (“teinte bilieuse”, especially on the face, hands, and feet without a distinct scleral icterus. Sometimes the development of repeatedly intermittent episodes of jaundice with high bilirubinemia (indirect bilirubin without the evidence of hemolysis (differential diagnostic feature is observed. 2. A tendency to development of pigmented and vascular nevi and xanthelasma of the eyelids, and hyperpigmentation around the eyes; to bradycardia, hypothermia, migraine, postural, intermittent albuminuria or to alimentary glycosuria. 3. An increased tendency to pigmentation under the influence of light, heat, and also chemical and mechanical stimuli. 4. A neuromuscular hyperexcitability. 5. Increased sensitivity to cold. 6. Dyspeptic complaints (pain, nausea, abdominal bloa­ting, diarrhea or constipation. 7. No signs of increased hemolysis (differential diagnostic feature with increasing content in, bilirubin (differential diagnostic feature. 8. The majority of patients have normal liver function tests (differential diagnostic feature also normal bromsulphalein test is also normal (differential diagnostic feature. 9. The biochemical abnormality is not detected by histological methods (differential diagnostic feature .10. Frequently, a family disease of the liver is observed. The differential diagnosis of GS is conducted with all types of hyperbilirubinemias, hemolytic anemias, congenital hepatic cirrhosis, hepatitis, cholecystopathy, atresia of biliary ducts or the small intestine. Medications are used only in severe hyperbilirubinemias and as concomitant therapy in the presence of symptoms of vitamin deficiencies, violations of a motor-evacuation function of the upper digestive tract in the clinical picture and to prevent complications (cholelithiasis.

Electrically conductive carbon fibre-reinforced composite for aircraft lightning strike protection

Science.gov (United States)

Katunin, Andrzej; Krukiewicz, Katarzyna; Turczyn, Roman; Sul, Przemysław; Bilewicz, Marcin

2017-05-01

Aircraft elements, especially elements of exterior fuselage, are subjected to damage caused by lightning strikes. Due to the fact that these elements are manufactured from polymeric composites in modern aircraft, and thus, they cannot conduct electrical charges, the lightning strikes cause burnouts in composite structures. Therefore, the effective lightning strike protection for such structures is highly desired. The solution presented in this paper is based on application of organic conductive fillers in the form of intrinsically conducting polymers and carbon fabric in order to ensure electrical conductivity of whole composite and simultaneously retain superior mechanical properties. The presented studies cover synthesis and manufacturing of the electrically conductive composite as well as its characterization with respect to mechanical and electrical properties. The performed studies indicate that the proposed material can be potentially considered as a constructional material for aircraft industry, which characterizes by good operational properties and low cost of manufacturing with respect to current lightning strike protection materials solutions.

Clinical Features and Outcomes of Gastric Ischemia.

Science.gov (United States)

Sharma, Ayush; Mukewar, Saurabh; Chari, Suresh T; Wong Kee Song, Louis M

2017-12-01

Gastric ischemia is a rare condition associated with poor prognosis. Our study aim was to highlight the clinical features and outcomes of patients with gastric ischemia. A retrospective review of patients diagnosed with isolated gastric ischemia at our institution from January 1, 2000, to May 5, 2016, was performed. Demographic, clinical, endoscopic, radiologic, and outcome variables were abstracted for analysis. Seventeen patients (65% men) with mean age of 69.3 ± 11.3 years and body mass index of 28.8 ± 11.1 were identified. The etiologies for gastric ischemia included local vascular causes (n = 8), systemic hypoperfusion (n = 4), and mechanical obstruction (n = 5). The most common presenting symptoms were abdominal pain (65%), gastrointestinal bleeding (47%), and altered mental status (23%). The typical endoscopic appearance was mucosal congestion and erythema with or without ulceration. Gastric pneumatosis and portal venous air were more commonly seen on CT imaging. Radiologic and/or surgical intervention was needed in 9 patients, while the remaining 8 patients were managed conservatively with acid suppression, antibiotics, and nasogastric tube decompression. The median duration of hospital stay was 15 days (range 1-36 days). There were no cases of rebleeding and the mortality rate as a direct result of gastric ischemia was 24% within 6 months of diagnosis. Although uncommon, gastric ischemia is associated with significant mortality. Endoscopy and CT imaging play an important role in its diagnosis. The management of gastric ischemia is dictated by its severity and associated comorbidities.

Clinical Features of Pregnancy-associated Retinal and Choroidal Diseases Causing Acute Visual Disturbance.

Science.gov (United States)

Park, Young Joo; Park, Kyu Hyung; Woo, Se Joon

2017-08-01

To report clinical features of patients with retinal and choroidal diseases presenting with acute visual disturbance during pregnancy. In this retrospective case series, patients who developed acute visual loss during pregnancy (including puerperium) and visited a tertiary hospital from July 2007 to June 2015, were recruited by searching electronic medical records. Patients were categorized according to the cause of visual loss. Clinical features and required diagnostic modalities were analyzed in the retinal and choroidal disease group. Acute visual loss occurred in 147 patients; 49 (38.9%) were classified into the retinal and choroidal group. The diagnoses included central serous chorioretinopathy (22.4%), hypertensive retinopathy with or without pre-eclampsia (22.4%), retinal tear with or without retinal detachment (18.4%), diabetic retinopathy progression (10.2%), Vogt-Koyanagi-Harada disease (4.1%), retinal artery occlusion (4.1%), multiple evanescent white dot syndrome (4.1%), and others (14.3%). Visual symptoms first appeared at gestational age 25.9 ± 10.3 weeks. The initial best-corrected visual acuity (BCVA) was 0.27 ± 0.39 logarithm of the minimum angle of resolution (logMAR); the final BCVA after delivery improved to 0.13 ± 0.35 logMAR. Serious visual deterioration (BCVA worth than 20 / 200) developed in two patients. Differential diagnoses were established with characteristic fundus and spectral-domain optical coherence tomography findings in all cases. In pregnant women with acute visual loss, retinal and choroidal diseases are common and could be vision threatening. Physicians should be aware of pregnancy-associated retinal and choroidal diseases and their clinical features. The differential diagnosis can be established with non-invasive techniques. © 2017 The Korean Ophthalmological Society

2005 Significant U.S. Hurricane Strikes Poster

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National Oceanic and Atmospheric Administration, Department of Commerce — The 2005 Significant U.S. Hurricane Strikes poster is one of two special edition posters for the Atlantic Hurricanes. This beautiful poster contains two sets of...

Are physicians strikes ever morally justifiable? A call for a return to tradition

Directory of Open Access Journals (Sweden)

Munyaradzi Mawere

2010-08-01

Full Text Available Though physicians strike provides an opportunity to generate more knowledge about the process in which legitimacy of an organization can be restored, it meets with a great deal of resistance not only by the public but from within the medical profession. This paper critically examines the legitimacy of strike by medical doctors heretofore referred to as physicians. Though critically reflecting on strikes of physicians in general, the paper makes more emphasis on Africa where physician strikes are rampant. More importantly, the paper argues that strike implies a failure for everyone in the organization (including the strikers themselves, not only the responsible government or authority. This is because when a strike occurs, an organization/fraternity is subjected to questions, scrutiny and slander. It becomes difficult to decouple what is said, decided and done. Traditionally, all medical fraternities the world-over are committed to acting comfortably to external demands- guaranteeing the patients lives and public health. By paying attention to external reactions, the medical fraternity adapts and learns what ought and should be done so that it is never again caught in the same messy. At the same time, the fraternity prepares itself for the future strikes. When the fraternity and those outside consider it is doing up to the external expectations, its lost legitimacy is restored. When legitimacy is restored, external pressure like once disturbed water returns to normal

Clinical and echocardiographic features of aorto-atrial fistulas

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Ananthasubramaniam Karthik

2005-01-01

Full Text Available Abstract Aorto-atrial fistulas (AAF are rare but important pathophysiologic conditions of the aorta and have varied presentations such as acute pulmonary edema, chronic heart failure and incidental detection of the fistula. A variety of mechanisms such as aortic dissection, endocarditis with pseudoaneurysm formation, post surgical scenarios or trauma may precipitate the fistula formation. With increasing survival of patients, particularly following complex aortic reconstructive surgeries and redo valve surgeries, recognition of this complication, its clinical features and echocardiographic diagnosis is important. Since physical exam in this condition may be misleading, echocardiography serves as the cornerstone for diagnosis. The case below illustrates aorto-left atrial fistula formation following redo aortic valve surgery with slowly progressive symptoms of heart failure. A brief review of the existing literature of this entity is presented including emphasis on echocardiographic diagnosis and treatment.

Remarkable rates of lightning strike mortality in Malawi.

Science.gov (United States)

Mulder, Monique Borgerhoff; Msalu, Lameck; Caro, Tim; Salerno, Jonathan

2012-01-01

Livingstone's second mission site on the shore of Lake Malawi suffers very high rates of consequential lightning strikes. Comprehensive interviewing of victims and their relatives in seven Traditional Authorities in Nkhata Bay District, Malawi revealed that the annual rate of consequential strikes was 419/million, more than six times higher than that in other developing countries; the rate of deaths from lightning was 84/million/year, 5.4 times greater than the highest ever recorded. These remarkable figures reveal that lightning constitutes a significant stochastic source of mortality with potential life history consequences, but it should not deflect attention away from the more prominent causes of mortality in this rural area.

The rupture process of the Manjil, Iran earthquake of 20 june 1990 and implications for intraplate strike-slip earthquakes

Science.gov (United States)

Choy, G.L.; Zednik, J.

1997-01-01

of activity the aftershock zone expands and appears to cluster about the geomorphic and geologic features several tens of kilometres from the rupture zone. The activity is interpreted as a regional response to quasistatic stress migration along zones of tectonic weakness. The radiated energy of the main shock and the estimate of seismic moment yields an apparent stress of 20 bars. High apparent stress may be typical of strike slip earthquakes occurring in intracontinental environments undergoing continental collision.

Features of clinical and radiographic appearances of SARS in children

International Nuclear Information System (INIS)

Zeng Jinjin; Sun Guoqiang; Shen Kunling; Yang Yonghong; Wei Xinmiao; Lei Gang

2003-01-01

Objective: To evaluate the features of clinical and radiographic appearances of SARS in children. Methods: The chest films obtained at clinical presentation and during treatment in 18 children with confirmed SARS were retrospectively evaluated. Results: The main X-ray manifestations included: (1) air-space opacity in 13/18; (2) round lesion with clear margin in 3/18; (3) ground-glass lesions in 2/18; (4) unilateral and single focal involvement was more common in children than in adults (5) no reticular shadow, lymphanopathy or pleural effusion was demonstrated; (6) radiographic changes of foci was not as rapid in children as in adults. The lesions migrated in 1 case. The average absorption time of the lesions was 19 days, and most of them had no remnant. Conclusion: Compare with that in adults , the clinical manifestation was not so severe in children with SARS, and most of the infected children had clear contact history. Chest X-ray appearance in affected children mainly showed unilateral involvement of the lungs with chiefly air-space infiltrates. Remnant lesion of lung is rare in children. Differential diagnosis of SARS in children includes mycoplasma pneumonia or adenovirus pneumonia

Analysis on Clinical Features of 2168 Patients with Lung Cancer Diagnosed by Bronchoscope

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Yu Zhang

2013-06-01

Full Text Available Objective: To analyze the clinical features of lung cancer diagnosed by bronchoscopy. Methods: The clinical features of 2168 patients with lung cancer diagnosed by bronchoscopy were retrospectively analyzed, including gender, age, pathological type, diseased region, manifestations under bronchoscopy and methods of drawing materials. Results: The ratio of male/female was 4.8:1 and the peak onset age was 60 - 69 years old. The major pathological type was squamous cell carcinoma (44.5%, then adenocarcinoma (25.9% and small cell lung cancer (18.3%. The incidence of squamous cell carcinoma was the highest in males (50.6%, while that of adenocarcinoma in females (56.2%. The positive diagnostic rates of forceps biopsy, brush biopsy, bronchial alveolar lavage and transbronchial needle aspiration were 81.6%, 49.4%, 18.2% and 62.6%, respectively, whereas that of biopsy combined with brush biopsy came up to 89.0%. Conclusion: Bronchoscopy is an important method in diagnosis of lung cancer. Different ages and genders of patients with lung cancer have different onset, and the distribution of pathological types is diverse. Attaching more importance to bronchoscopy and improving biopsy technique can significantly improve the diagnostic rate and provide reliable evidences for clinical treatment.

Continental United States Hurricane Strikes 1950-2012

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Continental U.S. Hurricane Strikes Poster is our most popular poster which is updated annually. The poster includes all hurricanes that affected the U.S. since...

The clinical features of osteogenesis imperfecta in Vietnam.

Science.gov (United States)

Binh, Ho Duy; Maasalu, Katre; Dung, Vu Chi; Ngoc, Can T Bich; Hung, Ton That; Nam, Tran V; Nhan, Le N Thanh; Prans, Ele; Reimann, Ene; Zhytnik, Lidiia; Kõks, Sulev; Märtson, Aare

2017-01-01

Osteogenesis imperfecta (OI) has not been studied in a Vietnamese population before. The aim of this study was to systematically collect epidemiological information, investigate clinical features and create a clinical database of OI patients in Vietnam for future research and treatment strategy development. Participants underwent clinical and physical examinations; also medical records were reviewed. Genealogical information was collected and family members' phenotypical manifestations recorded. Cases were classified according to the Sillence classification. In total, 146 OI patients from 120 families were studied: 46 with OI Type I, 46 with Type III and 54 with Type IV. Almost patients had skeletal deformations. One hundred and forty-two had a history of fractures, 117 blue sclera, 89 dentinogenesis imperfecta and 26 hearing loss. The total number of fractures was 1,932. Thirty-four patients had intra-uterine fractures and nine had perinatal fractures. Surgery was performed 163 times in 58 patients; 100 osteosyntheses and 63 osteotomies. Bisphosphonate treatment was used in 37 patients. The number of affected individuals and predominance of severe forms of OI indicate that the disease is under diagnosed in Vietnam, especially in cases without a family history or with mild form of OI. Deformities appeared in all patients with different severity and localisation, affecting mostly the lower limbs. OI medical and surgical treatment rates are low and in most cases surgery was performed due to fractures. Compared to previous studies, our results indicate a lower OI prevalence and greater severity of symptoms in the Vietnamese population when compared with other areas. Further investigation, improved diagnosis and treatment are needed to increase the patients' quality of life.

Collective Labor Disputes and Strikes in Russia: The Impact of Judicial Precedents and Enforcement

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Elena Gerasimova

2017-01-01

Full Text Available The right to strike is recognized in the Constitution and the Labor Code of the Russian Federation as a means to resolve collective labor disputes. However, in Russia labor protests come up for discussion much more frequently than strikes. In recent years the number of labor protests in Russia, including various forms of work stoppage, has increased significantly compared to previous years, but the number of legally constituted collective labor disputes and strikes has remained very low. The legislation on resolution of collective labor disputes and mounting strikes is quite restrictive in Russia, and its enforcement also encourages employees to seek alternative ways to settle collective labor conflicts. There is little empirical research on the judicial implementation of these norms and its influence on the enforcement of legislation. Therefore, this paper analyses the reasoning of courts in cases on the legality of strikes, their interpretations of the law, and the impact these decisions have on the enforcement of the legislation on resolution of collective labor disputes and strikes. Our conclusion is that the courts act as another restrictive influence on the resolution of collective labor disputes and the exercise of the right to strike in Russia.

Expert Anticipatory Skill in Striking Sports: A Review and a Model

Science.gov (United States)

Muller, Sean; Abernethy, Bruce

2012-01-01

Expert performers in striking sports can hit objects moving at high speed with incredible precision. Exceptionally well developed anticipation skills are necessary to cope with the severe constraints on interception. In this paper, we provide a review of the empirical evidence regarding expert interception in striking sports and propose a…

The balancing act between the constitutional right to strike and the ...

African Journals Online (AJOL)

While the South African Constitution enshrines both children's right to a basic education and teachers' right to strike, conflict between these two often occurs when the way in which teachers' unions conduct strike actions detracts from learners' education. This article identifies the parties affected by industrial action in the ...

Clinical features of dysthyroid optic neuropathy: a European Group on Graves' Orbitopathy (EUGOGO) survey

NARCIS (Netherlands)

McKeag, David; Lane, Carol; Lazarus, John H.; Baldeschi, Lelio; Boboridis, Kostas; Dickinson, A. Jane; Hullo, A. Iain; Kahaly, George; Krassas, Gerry; Marcocci, Claudio; Marinò, Michele; Mourits, Maarten P.; Nardi, Marco; Neoh, Christopher; Orgiazzi, Jacques; Perros, Petros; Pinchera, Aldo; Pitz, Susanne; Prummel, Mark F.; Sartini, Maria S.; Wiersinga, Wilmar M.

2007-01-01

BACKGROUND: This study was performed to determine clinical features of dysthyroid optic neuropathy (DON) across Europe. METHODS: Forty seven patients with DON presented to seven European centres during one year. Local protocols for thyroid status, ophthalmic examination and further investigation

Clinical features of type 1 autoimmune hepatitis in elderly Italian patients.

Science.gov (United States)

Granito, A; Muratori, L; Pappas, G; Muratori, P; Ferri, S; Cassani, F; Lenzi, M; Bianchi, F B

2005-05-15

The usual onset of type 1 autoimmune hepatitis occurs at puberty or around menopause, whereas disease presentation in the advanced age is less often reported. To assess the clinical, immunological and histological features of Type 1 autoimmune hepatitis in elderly Italian patients. We assessed, at diagnosis, the clinical and immunological features of 76 consecutive Italian patients with type 1 autoimmune hepatitis, focusing particularly on a subgroup of 20 patients presenting at > or = 65 years (females 95%, median age 72 years, range 65-82). In comparison with the younger group, at the time of autoimmune hepatitis diagnosis, elderly Italian patients are more often asymptomatic (25% vs. 7%; P = 0.04), are more frequently positive for antinuclear autoantibodies (95% vs. 52%; P = 0.0004) and HLA-DR4 (45% vs. 18%; P = 0.03); among the extra-hepatic manifestations, autoimmune thyroid disorders are prevalent in the elderly group (25% vs. 5%; P = 0.02). However, no difference was observed in the histological/biochemical expression of the liver disease and response to immunosuppression. In elderly Italian patients, autoimmune hepatitis has typical serological and genetic characteristics, is more frequently asymptomatic, although prognosis and response to therapy is similar to that of younger patients. As a concomitant autoimmune thyroid disorder is common, autoimmune hepatitis should be suspected and investigated in elderly patients with autoimmune thyroid disorder and abnormal liver function tests.

Imaging and Clinical Features of Thyroid Cancer in Children and Adolescents

International Nuclear Information System (INIS)

Lee, Kang Young; Hong, HyunSook; Lee, Eun Hye; Yi, Beom Ha; Lee, Hae Kyung; Lee, Yong Hwa; Koh, Eun Suk

2011-01-01

To evaluate clinical and imaging features of pediatric thyroid cancer, including BRAF'V 600E mutation status in papillary thyroid cancer (PTC). We evaluated clinical findings including BRAF''6 00E status, ultrasound (US), and CT features of 13 pediatric patients with thyroid cancer. US findings were retrospectively analyzed for location, presence of a nodule, echotexture, echogenicity, calcifications, margin, shape, intranodular vascularity and abnormal lymph nodes. CT characteristics of the lesions, including attenuation, calcification, and measured degree of enhancement, were assessed. The patients included three boys and ten girls with a mean age of 15.5 years (range 6-18 years). No patient was exposed to radiation. Palpable neck mass was the most common presentation. Eleven of 13 patients (84.6%) were diagnosed with PTC, and two (15.4%) had follicular thyroid cancer (FTC). Nine of 13 (69.2%) had high T-staging. BRAF V600E mutations were detected in 30.0% of PTC patients. A diffusely enlarged thyroid with calcifications (n = 2) or nodules (n = 7) was detected on US. All PTC nodules showed malignant US findings and one FTC displayed on indeterminate nodule. Nodules generally showed low attenuation on enhanced CT (n = 11/12). US demonstrated enlarged glands with calcifications or nodules. Diffusely enlarged thyroids with microcalcifications should be evaluated using fine-needle aspiration. A low attenuation nodule was a common finding on enhanced CT.

Joint contact loading in forefoot and rearfoot strike patterns during running.

Science.gov (United States)

Rooney, Brandon D; Derrick, Timothy R

2013-09-03

Research concerning forefoot strike pattern (FFS) versus rearfoot strike pattern (RFS) running has focused on the ground reaction force even though internal joint contact forces are a more direct measure of the loads responsible for injury. The main purpose of this study was to determine the internal loading of the joints for each strike pattern. A secondary purpose was to determine if converted FFS and RFS runners can adequately represent habitual runners with regards to the internal joint loading. Using inverse dynamics to calculate the net joint moments and reaction forces and optimization techniques to estimate muscle forces, we determined the axial compressive loading at the ankle, knee, and hip. Subjects consisted of 15 habitual FFS and 15 habitual RFS competitive runners. Each subject ran at a preferred running velocity with their habitual strike pattern and then converted to the opposite strike pattern. Plantar flexor muscle forces and net ankle joint moments were greater in the FFS running compared to the RFS running during the first half of the stance phase. The average contact forces during this period increased by 41.7% at the ankle and 14.4% at the knee joint during FFS running. Peak ankle joint contact force was 1.5 body weights greater during FFS running (pstrike pattern. Copyright © 2013 Elsevier Ltd. All rights reserved.

Properties of Lightning Strike Protection Coatings

Science.gov (United States)

Gagne, Martin

Composite materials are being increasingly used by many industries. In the case of aerospace companies, those materials are installed on their aircraft to save weight, and thus, fuel costs. These aircraft are lighter, but the loss of electrical conductivity makes aircraft vulnerable to lightning strikes, which hit commercial aircrafts on average once per year. This makes lightning strike protection very important, and while current metallic expanded copper foils offer good protection, they increase the weight of composites. Therefore, under the CRIAQ COMP-502 project, a team of industrial partners and academic researchers are investigating new conductive coatings with the following characteristics: High electromagnetic protection, high mechanical resistance, good environmental protection, manufacturability and moderate cost. The main objectives of this thesis, as part of this project, was to determine the main characteristics, such as electrical and tribomechanical properties, of conductive coatings on composite panels. Their properties were also to be tested after destructive tests such as current injection and environmental testing. Bombardier Aerospace provided the substrate, a composite of carbon fiber reinforced epoxy matrix, and the current commercial product, a surfacing film that includes an expanded copper foil used to compare with the other coatings. The conductive coatings fabricated by the students are: silver nanoparticles inside a binding matrix (PEDOT:PSS or a mix of Epoxy and PEDOT:PSS), silvered carbon nanofibers embedded in the surfacing film, cold sprayed tin, graphene oxide functionalized with silver nanowires, and electroless plated silver. Additionally as part of the project and thesis, magnetron sputtered aluminum coated samples were fabricated. There are three main types of tests to characterize the conductive coatings: electrical, mechanical and environmental. Electrical tests consist of finding the sheet resistance and specific resistivity

Law and ethics of strikes in the Nigerian health system | Mcfubara ...

African Journals Online (AJOL)

Despite that health services are essential, health sector strikes have continued. The purpose here was to examine the legal and ethical justification of strikes in the Nigerian health sector. Documentary analysis and literature reviews were carried out. It was found that the Trade Disputes Act and the National Health Act do not ...

[The specific microbiological and clinical features of acute otitis media].

Science.gov (United States)

Gurov, A V; Levina, Yu V; Guseva, A L; Elchueva, Z G; Efimova, S P; Gordienko, M V

The objective of the present study was to elucidate the specific features of the clinical course of acute otitis media as well as the peculiarities of the vestibular function and the microbial paysage associated with this pathological condition under the present-day conditions. The study included 135 patients presenting with acute otitis media (AOM) at different stages of the disease. The discharge obtained from the tympanic cavity of all the patients was examined with the use of polymerase chain reaction in real time, audiological and vestibulogical methods. The distinctive features of acute otitis medium associated with Streptococcus pneumoniae infection were found to be the intense pain syndrome with the symptoms of intoxication, well apparent inflammatory changes in the tympanic membrane as revealed by otoscopy, the increased frequency of sensorineural impairment of hearing, and the characteristic type B tympanometric curve. Typical of AOM associated with Haemophilus influenza infection are the mild pain syndrome, weak changes in the tympanic membrane as revealed by otoscopy, conductive hearing loss, and the type C tympanometric curve.

Non-traumatic rhabdomyolysis: Background, laboratory features, and acute clinical management.

Science.gov (United States)

Cervellin, Gianfranco; Comelli, Ivan; Benatti, Mario; Sanchis-Gomar, Fabian; Bassi, Antonella; Lippi, Giuseppe

2017-08-01

Rhabdomyolysis is a relatively rare condition, but its clinical consequences are frequently dramatic in terms of both morbidity and mortality. Although no consensus has been reached so far about the precise definition of this condition, the term rhabdomyolysis describes a rapid breakdown of striated, or skeletal, muscle. It is hence characterized by the rupture and necrosis of muscle fibers, resulting in release of cell degradation products and intracellular elements within the bloodstream and extracellular space. Notably, the percentage of patients with rhabdomyolysis who develop acute kidney injury, the most dramatic consequence, varies from 13% to over 50% according to both the cause and the clinical and organizational setting where they are diagnosed. Despite direct muscle injury (i.e., traumatic rhabdomyolysis) remains the most common cause, additional causes, frequently overlapping, include hypoxic, physical, chemical or biological factors. The conventional triad of symptoms includes muscle pain, weakness and dark urine. The laboratory diagnosis is essentially based on the measurement of biomarkers of muscle injury, being creatine kinase (CK) the biochemical "gold standard" for diagnosis, and myoglobin the "gold standard" for prognostication, especially in patients with non-traumatic rhabdomyolysis. The essential clinical management in the emergency department is based on a targeted intervention to manage the underlying cause, combined with infusion of fluids and eventually sodium bicarbonate. We will present and discuss in this article the pathophysiological and clinical features of non-traumatic rhabdomyolysis, focusing specifically on Emergency Department (ED) management. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Foot strike patterns and collision forces in habitually barefoot versus shod runners.

Science.gov (United States)

Lieberman, Daniel E; Venkadesan, Madhusudhan; Werbel, William A; Daoud, Adam I; D'Andrea, Susan; Davis, Irene S; Mang'eni, Robert Ojiambo; Pitsiladis, Yannis

2010-01-28

Humans have engaged in endurance running for millions of years, but the modern running shoe was not invented until the 1970s. For most of human evolutionary history, runners were either barefoot or wore minimal footwear such as sandals or moccasins with smaller heels and little cushioning relative to modern running shoes. We wondered how runners coped with the impact caused by the foot colliding with the ground before the invention of the modern shoe. Here we show that habitually barefoot endurance runners often land on the fore-foot (fore-foot strike) before bringing down the heel, but they sometimes land with a flat foot (mid-foot strike) or, less often, on the heel (rear-foot strike). In contrast, habitually shod runners mostly rear-foot strike, facilitated by the elevated and cushioned heel of the modern running shoe. Kinematic and kinetic analyses show that even on hard surfaces, barefoot runners who fore-foot strike generate smaller collision forces than shod rear-foot strikers. This difference results primarily from a more plantarflexed foot at landing and more ankle compliance during impact, decreasing the effective mass of the body that collides with the ground. Fore-foot- and mid-foot-strike gaits were probably more common when humans ran barefoot or in minimal shoes, and may protect the feet and lower limbs from some of the impact-related injuries now experienced by a high percentage of runners.

Migraine strikes as neuronal excitability reaches a tipping point.

Directory of Open Access Journals (Sweden)

Marten Scheffer

Full Text Available Self-propagating waves of cerebral neuronal firing, known as spreading depolarisations, are believed to be at the roots of migraine attacks. We propose that the start of spreading depolarisations corresponds to a critical transition that occurs when dynamic brain networks approach a tipping point. We show that this hypothesis is consistent with current pathogenetic insights and observed dynamics. Our view implies that migraine strikes when modulating factors further raise the neuronal excitability in genetically predisposed subjects to a level where even minor perturbations can trigger spreading depolarisations. A corollary is that recently discovered generic early warning indicators for critical transitions may be used to predict the onset of migraine attacks even before patients are clinically aware. This opens up new avenues for dissecting the mechanisms for the onset of migraine attacks and for identifying novel prophylactic treatment targets for the prevention of attacks.

The Poster Strikes Back

DEFF Research Database (Denmark)

Christensen, Line Hjorth

2005-01-01

The paper discusses fundamental issues in relation to placing graphic design in locations such as museums of decorative arts and living history museums. Based on my Ph.D. project on British commercial posters of the interwar years and approached from a combined perspective of museology, semiotics...... and design history, I argue that the poster during the interwar years inhabits a new active position. By exploiting and challenging the commercial and aesthetic paradox out of which it arose, the poster ‘strikes back' as a museologized, exhibited object. Rather than being absorbed into the city swirl...

Clinical features of movement disorders.

Science.gov (United States)

Yung, C Y

1983-08-01

The descriptive aspects of all types of movement disorders and their related syndromes and terminologies used in the literature are reviewed and described. This comprises the features of (a) movement disorders secondary to neurological diseases affecting the extrapyramidal motor system, such as: athetosis, chorea, dystonia, hemiballismus, myoclonus, tremor, tics and spasm, (b) drug induced movement disorders, such as: akathisia, akinesia, hyperkinesia, dyskinesias, extrapyramidal syndrome, and tardive dyskinesia, and (c) abnormal movements in psychiatric disorders, such as: mannerism, stereotyped behaviour and psychomotor retardation. It is intended to bring about a more comprehensive overview of these movement disorders from a phenomenological perspective, so that clinicians can familiarize with these features for diagnosis. Some general statements are made in regard to some of the characteristics of movement disorders.

[Clinical features of patients with Becker muscular dystrophy and deletions of the rod domain of dystrophin gene].

Science.gov (United States)

Wang, Yanyun; Zhu, Yuling; Yang, Juan; Li, Yaqin; Sun, Jiangwen; Zhan, Yixin; Zhang, Cheng

2018-02-10

OBJECTIVE To explore the clinical features of patients carrying deletions of the rod domain of the dystrophin gene. METHODS Clinical data of 12 Chinese patients with Becker muscular dystrophy (BMD) and such deletions was reviewed. RESULTS Most patients complained of muscle weakness of lower limbs. Two patients had muscle cramps, one had increased creatine kinase (CK) level, and one had dilated cardiomyopathy. CONCLUSION Compared with DMD, the clinical features of BMD are much more variable, particularly for those carrying deletions of the rod domain of the dystrophin gene. Muscular weakness may not be the sole complaint of BMD. The diagnosis of BMD cannot be excluded by moderately elevated CK. For male patients with dilated cardiomyopathy, the possibility of BMD should be considered.

Clinical analysis of CT features in 200 neonates with hypoxic-ischemic encephalopathy (HIE)

International Nuclear Information System (INIS)

Zhang Fan

2003-01-01

Objective: To analyze the CT features of HIE in neonates. Methods: CT scanning was performed in 200 neonates with HIE. Results: The CT features in 200 HIE were hypo-attenuated substantia alba, accompanied with intra-cranial hemorrhage, widened cavity of septum pellucidum and cerebral infarction. In total 200 cases, mild HIE was found in 118 cases, moderate HIE was revealed in 67 cases and severe condition was observed in 15 cases. Intra-cranial hemorrhage was noted in 87 cases. Conclusion: The cerebral injury should be diagnosed by the findings of hypo-attenuated substantia alba and intracranial hemorrhage on CT scan, combined with clinical histories and manifestations of intro-uterine neonate asphyxia

Clinical Efficacy of Various Diagnostic Tests for Small Bowel Tumors and Clinical Features of Tumors Missed by Capsule Endoscopy

Directory of Open Access Journals (Sweden)

Jung Wan Han

2015-01-01

Full Text Available Background. We aimed to evaluate the efficacy of various diagnostic tools such as computerized tomography (CT, small bowel follow-through (SBFT, and capsule endoscopy (CE in diagnosing small bowel tumors (SBTs. Additionally, we aimed to evaluate the clinical features of SBTs missed by CE. Methods. We retrospectively studied 79 patients with histologically proven SBT. Clinical data were analyzed with particular attention to the efficacy of CT, SBFT, and CE in detecting SBT preoperatively. We also analyzed the clinical features of SBTs missed by CE. Results. The most common symptoms of SBT were bleeding (43% and abdominal pain (13.9%. Diagnostic yields were as follows: CT detected 55.8% of proven SBTs; SBFT, 46.1%; and CE, 83.3%. The sensitivity for detecting SBTs was 40.4% for CT, 43.9% for SBFT, and 79.6% for CE. Two patients with nondiagnostic but suspicious findings on CE and seven patients with negative findings on CE were eventually found to have SBT. These nine patients were eventually diagnosed with gastrointestinal stromal tumor (4, small polyps (3, inflammatory fibroid polyp (1, and adenocarcinoma (1. These tumors were located in the proximal jejunum (5, middle jejunum (1, distal jejunum (1, and proximal ileum (1. Conclusion. CE is more efficacious than CT or SBFT for detecting SBTs. However, significant tumors may go undetected with CE, particularly when located in the proximal jejunum.

[Hunger striking in prisons: ethics and the ethical and legal aspects].

Science.gov (United States)

García-Guerrero, J

2013-01-01

Hunger strike is a common form of protest in prisons and is a potential cause of many types of problems, both for the prison administration and the doctors who care for prisoners who participate in one. Issues of conflict of rights and obligations involved, and how to treat people who are subject to the Administration, which in this case takes the position of guarantor, have created major controversies over doctrine. Conscientious objection and the conflict of dual loyalty of doctors working in prisons are also issues closely linked to a prison hunger strike. In this paper we review the solution given to the problem of treatment of a prison hunger strike from three perspectives: ethics, ethical and legal.

Physicians and strikes: can a walkout over the malpractice crisis be ethically justified?

Science.gov (United States)

Fiester, Autumn

2004-01-01

Malpractice insurance rates have created a crisis in American medicine. Rates are rising and reimbursements are not keeping pace. In response, physicians in the states hardest hit by this crisis are feeling compelled to take political action, and the current action of choice seems to be physician strikes. While the malpractice insurance crisis is acknowledged to be severe, does it justify the extreme action of a physician walkout? Should physicians engage in this type of collective action, and what are the costs to patients and the profession when such action is taken? I will offer three related arguments against physician strikes that constitute a prima facie prohibition against such action: first, strikes are intended to cause harm to patients; second, strikes are an affront to the physician-patient relationship; and, third, strikes risk decreasing the public's respect for the medical profession. As with any prima facie obligation, there are justifying conditions that may override the moral prohibition, but I will argue that the current malpractice crisis does not rise to the level of such a justifying condition. While the malpractice crisis demands and justifies a political response on the part of the nation's physicians, strikes and slow-downs are not an ethically justified means to the legitimate end of controlling insurance costs.

Relationship of renal insufficiency and clinical features or comorbidities with clinical outcome in patients hospitalised for acute heart failure syndromes.

Science.gov (United States)

Kajimoto, Katsuya; Sato, Naoki; Takano, Teruo

2017-12-01

Renal insufficiency is a well-known predictor of adverse events in patients with acute heart failure syndromes (AHFS). However, it remains unclear whether there are subgroups of AHFS patients in whom renal insufficiency is related to a higher risk of adverse events because of the heterogeneity of this patient population. Therefore, we investigated the relationship between renal insufficiency, clinical features or comorbidities, and the risk of adverse events in patients with AHFS. Of 4842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 4628 patients (95.6%) were evaluated in the present study in order to assess the relationship of renal insufficiency and clinical features or comorbidities with all-cause mortality after admission. Renal insufficiency was defined as an estimated creatinine clearance of ⩽40 mL/min (calculated by the Cockcroft-Gault formula) at admission. The median follow-up period after admission was 524 (391-789) days. The all-cause mortality rate after admission was significantly higher in patients with renal insufficiency (36.7%) than in patients without renal insufficiency (14.4%). Stratified analysis was performed in order to explore the heterogeneity of the influence of renal insufficiency on all-cause mortality. This analysis revealed that an ischaemic aetiology and a history of diabetes, atrial fibrillation, serum sodium, and anaemia at admission had significant influences on the relationship between renal insufficiency and all-cause mortality. The present study demonstrated that the relationship between renal insufficiency and all-cause mortality of AHFS patients varies markedly with clinical features or comorbidities and the mode of presentation due to the heterogeneity of this patient population.

Heel–toe running: A new look at the influence of foot strike pattern on impact force

OpenAIRE

John A. Mercer; Sarah Horsch

2015-01-01

Background/Objective: It is important to understand the factors that influence the impact force observed during running, since the impact force is likely to be related to overuse injuries. The purpose of this study was to compare the impact force during running when participants were instructed to use different foot strike patterns: obvious heel strike (Obvious-HS), subtle heel strike (Subtle-HS), midfoot strike (Mid-FS), and fore foot strike (Fore-FS) patterns. Methods: Participants (n = ...

Key-feature questions for assessment of clinical reasoning: a literature review.

Science.gov (United States)

Hrynchak, Patricia; Takahashi, Susan Glover; Nayer, Marla

2014-09-01

Key-feature questions (KFQs) have been developed to assess clinical reasoning skills. The purpose of this paper is to review the published evidence on the reliability and validity of KFQs to assess clinical reasoning. A literature review was conducted by searching MEDLINE (1946-2012) and EMBASE (1980-2012) via OVID and ERIC. The following search terms were used: key feature; question or test or tests or testing or tested or exam; assess or evaluation, and case-based or case-specific. Articles not in English were eliminated. The literature search resulted in 560 articles. Duplicates were eliminated, as were articles that were not relevant; nine articles that contained reliability or validity data remained. A review of the references and of citations of these articles resulted in an additional 12 articles to give a total of 21 for this review. Format, language and scoring of KFQ examinations have been studied and modified to maximise reliability. Internal consistency reliability has been reported as being between 0.49 and 0.95. Face and content validity have been shown to be moderate to high. Construct validity has been shown to be good using vector thinking processes and novice versus expert paradigms, and to discriminate between teaching methods. The very modest correlations between KFQ examinations and more general knowledge-based examinations point to differing roles for each. Importantly, the results of KFQ examinations have been shown to successfully predict future physician performance, including patient outcomes. Although it is inaccurate to conclude that any testing format is universally reliable or valid, published research supports the use of examinations using KFQs to assess clinical reasoning. The review identifies areas of further study, including all categories of evidence. Investigation into how examinations using KFQs integrate with other methods in a system of assessment is needed. © 2014 John Wiley & Sons Ltd.

The clinical and pathological features of hepatocellular carcinoma in Nnewi, Nigeria.

Science.gov (United States)

Okonkwo, U C; Nwosu, M N; Ukah, C; Okpala, O C; Ahaneku, J I

2011-01-01

Hepatocellular carcinoma (HCC) remains the commonest malignancy of the liver. In spite of the recent advances in treatment, prognosis is still abysmal especially in developing countries. This article aims to review the clinical and pathological features of HCC in a tertiary hospital at Nnewi. This was a cross-sectional study. Patients with HCC seen at the Medical Out-patient Department or admitted into the Medical wards of the Nnamdi Azikiwe University Teaching Hospital Nnewi were recruited. The study lasted from June 2007 to May, 2008. Subjects were clinically evaluated and blood samples collected for HBsAg, anti-HCV and HBeAg assays. The prevalence of HCC was 2.4%. Of the 60 patients studied, 38 were males and 22 were females with a male to female ratio of 2:1. Their ages ranged from 19-86 years with a mean age of 50.62 +/- 17.54. The mean duration of symptoms before presentation was 16 weeks and the mean duration from onset of symptoms to death is 20 weeks. Common presenting symptoms were painful right hypochondrial mass, abdominal swelling, weight loss, early satiety and fatigue while coagulopathy, ascites and hepatic encephalopathy were the most common complications. Multiple lesions affecting both lobes of the liver was seen in 48 patients on ultrasound, 36.6% were positive for HBsAg of which 41% were HBeAg positive. HCV antibodies were present in 8.3% of the patients. Well differentiated HCC of the pseudo-glandular variety was the most common histological type. HCC affects middle aged Nigerians. Though well differentiated, it presents late with clinical features of advanced disease leading to death within six months. It is more often associated with chronic HBV than HCV infection.

Radiological features and biomechanical patterns in Perthes disease

International Nuclear Information System (INIS)

Choo, B.S.; Hogg, A.D.C.; Burwell, R.G.; Moulton, A.; Worthington, B.S.

1990-01-01

This paper examines the relationship between radiologic features and biomechanical patterns in Perthes disease as shown in finite element models. A two-dimensional finite element model of a child's hip that allowed for movement at the joint line was loaded to simulate normal heel strike. The finite element method is a computer-based technique of mathematical modeling that permits calculation of the magnitude and direction of stresses, deformation, and dynamic behavior of continuous structures. In the normal hip model, maximum compressive stresses occur superolaterally and inferomedially in the femoral head, corresponding to the radiographic features of flattening and increased tear drop distance, attributable to cartilage thickening, seen in Perthes disease

The initiation and linkage of surface fractures above a buried strike ...

Indian Academy of Sciences (India)

a buried strike-slip fault: An experimental approach. N Ghosh and A ... conditions viz., (i) heterogeneous simple shear of the cover rocks above a buried strike slip fault. (wrench .... (iii) study of fracture types in the damage zones from Gozo .... was dominant, the results may vary from a true ... For example, as shown in figure 5 ...

Comparison of clinical, radionuclide, and radiographic features of osteoarthritis of the hands.

OpenAIRE

Macfarlane, D G; Buckland-Wright, J C; Emery, P; Fogelman, I; Clark, B; Lynch, J

1991-01-01

Simultaneous clinical, scintigraphic, and macroradiographic assessments were carried out on 32 patients with hand osteoarthritis and the results at entry and one year reported. The presence and growth of osteophyte correlated with symptoms and a positive scan. The scan did not detect the radiographic features of juxta-articular radiolucencies, subchondral sclerosis, or cartilage thinning. Osteophytes, particularly when fast growing, produce pain, a 'hot' scan, and may predict disintegration o...

Independent effects of step length and foot strike pattern on tibiofemoral joint forces during running.

Science.gov (United States)

Bowersock, Collin D; Willy, Richard W; DeVita, Paul; Willson, John D

2017-10-01

The purpose of this study was to examine the effects of step length and foot strike pattern along with their interaction on tibiofemoral joint (TFJ) and medial compartment TFJ kinetics during running. Nineteen participants ran with a rear foot strike pattern at their preferred speed using a short (-10%), preferred, and long (+10%) step length. These step length conditions were then repeated using a forefoot strike pattern. Regardless of foot strike pattern, a 10% shorter step length resulted in decreased peak contact force, force impulse per step, force impulse per kilometre, and average loading rate at the TFJ and medial compartment, while a 10% increased step length had the opposite effects (all P forefoot strike pattern significantly lowered TFJ and medial compartment TFJ average loading rates compared with a rear foot strike pattern (both forefoot strike pattern produced the greatest reduction in peak medial compartment contact force (P < 0.05). Knowledge of these running modification effects may be relevant to the management or prevention of TFJ injury or pathology among runners.

Active strike-slip faulting in El Salvador, Central America

Science.gov (United States)

Corti, Giacomo; Carminati, Eugenio; Mazzarini, Francesco; Oziel Garcia, Marvyn

2005-12-01

Several major earthquakes have affected El Salvador, Central America, during the Past 100 yr as a consequence of oblique subduction of the Cocos plate under the Caribbean plate, which is partitioned between trench-orthogonal compression and strike-slip deformation parallel to the volcanic arc. Focal mechanisms and the distribution of the most destructive earthquakes, together with geomorphologic evidence, suggest that this transcurrent component of motion may be accommodated by a major strike-slip fault (El Salvador fault zone). We present field geological, structural, and geomorphological data collected in central El Salvador that allow the constraint of the kinematics and the Quaternary activity of this major seismogenic strike-slip fault system. Data suggest that the El Salvador fault zone consists of at least two main ˜E-W fault segments (San Vicente and Berlin segments), with associated secondary synthetic (WNW-ESE) and antithetic (NNW-SSE) Riedel shears and NW-SE tensional structures. The two main fault segments overlap in a dextral en echelon style with the formation of an intervening pull-apart basin. Our original geological and geomorphologic data suggest a late Pleistocene Holocene slip rate of ˜11 mm/yr along the Berlin segment, in contrast with low historical seismicity. The kinematics and rates of deformation suggested by our new data are consistent with models involving slip partitioning during oblique subduction, and support the notion that a trench-parallel component of motion between the Caribbean and Cocos plates is concentrated along E-W dextral strike-slip faults parallel to the volcanic arc.

MR imaging of pregnancy luteoma: a case report and correlation with the clinical features

Energy Technology Data Exchange (ETDEWEB)

Kao, Hung Wen; Wu, Ching Jiunn; Chung, Kuo Teng; Wang, Sheng Ru; Chen, Cheng Yu [Tri-Service General Hospital, National Defense Medical Center, Taipei (Taiwan)

2005-03-15

We report here on a 26-year-old pregnant female who developed hirsutism and virilization during her third trimester along with a significantly elevated serum testosterone level. Abdominal US and MR imaging studies were performed, and they showed unique imaging features that may suggest the diagnosis of pregnancy luteoma in the clinical context. After the delivery, the serum testosterone level continued to decrease, and it returned to normal three weeks postpartum. The follow-up imaging findings were closely correlated with the clinical presentation.

Ebola outbreak in Conakry, Guinea: epidemiological, clinical, and outcome features.

Science.gov (United States)

Barry, M; Traoré, F A; Sako, F B; Kpamy, D O; Bah, E I; Poncin, M; Keita, S; Cisse, M; Touré, A

2014-12-01

The authors studied the epidemiological, clinical, and outcome features of the Ebola virus disease in patients hospitalized at the Ebola treatment center (ETC) in Conakry to identify clinical factors associated with death. A prospective study was conducted from March 25 to August 20, 2014. The diagnosis of Ebola virus infection was made on real-time PCR. Ninety patients, with a positive test result, were hospitalized. Their mean age was 34.12±14.29 years and 63% were male patients. Most worked in the informal sector (38%) and in the medical and paramedical staff (physicians 12%, nurses 6%, and laboratory technicians 1%). Most patients lived in the Conakry suburbs (74%) and in Boffa (11%). The main clinical signs were physical asthenia (80%) and fever (72%). Hemorrhagic signs were observed in 26% of patients. The comparison of clinical manifestations showed that hiccups (P=0.04), respiratory distress (P=0.04), and hemorrhagic symptoms (P=0.01) were more frequent among patients who died. Malaria (72%) and diabetes (2%) were the most frequent co-morbidities. The crude case fatality rate was 44% [95% confidence interval (33-54%)]. The average hospital stay was 7.96±5.81 days. The first Ebola outbreak in Conakry was characterized by the young age of patients, discrete hemorrhagic signs related to lethality. Its control relies on a strict use of preventive measures. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Clinical features and etiology of retinal vasculitis in Northern Thailand

Directory of Open Access Journals (Sweden)

Supanut Apinyawasisuk

2013-01-01

Full Text Available Purpose: To report on the clinical features and etiology of patients with retinal vasculitis (RV. Materials and Methods: We reviewed medical records of 47 patients (75 affected eyes diagnosed with RV. Clinical presentations, ocular complications, associated systemic diseases, and treatment regimens were registered. Results: Etiology of RV included infectious causes in 10/47, (21% while an association with systemic and/or ocular non-infectious disorders was noted in 22/47 (47%. Eales′ disease and Behcet′s disease represented the most common clinical entities in non-infectious group while tuberculosis-associated RV was diagnosed in 6/10 (60% among those with infectious disorders. RV was bilateral in 28/47 (60% patients. Retinal veins were most commonly affected (72%, 34/47. Involvement of arteries was present in 12/47 (25% and was associated with viral infections and Behcet′s disease. Ocular complications developed in 60/75 (80% eyes. The most common complications were elevated intraocular pressure and/or glaucoma (33/75, 44%. Retinal detachment, vitreous hemorrhage, and cystoid macular edema developed in similar percentages (15%. Conclusions: RV in Thailand manifested mostly in male patients, was typically bilateral and involved mostly veins. Involvement of arteries was observed in patients with viral infections and Behcet′s disease. Tuberculosis was the most common infectious cause.

Coronary heart disease in the diabetic African: frequency clinical and angiographic features.

Science.gov (United States)

Touze, J E; Ekra, A; Darracq, R; Mardelle, T; Adoh, A; Ake, E; Chauvet, J; Bertrand, E

1987-01-01

The frequency and clinical and coronarographic features of coronary heart disease (CHD) in black African diabetic patients were assessed in a two-part study. The aim of part I was to determine the frequency of CHD in 50 diabetic patients selected by the following criteria: male, age between 40 and 60 years, diabetes history less than 20 years, no history of CHD and normal E.K.G. All 50 of these patients underwent a stress test and those who failed or for whom results were inconclusive were submitted to coronary arteriography. Part II was a retrospective study of 104 patients with CHD. Its aim was to compare the clinical and coronarographic features of CHD patients with (27 cases) and without (77 cases) diabetes mellitus. The frequency of CHD in the 50 diabetics selected for this study was 10% (31 negative exercise tests, 19 inconclusive exercise tests, 5 coronary arteriographies with significant narrowing). Of these 5 diabetics with CHD, 3 had single vessel involvement (left descending artery: 2 cases, circumflex artery: 1 case), 1 patient had double vessel involvement (right coronary circumflex artery) and 1 had triple vessel involvement (left descending, circumflex, and right coronary artery). In the retrospective study the clinical profile of the diabetic and non-diabetic CHD patients was the same with respect to sex, age, angina, myocardial infarction, and death rate. As regard the risk factors, blood cholesterol level was higher in diabetics while cigarette smoking was higher in non-diabetics. The frequency of hypertension was the same in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Factors Associated with Clinical and Topographical Features of Laryngeal Tuberculosis.

Directory of Open Access Journals (Sweden)

João Gustavo Corrêa Reis

Full Text Available Laryngeal tuberculosis (LTB is the most frequent granulomatous disease of the larynx and represents less than 2% of extrapulmonary TB cases. There are no pathognomonic clinical and endoscopic features of this disease and studies on LTB that can assist in its diagnostic characterization are lacking.To identify factors associated with clinical and topographical features of LTB.a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis.Dysphonia and cough were the main symptoms presented by patients and the true vocal folds the most frequently affected site. The average of the duration of the disease evolution was significantly higher in patients with dysphonia than in patients without this symptom. We observed association between dysphonia and true vocal fold lesions and between odynophagia and lesions in the epiglottis, arytenoids and aryepiglottic folds. Odynophagia was more frequent in individuals with lesions in four or more laryngeal sites. Weight loss equal or above 10% of the body weight was more frequent in patients with odynophagia as first symptom and in patients with ulcerated lesion. Dyspnea on exertion was more frequent in individuals with more extensive laryngeal lesions. The percentage of smokers with lesions in four or more laryngeal sites was greater than that found in non-smokers. Laryngeal tissue fragment bacilloscopy and culture examinations were less positive than sputum ones.Smoking appears to be associated with the development of more extensive LTB lesions, and LTB with dyspnea on exertion and odynophagia with consequent impairment of nutritional status. We emphasize the need for histopathologic confirmation, once positive sputum bacteriological examinations seem not to necessarily reflect laryngeal involvement.

Factors Associated with Clinical and Topographical Features of Laryngeal Tuberculosis.

Science.gov (United States)

Reis, João Gustavo Corrêa; Reis, Clarissa Souza Mota; da Costa, Daniel César Silva; Lucena, Márcia Mendonça; Schubach, Armando de Oliveira; Oliveira, Raquel de Vasconcellos Carvalhaes; Rolla, Valéria Cavalcanti; Conceição-Silva, Fátima; Valete-Rosalino, Cláudia Maria

2016-01-01

Laryngeal tuberculosis (LTB) is the most frequent granulomatous disease of the larynx and represents less than 2% of extrapulmonary TB cases. There are no pathognomonic clinical and endoscopic features of this disease and studies on LTB that can assist in its diagnostic characterization are lacking. To identify factors associated with clinical and topographical features of LTB. a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis. Dysphonia and cough were the main symptoms presented by patients and the true vocal folds the most frequently affected site. The average of the duration of the disease evolution was significantly higher in patients with dysphonia than in patients without this symptom. We observed association between dysphonia and true vocal fold lesions and between odynophagia and lesions in the epiglottis, arytenoids and aryepiglottic folds. Odynophagia was more frequent in individuals with lesions in four or more laryngeal sites. Weight loss equal or above 10% of the body weight was more frequent in patients with odynophagia as first symptom and in patients with ulcerated lesion. Dyspnea on exertion was more frequent in individuals with more extensive laryngeal lesions. The percentage of smokers with lesions in four or more laryngeal sites was greater than that found in non-smokers. Laryngeal tissue fragment bacilloscopy and culture examinations were less positive than sputum ones. Smoking appears to be associated with the development of more extensive LTB lesions, and LTB with dyspnea on exertion and odynophagia with consequent impairment of nutritional status. We emphasize the need for histopathologic confirmation, once positive sputum bacteriological examinations seem not to necessarily reflect laryngeal involvement.

The Assessment of Patient Clinical Outcome: Advantages, Models, Features of an Ideal Model

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Mou’ath Hourani

2016-06-01

Full Text Available Background: The assessment of patient clinical outcome focuses on measuring various aspects of the health status of a patient who is under healthcare intervention. Patient clinical outcome assessment is a very significant process in the clinical field as it allows health care professionals to better understand the effectiveness of their health care programs and thus for enhancing the health care quality in general. It is thus vital that a high quality, informative review of current issues regarding the assessment of patient clinical outcome should be conducted. Aims & Objectives: 1 Summarizes the advantages of the assessment of patient clinical outcome; 2 reviews some of the existing patient clinical outcome assessment models namely: Simulation, Markov, Bayesian belief networks, Bayesian statistics and Conventional statistics, and Kaplan-Meier analysis models; and 3 demonstrates the desired features that should be fulfilled by a well-established ideal patient clinical outcome assessment model. Material & Methods: An integrative review of the literature has been performed using the Google Scholar to explore the field of patient clinical outcome assessment. Conclusion: This paper will directly support researchers, clinicians and health care professionals in their understanding of developments in the domain of the assessment of patient clinical outcome, thus enabling them to propose ideal assessment models.

The Assessment of Patient Clinical Outcome: Advantages, Models, Features of an Ideal Model

Directory of Open Access Journals (Sweden)

Mou’ath Hourani

2016-06-01

Full Text Available Background: The assessment of patient clinical outcome focuses on measuring various aspects of the health status of a patient who is under healthcare intervention. Patient clinical outcome assessment is a very significant process in the clinical field as it allows health care professionals to better understand the effectiveness of their health care programs and thus for enhancing the health care quality in general. It is thus vital that a high quality, informative review of current issues regarding the assessment of patient clinical outcome should be conducted. Aims & Objectives: 1 Summarizes the advantages of the assessment of patient clinical outcome; 2 reviews some of the existing patient clinical outcome assessment models namely: Simulation, Markov, Bayesian belief networks, Bayesian statistics and Conventional statistics, and Kaplan-Meier analysis models; and 3 demonstrates the desired features that should be fulfilled by a well-established ideal patient clinical outcome assessment model. Material & Methods: An integrative review of the literature has been performed using the Google Scholar to explore the field of patient clinical outcome assessment. Conclusion: This paper will directly support researchers, clinicians and health care professionals in their understanding of developments in the domain of the assessment of patient clinical outcome, thus enabling them to propose ideal assessment models.

Hippocampal sclerosis in advanced age: clinical and pathological features

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Schmitt, Frederick A.; Lin, Yushun; Abner, Erin L.; Jicha, Gregory A.; Patel, Ela; Thomason, Paula C.; Neltner, Janna H.; Smith, Charles D.; Santacruz, Karen S.; Sonnen, Joshua A.; Poon, Leonard W.; Gearing, Marla; Green, Robert C.; Woodard, John L.; Van Eldik, Linda J.; Kryscio, Richard J.

2011-01-01

Hippocampal sclerosis is a relatively common neuropathological finding (∼10% of individuals over the age of 85 years) characterized by cell loss and gliosis in the hippocampus that is not explained by Alzheimer’s disease. Hippocampal sclerosis pathology can be associated with different underlying causes, and we refer to hippocampal sclerosis in the aged brain as hippocampal sclerosis associated with ageing. Much remains unknown about hippocampal sclerosis associated with ageing. We combined three different large autopsy cohorts: University of Kentucky Alzheimer’s Disease Centre, the Nun Study and the Georgia Centenarian Study to obtain a pool of 1110 patients, all of whom were evaluated neuropathologically at the University of Kentucky. We focused on the subset of cases with neuropathology-confirmed hippocampal sclerosis (n = 106). For individuals aged ≥95 years at death (n = 179 in our sample), each year of life beyond the age of 95 years correlated with increased prevalence of hippocampal sclerosis pathology and decreased prevalence of ‘definite’ Alzheimer’s disease pathology. Aberrant TAR DNA protein 43 immunohistochemistry was seen in 89.9% of hippocampal sclerosis positive patients compared with 9.7% of hippocampal sclerosis negative patients. TAR DNA protein 43 immunohistochemistry can be used to demonstrate that the disease is usually bilateral even when hippocampal sclerosis pathology is not obvious by haematoxylin and eosin stains. TAR DNA protein 43 immunohistochemistry was negative on brain sections from younger individuals (n = 10) after hippocampectomy due to seizures, who had pathologically confirmed hippocampal sclerosis. There was no association between cases with hippocampal sclerosis associated with ageing and apolipoprotein E genotype. Age of death and clinical features of hippocampal sclerosis associated with ageing (with or without aberrant TAR DNA protein 43) were distinct from previously published cases of frontotemporal lobar

Hippocampal sclerosis in advanced age: clinical and pathological features.

Science.gov (United States)

Nelson, Peter T; Schmitt, Frederick A; Lin, Yushun; Abner, Erin L; Jicha, Gregory A; Patel, Ela; Thomason, Paula C; Neltner, Janna H; Smith, Charles D; Santacruz, Karen S; Sonnen, Joshua A; Poon, Leonard W; Gearing, Marla; Green, Robert C; Woodard, John L; Van Eldik, Linda J; Kryscio, Richard J

2011-05-01

Hippocampal sclerosis is a relatively common neuropathological finding (∼10% of individuals over the age of 85 years) characterized by cell loss and gliosis in the hippocampus that is not explained by Alzheimer's disease. Hippocampal sclerosis pathology can be associated with different underlying causes, and we refer to hippocampal sclerosis in the aged brain as hippocampal sclerosis associated with ageing. Much remains unknown about hippocampal sclerosis associated with ageing. We combined three different large autopsy cohorts: University of Kentucky Alzheimer's Disease Centre, the Nun Study and the Georgia Centenarian Study to obtain a pool of 1110 patients, all of whom were evaluated neuropathologically at the University of Kentucky. We focused on the subset of cases with neuropathology-confirmed hippocampal sclerosis (n=106). For individuals aged≥95 years at death (n=179 in our sample), each year of life beyond the age of 95 years correlated with increased prevalence of hippocampal sclerosis pathology and decreased prevalence of 'definite' Alzheimer's disease pathology. Aberrant TAR DNA protein 43 immunohistochemistry was seen in 89.9% of hippocampal sclerosis positive patients compared with 9.7% of hippocampal sclerosis negative patients. TAR DNA protein 43 immunohistochemistry can be used to demonstrate that the disease is usually bilateral even when hippocampal sclerosis pathology is not obvious by haematoxylin and eosin stains. TAR DNA protein 43 immunohistochemistry was negative on brain sections from younger individuals (n=10) after hippocampectomy due to seizures, who had pathologically confirmed hippocampal sclerosis. There was no association between cases with hippocampal sclerosis associated with ageing and apolipoprotein E genotype. Age of death and clinical features of hippocampal sclerosis associated with ageing (with or without aberrant TAR DNA protein 43) were distinct from previously published cases of frontotemporal lobar degeneration TAR

Stargardt disease: clinical features, molecular genetics, animal models and therapeutic options.

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Tanna, Preena; Strauss, Rupert W; Fujinami, Kaoru; Michaelides, Michel

2017-01-01

Stargardt disease (STGD1; MIM 248200) is the most prevalent inherited macular dystrophy and is associated with disease-causing sequence variants in the gene ABCA4 Significant advances have been made over the last 10 years in our understanding of both the clinical and molecular features of STGD1, and also the underlying pathophysiology, which has culminated in ongoing and planned human clinical trials of novel therapies. The aims of this review are to describe the detailed phenotypic and genotypic characteristics of the disease, conventional and novel imaging findings, current knowledge of animal models and pathogenesis, and the multiple avenues of intervention being explored. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Clinical and microbiological features of Haemophilus influenzae vulvovaginitis in young girls

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Cox, R A; Slack, M P E

2002-01-01

Aims: To define the clinical and microbiological features of vulvovaginitis in prepubertal girls whose genital swabs yielded Haemophilus influenzae. Methods: Laboratory based study and retrospective collection of clinical data from the requesting doctors. Results: Thirty eight isolates of non-capsulate Haemophilus influenzae and one of H parainfluenzae were isolated from 32 girls aged 18 months to 11 years. No other pathogens, such as β haemolytic streptococci or yeasts, were present with H influenzae. The most common biotype was biotype II, comprising 57% of the 26 isolates biotyped. Six children had more than one episode of vulvovaginitis caused by H influenzae and a total of 14 children had recurrent vaginal symptoms. Conclusion: Children who have H influenzae vulvovaginitis are at risk of recurrent symptoms. Biotype II is the one most commonly associated with this condition. PMID:12461068

Heel-toe running: A new look at the influence of foot strike pattern on impact force.

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Mercer, John A; Horsch, Sarah

2015-06-01

It is important to understand the factors that influence the impact force observed during running, since the impact force is likely to be related to overuse injuries. The purpose of this study was to compare the impact force during running when participants were instructed to use different foot strike patterns: obvious heel strike (Obvious-HS), subtle heel strike (Subtle-HS), midfoot strike (Mid-FS), and fore foot strike (Fore-FS) patterns. Participants ( n  = 10, 25 ± 5.7 years, 70.2 ± 12.1 kg, 174.6 ± 7.2 cm) completed four foot strike patterns while running over ground: Obvious-HS, Subtle-HS, Mid-FS, and Fore-FS. Speed was controlled between conditions (random order). Vertical ground reaction forces were recorded (1000 Hz) along with the impact force, peak force, and stance time for analysis. A repeated measures analysis of variance was used to compare each variable across foot strike instructions, with post hoc comparisons contrasting Obvious-HS to each of the other conditions. Impact force was influenced by foot strike instructions, with Obvious-HS being greater than Subtle-HS and Fore-FS ( p   0.05). The peak force was not influenced by foot strike instructions ( p  > 0.05); stance time was longer during Obvious-HS than during Mid-FS or Fore-FS ( p   0.05). The unique observation of this study was that impact force was different when participants were instructed to run with either an Obvious-HS or a Subtle-HS at contact. Both these foot strike patterns would have been considered rear foot strike patterns, suggesting that something other than which specific part of the foot strikes the ground initially influenced impact force.

MRI and clinical features of Langerhans cell histiocytosis (LCH) in the pelvis and extremities: can LCH really look like anything?

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Samet, Jonathan; Weinstein, Joanna; Fayad, Laura M.

2016-01-01

To assess clinical and MRI features of Langerhans cell histiocytosis in the pelvis and extremities. The MRI and clinical features of 21 pathologically proven cases of LCH involving the pelvis and extremities were studied. Multiple characteristics of the lesions were evaluated (location, size, T1/ T2/post-contrast features, perilesional bone and soft tissue signal, endosteal scalloping, periosteal reaction, soft tissue mass, pathologic fracture). Pre-biopsy radiologic diagnoses were collected from the original clinical reports. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), temperature, and white blood cell count (WBC) were collected at the time of diagnosis when available. The locations of the LCH lesions included five humerus, four femur, five ilium, one tibia, one clavicle, and three scapula. Lesional size ranged from 1.8 to 7.1 cm, with a mean of 3.6 cm. All lesions demonstrated perilesional bone marrow edema, periosteal reaction, endosteal scalloping, and post-contrast enhancement. An associated soft tissue mass was present in 15/21 (71.4 %). Clinically, the WBC, ESR, and CRP were elevated in 2/14 (14 %), 8/12 (67 %), and 4/10 (40 %) of cases, respectively. Fever was documented in 1/15 (7 %) patients and pain was reported in 15/15 (100 %). The clinical and radiologic features of LCH in the pelvis and extremities overlap with infection and malignancy, but LCH must be considered in the differential diagnosis, as it routinely presents with aggressive MRI features, including endosteal scalloping, periosteal reaction, perilesional edema, and a soft tissue mass. Furthermore, an unknown skeletal lesion at presentation without aggressive MRI features is unlikely to represent LCH. (orig.)

MRI and clinical features of Langerhans cell histiocytosis (LCH) in the pelvis and extremities: can LCH really look like anything?

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Samet, Jonathan [Northwestern University Feinberg School of Medicine, Department of Medical Imaging, Ann and Robert H. Lurie Children' s Hospital of Chicago, Chicago, IL (United States); Weinstein, Joanna [Northwestern University Feinberg School of Medicine, Departments of Pediatrics, Division of Hematology/Oncology/Stem Cell Transplant, Ann and Robert H. Lurie Children' s Hospital of Chicago, Chicago, IL (United States); Fayad, Laura M. [The Johns Hopkins University School of Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States)

2016-05-15

To assess clinical and MRI features of Langerhans cell histiocytosis in the pelvis and extremities. The MRI and clinical features of 21 pathologically proven cases of LCH involving the pelvis and extremities were studied. Multiple characteristics of the lesions were evaluated (location, size, T1/ T2/post-contrast features, perilesional bone and soft tissue signal, endosteal scalloping, periosteal reaction, soft tissue mass, pathologic fracture). Pre-biopsy radiologic diagnoses were collected from the original clinical reports. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), temperature, and white blood cell count (WBC) were collected at the time of diagnosis when available. The locations of the LCH lesions included five humerus, four femur, five ilium, one tibia, one clavicle, and three scapula. Lesional size ranged from 1.8 to 7.1 cm, with a mean of 3.6 cm. All lesions demonstrated perilesional bone marrow edema, periosteal reaction, endosteal scalloping, and post-contrast enhancement. An associated soft tissue mass was present in 15/21 (71.4 %). Clinically, the WBC, ESR, and CRP were elevated in 2/14 (14 %), 8/12 (67 %), and 4/10 (40 %) of cases, respectively. Fever was documented in 1/15 (7 %) patients and pain was reported in 15/15 (100 %). The clinical and radiologic features of LCH in the pelvis and extremities overlap with infection and malignancy, but LCH must be considered in the differential diagnosis, as it routinely presents with aggressive MRI features, including endosteal scalloping, periosteal reaction, perilesional edema, and a soft tissue mass. Furthermore, an unknown skeletal lesion at presentation without aggressive MRI features is unlikely to represent LCH. (orig.)

Clinical features and patient management of Lujo hemorrhagic fever.

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Nivesh H Sewlall

Full Text Available In 2008 a nosocomial outbreak of five cases of viral hemorrhagic fever due to a novel arenavirus, Lujo virus, occurred in Johannesburg, South Africa. Lujo virus is only the second pathogenic arenavirus, after Lassa virus, to be recognized in Africa and the first in over 40 years. Because of the remote, resource-poor, and often politically unstable regions where Lassa fever and other viral hemorrhagic fevers typically occur, there have been few opportunities to undertake in-depth study of their clinical manifestations, transmission dynamics, pathogenesis, or response to treatment options typically available in industrialized countries.We describe the clinical features of five cases of Lujo hemorrhagic fever and summarize their clinical management, as well as providing additional epidemiologic detail regarding the 2008 outbreak. Illness typically began with the abrupt onset of fever, malaise, headache, and myalgias followed successively by sore throat, chest pain, gastrointestinal symptoms, rash, minor hemorrhage, subconjunctival injection, and neck and facial swelling over the first week of illness. No major hemorrhage was noted. Neurological signs were sometimes seen in the late stages. Shock and multi-organ system failure, often with evidence of disseminated intravascular coagulopathy, ensued in the second week, with death in four of the five cases. Distinctive treatment components of the one surviving patient included rapid commencement of the antiviral drug ribavirin and administration of HMG-CoA reductase inhibitors (statins, N-acetylcysteine, and recombinant factor VIIa.Lujo virus causes a clinical syndrome remarkably similar to Lassa fever. Considering the high case-fatality and significant logistical impediments to controlled treatment efficacy trials for viral hemorrhagic fever, it is both logical and ethical to explore the use of the various compounds used in the treatment of the surviving case reported here in future outbreaks

Frontotemporal dementia with the C9ORF72 hexanucleotide repeat expansion: clinical, neuroanatomical and neuropathological features

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Mahoney, Colin J.; Beck, Jon; Rohrer, Jonathan D.; Lashley, Tammaryn; Mok, Kin; Shakespeare, Tim; Yeatman, Tom; Warrington, Elizabeth K.; Schott, Jonathan M.; Fox, Nick C.; Rossor, Martin N.; Hardy, John; Collinge, John; Revesz, Tamas; Mead, Simon

2012-01-01

An expanded hexanucleotide repeat in the C9ORF72 gene has recently been identified as a major cause of familial frontotemporal lobar degeneration and motor neuron disease, including cases previously identified as linked to chromosome 9. Here we present a detailed retrospective clinical, neuroimaging and histopathological analysis of a C9ORF72 mutation case series in relation to other forms of genetically determined frontotemporal lobar degeneration ascertained at a specialist centre. Eighteen probands (19 cases in total) were identified, representing 35% of frontotemporal lobar degeneration cases with identified mutations, 36% of cases with clinical evidence of motor neuron disease and 7% of the entire cohort. Thirty-three per cent of these C9ORF72 cases had no identified relevant family history. Families showed wide variation in clinical onset (43–68 years) and duration (1.7–22 years). The most common presenting syndrome (comprising a half of cases) was behavioural variant frontotemporal dementia, however, there was substantial clinical heterogeneity across the C9ORF72 mutation cohort. Sixty per cent of cases developed clinical features consistent with motor neuron disease during the period of follow-up. Anxiety and agitation and memory impairment were prominent features (between a half to two-thirds of cases), and dominant parietal dysfunction was also frequent. Affected individuals showed variable magnetic resonance imaging findings; however, relative to healthy controls, the group as a whole showed extensive thinning of frontal, temporal and parietal cortices, subcortical grey matter atrophy including thalamus and cerebellum and involvement of long intrahemispheric, commissural and corticospinal tracts. The neuroimaging profile of the C9ORF72 expansion was significantly more symmetrical than progranulin mutations with significantly less temporal lobe involvement than microtubule-associated protein tau mutations. Neuropathological examination in six cases

Skeletal Muscle Laminopathies: A Review of Clinical and Molecular Features

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Lorenzo Maggi

2016-08-01

Full Text Available LMNA-related disorders are caused by mutations in the LMNA gene, which encodes for the nuclear envelope proteins, lamin A and C, via alternative splicing. Laminopathies are associated with a wide range of disease phenotypes, including neuromuscular, cardiac, metabolic disorders and premature aging syndromes. The most frequent diseases associated with mutations in the LMNA gene are characterized by skeletal and cardiac muscle involvement. This review will focus on genetics and clinical features of laminopathies affecting primarily skeletal muscle. Although only symptomatic treatment is available for these patients, many achievements have been made in clarifying the pathogenesis and improving the management of these diseases.

Features of Onset and Clinical Course of Reactive Arthritis in Children

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I.S. Lebets

2013-09-01

Results. Reactive arthritis of chlamydial etiology is characterized by lesion of large and medium-sized joints of the lower limbs, which is often accompanied by short-term morning stiffness and rapid onset of transient hypomyatrophy. Reiter’s disease may develop rarely. Mycoplasma-induced reactive arthritis is characterized by debut with arthritis of knee, ankle, wrist and small joints of the hand, the development of bursitis and hypomyatrophy. Feature of Ureaplasma arthritis is the formation of bursitis in the heel and tendinitis. Reactive arthritis associated with elevated titers to antistreptolysin O differs with polymorphism of articular syndrome manifestations and, to some extent, of similarity with juvenile rheumatoid arthritis. Unspecified reactive arthritis has a number of the general features with others reactive arthritis and it is characterized by rather benign clinical course, long preservation of joints function and low laboratory activity. Relapse rate of reactive arthritis increases with an increase of duration of illness.

Clinical and ultrasonographic features of male breast tumors: A retrospective analysis.

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Yuan, Wei-Hsin; Li, Anna Fen-Yau; Chou, Yi-Hong; Hsu, Hui-Chen; Chen, Ying-Yuan

2018-01-01

The purpose of this study was to determine clinical and ultrasonographic characteristics of male breast tumors. The medical records of male patients with breast lesions were retrieved from an electronic medical record database and a pathology database and retrospectively reviewed. A total of 112 men (125 breast masses) with preoperative breast ultrasonography (US) were included (median age, 59.50 years; age range, 15-96 years). Data extracted included patient age, if the lesions were bilateral, palpable, and tender, and the presence of nipple discharge. Breast lesion features on static US images were reviewed by three experienced radiologists without knowledge of physical examination or pathology results, original breast US image interpretations, or surgical outcomes. The US features were documented according to the BI-RADS (Breast Imaging-Reporting and Data System) US lexicons. A forth radiologist compiled the data for analysis. Of the 125 breast masses, palpable tender lumps and bilateral synchronous masses were more likely to be benign than malignant (both, 100% vs 0%, P nipples were common in malignant lesions (P nipple, irregular shape, the presence of an echogenic halo, predominantly internal vascularity, and rich color flow signal on color Doppler ultrasound were significantly related to malignancy (all, P < 0.05). An echogenic halo and the presence of rich color flow signal were independent predictors of malignancy. Specific clinical and US characteristics of male breast tumors may help guide treatment, and determine if surgery or conservative treatment is preferable.

Global strike hypersonic weapons

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Lewis, Mark J.

2017-11-01

Beginning in the 1940's, the United States has pursued the development of hypersonic technologies, enabling atmospheric flight in excess of five times the speed of sound. Hypersonic flight has application to a range of military and civilian applications, including commercial transport, space access, and various weapons and sensing platforms. A number of flight tests of hypersonic vehicles have been conducted by countries around the world, including the United States, Russia, and China, that could lead the way to future hypersonic global strike weapon systems. These weapons would be especially effective at penetrating conventional defenses, and could pose a significant risk to national security.

San Andreas-sized Strike-slip Fault on Europa

Science.gov (United States)

1998-01-01

This mosaic of the south polar region of Jupiter's moon Europa shows the northern 290 kilometers (180 miles) of a strike-slip fault named Astypalaea Linea. The entire fault is about 810 kilometers (500 miles) long, about the size of the California portion of the San Andreas fault, which runs from the California-Mexico border north to the San Francisco Bay. In a strike-slip fault, two crustal blocks move horizontally past one another, similar to two opposing lanes of traffic. Overall motion along the fault seems to have followed a continuous narrow crack along the feature's entire length, with a path resembling steps on a staircase crossing zones that have been pulled apart. The images show that about 50 kilometers (30 miles) of displacement have taken place along the fault. The fault's opposite sides can be reconstructed like a puzzle, matching the shape of the sides and older, individual cracks and ridges broken by its movements. [figure removed for brevity, see original site] The red line marks the once active central crack of the fault. The black line outlines the fault zone, including material accumulated in the regions which have been pulled apart. Bends in the fault have allowed the surface to be pulled apart. This process created openings through which warmer, softer ice from below Europa's brittle ice shell surface, or frozen water from a possible subsurface ocean, could reach the surface. This upwelling of material formed large areas of new ice within the boundaries of the original fault. A similar pulling-apart phenomenon can be observed in the geological trough surrounding California's Salton Sea, in Death Valley and the Dead Sea. In those cases, the pulled-apart regions can include upwelled materials, but may be filled mostly by sedimentary and eroded material from above. One theory is that fault motion on Europa is induced by the pull of variable daily tides generated by Jupiter's gravitational tug on Europa. Tidal tension opens the fault and

Dedifferentiated chondrosarcoma of the larynx: Radiological, gross, microscopic and clinical features.

Science.gov (United States)

Magliocca, Kelly R; Edgar, Mark A; Corey, Amanda; Villari, Craig R

2017-10-01

Laryngeal chondrosarcoma is an uncommon malignancy with a predilection for the cricoid cartilage of adult male patients. Although rare, identification of aggressive chondrosarcoma variants, such as dedifferentiated chondrosarcoma (DDCS) may influence preoperative patient counseling, definitive surgical management, potential implementation of post-operative adjuvant therapy and prognosis. Herein we describe clinical and imaging features of laryngeal DDCS, the unique perspective of fresh and formalin fixed macroscopic examination, a spectrum of histopathologic findings, and detail the full course of the patient's disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Featuring animacy

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Elizabeth Ritter

2015-01-01

Full Text Available Algonquian languages are famous for their animacy-based grammatical properties—an animacy based noun classification system and direct/inverse system which gives rise to animacy hierarchy effects in the determination of verb agreement. In this paper I provide new evidence for the proposal that the distinctive properties of these languages is due to the use of participant-based features, rather than spatio-temporal ones, for both nominal and verbal functional categories (Ritter & Wiltschko 2009, 2014. Building on Wiltschko (2012, I develop a formal treatment of the Blackfoot aspectual system that assumes a category Inner Aspect (cf. MacDonald 2008, Travis 1991, 2010. Focusing on lexical aspect in Blackfoot, I demonstrate that the classification of both nouns (Seinsarten and verbs (Aktionsarten is based on animacy, rather than boundedness, resulting in a strikingly different aspectual system for both categories. 

Shell Tectonics: A Mechanical Model for Strike-slip Displacement on Europa

Science.gov (United States)

Rhoden, Alyssa Rose; Wurman, Gilead; Huff, Eric M.; Manga, Michael; Hurford, Terry A.

2012-01-01

We introduce a new mechanical model for producing tidally-driven strike-slip displacement along preexisting faults on Europa, which we call shell tectonics. This model differs from previous models of strike-slip on icy satellites by incorporating a Coulomb failure criterion, approximating a viscoelastic rheology, determining the slip direction based on the gradient of the tidal shear stress rather than its sign, and quantitatively determining the net offset over many orbits. This model allows us to predict the direction of net displacement along faults and determine relative accumulation rate of displacement. To test the shell tectonics model, we generate global predictions of slip direction and compare them with the observed global pattern of strike-slip displacement on Europa in which left-lateral faults dominate far north of the equator, right-lateral faults dominate in the far south, and near-equatorial regions display a mixture of both types of faults. The shell tectonics model reproduces this global pattern. Incorporating a small obliquity into calculations of tidal stresses, which are used as inputs to the shell tectonics model, can also explain regional differences in strike-slip fault populations. We also discuss implications for fault azimuths, fault depth, and Europa's tectonic history.

Electromiographic and kinematic characteristics of Kung Fu Yau-Man palm strike.

Science.gov (United States)

Neto, O P; Magini, Marcio

2008-12-01

A kinematic and electromyographic analysis of Kung Fu (KF) Yau-Man palm strikes without impact is presented. An empirical model applied to data obtained by a high-speed camera describes the kinematic characteristics of the movement. The electromyographic patterns of the biceps brachii, brachioradialis and triceps brachii muscles were studied during the strike in the time (root mean square) and frequency (wavelet transform) domains. Eight KF practitioners participated in the investigation. A wooden board was placed in front of the subjects, and they were asked to perform the strike imagining a target above the board. The results show that the Yau-Man KF palm strike has very similar kinematic characteristics to a simple moderate speed elbow extension movement. All practitioners positioned themselves in relation to the wooden board in a way to achieve their highest hand speeds in the instant their hands crossed the board. The analyses of the electromyography data shows a well developed muscle coordination of the practitioners in agreement with kinematic results. The results of this paper are important not only for improving the performance of practitioners but also to demonstrate the applicability of KF in the process of motor control development.

[Clinical features and management of acute myositis in idiopathic orbital inflammation].

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Halimi, E; Rosenberg, R; Wavreille, O; Bouckehove, S; Franquet, N; Labalette, P

2013-09-01

Acute myositis is the second most common component of non-specific orbital inflammation. We will describe its clinical features and natural history. This is a retrospective study of 10 cases. The diagnosis of acute myositis was based on clinical and imaging criteria. Our study includes five men and five women. The average age was 35.8 years (17-59 years). Clinical symptoms were: pain increased on eye movement (10/10), diplopia (4/10), proptosis (6/10), visual loss (3/10), lid edema (6/10), conjunctival hyperemia (7/10), anterior scleritis (2/10), episcleritis (2/10), chemosis (4/10), upper lid retraction (1/10), limitation of eye movement (3/10), fundus abnormalities (2/10). Imaging showed thickening of one or more extraocular muscles (10/10). Recovery was complete with anti-inflammatory therapy in six patients. Three patients experienced recurrence, and one patient had a clinical rebound upon tapering the treatment. Acute myositis can be defined by pain on eye movement, signs of inflammation, and extraocular muscle thickening on imaging. If the clinical presentation is typical, histopathological analysis can be deferred but remains necessary in cases of poor response to treatment, chronic duration or suspicion of tumor infiltration. The diagnosis of acute myositis may be suspected in the presence of consistent, well-defined clinical signs. Contiguous inflammation is often associated. Treatment is based on steroids or non-steroidal treatment anti-inflammatory therapy, administered alone or consecutively. Recurrences are frequent but do not alter the final prognosis. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Clinical Features, Presence of Human Herpesvirus-8 and Treatment Results in Classic Kaposi Sarcoma

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Özlem Su

2008-12-01

Full Text Available Background and Design: Classic Kaposi sarcoma (KS occurs predominantly among the elderly, with Jews, Italians and Greeks. Classic KS has been seen relatively frequently in Turkey. Our aim was to evaluate the demographic, clinical features of Kaposi sarcoma and etiopathological role of human herpesvirus-8 (HHV-8. Treatment results of 18 classic Kaposi’s sarcoma were also concluded.Material and Method: Eighteen cases of classic Kaposi sarcoma diagnosed as clinically and histopathologically between January 2001 and August 2008 in our dermatology department were taken to this study. Demographic, clinical features and treatment results were reviewed retrospectively in all patients. HHV-8 was investigated in the lesional skin of 7 patients.Results: A male/female ratio of 2/1 was found. Mean age at diagnosis was 67.2 (37-94 years. Bilaterally lower extremities were involved in 15 patients (83.3%, the trunk was involved in 3 patients (16.6%. Plaques and nodules were the common type of lesions (66.6% and 55.5%. Nine patients had no symptoms (50%. Edema was the most common symptom (38.8%. A second primary malignancy was found in 2 patients (11.1%. HHV-8 was detected in 6 of the 7 patients(85.7%. Majority of the patients were treated with interferon alfa (subcutaneously and cryotherapy as a monotherapy or a combination therapy. Imiquimod was the second agent in combined treatment (27.7%. Conclusion: We suggest that interferon alfa and imiquimod can be used as first line therapy agents with their antiviral and immunmodulatuar features in the treatment of KKS. (Turkderm 2008; 42: 122-6

Clinical Features of Refractory Ascites in Outpatients

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Wanda Regina Caly

Full Text Available OBJECTIVES: To present the clinical features and outcomes of outpatients who suffer from refractory ascites. METHODS: This prospective observational study consecutively enrolled patients with cirrhotic ascites who submitted to a clinical evaluation, a sodium restriction diet, biochemical blood tests, 24 hour urine tests and an ascitic fluid analysis. All patients received a multidisciplinary evaluation and diuretic treatment. Patients who did not respond to the diuretic treatment were controlled by therapeutic serial paracentesis, and a transjugular intrahepatic portosystemic shunt was indicated for patients who required therapeutic serial paracentesis up to twice a month. RESULTS: The most common etiology of cirrhosis in both groups was alcoholism [49 refractory (R and 11 non-refractory ascites (NR]. The majority of patients in the refractory group had Child-Pugh class B cirrhosis (p=0.034. The nutritional assessment showed protein-energy malnutrition in 81.6% of the patients in the R group and 35.5% of the patients in the NR group, while hepatic encephalopathy, hernia, spontaneous bacterial peritonitis, upper digestive hemorrhage and type 2 hepatorenal syndrome were present in 51%, 44.9%, 38.8%, 38.8% and 26.5% of the patients in the R group and 9.1%, 18.2%, 0%, 0% and 0% of the patients in the NR group, respectively (p=0.016, p=0.173, p=0.012, p=0.012, and p=0.100, respectively. Mortality occurred in 28.6% of the patients in the R group and in 9.1% of the patients in the NR group (p=0.262. CONCLUSION: Patients with refractory ascites were malnourished, suffered from hernias, had a high prevalence of complications and had a high postoperative death frequency, which was mostly due to infectious processes.

THE EFFECTS OF HEIGHT AND DISTANCE ON THE FORCE PRODUCTION AND ACCELERATION IN MARTIAL ARTS STRIKES

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Cynthia A. Bir

2009-11-01

Full Text Available Almost all cultures have roots in some sort of self defence system and yet there is relatively little research in this area, outside of a sports related environment. This project investigated different applications of strikes from Kung Fu practitioners that have not been addressed before in the literature. Punch and palm strikes were directly compared from different heights and distances, with the use of a load cell, accelerometers, and high speed video. The data indicated that the arm accelerations of both strikes were similar, although the force and resulting acceleration of the target were significantly greater for the palm strikes. Additionally, the relative height at which the strike was delivered was also investigated. The overall conclusion is that the palm strike is a more effective strike for transferring force to an object. It can also be concluded that an attack to the chest would be ideal for maximizing impact force and moving an opponent off balance

Clinical and neuropathological features of ALS/FTD with TIA1 mutations.

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Hirsch-Reinshagen, Veronica; Pottier, Cyril; Nicholson, Alexandra M; Baker, Matt; Hsiung, Ging-Yuek R; Krieger, Charles; Sengdy, Pheth; Boylan, Kevin B; Dickson, Dennis W; Mesulam, Marsel; Weintraub, Sandra; Bigio, Eileen; Zinman, Lorne; Keith, Julia; Rogaeva, Ekaterina; Zivkovic, Sasha A; Lacomis, David; Taylor, J Paul; Rademakers, Rosa; Mackenzie, Ian R A

2017-12-07

Mutations in the stress granule protein T-cell restricted intracellular antigen 1 (TIA1) were recently shown to cause amyotrophic lateral sclerosis (ALS) with or without frontotemporal dementia (FTD). Here, we provide detailed clinical and neuropathological descriptions of nine cases with TIA1 mutations, together with comparisons to sporadic ALS (sALS) and ALS due to repeat expansions in C9orf72 (C9orf72+). All nine patients with confirmed mutations in TIA1 were female. The clinical phenotype was heterogeneous with a range in the age at onset from late twenties to the eighth decade (mean = 60 years) and disease duration from one to 6 years (mean = 3 years). Initial presentation was either focal weakness or language impairment. All affected individuals received a final diagnosis of ALS with or without FTD. No psychosis or parkinsonism was described. Neuropathological examination on five patients found typical features of ALS and frontotemporal lobar degeneration (FTLD-TDP, type B) with anatomically widespread TDP-43 proteinopathy. In contrast to C9orf72+ cases, caudate atrophy and hippocampal sclerosis were not prominent. Detailed evaluation of the pyramidal motor system found a similar degree of neurodegeneration and TDP-43 pathology as in sALS and C9orf72+ cases; however, cases with TIA1 mutations had increased numbers of lower motor neurons containing round eosinophilic and Lewy body-like inclusions on HE stain and round compact cytoplasmic inclusions with TDP-43 immunohistochemistry. Immunohistochemistry and immunofluorescence failed to demonstrate any labeling of inclusions with antibodies against TIA1. In summary, our TIA1 mutation carriers developed ALS with or without FTD, with a wide range in age at onset, but without other neurological or psychiatric features. The neuropathology was characterized by widespread TDP-43 pathology, but a more restricted pattern of neurodegeneration than C9orf72+ cases. Increased numbers of round eosinophilic and Lewy

Acute hematogenous osteomyelitis in young children - clinical and radiological features

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Penushliev, T.; Brankov, O.; Georgiev, Tz.; Stoilov, S.; Panov, M.; Totev, M.

2007-01-01

Acute hematogenous osteomyelitis is a bacterial infectious disease which mainly affects the paediatrics age group. The incidence seems to decline through the last decade. The authors analyzed the clinical, bacteriological and radiological features of acute hematogenous osteomyelitis in 49 young children. Their age ranged from 12 days to 2.9 years (19 new-born and 30 babies). The most affected locus was the femur (46.9 %), followed by the humerus (40.9 %) and tibia (6.2 %). The adjacent joint was involved in 38.8 %. Up to the third day after onset of symptoms were admitted 32 children (65.3 %). A bacteriological diagnosis has been achieved in only 19 cases (38.8 %) which underwent different surgical procedures. Staphylococcus aureus (9 children; 64.3 %) was the most common causative microbe. Radiological characteristic showed mainly widening of joints, destruction of cartilage, bone destruction and osteoporosis. The median duration of antibiotic therapy was 31 days. Nine children underwent needle aspiration while another 10 required locus incision or open surgery with debridement or sequestrectomy. Definitive clinical restoration was observed in 42 cases (85.7%). (authors)

Do clinical features and MRI suggest the same nerve root in acute cervical radiculopathy

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M. Conradie

2006-02-01

Full Text Available Different proposed pathophysiological mechanisms can result in variable clinical presentations of cervical radiculopathy (CR, often making it difficult to detect minor nerve root (NR conditions. This descriptive study determined (1 the level(s of  NR involvement suggested by the distribution patterns of clinical features and detected by magnetic resonance imaging (MRI and (2 the most common associations between the different variables in patients diagnosed with acute CR by a neurosurgeon. A physiotherapist blinded to the level(s of NR involvement performed a standardized interview on 21 subjects to determine the distribution patterns of pain and paraesthesia, and a neurological examination. The Fisher exact test was used to determine associations between the different variables. Only seven subjects presented clinically and radiologically with the same single-level NR involvement. Multiple- level presentations occurred which might be due to dermatomal overlapping, central sensitization or the possible involvement of two adjacent NR levels. Distribution patterns of motor weakness, pain and paraesthesia, and to a lesser extent sensory and reflex changes, have value in identifying the compressed NR level. For this sample the distri-bution patterns of radicular features identified C6 and C8 with more certainty than C7.

Clinical and Diagnostic Features of Bronchial Asthma in Children on the Background of Latent Food Allergy

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V.M. Levytskyi

2015-09-01

Full Text Available Based on clinical and paraclinical examination of 112 children with bronchial asthma, there were studied the features of its course against the background of food allergy. It was found that only a set of clinical and paraclinical signs is the most important for the diagnosis of bronchial asthma in children on the background of latent food allergy.

Rearfoot striking runners are more economical than midfoot strikers.

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Ogueta-Alday, Ana; Rodríguez-Marroyo, José Antonio; García-López, Juan

2014-03-01

This study aimed to analyze the influence of foot strike pattern on running economy and biomechanical characteristics in subelite runners with a similar performance level. Twenty subelite long-distance runners participated and were divided into two groups according to their foot strike pattern: rearfoot (RF, n = 10) and midfoot (MF, n = 10) strikers. Anthropometric characteristics were measured (height, body mass, body mass index, skinfolds, circumferences, and lengths); physiological (VO2max, anaerobic threshold, and running economy) and biomechanical characteristics (contact and flight times, step rate, and step length) were registered during both incremental and submaximal tests on a treadmill. There were no significant intergroup differences in anthropometrics, VO2max, or anaerobic threshold measures. RF strikers were 5.4%, 9.3%, and 5.0% more economical than MF at submaximal speeds (11, 13, and 15 km·h respectively, although the difference was not significant at 15 km·h, P = 0.07). Step rate and step length were not different between groups, but RF showed longer contact time (P Foot strike pattern affected both contact and flight times, which may explain the differences in running economy.

Late Pleistocene-Holocene Activity of the Strike-slip Xianshuihe Fault Zone, Tibetan Plateau, Inferred from Tectonic Landforms

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Lin, A.; Yan, B.

2017-12-01

Knowledges on the activity of the strike-slip fault zones on the Tibetan Plateau have been promoted greatly by the interpretation of remote sensing images (Molnar and Tapponnier, 1975; Tapponnier and Molnar, 1977). The active strike-slip Xianshuihe-Xiaojiang Fault System (XXFS), with the geometry of an arc projecting northeastwards, plays an important role in the crustal deformation of the Tibetan Plateau caused by the continental collision between the Indian and Eurasian plates. The Xianshuihe Fault Zone (XFZ) is located in the central segment of the XXFS and extends for 370 km, with a maximum sinistral offset of 60 km since 13‒5 Ma. In this study, we investigated the tectonic landforms and slip rate along the central segment of the left-lateral strike-slip XFZ. Field investigations and analysis of ttectonic landforms show that horizontal offset has been accumulated on the topographical markers of different scales that developed since the Last Glacial Maximum (LGM). The central segment of the XFZ is composed of three major faults: Yalahe, Selaha, and Zheduotang faults showing a right-stepping echelon pattern, that is characterized by systematical offset of drainages, alluvial fans and terrace risers with typical scissoring structures, indicating a structural feature of left-lateral strike-slip fault. Based on the offset glacial morphology and radiocarbon dating ages, we estimate the Late Pleistocene-Holocene slip rate to be 10 mm/yr for the central segment of the XFZ, which is consistent with that estimated from the GPS observations and geological evidence as reported previously. Across the central segment of the XFZ, the major Selaha and Zheduotang faults participate a slip rate of 5.8 mm/yr and 3.4 mm/yr, respectively. Detailed investigations of tectonic landforms are essential for the understanding the activity of active faults. Our findings suggest that the left-lateral slipping of the XFZ partitions the deformation of eastward extrusion and northeastward

A model of high-rate indentation of a cylindrical striking pin into a deformable body

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Zalazinskaya, E. A.; Zalazinsky, A. G.

2017-12-01

Mathematical modeling of an impact and high-rate indentation to a significant depth of a flat-faced hard cylindrical striking pin into a massive deformable target body is carried out. With the application of the kinematic extreme theorem of the plasticity theory and the kinetic energy variation theorem, the phase trajectories of the striking pin are calculated, the initial velocity of the striking pin in the body, the limit values of the inlet duct length, and the depth of striking pin penetration into the target are determined.

Update on Merkel Cell Carcinoma: Epidemiology, Etiopathogenesis, Clinical Features, Diagnosis, and Staging.

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Llombart, B; Requena, C; Cruz, J

2017-03-01

Merkel cell carcinoma (MCC) is a rare, highly aggressive tumor, and local or regional disease recurrence is common, as is metastasis. MCC usually develops in sun-exposed skin in patients of advanced age. Its incidence has risen 4-fold in recent decades as the population has aged and immunohistochemical techniques have led to more diagnoses. The pathogenesis of MCC remains unclear but UV radiation, immunosuppression, and the presence of Merkel cell polyomavirus in the tumor genome seem to play key roles. This review seeks to update our understanding of the epidemiology, etiology, pathogenesis, and clinical features of MCC. We also review histologic and immunohistochemical features required for diagnosis. MCC staging is discussed, given its great importance in establishing a prognosis for these patients. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Clinical and Brain Magnetic Resonance Imaging Features in a Cohort of Chinese Patients with Kearns-Sayre Syndrome

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Meng Yu

2016-01-01

Conclusions: The clinical features of KSS evolve dynamically, affecting the cardiac conduction system predominantly, highlighting the significance of ECG monitoring. Brain MRI showed changes involving both the white matter and deep gray nuclei. Clinical presentation or severity of muscle pathological changes is not related to the size of mtDNA deletions.

Experimental staphylococcal mastitis in bitches: clinical, bacteriological, cytological, haematological and pathological features.

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Ververidis, H N; Mavrogianni, V S; Fragkou, I A; Orfanou, D C; Gougoulis, D A; Tzivara, A; Gouletsou, P G; Athanasiou, L; Boscos, C M; Fthenakis, G C

2007-09-20

The objectives of the work were to study the features of experimentally induced canine mastitis and to present hypotheses regarding the pathogenesis of the disease. The right caudal abdominal mammary gland of six bitches was inoculated on day 8 after whelping with Staphylococcus intermedius to induce mastitis; adjacent mammary glands were used as controls. Clinical examination, bacteriological and cytological (whiteside test, Giemsa) examination of mammary secretion, as well as haematological tests were performed from 5 days before until 34 days after challenge. Mastectomy was sequentially performed 1, 2, 4, 18, 26 and 34 days after challenge in each of the bitches, in order to carry out a pathological examination of mammary glands. All animals developed clinical mastitis: challenged glands became painful, hot, enlarged and oedematous; secretion was brownish, purulent, with flakes or clots, subsequently becoming yellowish and thick. Staphylococci were isolated from all inoculated glands (up to 22 days). WST was positive in 41/46 samples from inoculated glands and 66/138 samples from control glands; neutrophils predominated during the acute stage. Blood leukocyte counts increased, whilst platelet counts decreased. Gross pathological findings initially included congestion, purulent discharge and subcutaneous oedema; then abscesses, brownish areas and size decrease were seen. Salient histopathological features were initially neutrophilic infiltration, haemorrhages, destruction of mammary epithelial cells and alveoli, and then infiltration by lymphocytes, shrunken alveoli, loss of glandular architecture and fibrous tissue proliferation. We conclude that in bitches, intrammamary inoculation of Staphylococcus intermedius can induce clinical mastitis, followed by subclinical disease. The disorder is characterized by bacterial isolation and leukocyte influx in challenged glands, by leukocyte presence in adjacent mammary glands, by increased blood leukocyte counts and by

The impact of educational status on the clinical features of major depressive disorder among Chinese women

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Gan, Zhaoyu; Li, Yihan; Xie, Dong; Shao, Chunhong; Yang, Fuzhong; Shen, Yuan; Zhang, Ning; Zhang, Guanghua; Tian, Tian; Yin, Aihua; Chen, Ce; Liu, Jun; Tang, Chunling; Zhang, Zhuoqiu; Liu, Jia; Sang, Wenhua; Wang, Xumei; Liu, Tiebang; Wei, Qinling; Xu, Yong; Sun, Ling; Wang, Sisi; Li, Chang; Hu, Chunmei; Cui, Yanping; Liu, Ying; Li, Ying; Zhao, Xiaochuan; Zhang, Lan; Sun, Lixin; Chen, Yunchun; Zhang, Yueying; Ning, Yuping; Shi, Shenxun; Chen, Yiping; Kendler, Kenneth S.; Flint, Jonathan; Zhang, Jinbei

2012-01-01

Background Years of education are inversely related to the prevalence of major depressive disorder (MDD), but the relationship between the clinical features of MDD and educational status is poorly understood. We investigated this in 1970 Chinese women with recurrent MDD identified in a clinical setting. Methods Clinical and demographic features were obtained from 1970 Han Chinese women with DSM-IV major depression between 30 and 60 years of age across China. Analysis of linear, logistic and multiple logistic regression models were used to determine the association between educational level and clinical features of MDD. Results Subjects with more years of education are more likely to have MDD, with an odds ratio of 1.14 for those with more than ten years. Low educational status is not associated with an increase in the number of episodes, nor with increased rates of co-morbidity with anxiety disorders. Education impacts differentially on the symptoms of depression: lower educational attainment is associated with more biological symptoms and increased suicidal ideation and plans to commit suicide. Limitations Findings may not generalize to males or to other patient populations. Since the threshold for treatment seeking differs as a function of education there may an ascertainment bias in the sample. Conclusions The relationship between symptoms of MDD and educational status in Chinese women is unexpectedly complex. Our findings are inconsistent with the simple hypothesis from European and US reports that low levels of educational attainment increase the risk and severity of MDD. PMID:21824664

The impact of educational status on the clinical features of major depressive disorder among Chinese women.

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Gan, Zhaoyu; Li, Yihan; Xie, Dong; Shao, Chunhong; Yang, Fuzhong; Shen, Yuan; Zhang, Ning; Zhang, Guanghua; Tian, Tian; Yin, Aihua; Chen, Ce; Liu, Jun; Tang, Chunling; Zhang, Zhuoqiu; Liu, Jia; Sang, Wenhua; Wang, Xumei; Liu, Tiebang; Wei, Qinling; Xu, Yong; Sun, Ling; Wang, Sisi; Li, Chang; Hu, Chunmei; Cui, Yanping; Liu, Ying; Li, Ying; Zhao, Xiaochuan; Zhang, Lan; Sun, Lixin; Chen, Yunchun; Zhang, Yueying; Ning, Yuping; Shi, Shenxun; Chen, Yiping; Kendler, Kenneth S; Flint, Jonathan; Zhang, Jinbei

2012-02-01

Years of education are inversely related to the prevalence of major depressive disorder (MDD), but the relationship between the clinical features of MDD and educational status is poorly understood. We investigated this in 1970 Chinese women with recurrent MDD identified in a clinical setting. Clinical and demographic features were obtained from 1970 Han Chinese women with DSM-IV major depression between 30 and 60 years of age across China. Analysis of linear, logistic and multiple logistic regression models were used to determine the association between educational level and clinical features of MDD. Subjects with more years of education are more likely to have MDD, with an odds ratio of 1.14 for those with more than ten years. Low educational status is not associated with an increase in the number of episodes, nor with increased rates of co-morbidity with anxiety disorders. Education impacts differentially on the symptoms of depression: lower educational attainment is associated with more biological symptoms and increased suicidal ideation and plans to commit suicide. Findings may not generalize to males or to other patient populations. Since the threshold for treatment seeking differs as a function of education there may an ascertainment bias in the sample. The relationship between symptoms of MDD and educational status in Chinese women is unexpectedly complex. Our findings are inconsistent with the simple hypothesis from European and US reports that low levels of educational attainment increase the risk and severity of MDD. Copyright © 2011 Elsevier B.V. All rights reserved.

Pediatric-onset Takayasu's arteritis: clinical features and short-term outcome.

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Misra, Durga Prasanna; Aggarwal, Amita; Lawrence, Able; Agarwal, Vikas; Misra, Ramnath

2015-10-01

The aim of this was to assess clinical features and outcome in pediatric-onset Takayasu's arteritis (TA). Retrospective data analysis of patients diagnosed with TA over last 13 years with onset before 18 years of age was done. Their presenting features, activity (by NIH criteria, ITAS2010, ITAS-A), disease extent (by DEI.Tak) and angiographic findings were retrieved from clinic files. Treatment received and follow-up data on disease activity and damage by TA damage score (TADS) were also analyzed. Wherever repeated angiography data were available, the same was analyzed. Values are expressed as median with interquartile range in brackets. There were 29 patients (19 females) with median age at diagnosis of 14 (13-16) years and delay to diagnosis of 1 (0.4-2) year. Common presenting symptoms were pulse loss (23/29) and hypertension (22/29). Patients had extensive disease at presentation with median DEI.Tak of 12 (9.5-15); 23/29 had elevated acute-phase reactants, and 28/29 were active at presentation [median ITAS2010 13 (8-15.5), ITAS-A 14 (10-17)]. Numano's type V was the commonest angiographic type (22/29). At a median follow-up of 2.4 (1.5-5.1) years, 2/20 were active whereas all had sustained damage despite a majority (17/20) being on immunosuppression. The median TADS was 8 (6.3-9.8) with pulse loss, claudication and hypertension being the commonest damage item. Two needed renal artery stenting to control hypertension. Angiographic assessment at least 2 years apart demonstrated disease progression in 5 of 6 patients despite immunosuppression. Significant damage accrued on follow-up despite immunosuppression and control of disease activity. Hypertension remains the major long-term morbidity.

Analysis of clinical features and visual outcomes of pars planitis.

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Berker, Nilufer; Sen, Emine; Elgin, Ufuk; Atilgan, Cemile Ucgul; Dursun, Erdem; Yilmazbas, Pelin

2018-04-01

To evaluate the demographic characteristics, clinical features, treatment and outcomes of patients with pars planitis in a tertiary referral center in Turkey. Medical records of patients with pars planitis were retrospectively reviewed. The data including demographic and ocular features and treatment outcomes were recorded. The distribution of clinical findings and complications were evaluated according to age and gender groups. The changes in final BCVA compared to the initial BCVA were noted. Statistical analysis was performed using SPSS software (Version 18.0, SPSS Inc., Chicago, USA). Twenty-seven patients (54 eyes) were included in this study. 16 patients were male (59.3%), and 11 were female (40.7%). Mean age at diagnosis was 12.84 ± 8.26 (range 4-36) years. Mean follow-up period was 61.3 ± 52.15 (range 9-172) months. Mean BCVA was 0.58 ± 0.36 (range 0.03-1.00) (0.40 ± 0.45 logMAR) at presentation, and 0.81 ± 0.28 (range 0.10-1.00) (0.14 ± 0.27 logMAR) at final visit (P = 0.001). Vitreous inflammation (100%), vitreous haze (92.6%), snowballs (74.1%), snowbanks (66.7%), anterior chamber cells (66.7%) and peripheral retinal vascular sheathing (48.1%) were the most common presentations. Ocular complications included vitreous condensation (51.9%), cystoid macular edema (22.2%), cataract (18.5%), inferior peripheral retinal detachment (11.1%), glaucoma (5.6%) and vitreous hemorrhage (3.7%). Treatments included topical, periocular, intravitreal and systemic corticosteroids, immunosuppressives, peripheral laser photocoagulation and pars plana vitrectomy when needed. Pars planitis is an idiopathic chronic intermediate uveitis mostly affecting children and adolescents. In spite of its chronic nature with high potential of causing ocular complications, adequate treatment and close follow-up lead to favorable visual outcomes.

Geo-electrical and geological strikes of the Mount Lamongan geothermal area, East Java, Indonesia – preliminary results

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Nugraheni, L. R.; Niasari, S. W.; Nukman, M.

2018-04-01

Geothermal manifestations located in the Tiris, Mount Lamongan, Probolinggo, consist of warm springs. These warm springs have temperature from 35° until 45°C. Tiris fault has NW-SE dominant orientation, similar to some lineaments of maars and cinder cones around Mount Lamongan. The Mount Lamongan geothermal area is situated between Bromo and Argapura volcanoes. This study aims to map the geo-electrical and geological strikes in the study area. Phase tensor analysis has been performed in this study to determine geo-electrical strike of study area. Geological field campaign has been conducted to measure geological strikes. Then, orientation of geo-electrical strike was compared to geological strike. The result presents that the regional geological strike of study area is NW-SE while the orientation of geo-electrical strike is N-S.

A combination of molecular markers and clinical features improve the classification of pancreatic cysts.

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Springer, Simeon; Wang, Yuxuan; Dal Molin, Marco; Masica, David L; Jiao, Yuchen; Kinde, Isaac; Blackford, Amanda; Raman, Siva P; Wolfgang, Christopher L; Tomita, Tyler; Niknafs, Noushin; Douville, Christopher; Ptak, Janine; Dobbyn, Lisa; Allen, Peter J; Klimstra, David S; Schattner, Mark A; Schmidt, C Max; Yip-Schneider, Michele; Cummings, Oscar W; Brand, Randall E; Zeh, Herbert J; Singhi, Aatur D; Scarpa, Aldo; Salvia, Roberto; Malleo, Giuseppe; Zamboni, Giuseppe; Falconi, Massimo; Jang, Jin-Young; Kim, Sun-Whe; Kwon, Wooil; Hong, Seung-Mo; Song, Ki-Byung; Kim, Song Cheol; Swan, Niall; Murphy, Jean; Geoghegan, Justin; Brugge, William; Fernandez-Del Castillo, Carlos; Mino-Kenudson, Mari; Schulick, Richard; Edil, Barish H; Adsay, Volkan; Paulino, Jorge; van Hooft, Jeanin; Yachida, Shinichi; Nara, Satoshi; Hiraoka, Nobuyoshi; Yamao, Kenji; Hijioka, Susuma; van der Merwe, Schalk; Goggins, Michael; Canto, Marcia Irene; Ahuja, Nita; Hirose, Kenzo; Makary, Martin; Weiss, Matthew J; Cameron, John; Pittman, Meredith; Eshleman, James R; Diaz, Luis A; Papadopoulos, Nickolas; Kinzler, Kenneth W; Karchin, Rachel; Hruban, Ralph H; Vogelstein, Bert; Lennon, Anne Marie

2015-11-01

The management of pancreatic cysts poses challenges to both patients and their physicians. We investigated whether a combination of molecular markers and clinical information could improve the classification of pancreatic cysts and management of patients. We performed a multi-center, retrospective study of 130 patients with resected pancreatic cystic neoplasms (12 serous cystadenomas, 10 solid pseudopapillary neoplasms, 12 mucinous cystic neoplasms, and 96 intraductal papillary mucinous neoplasms). Cyst fluid was analyzed to identify subtle mutations in genes known to be mutated in pancreatic cysts (BRAF, CDKN2A, CTNNB1, GNAS, KRAS, NRAS, PIK3CA, RNF43, SMAD4, TP53, and VHL); to identify loss of heterozygozity at CDKN2A, RNF43, SMAD4, TP53, and VHL tumor suppressor loci; and to identify aneuploidy. The analyses were performed using specialized technologies for implementing and interpreting massively parallel sequencing data acquisition. An algorithm was used to select markers that could classify cyst type and grade. The accuracy of the molecular markers was compared with that of clinical markers and a combination of molecular and clinical markers. We identified molecular markers and clinical features that classified cyst type with 90%-100% sensitivity and 92%-98% specificity. The molecular marker panel correctly identified 67 of the 74 patients who did not require surgery and could, therefore, reduce the number of unnecessary operations by 91%. We identified a panel of molecular markers and clinical features that show promise for the accurate classification of cystic neoplasms of the pancreas and identification of cysts that require surgery. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Clinical Features of Anthroponotic Cutaneous Leishmaniasis in a Major Focus, Southeastern Iran, 1994-2014

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Ahmad KHOSRAVI

2017-12-01

Full Text Available AbstractBackground: Cutaneous leishmaniasis (CL is associated with a broad and complex clinical spectrum of diseases. The objectives of this study were to assess the clinical features and identification of the causative agents of CL in a well-known focus of anthroponotic CL (ACL caused by Leishmania tropica, southeast Iran.Methods: This study was performed randomly as a descriptive cross-sectional survey to evaluate 2000 CL patients by active and passive case-detection approaches in Kerman Province from 1994 to 2014. The ACL patients were confirmed by direct smear and 600 cases by one or a combination of intrinsic methods.Results: Children aged <10 yr old were the most infected patients (P<0.001. The majority of the CL lesions were located in hands (46.3%, face (34.1%, legs (14.3%, and other parts of the body (5.3%. The mean number of lesions was 1.5 and most of the patients had single lesion (65%.Typical clinical lesions included papule (36.8%, followed by ulcerated nodule (20.7%, plaque (18.4%, and ulcerated plaque (18.5%. While among atypical clinical features, leishmaniasis recidivans (LR (4.7% and leishmanid (0.3% were the dominant forms, followed by diffuse, disseminated, sporotrichoid, and erysipeloid types, 0.1% each, and then lymphedematous, lymphadenic, hyperkeratotic, paronychial, and mutilating types, 0.05% each. Based on various intrinsic methods the parasites isolated from the lesions were characterized as L. tropica.Conclusion: ACL due to L. tropica presents numerous cases of localized form and diverse uncommon clinical presentations, which mimic other disease conditions. Therefore, physicians should be aware of such manifestations for selecting appropriate treatment modality.

Genetic epidemiology, hematological and clinical features of hemoglobinopathies in Iran.

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Rahimi, Zohreh

2013-01-01

There is large variation in the molecular genetics and clinical features of hemoglobinopathies in Iran. Studying structural variants of hemoglobin demonstrated that the β-chain variants of hemoglobin S and D-Punjab are more prevalent in the Fars (southwestern Iran) and Kermanshah (western Iran) provinces, respectively. Also, α-chain variants of Hb Q-Iran and Hb Setif are prevalent in western Iran. The molecular basis and clinical severity of thalassemias are extremely heterogenous among Iranians due to the presence of multiethnic groups in the country. β-Thalassemia is more prevalent in northern and southern Iran. Among 52 different β-thalassemia mutations that have been identified among Iranian populations, IVSII-1 G:A is the most frequent mutation in most parts of the country. The presence of IVS I-5 G:C mutation with high frequency in southeastern Iran might reflect gene flow from neighboring countries. A wide spectrum of α-thalassemia alleles has been detected among Iranians with -α(3.7 kb) as the most prevalent α-thalassemia mutation. The prevention program of thalassemia birth in Iran has reduced the birth rate of homozygous β-thalassemia since the implementation of the program in 1997. In this review genetic epidemiology, clinical and hematological aspects of hemoglobinopathies, and the prevention programs of β-thalassemia in Iran will be discussed.

Genetic Epidemiology, Hematological and Clinical Features of Hemoglobinopathies in Iran

Directory of Open Access Journals (Sweden)

Zohreh Rahimi

2013-01-01

Full Text Available There is large variation in the molecular genetics and clinical features of hemoglobinopathies in Iran. Studying structural variants of hemoglobin demonstrated that the β-chain variants of hemoglobin S and D-Punjab are more prevalent in the Fars (southwestern Iran and Kermanshah (western Iran provinces, respectively. Also, α-chain variants of Hb Q-Iran and Hb Setif are prevalent in western Iran. The molecular basis and clinical severity of thalassemias are extremely heterogenous among Iranians due to the presence of multiethnic groups in the country. β-Thalassemia is more prevalent in northern and southern Iran. Among 52 different β-thalassemia mutations that have been identified among Iranian populations, IVSII-1 G:A is the most frequent mutation in most parts of the country. The presence of IVS I-5 G:C mutation with high frequency in southeastern Iran might reflect gene flow from neighboring countries. A wide spectrum of α-thalassemia alleles has been detected among Iranians with as the most prevalent α-thalassemia mutation. The prevention program of thalassemia birth in Iran has reduced the birth rate of homozygous β-thalassemia since the implementation of the program in 1997. In this review genetic epidemiology, clinical and hematological aspects of hemoglobinopathies, and the prevention programs of β-thalassemia in Iran will be discussed.

Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma?

Science.gov (United States)

Giourou, Evangelia; Skokou, Maria; Andrew, Stuart P; Alexopoulou, Konstantina; Gourzis, Philippos; Jelastopulu, Eleni

2018-03-22

Complex posttraumatic stress disorder (Complex PTSD) has been recently proposed as a distinct clinical entity in the WHO International Classification of Diseases, 11 th version, due to be published, two decades after its first initiation. It is described as an enhanced version of the current definition of PTSD, with clinical features of PTSD plus three additional clusters of symptoms namely emotional dysregulation, negative self-cognitions and interpersonal hardship, thus resembling the clinical features commonly encountered in borderline personality disorder (BPD). Complex PTSD is related to complex trauma which is defined by its threatening and entrapping context, generally interpersonal in nature. In this manuscript, we review the current findings related to traumatic events predisposing the above-mentioned disorders as well as the biological correlates surrounding them, along with their clinical features. Furthermore, we suggest that besides the present distinct clinical diagnoses (PTSD; Complex PTSD; BPD), there is a cluster of these comorbid disorders, that follow a continuum of trauma and biological severity on a spectrum of common or similar clinical features and should be treated as such. More studies are needed to confirm or reject this hypothesis, particularly in clinical terms and how they correlate to clinical entities' biological background, endorsing a shift from the phenomenologically only classification of psychiatric disorders towards a more biologically validated classification.

Perineural Infiltration of Cutaneous Squamous Cell Carcinoma and Basal Cell Carcinoma Without Clinical Features

Energy Technology Data Exchange (ETDEWEB)

Lin, Charles, E-mail: Charles_Lin@health.qld.gov.au [Cancer Care Services, Royal Brisbane and Women' s Hospital, Brisbane, Queensland (Australia); Tripcony, Lee; Keller, Jacqui [Cancer Care Services, Royal Brisbane and Women' s Hospital, Brisbane, Queensland (Australia); Poulsen, Michael [Mater Hospital, Brisbane, Queensland (Australia); Martin, Jarad [St. Andrews Hospital, Toowoomba, Queensland (Australia); Jackson, James; Dickie, Graeme [Cancer Care Services, Royal Brisbane and Women' s Hospital, Brisbane, Queensland (Australia)

2012-01-01

Purpose: To review the factors that influence outcome and patterns of relapse in patients with cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) with perineural infiltration (PNI) without clinical or radiologic features, treated with surgery and radiotherapy. Methods and Materials: Between 1991 and 2004, 222 patients with SCC or BCC with PNI on pathologic examination but without clinical or radiologic PNI features were identified. Charts were reviewed retrospectively and relevant data collected. All patients were treated with curative intent; all had radiotherapy, and most had surgery. The primary endpoint was 5-year relapse-free survival from the time of diagnosis. Results: Patients with SCC did significantly worse than those with BCC (5-year relapse-free survival, 78% vs. 91%; p < 0.01). Squamous cell carcinoma with PNI at recurrence did significantly worse than de novo in terms of 5-year local failure (40% vs. 19%; p < 0.01) and regional relapse (29% vs. 5%; p < 0.01). Depth of invasion was also a significant factor. Of the PNI-specific factors for SCC, focal PNI did significantly better than more-extensive PNI, but involved nerve diameter or presence of PNI at the periphery of the tumor were not significant factors. Conclusions: Radiotherapy in conjunction with surgery offers an acceptable outcome for cutaneous SCC and BCC with PNI. This study suggests that focal PNI is not an adverse feature.

Are physicians' strikes ever morally justifiable? A call for a return to ...

African Journals Online (AJOL)

Though physicians strike provides an opportunity to generate more knowledge about the process in which legitimacy of an organization can be restored, it meets with a great deal of resistance not only by the public but from within the medical profession. This paper critically examines the legitimacy of strike by medical ...

Effect of Acute Alterations in Foot Strike Patterns during Running on Sagittal Plane Lower Limb Kinematics and Kinetics.

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Valenzuela, Kevin A; Lynn, Scott K; Mikelson, Lisa R; Noffal, Guillermo J; Judelson, Daniel A

2015-03-01

The purpose of this study was to determine the effect of foot strike patterns and converted foot strike patterns on lower limb kinematics and kinetics at the hip, knee, and ankle during a shod condition. Subjects were videotaped with a high speed camera while running a 5km at self-selected pace on a treadmill to determine natural foot strike pattern on day one. Preferred forefoot group (PFFG, n = 10) and preferred rear foot group (PRFG, n = 11) subjects were identified through slow motion video playback (n = 21, age = 22.8±2.2 years, mass = 73.1±14.5 kg, height 1.75 ± 0.10 m). On day two, subjects performed five overground run trials in both their natural and unnatural strike patterns while motion and force data were collected. Data were collected over two days so that foot strike videos could be analyzed for group placement purposes. Several 2 (Foot Strike Pattern -forefoot strike [FFS], rearfoot strike [RFS]) x 2 (Group - PFFG, PRFG) mixed model ANOVAs (p strike patterns during shod running can create alterations in certain lower limb kinematic and kinetic measures that are not dependent on the preferred foot strike pattern of the individual. This research also challenges the contention that the impact transient spike in the vertical ground reaction force curve is only present during a rear foot strike type of running gait. Key pointsFootstrike pattern changes should be individually considered and implemented based on individual histories/abilitiesForefoot strike patterns increase external dorsiflexion momentsRearfoot strike patterns increase external knee flexion momentsRecreational shod runners are able to mimic habitual mechanics of different foot strike patterns.

Visual search for features and conjunctions in development.

Science.gov (United States)

Lobaugh, N J; Cole, S; Rovet, J F

1998-12-01

Visual search performance was examined in three groups of children 7 to 12 years of age and in young adults. Colour and orientation feature searches and a conjunction search were conducted. Reaction time (RT) showed expected improvements in processing speed with age. Comparisons of RT's on target-present and target-absent trials were consistent with parallel search on the two feature conditions and with serial search in the conjunction condition. The RT results indicated searches for feature and conjunctions were treated similarly for children and adults. However, the youngest children missed more targets at the largest array sizes, most strikingly in conjunction search. Based on an analysis of speed/accuracy trade-offs, we suggest that low target-distractor discriminability leads to an undersampling of array elements, and is responsible for the high number of misses in the youngest children.

[Clinical features of 32 patients with cutaneous small vessel vasculitis].

Science.gov (United States)

López de Maturana, Donaldo; Amaro, Patricio; Segovia, Laura; Balestrini, Claudia

2004-02-01

The skin is a common target of small vessel vasculitis, with a wide assortment of pathological changes. This condition is usually associated to systemic diseases. To report the clinical and pathological features of patients with cutaneous small vessel vasculitis. A retrospective review of 32 patients with a pathological diagnosis of cutaneous vasculitis. Seventy two percent of patients were women. Cutaneous lesions were mainly located in the lower limbs (94%). The most common lesion was palpable purpura (62%). Connective tissue diseases and systemic vasculitis were the most commonly associated systemic diseases. Palpable purpura is the most common manifestation of cutaneous small vessel vasculitis, that is usually associated to connective tissue diseases or systemic vasculitis.

Clinical features and early treatment response of central nervous system involvement in childhood acute lymphoblastic leukemia

DEFF Research Database (Denmark)

Levinsen, Mette; Taskinen, Mervi; Abrahamsson, Jonas

2014-01-01

BACKGROUND: Central nervous system (CNS) involvement in childhood acute lymphoblastic leukemia (ALL) remains a therapeutic challenge. PROCEDURE: To explore leukemia characteristics of patients with CNS involvement at ALL diagnosis, we analyzed clinical features and early treatment response of 744...... leukemia and patients without such characteristics (0.50 vs. 0.61; P = 0.2). CONCLUSION: CNS involvement at diagnosis is associated with adverse prognostic features but does not indicate a less chemosensitive leukemia....

MRI features of patients with heroin spongiform leukoencephalopathy of different clinical stages

International Nuclear Information System (INIS)

Shi Zhu; Pan Suyue; Zhou Liang; Dong Zhao; Lu Bingxun

2007-01-01

Objective: To investigate radiological features of patients with heroin spongiform leukoencephalopathy (HSLE) of different clinical stages and discuss the evolutional characteristics of the disease. Methods: Thirty two patients with HSLE underwent precontrast MRI and postcontrast MRI. The history of addiction, clinical presentations, and brain MRI were analyzed and summarized according to the patient's clinical staging. There are 6 cases in I stage, 21 cases in II stage, 5 cases in III stage. Results: All patients had history of heroin vapor inhalation. Most of the cases developed subacute cerebellar impairment in earlier period. Brain MRI revealed symmetrical lesion within bilateral cerebellum in all patients. Splenium of the corpus callosum, posterior limb of the internal capsule, deep white matter of the occipital and parietal lobes, were gradually involved with progressive deterioration of HSLE. The brain stem and deep white matter of the frontal and temporal lobes were involved in some cases. Conclusions: The history of heated heroin vapor inhalation was the prerequisite for the diagnosis of HSLE. Brain MRI presented the characteristic lesion and its evolution of HSLE. Brain MRI was very important for accurate diagnosis and helpful to judge the clinical stages according to the involved brain region. (authors)

Clinical features of Parkinson’s disease with and without rapid eye movement sleep behavior disorder

OpenAIRE

Liu, Ye; Zhu, Xiao-Ying; Zhang, Xiao-Jin; Kuo, Sheng-Han; Ondo, William G.; Wu, Yun-Cheng

2017-01-01

Background Rapid eye movement sleep behavior disorder (RBD) and Parkinson’s disease (PD) are two distinct clinical diseases but they share some common pathological and anatomical characteristics. This study aims to confirm the clinical features of RBD in Chinese PD patients. Methods One hundred fifty PD patients were enrolled from the Parkinson`s disease and Movement Disorders Center in  Department of Neurology, Shanghai General Hospital from January 2013 to August 2014. This study examined P...

MIBG avidity correlates with clinical features, tumor biology, and outcomes in neuroblastoma: A report from the Children's Oncology Group.

Science.gov (United States)

DuBois, Steven G; Mody, Rajen; Naranjo, Arlene; Van Ryn, Collin; Russ, Douglas; Oldridge, Derek; Kreissman, Susan; Baker, David L; Parisi, Marguerite; Shulkin, Barry L; Bai, Harrison; Diskin, Sharon J; Batra, Vandana; Maris, John M; Park, Julie R; Matthay, Katherine K; Yanik, Gregory

2017-11-01

Prior studies suggest that neuroblastomas that do not accumulate metaiodobenzylguanidine (MIBG) on diagnostic imaging (MIBG non-avid) may have more favorable features compared with MIBG avid tumors. We compared clinical features, biologic features, and clinical outcomes between patients with MIBG nonavid and MIBG avid neuroblastoma. Patients had metastatic high- or intermediate-risk neuroblastoma and were treated on Children's Oncology Group protocols A3973 or A3961. Comparisons of clinical and biologic features according to MIBG avidity were made with chi-squared or Fisher exact tests. Event-free (EFS) and overall (OS) survival compared using log-rank tests and modeled using Cox models. Thirty of 343 patients (8.7%) had MIBG nonavid disease. Patients with nonavid tumors were less likely to have adrenal primary tumors (34.5 vs. 57.2%; P = 0.019), bone metastases (36.7 vs. 61.7%; P = 0.008), or positive urine catecholamines (66.7 vs. 91.0%; P neuroblastoma have lower rates of adrenal primary tumors, bone metastasis, and catecholamine secretion. Despite being more likely to have MYCN-amplified tumors, these patients have superior outcomes compared with patients with MIBG avid disease. © 2017 Wiley Periodicals, Inc.

Rickettsioses in Denmark: A retrospective survey of clinical features and travel history.

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Ocias, Lukas Frans; Jensen, Bo Bødker; Villumsen, Steen; Lebech, Anne-Mette; Skarphedinsson, Sigurdur; Dessau, Ram Benny; Krogfelt, Karen Angeliki

2018-03-01

Rickettsia spp. can be found across the globe and cause disease of varying clinical severity, ranging from life-threatening infections with widespread vasculitis to milder, more localized presentations. Vector and, to some degree, reservoir are hematophagous arthropods, with most species harboured by ticks. In Denmark, rickettsiae are known as a cause of imported travel-related infections, but are also found endemically in ticks across the country. Data are, however, lacking on the geographical origin and clinical features of diagnosed cases. In this study, we have examined the travel history and clinical features of two groups of patients; 1) hospital-patients diagnosed with rickettsioses in the years 2010-2015 and 2) patients from primary health care (PHC) centers in Denmark having demonstrated anti-rickettsia antibodies in the years 2012-2015. The patients were identified using the Danish National Patient Registry (DNPR) and through the serological database at the State Serum Institute, where the laboratory diagnosis of rickettsioses is currently centralized. Data were collected for 86 hospital patients and 26 PHC center patients by reviewing hospital medical records and performing telephone interviews with PHC centers. Of the hospital patients, 91% (78/86) had a history of international travel 14 days prior to symptom start, with most having imported their infection from southern Africa, South Africa in particular (65%), and presenting with a clinical picture most compatible with African tick-bite fever caused by R. africae. Only two patients presented with a CRP > 100 mg/L and no mortalities were reported. At the PHC centers, most patients presented with mild flu-like symptoms and had an unknown (50%) or no history (19%) of international travel, raising the possibility of endemic rickettsioses. In view of our findings, rickettsioses do not appear to constitute a major public health problem in Denmark, with most cases being imported infections and

Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years.

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Qi, Fei; Zhang, Guo-Xin; She, Dan-Yang; Liang, Zhi-Xin; Wang, Ren-Tao; Yang, Zhen; Chen, Liang-An; Cui, Jun-Chang

2015-10-20

Healthcare-associated pneumonia (HCAP) is associated with drug-resistant pathogens and high mortality, and there is no clear evidence that this is due to inappropriate antibiotic therapy. This study was to elucidate the clinical features, pathogens, therapy, and outcomes of HCAP, and to clarify the risk factors for drug-resistant pathogens and prognosis. Retrospective observational study among hospitalized patients with HCAP over 10 years. The primary outcome was 30-day all-cause hospital mortality after admission. Demographics (age, gender, clinical features, and comorbidities), dates of admission, discharge and/or death, hospitalization costs, microbiological results, chest imaging studies, and CURB-65 were analyzed. Antibiotics, admission to Intensive Care Unit (ICU), mechanical ventilation, and pneumonia prognosis were recorded. Patients were dichotomized based on CURB-65 (low- vs. high-risk). Among 612 patients (mean age of 70.7 years), 88.4% had at least one comorbidity. Commonly detected pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%). Mean age, length of stay, hospitalization expenses, ICU admission, mechanical ventilation use, malignancies, and detection rate for P. aeruginosa, and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group. CURB-65 ≥3, malignancies, and mechanical ventilation were associated with an increased mortality. Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAP. Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach. CURB-65 ≥3, malignancies, and mechanical ventilation may result in an increased mortality.

Clinical and Laboratory Features, Treatment and Prognosis in Children with Guillian-Barre Syndrome

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N. A. Suponeva

2015-01-01

Full Text Available A retrospective study of 42 cases of acute flaccid paralysis (AFP in children aged between 7 months and 15 years, registered at the Municipal Clinical Hospital №1 throughout a 7 year period (2007—2014, was performed to investigate the features of pediatric Guillian-Barre Syndrome (GBS. GBS has shown to be the most common cause of AFP in children, with prevalence of 74% of all 31 cases. Clinical manifestations, functional status, laboratory and electrodiagnostic data were evaluated in group of 31 children in order to highlight particular features of childhood GBS in Russia. The highest frequency of GBS was observed in children aged between 1 to 3 with the median 6 [3; 11] years. Boys with GBS outnumbered girls by a 2,1:1 ratio. No seasonal dependence has been observed, with children equally suffering from this disease without a seasonal pattern throughout the year. According to the electrophysiological and clinical data, 24 children were diagnosed with acute inflammatory demyelinating polyradiculoneuropathy (AIDP (77%, 5 with acute motor axonal neuropathy (AMAN (16% and 2 with аcute motor-sensory axonal neuropathy (AMSAN in a total of cases (7%. Several exclusive features of GBS in children for Russia were discovered. The most common initial symptom was limb pain, with the impartial sensory disturbance found only in 13% of the patients observed, 10% of which were paresthesias and the remaining 3% belonging to hypostesias. Children reached the nadir state rapidly, the median time from onset to nadir was 9.5 [6,25; 12,5] days. Cranial nerve dysfunction at nadir was observed in a greater percentage of patients (51% compared to that of 23% cases at the onset, with the facial palsy increasing from 10 to 32% and the bulbar palsy from 12 to 19%. The patients were given intravenous immunoglobulin in various doses: from 0.2 to 1.75 mg/kg per course (0.5 [0.5; 0.8] g/kg and/or plasmapheresis with a median volume of 93 [81; 100] ml/kg per

Vådområder, flyvepladser og risiko for bird strikes

DEFF Research Database (Denmark)

Christensen, Thomas Kjær; Hounisen, Jens Peder

2015-01-01

Rapporten udgør en opdatering af Teknisk anvisning nr. 23 fra DMU (Christensen & Hounisen 2006), omhandlende risikovurdering for bird strikes (kollisioner mellem fugle og fly) i danske lufthavne ved etablering af vådområder nær disse. Rapporten analyserer relationen mellem ændrede forekomster af...... søer og enge/moser indenfor lufthavnenes sikkerhedszoner på 13 km og forekomsten af bird strikes i perioden 2006-2013. Anbefalinger til placering og størrelse af vådområder i lufthavnenes sikkerhedszoner er opdateret på baggrund af rapportens resultater....

Assessment of Correlation between Sweat Chloride Levels and Clinical Features of Cystic Fibrosis Patients.

Science.gov (United States)

Raina, Manzoor A; Khan, Mosin S; Malik, Showkat A; Raina, Ab Hameed; Makhdoomi, Mudassir J; Bhat, Javed I; Mudassar, Syed

2016-12-01

Cystic Fibrosis (CF) is an autosomal recessive disorder and the incidence of this disease is undermined in Northern India. The distinguishable salty character of the sweat belonging to individuals suffering from CF makes sweat chloride estimation essential for diagnosis of CF disease. The aim of this prospective study was to elucidate the relationship of sweat chloride levels with clinical features and pattern of CF. A total of 182 patients, with clinical features of CF were included in this study for quantitative measurement of sweat chloride. Sweat stimulation and collection involved pilocarpine iontophoresis based on the Gibson and Cooks methodology. The quantitative estimation of chloride was done by Schales and Schales method with some modifications. Cystic Fibrosis Trans Membrane Conductance Regulator (CFTR) mutation status was recorded in case of patients with borderline sweat chloride levels to correlate the results and for follow-up. Out of 182 patients having clinical features consistent with CF, borderline and elevated sweat chloride levels were present in 9 (5%) and 41 (22.5%) subjects respectively. Elevated sweat chloride levels were significantly associated with wheeze, Failure To Thrive (FTT), history of CF in Siblings, product of Consanguineous Marriage (CM), digital clubbing and steatorrhoea on univariate analysis. On multivariate analysis only wheeze, FTT and steatorrhoea were found to be significantly associated with elevated sweat chloride levels (p<0.05). Among the nine borderline cases six cases were positive for at least two CFTR mutations and rest of the three cases were not having any mutation in CFTR gene. The diagnosis is often delayed and the disease is advanced in most patients at the time of diagnosis. Sweat testing is a gold standard for diagnosis of CF patients as genetic mutation profile being heterozygous and unlikely to become diagnostic test.

Foot strike pattern in children during shod-unshod running.

Science.gov (United States)

Latorre Román, Pedro Ángel; Balboa, Fernando Redondo; Pinillos, Felipe García

2017-10-01

The purpose of this study was to determine the foot strike patterns (FSPs) and neutral support (no INV/EVE and no foot rotation) in children, as well as to determine the influence of shod/unshod conditions and sex. A total of 713 children, aged 6 to 16 years, participated in this study (Age=10.28±2.71years, body mass index [BMI]=19.70±3.91kg/m 2 , 302 girls and 411 boys). A sagittal and frontal-plane video (240Hz) was recorded using a high-speed camcorder, to record the following variables: rearfoot strike (RFS), midfoot strike (MFS), forefoot strike (FFS), inversion/eversion (INV/EVE) and foot rotation on initial contact. RFS prevalence was similar between boys and girls in both shod and unshod conditions. In the unshod condition there was a significant reduction (p<0.001) of RFS prevalence both in boys (shod condition=83.95% vs. 62.65% unshod condition) and in girls (shod condition=87.85% vs. 62.70% unshod condition). No significant differences were found in INV/EVE and foot rotation between sex groups. In the unshod condition there was a significant increase (p<0.001) of neutral support (no INV/EVE) both in boys (shod condition=12.55% vs. 22.22% unshod condition) and in girls (shod condition=17.9% vs. 28.15% unshod condition). In addition, in the unshod condition there is a significant reduction (p<0.001) of neutral support (no foot rotation) both in boys (shod condition=21.55% vs. 11.10% unshod condition) and in girls (shod condition=21.05% vs. 11.95% unshod condition). In children, RFS prevalence is lower than adult's population. Additionally, barefoot running reduced the prevalence of RFS and INV/EVE, however increased foot rotation. Copyright © 2017 Elsevier B.V. All rights reserved.

Clinical features and treatment of organ failure in severe acute pancreatitis

Directory of Open Access Journals (Sweden)

CUI Lijian

2014-08-01

Full Text Available Organ failure is an important factor causing death in patients with severe acute pancreatitis (SAP. In recent years, thanks to the further study of pathophysiology of SAP and the continuous accumulation of experience and technology, substantial progress has been made in the diagnosis and treatment of SAP complicated by organ failure. The clinical features of SAP complicated by organ failure and the measures to be strengthened in the treatment of SAP are summarized. Currently, it is thought that organ failure tends to appear once SAP occurs, so timely, standardized treatment can shorten the course of disease and significantly reduce mortality.

Clinical, haematobiochemical, radiographic and ultrasonographic features of traumatic reticuloperitonitis in bovines

International Nuclear Information System (INIS)

Mohindroo, J.; Singh, Kiranjeet; Kumar, Ashwani; Randhawa, C.S.

2010-01-01

Study was conducted to compare the clinical, haematobiochemical, radiographic and ultrasonographic features of traumatic reticuloperitonitis in bovines. Clinical cases (4 cows and 17 buffaloes) presented with a history of anorexia, fever, decreased milk yield and loss of defecation/scant faeces, were used. Haematological picture revealed neutrophilic leucocytosis with left shift and blood biochemical status showed elevated levels of total protein, albumin, and fibrinogen. Decreased plasma concentration of sodium, potassium and chloride was observed in majority of the cases. Radiographic examination revealed presence of multiple metallic foreign densities in the reticulum of the bovines. Ultrasonographically, morphological changes of reticular wall and reticulophrenic adhesions in cases of localised peritonitis were visualized. The presence of anechoic fluid without echogenic margins, not restricted to reticulum and sometimes with floating fibrinous shreds was observed in cases of diffuse peritonitis. Ultrasonography in B mode and B+ mode found helpful for the diagnosis of traumatic reticuloperitonitis and differentiation of localised peritonitis from diffuse peritonitis

Clinically Important Features of Porphyrin and Heme Metabolism and the Porphyrias

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Siddesh Besur

2014-11-01

Full Text Available Heme, like chlorophyll, is a primordial molecule and is one of the fundamental pigments of life. Disorders of normal heme synthesis may cause human diseases, including certain anemias (X-linked sideroblastic anemias and porphyrias. Porphyrias are classified as hepatic and erythropoietic porphyrias based on the organ system in which heme precursors (5-aminolevulinic acid (ALA, porphobilinogen and porphyrins are chiefly overproduced. The hepatic porphyrias are further subdivided into acute porphyrias and chronic hepatic porphyrias. The acute porphyrias include acute intermittent, hereditary copro-, variegate and ALA dehydratase deficiency porphyria. Chronic hepatic porphyrias include porphyria cutanea tarda and hepatoerythropoietic porphyria. The erythropoietic porphyrias include congenital erythropoietic porphyria (Gűnther’s disease and erythropoietic protoporphyria. In this review, we summarize the key features of normal heme synthesis and its differing regulation in liver versus bone marrow. In both organs, principal regulation is exerted at the level of the first and rate-controlling enzyme, but by different molecules (heme in the liver and iron in the bone marrow. We also describe salient clinical, laboratory and genetic features of the eight types of porphyria.

Triggered lightning strikes to aircraft and natural intracloud discharges

Science.gov (United States)

Mazur, Vladislav

1989-01-01

The physical model of Mazur (1989) for triggering lightning strikes by aircraft was used to interpret the initiation of intracloud flashes observed by the French UHF-VHF interferometric system. It is shown that both the intracloud discharges and airplane-triggered lightning strikes were initiated by simultaneous bidirectional development of the negative stepped leader and the positive leader-continous current process. However, the negative stepped leader phase in triggered flashes is of shorter duration (tens of milliseconds), than that in intracloud flashes (usually hundreds of milliseconds). This is considered to be due to the fact that, on the aircraft there is a single initiation process, versus the numerous initiation processes that occur inside the cloud.

Evaluation of clinical features scoring system as screening tool for influenza A (H1N1 in epidemic situations

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P Ranjan

2012-01-01

Full Text Available Background: Influenza A (H1N1 hit the headlines in recent times and created mass hysteria and general panic. The high cost and non-availability of diagnostic laboratory tests for swine flu, especially in the developing countries underlines the need of having a cheaper, easily available, yet reasonably accurate screening test. Aims: This study was carried out to develop a clinical feature-based scoring system (CFSS for influenza A (H1N1 and to evaluate its suitability as a screening tool when large numbers of influenza-like illness cases are suspect. Settings and Design: Clinical-record based study, carried out retrospectively in post-pandemic period on subject′s case-sheets who had been quarantined at IG International Airport′s quarantine center at Delhi. Materials and Methods: Clinical scoring of each suspected case was done by studying their case record sheet and compared with the results of RT-PCR. RT-PCR was used to confirm the diagnosis (Gold Standard. Statistical Analysis: We calculated sensitivity, specificity, positive and negative predictive values of the clinical feature-based scoring system (the proposed new screening tool at different cut-off values. The most discriminant cut-off value was determined by plotting the ROC curve. Results: Of the 638 suspected cases, 127 (20% were confirmed to have H1N1 by RT-PCR examination. On the basis of ROC, the most discriminant clinical feature score for diagnosing Influenza A was found to be 7, which yielded sensitivity, specificity, positive, and negative predictive values of 86%, 88%, 64%, and 96%, respectively. Conclusion: The clinical features scoring system (CFSS can be used as a valid and cost-effective tool for screening swine flu (influenza A (H1N1 cases from large number of influenza-like illness suspects.

Classification and clinical features of headache patients: an outpatient clinic study from China.

Science.gov (United States)

Wang, Yunfeng; Zhou, Jiying; Fan, Xiaoping; Li, Xuelian; Ran, Li; Tan, Ge; Chen, Lixue; Wang, Kuiyun; Liu, Bowen

2011-10-01

This study aimed to analyze and classify the clinical features of headache in neurological outpatients. A cross-sectional study was conducted consecutively from March to May 2010 for headache among general neurological outpatients attending the First Affiliated Hospital of Chongqing Medical University. Personal interviews were carried out and a questionnaire was used to collect medical records. Diagnosis of headache was according to the International classification of headache disorders, 2nd edition (ICHD-II). Headache patients accounted for 19.5% of the general neurology clinic outpatients. A total of 843 (50.1%) patients were defined as having primary headache, 454 (27%) secondary headache, and 386 (23%) headache not otherwise specified (headache NOS). For primary headache, 401 (23.8%) had migraine, 399 (23.7%) tension-type headache (TTH), 8 (0.5%) cluster headache and 35 (2.1%) other headache types. Overall, migraine patients suffered (1) more severe headache intensity, (2) longer than 6 years of headache history and (3) more common analgesic medications use than TTH ones (p headaches than migraine patients, and typically headache frequency exceeded 15 days/month (p headache patients were defined as chronic daily headache. Almost 20% of outpatient visits to the general neurology department were of headache patients, predominantly primary headache of migraine and TTH. In outpatient headaches, more attention should be given to headache intensity and duration of headache history for migraine patients, while more attention to headache frequency should be given for the TTH ones.

Differential diagnosis of scrub typhus meningitis from tuberculous meningitis using clinical and laboratory features.

Science.gov (United States)

Valappil, Ashraf V; Thiruvoth, Sohanlal; Peedikayil, Jabir M; Raghunath, Praveenkumar; Thekkedath, Manojan

2017-12-01

The involvement of the central nervous system in the form of meningitis or meningoencephalitis is common in scrub typhus and is an important differential diagnosis of other lymphocytic meningitis like tuberculous meningitis (TBM). The aim of this study was to identify the clinical and laboratory parameters that may be helpful in differentiating scrub typhus meningitis from TBM. We compared of the clinical and laboratory features of 57 patients admitted with scrub typhus meningitis or TBM during a 3-year period. Patients who had abnormal cerebrospinal fluid (CSF) and positive scrub typhus enzyme-linked immunosorbent assay serology (n=28) were included in the scrub typhus meningitis group, while the TBM group included those who satisfied the consensus diagnostic criteria of TBM (n=29). Compared with the TBM group, the mean duration of symptoms was less in patients with scrub typhus meningitis, who also had a lower magnitude of neurological deficits, such as altered mental status and cranial nerve and motor deficits. Patients with scrub typhus meningitis had a lower CSF white blood-cell count (WBC) than the TBM group (130.8±213 195±175 cells/mm 3 , P=0.002), lower CSF protein elevation (125±120 vs. 195.2±108.2mg/dl, P=0.002), and higher CSF sugar (70.1±32.4 vs. 48.7±23.4mg/dl, P=0.006). Features predictive of the diagnosis of scrub typhus meningitis included the absence of neurological impairment at presentation, blood serum glutamic-oxaloacetic transaminase>40 international units (IU)/L, serum glutamic-pyruvic transaminase>60 IU/L, total blood leukocyte count>10,000/mm 3 , CSF protein50mg/dl, CSF WBC<100 cells/mm 3 . All patients with scrub typhus meningitis recovered completely following doxycycline therapy CONCLUSIONS: This study suggests that, clinical features, including duration of fever, neurological deficits at presentation and laboratory parameters such as CSF pleocytosis,CSF protein elevation, CSF sugar levels and liver enzyme values are helpful in

Microinvasive ductal carcinoma in situ: Clinical presentation, imaging features, pathologic findings, and outcome

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Vieira, Cristina C. [Department of Radiology, New York University School of Medicine (United States); Mercado, Cecilia L. [Department of Radiology, New York University School of Medicine (United States)], E-mail: Cecilia.mercado@nyumc.org; Cangiarella, Joan F. [Department of Pathology, New York University School of Medicine (United States); Moy, Linda; Toth, Hildegard K. [Department of Radiology, New York University School of Medicine (United States); Guth, Amber A. [Department of Surgery, New York University School of Medicine (United States)

2010-01-15

Objective: The purpose of our study was to describe the clinical features, imaging characteristics, pathologic findings and outcome of microinvasive ductal carcinoma in situ (DCISM). Materials and methods: The records of 21 women diagnosed with microinvasive ductal carcinoma in situ (DCISM) from November 1993 to September 2006 were retrospectively reviewed. The clinical presentation, imaging and histopathologic features, and clinical follow-up were reviewed. Results: The 21 lesions all occurred in women with a mean age of 56 years (range, 27-79 years). Clinical findings were present in ten (48%): 10 with palpable masses, four with associated nipple discharge. Mean lesion size was 21 mm (range, 9-65 mm). The lesion size in 62% was 15 mm or smaller. Mammographic findings were calcifications only in nine (43%) and an associated or other finding in nine (43%) [mass (n = 7), asymmetry (n = 1), architectural distortion (n = 1)]. Three lesions were mammographically occult. Sonographic findings available in 11 lesions showed a solid hypoechoic mass in 10 cases (eight irregular in shape, one round, one oval). One lesion was not seen on sonography. On histopathologic examination, all lesions were diagnosed as DCISM, with a focus of invasive carcinoma less than or equal to 1 mm in diameter within an area of DCIS. Sixteen (76%) lesions were high nuclear grade, four (19%) were intermediate and one was low grade (5%). Sixteen (76%) had the presence of necrosis. Positivity for ER and PR was noted in 75% and 38%. Nodal metastasis was present in one case with axillary lymph node dissection. Mean follow-up time for 16 women was 36 months without evidence of local or systemic recurrence. One patient developed a second primary in the contralateral breast 3 years later. Conclusion: The clinical presentation and radiologic appearance of a mass are commonly encountered in DCISM lesions (48% and 57%, respectively), irrespective of lesion size, mimicking findings seen in invasive carcinoma

Microinvasive ductal carcinoma in situ: Clinical presentation, imaging features, pathologic findings, and outcome

International Nuclear Information System (INIS)

Vieira, Cristina C.; Mercado, Cecilia L.; Cangiarella, Joan F.; Moy, Linda; Toth, Hildegard K.; Guth, Amber A.

2010-01-01

Objective: The purpose of our study was to describe the clinical features, imaging characteristics, pathologic findings and outcome of microinvasive ductal carcinoma in situ (DCISM). Materials and methods: The records of 21 women diagnosed with microinvasive ductal carcinoma in situ (DCISM) from November 1993 to September 2006 were retrospectively reviewed. The clinical presentation, imaging and histopathologic features, and clinical follow-up were reviewed. Results: The 21 lesions all occurred in women with a mean age of 56 years (range, 27-79 years). Clinical findings were present in ten (48%): 10 with palpable masses, four with associated nipple discharge. Mean lesion size was 21 mm (range, 9-65 mm). The lesion size in 62% was 15 mm or smaller. Mammographic findings were calcifications only in nine (43%) and an associated or other finding in nine (43%) [mass (n = 7), asymmetry (n = 1), architectural distortion (n = 1)]. Three lesions were mammographically occult. Sonographic findings available in 11 lesions showed a solid hypoechoic mass in 10 cases (eight irregular in shape, one round, one oval). One lesion was not seen on sonography. On histopathologic examination, all lesions were diagnosed as DCISM, with a focus of invasive carcinoma less than or equal to 1 mm in diameter within an area of DCIS. Sixteen (76%) lesions were high nuclear grade, four (19%) were intermediate and one was low grade (5%). Sixteen (76%) had the presence of necrosis. Positivity for ER and PR was noted in 75% and 38%. Nodal metastasis was present in one case with axillary lymph node dissection. Mean follow-up time for 16 women was 36 months without evidence of local or systemic recurrence. One patient developed a second primary in the contralateral breast 3 years later. Conclusion: The clinical presentation and radiologic appearance of a mass are commonly encountered in DCISM lesions (48% and 57%, respectively), irrespective of lesion size, mimicking findings seen in invasive carcinoma

Acute changes in foot strike pattern and cadence affect running parameters associated with tibial stress fractures.

Science.gov (United States)

Yong, Jennifer R; Silder, Amy; Montgomery, Kate L; Fredericson, Michael; Delp, Scott L

2018-05-18

Tibial stress fractures are a common and debilitating injury that occur in distance runners. Runners may be able to decrease tibial stress fracture risk by adopting a running pattern that reduces biomechanical parameters associated with a history of tibial stress fracture. The purpose of this study was to test the hypothesis that converting to a forefoot striking pattern or increasing cadence without focusing on changing foot strike type would reduce injury risk parameters in recreational runners. Running kinematics, ground reaction forces and tibial accelerations were recorded from seventeen healthy, habitual rearfoot striking runners while running in their natural running pattern and after two acute retraining conditions: (1) converting to forefoot striking without focusing on cadence and (2) increasing cadence without focusing on foot strike. We found that converting to forefoot striking decreased two risk factors for tibial stress fracture: average and peak loading rates. Increasing cadence decreased one risk factor: peak hip adduction angle. Our results demonstrate that acute adaptation to forefoot striking reduces different injury risk parameters than acute adaptation to increased cadence and suggest that both modifications may reduce the risk of tibial stress fractures. Copyright © 2018 Elsevier Ltd. All rights reserved.

The clinical pathological features, diagnosis, treatment and prognosis of small intestine primary malignant tumors.

Science.gov (United States)

Guo, Xiaochuan; Mao, Zhiyuan; Su, Dan; Jiang, Zhaocai; Bai, Li

2014-04-01

The aim of the study was to describe and analyze the clinicopathological features and diagnosis of Chinese patients with small intestine primary malignant tumors and to explore the best therapy to small bowel adenocarcinoma (SBA). More than 26,000 patients with digestive tract malignant tumors received treatment in PLA hospital from 2000 to 2011, and among them, there were 887 patients who had small intestine primary malignant tumors, and 666 of 887 patients had the completed basic clinical documents. We retrospectively analyzed the correlation between clinical and pathological features of the 666 patients and analyzed the survival and prognosis of 173 SBA patients with follow-up data. Both the number of patients with primary malignant tumors of the small intestine and the number of patients who received chemotherapy showed an increasing trend. The ratio of male to female was 1.58:1. The male patients significantly exceed the female patients with tumors of non-ampullary duodenum, jejunum and duodenal ampulla; and most of the patients are over 60 years of age. For patients burdened with either of the pathological types of tumors, the males exceeded the females, but there was no significant difference. Abdominal pain was the main clinical manifestation for patients with tumors of non-ampullary duodenum, jejunum and ileum, and the most common clinical manifestations were jaundice and abdominal pain for patients with ampullary duodenal tumors, adenocarcinoma, neuroendocrine tumors and sarcoma. In addition, patients with stromal tumors were prone to gastrointestinal bleeding. Gastrointestinal endoscopy was the most common examinational procedure. Patients under 60 years of age were prone to surgery and chemotherapy after surgery, and patients over 60 years of age were prone to supportive treatment and chemotherapy without surgery. The medium overall survival of patients who received surgery without chemotherapy, chemotherapy after surgery, chemotherapy without surgery

Analysis of correlation between the clinical feature of dry eye and the disease condition in type 2 diabetic patients

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Yu-Mei Zhou

2017-08-01

Full Text Available AIM: To investigate the clinical features of dry eye with type 2 diabetic patients, and to analyze the correlation between the clinical features of dry eye and the disease condition. METHODS: Retrospective case series study. Dry eye cases with type 2 diabetic were analyzed from March to December in 2016. And the clinical features of patients were summarized. Dry eye examination including tear break-up time(BUTand Schirmer test(schirmer Ⅰ test, SⅠt. Patients were divided into RESULTS: There were 178 cases collected. All cases were diagnosed as dry eye both eyes. The patient's age ranged from 32 to 85 years, with an average 58.41±13.06 years. There were 110(61.8%male cases, and 68(38.2%female cases. In all cases, the mean value of BUT was 4.52±2.31s, and the mean value of SⅠt was 4.25±1.99mm/5min. The value of women were more than men, but the differences were not significant statistically. Patients of ≥60 group were less than the age group of t=4.153, 4.021; PF=68.884, 60.204; Pt=-6.615, -5.918; PCONCLUSION:There were two types dry eye in 2 diabetic patients: the instability of tear-film and the reduction of tear secretion. The clinic features of dry eye were related to age, the course of the disease, and the level of blood glucose.

Clinical features and imaging of central poststroke pain

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Ramesh Bhattacharyya

2016-01-01

Full Text Available Introduction: Central post stroke pain is a variety of neuropathic pain that occurs after stroke as a result of dysfunction of either spino-thalamic tract or thalamo-cortical sensory pathway. Hyperirritability in surviving cells along the affected pain pathways found with changes in inhibitory pathways, spinal and cortical reorganization and central sensitization. Aim: Clinical features like character of pain and other sensory features with neuroimaging findings of central post stroke pain for a part of Indian population were analyzed in this study. Materials and Method including analysis: 120 numbers of patients, who developed new onset pain symptoms after stroke, attending outpatient and inpatient department of a neurology department during a whole year were examined with history including extensive sensory symptoms analysis; sensory examinations including assessment of pain score and other neurological examinations were done and rechecked by neurologists. All were investigated by neuroimaging with either MRI or CT scan or both. Neuro imaging was interpreted by experienced neuroradiologist and corroborated by neurologists and pain physician. Results: 45% of the lesions were in Thalamus when 75% of the lesions were detected as infarction. 57.5% symptoms started within 3 months. Ataxia found with 60%, increased threshold to warm and cold were seen in 40% of patients, burning sensation was seen in 40% followed by numbness with 20%, dysesthesia found with 60%, reduced sensation to temperature changes found with 40% patients. Conclusion: CPSP patients may presents with various sensory symptoms beside pain. Distribution of sensory symptoms may be with any part of the body as well as over one half of the body. Most common trigger factor was mechanical; while thalamic lesions found in 45%, extra thalamic lesions werefound with 55% of patients.

Strike type variation among Tarahumara Indians in minimal sandals versus conventional running shoes

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Daniel E. Lieberman

2014-06-01

Conclusion: These data reinforce earlier studies that there is variation among foot strike patterns among minimally shod runners, but also support the hypothesis that foot stiffness and important aspects of running form, including foot strike, differ between runners who grow up using minimal versus modern, conventional footwear.

Clinical Investigation of Radiation Retinopathy Fundus and Fluorescein Angiographic Features

Institute of Scientific and Technical Information of China (English)

LiMei; QiuGT

1999-01-01

Purpose:To investigate the fundus and fluorescein angiographic features in the patients with radiation retinopathy.Clinical Materials:Color fundus photography and/or fluorescein angiography from 13 patients with nasopharyngeal carcinomas received external beam radiation were retrospectively analyzed.Reslts:In this study,26 damaged eyes of 13 patients eveloped some degree of radiation retinopathy.The earliest and most common finding was macular microvascular changes (microaneurysms and/or telangiectasia),which was observed in 100%(26/26)of the eyes.Intraretinal hemorrhages,macular capillary nonperfusion,and macular edema were noted in 84%,50%,and 42% of the eyes,respectively.Conclusions:Radiation retinopathy is common after external beam radiation of nasopharyngeal carcinomas.The prominent changes include maular microvascular changes,intraretinal hemorrhages and macular capillary nonperfusion.

Is the rearfoot pattern the most frequently foot strike pattern among recreational shod distance runners?

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de Almeida, Matheus Oliveira; Saragiotto, Bruno Tirotti; Yamato, Tiê Parma; Lopes, Alexandre Dias

2015-02-01

To determine the distribution of the foot strike patterns among recreational shod runners and to compare the personal and training characteristics between runners with different foot strike patterns. Cross-sectional study. Areas of running practice in São Paulo, Brazil. 514 recreational shod runners older than 18 years and free of injury. Foot strike patterns were evaluated with a high-speed camera (250 Hz) and photocells to assess the running speed of participants. Personal and training characteristics were collected through a questionnaire. The inter-rater reliability of the visual foot strike pattern classification method was 96.7% and intra-rater reliability was 98.9%. 95.1% (n = 489) of the participants were rearfoot strikers, 4.1% (n = 21) were midfoot strikers, and four runners (0.8%) were forefoot strikers. There were no significant differences between strike patterns for personal and training characteristics. This is the first study to demonstrate that almost all recreational shod runners were rearfoot strikers. The visual method of evaluation seems to be a reliable and feasible option to classify foot strike pattern. Copyright © 2014 Elsevier Ltd. All rights reserved.

Clinical features in patients with chronic muscle pain--with special reference to fibromyalgia

DEFF Research Database (Denmark)

Jacobsen, Søren; Petersen, I S; Danneskiold-Samsøe, B

1993-01-01

was not excessive and seemed appropriate compared to the other patient groups. Effects of various biases and classification criteria on the results of fibromyalgia studies are discussed. The characteristic features of fibromyalgia, its stability when diagnosed and the promotion of research and patient management......Clinical characteristics were studied in patients with chronic muscle pain, divided into three groups according to the characteristics of their pain; "fibromyalgia" (n = 23), "widespread muscle pain" (n = 21), and "regional muscle pain" (n = 28). Typical fibromyalgia features were also seen...... in the other groups of patients, but not to the same extent. In particular, sleep disturbance, subjective swelling, cold and exercise intolerance and low self-reported physical performance were significantly related to fibromyalgia. The major components of fibromyalgia were not wholly different compared...

The General Strike - An Artist Talk on the Work of Santiago Sierra & Claire Fontaine

OpenAIRE

Mansoor, Jaleh

2012-01-01

The General Strike, the organized refusal to work among a critical mass of laborers, has been attendant upon and responsive to the capitalist form of accumulation since the latter’s inception. Having variously emerged and receded as a broadly recognized means of resistance since the mid 19th century, the potential of a general strike to precipitate capitalism's inherent tendency to crisis was forcefully expressed by the anti-austerity movement in Greece and in Spain in 2012. A general strike ...

[Urological emergencies at the Dakar university teaching hospital: epidemiological, clinical and therapeutic features].

Science.gov (United States)

Fall, B; Diao, B; Fall, P A; Diallo, Y; Sow, Y; Ondongo, A A M; Diagana, M; Ndoye, A K; Ba, M; Diagne, B A

2008-11-01

To present the epidemiological, clinical and therapeutic features of the urological emergencies in Senegal, West Africa. The authors conducted a 20 months retrospective study that analyzed the epidemiological, clinical and therapeutic features of all urological emergencies admitted to the urology department of the university teaching hospital Aristide-Le-Dantec (Dakar). There were 1237 urological emergencies. The mean age of the patients was 58.8 years (range one month-94 years). The sex ratio (M/F) was 20.32. These patients had an age equal to or higher than 60 years in 50.7% of the cases. The most frequent illness was urinary retention (53%) and genitor-urinary system infectious, which represented as a whole 16.4% of the cases. The gangrenes of male external genitalia (Fournier's gangrene) accounted for 4.1% of the cases and the priapism 1.3%. In emergency, 331 surgical operations were performed. The most performed procedures were the installation of a suprapubic catheter (59.8%) and debridement of a gangrene of male external genitalia (15.4%). The most frequent urological emergency in our country was the acute urinary retention. Some serious illness like gangrene of male external genitalia (Fournier's gangrene) and priapism are not rare there.

Managing the risks: An analysis of bird strike reporting at Part 139 Airports in Indiana 2001-2014

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Flavio Mendonca

2017-04-01

Full Text Available Purpose: The purpose of the current study was fourfold: to identify bird strike reporting trends at Part 139 airports in Indiana (2001-2014 for comparison to national data; to determine which quarter of the year yields the most bird strike data; to gain a clearer understanding of the relationship between altitude and bird strikes, and to develop information based upon the data analyzed that can be used for the safety management of birds including comparisons to national data.  Design/methodology: The researchers in this study answered the research questions by reviewing, sorting, and analyzing existing data.  The data collection took place from March 01 to May 02, 2016. Two data sets were utilized for data collection. The National Wildlife Strike Database (NWSD and the FAA Air Traffic Activity System (ATADS. Findings: When compared to national data, Indiana Part 139 airports have seen a faster increase in bird strike reporting during 2012 and 2014. Aggregate data indicated June through September (Quarter 3 had a significantly higher frequency of bird strikes reported.  When examining bird strikes and altitude of occurrences, the exponential equation explained 95 % of the variation in number of strikes by 1,000-foot intervals from 1000 to 10,000 feet. Not surprisingly, the risk of bird strikes appears to decrease as altitude increases. Originality/value: This study adds to the body of knowledge by addressing the lack of published bird strike report analyses at a regional level.  It also connects data analyses to safety management system (SMS concepts and Wildlife Hazards Management Programs (WHMP. The aviation community can use regional bird strike data and information to develop or enhance existing wildlife hazard management programs, increase pilot awareness, and offers airport managerial implications.

Clinical features of GH deficiency and effects of 3 years of GH replacement in adults with controlled Cushing's disease

DEFF Research Database (Denmark)

Höybye, Charlotte; Ragnarsson, Oskar; Jönsson, Peter J

2010-01-01

Patients in remission from Cushing's disease (CD) have many clinical features that are difficult to distinguish from those of concomitant GH deficiency (GHD). In this study, we evaluated the features of GHD in a large cohort of controlled CD patients, and assessed the effect of GH treatment....

Clinical and genetic features of dyskeratosis congenita, cryptic dyskeratosis congenita, and Hoyeraal-Hreidarsson syndrome in Japan.

Science.gov (United States)

Yamaguchi, Hiroki; Sakaguchi, Hirotoshi; Yoshida, Kenichi; Yabe, Miharu; Yabe, Hiromasa; Okuno, Yusuke; Muramatsu, Hideki; Takahashi, Yoshiyuki; Yui, Shunsuke; Shiraishi, Yuichi; Chiba, Kenichi; Tanaka, Hiroko; Miyano, Satoru; Inokuchi, Koiti; Ito, Etsuro; Ogawa, Seishi; Kojima, Seiji

2015-11-01

Dyskeratosis congenita (DKC) is an inherited bone marrow failure (BMF) syndrome typified by reticulated skin pigmentation, nail dystrophy, and mucosal leukoplakia. Hoyeraal-Hreidarsson syndrome (HHS) is considered to be a severe form of DKC. Unconventional forms of DKC, which develop slowly in adulthood but without the physical anomalies characteristic of DKC (cryptic DKC), have been reported. Clinical and genetic features of DKC have been investigated in Caucasian, Black, and Hispanic populations, but not in Asian populations. The present study aimed to determine the clinical and genetic features of DKC, HHS, and cryptic DKC among Japanese patients. We analyzed 16 patients diagnosed with DKC, three patients with HHS, and 15 patients with cryptic DKC. We found that platelet count was significantly more depressed than neutrophil count or hemoglobin value in DKC patients, and identified DKC patients with large deletions in the telomerase reverse transcriptase and cryptic DKC patients with RTEL1 mutations on both alleles. This led to some patients previously considered to have unclassifiable BMF being diagnosed with cDKC through identification of new gene mutations. It thus seems important from a clinical viewpoint to re-examine the clinical characteristics, frequency of genetic mutations, and treatment efficacy in DKC, HHS, and cDKC.

Interaction effects of stride angle and strike pattern on running economy.

Science.gov (United States)

Santos-Concejero, J; Tam, N; Granados, C; Irazusta, J; Bidaurrazaga-Letona, I; Zabala-Lili, J; Gil, S M

2014-12-01

This study aimed to investigate the relationship between stride angle and running economy (RE) in athletes with different foot strike patterns. 30 male runners completed 4 min running stages on a treadmill at different velocities. During the test, biomechanical variables such as stride angle, swing time, contact time, stride length and frequency were recorded using an optical measurement system. Their foot strike pattern was determined, and VO2 at velocities below the lactate threshold were measured to calculate RE. Midfoot/forefoot strikers had better RE than rearfoot strikers (201.5±5.6 ml · kg(-1) · km(-1) vs. 213.5±4.2 ml · kg(-1) · km(-1)respectively; p=0.019). Additionally, midfoot/fore-foot strikers presented higher stride angles than rearfoot strikers (p=0.043). Linear modelling analysis showed that stride angle is closely related to RE (r=0.62, pstrike pattern is likely to be more economical, whereas at any lower degree, the midfoot/forefoot strike pattern appears to be more desirable. A biomechanical running technique characterised by high stride angles and a midfoot/forefoot strike pattern is advantageous for a better RE. Athletes may find stride angle useful for improving RE. © Georg Thieme Verlag KG Stuttgart · New York.

Crimea-Kopet Dagh zone of concentrated orogenic deformations as a transregional late collisional right-lateral strike-slip fault

Science.gov (United States)

Patina, I. S.; Leonov, Yu. G.; Volozh, Yu. A.; Kopp, M. L.; Antipov, M. P.

2017-07-01

It is shown that the Crimea, Caucasus, and Kopet Dagh fold systems make up a single whole unified by a lithospheric strike-slip fault zone of concentrated dislocations. The strike-slip fault that dissects the sedimentary cover and consolidated crust is rooted in subcrustal layers of the mantle. The notions about strike-slip dislocations in the structure of the Crimea-Kopet Dagh System are considered. Comparative analysis of structure, age, and amplitude of strike-slip fault segments is carried out. The effect of strike-slip faulting on the deep-seated and near-surface structure of the Earth's crust is considered. Based on estimation of strike-slip offsets, the paleogeography of Paleogene basins is refined; their initial contours, which have been disturbed and fragmented by slipping motion strike-slip displacement, have been reconstructed.

Electromyographic Study of a Sequence of Yau-Man Kung Fu Palm Strikes with and without Impact.

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Neto, Osmar Pinto; Magini, Marcio; Pacheco, Marcos T T

2007-01-01

IN MARTIAL ARTS AND CONTACT SPORTS, STRIKES ARE OFTEN TRAINED IN TWO DIFFERENT WAYS: with and without impacts. This study aims to compare the electromyographical activity (EMG) of the triceps brachii (TB), biceps brachii (BB) and brachioradialis (BR) muscles during strikes with and without impacts. Eight Yau-Man Kung Fu practitioners participated in the experiment. Each participant performed 5 sequences of 5 consecutive KF Yau-Man palm strikes with no impact intercalated with 5 sequences of 5 repetitions targeting a KF training shield. Surface EMG signals were obtained from the TB, BB, and RB for 3.0 seconds using an eight-channel module with a total amplifier gain of 2000 and sampled at 3500 Hz. The EMG analyses were done in the time (rms) and frequency (wavelet) domains. For the frequency domain, Morlet wavelet power spectra were obtained and an original method was used to quantify statistically significant regions on the power spectra. The results both in the time and frequency domains indicate a higher TB and BR muscle activity for the strikes with impacts. No significant difference was found for the BB in the two different scenarios. In addition, the results show that the wavelet power spectra pattern for the three analysed muscles obtained from the strikes with and without impacts were similar. Key pointsEMG analysis of a sequence of Kung Fu strikes demonstrates higher Triceps Brachii and Brachioradialis muscle activity for strikes with impact than strikes without impact.An original reliable method for quantifying EMG wavelet transform results is presented.EMG wavelet power spectra describe muscle roles during a Kung Fu sequence of strikes.

Clinical Features and Management of Cartilage-Hair Hypoplasia: A Narrative Review

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Kobra Shiasi Arani

2015-01-01

Full Text Available Context: Cartilage-hair hypoplasia is a rare hereditary cause of short stature. The aim of this study was to familiarize physicians with this rare but important disease. Evidence Acquisition: This article is a narrative review of the scientific literature to inform about clinical features and management of Cartilage-hair hypoplasia. A systematic search identified 127 papers include original and review articles and case reports. Results: Cartilage-Hair Hypoplasia characterized by short-limb dwarfism associated with metaphyseal chondrodysplasia. The inheritance is autosomal recessive. Other findings include hair hypoplasia, anemia, immunodeficiency, propensity to infections, gastrointestinal disorders (Hirschsprung disease, anal stenosis, esophageal atresia and malabsorption, defective spermatogenesis, increased risk of malignancies and higher rate of mortality. Immunodeficiency in cartilage-hair hypoplasia may be an isolated B-cell or isolated T-cell immunodeficiency or combined B and T-cell immunodeficiency; however, severe combined immunodeficiency is rare. There is no known treatment for hair hypoplasia. Growth hormone was used with conflicting results for short stature in children with Cartilage-hair hypoplasia. Skeletal problems must be managed with physiotherapy and appropriate orthopedic interventions. Hirschsprung disease, anal stenosis and esophageal atresia should be surgically corrected. Patients with severe hypoplastic anemia require repeated transfusions. Bone marrow transplantation may be required for patients with severe combined immunodeficiency or severe persistent hypoplastic anemia. Treatment with G-CSF is useful for neutropenia. Patients should be monitored closely for developing malignancy such as skin neoplasms, lymphomas and leukemias. Conclusions: Cartilage-hair hypoplasia is an important hereditary disease with different medical aspects. The high rate of consanguineous marriages in Iran necessitates considering CHH in any

Clinical features and treatment outcomes of vasoproliferative tumors in Indian participants

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Jaydeep Avinash Walinjkar

2018-01-01

Full Text Available Purpose: The aim of the study was to describe the clinical features and treatment outcomes of vasoproliferative tumors (VPT in Indian participants. Methods: This study design was a retrospective case series in a tertiary eye care center. Case records of patients diagnosed with VPT from 2011 to 2015 were reviewed, and their demographic details, clinical presentation, and treatment outcomes were documented. Baseline and follow-up visual acuity and tumor dimensions were statistically compared by applying paired t-test. Statistical analysis used SPSS version 14. Results: Twenty-two tumors from 19 eyes of 17 patients were included. Mean age at presentation was 43.5 years (range: 15–68 years. Mean presenting best-corrected visual acuity (BCVA was + 1.10 logMAR. Sixty-eight percent eyes had secondary tumors. Most common association of secondary VPT was Coats disease followed by retinal vasculitis, polypoidal choroidal vasculopathy, familial exudative vitreoretinopathy, and traumatic chorioretinopathy. Ten tumors (45% involved the inferior quadrant. Tumor-associated features were intra/subretinal exudates, vitritis, subretinal fluid, vitreous hemorrhage, preretinal fibrosis, epiretinal membrane, and subretinal blood. Treatment included cryotherapy, intravitreal or oral steroids, laser photocoagulation, cryotherapy with encirclage, cryotherapy with anti-vascular endothelial growth factor, and observation. Complications included tumor recurrence, retinal detachment, raised intraocular pressure, neovascularization of iris, and cataract. Ninety-five percent VPT regressed at mean 21 months (Median: 17 months; Range: 3–64 months. Mean final BCVA was + 1.21 logMAR. Conclusion: VPTs are commonly unilateral, unifocal, and located anterior to equator in inferior fundus. Secondary tumors are more common than primary tumors. Treatment achieves tumor regression in majority of cases.

Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years

Science.gov (United States)

Qi, Fei; Zhang, Guo-Xin; She, Dan-Yang; Liang, Zhi-Xin; Wang, Ren-Tao; Yang, Zhen; Chen, Liang-An; Cui, Jun-Chang

2015-01-01

Background: Healthcare-associated pneumonia (HCAP) is associated with drug-resistant pathogens and high mortality, and there is no clear evidence that this is due to inappropriate antibiotic therapy. This study was to elucidate the clinical features, pathogens, therapy, and outcomes of HCAP, and to clarify the risk factors for drug-resistant pathogens and prognosis. Methods: Retrospective observational study among hospitalized patients with HCAP over 10 years. The primary outcome was 30-day all-cause hospital mortality after admission. Demographics (age, gender, clinical features, and comorbidities), dates of admission, discharge and/or death, hospitalization costs, microbiological results, chest imaging studies, and CURB-65 were analyzed. Antibiotics, admission to Intensive Care Unit (ICU), mechanical ventilation, and pneumonia prognosis were recorded. Patients were dichotomized based on CURB-65 (low- vs. high-risk). Results: Among 612 patients (mean age of 70.7 years), 88.4% had at least one comorbidity. Commonly detected pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%). Mean age, length of stay, hospitalization expenses, ICU admission, mechanical ventilation use, malignancies, and detection rate for P. aeruginosa, and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group. CURB-65 ≥3, malignancies, and mechanical ventilation were associated with an increased mortality. Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAP. Conclusion: Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach. CURB-65 ≥3, malignancies, and mechanical ventilation may result in an increased mortality. PMID:26481734

Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years

Directory of Open Access Journals (Sweden)

Fei Qi

2015-01-01

Full Text Available Background: Healthcare-associated pneumonia (HCAP is associated with drug-resistant pathogens and high mortality, and there is no clear evidence that this is due to inappropriate antibiotic therapy. This study was to elucidate the clinical features, pathogens, therapy, and outcomes of HCAP, and to clarify the risk factors for drug-resistant pathogens and prognosis. Methods: Retrospective observational study among hospitalized patients with HCAP over 10 years. The primary outcome was 30-day all-cause hospital mortality after admission. Demographics (age, gender, clinical features, and comorbidities, dates of admission, discharge and/or death, hospitalization costs, microbiological results, chest imaging studies, and CURB-65 were analyzed. Antibiotics, admission to Intensive Care Unit (ICU, mechanical ventilation, and pneumonia prognosis were recorded. Patients were dichotomized based on CURB-65 (low- vs. high-risk. Results: Among 612 patients (mean age of 70.7 years, 88.4% had at least one comorbidity. Commonly detected pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%. Mean age, length of stay, hospitalization expenses, ICU admission, mechanical ventilation use, malignancies, and detection rate for P. aeruginosa, and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group. CURB-65 ≥3, malignancies, and mechanical ventilation were associated with an increased mortality. Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAP. Conclusion: Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach. CURB-65 ≥3, malignancies, and mechanical ventilation may result in an increased mortality.

Foot drop caused by lumbar degenerative disease: clinical features, prognostic factors of surgical outcome and clinical stage.

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Kun Liu

Full Text Available OBJECTIVE: The purpose of this study was to analyze the clinical features and prognostic factors of surgical outcome of foot drop caused by lumbar degenerative disease and put forward the clinical stage. METHODS: We retrospectively reviewed 135 patients with foot drop due to lumbar degenerative disease. The clinical features and mechanism were analyzed. Age, sex, duration of palsy, preoperative muscle strength of tibialis anterior (TA, sensation defect of affected lower limb, affected foot, diagnosis and compressed nerve roots were recorded and compared with surgical outcome. RESULTS: Foot drop was observed in 8.1% of all inpatients of lumbar degenerative disease. L5 nerve root compression was observed in 126 of all 135 patients (93.3%. Single, double and triple roots compression was observed respectively in 43, 83, and 9 patients (31.9%, 61.5%, and 6.6%. But there was no significant relationship between preoperative muscle strength of TA and the number of compressed roots. The muscle strength of TA was improved in 113 (83.7% patients after surgery, but it reached to >=4 in only 21 (15.6% patients. Improvement of the muscle strength of TA was almost stable at the 6-month follow-up. At the last follow-up, the muscle strength of TA was 1, 2, 3, 4, 5 respectively in 28, 24, 62, 13, 8 patients. Multivariate logistic regression showed duration of palsy (p=0.0360, OR=2.543, preoperative muscle strength of TA (p=0.0064, OR=5.528 and age (p=0.0309, OR=3.208 were factors that influenced recovery following an operation. CONCLUSIONS: L5 nerve root was most frequently affected. The muscle strength of TA improved in most patients after surgery, but few patients can get a good recovery from foot drop. Patients of shorter duration of palsy, better preoperative muscle strength of TA and younger age showed a better surgical outcome.

When the Ocean Strikes Back

DEFF Research Database (Denmark)

Gebauer, Mirjam

2013-01-01

The disaster scenario is one of the predominant settings we find unfold in the pop-cultural imagination, namely in films and novels. In recent years, as increased awareness of environmental issues affect the agendas of public debate, we also see local and increasingly global environmental disasters...... is evolving caused by an intelligent life form of the deep sea striking back at mankind. This article aims at discussing in what ways The Swarm uses elements and patterns of the pop-cultural disaster imagination, specifically the disaster and science fiction movie of the 1990s. Furthermore, it investigates...

Histological, Immunohistological, and Clinical Features of Merkel Cell Carcinoma in Correlation to Merkel Cell Polyomavirus Status

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T. Jaeger

2012-01-01

Full Text Available Merkel cell carcinoma is a rare, but highly malignant tumor of the skin with high rates of metastasis and poor survival. Its incidence rate rises and is currently about 0.6/100000/year. Clinical differential diagnoses include basal cell carcinoma, cyst, amelanotic melanoma, lymphoma and atypical fibroxanthoma. In this review article clinical, histopathological and immunhistochemical features of Merkel cell carcinoma are reported. In addition, the role of Merkel cell polyomavirus is discussed.