Investigating suspected acute pulmonary embolism - what are hospital clinicians thinking?
International Nuclear Information System (INIS)
McQueen, A.S.; Worthy, S.; Keir, M.J.
2008-01-01
Aims: To assess local clinical knowledge of the appropriate investigation of suspected acute pulmonary embolism (PE) and this compare with the 2003 British Thoracic Society (BTS) guidelines as a national reference standard. Methods: A clinical questionnaire was produced based on the BTS guidelines. One hundred and eight-six participants completed the questionnaires at educational sessions for clinicians of all grades, within a single NHS Trust. The level of experience amongst participants ranged from final year medical students to consultant physicians. Results: The clinicians were divided into four groups based on seniority: Pre-registration, Junior, Middle, and Senior. Forty-six point eight percent of all the clinicians correctly identified three major risk factors for PE and 25.8% recognized the definition of the recommended clinical probability score from two alternatives. Statements regarding the sensitivity of isotope lung imaging and computed tomography pulmonary angiography (CTPA) received correct responses from 41.4 and 43% of participants, respectively, whilst 81.2% recognized that an indeterminate ventilation-perfusion scintigraphy (V/Q) study requires further imaging. The majority of clinicians correctly answered three clinical scenario questions regarding use of D-dimers and imaging (78, 85, and 57.5%). There was no statistically significant difference between the four groups for any of the eight questions. Conclusions: The recommended clinical probability score was unfamiliar to all four groups of clinicians in the present study, and the majority of doctors did not agree that a negative CTPA or isotope lung scintigraphy reliably excluded PE. However, questions based on clinical scenarios received considerably higher rates of correct responses. The results indicate that various aspects of the national guidelines on suspected acute pulmonary embolism are unfamiliar to many UK hospital clinicians. Further research is needed to identify methods to improve
International Nuclear Information System (INIS)
Larcos, G.; Chi, K.K.G.; Berry, G.; Westmead Hospital, Sydney, NSW; Shiell, A.
2000-01-01
There is a controversy regarding the investigation of patients with suspected acute pulmonary embolism (PE). To compare the cost-effectiveness of alternative methods of diagnosing acute PE, chest helical computed tomography (CT) alone and in combination with venous ultrasound (US) of legs and pulmonary angiography (PA) were compared to a conventional algorithm using ventilation-perfusion (V/Q) scintigraphy supplemented in selected cases by US and PA. A decision-analytical model was constructed to model the costs and effects of the three diagnostic strategies in a hypothetical cohort of 1000 patients each. Transition probabilities were based on published data. Life years gained by each strategy were estimated from published mortality rates. Schedule fees were used to estimate costs. The V/Q protocol is both more expensive and more effective than CT alone resulting in 20.1 additional lives saved at a (discounted) cost of $940 per life year gained. An additional 2.5 lives can be saved if CT replaces V/Q scintigraphy in the diagnostic algorithm but at a cost of $23,905 per life year saved. It resulted that the more effective diagnostic strategies are also more expensive. In patients with suspected PE, the incremental cost-effectiveness of the V/Q based strategy over CT alone is reasonable in comparison with other health interventions. The cost-effectiveness of the supplemented CT strategy is more questionable. Copyright (2000) The Australasian College of Physicians
Multidetector-row computed tomography management of acute pulmonary embolism
International Nuclear Information System (INIS)
Yasui, Takahiro; Tanabe, Nobuhiro; Terada, Jiro
2007-01-01
The purpose of this study was to evaluate the usefulness and safety of multidetector-row computed tomography (MDCT) pulmonary angiography and indirect venography management of acute pulmonary embolism (PE), including indication for inferior vena cava (IVC) filter. Seventy-one consecutive patients who were clinically suspected of PE and underwent 16-slice MDCT pulmonary angiography and indirect venography were enrolled. Management included indication of IVC filter for patients with extensive deep venous thrombosis (DVT) in submassive or massive PE. A right ventricular to left ventricular short-axis diameter by MDCT >1.0 was judged as submassive PE. All patients were followed for 1 year. MDCT identified 50 patients with venous thromboembolism and 47 patients had acute PE: 4 were judged as massive, 14 as submassive, and 29 as non-massive by MDCT; 3 patients had DVT alone and 7 patients had caval or iliac DVT. Only 1 patient with massive PE and DVT near the right atrium died of recurrence. No other patients died of PE. Management based on MDCT pulmonary angiography combined with indirect venography is considered to be safe and reliable in patients with suspected acute PE. (author)
Negative spiral CT in acute pulmonary embolism
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Nilsson, T.; Olausson, A. [Karolinska Hospital, Stockholm (Sweden). Dept. of Thoracic Radiology; Johnsson, H. [Karolinska Hospital, Stockholm (Sweden). Dept. of Internal Medicine; Nyman, U. [County Hospital, Trelleborg (Sweden). Dept. of Radiology; Aspelin, P. [Huddinge Univ. Hospital (Sweden). Dept. of Radiology
2002-09-01
Purpose: To retrospectively evaluate the clinical outcome of non-anticoagulated patients with clinically suspected acute pulmonary embolism (PE) and no symptoms or signs of deep venous thrombosis (DVT) following a negative contrast medium-enhanced spiral CT of the pulmonary arteries (s-CTPA). Material and Methods: During a 24-month period, 739 of 751 patients underwent s-CTPA with acceptable diagnostic quality for clinically suspected acute PE. All patients who had a CT study not positive for PE were followed up with a questionnaire, a telephone interview and review of all medical reports, including autopsies and death certificates for any episodes of venous thromboembolism (VTE) during a 3-month period. Results: PE was diagnosed in 158 patients. Of the remaining 581 patients with a negative s-CTPA, 45 patients were lost to follow-up. 88 patients were excluded because of anticoagulation treatment (cardiac disorder n=32, chronic VTE or acute symptomatic DVT n=31, PE diagnosed at pulmonary angiography n=1, thrombus prophylaxis during diagnostic work-up or other reasons than VTE n=24) and 7 patients undergoing lower extremity venous studies because of symptoms of DVT (all negative). Thus, 441 patients with a negative s-CTPA and no DVT symptoms, venous studies or anticoagulant treatment constituted the follow-up cohort. Four of these patients had proven VTE (all PE) during the 3-month follow-up period. Two of the PE episodes contributed to the patient's death. Conclusion: Patients with clinically suspected acute PE, no symptoms or signs of DVT and a negative single slice s-CTPA using 3-5 mm collimation, may safely be left without anticoagulation treatment unless they are critically ill, have a limited cardiopulmonary reserve and/or if a high clinical suspicion remains.
Value of noncontrast spiral CT for suspected acute appendicitis
International Nuclear Information System (INIS)
Choi, Pil Yeob; Lee, Sang Wook; Kwon, Jae Soo; Sung, Young Soon; Rho, Myoung Ho; Chang, Jeong A.
1998-01-01
To assess the diagnostic accuracy and clinical efficacy of noncontrast spiral CT in patients with suspected acute appendicitis. Over a six-month period, 100 patients with suspected acute appendicitis were prospectively evaluated with noncontrast spiral CT. All scans were obtained from the lower body of L3 to the symphysis pubis, with 5mm or 10mm collimation and pitch of 1 or 1.5, and without intravenous or oral contrast material. Diagnosis was established by means of surgical or clinical follow-up. Prospective diagnosis based on CT findings was compared with surgical results and clinical follow-up. Acute appendicitis was confirmed in 47 of 100 patients. On the basis of the Ct findings, SI patients were prospectively interpreted as positive for appendicitis, but in six the diagnosis was false-positive. Two of the 47 with acute appendicitis were prospectively interpreted as normal. The preoperative diagnosis of acute appendicitis was, thus, 45 true-positive, 47 true-negative, six false-positive and two false-negative yielding a sensitivity of 96%, a specificity of 89%, an accuracy of 92%, a positive predictive value of 88%, and a negative predictive value of 96%. Using CT, an alternative diagnosis was established in 14 patients. Noncontrast spiral CT is a useful technique for diagnosing acute appendicitis. =20
Cholescintigraphy and ultrasonography in patients suspected of having acute cholecystitis
DEFF Research Database (Denmark)
Lauritsen, K B; Sommer, W; Hahn, L
1988-01-01
The diagnostic power of combined cholescintigraphy and ultrasonography was tested in 67 patients suspected of having acute cholecystitis; of these, 42 (63%) had acute cholecystitis. The predictive value of a positive scintigraphy (PVpos) was 95% and that of a negative (PVneg) was 91% (n = 67......). The PVpos and PVneg of ultrasonography were 89% and 75%, respectively (n = 54), and these values did not achieve statistical significance when compared with those for scintigraphy. Inconclusive tests were 10% and 11%, respectively, but in no patient were both scintigraphy and ultrasonography inconclusive...... that in patients suspected of having acute cholecystitis cholescintigraphy should be the first diagnostic procedure performed. If the scintigraphy is positive, additional ultrasonographic detection of gallstones makes the diagnosis almost certain. If one diagnostic modality is inconclusive, the other makes a fair...
Gimber, Lana Hirai; Travis, R Ing; Takahashi, Jayme M; Goodman, Torrey L; Yoon, Hyo-Chun
2009-01-01
Pulmonary computed tomography angiography (CTA) and the Wells criteria both have interobserver variability in the assessment of pulmonary embolism (PE). Quantitative D-dimer assay findings have been shown to have a high negative predictive value in patients with low pretest probability of PE. Evaluate roles for clinical probability and CTA in Emergency Department (ED) patients suspected of acute PE but having a low serum D-dimer level. Prospective observational study of ED patients with possible PE who underwent pulmonary CTA and had D-dimer levels tiebreaker. Pulmonary CTA findings positive for acute embolism should be viewed with caution, especially if the suspected PE is in a distal segmental or subsegmental artery in a patient with a serum D-dimer level of =1.0 mug/mL. Furthermore, the Wells criteria may be of limited additional value in this group of patients with low D-dimer levels because most will have low or intermediate clinical probability of PE.
den Exter, Paul L; van Es, Josien; Erkens, Petra M G; van Roosmalen, Mark J G; van den Hoven, Pim; Hovens, Marcel M C; Kamphuisen, Pieter W; Klok, Frederikus A; Huisman, Menno V
2013-06-15
The nonspecific clinical presentation of pulmonary embolism (PE) frequently leads to delay in its diagnosis. This study aimed to assess the impact of delay in presentation on the diagnostic management and clinical outcome of patients with suspected PE. In 4,044 consecutive patients with suspected PE, patients presenting more than 7 days from the onset of symptoms were contrasted with those presenting within 7 days as regards the safety of excluding PE on the basis of a clinical decision rule combined with D-dimer testing. Patients were followed for 3 months to assess the rates of recurrent venous thromboembolism and mortality. A delayed presentation (presentation >7 d) was present in 754 (18.6%) of the patients. The failure rate of an unlikely clinical probability and normal D-dimer test was 0.5% (95% confidence interval [CI], 0.01-2.7) for patients with and 0.5% (95% CI, 0.2-1.2) for those without diagnostic delay. D-dimer testing yielded a sensitivity of 99% (95% CI, 96-99%) and 98% (95% CI, 97-99%) in these groups, respectively. Patients with PE with diagnostic delay more frequently had centrally located PE (41% vs. 26%; P presentation. PE can be safely excluded based on a clinical decision rule and D-dimer testing in patients with a delayed clinical presentation. A delayed presentation for patients who survived acute PE was associated with a more central PE location, although this did not affect the clinical outcome at 3 months.
Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome
Biso, Sylvia Marie; Lu, Marvin; De Venecia, Toni Anne; Wongrakpanich, Supakanya; Rodriguez-Ziccardi, Mary; Yadlapati, Sujani; Kishlyansky, Marina; Rammohan, Harish Seetha; Figueredo, Vincent M.
2017-01-01
Background Acute coronary syndrome (ACS) can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-...
Acute pulmonary embolism in the era of multi-detector CT: a reality in sub-Saharan Africa
International Nuclear Information System (INIS)
Tambe, Joshua; Moifo, Boniface; Fongang, Emmanuel; Guegang, Emilienne; Juimo, Alain Georges
2012-01-01
The advantages of multi-detector computed tomography (MDCT) have made it the imaging modality of choice for some patients with suspected cardiothoracic disease, of which pulmonary embolism (PE) is an exponent. The aim of this study was to assess the incidence of PE in patients with clinical suspicion of acute PE using MDCT in a sub-Saharan setting, and to describe the demographic characteristics of these patients. Consecutive records of patients who underwent MDCT pulmonary angiography for suspected acute PE over a two-year period at the Radiology Department of a university-affiliated hospital were systematically reviewed. All MDCT pulmonary angiograms were performed with a 16-detector computed tomography (CT) scanner using real-time bolus tracking technique. Authorization for the study was obtained from the institutional authorities. Forty-one MDCT pulmonary angiograms were reviewed of which 37 were retained. Of the 4 excluded studies, 3 were repeat angiograms and 1 study was not technically adequate. Twelve of 37 patients (32.4%) had CT angiograms that were positive for PE, of which 7 were males. The mean age of these patients was 47.6±10.5 years (age range from 33 to 65 years). Twenty five patients out of 37 (67.6%) had CT angiograms that were negative for PE. Eleven PE-positive patients (91.7%) had at least 1 identifiable thromboembolic risk factor whilst 5 PE-negative patients (20%) also had at least a thromboembolic risk factor. The relative risk of the occurrence of PE in patients with at least a thromboembolic risk factor was estimated at 14.4. Acute PE is a reality in sub-Saharan Africa, with an increased likelihood of MDCT evidence in patients with clinical suspicion of PE who have at least a thromboembolic risk factor. The increasing availability of MDCT will help provide more information on the occurrence of PE in these settings
Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome
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Sylvia Marie Biso
2017-01-01
Full Text Available Background. Acute coronary syndrome (ACS can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods. This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-cause mortality. Results. Of the 82 patients, 32% had chest pain and 88% had ischemic ECG changes; mean peak troponin level was 18, and mean ejection fraction was 40%. The medical management group had older individuals (73 versus 67 years, p<0.05, lower mean peak troponin levels (12 versus 49, p<0.05, and lower mean length of stay (12 versus 25 days, p<0.05 compared to those who underwent stent or CABG. Troponin levels were significantly associated with 1-year all-cause mortality. Conclusion. Age and troponin level appear to play a role in the current clinical decision making for patient with suspected poststroke ACS. Troponin level appears to significantly correlate with 1-year all-cause mortality. In the management of poststroke acute coronary syndrome, optimal medical therapy had similar inpatient and all-cause mortality compared to PCI and/or CABG.
Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome
De Venecia, Toni Anne; Wongrakpanich, Supakanya; Rodriguez-Ziccardi, Mary; Yadlapati, Sujani; Kishlyansky, Marina; Rammohan, Harish Seetha; Figueredo, Vincent M.
2017-01-01
Background Acute coronary syndrome (ACS) can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-cause mortality. Results Of the 82 patients, 32% had chest pain and 88% had ischemic ECG changes; mean peak troponin level was 18, and mean ejection fraction was 40%. The medical management group had older individuals (73 versus 67 years, p < 0.05), lower mean peak troponin levels (12 versus 49, p < 0.05), and lower mean length of stay (12 versus 25 days, p < 0.05) compared to those who underwent stent or CABG. Troponin levels were significantly associated with 1-year all-cause mortality. Conclusion Age and troponin level appear to play a role in the current clinical decision making for patient with suspected poststroke ACS. Troponin level appears to significantly correlate with 1-year all-cause mortality. In the management of poststroke acute coronary syndrome, optimal medical therapy had similar inpatient and all-cause mortality compared to PCI and/or CABG. PMID:29130017
International Nuclear Information System (INIS)
Engeike, C.; Rummeny, E.; Marten, K.
2006-01-01
Purpose: evaluation of the prognostic value of morphological cardiac parameters in patients with suspected and incidental acute pulmonary embolism (PE) using multidetector-row chest CT (MSCT). Materials and methods: 2335 consecutive MSCT scans were evaluated for the presence of PE. The arterial enhancement and analysability of pulmonary arteries and the heart were assessed as parameters of the scan quality. The diastolic right and left ventricular short axes (RV D , LV D ) and the interventricular septal deviation (ISD) were measured in all PE-positive patients and the echocardiography reports were reviewed. The clinical data assessment included cardio-respiratory and other co-morbidities, systemic anticoagulant therapy (ACT), and the 30-day outcome. Predictors of acute cor pulmonale and the short-term outcome were calculated by univariate and multivariate logistic regressions including odds ratios (OR) and ROC analyses using positive (PPV) and negative predictive values (NPV). Results: 90 patients with acute PE were included (36 with clinically suspected PE, 54 with incidental PE). 26 patients had cardio-respiratory co-morbidities. Four patients underwent systemic thrombolysis, 43 underwent anticoagulation in therapeutic doses, 19 underwent anticoagulation in prophylactic doses, and 24 patients did not undergo ACT. 15 of 41 patients had echocardiographic evidence of acute cor pulmonale. 8 patients died within 30 days. The RV D was the best independent predictor of acute cor pulmonale (p = 0,002, OR = 9.16, PPV = 0.68, NPV=1 at 4.49 cm cut off) and short-term outcome (p= 0,0005, OR = 2.82, PPV = 0.23, NPV = 0.98 at 4.75 cm cut off). The RV D /LV D ratio had a PPV of 0.85 for cor pulmonale. (orig.)
Unenhanced MR Imaging in adults with clinically suspected acute appendicitis
DEFF Research Database (Denmark)
Chabanova, Elizaveta; Balslev, Ingegerd; Achiam, Michael
2011-01-01
PURPOSE: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. MATERIALS...... radiologists and one surgeon independent of each other and compared with surgical and pathological records. RESULTS: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14...... patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate (kappa=0.51) and fair (kappa=0.31) interobserver agreements in the MR diagnosis of acute...
The impact of ultrasound in suspected acute appendicitis
International Nuclear Information System (INIS)
Gracey, D.; McClure, M.J.
2007-01-01
Aims: To evaluate prospectively the impact of an appendix ultrasound (US) service on the clinical management of patients presenting with suspected acute appendicitis. Materials and methods: The referring clinician completed a proforma for patients presenting with suspected acute appendicitis. Two visual analogue scales assessed clinical suspicion before and after knowledge of laboratory results. The clinician also indicated if they intended to operate had US been unavailable. During a 3-year period, 327 patients were examined by graded-compression US and diagnosed 'positive' or 'negative' for acute appendicitis. Findings were correlated with histopathology results. The referring clinician completed a retrospective audit questionnaire to assess user satisfaction. Results: Clinical suspicion was altered by knowledge of laboratory results. The decision to operate if US had been unavailable, was 'yes' in 70 cases (group A), 'no' in 231 (group B), and incomplete in 26 (group C). In group A, 31 patients (44.3%) had a negative US and 25 avoided surgery. US identified 39 cases of appendicitis and 37 appendicectomies confirmed appendicitis in 34 cases. In group B, 72 (31.2%) patients had a positive US and 66 appendicectomies confirmed 51 cases of appendicitis. The sensitivity of US was 94.7% in group A, 93.3% in group B and 93.8% overall. Specificity was 90.6% in group A, 91.2% in group B and 91.3% overall. US findings were contrary to intended surgical management in 103 cases. Management was altered in 97 cases (32.2%), with a positive outcome in 85 (28.2%). The referrers found US of appendix very useful in planning appropriate management. Conclusion: US of the appendix increases diagnostic accuracy, alters management and is more sensitive and specific than clinical impression, either alone, or in conjunction with laboratory results
Duplex scanning in the diagnosis of acute deep vein thrombosis of the lower extremity
van Ramshorst, B.; Legemate, D. A.; Verzijlbergen, J. F.; Hoeneveld, H.; Eikelboom, B. C.; de Valois, J. C.; Meuwissen, O. J.
1991-01-01
In a prospective study the value of duplex scanning in the diagnosis of acute femoro-popliteal thrombosis was compared to conventional contrast venography (CV) as a gold standard. A total of 126 legs in 117 patients suspected of having deep vein thrombosis (DVT) or pulmonary embolism (PE) were
Triage for suspected acute Pulmonary Embolism: Think before opening Pandora's Box
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Levin, David [Department of Radiology, Mayo Clinic, Rochester, MN (United States); Seo, Joon Beom [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kiely, David G. [Sheffield Pulmonary Vascular Disease Unit, M-15, M-Floor, Royal Hallamshire Hospital, Sheffield (United Kingdom); Hatabu, Hiroto [Department of Radiology, Brigham and Women' s Hospital and Harvard Medical School Boston, MA (United States); Gefter, Warren [Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States); Beek, Edwin J.R. van [Clinical Research Imaging Centre, University of Edinburgh, Scotland (United Kingdom); Schiebler, Mark L., E-mail: mschiebler@uwhealth.org [Department of Radiology, UW-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252 (United States)
2015-06-15
This is a review of the current strengths and weaknesses of the various imaging modalities available for the diagnosis of suspected non-massive Pulmonary Embolism (PE). Without careful consideration for the clinical presentation, and the timely application of clinical decision support (CDS) methodology, the current overutilization of imaging resources for this disease will continue. For a patient with a low clinical risk profile and a negative D-dimer there is no reason to consider further workup with imaging; as the negative predictive value in this scenario is the same as imaging. While the current efficacy and effectiveness data support the continued use of Computed Tomographic angiography (CTA) as the imaging golden standard for the diagnosis of PE; this test does have the unintended consequences of radiation exposure, possible overdiagnosis and overuse. There is a persistent lack of appreciation on the part of ordering physicians for the effectiveness of the alternatives to CTA (ventilation–perfusion imaging and contrast enhanced magnetic resonance angiography) in these patients. Careful use of standardized protocols for patient triage and the application of CDS will allow for a better use of imaging resources.
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Bossuyt Patrick MM
2010-10-01
Full Text Available Abstract Background In patients with clinically suspected appendicitis, imaging is needed to substantiate the clinical diagnosis. Imaging accuracy of ultrasonography (US is suboptimal, while the most accurate technique (CT is associated with cancer related deaths through exposure to ionizing radiation. MRI is a potential replacement, without associated ionizing radiation and no need for contrast medium administration. If MRI is proven to be sufficiently accurate, it could be introduced in the diagnostic pathway of patients with suspected appendicitis, increasing diagnostic accuracy and improving clinical outcomes, without the risk of radiation induced cancer or iodinated contrast medium-related drawbacks. The multicenter OPTIMAP study was designed to estimate the diagnostic accuracy of MRI in patients with suspected acute appendicitis in the general population. Methods/Design Eligible for this study are consecutive patients presenting with clinically suspected appendicitis at the emergency department in six centers. All patients will undergo imaging according to the Dutch guideline for acute appendicitis: initial ultrasonography in all and subsequent CT whenever US does not confirm acute appendicitis. Then MRI is performed in all patients, but the results are not used for patient management. A final diagnosis assigned by an expert panel, based on all available information including 3-months follow-up, except MRI findings, is used as the reference standard in estimating accuracy. We will calculate the sensitivity, specificity, predictive values and inter-observer agreement of MRI, and aim to include 230 patients. Patient acceptance and total imaging costs will also be evaluated. Discussion If MRI is found to be sufficiently accurate, it could replace CT in some or all patients. This will limit or obviate the ionizing radiation exposure associated risk of cancer induction and contrast medium induced nephropathy with CT, preventing the burden and
International Nuclear Information System (INIS)
Chowdhury, F.U.; Kotwal, S.; Raghunathan, G.; Wah, T.M.; Joyce, A.; Irving, H.C.
2007-01-01
Aim: To evaluate a new imaging pathway for the investigation of patients presenting with suspected acute renal colic. Materials and methods: A retrospective review of 500 consecutive cases of suspected acute renal colic was undertaken to evaluate the initial results of a new imaging pathway introduced at our institution, which completely replaced the intravenous urogram (IVU) with unenhanced multidetector CT (CT KUB). Results: The positive rate for urolithiasis was 44% (221/500), the negative rate 46% (229/500) and the rate of other significant findings was 12% (59/500). Female patients had a low positive rate compared with male patients (27.5 versus 57.5%; p < 0.001). Urological intervention was required in 28% (61/221) and these patients had a larger average stone size (6.6 versus 3.7 mm; p < 0.001) and the stone was located more proximally. Out-of-hours imaging was performed in 37% (186/500), and these patients had a higher positive rate (52 versus 40%; p < 0.001). Other findings included a wide range of acute non-urological conditions. Conclusion: The feasibility of replacing the acute IVU with CT KUB in the initial assessment of suspected acute renal colic was demonstrated in the present study. The technique enables rapid diagnosis of urolithiasis, stratification of patients likely to proceed to urological intervention, and prompt diagnosis of a variety of other acute pathological conditions
Improving the diagnostic performance of lung scintigraphy in suspected pulmonary embolic disease
International Nuclear Information System (INIS)
Gleeson, F.V.; Turner, S.; Scarsbrook, A.F.
2006-01-01
Aim: to determine the effectiveness of a new imaging algorithm in the investigation of suspected pulmonary embolism (PE). Materials and methods: A new imaging algorithm for suspected PE was introduced following the installation of a multisection computed tomography (CT) machine at our institution. Before its installation, patients with suspected PE were evaluated with ventilation/perfusion (V/Q) scintigraphy. Subsequently, patients were triaged according to chest radiography (CR) and respiratory history to either lung scintigraphy or CT pulmonary angiography (CTPA). Patients with a normal CR and no history of lung disease were evaluated using perfusion (Q) scintigraphy [ventilation (V) scintigraphy was no longer performed]. Patients with an abnormal CR, asthma or chronic lung disease were evaluated using CTPA. All V/Q images in a continuous 3-year period before the introduction of the new imaging algorithm and all Q images performed in a 3-year period after its introduction were retrospectively reviewed. Imaging reports were categorized into normal, non-diagnostic (low or intermediate probability) or high probability for PE. Patients in the later group who subsequently underwent CTPA, were also reviewed. Results: After the policy change the percentage of normal scintigrams significantly increased (39 to 60%; p < 0.001). There was a non-significant increase in the percentage of high probability scintigrams (15 to 18%; p = 0.716). Overall the diagnostic yield of lung scintigraphy improved significantly (54 to 78%; p < 0.001). Conclusion: the diagnostic performance of lung scintigraphy can be improved by careful triage of patients to either Q scintigraphy or CTPA based on clinical history and CR findings. Q scintigraphy remains a valuable diagnostic test in the investigation of suspected PE in carefully selected patients
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Wolfe Rory
2006-06-01
Full Text Available Abstract Background The objective of this paper is to estimate the amount of cost-savings to the Australian health care system from implementing an evidence-based clinical protocol for diagnosing emergency patients with suspected pulmonary embolism (PE at the Emergency department of a Victorian public hospital with 50,000 presentations in 2001–2002. Methods A cost-minimisation study used the data collected in a controlled clinical trial of a clinical protocol for diagnosing patients with suspected PE. Thenumber and type of diagnostic tests in a historic cohort of 185 randomly selected patients, who presented to the emergency department with suspectedPE during an eight month period prior to the clinical trial (January 2002 -August 2002 were compared with the number and type of diagnostic tests in745 patients, who presented to the emergency department with suspected PE from November 2002 to August 2003. Current Medicare fees per test were usedas unit costs to calculate the mean aggregated cost of diagnostic investigation per patient in both study groups. A t-test was used to estimate the statistical significance of the difference in the cost of resources used for diagnosing PE in the control and in the intervention group. Results The trial demonstrated that diagnosing PE using an evidence-based clinical protocol was as effective as the existing clinical practice. The clinical protocol offers the advantage of reducing the use of diagnostic imaging, resulting in an average cost savings of at least $59.30 per patient. Conclusion Extrapolating the observed cost-savings of $59.30 per patient to the wholeof Australia could potentially result in annual savings between $3.1 million to $3.7 million.
Abdominal CT Does Not Improve Outcome for Children with Suspected Acute Appendicitis
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Danielle I. Miano
2015-12-01
Full Text Available Introduction: Acute appendicitis in children is a clinical diagnosis, which often requires preoperative confirmation with either ultrasound (US or computed tomography (CT studies. CTs expose children to radiation, which may increase the lifetime risk of developing malignancy. US in the pediatric population with appropriate clinical follow up and serial exam may be an effective diagnostic modality for many children without incurring the risk of radiation. The objective of the study was to compare the rate of appendiceal rupture and negative appendectomies between children with and without abdominal CTs; and to evaluate the same outcomes for children with and without USs to determine if there were any associations between imaging modalities and outcomes. Methods: We conducted a retrospective chart review including emergency department (ED and inpatient records from 1/1/2009–2/31/2010 and included patients with suspected acute appendicitis. Results: 1,493 children, aged less than one year to 20 years, were identified in the ED with suspected appendicitis. These patients presented with abdominal pain who had either a surgical consult or an abdominal imaging study to evaluate for appendicitis, or were transferred from an outside hospital or primary care physician office with the stated suspicion of acute appendicitis. Of these patients, 739 were sent home following evaluation in the ED and did not return within the subsequent two weeks and were therefore presumed not to have appendicitis. A total of 754 were admitted and form the study population, of which 20% received a CT, 53% US, and 8% received both. Of these 57%, 95% CI [53.5,60.5] had pathology-proven appendicitis. Appendicitis rates were similar for children with a CT (57%, 95% CI [49.6,64.4] compared to those without (57%, 95% CI [52.9,61.0]. Children with perforation were similar between those with a CT (18%, 95% CI [12.3,23.7] and those without (13%, 95% CI [10.3,15.7]. The proportion of
V/P SPECT as a diagnostic tool for pregnant women with suspected pulmonary embolism
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Bajc, Marika; Olsson, Berit; Joegi, Jonas [Skaane University Hospital and Lund University, Clinical Physiology and Nuclear Medicine, Lund (Sweden); Gottsaeter, Anders [Skaane University Hospital, Vascular Diseases, Malmoe (Sweden); Hindorf, Cecilia [Skaane University Hospital, Radiation Physics, Lund (Sweden)
2015-07-15
The purpose of the study was to assess the prevalence of pulmonary embolism (PE) and other lung diseases among pregnant women with suspected PE and to calculate the radiation exposure to patient and fetus in this population. As a secondary aim, we evaluated the negative predictive value of a normal ventilation/perfusion single photon emission computed tomography (V/P SPECT) examination in pregnancy. We studied all 127 pregnant women who had suspected PE and had undergone V/P SPECT at our institution in the course of a 5-year period. Radiation exposure to patient and fetus and the negative predictive value of a normal V/P SPECT examination were also measured. V/P SPECT identified PE in 11 women (9 %). Moreover, in 15 women (12 %) the examination revealed pneumonia (in 2 cases in addition to PE) and in 1 woman signs of airway obstruction were revealed. Among the 116/127 women (91 %) where PE was ruled out by V/P SPECT, none was diagnosed subsequently with PE or deep venous thrombosis (DVT) during the same pregnancy or puerperal period. For P SPECT, the calculated fetal absorbed dose was < 0.6 mGy,and the calculated breast absorbed dose 0.6 mGy. For V SPECT, the calculated fetal absorbed dose was < 0.014 mGy and the breast absorbed dose 0.25 mGy. The prevalence of PE was low (9 %) among pregnant women with suspected disease. Pneumonia was diagnosed in 12 % of patients. The negative predictive value of V/P SPECT was high, and the radiation exposure from V/P SPECT was low both for fetus and patient. (orig.)
Optimisation of the MR protocol in pregnant women with suspected acute appendicitis
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Shin, Ilah; Chung, Yong Eun; An, Chansik; Kim, Honsoul; Lim, Joon Seok; Kim, Myeong-Jin [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Seoul (Korea, Republic of); Lee, Hye Sun [Yonsei University College of Medicine, Department of Research Affairs, Biostatistics Collaboration Unit, Seoul (Korea, Republic of)
2018-02-15
To investigate the optimal magnetic resonance (MR) imaging protocol in pregnant women suspected of having acute appendicitis. One hundred and forty-six pregnant women with suspected appendicitis were included. MR images were reviewed by two radiologists in three separate sessions. In session 1, only axial single-shot turbo spin echo (SSH-TSE) T2-weighted images (WI) were included with other routine sequences. In sessions 2 and 3, coronal and sagittal T2WI were sequentially added. The visibility of the appendix and diagnostic confidence of appendicitis were evaluated in each session using a 5-point grading scale. If diseases other than appendicitis were suspected, specific diagnosis with a 5-point confidence scale was recorded. Diagnostic performance for appendicitis and other diseases were evaluated. Twenty-five patients (17.1%) were diagnosed with appendicitis. Among the patients with normal appendix, 28 were diagnosed with other disease. Diagnostic performance including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve values for diagnosing appendicitis and other diseases showed no significant difference among sets for both reviewers (p>0.05). Diagnostic performance of MR in pregnant patients with suspected appendicitis can be preserved with omission of sagittal or both coronal and sagittal SSH-T2WI. (orig.)
Optimisation of the MR protocol in pregnant women with suspected acute appendicitis
International Nuclear Information System (INIS)
Shin, Ilah; Chung, Yong Eun; An, Chansik; Kim, Honsoul; Lim, Joon Seok; Kim, Myeong-Jin; Lee, Hye Sun
2018-01-01
To investigate the optimal magnetic resonance (MR) imaging protocol in pregnant women suspected of having acute appendicitis. One hundred and forty-six pregnant women with suspected appendicitis were included. MR images were reviewed by two radiologists in three separate sessions. In session 1, only axial single-shot turbo spin echo (SSH-TSE) T2-weighted images (WI) were included with other routine sequences. In sessions 2 and 3, coronal and sagittal T2WI were sequentially added. The visibility of the appendix and diagnostic confidence of appendicitis were evaluated in each session using a 5-point grading scale. If diseases other than appendicitis were suspected, specific diagnosis with a 5-point confidence scale was recorded. Diagnostic performance for appendicitis and other diseases were evaluated. Twenty-five patients (17.1%) were diagnosed with appendicitis. Among the patients with normal appendix, 28 were diagnosed with other disease. Diagnostic performance including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve values for diagnosing appendicitis and other diseases showed no significant difference among sets for both reviewers (p>0.05). Diagnostic performance of MR in pregnant patients with suspected appendicitis can be preserved with omission of sagittal or both coronal and sagittal SSH-T2WI. (orig.)
Four therapeutic cases of RS3PE syndrome
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Nakajima, Naoya; Fukuda, Yukiko; Yang, Kwang-Seok; Aiba, Miyoji; Tsuda, Hiroshi
2007-01-01
RS3PE syndrome (Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome) is one of the disorders which present as polyarthritis. It is important to be aware of RS3PE syndrome when encountering elderly patients with polyarthritis who are negative for rheumatoid factor. We report 4 cases of RS3PE syndrome. All cases shared common clinical findings, such as acute onset, symmetrical polyarthritis, pitting edema of the hands and feet, and being negative for rheumatoid factor in serum. Treatment with corticosteroid was very effective in all cases. However, two patients showed a deteriorated clinical condition during the tapering of corticosteroid. Corticosteroid should be tapered off cautiously in patients with RS3PE syndrome. (author)
Kline, Jeffrey A; Neumann, Dawn; Hall, Cassandra L; Capito, Jacob
2017-02-01
Many clinicians use a global visual interpretation of patient appearance to decide if a patient looks sick or not. For patients with suspected acute pulmonary embolism (PE), we tested the relationship between visual appearance of a happy patient facial affect and probability of PE+ on CT pulmonary angiography (CTPA). Eligible patients were selected by usual care to undergo CTPA, the criterion standard for PE+ or PE-. Prior to CTPA result, trained study personnel obtained physician pretest probability using the gestalt method (visual analogue scale, 0%-100%), the Wells score (0-12) and physicians' impression of whether the patient smiled during the initial examination (smile+). Patients' faces were also video recorded and analysed with an automated neural network-based algorithm (Noldus FaceReader) for happy affect. Of the 208 patients enrolled, 27 were PE+ and smile+ was more frequent in patients with PE+ than PE-, a finding confirmed by the Noldus. The diagnostic sensitivity and specificity of smile was low, and physicians overestimated presence of an alternative diagnosis more likely to PE with smile+ than smile- patients in patients with true PE. As a result, the area under the receiver operating characteristic curve (AUROC) was lower for the Wells score in smile+ patients. However, the physicians' mean gestalt estimate of PE did not differ with smile status, nor did smile status affect the AUROC for gestalt. In patients with suspected PE, physician recollection of patients' smile+ was more common in PE+ patients, and was associated with a less accurate Wells score, primarily because physicians overestimated probability of alternative diagnosis. However, the overall diagnostic accuracy of physicians' gestalt did not differ with perceived smile status. These data suggest that the patients' smile had less effect on the numeric gestalt pretest probability assessment than on the binary decision about an alternative diagnosis. Published by the BMJ Publishing Group
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Jacob Ortiz
2017-01-01
Full Text Available Risk assessment for pulmonary embolism (PE currently relies on physician judgment, clinical decision rules (CDR, and D-dimer testing. There is still controversy regarding the role of D-dimer testing in low or intermediate risk patients. The objective of the study was to define the role of clinical decision rules and D-dimer testing in patients suspected of having a PE. Records of 894 patients referred for computed tomography pulmonary angiography (CTPA at a University medical center were analyzed. The clinical decision rules overall had an ROC of approximately 0.70, while signs of DVT had the highest ROC (0.80. A low probability CDR coupled with a negative age-adjusted D-dimer largely excluded PE. The negative predictive value (NPV of an intermediate CDR was 86–89%, while the addition of a negative D-dimer resulted in NPVs of 94%. Thus, in patients suspected of having a PE, a low or intermediate CDR does not exclude PE; however, in patients with an intermediate CDR, a normal age-adjusted D-dimer increases the NPV.
International Nuclear Information System (INIS)
Anwar, M.W.; Abid, I.
2012-01-01
Objective: To compare the diagnostic accuracy of Total Leucocytes Count (TLC) with Neutrophil count; Differential Leucocytes Count (DLC) in diagnosing cases of suspected acute appendicitis. Study design: Validation study. Place and duration of the study: Department of Surgery, Combined Military Hospital (CMH) Rawalpindi, from April 2008 to October 2008. Method: A total of 100 patients of Pain right iliac fossae who underwent appendicectomy were included. Detailed history of all the patients was taken for pain in right lower abdomen, its severity, its nature, relieving or provoking factors. Clinical examination was done in detail. Total and Differential Leucocytes Count was done. Every patient's appendix was examined grossly after appendicectomy for evidence of appendicitis. Diagnostic measures of TLC and DLC were calculated by standard formulas. Results: Sensitivity and specificity of TLC is 86.9% and 81.25% respectively and that of DLC is 82% and 68.75% respectively. Accuracy was 86% for TLC and 80% for DLC. Conclusion: TLC is more sensitive, specific and accurate test as compared to DLC and it should be used as diagnostic aid for suspected acute appendicitis cases. (author)
Directory of Open Access Journals (Sweden)
Nick Kennedy
2015-01-01
Full Text Available Aims. To study the use of CT pulmonary angiography (CTPA at Hutt Hospital and investigate the use of pretest probability scoring in the assessment of patients with suspected pulmonary embolism (PE. Methods. We studied patients with suspected PE that underwent CTPA between January and May 2012 and collected data on demographics, use of pretest probability scoring, and use of D Dimer and compared our practice with the British Thoracic Society (BTS guideline. Results. 105 patients underwent CTPA and 15% of patients had PE. 13% of patients had a Wells score prior to their scan. Wells score calculated by researchers revealed 54%, 36%, and 8% patients had low, medium, and high risk pretest probabilities and 8%, 20%, and 50% of these patients had positive scans. D Dimer was performed in 58% of patients and no patients with a negative D Dimer had a PE. Conclusion. The CTPA positive rate was similar to other contemporary studies but lower than previous New Zealand studies and some international guidelines. Risk stratification of suspected PE using Wells score and D Dimer was underutilised. A number of scans could have been safely avoided by using accepted guidelines reducing resources use and improving patient safety.
Unenhanced MR Imaging in adults with clinically suspected acute appendicitis
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Chabanova, Elizaveta, E-mail: elcha@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Balslev, Ingegerd, E-mail: inbal@heh.regionh.dk [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Achiam, Michael, E-mail: micach01@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Nielsen, Yousef W., E-mail: yujwni01@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Adamsen, Sven, E-mail: svad@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Gocht-Jensen, Peter, E-mail: petgoc01@heh.reginh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Brisling, Steffen K., E-mail: stkibr01@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Logager, Vibeke B., E-mail: viloe@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Thomsen, Henrik S., E-mail: heth@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark)
2011-08-15
Purpose: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. Materials and methods: The prospective study included 48 consecutive patients (29 female, 19 male, 18-70 years old, mean age = 37.1 years). MRI examination was designed to be comfortable and fast; no contrast was administered. The sequences were performed during quiet respiration. The MRI findings were reviewed by two radiologists and one surgeon independent of each other and compared with surgical and pathological records. Results: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14 patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate ({kappa} = 0.51) and fair ({kappa} = 0.31) interobserver agreements in the MR diagnosis of acute appendicitis were found between the reviewers. Sensitivity, specificity and accuracy values for overall performance of MRI in detecting pelvic abnormalities were 100%, 75% (3 of 4 healthy patients were identified by MRI) and 98%, respectively. Conclusion: Unenhanced fast MRI is feasible as an additional fast screening before the appendectomy. It may prevent unnecessary surgeries. The fast MRI examination can be adequately performed on an MRI unit of broad range of field strengths.
International Nuclear Information System (INIS)
Buckley, B.T.; Wainwright, A.; Meagher, T.; Briley, D.
2003-01-01
AIM: To audit the feasibility and use of diffusion-weighted (DW) magnetic resonance imaging (MRI) as initial neuroimaging for in-patients with clinically suspected acute stroke. MATERIALS AND METHODS: In April 2000, MRI with DW and T2-weighted sequence was locally instituted as initial neuroimaging for patients with clinically suspected acute stroke. This retrospective study reviewed imaging performed for in-patients with suspected acute stroke over a 9-month period. Data were collected on image type, result and need for repeat imaging. RESULTS: During the study period, 124 patients had neuroimaging for suspected cerebrovascular accident, and 119 were MRI safe. Eighty-eight (73.9%) patients underwent DW MRI as first-line investigation. Five patients were not MRI safe and 31 had computed tomography (CT) as first-line imaging due to lack of available MRI capacity. Repeat neuroimaging was performed in 16 (12.9%) patients. Study times were comparable for both types of neuroimaging: a mean of 13 min for MRI and 11 min for CT. CONCLUSION: The audit standard was achieved in 88 (73.9%) patients. The use of DW MRI as a first-line investigation for patients with a clinical diagnosis of acute stroke is achievable in a district general hospital setting
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Buckley, B.T.; Wainwright, A.; Meagher, T.; Briley, D
2003-03-01
AIM: To audit the feasibility and use of diffusion-weighted (DW) magnetic resonance imaging (MRI) as initial neuroimaging for in-patients with clinically suspected acute stroke. MATERIALS AND METHODS: In April 2000, MRI with DW and T2-weighted sequence was locally instituted as initial neuroimaging for patients with clinically suspected acute stroke. This retrospective study reviewed imaging performed for in-patients with suspected acute stroke over a 9-month period. Data were collected on image type, result and need for repeat imaging. RESULTS: During the study period, 124 patients had neuroimaging for suspected cerebrovascular accident, and 119 were MRI safe. Eighty-eight (73.9%) patients underwent DW MRI as first-line investigation. Five patients were not MRI safe and 31 had computed tomography (CT) as first-line imaging due to lack of available MRI capacity. Repeat neuroimaging was performed in 16 (12.9%) patients. Study times were comparable for both types of neuroimaging: a mean of 13 min for MRI and 11 min for CT. CONCLUSION: The audit standard was achieved in 88 (73.9%) patients. The use of DW MRI as a first-line investigation for patients with a clinical diagnosis of acute stroke is achievable in a district general hospital setting.
Faggioni, L; Neri, E; Bargellini, I; Scalise, P; Calcagni, F; Mantarro, A; D'Ippolito, G; Bartolozzi, C
2015-03-01
To evaluate the effectiveness of the iPad (Apple Inc., Cupertino, CA) for two-dimensional (2D) reading of CT angiography (CTA) studies performed for suspected acute non-variceal gastrointestinal bleeding. 24 CTA examinations of patients with suspected acute gastrointestinal bleeding confirmed (19/24, 79.2%) or ruled out (5/24, 20.8%) by digital subtraction angiography (DSA) were retrospectively reviewed by three independent readers on a commercial picture archiving communication system (PACS) workstation and on an iPad with Retina Display® 64 GB (Apple Inc.). The time needed to complete reading of every CTA examination was recorded, as well as the rate of detection of arterial bleeding and identification of suspected bleeding arteries on both devices. Overall, the area under the receiver operating characteristic curve, sensitivity, specificity, positive- and negative-predictive values for bleeding detection were not significantly different while using the iPad and workstation (0.774 vs 0.847, 0.947 vs 0.895, 0.6 vs 0.8, 0.9 vs 0.944 and 0.750 vs 0.667, respectively; p > 0.05). In DSA-positive cases, the iPad and workstation allowed correct identification of the bleeding source in 17/19 cases (89.5%) and 15/19 cases (78.9%), respectively (p > 0.05). Finally, the time needed to complete reading of every CTA study was significantly shorter using the iPad (169 ± 74 vs 222 ± 70 s, respectively; p < 0.01). Compared with a conventional PACS workstation, iPad-based preliminary 2D reading of CTA studies has comparable diagnostic accuracy for detection of acute gastrointestinal bleeding and can be significantly faster. The iPad could be used by on-call interventional radiologists for immediate decision on percutaneous embolization in patients with suspected acute gastrointestinal bleeding.
International Nuclear Information System (INIS)
Pruszczyk, P.; Torbicki, A.; Pacho, R.
1998-01-01
Patients with pulmonary embolism (PE) and echocardiographic signs of right ventricular over-lead have worse prognosis and may be require aggressive therapy. Unequivocal confirmation of PE is required before thrombolysis or embolectomy. This study compares the value of trans-esophageal echocardiography (TEE) and spiral CT (sCT) in direct visualization of pulmonary artery thrombo-emboli in patients with suspected PE and echocardiographic signs of right ventricular over-lead. Because of high prevalence of bilateral central pulmonary thrombo-emboli in patients with hemo-dynamically significant PE, both sCT and TEE allow its definitive confirmation in most cases. Thrombi reported by sCT distally to lobar arteries should be interpreted with caution. (author)
Den Exter, Paul L.; Van Es, Josien; Erkens, Petra M.G.; Van Roosmalen, Mark J.G.; Van Den Hoven, Pim; Hovens, Marcel M.C.; Kamphuisen, Pieter W.; Klok, Frederikus A.; Huisman, Menno V.
2013-01-01
Rationale: The nonspecific clinical presentation of pulmonary embolism (PE) frequently leads to delay in its diagnosis. Objectives: This study aimed to assess the impact of delay in presentation on the diagnostic management and clinical outcome of patients with suspected PE. Methods: In 4,044
Den Exter, P. L.; Van Es, J.; Erkens, P. G. M.; Roosmalen, M.; Hoven, P.; Hovens, M.; Kamphuisen, P. W.; Klok, F. A.; Huisman, M.
Background: The non-specific clinical presentation of pulmonary embolism (PE) frequently leads to delay in its diagnosis. Aims: To assess the impact of delay in presentation on the diagnostic management and clinical outcome of patients with suspected PE. Methods: For this post-hoc analysis, we used
International Nuclear Information System (INIS)
Bauer, Ralf W.; Kerl, J. Matthias; Weber, Eva; Weisser, Philipp; Korkusuz, Huedayi; Lehnert, Thomas; Jacobi, Volkmar; Vogl, Thomas J.
2011-01-01
Purpose: On lung perfusion analysis with dual energy CT (DECT) in patients with suspected pulmonary embolism (PE) commonly three patterns of perfusion defects (PD) are observed: wedge-shaped, circumscribed but not wedge-shaped, and patchy. We investigated the influence of different window settings on the identification of the underlying pathologies for these types of PD. Materials and methods: 3724 segments in 196 consecutive patients who underwent pulmonary DECT angiography for clinically suspected acute PE were analyzed. Iodine distribution in the lung parenchyma was calculated from the dual energy data and displayed as color map in axial, sagittal and coronal view. Afterwards, lung and angiography window were applied separately and assessed for pulmonary embolism and pathologies of the lung parenchyma. Results: 1420 segments in 141 patients showed PD, of which 276 were wedge-shaped, 287 circumscribed and 857 patchy. Circumscribed PD were associated in 99% with interstitial or alveolar fluid collections and in 1% with located bullae. Patchy PD were associated in 65% with emphysematous or fibrotic changes, in 38% with diffuse infiltrations or interstitial fluid collections and in 0.2% with PE. The underlying pathologies for wedge-shaped PD were in 78% PE, in 3% tumors compressing pulmonary arteries, in another 3% located bullae and in further 3% infiltrations. 13% (n = 15) of the segments in this group did not show vascular or parenchymal pathologies, but in 80% (n = 10) of these cases patients had PE in another segment. Totally n = 6 of wedge-shaped PD in 5 patients remained with unclear direct cause. Conclusion: Whereas patchy and circumscribed PD are almost exclusively associated with pathologies of the lung parenchyma, wedge-shaped PD are mostly associated with PE. For a small number of wedge-shaped PD the underlying cause cannot be detected with DECT. Very small peripherally situated micro-emboli may be discussed as a reason. However, prospective trials are
Recovery of right and left ventricular function after acute pulmonary embolism
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Klok, F.A., E-mail: f.a.klok@lumc.nl [Section of Vascular Medicine, Department of General Internal Medicine-Endocrinology, Leiden University Medical Center, Leiden (Netherlands); Romeih, S. [Department of Cardiology, Leiden University Medical Center, Leiden (Netherlands); Kroft, L.J.M.; Westenberg, J.J.M. [Department of Radiology, Leiden University Medical Center, Leiden (Netherlands); Huisman, M.V. [Section of Vascular Medicine, Department of General Internal Medicine-Endocrinology, Leiden University Medical Center, Leiden (Netherlands); Roos, A. de [Department of Radiology, Leiden University Medical Center, Leiden (Netherlands)
2011-12-15
Aim: To evaluate recovery of cardiac function after acute pulmonary embolism (PE). Materials and methods: Routine breath-held computed tomography (CT)-pulmonary angiography was performed in patients with suspected PE to confirm or exclude the diagnosis of PE at initial presentation. Electrocardiogram (ECG)-triggered cardiac CT was performed to assess biventricular function. After 6 months, cardiac magnetic resonance imaging (MRI) was performed. In total, 15 consecutive patients with PE and 10 without were studied. A significant change in ventricular volume was defined as a >15% change in end-diastolic or -systolic volumes (EDV, ESV), and significant ventricular function improvement as a >5% increase in ejection fraction (EF) as based on reported cut-off values. Results: Right and left ventricular (RV and LV) EDV and ESV changed non-significantly (<1.3%) in the patients without PE, indicating good comparability of those values measured by CT and MRI. PE patients with baseline normal RV function (RVEF {>=}47%) revealed a >5% improvement in the RVEF (+5.4 {+-} 3.1%) due to a decrease in the RVESV. Patients with baseline abnormal RV function showed a >5% improvement in the RVEF (+14 {+-} 15%) due to decreases in both the RVESV and RVEDV. Furthermore, the LVEDV increased in this latter patient group. Conclusions: The present study demonstrated an improvement in RV function in the majority of patients with PE, independent of baseline RV function. The degree of RV and LV recovery was dependent on the severity of baseline RV dysfunction.
Directory of Open Access Journals (Sweden)
Rita C. Silveira
2001-12-01
Full Text Available OBJETIVOS: avaliar os escores SNAP e SNAP-PE como preditores de mortalidade neonatal na nossa UTI neonatal, comparando seus resultados. MÉTODOS: todos os recém-nascidos admitidos na UTI neonatal no período de março de 1997 a dezembro de 1998 foram avaliados prospectivamente quanto ao SNAP e SNAP-PE com 24 horas de vida. Foram critérios de exclusão o óbito ou alta da UTI nas primeiras 24 horas de vida, as malformações congênitas incompatíveis com a vida, e recém-nascidos transferidos de outros hospitais. RESULTADOS: 553 recém-nascidos foram incluídos, 54 faleceram. Os valores das medianas do SNAP e SNAP-PE foram mais elevados naqueles que não sobreviveram. Os recém-nascidos foram divididos em cinco faixas de gravidade crescente de SNAP e SNAP-PE. SNAP: até 6, 7-11, 12-15, 16-24, acima de 24 (mortalidade: 3%, 11%, 29%, 48%, 75%, respectivamente. SNAP-PE: até 11, 12-23, 24-32, 33-50, acima de 50 (mortalidade: 3%, 10%, 53%, 78%, 83%, respectivamente. A partir da Curva ROC, os pontos de corte foram 12 para SNAP e 24 para SNAP-PE, obtendo-se sensibilidade, especificidade, valor preditivo positivo (VPP e valor preditivo negativo (VPN para mortalidade. SNAP 12: sensibilidade 79,6%, especificidade 71,7%, VPP 23,4%, VPN 97%. SNAP-PE 24: sensibilidade 79,6%, especificidade 80%, VPP 30%, VPN 97,3%. A área abaixo da Curva ROC (Az para SNAP foi 81,4% e para SNAP-PE 85,1%, ambas estatisticamente significativas. A comparação entre as áreas das duas curvas não evidenciou diferença estatisticamente significativa. CONCLUSÕES: os escores SNAP e SNAP-PE são excelentes preditores de sobrevida neonatal, recomendamos sua utilização rotineiramente na admissão de recém-nascidos nas Unidades de Tratamento Intensivo Neonatal.OBJECTIVE: to evaluate the Score for Neonatal Acute Physiology and the Score for Neonatal Acute Physiology Perinatal Extension as neonatal mortality predictors in our neonatal intensive care unit, and to compare their
Rational clinical evaluation of suspected acute coronary syndromes: The value of more information.
Hancock, David G; Chuang, Ming-Yu Anthony; Bystrom, Rebecca; Halabi, Amera; Jones, Rachel; Horsfall, Matthew; Cullen, Louise; Parsonage, William A; Chew, Derek P
2017-12-01
Many meta-analyses have provided synthesised likelihood ratio data to aid clinical decision-making. However, much less has been published on how to safely combine clinical information in practice. We aimed to explore the benefits and risks of pooling clinical information during the ED assessment of suspected acute coronary syndrome. Clinical information on 1776 patients was collected within a randomised trial conducted across five South Australian EDs between July 2011 and March 2013. Bayes theorem was used to calculate patient-specific post-test probabilities using age- and gender-specific pre-test probabilities and likelihood ratios corresponding to the presence or absence of 18 clinical factors. Model performance was assessed as the presence of adverse cardiac outcomes among patients theoretically discharged at a post-test probability less than 1%. Bayes theorem-based models containing high-sensitivity troponin T (hs-troponin) outperformed models excluding hs-troponin, as well as models utilising TIMI and GRACE scores. In models containing hs-troponin, a plateau in improving discharge safety was observed after the inclusion of four clinical factors. Models with fewer clinical factors better approximated the true event rate, tended to be safer and resulted in a smaller standard deviation in post-test probability estimates. We showed that there is a definable point where additional information becomes uninformative and may actually lead to less certainty. This evidence supports the concept that clinical decision-making in the assessment of suspected acute coronary syndrome should be focused on obtaining the least amount of information that provides the highest benefit for informing the decisions of admission or discharge. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
DEFF Research Database (Denmark)
Clark, Elaine N; Ripa, Maria Sejersten; Clemmensen, Peter
2010-01-01
The aims of this study were to assess the effectiveness of 2 automated electrocardiogram interpretation programs in patients with suspected acute coronary syndrome transported to hospital by ambulance in 1 rural region of Denmark with hospital discharge diagnosis used as the gold standard...
Acute aortic dissection in patient with suspected pheochromocytoma
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Lešanović Jelena
2016-01-01
Full Text Available Introduction: Aortic dissection is one of the most fatal vascular emergencies. Almost 40% of the patients do not reach hospital in time while more than quarter die in the first 24 hours after the dissection begins. Case Report: A 37-year old man was admitted to our hospital with severe anterior chest pain which had lasted for over a week. Suspected aortic dissection was rapidly confirmed using imaging modalities - MDCT chest scan and TTE, followed by an urgent surgical management - Bentall procedure. MDCT chest scan also discovered adrenal incidentaloma defined as malignant, pheochromocytoma like mass. Due to the critical state of the patient, there was not enough time for further endocrinologic testing. Discussion and conclusion: When treating patients with pheochromocytoma and acute aortic disection, it is crucial to obtain a stable hemodynamic state before the surgery, since they can trigger a severe hypertensive crisis due to high levels of cathecholamines induced chronic vasoconctriction. The most vulnerable periods are the induction of anesthesia and perioperative hemodynamic oscillations, so treating patients with short acting alpha- 1 adrenergic blocking agents preoperatively has proven to be helpful - Phentolamine. Both dissection of aorta and pheochromocytoma present challenges for anesthesiologists and early recognition of symptoms is essential in establishing the diagnosis and reducing the mortality rate.
International Nuclear Information System (INIS)
Brunot, S.; Corneloup, O.; Latrabe, V.; Montaudon, M.; Laurent, F.
2005-01-01
The aim of this study was to evaluate the inter-observer and intra-observer agreement of the diagnosis of sub-segmental acute pulmonary embolism (PE) in an inpatient population explored by 16 slice multi-detector spiral computed tomography (MDCT). Four hundred consecutive inpatients were referred for MDCT for the clinical suspicion of acute PE. One hundred and seventy seven (44.2%) had a known cardio-respiratory disease at the time of examination. Inter-observer and intra-observer agreements for the diagnosis of acute PE and of sub-segmental acute PE were assessed blind and independently by three experienced readers and by kappa statistics. Seventy-five patients were diagnosed as having acute PE findings (19.5%), and clots were located exclusively within sub-segmental arteries in nine patients (12%). When clots were limited to sub-segmental or more distal branches of the pulmonary arteries, kappa values were found to be moderate (0.56) to very good (0.85) for the diagnosis of sub-segmental acute PE, whereas for the diagnosis of acute PE in the whole population, kappa values ranged from 0.84 to 0.97. Intra-observer agreement was found to be perfect (kappa=1). MDCT is a reproducible technique for the diagnosis of sub-segmental acute PE as well as for acute PE. In this inpatient population, sub-segmental acute PE was not a rare event. (orig.)
Acute Intravenous Calcium Antagonist for Suspected Hemiplegic Migraine – A Case Story
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Charlotte Lützhøft Rath
2017-05-01
Full Text Available Stroke mimics, like attacks of hemiplegic migraine, are challenging in acute stroke evaluation. We present a 28-year-old woman with a suspected hemiplegic migraine attack with left-sided hemiparalysis. Brain CT with perfusion imaging 1 h 54 min after symptom onset revealed hypoperfusion in the right hemisphere. The patient was treated with intravenous recombinant tissue plasminogen activator (rtPA with no effect. After a subsequent intravenous verapamil infusion, the patient gained full motor function within 10 min. Brain magnetic resonance imaging (MRI performed 5 h 46 min after symptom onset revealed diffusion restriction in the same area as the hypoperfusion on CT. There were no notable changes on T2 images. The patient stayed clinically in remission, except for reduced sensation for all modalities on the extremities on the left side. Although brain CT 24 h after symptom onset revealed an edema in the same area, an MRI performed 17 days later showed no new infarctions. Young patients with a history of migraine with aura admitted with symptoms of acute ischemic stroke are at risk of insufficient treatment. Calcium antagonists might be considered if there is no effect of first-line treatment with rtPA.
Targeting the initial investigation and management in cases of acute pulmonary embolism.
Moore, Nicholas; Hawkins, Peter
2013-01-01
It was noted by consultants in our hospital that the early investigation of suspected pulmonary embolism (PE) lacked structure. This was causing delays in definitive diagnosis and early management. The resulting unnecessary use of investigation was also wasting resources. In particular, the inappropriate use of serum d-dimer tests was causing concern. The National Institute of Clinical Excellence (NICE) guidelines recommend use of the 2-level Well's score to target investigation in suspected PE. A baseline audit against the NICE guideline revealed that Well's scores were rarely used (only calculated in 12% of cases) and confirmed the suspicion that early investigation was poorly targeted. This project intervened using educational talks promoting the use of Well's scores in cases of suspected PE. Well's score proformas were placed in the emergency department and emergency assessment unit for reference. Their availability was advertised. This significantly increased the use of Well's scores (46% vs 11%, p<0.001). Fewer patients underwent unnecessary d-dimer measurements in cases of likely PE (65% vs 86%). Initial investigation was more targeted in cases where a Well's score had been calculated than in cases without a Well's score. For example, significantly fewer unnecessary d-dimer tests were performed in these cases (45% vs 100%, p<0.05). The cost of unnecessary investigation in suspected PE is not only significant financially but also in the resulting delay in definitive diagnosis and management for the patient. The simple intervention used here was effective in addressing this problem.
Chew, Pei Gee; Frost, Fredrick; Mullen, Liam; Fisher, Michael; Zadeh, Heidar; Grainger, Ruth; Albouaini, Khaled; Dodd, James; Patel, Bilal; Velavan, Periaswamy; Kunadian, Babu; Rawat, Anju; Obafemi, Toba; Tong, Sarah; Jones, Julia; Khand, Aleem
2018-02-01
We tested the hypothesis that a single high sensitivity troponin at limits of detection (LOD HSTnT) (Acute Coronary Events (GRACE) (acute coronary syndrome. In a prospective cohort study, risk scores were computed in consecutive patients with suspected acute coronary syndrome presenting to the Emergency Room of a large English hospital. Adjudication of myocardial infarction, as per third universal definition, involved a two-physician, blinded, independent review of all biomarker positive chest pain re-presentations to any national hospital. The primary and secondary outcome was a composite of type 1 myocardial infarction, unplanned coronary revascularisation and all cause death (MACE) at six weeks and one year. Of 3054 consecutive presentations with chest pain 1642 had suspected acute coronary syndrome (52% male, median age 59 years, 14% diabetic, 20% previous myocardial infarction). Median time from chest pain to presentation was 9.7 h. Re-presentations occurred in eight hospitals with 100% follow-up achieved. Two hundred and eleven (12.9%) and 279 (17%) were adjudicated to suffer MACE at six weeks and one year respectively. Only HEART ≤3 (negative predictive value MACE 99.4%, sensitivity 97.6%, %discharge 53.4) and LOD HSTnT strategy (negative predictive value MACE 99.8%, sensitivity 99.5%, %discharge 36.9) achieved pre-specified negative predictive value of >99% for MACE at six weeks. For type 1 myocardial infarction alone the negative predictive values at six weeks and one year were identical, for both HEART ≤3 and LOD HSTnT at 99.8% and 99.5% respectively. HEART ≤3 or LOD HSTnT strategy rules out short and medium term myocardial infarction with ≥99.5% certainty, and short-term MACE with >99% certainty, allowing for early discharge of 53.4% and 36.9% respectively of suspected acute coronary syndrome. Adoption of either strategy has the potential to greatly reduce Emergency Room pressures and minimise follow-up investigations. Very early presenters (<3 h
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Holst Pedersen, J.; Hancke, S.; Christensen, B.; Gammelgaard, J.; Haubek, A.; Ingemann Jensen, L.; Munck, O.; Wied, U. (Koebenhavns amts sygehus i Herlev, kirurgisk gastroenterologisk afd., Herlev, Denmark)
1982-01-01
Ultrasonography, infusion tomography of the gall-bladder and sup(99m)Tc-diethyl acetanilide iminodiacetic acid (DIDA) hepatobiliary scanning were compared in a prospective investigation of 45 consecutive patients in whom acute cholecystitis was suspected clinically. The definitive diagosis of acute cholecystitis was established or excluded at operation in 35 patients, by oral cholecystography in five and by intravenous cholangiography in five. The predictive values of positive and negative results of investigation were 100% and 83%. respectively, with ultrasonography and 98% and 88%, respectively, in hepatobiliary scanning. The corresponding values for infusion tomography were 87% and 33%, respectively. It is concluded from these results that ultrasonography and sup(99m)Tc-DIDA hepatobiliary scanning are capable of establishing the diagnosis rapidly and with certainty in cases of suspected acute cholecystitis. A preliminary account of the results of routine employment of sup(99m)Tc-DIDA hepatobiliary scanning in 29 consecutive patients revealed no erroneous diagnoses. In the majority of patients with acute cholecystitis, operation proved possible within 48 hours of admission.
Pasha, Sharif M; Klok, Frederikus A; van der Bijl, Noortje; de Roos, Albert; Kroft, Lucia J M; Huisman, Menno V
2012-08-01
N-terminal pro-Brain Natriuretic Peptide (NT-pro-BNP) is primarily secreted by left ventricular (LV) stretch and wall tension. Notably, NT-pro-BNP is a prognostic marker in acute pulmonary embolism (PE), which primarily stresses the right ventricle (RV). We sought to evaluate the relative contribution of the RV to NT-pro-BNP levels during PE. A post-hoc analysis of an observational prospective outcome study in 113 consecutive patients with computed tomography (CT)-proven PE and 226 patients in whom PE was clinically suspected but ruled out by CT. In all patients RV and LV function was established by assessing ECG-triggered-CT measured ventricular end-diastolic-volumes and ejection fraction (EF). NT-pro-BNP was assessed in all patients. The correlation between RV and LV end-diastolic-volumes and systolic function was evaluated by multiple linear regression corrected for known confounders. In the PE cohort increased RVEF (β-coefficient (95% confidence interval [CI]) -0.044 (± -0.011); p<0.001) and higher RV end-diastolic-volume (β-coefficient 0.005 (± 0.001); p<0.001) were significantly correlated to NT-pro-BNP, while no correlation was found with LVEF (β-coefficient 0.005 (± 0.010); p=0.587) and LV end-diastolic-volume (β-coefficient -0.003 (± 0.002); p=0.074). In control patients without PE we found a strong correlation between NT-pro-BNP levels and LVEF (β-coefficient -0.027 (± -0.006); p<0.001) although not LV end-diastolic-volume (β-coefficient 0.001 (± 0.001); p=0.418). RVEF (β-coefficient -0.002 (± -0.006); p=0.802) and RV end-diastolic-volume (β-coefficient <0.001 (± 0.001); p=0.730) were not correlated in patients without PE. In PE patients, lower RVEF and higher RV end-diastolic-volume were significantly correlated to NT-pro-BNP levels as compared to control patients without PE. These observations provide pathophysiological ground for the well-known prognostic value of NT-pro-BNP in acute PE.
Therapeutic management of acute pulmonary embolism.
Tromeur, Cécile; Van Der Pol, Liselotte M; Couturaud, Francis; Klok, Frederikus A; Huisman, Menno V
2017-08-01
Acute pulmonary embolism (PE) is a potentially fatal manifestation of venous thromboembolism. Prompt anticoagulant treatment is crucial for PE patients, which can decrease morbidity and mortality. Risk assessment is the cornerstone of the therapeutic management of PE. It guides physicians to the most appropriate treatment and selects patients for early discharge or home treatment. Areas covered: Here, we review the current treatments of acute PE according to contemporary risk stratification strategies, highlighting each step of PE therapeutic management. Expert commentary: Currently, direct oral anticoagulants (DOACs) represent the first-line therapy of patients presenting with non-high risk PE with a better risk-benefit ratios than vitamin K antagonists (VKAs) due to lower risk of major bleeding. Only high-risk patients with PE who present in shock should be treated with systematic thrombolysis, while surgical thrombectomy or catheter direct thrombolysis (CDT) should only be considered when thrombolysis is contraindicated because of too high bleeding risk.
Gerbier, Pierre; Binet, Aurélien; Etancelin, Mathilde; Barteau, Emmanuel; Auger, Marie; Morales, Luciano; Bertrand, Philippe; Sirinelli, Dominique; Morel, Baptiste
2018-04-01
The objective of this study was to evaluate the progress in performance of senior residents in diagnosing acute appendicitis. Results were collected and compared of ultrasound examinations performed for suspected acute appendicitis by three senior residents and two faculty members over a six-month period in a university hospital setting. A grid with the sonographic findings was completed separately by the residents and the faculty members immediately after each examination. The duration of each examination was reported. The final ultrasound diagnosis was compared to the surgical and pathological results and to the clinical follow-up. The residents and faculty members performed 171 consecutive ultrasound examinations including 49 children with acute appendicitis and 122 with normal appendices. The accuracy of the diagnosis by the residents was 96%, and was similar to that of the faculty members (kappa=0.90) over the six months. The duration of the resident ultrasound examinations was significantly shorter during the second three-month period (p=0.01). No significant differences in diagnostic accuracy were demonstrated by the residents between the first and second three-month periods (p=0.06). The residents performed well when using sonography to diagnose acute appendicitis in children, and were faster during the second three-month period. I. Copyright © 2017 Elsevier Inc. All rights reserved.
Panovský, Roman; Borová, Júlia; Pleva, Martin; Feitová, Věra; Novotný, Petr; Kincl, Vladimír; Holeček, Tomáš; Meluzín, Jaroslav; Sochor, Ondřej; Štěpánová, Radka
2017-06-28
Patients with chest pain, elevated troponin, and unobstructed coronary disease present a clinical dilemma. The purpose of this study was to investigate the incremental diagnostic value of cardiovascular magnetic resonance (CMR) in a cohort of patients with suspected acute coronary syndrome (ACS) and unobstructed coronary arteries. Data files of patients meeting the inclusion criteria in two cardiology centres were searched and analysed. The inclusion criteria included: 1) thoracic pain suspected with ACS; 2) a significant increase in the high-sensitive Troponin T value; 3) ECG changes; 4) coronary arteries without any significant stenosis; 5) a CMR examination included in the diagnostic process; 6) an uncertain diagnosis before the CMR exam; and 7) the absence of known CMR and contrast media contraindications. Special attention was paid to the benefits of CMR in determining the final diagnosis. In total, 136 patients who underwent coronary angiography for chest pain were analysed. The most frequent underlying causes were myocarditis (38%) and perimyocarditis (18%), followed by angiographically unrecognised acute myocardial infarction (18%) and Takotsubo cardiomyopathy (15%). The final diagnosis remained unclear in 6% of the patients. The contribution of CMR in determining the final diagnosis determination was crucial in 57% of the patients. In another 35% of the patients, CMR confirmed the suspicion and, only 8% of the CMR examinations did not help at all and had no influence on diagnosis or treatment. CMR provided a powerful incremental diagnostic value in the cohort of patients with suspected ACS and unobstructed coronary arteries. CMR is highly recommended to be incorporated as an inalienable part of the diagnostic algorithms in these patients.
Quality of CT pulmonary angiography for suspected pulmonary embolus in pregnancy
International Nuclear Information System (INIS)
U-King-Im, Jean Marie; Freeman, Susan J.; Boylan, Teresa; Cheow, Heok K.
2008-01-01
The main objective of this study was to assess the quality of CT pulmonary angiography (CTPA) for suspected pulmonary embolus (PE) in the pregnant population. We retrospectively identified 40 consecutive pregnant patients who underwent CTPA from January 2005 to December 2006. Forty consecutive age-matched non-pregnant women were used as a control group. Studies were subjectively graded according to overall image quality by two readers in consensus, in randomised and blinded manner. Moreover, contrast enhancement of pulmonary arteries was subjectively and objectively evaluated. The proportion of sub-optimal studies was more than three times higher in the pregnant group (27.5%, n = 11) compared with the non-pregnant group (7.5%, n = 3; p = 0.015). Mean contrast enhancement was consistently higher in the non-pregnant group compared with pregnant group, both subjectively and objectively. The percentage of inadequately opacified vascular segments was more than two times higher in the pregnant group (28.7%, n = 264) than in the non-pregnant group (13.3%, n 122; p = 0.0001). The incidence of sub-optimal CTPA studies is higher in pregnancy when compared with an age-matched non-pregnant control group. In addition to radiation issues, this should also be considered when implementing diagnostic strategies for suspected PE in pregnancy. (orig.)
Surgical treatment of acute pulmonary embolism--a 12-year retrospective analysis
DEFF Research Database (Denmark)
Lehnert, Per; Møller, Christian H; Carlsen, Jørn
2012-01-01
Surgical embolectomy for acute pulmonary embolism (PE) is considered to be a high risk procedure and therefore a last treatment option. We wanted to evaluate the procedures role in modern treatment of acute PE....
A clinical study on the interventional treatment of acute pulmonary embolism
International Nuclear Information System (INIS)
Yu Xixiang; Zhang Minghua; Ci Xiao; Wang Chunmei; Lin Xiaojie; Si Tongguo; Huang Linfen; Feng Xiaofeng
2004-01-01
Objective: To evaluate the effectiveness of interventional procedures in the treatment of acute pulmonary embolism (PE). Methods: Pulmonary arterial thrombolytic therapy, suction and fragmentation of thromhi, anti-spasm, and balloon dilation were performed in eighteen cases with clinically highly suspected PE confirmed by emergent pulmonary artery angiography beforehand. Wedged pulmonary arterial pressure, pulmonary recanalization rate, the display ratio of distal pulmonary capillary net, blood gas analysis, blood oxygen saturation, and the improvement of clinical symptoms and signs were used for evaluation of the effectiveness. Seventeen of the alive cases with dislodgement of deep vein thrombi of the lower extremities were confirmed for the formation of PE and then thrombolytic treatment of the thrombotic deep vein was performed after the placement of inferior vena cava filter. Results: Pulmanory artery angiographies showed embolism of the pulmonary arterial trunks or more than two of the branches. The post-treatment pulmonary patency reached 80%-90% in three cases, 90%-95% in eleven cases and 100% in five cases. The display ratio of distal pulmonary capillary net was over 90% in all the cases. Wedged pulmonary arterial pressure decreased to below 25 mmHg in thirteen cases, and to 25-30 mmHg in five cases. Blood oxygen saturation rate improved immediately to 90%-95% in ten cases and to 95%-100% in eight cases. Cough, hemoptysis, dyspnea, and chest pain were completely relieved in thirteen cases and significantly relieved in five cases. Digestive track bleeding was complicated in one case. Conclusions: Pulmonary artery angiography is the golden standard for the diagnosis of pulmonary embolism. Interventional therapy is very effective for acute pulmonary embolism, which can significantly reduce the mortality rate. (authors)
PLA/Bio-PE blends: effect of the Bio-PE content on the crystallinity rheological properties
International Nuclear Information System (INIS)
Araujo, Aylanna P.M. de; Agrawal, Pankaj; Cavalcanti, Shirley N.; Alves, Amanda M.; Melo, Tomas J.A. de; Brito, Gustavo F.
2014-01-01
The aim of this work is to evaluate the effect of the Bio-PE content on the crystallinity and rheological properties of PLA/Bio-PE blend. The blends containing 05 and 15% of Bio-PE were prepared by extrusion followed by injection molding and characterized by X-Ray Diffraction (XRD) and rheological properties at low and high shear rates. XRD results indicated that the PLA present low crystallinity and this behavior was not changed with the addition of Bio-PE, regardless of Bio-PE content. Rheological properties results indicated that at low shear rates the viscosity of the PLA/Bio-PE increased with the increase in the Bio-PE content while at high shear rates the viscosities where almost similar, which may be ascribed to the orientation of Bio-PE particles in the flow direction or by the viscous dissipation. (author)
International Nuclear Information System (INIS)
Menezes, Claudio J.M.
2005-01-01
In 1998, it was created in the Centro Regional de Ciencias Nucleares (CRCN-NE) - the Brazilian regional center of nuclear sciences -, Recife, PE, Brazil, the Service for Radiological Emergency Response with the objective of providing the population of Pernambuco and neighboring States a team of professionals specialized in emergency situations and radiological protection. This action has the purpose of decentralization of actions of the Brazilian National Nuclear Energy Commission (CNEN), an agency responsible for licensing and safety of radioactive sources in Brazil. With this study we can conclude that the settlement of SAER/CRCN came to meet initial expectations, having in the last years provided assistance in situations with suspected radioactive material and participated actively: with radioactive load simulation; of the Exercicio de Emergencia Aeronautica Completo (EXEAC) - an emergency simulated training in airports- from the Guararapes-Gilberto Freire Airport; trained, every two years, the services of emergency for accidents and participated in events of the area
Diagnostic value of dual section helical CT in suspected acute pulmonary embolism
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Marangoni, Alberto A.; Torrecillas, Maria D.; Marchegiani, Silvio H.; Surur, Alberto
2003-01-01
Purpose: To asses the role of Dual Section Helical Computed Tomography (DSHCT) in patients with clinically suspected acute pulmonary embolism (APE). Material and Methods: A retrospective evaluation of 102 patients (57 male, 45 female; age range: 30-83 years; mean: 56 years) with high suspicion of APE studied by DSHCT, was carried out. From the medical records we analyzed clinical parameters, blood gases, D-dimer, risk factors and other imaging examinations. US Doppler of the inferior limbs was performed in 58/102 patients (57%). Results. 52 patients (51%) had APE on DSHCT. Scans of the other 50 patients (49%) were negative for APE. In 39/50 cases (78%) without evidence of APE, DSHCT detected ancillary thoracic findings such as atelectasia (n=11), pulmonary consolidation/edema (n=10), interstitial lung disease (n=8), pleural effusion (n=6), emphysema (n=2), nodules (n=2). 11 cases (22%) DSHCT showed no abnormal features. In this group, with persistent clinical symptoms, angio MRI showed 2 additional cases of APE (false negatives on DSHCT). On DSHCT 51/52 patients (98%) with APE showed satisfactory filling of iodinate contrast in segmental pulmonary arteries, and 45/52 patients (87%) in sub segmental arteries. On DSHCT 36 patients showed bilateral APE, and 7 had isolated peripheral APE. In 7/12 patients DSHCT demonstrated deep venous thrombosis (DVT) of the inferior limbs. In other 27/58 cases (47%) US Doppler was positive for DVT. Conclusion: DSHCT can be effectively used to rule out suspected APE and also provides additional information in patients without APE. In addition DSHCT also contributes to demonstrate deep venous thrombosis. (author)
Acute pulmonary embolism. Part 1: Epidemiology and diagnosis
Douma, Renée A.; Kamphuisen, Pieter W.; Büller, Harry R.
2010-01-01
Pulmonary embolism (PE) is a frequently occurring, acute, and potentially fatal condition. Numerous risk factors for PE, both inherited and acquired, have been identified. Adequate diagnosis is mandatory to prevent PE-related morbidity and mortality on the one hand, and unnecessary treatment on the
Scintigraphic evaluation of suspected acute myocardial infarction
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Kan, M.K.; Hopkins, G.B.; Carroll, C.F.X.
1977-01-01
Ninety-one patients with chest pain suggestive of acute myocardial infarction were studied by static technetium /sup 99m/Tc stannous pyrophosphate scintigraphy and dynamic sodium pertechnetate /sup 99m/Tc cardioangiography. Twenty-three of 26 patients (88%) with acute transmural infarcts and 12 of 17 patients (71%) with nontransmural infarcts had abnormal static studies. In 45 patients with negative scintigrams, ECG or serum enzyme changes consistent with acute infarction failed to develop. Three false-positive static studies (6%) were recorded. Twenty of 43 (47%) patients with acute infarction had hemodynamic or structural abnormalities identified by cardioangiography. The dynamic study also proved helpful in localizing the site of infarction and in ruling out certain causes of false-positive static scintigrams
Barco, Stefano; Lankeit, Mareike; Binder, Harald; Schellong, Sebastian; Christ, Michael; Beyer-Westendorf, Jan; Duerschmied, Daniel; Bauersachs, Rupert; Empen, Klaus; Held, Matthias; Schwaiblmair, Martin; Fonseca, Cândida; Jiménez, David; Becattini, Cecilia; Quitzau, Kurt; Konstantinides, Stavros
2016-07-04
Pulmonary embolism (PE) is a potentially life-threatening acute cardiovascular syndrome. However, more than 95 % of patients are haemodynamically stable at presentation, and among them are patients at truly low risk who may qualify for immediate or early discharge. The Home Treatment of Pulmonary Embolism (HoT-PE) study is a prospective international multicentre single-arm phase 4 management (cohort) trial aiming to determine whether home treatment of acute low-risk PE with the oral factor Xa inhibitor rivaroxaban is feasible, effective, and safe. Patients with confirmed PE, who have no right ventricular dysfunction or free floating thrombi in the right atrium or ventricle, are eligible if they meet none of the exclusion criteria indicating haemodynamic instability, serious comorbidity or any condition mandating hospitalisation, or a familial/social environment unable to support home treatment. The first dose of rivaroxaban is given in hospital, and patients are discharged within 48 hours of presentation. Rivaroxaban is taken for at least three months. The primary outcome is symptomatic recurrent venous thromboembolism or PE-related death within three months of enrolment. Secondary outcomes include quality of life and patient satisfaction, and health care resource utilisation compared to existing data on standard-duration hospital treatment. HoT-PE is planned to analyse 1,050 enrolled patients, providing 80 % power to reject the null hypothesis that the recurrence rate of venous thromboembolism is >3 % with α≤0.05. If the hypothesis of HoT-PE is confirmed, early discharge and out-of-hospital treatment may become an attractive, potentially cost-saving option for a significant proportion of patients with acute PE.
Goliszek, Sylwia; Wiśniewska, Małgorzata; Kurnicka, Katarzyna; Lichodziejewska, Barbara; Ciurzyński, Michał; Kostrubiec, Maciej; Gołębiowski, Marek; Babiuch, Marek; Paczynska, Marzanna; Koć, Marcin; Palczewski, Piotr; Wyzgał, Anna; Pruszczyk, Piotr
2014-11-01
Patent foramen ovale (PFO) is an established risk factor for ischemic stroke. Since acute right ventricular dysfunction (RVD) observed in patients with PE can lead to right-to-left inter-atrial shunt via PFO, we hypothesized that PFO is a risk factor for ischemic stroke in PE with significant right ventricular dysfunction. 55 patients (31 F, 24M), median age 49 years (range 19-83 years) with confirmed PE underwent echocardiography for RVD and PFO assessment. High risk acute PE was diagnosed in 3 (5.5%) patients, while 16 (29%) hemodynamically stable with RVD patients formed a group with intermediate-risk PE. PFO was diagnosed in 19 patients (34.5%). Diffusion-weighted MRI of the brain for acute ischemic stroke (AIS) was performed in all patients 4.91 ± 4.1 days after admission. AIS was detected by MRI in 4 patients (7.3%). Only one stroke was clinically overt and resulted in hemiplegia. All 4 AIS occurred in the PFO positive group (4 of 19 patients), and none in subjects without PFO (21.0% vs 0%, p=0.02). Moreover, all AIS occurred in patients with RVD and PFO, and none in patients with PFO without RVD (50% vs 0%, p=0.038). Our data suggest that acute pulmonary embolism resulting in right ventricular dysfunction may lead to acute ischemic stroke in patients with patent foramen ovale. However, the clinical significance of such lesions remains to be determined. Copyright © 2014 Elsevier Ltd. All rights reserved.
Sun, Benjamin C; Laurie, Amber; Fu, Rongwei; Ferencik, Maros; Shapiro, Michael; Lindsell, Christopher J; Diercks, Deborah; Hoekstra, James W; Hollander, Judd E; Kirk, J Douglas; Peacock, W Frank; Anantharaman, Venkataraman; Pollack, Charles V
2016-03-01
The emergency department evaluation for suspected acute coronary syndrome (ACS) is common, costly, and challenging. Risk scores may help standardize clinical care and screening for research studies. The Thrombolysis in Myocardial Infarction (TIMI) and HEART are two commonly cited risk scores. We tested the null hypothesis that the TIMI and HEART risk scores have equivalent test characteristics. We analyzed data from the Internet Tracking Registry of Acute Coronary Syndromes (i*trACS) from 9 EDs on patients with suspected ACS, 1999-2001. We excluded patients with an emergency department diagnosis consistent with ACS, or without sufficient data to calculate TIMI and HEART scores. The primary outcome was 30-day major adverse cardiovascular events, including all-cause death, acute myocardial infarction, and urgent revascularization. We describe test characteristics of the TIMI and HEART risk scores. The study cohort included 8255 patients with 508 (6.2%) 30-day major adverse cardiovascular events. Receiver operating curve and reclassification analyses favored HEART [c statistic: 0.753, 95% confidence interval (CI): 0.733-0.773; continuous net reclassification improvement: 0.608, 95% CI: 0.527-0.689] over TIMI (c statistic: 0.678, 95% CI: 0.655-0.702). A HEART score 0-3 [negative predictive value (NPV) 0.982, 95% CI: 0.978-0.986; positive predictive value (PPV) 0.103, 95% CI: 0.094-0.113; likelihood ratio (LR) positive 1.76; LR negative 0.28] demonstrates similar or superior NPV/PPV/LR compared with TIMI = 0 (NPV 0.978, 95% CI: 0.971-0.983; PPV 0.077, 95% CI: 0.071-0.084; LR positive 1.28; LR negative 0.35) and TIMI = 0-1 (NPV 0.963, 95% CI: 0.958-0.968; PPV 0.102, 95% CI: 0.092-0.113; LR positive 1.73; LR negative 0.58). The HEART score has better discrimination than TIMI and outperforms TIMI within previously published "low-risk" categories.
Fukui, Shoichi; Iwamoto, Naoki; Tsuji, Sosuke; Umeda, Masataka; Nishino, Ayako; Nakashima, Yoshikazu; Suzuki, Takahisa; Horai, Yoshiro; Koga, Tomohiro; Kawashiri, Shin-ya; Ichinose, Kunihiro; Hirai, Yasuko; Tamai, Mami; Nakamura, Hideki; Origuchi, Tomoki; Kawakami, Atsushi
2015-01-01
A 55-year-old man was diagnosed with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. Contrast-enhanced computed tomography for cancer screening showed a mass with low-density centers with an enhanced rim in the left iliopsoas muscle. We suspected an iliopsoas abscess and performed computed-tomography-guided puncture of the mass. Both Gram staining and the culture of the fluid were negative. We diagnosed the patient with RS3PE syndrome with iliopsoas bursitis and administered low-dose corticosteroids without antibiotics. The symptoms, including left hip pain, quickly disappeared following treatment. Clinicians should be aware that iliopsoas bursitis may resemble an iliopsoas abscess. As a result, it is important to make an accurate differential diagnosis.
Acute appendicitis mistaken as acute rejection in renal transplant recipients.
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Talwalkar N
1994-01-01
Full Text Available Case histories of 2 renal transplant recipients are reported who had presenting features of fever, leukocytosis and pain/tenderness over right iliac fossa and were diagnosed to be due to acute appendicitis rather than more commonly suspected acute rejection episode which has very similar features. Diagnosis of acute appendicitis was suspected on the basis of rectal examination and later confirmed by laparotomy. The purpose of this communication is to emphasize the need for proper diagnosis in patient with such presentation; otherwise wrong treatment may be received.
International Nuclear Information System (INIS)
Beek, Edwin J.R. van; Brouwers, Elise M.J.; Song Bin; Stein, Paul D.; Oudkerk, Matthijs
2001-01-01
AIM: To determine the validity of a normal pulmonary angiogram in the exclusion of pulmonary embolism (PE), based on the safety of withholding anticoagulant therapy in patients with a normal pulmonary angiogram. MATERIALS AND METHODS: A review of English reports published between 1965 and April 1999 was carried out. Eligible articles described prospective studies in patients with suspected PE and a normal pulmonary angiogram, who remained untreated and were followed-up for a minimum of 3 months. Articles were evaluated by two authors, using pre-defined criteria for strength of design. End points consisted of fatal and non-fatal recurrent thromboembolic events. A sensitivity analysis was performed, by removing one study at a time from the overall results and by comparing pre- and post-1990 publications. RESULTS: Among 1050 patients in eight articles included in the analysis, recurrent thromboembolic events were described in 18 patients (1.7% 95% CI: 1.0-2.7%). These were fatal in three patients (0.3% 95% CI: 0.02-0.7%). The recurrence rate of PE decreased from 2.9% (95% CI: 1.4-6.8%) before 1990 to 1.1% (95% CI: 0.5-2.2%) after 1990. CONCLUSION: It would appear that the ability to exclude PE by angiography has improved over the years, as indicated by recurrence rate of PE. The low recurrence rate of PE supports the validity of a normal pulmonary angiogram for the exclusion of PE. Beek, E.J.R. van et al. (2001)
International Nuclear Information System (INIS)
Lee, Eun Joo; Kim, Soon; Oh, Yeon Hee; Kim, Seung Hyeon; Lee, Sung Woo
2004-01-01
To evaluate the usefulness and limitations of measurement of the outer diameter of the vermiform appendix in men and women patients suspected of acute appendicitis on ultrasonography (US). Retrospectively, the review of the outer diameter of the appendix measured in 197 adult patients, 70 men and 127 women (age ranged from 16 to 83 years), suspected of acute appendicitis on sustained-compression US was done. The measured outer diameters were categorized into two groups according to the patient's sex, and relationships between categoric variables were analyzed by calculating sensitivity, specificity, positive and negative predictive values and accuracy. Data analyses were performed using MedCalc for windows version 7.1.0.1. The outer appendiceal diameters in men ranged between 3.2 and 15 mm, while those in women, between 3.4 and 17 mm. The diameters of acute inflamed appendices ranged from 6 to 17 mm. In men, a diameter equal to or larger than 6 mm was confirmed as acute appendicitis with the sensitivity, specificity and positive and negative predictive values of 100%, 57.6%, 70.2% and 100%, respectively. Meanwhile, in women, a diameter of ≥ 6 mm was confirmed as acute appendicitis with the sensitivity, specificity and positive and negative predictive values of 98%, 55.8%, 68.9% and 96.5%, respectively. The accuracy in women (67.7%) was lower than in men(75.7%), but no statistically significant difference (p=0.395) was seen between men and women. The outer appendiceal diameter of ≥ 6 mm as a sign of acute appendicitis provides a high sensitivity and negative predictive values. This diagnostic criterion is more useful in excluding acute appendicitis than confirming it. There was no statistically significant difference in the accuracy between men and women.
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Lee, Eun Joo; Kim, Soon; Oh, Yeon Hee; Kim, Seung Hyeon; Lee, Sung Woo [Gyeong Ju Hospital, Dongguk University School of Medicine, Gyeongju (Korea, Republic of)
2004-03-15
To evaluate the usefulness and limitations of measurement of the outer diameter of the vermiform appendix in men and women patients suspected of acute appendicitis on ultrasonography (US). Retrospectively, the review of the outer diameter of the appendix measured in 197 adult patients, 70 men and 127 women (age ranged from 16 to 83 years), suspected of acute appendicitis on sustained-compression US was done. The measured outer diameters were categorized into two groups according to the patient's sex, and relationships between categoric variables were analyzed by calculating sensitivity, specificity, positive and negative predictive values and accuracy. Data analyses were performed using MedCalc for windows version 7.1.0.1. The outer appendiceal diameters in men ranged between 3.2 and 15 mm, while those in women, between 3.4 and 17 mm. The diameters of acute inflamed appendices ranged from 6 to 17 mm. In men, a diameter equal to or larger than 6 mm was confirmed as acute appendicitis with the sensitivity, specificity and positive and negative predictive values of 100%, 57.6%, 70.2% and 100%, respectively. Meanwhile, in women, a diameter of {>=} 6 mm was confirmed as acute appendicitis with the sensitivity, specificity and positive and negative predictive values of 98%, 55.8%, 68.9% and 96.5%, respectively. The accuracy in women (67.7%) was lower than in men(75.7%), but no statistically significant difference (p=0.395) was seen between men and women. The outer appendiceal diameter of {>=} 6 mm as a sign of acute appendicitis provides a high sensitivity and negative predictive values. This diagnostic criterion is more useful in excluding acute appendicitis than confirming it. There was no statistically significant difference in the accuracy between men and women.
de Hoog, Vince C; Lim, Swee Han; Bank, Ingrid Em; Gijsberts, Crystel M; Ibrahim, Irwani B; Kuan, Win Sen; Ooi, Shirley Bs; Chua, Terrance Sj; Tai, E Shyong; Gao, Fei; Pasterkamp, Gerard; den Ruijter, Hester M; Doevendans, Pieter A; Wildbergh, Thierry X; Mosterd, Arend; Richards, A Mark; de Kleijn, Dominique Pv; Timmers, Leo
2017-03-01
The HEART score is a simple and effective tool to predict short-term major adverse cardiovascular events in patients suspected of acute coronary syndrome. Patients are assigned to three risk categories using History, ECG, Age, Risk factors and Troponin (HEART). The purpose is early rule out and discharge is considered safe for patients in the low risk category. Its performance in patients of Asian ethnicity is unknown. We evaluated the performance of the HEART score in patients of Caucasian, Chinese, Indian and Malay ethnicity. The HEART score was assessed retrospectively in 3456 patients presenting to the emergency department with suspected acute coronary syndrome (1791 Caucasians, 1059 Chinese, 344 Indians, 262 Malays), assigning them into three risk categories. The incidence of major adverse cardiovascular events within six weeks after presentation was similar between the ethnic groups. A smaller proportion of Caucasians was in the low risk category compared with Asians (Caucasians 35.8%, Chinese 43.5%, Indians 45.3%, Malays 44.7%, p<0.001). The negative predictive value of a low HEART score was comparable across the ethnic groups, but lower than previously reported (Caucasians 95.3%, Chinese 95.0%, Indians 96.2%, Malays 96.6%). Also the c-statistic for the HEART score was not significantly different between the groups. These results show that the overall performance of the HEART score is equal among Caucasian and Asian ethnic groups. The event rate in the low risk group, however, was higher than reported in previous studies, which queries the safety of early discharge of patients in the low risk category.
DEFF Research Database (Denmark)
Dimitrijevic, Ivan; Ekelund, Ulf; Edvinsson, Lars
2009-01-01
of arterial vasoconstrictor endothelin (ET) and angiotensin (AT) receptors. Our aim was to investigate if the arterial expressions of these receptors are changed in patients with suspected but ruled out acute coronary syndrome (ACS). Small subcutaneous arteries (diameter of 100 microm) were surgically removed...... in the regulation of coronary tone and in the development of atherosclerosis, and may be related to increased cardiovascular risk....
Jernberg, Tomas; Lindahl, Bertil; James, Stefan; Larsson, Anders; Hansson, Lars-Olof; Wallentin, Lars
2004-10-19
Patients with suspected or confirmed non-ST-elevation acute coronary syndrome (ACS) constitute a large and heterogeneous group. Measurements of renal function such as serum creatinine and estimation of creatinine clearance carry independent prognostic information in this population. Cystatin C is a new and better marker of renal function than creatinine. The aim was therefore to evaluate the prognostic value of cystatin C in this population. Cystatin C was analyzed on admission in 726 patients admitted because of symptoms suggestive of an acute coronary syndrome and no ST-segment elevations. Patients were followed up with regard to death and myocardial infarction for a median of 40 and 6 months, respectively. The median cystatin C level was 1.00 mg/L (25th to 75th percentile, 0.83 to 1.24 mg/L). The risk of death during follow-up increased with increasing levels of cystatin C. In the group with non-ST-elevation ACS, patients in the second, third, and fourth quartiles had a relative risk of subsequent death of 1.8 (95% CI, 0.6 to 5.3), 3.2 (95% CI, 1.2 to 8.5), and 11.7 (95% CI, 4.7 to 29.3) compared with the lowest quartile. In Cox regression models including well-known predictors of outcome, cystatin C level was independently associated with mortality but not with the risk of subsequent myocardial infarction. In a comparison of the markers of renal function in receiver-operating curve analyses, cystatin C had the best ability to discriminate between survivors and nonsurvivors. A single measurement of cystatin C will substantially improve the early risk stratification of patients with suspected or confirmed non-ST-elevation ACS.
Emergency perfusion lung scan of pulmonary embolism
International Nuclear Information System (INIS)
Ueno, Kyoichi; Kabuto, Hiroko; Rikimaru, Shigeho
1984-01-01
Pulmonary embolism (PE) has been reported to be quite rare in Japan, and there have been few clinical studies on the nuclear diagnosis of PE with the exception of several case reports. However, we have experienced 12 acute PE, and 2 chronic PE in 5 years 2 months. In 33 emergency cases who were highly suspected to have PE, we could diagnose 12 cases of PE, and 19 cases of non-PE. However, the remaining 2 cases were equivocal because of underlying chronic lung disease. Using Kr-81m ventilation lung scan, V/Q mismatch was found in all of 10 cases. Usefulness of emergency perfusion lung scan in Japan should be stressed. (author)
Frusca, Tiziana; Gervasi, Maria-Teresa; Paolini, Davide; Dionisi, Matteo; Ferre, Francesca; Cetin, Irene
2017-09-01
Preeclampsia (PE) is a pregnancy disease which represents a leading cause of maternal and perinatal mortality and morbidity. Accurate prediction of PE risk could provide an increase in health benefits and better patient management. To estimate the economic impact of introducing Elecsys sFlt-1/PlGF ratio test, in addition to standard practice, for the prediction of PE in women with suspected PE in the Italian National Health Service (INHS). A decision tree model has been developed to simulate the progression of a cohort of pregnant women from the first presentation of clinical suspicion of PE in the second and third trimesters until delivery. The model provides an estimation of the financial impact of introducing sFlt-1/PlGF versus standard practice. Clinical inputs have been derived from PROGNOSIS study and from literature review, and validated by National Clinical Experts. Resources and unit costs have been obtained from Italian-specific sources. Healthcare costs associated with the management of a pregnant woman with clinical suspicion of PE equal €2384 when following standard practice versus €1714 using sFlt-1/PlGF ratio test. Introduction of sFlt-1/PlGF into hospital practice is cost-saving. Savings are generated primarily through improvement in diagnostic accuracy and reduction in unnecessary hospitalization for women before PE's onset.
Prognostic impact of pleural effusion in acute pulmonary embolism.
Kiris, Tuncay; Yazıcı, Selçuk; Koc, Ali; Köprülü, Cinar; Ilke Akyildiz, Zehra; Karaca, Mustafa; Nazli, Cem; Dogan, Abdullah
2017-07-01
Background Pulmonary embolism (PE) is a common and life-threatening condition associated with considerable morbidity and mortality. Pleural effusion occurs in about one in three cases; however, data on its prognostic value are scarce. Purpose To investigate the association between pleural effusion and both 30-day and long-term mortality in patients with acute PE. Material and Methods We retrospectively evaluated 463 patients diagnosed with acute PE using computed tomography pulmonary angiography (CTPA). Echocardiographic, demographic, and laboratory data were collected. The study population was divided into two groups: patients with and without pleural effusions. Pleural effusion detected on CT was graded as small, moderate, and large according to the amount of effusion. The predictors of 30-day and long-term total mortality were analyzed. Results Pleural effusions were found in 120 patients (25.9%). After the 30-day follow-up, all-cause mortality was higher in acute PE patients with pleural effusions than in those without (23% versus 9%, P pleural effusions had significantly higher incidence of long-term total mortality than those without pleural effusions (55% versus 23%, P pleural effusion was an independent predictor of 30-day and long-term mortality (odds ratio [OR], 2.154; 95% confidence interval [CI], 1.186-3.913; P = 0.012 and OR, 1.591; 95% CI, 1.129-2.243; P = 0.008, respectively). Conclusion Pleural effusion can be independently associated with both 30-day and long-term mortality in patients with acute PE.
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Atoosa Adibi
2016-01-01
Full Text Available Background: The aim of the study was to determine the correlation between clinical and echocardiographic findings and risk factors of patients with suspected acute pulmonary thromboembolism (PTE who underwent computed tomography pulmonary angiography (CTPA. Materials and Methods: In this cross-sectional study, 310 hospitalized patients aged >18 years with high clinical suspicion of PTE referred to imaging center of our hospital from different wards for CTPA were enrolled. The frequency of different clinical presentations, risk factors, items of Wells' criteria, and echocardiographic findings was compared in patients with and without PTE, which have been diagnosed according to the CTPA results. Results: PTE was diagnosed in 53 (17.1% of patients with suspected PTE. From clinical manifestations, tachypnea, pleuritic chest pain, and edema of lower extremities were significantly more frequent among patients with PTE (P < 0.05. Major surgery was the risk factor which was significantly more prevalent among patients with PTE (P < 0.05. Frequency of all criteria of Wells' criteria, except hemoptysis, was significantly higher in patients with PTE (P < 0.05. The frequency of all studied echocardiographic variables was significantly higher in patients with PTE (P < 0.05. Conclusion: It is suggested that we could use the results of this study for utilizing the diagnostic process of PTE in patients with highly clinical suspicion of PTE and providing more validated decision. Using the results of this study, we could identify high-risk patients and made appropriate risk assessment for better management of patients with suspected PTE as well as reduce the rate of unnecessary CTPA and its related adverse consequences.
Cramer, G.E.; Kievit, P.C.; Brouwer, M.A.; Keijzer, M.H. de; Luijten, H.E.; Verheugt, F.W.A.
2007-01-01
OBJECTIVES: This study was designed to test the usefulness of a bedside assay as compared to a laboratory method of troponin testing to predict adverse cardiac outcome of chest pain patients. METHODS: We studied 358 ER visits of patients suspected of a non ST-elevation acute coronary syndrome. cTnI
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Clark, Elaine N; Ripa, Maria Sejersten; Clemmensen, Peter
2010-01-01
The aims of this study were to assess the effectiveness of 2 automated electrocardiogram interpretation programs in patients with suspected acute coronary syndrome transported to hospital by ambulance in 1 rural region of Denmark with hospital discharge diagnosis used as the gold standard...... infarction with respect to discharge diagnosis were 78%, 91%, and 81% for LIFEPAK 12 and 78%, 94%, and 87% for the Glasgow program. Corresponding data for attending cardiologists were 85%, 90%, and 81%. In conclusion, the Glasgow program had significantly higher specificity than the LIFEPAK 12 program (p = 0...
Effect of HALS on radiation discoloration of PE
International Nuclear Information System (INIS)
Wang Huiliang; Wang Chun; Chen Wenxiu
2001-01-01
The effects of hindered amine light stabilizers (HALS) on the radiation-induced discoloration of polyethylene (PE) are studied by measuring the yellowness index (YI) of PE. It is found that all the HALS used are effective in preventing PE from radiation-induced discoloration. The YI of PE added pentamethyl HALS (PMPM, PPMPM) is a little higher than that of PE added corresponding tetramethyl HALS (TMPM, PTMPM) when radiation dose is low than 100 kGy, but when the radiation dose is higher than 100 kGy, the YI of PE added pentamethyl HALS is lower. Pentamethyl HALS is more effective in preventing PE from radiation-induced discoloration when radiation dose is higher. It is also found that polymeric HALS is more effective in preventing PE from radiation-induced discoloration than corresponding monomeric HALS when radiation dose is higher than 200 kGy. The formation of alkyl free radical, carbonyl after irradiation is measured. It is found that the relative concentration of free radical formed in PE added TMPM is higher than that of PE added PMPM when radiation dose is relatively high. The carbonyl index of PE containing pentamethyl HALS is less than that of PE containing tetramethyl HALS when radiation is relatively low, but the results is contrary when radiation dose is relatively high. It is believed that HALS prevents PE from radiation-induced discoloration by scavenging free radicals formed in irradiated PE
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Kleif, J.; Kirkegaard, A.; Vilandt, J.
2017-01-01
Background: Few studies have investigated the effects of preoperative dexamethasone in acute surgical patients. This study examined the effects of 8 mg dexamethasone administered intravenously 30 min before surgery for suspected acute appendicitis. Methods: A multicentre, parallel-group, double......-blind, placebo-controlled study was conducted at two university hospitals in Denmark. Adults undergoing laparoscopic surgery for suspected appendicitis were eligible for inclusion. Participants, healthcare staff and investigators were blinded until all data analysis had been done. The primary outcome...
Prins, Martin H; Lensing, Anthonie Wa; Bauersachs, Rupert; van Bellen, Bonno; Bounameaux, Henri; Brighton, Timothy A; Cohen, Alexander T; Davidson, Bruce L; Decousus, Hervé; Raskob, Gary E; Berkowitz, Scott D; Wells, Philip S
2013-09-20
Standard treatment for venous thromboembolism (VTE) consists of a heparin combined with vitamin K antagonists. Direct oral anticoagulants have been investigated for acute and extended treatment of symptomatic VTE; their use could avoid parenteral treatment and/or laboratory monitoring of anticoagulant effects. A prespecified pooled analysis of the EINSTEIN-DVT and EINSTEIN-PE studies compared the efficacy and safety of rivaroxaban (15 mg twice-daily for 21 days, followed by 20 mg once-daily) with standard-therapy (enoxaparin 1.0 mg/kg twice-daily and warfarin or acenocoumarol). Patients were treated for 3, 6, or 12 months and followed for suspected recurrent VTE and bleeding. The prespecified noninferiority margin was 1.75. A total of 8282 patients were enrolled; 4151 received rivaroxaban and 4131 received standard-therapy. The primary efficacy outcome occurred in 86 (2.1%) rivaroxaban-treated patients compared with 95 (2.3%) standard-therapy-treated patients (hazard ratio, 0.89; 95% confidence interval [CI], 0.66-1.19; pnoninferiority EINSTEIN-DVT: ClinicalTrials.gov, NCT00440193.
Tulevski, I. I.; Hirsch, A.; Sanson, B. J.; Romkes, H.; van der Wall, E. E.; van Veldhuisen, D. J.; Büller, H. R.; Mulder, B. J.
2001-01-01
Right ventricular (RV) function is of major prognostic significance in patients with acute pulmonary embolism (PE). The aim of the present study was to evaluate the role of neurohormone plasma brain natriuretic peptide (BNP) in assessing RV function in patients with acute PE. BNP levels were
Tulevski, I.I.; Hirsch, A; Sanson, BJ; Romkes, H; van der Wall, EE; van Veldhuisen, DJ; Buller, HR; Mulder, BJM
Right ventricular (RV) function is of major prognostic significance in patients with acute pulmonary embolism (PE). The aim of the present study was to evaluate the role of neurohormone plasma brain natriuretic peptide (BNP) in assessing RV function in patients with acute PE. BNP levels were
Suspected acute toxoplasmosis in pregnant women Suspeita de toxoplasmose aguda em gestantes
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Marcela Peres Castilho-Pelloso
2007-02-01
Full Text Available OBJECTIVE: To determine the prevalence of reagent serology for suspected acute toxoplasmosis in pregnant women and to describe clinical, laboratory and therapeutic profiles of mothers and their children. METHODS: A retrospective study was conducted with IgM-anti-Toxoplasma gondii-reagent pregnant women and their children who attended the public health system in the state of Paraná, Southern Brazil, from January 2001 to December 2003. Information were obtained from clinical, laboratory (ELISA IgM/IgG and ultrasonographic data and from interviews with the mothers. To test the homogeneity of the IgM indices in relation to the treatment used, the Pearson's Chi-square test was applied. Comparisons were considered significant at a 5% level. RESULTS: Two hundred and ninety (1.0% cases of suspected IgM-reagent infection were documented, with a prevalence of 10.7 IgM-reagent women per 1,000 births. Prenatal care started within the first 12 weeks for 214/290; 146/204 were asymptomatic. Frequent complaints included headaches, visual disturbance and myalgia. Ultrasonography revealed abnormalities in 13 of 204 pregnancies. Chemoprophylaxis was administered to 112/227; a single ELISA test supported most decisions to begin treatment. Pregnant women with IgM indices =2.000 tended to be treated more often. Among exposed children, 44/208 were serologically followed up and all were IgG-reagent, and three IgM-reagent cases showed clinical symptoms. CONCLUSIONS: The existence of pregnant women with laboratorially suspected acute toxoplasmosis who were not properly followed up, and of fetuses that were not adequately monitored, shows that basic aspects of the prenatal care are not being systematically observed. There is need of implementing a surveillance system of pregnant women and their children exposed to T. gondii.OBJETIVO: Determinar a prevalência de gestantes com sorologia reagente suspeita de toxoplasmose aguda e descrever as variáveis maternas e do
Stelzle, Dominik; Shah, Anoop S V; Anand, Atul; Strachan, Fiona E; Chapman, Andrew R; Denvir, Martin A; Mills, Nicholas L; McAllister, David A
2018-01-01
Heart failure may occur following acute myocardial infarction, but with the use of high-sensitivity cardiac troponin assays we increasingly diagnose patients with minor myocardial injury. Whether troponin concentrations remain a useful predictor of heart failure in patients with acute coronary syndrome is uncertain. We identified all consecutive patients (n = 4748) with suspected acute coronary syndrome (61 ± 16 years, 57% male) presenting to three secondary and tertiary care hospitals. Cox-regression models were used to evaluate the association between high-sensitivity cardiac troponin I concentration and subsequent heart failure hospitalization. C-statistics were estimated to evaluate the predictive value of troponin for heart failure hospitalization. Over 2071 years of follow-up there were 83 heart failure hospitalizations. Patients with troponin concentrations above the upper reference limit (URL) were more likely to be hospitalized with heart failure than patients below the URL (118/1000 vs. 17/1000 person years, adjusted hazard ratio: 7.0). Among patients with troponin concentrations acute coronary syndrome. The strongest associations were observed in patients with troponin concentrations in the normal reference range, in whom high-sensitivity cardiac troponin assays identify those at increased risk of heart failure who may benefit from further investigation and treatment. © The Author 2017. Published on behalf of the European Society of Cardiology
Imaging diagnosis of acute appendicitis
International Nuclear Information System (INIS)
Vovc, Virgiliu
2012-01-01
The nontraumatic acute abdomen is one of the most common presentation to the emergency room, with appendicitis being one of the most common causes of the acute abdomen. Up to 30 % of patients suspected of having acute appendicitis will present with atypical signs and symptoms. There are many conditions that imitate acute appendicitis. The percentage of unnecessary appendectomies that result from a clinical false-positive diagnosis of appendicitis. The use of computed tomography (CT) before planned surgery has decreased the negative appendicectomy rate for patients with suspected acute appendicitis. Recognition of the typical and atypical CT signs of appendicitis is important to optimize the diagnosis yield of the examination. Visualization of an appendix with normal characteristics is the most important finding to exclude appendicitis. (author)
Risk-Adapted Management of Acute Pulmonary Embolism: Recent Evidence, New Guidelines
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Anja Käberich
2014-10-01
Full Text Available Venous thromboembolism (VTE, the third most frequent acute cardiovascular syndrome, may cause life-threatening complications and imposes a substantial socio-economic burden. During the past years, several landmark trials paved the way towards novel strategies in acute and long-term management of patients with acute pulmonary embolism (PE. Risk stratification is increasingly recognized as a cornerstone for an adequate diagnostic and therapeutic management of the highly heterogeneous population of patients with acute PE. Recently published European Guidelines emphasize the importance of clinical prediction rules in combination with imaging procedures (assessment of right ventricular function and laboratory biomarkers (indicative of myocardial stress or injury for identification of normotensive PE patients at intermediate risk for an adverse short-term outcome. In this patient group, systemic full-dose thrombolysis was associated with a significantly increased risk of intracranial bleeding, a complication which discourages its clinical application unless hemodynamic decompensation occurs. A large-scale clinical trial program evaluating new oral anticoagulants in the initial and long-term treatment of venous thromboembolism showed at least comparable efficacy and presumably increased safety of these drugs compared to the current standard treatment. Research is continuing on catheter-directed, ultrasound-assisted, local, low-dose thrombolysis in the management of intermediate-risk PE.
A prospective validation of the Bova score in normotensive patients with acute pulmonary embolism.
Bova, Carlo; Vanni, Simone; Prandoni, Paolo; Morello, Fulvio; Dentali, Francesco; Bernardi, Enrico; Mumoli, Nicola; Bucherini, Eugenio; Barbar, Sofia; Picariello, Claudio; Enea, Iolanda; Pesavento, Raffaele; Bottino, Fabrizio; Jiménez, David
2018-05-01
The Bova score has shown usefulness in the identification of intermediate-high risk patients with acute pulmonary embolism (PE), but lacks prospective validation. The aim of this study was to prospectively validate the Bova score in different settings from the original derivation cohort. Consecutive, normotensive patients with acute PE recruited at 13 academic or general hospitals were stratified, using their baseline data, into the three Bova risk stages (I-III). The primary outcome was the 30-day composite of PE-related mortality, hemodynamic collapse and non-fatal PE recurrences in the three risk categories. In the study period, 639 patients were enrolled. The primary end point occurred in 45 patients (7.0%; 95% Confidence Intervals, 5.2%-9.3%). Risk stage correlated with the PE-related complication rate (stage I, 2.9%; stage II, 17%; stage III, 27%). Patients classified as stage III by the Bova score had a 6.5-fold increased risk for adverse outcomes (3.1-13.5, p < 0.001) compared with stages I and II combined. Rescue thrombolysis increased from stage I to stage III (0.6%, 12% and 15% respectively). All-cause mortality (5.3%) did not substantially differ among the stages. The Bova score accurately stratifies normotensive patients with acute PE into stages of increasing risk of 30-day PE-related complications. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Forbes, Kirsten P.N.; Reid, John H.; Murchison, John T.
2001-01-01
AIM: To investigate if preliminary chest radiograph (CXR) findings can define the optimum role of lung scintigraphy in subjects investigated for pulmonary embolism (PE). MATERIALS AND METHODS: The CXR and scintigraphy findings from 613 consecutive subjects investigated for suspected PE were retrieved from a radiological database. Of 393 patients with abnormal CXRs, a subgroup of 238 was examined and individual radiographic abnormalities were characterized. CXR findings were related to the scintigraphy result. RESULTS: Scintigraphy was normal in 286 subjects (47%), non-diagnostic in 207 (34%) and high probability for PE in 120 (20%). In 393 subjects (64%) the preliminary CXR was abnormal and 188 (48%) of scintigrams in this group were non-diagnostic. Individual radiographic abnormalities were not associated with significantly different scintigraphic outcomes. If the preliminary CXR was normal (36%), the proportion of non-diagnostic scintigrams decreased to 9% (19 of 220 subjects) (P < 0.05). CONCLUSION: In subjects investigated for PE, an abnormal CXR increases the prevalence of non-diagnostic scintigrams. A normal pre-test CXR is more often associated with a definitive (normal or high probability) scintigram result. The chest radiograph may be useful in deciding the optimum sequence of investigations. Forbes, K.P.N., Reid, J.H., Murchison, J.T. (2001)
Chioncel, Ovidiu; Ambrosy, Andrew P; Bubenek, Serban; Filipescu, Daniela; Vinereanu, Dragos; Petris, Antoniu; Christodorescu, Ruxandra; Macarie, Cezar; Gheorghiade, Mihai; Collins, Sean P
2016-02-01
The objective of this study was to evaluate the clinical presentation, inpatient management, and in-hospital outcome of patients hospitalized for acute heart failure syndromes (AHFS) and classified as pulmonary edema (PE). The Romanian Acute Heart Failure Syndromes (RO-AHFS) study was a prospective, national, multicenter registry of all consecutive patients admitted with AHFS over a 12-month period. Patients were classified at initial presentation by clinician-investigators into the following clinical profiles: acute decompensated HF, cardiogenic shock, PE, right HF, or hypertensive HF. RO-AHFS enrolled 3224 patients and 28.7% (n = 924) were classified as PE. PE patients were more likely to present with pulmonary congestion, tachypnea, tachycardia, and elevated systolic blood pressure and less likely to have peripheral congestion and body weight increases. Mechanical ventilation was required in 8.8% of PE patients. PE patients received higher doses (i.e. 101.4 ± 27.1 mg) of IV furosemide for a shorter duration (i.e. 69.3 ± 22.3 hours). Vasodilators were given to 73.6% of PE patients. In-hospital all-cause mortality (ACM) in PE patients was 7.4%, and 57% of deaths occurred on day one. Increasing age, concurrent acute coronary syndromes, life-threatening ventricular arrhythmias, elevated BUN, left bundle branch block, inotrope therapy, and requirement for invasive mechanical ventilation were independent risk factors for ACM. In this national registry, the PE profile was found to be a high-acuity clinical presentation with distinctive treatment patterns and a poor short-term prognosis. Advances in the management of PE may necessitate both the development of novel targeted therapies as well as systems-based strategies to identify high-risk patients early in their course.
Suspected post-vaccinal acute polyradiculoneuritis in a puppy : short communication
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R. Gehring
2001-07-01
Full Text Available A 4-month-old German shepherd puppy developed hindquarter weakness after vaccination with a multivalent vaccine. This is suggestive of post-vaccinal polyradiculoneuritis. To date, only 1 similar case has been reported, which may be due to the under-reporting of suspected adverse drug reactions.
Investigation of suspected TRALI cases in 2006–2011
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Marjeta Maček Kvanka
2012-12-01
Methods: In 2006–2011, eight suspected TRALI cases that met consensus clinical criteria and had chest radiograph were investigated in the Blood Transfusion Center of Slovenia. Patients and all donors of blood components transfused within 6 hours before the onset of acute respiratory distress were investigated for leukocyte antibodies against HLA class I and II antigens, and antibodies against neutrophil antigens HNA. All cases were investigated for patient, donor and blood component characteristics. In cooperation with clinicians, chest radiographs and alternative risk factors for acute lung injury (ALI were evaluated.
International Nuclear Information System (INIS)
Okada, Munemasa; Kunihiro, Yoshie; Nakashima, Yoshiteru; Nomura, Takafumi; Kudomi, Shohei; Yonezawa, Teppei; Suga, Kazuyoshi; Matsunaga, Naofumi
2015-01-01
Purpose: To investigate the added value of lung perfused blood volume (LPBV) using dual-energy CT for the evaluation of intrapulmonary clot (IPC) in patients suspected of having acute pulmonary embolism (PE). Materials and methods: Institutional review board approval was obtained for this retrospective study. Eighty-three patients suspected of having PE who underwent CT pulmonary angiography (CTPA) using a dual-energy technique were enrolled in this study. Two radiologists who were blinded retrospectively and independently reviewed CTPA images alone and the combined images with color-coded LPBV over a 4-week interval, and two separate sessions were performed with a one-month interval. Inter- and intraobserver variability and diagnostic accuracy were evaluated for each reviewer with receiver operating characteristic (ROC) curve analysis. Results: Values for inter- and intraobserver agreement, respectively, were better for CTPA combined with LPBV (ICC = 0.847 and 0.937) than CTPA alone (ICC = 0.748 and 0.861). For both readers, diagnostic accuracy (area under the ROC curve [A z ]) were also superior, when CTPA alone (A z = 0.888 [reader 1] and 0.912 [reader 2]) was compared with that after the combination with LPBV images (A z = 0.966 [reader 1] and 0.959 [reader 2]) (p < 0.001). However, A z values of both images might not have significant difference in statistics, because A z value of CTPA alone was high and 95% confidence intervals overlapped in both images. Conclusion: Addition of dual-energy perfusion CT to CTPA improves detection of peripheral IPCs with better interobserver agreement
International Nuclear Information System (INIS)
Wittenberg, R.; Vliet, J.W. van; Ghaye, B.; Peters, J.F.; Schaefer-Prokop, C.M.; Coche, E.
2012-01-01
Purpose: Compare the right ventricle to left ventricle (RV/LV) diameter ratio obtained from axial pulmonary CT angiograms (CTPA) with those derived from automatically generated 4-chamber (4-CH) reformats in patients with suspected pulmonary embolism (PE). Methods: In this institutional review board-approved study we included 120 consecutive non ECG-gated CTPA from 3 institutions (mean age 60 ± 16 years; 71 women). Twenty 64-slice CTPA with PE and 20 without PE were selected per institution. For each patient the RV/LV diameter ratio was obtained from both axial CTPA images and automatically generated 4-CH reformats. Measurements were performed twice in two separated sessions by 2 experienced radiologists and 2 residents. The differences between the measurements on both views were evaluated. Results: The 4-CH view was successfully obtained in 113 patients. The mean axial and 4-CH diameter ratios were comparable for three of the four readers (p = 0.56, p = 0.13, p = 0.08). Although the mean diameters (1.0 and 1.03 respectively) for one resident were significantly different (p = 0.013), the difference of 0.03 seems negligible in clinical routine. Three readers achieved equally high intra-reader agreements with both measurements (ICCs of 0.94, 0.95 and 0.96), while one reader showed a different variability with ICCs of 0.96 for the axial view and 0.91 for the 4-CH view. The inter-reader agreement was equally high for both measurement types with ICCs of 0.95 and 0.94, respectively. Conclusion: In patients with suspected PE, RV/LV diameters ratio can be measured with the same reproducibility and accuracy using an automatically generated 4-CH view compared to the axial view.
Kırış, Tuncay; Yazıcı, Selcuk; Durmuş, Gündüz; Çanga, Yiğit; Karaca, Mustafa; Nazlı, Cem; Dogan, Abdullah
2018-01-01
Acute pulmonary embolism (PE) is a serious clinical disease characterized by a high mortality rate. The aim of this study was to assess the prognostic value of international normalized ratio (INR) in acute PE patients not on anticoagulant therapy. The study included 244 hospitalized acute PE patients who were not receiving previous anticoagulant therapy. Based on their 30-day mortality, patients were categorized as survivors or non-survivors. INR was measured during the patients' admission, on the same day as the diagnosis of PE but before anticoagulation started. Thirty-day mortality occurred in 39 patients (16%). INR was higher in non-survivors than in survivors (1.3±0.4 vs 1.1±0.3, P=.003). In multivariate analysis, INR (HR: 3.303, 95% CI: 1.210-9.016, P=.020) was independently associated with 30-day mortality from PE. Inclusion of INR in a model with simplified pulmonary embolism severity index (sPESI) score improved the area under the receiver operating characteristics (ROC) curve from 0.736 (95% CI: 0.659-0.814) to 0.775 (95% CI: 0.701-0.849) (P=.028). Also, the addition of INR to sPESI score enhanced the net reclassification improvement (NRI=8.8%, P<.001) and integrated discrimination improvement (IDI=0.043, P=.027). Elevated INR may have prognostic value for 30-day mortality in acute PE patients not on anticoagulation. Combining INR with sPESI score improved the predictive value for all-cause mortality. However, further large-scale studies are needed to confirm it's prognostic role. © 2017 Wiley Periodicals, Inc.
DEFF Research Database (Denmark)
Rasmussen, Martin B; Stengaard, Carsten; Sørensen, Jacob T
2017-01-01
-of-care cardiac troponin T measurements (11.0%) had a value ≥50 ng/l, including 966 with acute myocardial infarction (sensitivity: 44.2%, specificity: 92.8%). Patients presenting with a prehospital point-of-care cardiac troponin T value ≥50 ng/l had a one-year mortality of 24% compared with 4.8% in those...... with values analysis: point-of-care cardiac troponin T≥50 ng/l (hazard ratio 2.10, 95% confidence interval: 1.90-2.33), congestive heart failure (hazard ratio 1.93, 95% confidence interval: 1......OBJECTIVE: The purpose of this study was to determine the predictive value of routine prehospital point-of-care cardiac troponin T measurement for diagnosis and risk stratification of patients with suspected acute myocardial infarction. METHODS AND RESULTS: All prehospital emergency medical service...
Saleh, Langeza; Verdonk, Koen; Jan Danser, A H; Steegers, Eric A P; Russcher, Henk; van den Meiracker, Anton H; Visser, Willy
2016-04-01
To evaluate the additive value of the sFlt-1/PlGF ratio for diagnosing preeclampsia (PE) and predicting prolongation of pregnancy and adverse outcome in a cohort of women with PE or at high risk of PE. Patients with suspected or confirmed clinical PE were recruited. At time of inclusion blood for measurement of sFlt-1and PlGF was taken. Values were determined after delivery. A cut-off ratio of ≥85 was defined as a positive test. A total of 107 patients were included. Of the patients, 62 (58%) met the clinical criteria of PE at time of blood sampling. In 10% of these patients (n=6) the ratio was ratio was ≥85 (false positive), resulting in positive and negative predictive values of 95% and 88% respectively. One patient with false positive ratio developed superimposed PE and 2 developed gestational hypertension, and adverse outcome occurred in all three. An adverse pregnancy outcome was only encountered in 1 of the 6 patients with a false negative ratio. Using a binary regression model with adjustment for gestational age ratio (P=0.036). The additive value of an increased ratio for diagnosing PE is limited since most patients with clinical PE also have a positive ratio. However, an elevated ratio is superior to the clinical diagnosis of PE for predicting an adverse pregnancy outcome. Furthermore, irrespective of clinical PE, a low ratio is inversely correlated with prolongation of pregnancy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
A compact PE memory for vision chips
Cong, Shi; Zhe, Chen; Jie, Yang; Nanjian, Wu; Zhihua, Wang
2014-09-01
This paper presents a novel compact memory in the processing element (PE) for single-instruction multiple-data (SIMD) vision chips. The PE memory is constructed with 8 × 8 register cells, where one latch in the slave stage is shared by eight latches in the master stage. The memory supports simultaneous read and write on the same address in one clock cycle. Its compact area of 14.33 μm2/bit promises a higher integration level of the processor. A prototype chip with a 64 × 64 PE array is fabricated in a UMC 0.18 μm CMOS technology. Five types of the PE memory cell structure are designed and compared. The testing results demonstrate that the proposed PE memory architecture well satisfies the requirement of the vision chip in high-speed real-time vision applications, such as 1000 fps edge extraction.
A compact PE memory for vision chips
International Nuclear Information System (INIS)
Shi Cong; Chen Zhe; Yang Jie; Wu Nanjian; Wang Zhihua
2014-01-01
This paper presents a novel compact memory in the processing element (PE) for single-instruction multiple-data (SIMD) vision chips. The PE memory is constructed with 8 × 8 register cells, where one latch in the slave stage is shared by eight latches in the master stage. The memory supports simultaneous read and write on the same address in one clock cycle. Its compact area of 14.33 μm 2 /bit promises a higher integration level of the processor. A prototype chip with a 64 × 64 PE array is fabricated in a UMC 0.18 μm CMOS technology. Five types of the PE memory cell structure are designed and compared. The testing results demonstrate that the proposed PE memory architecture well satisfies the requirement of the vision chip in high-speed real-time vision applications, such as 1000 fps edge extraction. (semiconductor integrated circuits)
Studies on flame retardancy of radiation crosslinked PE foam
International Nuclear Information System (INIS)
Yang Huili; Yao Zhanhai; Xu Jun
1996-01-01
CPE, DBDPO and Sb 2 O 3 were used as flame-retardant of PE foam. Effect of CPE on PE foam under radiation and it's flame-retardancy were studied. The result showed that CPE can enhance radiation cross-linking of PE, and trinary of addition being made of CPE, DBDPO and Sb 2 O 3 made oxygen index of PE foam achieve over 30, and self-extinguish, it did not influence manufacture and mechanical properties of PE foam
Bogdanova-Mihaylova, Petya; Burke, David; O'Dwyer, John P; Bradley, David; Williams, Jennifer A; Cronin, Simon J; Smyth, Shane; Murphy, Raymond P; Murphy, Sinead M; Wall, Catherine; McCabe, Dominick J H
2018-01-06
Patients with 'suspected viral encephalitis' are frequently empirically treated with intravenous aciclovir. Increasing urea and creatinine are 'common', but rapidly progressive renal failure is reported to be 'very rare'. To describe the clinical course and outcome of cases of aciclovir-induced acute kidney injury (AKI) encountered by the Liaison Neurology Service at AMNCH and to highlight the importance of surveillance and urgent treatment of this iatrogenic complication. Retrospectively and prospectively collected data from the Liaison Neurology Service at AMNCH on patients who received IV aciclovir for suspected viral encephalitis and developed AKI were analysed. Aciclovir-induced AKI was defined by a consultant nephrologist in all cases as a rise in serum creatinine of > 26 μmol/L in 48 h or by ≥ 1.5 times the baseline value. Renal function, haematocrit, and fluid balance were monitored following AKI onset. Data from 10 patients were analysed. Median time to AKI onset was 3.5 days (range: 1-6 days). Aciclovir was stopped or the dose adjusted. All patients recovered with IV normal saline, aiming for a urine output > 100-150 ml/h. The interval between first rise in creatinine and return to normal levels varied between 5 and 19 days. Liaison neurologists and general physicians need to be aware that aciclovir may cause AKI attributed to distal intra-tubular crystal nephropathy. Daily fluid balance and renal function monitoring are essential because AKI may arise even with intensive pre-hydration. Prognosis is good if identified early and actively treated.
The characterisation of two different degradable polyethylene (PE) sacks
International Nuclear Information System (INIS)
Davis, G.
2006-01-01
The compostability of two different polyethylene (PE) products on the UK market under open-windrow composting conditions is explored within this paper. Chemical analysis of the PE bags has established their constituents in order to examine how the PE bags have an increased degradability depending on additives. Weight loss of the two different PE products within open-windrow composting conditions was recorded in order to establish the percentage weight loss as an indication of the degradability of the two products and their relative suitability for open-windrow composting. Scanning electron microscopy (SEM) of the PE products over the composting duration established the degradation processes for the PE products within the compost. These analyses concluded that one of the PE product mixes was more degradable than the other. However, neither product completed degraded within the timeframe of 12-14 weeks generally accepted for open-windrow composting in the UK
Directory of Open Access Journals (Sweden)
Mohd eKhubaib
2016-05-01
Full Text Available PE/PPE genes, present in cluster with ESAT-6 like genes, are suspected to have a role in antigenic variation and virulence of Mycobacterium tuberculosis. Their roles in immune evasion and immune modulation of host are also well documented. We present evidence that PE32/PPE65 present within the RD8 region are co-operonic, co-transcribed and co-translated, and play role in modulating host immune responses. Experiments with macrophage cell lines revealed that this protein complex suppresses pro-inflammatory cytokines such as TNF-α and IL-6 whereas also inducing high expression of anti-inflammatory IL-10. Immunization of mice with these recombinant proteins dampens an effective Th1 response as evident from reduced frequency of IFN-g and IL-2 producing CD4+ and CD8+ T cells. IgG sub-typing from serum of immunized mice revealed high levels of IgG1 when compared with IgG2a and IgG2b. Further IgG1/IgG2a ratio clearly demonstrated that the protein complex manipulates the host immune response favourable to the pathogen. Our results demonstrate that the co-transcribed and co-translated PE32 and PPE65 antigens are involved specifically in modulating anti-mycobacterial host immune response by hampering Th1 response.
Anggraini, Mita; Mahastanti, Linda Ariany
2012-01-01
Institutional investors needs analysis in making decisions for investing activities. Analysis of the most widely used is the fundamental analysis approach is through a P/E ratio. P/E (price earnings ratio) can be interpreted as an indicator of market confidence in the company's growth prospects in the future. High P/E indicates that the better performance of the company and this caught a lot of institutional investors to buy shares so that the percentage of institutional ownership in the comp...
Directory of Open Access Journals (Sweden)
Preciosa M Coloma
Full Text Available Drug-related adverse events remain an important cause of morbidity and mortality and impose huge burden on healthcare costs. Routinely collected electronic healthcare data give a good snapshot of how drugs are being used in 'real-world' settings.To describe a strategy that identifies potentially drug-induced acute myocardial infarction (AMI from a large international healthcare data network.Post-marketing safety surveillance was conducted in seven population-based healthcare databases in three countries (Denmark, Italy, and the Netherlands using anonymised demographic, clinical, and prescription/dispensing data representing 21,171,291 individuals with 154,474,063 person-years of follow-up in the period 1996-2010. Primary care physicians' medical records and administrative claims containing reimbursements for filled prescriptions, laboratory tests, and hospitalisations were evaluated using a three-tier triage system of detection, filtering, and substantiation that generated a list of drugs potentially associated with AMI. Outcome of interest was statistically significant increased risk of AMI during drug exposure that has not been previously described in current literature and is biologically plausible.Overall, 163 drugs were identified to be associated with increased risk of AMI during preliminary screening. Of these, 124 drugs were eliminated after adjustment for possible bias and confounding. With subsequent application of criteria for novelty and biological plausibility, association with AMI remained for nine drugs ('prime suspects': azithromycin; erythromycin; roxithromycin; metoclopramide; cisapride; domperidone; betamethasone; fluconazole; and megestrol acetate.Although global health status, co-morbidities, and time-invariant factors were adjusted for, residual confounding cannot be ruled out.A strategy to identify potentially drug-induced AMI from electronic healthcare data has been proposed that takes into account not only statistical
Energy Technology Data Exchange (ETDEWEB)
Bauer, Ralf W.; Frellesen, Claudia; Schell, Boris; Lehnert, Thomas; Jacobi, Volkmar; Vogl, Thomas J.; Kerl, J.M. [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Renker, Matthias [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States); Ackermann, Hanns [Clinic of the Goethe University, Department of Biostatistics and Mathematical Modelling, Frankfurt (Germany); Schoepf, U.J. [Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States)
2011-09-15
To investigate the role of perfusion defect (PD) size on dual energy CT pulmonary blood volume assessment as predictor of right heart strain and patient outcome and its correlation with d-dimer levels in acute pulmonary embolism (PE). 53 patients with acute PE who underwent DECT pulmonary angiography were retrospectively analyzed. Pulmonary PD size caused by PE was measured on DE iodine maps and quantified absolutely (VolPD) and relatively to the total lung volume (RelPD). Signs of right heart strain (RHS) on CT were determined. Information on d-dimer levels and readmission for recurrent onset of PE and death was collected. D-dimer level was mildly (r = 0.43-0.47) correlated with PD size. Patients with RHS had significantly higher VolPD (215 vs. 73 ml) and RelPD (9.9 vs. 2.9%) than patients without RHS (p < 0.003). There were 2 deaths and 1 readmission due of PE in 18 patients with >5% RelPD, while no such events were found for patients with <5% RelPD. Pulmonary blood volume on DECT in acute PE correlates with RHS and appears to be a predictor of patient outcome in this pilot study. (orig.)
Energy Technology Data Exchange (ETDEWEB)
Brewster, D.W.; Elwell, M.R.; Birnbaum, L.S.
1988-04-01
The toxicity and disposition of 2,3,4,7,8-pentachlorodibenzofuran (4PeCDF), a ubiquitous and acutely toxic environmental contaminant, was examined in three adult male Rhesus monkeys administered a single iv dose of 34 micrograms (0.1 mumol)/kg. Within 20 min, 4PeCDF was eliminated from the blood and was distributed to the liver, skin, adipose, and muscle tissues. Excretion occurred primarily via the feces with a minimum whole body half-life approximately 38 days. Within 7-14 days after administration, the packed cell volume and serum triglyceride and bile acid concentrations were significantly increased while serum cholesterol, protein, and albumin concentrations were decreased relative to pretreatment levels. Thyroid hormone levels were also altered with an increase in TSH and a decrease in T3 and T4 concentrations. After 28 days, two monkeys began exhibiting alopecia, hyperkeratinization of the toe and finger nails, facial chloracne-like lesions, and loss of body weight. They subsequently died 40 and 48 days after treatment. Similar symptoms of toxicity were observed in the third animal 58 days after 4PeCDF administration, but this animal appeared to fully recover and was administered 4PeCDF orally and (3H)1,2,3,7,8-pentachloro-dibenzofuran (1PeCDF) dermally 238 days after the initial iv dose. In this animal, approximately 2% of an oral dose of (14C)-4PeCDF was absorbed from the stomach and small intestine in 6 hr and was distributed mainly to the muscle and skin and less than 99% of a dermal dose of 1PeCDF remained at the site of application. Pathological findings in the monkeys that died indicated hyperplastic and metaplastic changes in the gastric mucosa, the Meibomian glands of the eyelid, and the ceruminous glands of the ear. Regression of these lesions was present in the surviving animal.
International Nuclear Information System (INIS)
Lee, Hwa Yeon; Song, In Sup; Yoo, Seung Min; Rho, Ji Young; Moon, Jae Youn; Kim, In Jai; Lim, Sang Wook; Sung, Jung Hoon; Cha, Dong Hun; White, Charles S.
2011-01-01
Background Although triple rule-out CT angiography (TRO) to simultaneously evaluate acute coronary syndrome (ACS), pulmonary embolism (PE), and acute aortic syndrome (AAS) is increasingly used in many institutions, TRO is inevitably associated with increased radiation exposure due to extended z-axis coverage compared with dedicated coronary CT angiography (DCTA). Purpose To determine the frequency of exclusion of findings of AAS, PE, and significant incidental non-cardiac pathology that may be the cause of acute chest pain when using a restricted DCTA field of view (FOV). Material and Methods We retrospectively reviewed CT images and charts of 103 patients with acute PE and 50 patients with AAS. Either non-ECG gated dedicated pulmonary or aortic CT angiography was performed using 16- or 64-slice multidetector CT (MDCT). We analyzed the incidence of isolated PE, AAS, or significant non-cardiac pathology outside of DCTA FOV (i.e. from tracheal carina to the base of heart). Results There were two cases of isolated PE (2/103, 1.9%) excluded from the FOV of DCTA. One case of PE was isolated to the subsegmental pulmonary artery in the posterior segment of the right upper lobe. In the second case, pulmonary embolism in the left main pulmonary artery was located out of the FOV of DCTA because the left main pulmonary artery was retracted upwardly by fibrotic scar in the left upper lobe due to prior tuberculosis. There was no case of AAS and significant non-cardiac pathology excluded from the FOV of DCTA. AAS (n = 50) consisted of penetrating atherosclerotic ulcer (n = 7), intramural hematoma (n = 5) and aortic dissection (n = 38). Conclusion As isolated PE, AAS, and significant non-cardiac pathology outside of the DCTA FOV rarely occur, DCTA may replace TRO in the evaluation of patients with non-specific acute chest pain and a low pre-test probability of PE or aortic dissection
Energy Technology Data Exchange (ETDEWEB)
Lee, Hwa Yeon; Song, In Sup (Dept. of Diagnostic Radiology Chung-Ang Univ. College of Medicine, Seoul (Korea, Republic of)); Yoo, Seung Min; Rho, Ji Young (Dept. of Diagnostic Radiology CHA Medical Univ. Hospital, Bundang (Korea, Republic of)), email: smyoo68@hanmail.net; Moon, Jae Youn; Kim, In Jai; Lim, Sang Wook; Sung, Jung Hoon; Cha, Dong Hun (Dept. of Cardiology CHA Medical Univ. Hospital, Bundang (Korea, Republic of)); White, Charles S. (Dept. of Diagnostic Radiology Univ. of Maryland, Baltimore (United States))
2011-05-15
Background Although triple rule-out CT angiography (TRO) to simultaneously evaluate acute coronary syndrome (ACS), pulmonary embolism (PE), and acute aortic syndrome (AAS) is increasingly used in many institutions, TRO is inevitably associated with increased radiation exposure due to extended z-axis coverage compared with dedicated coronary CT angiography (DCTA). Purpose To determine the frequency of exclusion of findings of AAS, PE, and significant incidental non-cardiac pathology that may be the cause of acute chest pain when using a restricted DCTA field of view (FOV). Material and Methods We retrospectively reviewed CT images and charts of 103 patients with acute PE and 50 patients with AAS. Either non-ECG gated dedicated pulmonary or aortic CT angiography was performed using 16- or 64-slice multidetector CT (MDCT). We analyzed the incidence of isolated PE, AAS, or significant non-cardiac pathology outside of DCTA FOV (i.e. from tracheal carina to the base of heart). Results There were two cases of isolated PE (2/103, 1.9%) excluded from the FOV of DCTA. One case of PE was isolated to the subsegmental pulmonary artery in the posterior segment of the right upper lobe. In the second case, pulmonary embolism in the left main pulmonary artery was located out of the FOV of DCTA because the left main pulmonary artery was retracted upwardly by fibrotic scar in the left upper lobe due to prior tuberculosis. There was no case of AAS and significant non-cardiac pathology excluded from the FOV of DCTA. AAS (n = 50) consisted of penetrating atherosclerotic ulcer (n = 7), intramural hematoma (n = 5) and aortic dissection (n = 38). Conclusion As isolated PE, AAS, and significant non-cardiac pathology outside of the DCTA FOV rarely occur, DCTA may replace TRO in the evaluation of patients with non-specific acute chest pain and a low pre-test probability of PE or aortic dissection
Role of CT scan in diagnosis of acute appendicitis
International Nuclear Information System (INIS)
Salem, O.A.; Khasawneh, M.
2007-01-01
To evaluate the diagnostic accuracy of the spiral-CT in patients with clinically suspected acute appendicitis. A total of 124 patients referred for CT scan with suspected appendicitis between January 2005 and October 2006 were assessed for the appendiceal size and the presence of signs of appendicitis. The findings were correlated with surgical histopathology. CT scan had a sensitivity of 95 percent and a specifity of 93 percent and an overall accuracy of 92 percent. The use of spiral CT in patients with equivocal clinical presentation suspected of having acute appendicitis can lead to significant improvement in the preoperative diagnosis. (author)
Unenhanced MR Imaging in adults with clinically suspected acute appendicitis
DEFF Research Database (Denmark)
Chabanova, Elizaveta; Balslev, Ingegerd; Achiam, Michael
2011-01-01
patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate (kappa=0.51) and fair (kappa=0.31) interobserver agreements in the MR diagnosis of acute...
Flamenco guitarist Paco Peña tours CERN
Pauline Gagnon
2013-01-01
CERN continues to attract a wide variety of visitors. On 5 June, it was the turn of renowned flamenco guitarist Paco Peña. With a broad interest in science, Peña was here to celebrate his 60th birthday, accompanied by friends David Ashton and Chrissie Twigg, and his wife Karin. Paco Peña during his visit to ATLAS. Paco Peña’s most famous compositions include Misa Flamenca, a Flamenco Mass, and Requiem for the Earth. In 1997, he was named Oficial de la Cruz de la Orden del Mérito Civil by King Juan Carlos of Spain. "This is truly amazing!" said Peña after seeing the ATLAS detector. His wife confessed that she had never seen him take so many pictures. The group asked numerous questions during their visit. It is not always easy to impress world travellers, but the ATLAS detector did the trick.
PE-3 - a high class pipeline; PE-3 - um oleoduto high-class
Energy Technology Data Exchange (ETDEWEB)
Hashiguchi, D Issao; Santos, J.A. Costa; Medeiros, A Roberto [GDK Engenharia, Salvador, BA (Brazil); Garcia, Amaury [TRANSPETRO - PETROBRAS Transportes, Rio de Janeiro, RJ (Brazil); Santos, F Cesar [Superpesa Transportes Especiais e Intermodais, Rio de Janeiro, RJ (Brazil)
2003-07-01
Pipeline PE-3, with a length of approximately 17 Km mainly inside of Guanabara Bay, connects the refinery of Duque de Caxias to the terminal of the Ilha D'Agua. It is used to export dark products from the refinery. Product transfer, by operational necessity, is conducted at a temperature of 75 deg C. This introduces a considerable load of tension on the pipeline, in addition to creating a fatigue-inducing thermal cycle. Because of this, and unlike almost all other existing oil and gas pipelines, PE-3 posses a zig zag configuration, alternating a straight tube with a curve of 10 degrees. This stands out as an innovative concept. Their are only two other similar installations in the world, but in very different conditions, thus conferring a pioneering aspect on this pipeline. Due to its criticality, the pipeline is predicated on complete certification in its entirety, from design to operation and in adherence with the strictest requirements. The environmental conditions encountered along its right of way, and the constructive tolerances imposed by the project, obligate the adoption of constructive and technical solutions that are themselves innovative in the terrestrial and marine realms. The principal objective of this work is to present a general overview of the methodology employed in PE-3 construction, installation and assembly. (author)
PE-3 - a high class pipeline; PE-3 - um oleoduto high-class
Energy Technology Data Exchange (ETDEWEB)
Hashiguchi, D. Issao; Santos, J.A. Costa; Medeiros, A. Roberto [GDK Engenharia, Salvador, BA (Brazil); Garcia, Amaury [TRANSPETRO - PETROBRAS Transportes, Rio de Janeiro, RJ (Brazil); Santos, F. Cesar [Superpesa Transportes Especiais e Intermodais, Rio de Janeiro, RJ (Brazil)
2003-07-01
Pipeline PE-3, with a length of approximately 17 Km mainly inside of Guanabara Bay, connects the refinery of Duque de Caxias to the terminal of the Ilha D'Agua. It is used to export dark products from the refinery. Product transfer, by operational necessity, is conducted at a temperature of 75 deg C. This introduces a considerable load of tension on the pipeline, in addition to creating a fatigue-inducing thermal cycle. Because of this, and unlike almost all other existing oil and gas pipelines, PE-3 posses a zig zag configuration, alternating a straight tube with a curve of 10 degrees. This stands out as an innovative concept. Their are only two other similar installations in the world, but in very different conditions, thus conferring a pioneering aspect on this pipeline. Due to its criticality, the pipeline is predicated on complete certification in its entirety, from design to operation and in adherence with the strictest requirements. The environmental conditions encountered along its right of way, and the constructive tolerances imposed by the project, obligate the adoption of constructive and technical solutions that are themselves innovative in the terrestrial and marine realms. The principal objective of this work is to present a general overview of the methodology employed in PE-3 construction, installation and assembly. (author)
CMFD simulation of ERCOSAM PANDA spray tests PE1 and PE2
Energy Technology Data Exchange (ETDEWEB)
Filippov, A., E-mail: phil@ibrae.ac.ru [Nuclear Safety Institute of the Russian Academy of Sciences (IBRAE RAN) (Russian Federation); Moscow Institute of Physics and Technology (Russian Federation); Grigoryev, S. [Nuclear Safety Institute of the Russian Academy of Sciences (IBRAE RAN) (Russian Federation); Moscow Institute of Physics and Technology (Russian Federation); Drobyshevsky, N.; Kiselev, A.; Shyukin, A.; Yudina, T. [Nuclear Safety Institute of the Russian Academy of Sciences (IBRAE RAN) (Russian Federation)
2016-04-01
Highlights: • Successful modeling of gas mixtures and droplet flows in multicompartment system. • For pressure, modeling of gas-wall heat transfer (and heat radiation) is important. • Dependence of gas mixing time in spray vessel on the used nozzle may be essential. • Penetration of helium-enriched mixture into another vessel due to spray operation. • Effect on pressure of sump re-evaporation and gas heating (by walls) during spray. - Abstract: The ERCOSAM project (together with the SAMARA project) includes a set of multi-stage experiments carried out at different thermal-hydraulics facilities (TOSQAN, MISTRA, PANDA, SPOT) and their numerical simulation. The test sequences aim to investigate hydrogen concentration build-up and stratification during a postulated severe accident as well as the effect of activation of Severe Accident Management systems (SAMs) on stratification. At the initial Phases I–III of the tests stratification of the injected light gases (steam, helium) is established, pressure increases. The models of SAMs are activated at the final Phase IV. In the paper, two spray tests PE1 and PE2 performed at PANDA facility are numerically investigated aiming for code validation (FLUENT) and better understanding of physical processes. Phases I–IV of the tests were simulated. A satisfactory agreement with the experimental results on gas component mole fractions was obtained. The reasons of obtained some discrepancies in pressure and temperature were studied in multivariate calculations and discussed in the paper. The tests PE1 and PE2 were performed with different spray nozzles and initial conditions. In simulation that resulted in different flow patterns during spray operation. The sensitivity to nozzle angle and some other input parameters was investigated. Possible factors of depressurization rate caused by spray operation were also studied. The key features observed in the experiments and obtained numerically being of interest in terms of
International Nuclear Information System (INIS)
Bauer, Ralf W.; Frellesen, Claudia; Schell, Boris; Lehnert, Thomas; Jacobi, Volkmar; Vogl, Thomas J.; Kerl, J.M.; Renker, Matthias; Ackermann, Hanns; Schoepf, U.J.
2011-01-01
To investigate the role of perfusion defect (PD) size on dual energy CT pulmonary blood volume assessment as predictor of right heart strain and patient outcome and its correlation with d-dimer levels in acute pulmonary embolism (PE). 53 patients with acute PE who underwent DECT pulmonary angiography were retrospectively analyzed. Pulmonary PD size caused by PE was measured on DE iodine maps and quantified absolutely (VolPD) and relatively to the total lung volume (RelPD). Signs of right heart strain (RHS) on CT were determined. Information on d-dimer levels and readmission for recurrent onset of PE and death was collected. D-dimer level was mildly (r = 0.43-0.47) correlated with PD size. Patients with RHS had significantly higher VolPD (215 vs. 73 ml) and RelPD (9.9 vs. 2.9%) than patients without RHS (p 5% RelPD, while no such events were found for patients with <5% RelPD. Pulmonary blood volume on DECT in acute PE correlates with RHS and appears to be a predictor of patient outcome in this pilot study. (orig.)
Saleh, Langeza; van den Meiracker, Anton H; Geensen, Roos; Kaya, Aslihan; van Lennep, Jeanine E Roeters; Duvekot, Johannes J; Verdonk, Koen; Steegers, Eric A P; Russcher, Henk; Danser, Jan A H; Visser, Willy
2017-06-10
To assess the evolution of the sFlt-1/PlGF ratio in women with suspected or with confirmed preeclampsia and to investigate the changes in sFlt-1 and PlGF levels in preeclamptic women after delivery. In this exploratory tertiary referral university centre study, using the Roche Diagnostics Elecsys assay, sFlt-1 and PlGF were determined in two groups of patients. In the first group of 46 patients with suspected or confirmed preeclampsia, sFlt-1 and PlGF were measured at least twice during their pregnancy. Women had singleton pregnancies and a median pregnancy duration of 26 weeks (range 18 - 40 weeks). In the second group, sFlt-1 and PlGF of 26 preeclamptic patients were determined before and after delivery. The median gestational age at inclusion was 29 weeks (16 - 37) and the median days between antepartum measurement and delivery was 2 days (1 - 7). In the first group, 90% of patients with a sFlt-1/PlGF ratio ≤38 at baseline (n = 30), ruling out PE, the sFlt-1/PlGF ratio remained stable for up to 100 days. In 16 patients with a sFlt-1/PlGF ratio >38 and in 10% of those with a sFlt-1/PlGF ratio <38 at baseline the ratio increased further. In the second group, after delivery, sFlt-1 dropped to <1% of its pre-delivery values with a half-life of 1.4 ± 0.3 days, while PlGF dropped to ≈ 30% of its pre-delivery values with a half-life of 3.7 ± 4.3 days. Based on this small cohort, up to 10% of women admitted with suspected or confirmed PE presenting with a sFlt-1/PlGF ratio ≤38 display a rise of this sFlt-1/PlGF ratio in subsequent weeks, implying that repeated determination of the sFlt-1/PlGF ratio is required to reject this condition definitively. Furthermore, the rapid and pronounced decline of sFlt-1 values after delivery in patients with PE/HELLP suggests that sFlt-1, in contrast with PlGF, is almost entirely placenta-derived. This article is protected by copyright. All rights reserved.
DEFF Research Database (Denmark)
Bilgin, Mesut; Markgraf, Daniel F; Duchoslav, Eva
2011-01-01
We report a method for the simultaneous identification and quantification of phosphatidylethanolamine (PE), monomethyl-phosphatidylethanolamine (MMPE), dimethyl-phosphatidylethanolamine (DMPE), and phosphatidylcholine (PC) species in lipid extracts. The method employs a specific "mass-tag" strategy...... where DMPE, MMPE, and PE species are chemically methylated with deuterated methyliodide (CD(3)I) to produce PC molecules having class-specific mass offsets of 3, 6 and 9Da, respectively. The derivatized aminoglycerophospholipids release characteristic phosphorylcholine-like fragment ions having specific...... and DMPE, and abundant PE and PC species in a single mass spectrometric analysis. We demonstrated the efficacy of the methodology by conducting a series of biochemical experiments using stable isotope labeled ethanolamine to survey the activities and substrate specificities of enzymes involved in PE...
Clinical presentation and in-hospital death in acute pulmonary embolism: does cancer matter?
Casazza, Franco; Becattini, Cecilia; Rulli, Eliana; Pacchetti, Ilaria; Floriani, Irene; Biancardi, Marco; Scardovi, Angela Beatrice; Enea, Iolanda; Bongarzoni, Amedeo; Pignataro, Luigi; Agnelli, Giancarlo
2016-09-01
Cancer is one of the most common risk factors for acute pulmonary embolism (PE), but only few studies report on the short-term outcome of patients with PE and a history of cancer. The aim of the study was to assess whether a cancer diagnosis affects the clinical presentation and short-term outcome in patients hospitalized for PE who were included in the Italian Pulmonary Embolism Registry. All-cause and PE-related in-hospital deaths were also analyzed. Out of 1702 patients, 451 (26.5 %) of patients had a diagnosis of cancer: cancer was known at presentation in 365, or diagnosed during the hospital stay for PE in 86 (19 % of cancer patients). Patients with and without cancer were similar concerning clinical status at presentation. Patients with cancer less commonly received thrombolytic therapy, and more often had an inferior vena cava filter inserted. Major or intracranial bleeding was not different between groups. In-hospital all-cause death occurred in 8.4 and 5.9 % of patients with and without cancer, respectively. At multivariate analysis, cancer (OR 2.24, 95 % CI 1.27-3.98; P = 0.006) was an independent predictor of in-hospital death. Clinical instability, PE recurrence, age ≥75 years, recent bed rest ≥3 days, but not cancer, were independent predictors of in-hospital death due to PE. Cancer seems a weaker predictor of all-cause in-hospital death compared to other factors; the mere presence of cancer, without other risk factors, leads to a probability of early death of 2 %. In patients with acute PE, cancer increases the probability of in-hospital all-cause death, but does not seem to affect the clinical presentation or the risk of in-hospital PE-related death.
International Nuclear Information System (INIS)
Cura del, J. L.; Oleaga, L.; Grande, D.; Vela, A. C.; Ibanez, A. M.
2001-01-01
To study the utility of ultrasound and computed tomography (CT) in case of suspected appendicitis. To determine the diagnostic yield in terms of different clinical contexts and patient characteristics. to assess the costs and benefits of introducing these techniques and propose a protocol for their use. Negative appendectomies, complications and length of hospital stay in a group of 152 patients with suspected appendicitis who underwent ultrasound and CT were compared with those of 180 patients who underwent appendectomy during the same time period, but had not been selected for the first group: these patients costs for each group were calculated. In the first group, the diagnostic value of the clinical signs was also evaluated. The reliability of the clinical signs was limited, while the results with ultrasound and CT were excellent. The incidence of negative appendectomy was 9.6% in the study group and 12.2% in the control group. Moreover, there were fewer complications and a shorter hospital stay in the first group. Among men, however, the rate of negative appendectomy was lower in the control group. The cost of using ultrasound and CT in the management of appendicitis was only slightly higher than that of the control group. Although ultrasound and CT are not necessary in cases in which the probability of appendicitis is low or in men presenting clear clinical evidence, the use of these techniques is indicated in the remaining cases in which appendicitis is suspected. In children, ultrasound is the technique of choice. In all other patients, if negative results are obtained with one of the two techniques, the other should be performed. (Author) 49 refs
Yip, Thomas P Y; Pascoe, Heather M; Lane, Stephen E
2014-08-04
To determine whether introduction of high-sensitivity cardiac troponin I (hscTn-I) assays affected management of patients presenting with suspected acute coronary syndrome (ACS) to the emergency department (ED) of a tertiary referral hospital. A retrospective analysis of all patients presenting to the Geelong Hospital ED with suspected ACS from 23 April 2010 to 22 April 2013 -2 years before and 1 year after the changeover to hscTn-I assays on 23 April 2012. Hospital admission rates, time spent in the ED, rates of coronary angiography, rates of percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABGS), rates of discharge with a diagnosis of ACS, and rates of inhospital mortality. 12 360 consecutive patients presented with suspected ACS during the study period; 1897 were admitted to Geelong Hospital in the 2 years before and 944 in the 1 year after the changeover to hscTn-I assays. Comparing the two patient groups, there was no statistically significant difference in all-hospital admission rates (95% CI for the difference, - 3.1% to 0.3%; P = 0.10) or proportion of patients subsequently discharged with a diagnosis of ACS (95% CI for the difference, - 2.3% to 5.4%; P = 0.43). After the changeover, the median time patients spent in the ED was 11.5% shorter (3.85 h v 4.35 h; 95% CI for the difference, - 0.59 to - 0.43; P rise in the proportion of patients who had invasive treatment (PCI and/or CABGS) (95% CI for the difference, - 0.4% to 6.3%; P = 0.08). Inhospital mortality rates from ACS did not change significantly (95% CI for the difference, - 1.5% to 0.8%; P = 0.43). The introduction of hscTn-I assays appeared to be associated with more rapid diagnosis, resulting in less time spent in the ED, without a change in hospital admission rates. A higher proportion of patients had coronary angiographies after the changeover, but there was no significant change in rates of invasive treatment or inhospital mortality.
Study on radiation discoloration of PE and its mechanisms
International Nuclear Information System (INIS)
Wang Huiliang; Wang Chun; Chen Wenxiu
2001-01-01
In order to find the major reason for the radiation discoloration of PE, the changes of yellow index (YI) of HDPE and LDPE under γ irradiation in air or N 2 and after irradiation are measured using colorimeter. The growth and decay of alkyl free radical formed in HDPE and LDPE, and the change of the absorbance of conjugated double bonds formed in PE are measured using ESR and UV-Visible spectrometer. The YI of HDPE is higher than that of LDPE at the same radiation dose. The YI of PE irradiated in air is higher than that of PE irradiated in N 2 at the same radiation dose. The YI of PE irradiated different dose decreases with post-irradiation storage time firstly, up to a certain time, it becomes stable. It is found that the formation and decay of free radicals is very similar to that of the change of YI, whereas, the change of the absorbance of conjugated double bonds formed in PE is different to the change of YI. The results are discussed, it is believed that the major reason for the radiation discoloration is the formation of trapped free radicals
Ultrasonographic diagnosis of acute appendicitis
International Nuclear Information System (INIS)
Lee, Sang Hun; Chang, Young Duk; Kim, Dae Ho; Lee, Hae Kyung; Kwon, Kui Hyang; Kim, Ki Jung
1988-01-01
Acute appendicitis is the most common surgical disease of acute abdomen, But the diagnosis of acute appendicitis is often difficult, and not in frequently, operation for appendicitis is performed only to find a normal appendix. Various radiological examinations have been proposed to improve diagnostic accuracy of appendicitis. The purpose of this study was to improve the diagnostic accuracy of appendicitis, and to decline negative exploration. High resolution real time ultrasonographical examination using graded compression was performed in 57 consecutive patients who were clinically suspected of appendicitis. Autors analysed ultrasonographical, surgical, and clinical follow up findings. The results were are follows: 1. Ultrasonographical finding of acute appendicitis was visualization of appendix as a tubular structure with one bline end, or target phenomenon. 2. Hypoechoic area over the appendix was thought to be a sign of periappendiceal abscess. 3. The sensitivity of US diagnosis of acute appendicitis in this study was 92.8% with a specificity of 93.1%. The overall accuracy was 93.0%. 4. In control group of 50 individuals, the abnormal appendix was not visualized. 5. In cases of clinically suspected appendicitis, the US evaluation with graded compression technique is very accurate and effective examination.
Carboxyhemoglobin and methemoglobin levels as prognostic markers in acute pulmonary embolism.
Kakavas, Sotirios; Papanikolaou, Aggeliki; Ballis, Evangelos; Tatsis, Nikolaos; Goga, Christina; Tatsis, Georgios
2015-04-01
Carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels have been associated with a poor outcome in patients with various pathological conditions including cardiovascular diseases. Our aim was to retrospectively assess the prognostic value of arterial COHb and MetHb in patients with acute pulmonary embolism (PE). We conducted a retrospective study of 156 patients admitted in a pulmonary clinic due to acute PE. Measured variables during emergency department evaluation that were retrospectively analyzed included the ratio of the partial pressure of oxygen in arterial blood to the fraction of oxygen in inspired gas, Acute Physiology and Chronic Health Evaluation II score, risk stratification indices, and arterial blood gases. The association between arterial COHb and MetHb levels and disease severity or mortality was evaluated using bivariate tests and logistic regression analysis. Arterial COHb and MetHb levels correlated with Acute Physiology and Chronic Health Evaluation II and pulmonary severity index scores. Furthermore, arterial COHb and MetHb levels were associated with troponin T and N-terminal pro-B-type natriuretic peptide levels. In univariate logistic regression analysis, COHb and MetHb levels were both significantly associated with an increased risk of death. However, in multivariate analysis, only COHb remained significant as an independent predictor of in-hospital mortality. Our preliminary data suggest that arterial COHb and MetHb levels reflect the severity of acute PE, whereas COHb levels are independent predictors of in hospital death in patients in this clinical setting. These findings require further prospective validation. Copyright © 2015 Elsevier Inc. All rights reserved.
Contrast enhancement pattern in MR imaging of acute cerebral infarction
International Nuclear Information System (INIS)
Kim, Jong Deok; Cho, Mee Young; Lee, Chae Guk; Song, Dong Hoon
1994-01-01
To present the enhancement pattern of acute cerebral or cerebellar cortical infarctions aged 1-3 days on MR. Contrast-enhanced MR images of 26 patients with acute cerebral or cerebellar ischemic events were retrospectively reviewed. MR was performed within 3 days after ictus. Contrast enhancement in the area of infarction was observed in 61.5% (16/26) on MR. Of these 50% (13/26) showed non-parenchymal enhancement (NPE) representing either vascular or leptomeningeal enhancement, 7.7% (2/26) showed parenchymal enhancement (PE), and 2.8% (1/26) showed both NPE and PE. The earliest enhancement was seen in images obtained 12 hours after the onset of symptoms and appeared as NPE. One patient showed NPE without apparent high signal intensity at the corresponding area on T2-weighted images. In 38.5% (10/26), there was no enhancement. Contrast-enhanced MR imaging may be needed in acute ischemic infarction, because NPE may be seen as the earliest MR finding of acute cortical infraction aged 1-3 days
Contrast enhancement pattern in MR imaging of acute cerebral infarction
Energy Technology Data Exchange (ETDEWEB)
Kim, Jong Deok; Cho, Mee Young; Lee, Chae Guk; Song, Dong Hoon [Inje University College of Medicine, Pusan (Korea, Republic of)
1994-08-15
To present the enhancement pattern of acute cerebral or cerebellar cortical infarctions aged 1-3 days on MR. Contrast-enhanced MR images of 26 patients with acute cerebral or cerebellar ischemic events were retrospectively reviewed. MR was performed within 3 days after ictus. Contrast enhancement in the area of infarction was observed in 61.5% (16/26) on MR. Of these 50% (13/26) showed non-parenchymal enhancement (NPE) representing either vascular or leptomeningeal enhancement, 7.7% (2/26) showed parenchymal enhancement (PE), and 2.8% (1/26) showed both NPE and PE. The earliest enhancement was seen in images obtained 12 hours after the onset of symptoms and appeared as NPE. One patient showed NPE without apparent high signal intensity at the corresponding area on T2-weighted images. In 38.5% (10/26), there was no enhancement. Contrast-enhanced MR imaging may be needed in acute ischemic infarction, because NPE may be seen as the earliest MR finding of acute cortical infraction aged 1-3 days.
Ormesher, L; Johnstone, E D; Shawkat, E; Dempsey, A; Chmiel, C; Ingram, E; Higgins, L E; Myers, J E
2018-03-13
To evaluate the use of plasma Placental Growth Factor (PlGF), recommended by the recent NICE guidance, in women with suspected pre-eclampsia (PE) and/or fetal growth restriction (FGR). Non-randomised prospective clinical evaluation study in high-risk antenatal clinics in a tertiary maternity unit. PlGF testing was performed in addition to routine clinical assessment in 260 women >20 weeks' gestation with chronic disease (hypertension, renal disease ± diabetes) with a change in maternal condition or in women with suspected FGR to determine the impact on clinical management. Results were revealed and standardised care pathways followed. Outcome of pregnancies with a low PlGF (women had an adverse outcome (PE/birthweight women with PlGF 14 days. The PlGF result altered clinical management (surveillance or timing of birth) in 196/260 (75.4%) cases. Alternative PlGF thresholds did not significantly improve diagnostic performance. Our evaluation confirms the value of PlGF as a diagnostic tool for placental dysfunction. However, low PlGF in isolation should not trigger iatrogenic delivery. Further research linking placental pathology, maternal disease and maternal PlGF levels is urgently needed before this test can be implemented in routine clinical practice. Copyright © 2018. Published by Elsevier B.V.
Association between QRS duration on prehospital ECG and mortality in patients with suspected STEMI
DEFF Research Database (Denmark)
Hansen, Rikke; Frydland, Martin; Møller-Helgestad, Ole Kristian
2017-01-01
BACKGROUND: QRS duration has previously shown association with mortality in patients with acute myocardial infarction treated with thrombolytics, less is known in patients with suspected ST segment elevation myocardial infarction (STEMI) when assessing QRS duration on prehospital ECG. Thus......, the objective was to investigate the prognostic effect of QRS duration on prehospital ECG and presence of classic left and right bundle branch block (LBBB/RBBB) for all-cause mortality in patients with suspected STEMI. METHOD: In total 2105 consecutive patients (mean age 64±13years, 72% men) with suspected...... STEMI were prospectively included. QRS duration was registered from automated QRS measurement on prehospital ECG and patients were divided according to quartiles of QRS duration (111ms). Primary endpoint was all-cause 30-day mortality. Predictors of all-cause mortality were...
Infectious mononucleosis presenting as bilateral acute dacryocystitis.
Atkinson, P L; Ansons, A M; Patterson, A
1990-01-01
A case of infectious mononucleosis presenting as bilateral acute dacryocystitis in a 7-year-old girl is reported. Acute dacryocystitis is uncommon in this age group, and an underlying systemic illness should be suspected particularly when it is bilateral. Images PMID:2275940
International Nuclear Information System (INIS)
Staskiewicz, Grzegorz; Czekajska-Chehab, Elzbieta; Trojanowska, Agnieszka; Drop, Andrzej; Przegalinski, Jerzy; Tomaszewski, Andrzej; Torres, Kamil; Torres, Anna; Maciejewski, Ryszard
2010-01-01
Right ventricular dysfunction (RVD) may occur in the course of acute pulmonary embolism (PE). Patients with RVD need more intensive treatment, and the prognosis is more severe. The aim of this study was to evaluate the usefulness of the measurement of the coronary sinus in the assessment of RVD in patients with acute PE and to compare it with other indicators of RVD. Retrospective assessment of 55 CT pulmonary angiography examinations with signs of acute PE was performed. Pulmonary artery systolic pressure (PASP) was echocardiographically assessed in all patients, and RVD was defined as PASP values greater than 30 mmHg. CT measurements included the size of the heart ventricles, mediastinal vessels and the width of the coronary sinus. Median width of the coronary sinus was 16 mm (range 12-24 mm) in patients with increased PASP and 10 mm (range 7-22 mm) in patients with normal PASP (p = 0.001). Best cut-off value was assessed to be 12.5 mm, with sensitivity 94% and specificity 75%. It was characterised by the largest area under ROC curve (0.82) among analysed parameters. Width of the coronary sinus seems to be a promising parameter for identification of RVD in patients with acute PE. A prospective study should be undertaken to further assess its clinical and prognostic applicability. (orig.)
Making the Case for Developing New PE-for-Health Pedagogies
Armour, Kathleen; Harris, Jo
2013-01-01
This article argues for a new direction in research on health education within physical education (PE). Governments are increasingly looking to schools as a convenient form of public health investment. PE is implicated in health because of its core focus on physical activity, but there is little evidence to suggest that PE improves health…
Kayrak, Mehmet; Erdoğan, Halil Ibrahim; Solak, Yalcin; Akilli, Hakan; Gül, Enes Elvin; Yildirim, Oğuzhan; Erer, Murat; Akilli, Nezire Belgin; Bekci, Taha Tahir; Aribaş, Alpay; Yazici, Mehmet
2014-01-01
Acute pulmonary embolism (PE) is a serious clinical condition characterised by a high mortality rate. Previous studies showed that leukocytosis was associated with recurrences of venous thromboemboli, major bleeding and increased mortality. The aim of the present study was to investigate the prognostic value of neutrophil to lymphocyte ratio (NLR) in patients with acute PE during short term follow-up. A total of 640 patients were screened by I26 code of ICD-9 and 359 patients were included as cases of confirmed acute PE. Admission blood counts and clinical data were obtained from medical charts. The predictors of 30-day mortality were examined. Fifty-one out of 359 patients (14.2%) included in the study died during 30 days follow-up. In multivariate Cox regression analysis systolic blood pressure (HR:0.97 (0.94-0.99 CI95%), p=0.019), diabetes mellitus (HR:3.3 (1.30-8.39 CI95%), p=0.012), CK-MB(HR:1.03 (1.01-1.06 CI95%), p=0.024) and NLR (HR:1.03 (1.01-1.06 CI95%), p=0.008) were predictors of 30-day mortality. An optimal cut-off value of NLR was determined as 9.2 by using ROC curve. Hazards ratio of NLR>9.2 was found to be 3.60 (1.44-9.18 CI95%, p=0.006). NLR>9.2 had a sensitivity, specificity, negative predictive value, and positive predictive value of 68.6%, 80.5%, 93.9% and 36.5%, respectively. NLR on hospital admission may be a predictor of 30-day mortality in acute PE. Since complete blood count is a part of the routine laboratory investigation in the most hospitalised patients use and preliminary promising results of this study, NLR should be investigated in future prospective randomised trials regarding prognostic value in acute PE. Copyright © 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
Prognostic role of alveolar-arterial oxygen pressure difference in acute pulmonary embolism
International Nuclear Information System (INIS)
Hsu Jente; Chang Shihtai; Cheng Huiwen; Chung Changmin; Chu, Chiming; Cheng Nyejan; Ho Wanching
2006-01-01
This study investigated the utility of the alveolar-arterial oxygen pressure difference (AaDO 2 ) in predicting the short-term prognosis of acute pulmonary embolism (PE). This study retrospectively enrolled 114 consecutive patients with acute PE, diagnosed by either spiral computed tomography or high probability ventilation-perfusion lung scans. During the first 24 h of admission, all patients had initial artery blood gas collected under room air. Patient exclusion criteria were chronic lung disease, septic emboli, and moderate and low probability lung scans. Patients were assigned to 2 groups based on either 30-day death or a 30-day composite event. Receiver operating characteristic analyses was used to determine the AaDO 2 cut-off value for predicting primary and composite endpoints. Statistical analysis demonstrated significant differences in AaDO 2 between the 30-day composite endpoint group and the 30-day composite event-free survival group (p=0.012). The AaDO 2 had a strong trend between the 30-day death group and the survival group (p=0.062). The best cut-off value for AaDO 2 was 53 mmHg and using this, the positive predictive value for 30-day death was 25% and the negative predictive value was 92%. For the 30-day composite endpoint, the positive predictive value for AaDO 2 was 35%, and the negative predictive value was 84%. In this study, thrombocytopenia was also an indicator of poor prognosis for patients with acute PE. The AaDO 2 measurement is a highly useful and simple measurement for predicting short-term prognosis in patients with acute PE. It has high negative predictive value and moderate positive predictive value for 30-day death and 30-day composite event. Aggressive thrombolytic treatment strategies should be considered for patients with an initial poor prognostic parameter (ie, AaDO 2 ≥53 mmHg). (author)
Earnings quality and P/E ratio: Evidence from Tehran Stock Exchange
Directory of Open Access Journals (Sweden)
Hassan Ghodrati
2014-08-01
Full Text Available This paper evaluates the impacts of earnings quality criteria on the ratio of price to earnings per share (P/E on 88 accepted companies in Tehran Stock Exchange (TSE over the period 2007- 2012. The results indicate that there was a positive and significant relationship between the P/E ratio and cash dividend. There is also a positive and significant relationship between P/E ratio as dependent variable and the gross profit ratio to sales. On the other hand, there is a significant reverse relationship between P/E ratio and the profit variability. However, no significant relationship exists between P/E as dependent variable and deferrals (accruals variable.
Ultrasonic testing standard of fusion joint for polythylene(PE) pipeline
International Nuclear Information System (INIS)
Lee, Euy Jong; Hur, Sam Suk; Chae, Gug Byeong
2006-01-01
The polyethylene(PE) pipes are widely used to transport city gas worldwide with steel pipes. Generally, Steel pipe are used for high pressure line and PE pipe for low pressure line whose pressure is less than 4 kg/m 2 . The steel pipe line are subject to 100 percent Radiographic Testing(RT) during installation stage, on the contrary, there has been no the established testing method for the welding fusion joint of polyethylene pipes, so all quality control is limited only Visual Testing(VT) or management of Fusion welding equipment. Even though PE pipeline is exposed to lower pressure than steel pipeline, the gas leakage from PE pipe may result in almost the same serious consequence from steel pipeline. So, it is necessary to develop the reliable testing standard for PE pipeline from the point of view of NDT engineers.
Amino acids grafting of Ar+ ions modified PE
International Nuclear Information System (INIS)
Svorcik, V.; Hnatowicz, V.; Stopka, P.; Bacakova, L.; Heitz, J.; Oechsner, R.; Ryssel, H.
2001-01-01
Polyethylene (PE) was irradiated with 63 keV Ar + ions to the fluences from 1x10 12 to 3x10 15 cm -2 and then grafted at room temperature from water solution with amino acids (alanine, leucine). Using various spectroscopic techniques (UV-VIS, FTIR, RBS and EPR) it was shown that the amino acids penetrate into PE where they are eventually captured either on double bonds or on free radicals created by the ion irradiation. Grafting with amino acids in the whole specimen layer modified by irradiation is observed. The ion-beam-modified and amino-acid grafted PE is supposed to exhibit increased biocompatibility. (author)
Directory of Open Access Journals (Sweden)
Seung-Whan Cha
Full Text Available Shear wave elastography (SWE has not been studied for diagnosing appendicitis. We postulated that an inflamed appendix would become stiffer than a normal appendix. We evaluated the elastic modulus values (EMV by SWE in healthy volunteers, patients without appendicitis, and patients with appendicitis. We also evaluated diagnostic ability of SWE for differentiating an inflamed from a normal appendix in patients with suspected appendicitis.Forty-one patients with clinically suspected acute appendicitis and 11 healthy volunteers were prospectively enrolled. Gray-scale ultrasonography (US, SWE and multi-slice computed tomography (CT were performed. The EMV was measured in the anterior, medial, and posterior appendiceal wall using SWE, and the highest value (kPa was recorded.Patients were classified into appendicitis (n = 30 and no appendicitis groups (n = 11. One case of a negative appendectomy was detected. The median EMV was significantly higher in the appendicitis group (25.0 kPa compared to that in the no appendicitis group (10.4 kPa or in the healthy controls (8.3 kPa (p<0.001. Among SWE and other US and CT features, CT was superior to any conventional gray-scale US feature or SWE. Either the CT diameter criterion or combined three CT features predicted true positive in 30 and true negative in 11 cases and yielded 100% sensitivity and 100% specificity. An EMV of 12.5 kPa for the stiffest region of the appendix predicted true positive in 28, true negative in 11, and false negative in two cases. The EMV (≥12.5 kPa yielded 93% sensitivity and 100% specificity.Our results suggest that EMV by SWE helps distinguish an inflamed from a normal appendix. Given that SWE has high specificity, quantitative measurement of the elasticity of the appendix may provide complementary information, in addition to morphologic features on gray-scale US, in the diagnosis of appendicitis.
Wang, Qian; Ma, Junfen; Jiang, Zhiyun; Ming, Liang
2018-02-01
Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been reported to predict prognosis of acute pulmonary embolism (PE). However, the prognostic value of NLR and PLR remained inconsistent between studies. The aim of this meta-analysis was to assess the prognostic role of NLR and PLR in acute PE. We systematically searched Pubmed, Embase, Web of Science and CNKI for relative literature up to March 2017. The pooled statistics for all outcomes were expressed as odds ratio (OR) and 95% confidence intervals (95% CI). The statistical analyses were performed using Review Manager 5.3.5 analysis software and Stata software. Totally 7 eligible studies consisting of 2323 patients were enrolled in our meta-analysis. Elevated NLR was significantly associated with overall (short-term and long-term) mortality (OR 10.13, 95% CI 6.57-15.64, Panalysis revealed that NLR and PLR are promising biomarkers in predicting prognosis in acute PE patients. We suggest NLR and PLR be used routinely in the PE prognostic assessment.
Imaging the child with right lower quadrant pain and suspected appendicitis: current concepts
Energy Technology Data Exchange (ETDEWEB)
Sivit, Carlos J. [Departments of Radiology and Pediatrics, Rainbow Babies and Childrens Hospital of the University Hospitals of Cleveland and Case Western Reserve School of Medicine, Euclid Avenue, 11100, 44106-5056, Cleveland, OH (United States)
2004-06-01
Acute appendicitis is the most common condition presenting with right lower quadrant pain requiring acute surgical intervention in childhood. The clinical diagnosis of acute appendicitis is often not straightforward and can be challenging. Approximately one-third of children with the condition have atypical clinical findings and are initially managed non-operatively. Complications usually result from perforation and include abscess formation, peritonitis, sepsis, bowel obstruction and death. Cross-sectional imaging with sonography and computed tomography (CT) have proven useful for the evaluation of suspected acute appendicitis in children. The principal advantages of sonography are its lower cost, lack of ionizing radiation, and ability to precisely delineate gynecologic disease. The principal advantages of CT are its operator independency with resultant higher diagnostic accuracy, enhanced delineation of disease extent in perforated appendicitis, and improved patient outcomes including decreased negative laparotomy and perforation rates. (orig.)
The use of echocardiography in acute cardiovascular care
DEFF Research Database (Denmark)
Lancellotti, Patrizio; Price, Susanna; Edvardsen, Thor
2014-01-01
Echocardiography is one of the most powerful diagnostic and monitoring tools available to the modern emergency/critical care practitioner. Currently, there is a lack of specific European Association of Cardiovascular Imaging/Acute Cardiovascular Care Association recommendations for the use...... of echocardiography in acute cardiovascular care. In this document, we describe the practical applications of echocardiography in patients with acute cardiac conditions, in particular with acute chest pain, acute heart failure, suspected cardiac tamponade, complications of myocardial infarction, acute valvular heart...
The use of echocardiography in acute cardiovascular care
DEFF Research Database (Denmark)
Lancellotti, Patrizio; Price, Susanna; Edvardsen, Thor
2015-01-01
Echocardiography is one of the most powerful diagnostic and monitoring tools available to the modern emergency/ critical care practitioner. Currently, there is a lack of specific European Association of Cardiovascular Imaging/Acute Cardiovascular Care Association recommendations for the use...... of echocardiography in acute cardiovascular care. In this document, we describe the practical applications of echocardiography in patients with acute cardiac conditions, in particular with acute chest pain, acute heart failure, suspected cardiac tamponade, complications of myocardial infarction, acute valvular heart...
The use of echocardiography in acute cardiovascular care
DEFF Research Database (Denmark)
Lancellotti, Patrizio; Price, Susanna; Edvardsen, Thor
2015-01-01
Echocardiography is one of the most powerful diagnostic and monitoring tools available to the modern emergency/critical care practitioner. Currently, there is a lack of specific European Association of Cardiovascular Imaging/Acute Cardiovascular Care Association recommendations for the use...... of echocardiography in acute cardiovascular care. In this document, we describe the practical applications of echocardiography in patients with acute cardiac conditions, in particular with acute chest pain, acute heart failure, suspected cardiac tamponade, complications of myocardial infarction, acute valvular heart...
Current Status and Prediction on Development of PE Market
Institute of Scientific and Technical Information of China (English)
Yu Jiao
2003-01-01
This article comprehensively analyzes the status of market demand/supply and import/export volumes of PE in the world and in China, and predicts the future development trends in the fields of PE production and consumption.
Wang, Yuqi; Wang, Chen; Chen, Zhong; Zhang, Jiwei; Liu, Zhihong; Jin, Bi; Ying, Kejing; Liu, Changwei; Shao, Yuxia; Jing, Zhicheng; Meng, Isabelle Ling; Prins, Martin H; Pap, Akos F; Müller, Katharina; Lensing, Anthonie Wa
2013-12-16
The worldwide EINSTEIN DVT and EINSTEIN PE studies randomized 8282 patients with acute symptomatic deep-vein thrombosis (DVT) and/or pulmonary embolism (PE) and, for the first time in trials in this setting, included patients in China. This analysis evaluates the results of these studies in this subgroup of patients. A total of 439 Chinese patients who had acute symptomatic DVT (n=211), or PE with or without DVT (n=228), were randomized to receive rivaroxaban (15 mg twice daily for 21 days, followed by 20 mg once daily) or standard therapy of enoxaparin overlapping with and followed by an adjusted-dose vitamin K antagonist, for 3, 6, or 12 months. The primary efficacy outcome was symptomatic recurrent venous thromboembolism. The principal safety outcome was major or non-major clinically relevant bleeding. The primary efficacy outcome occurred in seven (3.2%) of the 220 patients in the rivaroxaban group and in seven (3.2%) of the 219 patients in the standard-therapy group (hazard ratio, 1.04; 95% confidence interval 0.36-3.0; p=0.94). The principal safety outcome occurred in 13 (5.9%) patients in the rivaroxaban group and in 20 (9.2%) patients in the standard-therapy group (hazard ratio, 0.63; 95% confidence interval 0.31-1.26; p=0.19). Major bleeding was observed in no patients in the rivaroxaban group and in five (2.3%) patients in the standard-therapy group. In fragile patients (defined as age >75 years, creatinine clearance EINSTEIN PE, ClinicalTrials.gov NCT00439777; EINSTEIN DVT, ClinicalTrials.gov NCT00440193.
Scintigraphic evidence for overdiagnosis of small PE on CT pulmonary angiography
International Nuclear Information System (INIS)
Lu, Yang
2017-01-01
A 68-year-old man with recent history of a fall presented with dyspnea on exertion, and underwent computed tomography pulmonary angiography (CTPA) for possible pulmonary embolism (PE). The CTPA was first read by the radiology resident as nondiagnostic for segmental PE. Subsequent planar perfusion (Q) images were normal; meanwhile, the attending radiologist revised the CTPA results as subsegmental PE in the left upper lobe. Further Q-SPECT images were obtained and fused with CTPA for clarification, which showed normal perfusion in the region of PE. The patient was monitored without anticoagulation treatment and remained uneventful for 12 months. This case illustrates that CTPA can lead to overdiagnosis and overtreatment of nonocclusive subsegmental PE
Bookhart, Brahim K; Haskell, Lloyd; Bamber, Luke; Wang, Maria; Schein, Jeff; Mody, Samir H
2014-10-01
Venous thromboembolism (VTE) (deep vein thrombosis [DVT] and pulmonary embolism [(PE]) represents a substantial economic burden to the healthcare system. Using data from the randomized EINSTEIN DVT and PE trials, this North American sub-group analysis investigated the potential of rivaroxaban to reduce the length of initial hospitalization in patients with acute symptomatic DVT or PE. A post-hoc analysis of hospitalization and length-of-stay (LOS) data was conducted in the North American sub-set of patients from the randomized, open-label EINSTEIN trial program. Patients received either rivaroxaban (15 mg twice daily for 3 weeks followed by 20 mg once daily; n = 405) or dose-adjusted subcutaneous enoxaparin overlapping with (guideline-recommended 'bridging' therapy) and followed by a vitamin K antagonist (VKA) (international normalized ratio = 2.0-3.0; n = 401). The open-label study design allowed for the comparison of LOS between treatment arms under conditions reflecting normal clinical practice. LOS was evaluated using investigator records of dates of admission and discharge. Analyses were carried out in the intention-to-treat population using parametric tests. Costs were applied to the LOS based on weighted mean cost per day for DVT and PE diagnoses obtained from the Healthcare Cost and Utilization Project dataset. Of 382 patients hospitalized, 321 (84%), had acute symptomatic PE; few DVT patients required hospitalization. Similar rates of VTE patients were hospitalized in the rivaroxaban and enoxaparin/VKA treatment groups, 189/405 (47%) and 193/401 (48%), respectively. In hospitalized VTE patients, rivaroxaban treatment produced a 1.6-day mean reduction in LOS (median = 1 day) compared with enoxaparin/VKA (mean = 4.5 vs 6.1; median = 3 vs 4), translating to total costs that were $3419 lower in rivaroxaban-treated patients. In hospitalized North American patients with VTE, treatment with rivaroxaban produced a statistically
Paradoxical embolization via a patent foramen ovale following acute pulmonary embolism
International Nuclear Information System (INIS)
Thomas, D.V.; Bynevelt, V.; Price, R.
2005-01-01
The foramen ovale is usually obliterated following establishment of the adult circulation but remains patent in 25% of individuals. This potential communication between the venous and arterial circulations can allow thromboembolic material to bypass the lungs and enter the systemic circulation. We report two cases of paradoxical embolization through a patent foramen ovale following acute large pulmonary embolism (PE) and discuss the factors that predispose to paradoxical embolization following PE Copyright (2005) Blackwell Publishing Asia Pty Ltd
Results of the speleological exploration on Pešter plateau
Directory of Open Access Journals (Sweden)
Nešić Dragan
2015-01-01
Full Text Available During the period 2006-2008, basic speleological research was done on Pešter Plateau in Southwestern Serbia. On that occasion, 40 caves were surveyed, 11 of which were measured in detail. Registered caves were grouped on the basis of landscape characteristics and morphogenetic relations. Based on the location and general characteristics of the Pešter karst, it is considered that the objects near Boljare and in the ponor (sinking area of Boroštica are connected to the drainage system of the Pećina nad Vražjim firovima (Vražiji firovi Cave. In morphological terms, the cave Bezdan Kaćunova ravan (Kaćunova Cave near Boljare with its imposing hall is the most important object on Pešter Plateau for the time being. Realized research on Pešter Plateau has the character of basic or initial speleological research, which should be continued in order to solve different problems of karst in this area.
Improvement of barrier properties of rotomolded PE containers with nanoclay
Energy Technology Data Exchange (ETDEWEB)
Jamshidi, Shadi; Sundararaj, Uttandaraman, E-mail: u.sundararaj@ucalgary.ca [Department of Chemical and Petroleum Engineering, University of Calgary, Calgary, Alberta, T2N 1N4 (Canada)
2015-05-22
Polyethylene (PE) is widely used to make bulk containers in rotational molding process. The challenge in this study is to improve permeation resistance of PE to hydrocarbon solvents and gases. Adding organomodified clay improves the thermal, barrier and mechanical properties of PE. In fact, clay layers create a tortuous path against the permeant, yielding better barrier properties. Due to the non-polar hydrophobic nature of PE and polar hydrophilic structure of clay minerals, the compatibilizer plays a crucial role to enhance the dispersion level of clay in the matrix. In this study High Density Polyethylene (HDPE) and Linear Low Density Polyethylene (LLDPE) layered silicate nanocomposite were melt-compounded with two concentrations of organomodified clay (2 and 4 wt. %). The interaction between nanoclay, compatibilizer and rotomolding grade of PE were examined by using X-ray diffraction, transmission electron microscopy (TEM) and rheology test. Rheology was used to determine the performance of our material at low shear processing condition.
Au-nanoparticles grafted on plasma treated PE
International Nuclear Information System (INIS)
Svorcik, V.; Chaloupka, A.; Rezanka, P.; Slepicka, P.; Kolska, Z.; Kasalkova, N.; Hubacek, T.; Siegel, J.
2010-01-01
Polyethylene (PE) surface was treated with Ar plasma. Activated surface was grafted from methanol solution of 1,2-ethanedithiol. Then the sample was immersed into freshly prepared colloid solution of Au-nanoparticles. Finally Au layer was sputtered on the samples. Properties of the modified PE were studied using various methods: AFM, EPR, RBS and nanoindentation. It was shown that the plasma treatment results in degradation of polymer chain (AFM) and creation of free radicals by EPR. After grafting with dithiol, the concentration of free radicals declines. The presence of Au and S in the surface layer after the coating with Au-nanoparticles was proved by RBS. Plasma treatment changes PE surface morphology and increases surface roughness, too. Another significant change in surface morphology and roughness was observed after deposition of Au-nanoparticles. Nanoindentation measurements show that the grafting with Au-nanoparticles increases adhesion of subsequently sputtered Au layer.
The incidence of suspected myocardial infarction in Dutch general practice in the period 1978-1994.
Pal-de Bruin, K.M. van der; Verkleij, H.; Jansen, J.; Bartelds, A.; Kromhout, D.
1998-01-01
Aim: To evaluate how the incidence of suspected myocardial infarction has developed from 1978 to 1994 and to study the incidence of confirmed acute myocardial infarction in Dutch general practices during the period 1991-1994. Methods: In three periods (1978, 1983-1985 and 1991-1994) the incidence of
Vandertie, Joan; Corner, Amy B.; Corner, Kevin J.
2012-01-01
Marana Middle School in Tucson, Ariz., scrapped its traditional P.E. program that emphasized team sports and shifted to a program that focuses on lifetime fitness, student choice in activities, and nutrition and health education. The program also includes student leadership development and informal community service. As a result, Marana students…
Does the Intestinal Parasite Enterobius vermicularis Cause Acute Appendicitis?
Pirhan, Yavuz; Özen, Fatma Zeynep; Kılınç, Çetin; Güçkan, Rıdvan
2017-06-01
Although intestinal parasitic infections rarely cause acute appendicitis, they are common public health problems in undeveloped and developing countries. Parasitic infections should be kept in mind in patients clinically suspected of having acute appendicitis, and treatment procedures should be adopted according to the etiology. Herein we presented the cases of four patients with clinical findings of acute appendicitis. Patients were clinically suspected of having acute appendicitis, and Enterobius vermicularis was detected in the pathological examinations of specimens. Pinworm infections are common parasitic infections that may mimic appendicitis. The pathology of the four cases was noted when the file of 186 patients aged between 4 and 72 years who underwent surgery for acute appendicitis in my hospital was retrospectively reviewed. When the appendectomy specimen was examined histopathologically it was understood that acute appendicitis was caused by Enterobius vermicularis parasite. In Enterobius infections, performing systemic therapy for patients and their family members is sufficient. To prevent unnecessary appendectomy, this type of infection should be made to ask in the history and clinical findings of patients.
Nazerian, Peiman; Morello, Fulvio; Vanni, Simone; Bono, Alessia; Castelli, Matteo; Forno, Daniela; Gigli, Chiara; Soardo, Flavia; Carbone, Federica; Lupia, Enrico; Grifoni, Stefano
2014-07-15
Acute aortic dissection (AD) represents a diagnostic conundrum. Validated algorithms are particularly needed to identify patients where AD could be ruled out without aortic imaging. We evaluated the diagnostic accuracy of a strategy combining the aortic dissection detection (ADD) risk score with D-dimer, a sensitive biomarker of AD. Patients from two clinical centers with suspected AD were prospectively enrolled in a registry, from January 2008 to March 2013. The ADD risk score was calculated by retrospective blinded chart review. For D-dimer, a cutoff of 500 ng/ml was applied. AD was diagnosed in 233 of 1035 (22.5%) patients. The ADD risk score was 0 in 322 (31.1%), 1 in 508 (49.1%) and >1 in 205 (19.8%) patients. The sensitivity and the failure rate of D-dimer were 100% and 0% in patients with ADD score 0, versus 97.5% (95% CI 91.4-99.6%) and 4.2% (95% CI 0.7-12.5%) in patients with ADD risk score >1. In patients with ADD risk score ≤ 1, the sensitivity and the failure rate of D-dimer were 98.7% (95% CI 95.3-99.8%) and 0.8% (95% CI 0.1-2.6%). The diagnostic efficiency of D-dimer in patients with ADD risk score 0 and ≤ 1 was 8.9% (95% CI 7.2-10.7%) and 23.6% (95% CI 21.1-26.2%) respectively. In a large cohort of patients with suspected AD, the presence of ADD risk score 0 or ≤ 1 combined with a negative D-dimer accurately and efficiently ruled out AD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Gribanov, G A; Leshchenko, D V; Golovko, M Iu
2004-01-01
The development of autolysis in grey brain matter of albino rats was accompanied by desintegration of aminophospholipids with parallel increase of glycerophosphates (GLP) and phosphatidic acids (PA) on early stages of incubation and lysophospholipids (LPL) on later stages. Acute hypobaric hypoxic hypoxia decreased the level of phosphatidylethanolamines (PE) with simultaneous accumulation of PA. Previous hypoxia altered the character of autolytic reorganizations of phospholipids. Oscillatory reciprocal reorganizations in the system PE > PS (phosphatidylserine) were observed at early stage (1 h) and at late stages of autolysis (24 h). At the same time increased transformation of phosphatidylcholines (PC) into sphingomyelins (SM) with simultaneous accumulation GLP was registered. During autolysis of brain white matter of control rats opposite oscillatory reorganizations of PE, PC, SM, PA with reduction of PE and simultaneous increase of LPL and PA level after 1 hour of incubation were observed. Reciprocal reactions of biotransformation in system PS > PE were revealed at 4th hour. Previous hypobaric hypoxic hypoxia reduced the level of total phospholipids as well as PS at simultaneous increase of LPL. Acute hypobaric hypoxic hypoxia increased autolytic transformations in system PC > SM and induced hydrolysis of PE, PC into LPL at late stages of autolysis.
DEFF Research Database (Denmark)
Madsen, J K; Hommel, E; Hansen, J F
1987-01-01
. Impaired prognosis was found in patients with negative T waves or ST depression at rest or with ST--T abnormalities or angina pectoris during exercise. Patients with ST depression or elevation, Q wave or intraventricular block at rest. ST abnormalities during exercise or both constituted a high-risk group......The prognosis following discharge in 217 patients admitted with suspected acute myocardial infarction (AMI) due to chest pain, but in whom AMI was not confirmed, was related to the electrocardiogram (ECG) at rest and a symptom-limited exercise test. The patients were followed for 12 to 24 months...... in the ECG at rest and during exercise can be used to identify high and low risk patients....
Radiologic diagnosis of acute appendicitis
International Nuclear Information System (INIS)
Park, Bok Hwan; Oh, Jang Suk
1972-01-01
Sixty-six cases of acute appendicitis were proved by surgery during the period from May 1969 to May 1971. The present study was designated to elucidate the findings of roentgen examination in acute appendicitis. The results obtained were summarized as follows: 1. Over 90 percent of cases of acute appendicitis showed significant radiographic findings. 2. Distension and fluid level in cecum and terminal ileum were disclosed approximately 75 percent of cases. It believe diagnostically significant in acute appendicitis. 3. About 10 percent of cases were found extra-alimentary free air. 4. The roentgen findings of the fluid interposed between colonic contents and frank stripesin the right lower quadrant was another interesting findings to suspect acute appendicitis
Near fatal pulmonary embolism in a 16-year-old
International Nuclear Information System (INIS)
Farlow, D.; Field, L.
1992-01-01
Acute pulmonary thrombo-embolism (PE) may present with a variety of clinical problems; patients with this condition may range from being asymptomatic to acutely unwell, with sudden death being at the extreme end of the spectrum. This case report of a young man with PE demonstrates the scintigraphic features of massive, near-fatal embolism. On transfer to the Nuclear Medicine Department, the patient's blood pressure was unrecordable, the heart rate was 150/min, there was deep cyanosis despite 100 per cent oxygen and the pupils were fixed and dilated. A limited perfusion scan was obtained using 76 MBq of 99m Tc-MAA (Technescan MAA, Mallinckrodt), with an estimated 260 000 MAA particles being injected directly into a peripheral vein. Anterior and posterior images showed perfusion only to a small portion of the left upper lobe. The patient recovered quickly following embolectomy resulting in removal of a large amount of thrombus from both pulmonary arteries. It has been thus demonstrated that the perfusion scan is a rapid and safe method of confirming suspected massive PE prior to surgery. 4 refs., 2 figs
Faxén, Jonas; Hall, Marlous; Gale, Chris P; Sundström, Johan; Lindahl, Bertil; Jernberg, Tomas; Szummer, Karolina
2017-12-01
To develop a simple risk-score model for predicting in-hospital cardiac arrest (CA) among patients hospitalized with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). Using the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART), we identified patients (n=242 303) admitted with suspected NSTE-ACS between 2008 and 2014. Logistic regression was used to assess the association between 26 candidate variables and in-hospital CA. A risk-score model was developed and validated using a temporal cohort (n=126 073) comprising patients from SWEDEHEART between 2005 and 2007 and an external cohort (n=276 109) comprising patients from the Myocardial Ischaemia National Audit Project (MINAP) between 2008 and 2013. The incidence of in-hospital CA for NSTE-ACS and non-ACS was lower in the SWEDEHEART-derivation cohort than in MINAP (1.3% and 0.5% vs. 2.3% and 2.3%). A seven point, five variable risk score (age ≥60 years (1 point), ST-T abnormalities (2 points), Killip Class >1 (1 point), heart rate Model discrimination was good in the derivation cohort (c-statistic 0.72) and temporal validation cohort (c-statistic 0.74), and calibration was reasonable with a tendency towards overestimation of risk with a higher sum of score points. External validation showed moderate discrimination (c-statistic 0.65) and calibration showed a general underestimation of predicted risk. A simple points score containing five variables readily available on admission predicts in-hospital CA for patients with suspected NSTE-ACS. Copyright © 2017 Elsevier B.V. All rights reserved.
Drescher, Michael J; Fried, Jeremy; Brass, Ryan; Medoro, Amanda; Murphy, Timothy; Delgado, João
2017-10-01
Computerized decision support decreases the number of computed tomography pulmonary angiograms (CTPA) for pulmonary embolism (PE) ordered in emergency departments, but it is not always well accepted by emergency physicians. We studied a department-endorsed, evidence-based clinical protocol that included the PE rule-out criteria (PERC) rule, multi-modal education using principles of knowledge translation (KT), and clinical decision support embedded in our order entry system, to decrease the number of unnecessary CTPA ordered. We performed a historically controlled observational before-after study for one year pre- and post-implementation of a departmentally-endorsed protocol. We included patients > 18 in whom providers suspected PE and who did not have a contraindication to CTPA. Providers entered clinical information into a diagnostic pathway via computerized order entry. Prior to protocol implementation, we provided education to ordering providers. The primary outcome measure was the number of CTPA ordered per 1,000 visits one year before vs. after implementation. CTPA declined from 1,033 scans for 98,028 annual visits (10.53 per 1,000 patient visits (95% CI [9.9-11.2]) to 892 scans for 101,172 annual visits (8.81 per 1,000 patient visits (95% CI [8.3-9.4]) pPatient characteristics were similar for both periods. Knowledge translation clinical decision support using the PERC rule significantly reduced the number of CTPA ordered.
Segregation to grain boundaries in nimonic PE16 superalloy
International Nuclear Information System (INIS)
Nettleship, D.J.; Wild, R.K.
1990-01-01
Nimonic PE16 alloy is a nickel-based superalloy containing 34 wt.% iron and 16wt.% chromium with additions of molybdenum, titanium and aluminium. It is used in the fuel assembly of the UK advanced gas-cooled reactors (AGR). This component supports significant loads in service and its mechanical integrity is therefore of paramount importance. Mechanical properties may be influenced by the grain size and grain boundary composition, both of which can themselves alter during service. Scanning Auger microscopy is a well-established method for investigating grain boundaries, and has now been applied to the study of PE16. In order to expose PE16 grain boundary surfaces it is necessary to hydrogen charge samples and fracture by pulling in tension at a slow strain rate within the ultra-high vacuum chamber of the Auger microprobe. A series of casts of nimonic PE16 alloy that have received a range of thermal ageing treatments have been fractured in an intergranular manner and the grain boundary composition determined. Segregation of trace and minority elements, particularly Mo and P, has been detected at grain boundaries. Significant variations between different as-manufactured casts were observed, whilst ageing brought about the growth of chromium-rich particles on the grain boundaries. Ductile fracture in PE16 followed a path through Ti(C, N) particles. Many of these particles incorporated large amounts of sulphur. (author)
Fluctuation measurements at c/ωpe spatial scales in a tokamak
International Nuclear Information System (INIS)
Haines, E.J.; Tan, I.H.; Prager, S.C.
1994-07-01
Magnetic and electrostatic fluctuations have been measured at the short scale length of the collisionless skin depth (c/ω pe using small magnetic and electrostatic probes in the Tokapole II tokamak. For certain conditions and at high frequency (MHz range) the amplitude is observed to increase as wavelength is decreased toward the c/ω pe scale. Wavelength dependence is inferred from measurements with probes of varying sizes. The amplitude of the turbulence at the c/ω pe scale is smaller than the dominant low frequency turbulence, and is thus not relevant to transport in Tokapole II. Comparison with theoretical treatments of c/ω pe turbulence is discussed
Global Gridded Emission Inventories of Pentabrominated Diphenyl Ether (PeBDE)
Li, Yi-Fan; Tian, Chongguo; Yang, Meng; Jia, Hongliang; Ma, Jianmin; Li, Dacheng
2010-05-01
Polybrominated diphenyl ethers (PBDEs) are flame retardants widely used in many everyday products such as cars, furniture, textiles, and other electronic equipment. The commercial PBDEs have three major technical mixtures: penta-(PeBDE), octa-(OBDE) and decabromodiphenyl ethers (DeBDE). PeBDE is a mixture of several BDE congeners, such as BDE-47, -99, and -100, and has been included as a new member of persistent organic pollutants (POPs) under the 2009 Stockholm Convention. In order to produce gridded emission inventories of PeBDE on a global scale, information of production, consumption, emission, and physiochemical properties of PeBDE have been searched for published papers, government reports, and internet publications. A methodology to estimate the emissions of PeBDE has been developed and global gridded emission inventories of 2 major congener in PeBDE mixture, BDE-47 and -99, on a 1 degree by 1degree latitude/longitude resolution for 2005 have been compiled. Using these emission inventories as input data, the Canadian Model for Environmental Transport of Organochlorine Pesticides (CanMETOP) model was used to simulate the transport of these chemicals and their concentrations in air were calculated for the year of 2005. The modeled air concentration of BDE-47 and -99 were compared with the monitoring air concentrations of these two congeners in the same year obtained from renowned international/national monitoring programs, such as Global Atmospheric Passive Sampling (GAPS), the Integrated Atmospheric Deposition Network (IADN), and the Chinese POPs Soil and Air Monitoring Program (SAMP), and significant correlations between the modeled results and the monitoring data were found, indicating the high quality of the produced emission inventories of BDE-47 and -99. Keywords: Pentabrominated Diphenyl Ether (PeBDE), Emission Inventories, Global, Model
Omental infarction in children misdiagnosed as acute appendicitis ...
African Journals Online (AJOL)
Omental infarction (OI) is a rare cause of acute abdomen in children. It is found in 0.1–0.5% of pediatric patients undergoing abdominal exploration for the suspect of acute appendicitis. OI is considered a self-limited entity, and conservative management should be considered. This approach implicates computer tomography ...
Development and perspectives of PE for gas networks in Italy
International Nuclear Information System (INIS)
Bergamino, R.; Cammelli, W.; Torre, C.
1999-01-01
After comparing the result of two large surveys carried out in 1998 and 1992 on the utilization of PE pipes for gas distribution, the features of PE pipe, which allow the adoption of innovative techniques such as 'rapid trenching' for the laying of new pipelines and 'NO-DIG' for the relining of old on, are described. The technical, operational and economical fea-activities developed in this field by AMGA SpA Genoa. Besides, the time behaviour of PE pipes welding is evaluated on the basis of values taken from AMGA's database [it
Chalupa, Pavel; Kaspar, Miroslav; Holub, Michal
2009-02-01
Acute acalculous cholecystitis is a rare complication of Epstein-Barr virus mononucleosis and involves thickening of the gallbladder wall. We describe the case of a 22-year-old woman with acute acalculous cholecystitis and pericholecystitis associated with Epstein-Barr virus primary infection. Surgical intervention was not performed, even though gallbladder perforation was suspected. The patient was treated conservatively with careful monitoring, including repeated ultrasonographic examinations. Epstein-Barr virus infections are usually self-limited, and surgical treatment of acute acalculous cholecystitis should only be considered when the ultrasonographic criteria persist on follow-up examinations or when they deteriorate. This is the first report of a severe course of acute acalculous cholecystitis with suspected gallbladder perforation associated with infectious mononucleosis.
Morag, Ido; Luria, Gil
2018-04-01
Most studies concerned with participative ergonomic (PE) interventions, focus on organizational rather than group level analysis. By implementing an intervention at a manufacturing plant, the current study, utilizing advanced information systems, measured the effect of line-supervisor leadership on employee exposure to risks. The study evaluated which PE dimensions (i.e., extent of workforce involvement, diversity of reporter role types and scope of analysis) are related to such exposure at the group level. The data for the study was extracted from two separate computerized systems (workforce medical records of 791 employees and an intranet reporting system) during a two-year period. While the results did not confirm the effect of line-supervisor leadership on subordinates' exposure to risks, they did demonstrate relationships between PE dimensions and the employees' exposure to risks. The results support the suggested level of analysis and demonstrate that group-based analysis facilitates the assimilation of preventive interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.
Miura, Fumihiko; Okamoto, Kohji; Takada, Tadahiro; Strasberg, Steven M.; Asbun, Horacio J.; Pitt, Henry A.; Gomi, Harumi; Solomkin, Joseph S.; Schlossberg, David; Han, Ho-Seong; Kim, Myung-Hwan; Hwang, Tsann-Long; Chen, Miin-Fu; Huang, Wayne Shih-Wei; Kiriyama, Seiki; Itoi, Takao; Garden, O. James; Liau, Kui-Hin; Horiguchi, Akihiko; Liu, Keng-Hao; Su, Cheng-Hsi; Gouma, Dirk J.; Belli, Giulio; Dervenis, Christos; Jagannath, Palepu; Chan, Angus C. W.; Lau, Wan Yee; Endo, Itaru; Suzuki, Kenji; Yoon, Yoo-Seok; de Santibañes, Eduardo; Giménez, Mariano Eduardo; Jonas, Eduard; Singh, Harjit; Honda, Goro; Asai, Koji; Mori, Yasuhisa; Wada, Keita; Higuchi, Ryota; Watanabe, Manabu; Rikiyama, Toshiki; Sata, Naohiro; Kano, Nobuyasu; Umezawa, Akiko; Mukai, Shuntaro; Tokumura, Hiromi; Hata, Jiro; Kozaka, Kazuto; Iwashita, Yukio; Hibi, Taizo; Yokoe, Masamichi; Kimura, Taizo; Kitano, Seigo; Inomata, Masafumi; Hirata, Koichi; Sumiyama, Yoshinobu; Inui, Kazuo; Yamamoto, Masakazu
2018-01-01
The initial management of patients with suspected acute biliary infection starts with the measurement of vital signs to assess whether or not the situation is urgent. If the case is judged to be urgent, initial medical treatment should be started immediately including respiratory/circulatory
Korekcija temperature v tunelski peči
DOLENC, PETER
2016-01-01
Cilj diplomske naloge je bil programsko odpraviti problem preveč zapečenih izdelkov v serijski proizvodnji peke kruha. Ta problem nastane, ko se zaradi določenega razloga, kot je npr. menjava vrste izdelka, pojavi večja luknja na tekočem traku. Vnos testa v peč je v tem primeru močno zmanjšan in posledično prihaja do dviga temperature v območju in okolici luknje. Programska logika peči teče na programirljivem logičnem krmilniku. Program je večinoma izdelan v lestvičnem diagramu, določene ...
Directory of Open Access Journals (Sweden)
Deisy Barrios
Full Text Available We sought to examine sex-related differences in the characteristics and outcome in patients presenting with acute symptomatic pulmonary embolism (PE.We conducted a retrospective cohort study of 2,096 patients diagnosed with acute PE. The characteristics were recorded at presentation. Treatment was at the discretion of patients' physicians. The primary study outcome, all-cause mortality, and the secondary outcomes of PE-specific mortality, recurrent venous thromboembolism, and major bleeding were assessed during the first month of follow-up after PE diagnosis.Overall, the women were older than the men and had significantly higher rates of immobilization. They had significantly lower rates of chronic obstructive pulmonary disease and cancer. Women had a higher prevalence of syncope and elevated brain natriuretic peptide levels. Thirty-day all-cause mortality was similar between women and men (7.1% versus 6.2%; P = 0.38. Male gender was not independently significantly associated with PE-related death (adjusted odds ratio [OR] 1.02; 95% CI, 0.50 to 2.07; P = 0.96. Restricting the analyses to haemodynamically stable patients (n = 2,021, female gender was an independent predictor of all-cause (adjusted OR 1.56; 95% CI, 1.07 to 2.28; P = 0.02 and PE-specific mortality (adjusted OR 1.85; 95% CI, 1.02 to 3.33; P = 0.04. Compared with men, women were 2.05 times more likely to experience a major bleed.Women and men with PE had different clinical characteristics, presentation, and outcomes. Women receiving anticoagulation have a significantly higher risk of major bleeding, suggesting the need for careful monitoring of anticoagulant intensity in women.
Directory of Open Access Journals (Sweden)
Luca Masotti
2009-07-01
Full Text Available Luca Masotti1, Marc Righini2, Nicolas Vuilleumier3, Fabio Antonelli4, Giancarlo Landini5, Roberto Cappelli6, Patrick Ray71Internal Medicine, 4Clinical Chemistry, Cecina Hospital, Cecina, Italy; 2Division of Angiology and Haemostasis, Department of Internal Medicine, Geneva University Hospital, Switzerland; 3Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals and University of Geneva, Switzerland; 5Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy; 6Thrombosis Center, University of Siena, Siena, Italy; 7Department of Emergency Medicine, Centre Hospitalo-Universitaire Pitié-Salpêtrière, UPMC Paris 6, Paris, FranceAbstract: Pulmonary embolism (PE represents a common disease in emergency medicine and guidelines for diagnosis and treatment have had wide diffusion. However, PE morbidity and mortality remain high, especially when associated to hemodynamic instability or right ventricular dysfunction. Prognostic stratification to identify high risk patients needing to receive more aggressive pharmacological and closer monitoring is of utmost importance. Modern guidelines for management of acute PE are based on risk stratification using either clinical, radiological, or laboratory findings. This article reviews the modern treatment of acute PE, which is customized upon patient prognosis. Accordingly the current risk stratification tools described in the literature such as clinical scores, echocardiography, helical computer tomography, and biomarkers will be reviewed.Keywords: pulmonary embolism, prognosis, troponin, BNP, NT-proBNP, echocardiography, computer tomography
International Nuclear Information System (INIS)
Reichert, Miriam; Henzler, Thomas; Krissak, Radko; Apfaltrer, Paul; Huck, Kurt; Buesing, Karen; Sueselbeck, Tim; Schoenberg, Stefan O.; Fink, Christian
2011-01-01
detection of VTE, because the additional radiation dose is high and isolated pelvic DVT is very rare. Venous imaging of the legs (preferably by radiation-free ultrasound) is sufficient for the diagnosis of underlying DVT in patients with suspected PE.
Secretoneurin and PE-11 immunoreactivity in the human dental pulp.
Steiner, René; Fischer-Colbrie, Reiner; Bletsa, Athanasia; Laimer, Johannes; Troger, Josef
2018-02-01
To explore whether there are differences in the concentration of the secretogranin II-derived peptide secretoneurin and the chromogranin B-derived peptide PE-11 between the healthy and inflamed human dental pulps. Furthermore, colocalization studies with calcitonin gene-related peptide were performed to confirm the sensory origin of the peptidergic nerves in the dental pulp. The concentrations of secretoneurin and PE-11 were determined by highly sensitive radioimmunoassays in extracts of dental pulps, the molecular form of secretoneurin immunoreactivities by RP-HPLC with subsequent radioimmunoassay and colocalization studies with calcitonin gene-related peptide were performed by double immunofluorescence. Only secretoneurin but not PE-11 was detectable by radioimmunoassays whereas nerve fibers could be made visible for both secretoneurin and PE-11. Furthermore, there was a full colocalization of secretoneurin and PE-11 with calcitonin gene-related peptide in immunohistochemical experiments. There were no differences in the concentration of secretoneurin between the healthy and inflamed human dental pulp and moreover, the characterization of the secretoneurin immunoreactivities revealed that only authentic secretoneurin was detected with the secretoneurin antibody. There is unequivocal evidence that secretoneurin and PE-11 are constituents of the sensory innervation of the human dental pulp and although not exclusively but are yet present in unmyelinated C-fibers which transmit predominantly nociceptive impulses. Secretoneurin might be involved in local effector functions as well, particularly in neurogenic inflammation, given that this is the case despite of unaltered levels in inflamed tissue. Copyright © 2017 Elsevier Ltd. All rights reserved.
Bank, Ingrid Em; Dekker, Marieke S; Hoes, Arno W; Zuithoff, Nicolaas Pa; Verheggen, Peter Whm; de Vrey, Evelyn A; Wildbergh, Thierry X; Timmers, Leo; de Kleijn, Dominique Pv; Glatz, Jan Fc; Mosterd, Arend
2016-08-01
Timely recognition of acute coronary syndrome remains a challenge as many biomarkers, including troponin, remain negative in the first hours following the onset of chest pain. We assessed the diagnostic accuracy of heart-type fatty acid binding protein (H-FABP), a cardiac biomarker with potential value immediately post symptom onset. Prospective monocentre diagnostic accuracy study of H-FABP bedside point of care (CardioDetect®) and ELISA tests in acute coronary syndrome suspected patients presenting within 24 hours of symptom onset to the emergency department, in addition to clinical findings, electrocardiography and the currently recommended biomarker high sensitivity troponin-T (hs-cTnT). The final diagnosis of acute coronary syndrome was adjudicated by two independent cardiologists, blinded to H-FABP results. Acute coronary syndrome was diagnosed in 149 (32.9%) of 453 unselected patients with suspected acute coronary syndrome (56% men, mean age 62.6 years). Negative predictive values were similar for H-FABP point of care and ELISA tests (79% vs. 78% respectively), but inferior to initial hs-cTnT (negative predictive value 86%). The addition of H-FABP point of care results to hs-cTnT increased the negative predictive value to 89%. In a multivariable logistic regression model, H-FABP point of care and ELISA tests yielded relevant diagnostic information in addition to clinical findings and ECG (likelihood ratio test pacute coronary syndrome presenting to the emergency department, H-FABP testing improves diagnostic accuracy in addition to clinical findings and electrocardiography. H-FABP, however, has no additional diagnostic value when hs-cTnT measurements are also available. © The European Society of Cardiology 2015.
Yue-Meng, Wan; Yang, Li-Hong; Yang, Jin-Hui; Xu, Ying; Yang, Jing; Song, Gui-Bo
2016-05-01
Various studies showed that entecavir (ETV) failed to improve the short-term survival in chronic hepatitis B (CHB) patients with severe acute exacerbation (SAE) and hepatic de-compensation or acute-on-chronic liver failure (ACLF). One study concluded that plasma exchange (PE) significantly decreased the short-term mortality of CHB patients with ACLF who were treated with lamivudine (LAM). Our study was designed to examine the effect of PE on CHB patients with ACLF who were treated with ETV. From August 2010 to January 2015, 38 (PE group) and 120 (control group) consecutive CHB-naïve patients with hepatic de-compensation and ACLF treated with PE plus ETV and ETV, respectively, were recruited. The primary endpoint was liver-related mortality at week 12. Biochemical and virological responses were also studied. At baseline, the PE group had higher serum alanine aminotransferase (ALT) levels and model for end-stage liver disease (MELD) scores, and had lower albumin levels than the control group. The cumulative survival rate at week 4 and week 12 in the PE group and control group were, respectively, 37 and 18 %, and 29 and 14 % (p 0.05). Univariate analysis showed that the control group had a higher liver-related mortality (p = 0.038) at week 12 than the PE group. Multivariate analysis showed that hepatic encephalopathy, ascites, PE treatment, and MELD scores were independent factors for liver-related mortality at week 12. PE significantly improved the short-term survival of CHB patients with hepatic de-compensation and ACLF who were treated with ETV. Hepatic encephalopathy, ascites, PE treatment, and MELD scores were independent factors for liver-related mortality at week 12.
Sequence analysis corresponding to the PPE and PE proteins in ...
Indian Academy of Sciences (India)
Unknown
AB repeats; Mycobacterium tuberculosis genome; PE-PPE domain; PPE, PE proteins; sequence analysis; surface antigens. J. Biosci. | Vol. ... bacterium tuberculosis genomes resulted in the identification of a previously uncharacterized 225 amino acid- ...... Vega Lopez F, Brooks L A, Dockrell H M, De Smet K A,. Thompson ...
Optimization of esterification of oleic acid and trimethylolpropane (TMP) and pentaerythritol (PE)
Energy Technology Data Exchange (ETDEWEB)
Mahmud, Hamizah Ammarah; Salimon, Jumat [School of Chemical Sciences and Food Technology, Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor Darul Ehsan (Malaysia)
2014-09-03
Vegetable oil (VO) is the most potential alternative to replace mineral oil for lubricant due to better lubricating properties and great physicochemical properties. Chemical modification has to be done to overcome low temperature performance and low oxidation instability due to the presence of β-hydrogen atoms of glycerol molecule. The optimization of esterification of oleic acid and polyhydric alcohol with sulfuric acid catalyst was carried out to find the optimum conditions with the highest yield. Reeaction variables such as; molar ratio, temperature, duration and catalyst concentration. Two types of polyhydric alcohol have been used; TMP and PE. The optimum results showed oleic acid successfully converted 91.2% ester TMP and 92.7% ester PE at duration: 5 hours (Ester TMP), 6 hours (Ester PE); temperature: 150°C (ester TMP), 180°C (Ester PE); catalyst concentration: 1.5% (w/w); and mol ratio: 3.9:1 (ester TMP), 4.9:1 (ester PE). From the data obtained, mole ratio showed most influenced factors to the increasing yields of ester conversions.. The TMP/PE ester was confirmed using gas chromatography (GC-FID), Fourier Transform Infrared Spectroscopy (FTIR) and Nuclear Magnetic Resonance (NMR)
An analytic approach to 2D electronic PE spectra of molecular systems
International Nuclear Information System (INIS)
Szoecs, V.
2011-01-01
Graphical abstract: The three-pulse photon echo (3P-PE) spectra of finite molecular systems using direct calculation from electronic Hamiltonians allows peak classification from 3P-PE spectra dynamics. Display Omitted Highlights: → RWA approach to electronic photon echo. → A straightforward calculation of 2D electronic spectrograms in finite molecular systems. → Importance of population time dynamics in relation to inter-site coherent coupling. - Abstract: The three-pulse photon echo (3P-PE) spectra of finite molecular systems and simplified line broadening models is presented. The Fourier picture of a heterodyne detected three-pulse rephasing PE signal in the δ-pulse limit of the external field is derived in analytic form. The method includes contributions of one and two-excitonic states and allows direct calculation of Fourier PE spectrogram from corresponding Hamiltonian. As an illustration, the proposed treatment is applied to simple systems, e.g. 2-site two-level system (TLS) and n-site TLS model of photosynthetic unit. The importance of relation between Fourier picture of 3P-PE dynamics (corresponding to nonzero population time, T) and coherent inter-state coupling is emphasized.
Ham, H. W (Wietske); Schoonhoven, Lisette; Schuurmans, M. (Marieke) J; Leenen, L. (Luke) P H
2017-01-01
Objectives To explore the influence of risk factors present at Emergency Department admission on pressure ulcer development in trauma patients with suspected spinal injury, admitted to the hospital for evaluation and treatment of acute traumatic injuries. Design Prospective cohort study setting
High‑risk pulmonary embolism in a patient with acute dissecting ...
African Journals Online (AJOL)
In the last decades, an increased incidence of pulmonary embolism (PE) and acute dissection (AD) of aortic aneurysms has been registered mostly due to increased availability of advanced imaging techniques. They seldom occur concomitantly in the same patient. In this paper, we present the clinical challenges and ...
[Acute Stress and Broken Heart Syndrome. A Case Report].
Vergel, Juliana; Tamayo-Orozco, Sebastián; Vallejo-Gómez, Andrés Felipe; Posada, María Teresa; Restrepo, Diana
Stress has been associated with an acute heart failure syndrome of important morbidity and mortality. Case report and non-systematic review of the relevant literature. A 65-year-old woman with a history of an untreated generalized anxiety disorder, whom after the violent death of her son presented with oppressive chest pain irradiated to neck and left superior extremity, lasting for more than 30minutes, initial clinical suspect suggests acute coronary syndrome. Tako-tsubo cardiomyopathy is characterized by a reversible left ventricular dysfunction and wall movement abnormalities, without any compromise of the coronary arteries, associated to high plasma levels of catecholamines which in most cases correlates with an acute stress of emotional or physical type. Tako-tsubo cardiomyopathy has to be considered by physicians among the differential diagnosis when facing a patient with suspected acute coronary syndrome, especially in post-menopausal women with a history of psychiatric comorbidities such as a generalized anxiety disorder. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Sandfort, Veit; Johnson, Alistair E W; Kunz, Lauren M; Vargas, Jose D; Rosing, Douglas R
2018-01-01
We sought to evaluate the association of prolonged elevated heart rate (peHR) with survival in acutely ill patients. We used a large observational intensive care unit (ICU) database (Multiparameter Intelligent Monitoring in Intensive Care III [MIMIC-III]), where frequent heart rate measurements were available. The peHR was defined as a heart rate >100 beats/min in 11 of 12 consecutive hours. The outcome was survival status at 90 days. We collected heart rates, disease severity (simplified acute physiology scores [SAPS II]), comorbidities (Charlson scores), and International Classification of Diseases (ICD) diagnosis information in 31 513 patients from the MIMIC-III ICU database. Propensity score (PS) methods followed by inverse probability weighting based on the PS was used to balance the 2 groups (the presence/absence of peHR). Multivariable weighted logistic regression was used to assess for association of peHR with the outcome survival at 90 days adjusting for additional covariates. The mean age was 64 years, and the most frequent main disease category was circulatory disease (41%). The mean SAPS II score was 35, and the mean Charlson comorbidity score was 2.3. Overall survival of the cohort at 90 days was 82%. Adjusted logistic regression showed a significantly increased risk of death within 90 days in patients with an episode of peHR ( P < .001; odds ratio for death 1.79; confidence interval, 1.69-1.88). This finding was independent of median heart rate. We found a significant association of peHR with decreased survival in a large and heterogenous cohort of ICU patients.
International Nuclear Information System (INIS)
Yavas, Ulas Savas; Calisir, Cuneyt; Ozkan; Ibrahim Ragip
2008-01-01
We wanted to prospectively evaluate the interobserver agreement between radiology residents and expert radiologists for interpreting CT images for making the diagnosis of pulmonary embolism (PE). We assessed 112 consecutive patients, from April 2007 to August 2007, who were referred for combined CT pulmonary angiography and indirect CT venography for clinically suspected acute PE. CT scanning was performed with a 64x0.5 collimation multi-detector CT scanner. The CT studies were initially interpreted by the radiology residents alone and then the CT images were subsequently interpreted by a consensus of the resident plus an experienced general radiologist and an experienced chest radiologist. Two of the 112 CTs were unable to be interpreted (1.7%). Pulmonary artery clots were seen on 36 of the thoracic CT angiographies (32%). The interobserver agreement between the radiology residents and the consensus interpretation was good (a kappa index of 0.73). All of the disagreements (15 cases) were instances of overcall by the resident on the initial interpretation. Deep venous thrombosis was detected in 72% (26 of 36) of the patients who had PE seen on thoracic CT. The initial and consensus interpretations of the CT venography images disagreed for two cases (kappa statistic: 0.96). It does not seem adequate to base the final long-term treatment of PE on only the resident's reading, as false positives occurred in 13% of such cases. Timely interpretation of the CT pulmonary angiography and CT venography images should be performed by experienced radiologists for the patients with suspected PE
Hugues, T; Yaici, K; Latcu, D-G; Rinaldi, J-P; Zarqane, N; Saoudi, N; Gibelin, P
2011-02-01
Echocardiographic criteria of right ventricular dysfunction (RVD) in acute pulmonary embolism (PE) differ among published studies. Assessment of RV systolic function remains difficult because of the RV's complex shape. We aimed to evaluate RV systolic function with TAD in patients (pts) with acute PE. TAD (QLAB, Philips Medical Imaging) was based on a tissue-tracking algorithm that is ultrasound beam angle independent for automated detection of tricuspid annular displacement. Prospective and observational study. All adults' pts who were diagnosed with PE from December 2008 to December 2009 at Princess Grace Hospital, Monaco were eligible for this study after exclusion of history of heart failure. We evaluated 36 consecutive pts with PE (18 male, mean age 62.7 years), which underwent echocardiography, plasma BNP titration during the first day after admission, and a second echocardiography obtained within 48 hours before discharge. TAD value were significantly lower in pts with abnormal RV function by echocardiogram (15.9 ± 0.3 vs. 12.7 ± 0.2 ; P = 0.026). Pts with a normal BNP (TAD (16.4 ± 0.2 vs. 11.2 ± 0.3 mm ; P TAD were significantly improved. There was no difference between TAD among pts with echocardiographic RVD at baseline vs. pts without RVD (14.9 ± 3.7 vs. 16.1 ± 2.9 mm ; P = 0.3). Four pts who deteriorated during short-term observation had substantially lower TAD values than those with uncomplicated courses (7.7 ± 0.4mm vs. 14.6 ± 0.2 mm ; P = 0.001). In conclusion, impaired TAD was associated with decreased RV systolic function in pts with acute PE. To identify the clinical meaning of decreased TAD, larger trials with longer follow-up periods are needed. Copyright © 2010 Elsevier Masson SAS. All rights reserved.
Phelan, Jody E.
2016-02-29
Background Approximately 10 % of the Mycobacterium tuberculosis genome is made up of two families of genes that are poorly characterized due to their high GC content and highly repetitive nature. The PE and PPE families are typified by their highly conserved N-terminal domains that incorporate proline-glutamate (PE) and proline-proline-glutamate (PPE) signature motifs. They are hypothesised to be important virulence factors involved with host-pathogen interactions, but their high genetic variability and complexity of analysis means they are typically disregarded in genome studies. Results To elucidate the structure of these genes, 518 genomes from a diverse international collection of clinical isolates were de novo assembled. A further 21 reference M. tuberculosis complex genomes and long read sequence data were used to validate the approach. SNP analysis revealed that variation in the majority of the 168 pe/ppe genes studied was consistent with lineage. Several recombination hotspots were identified, notably pe_pgrs3 and pe_pgrs17. Evidence of positive selection was revealed in 65 pe/ppe genes, including epitopes potentially binding to major histocompatibility complex molecules. Conclusions This, the first comprehensive study of the pe and ppe genes, provides important insight into M. tuberculosis diversity and has significant implications for vaccine development.
A review of factors affecting the attractiveness of Angola to private equity (PE investments
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Estefania Jover
2014-11-01
Full Text Available Angola’s attractiveness to PE investors and the potential to increase PE investments in the country are explored. Primary data were collected using a survey of 18 PE funds that invest or have considered investing in Angola, followed by 10 expert interviews to gain deeper insight into the country’s institutional and economic environment, and its potential for PE investments. It is found that most PE funds are attracted to Angola by its rapid economic growth and high potential returns. The country is also vastly undersupplied, and many key economic sectors are fast developing, presenting exciting opportunities for investors. Nevertheless, PE in Angola remains limited, mainly owing to the difficulty of doing business in Angola, and owing particularly to the unfavourable regulatory environment. There is no regulation or process when it comes to the registration of PE funds in Angola, and any new regulation that applies to foreign investments is marred by unnecessary red tape, making it difficult for the investment to enter the market. Only two funds are authorised to operate in Angola: Fundo de Investimento Privado de Angola (FIPA, and BESA Activ. Streamlining regulation is critical to increasing PE flows to Angola in order to advance the country’s economic and social objectives.
MRI in venous thromboembolic disease
International Nuclear Information System (INIS)
Sostman, H.D.; Debatin, J.F.; Spritzer, C.E.; Coleman, R.E.; Grist, T.M.; MacFall, J.R.
1993-01-01
We evaluated the ability of magnetic resonance (MR) imaging to detect deep venous thrombosis (DVT) and pulmonary embolism (PE). MR venography was performed on 217 patients suspected of having DVT. Cine-MR imaging of the pulmonary arteries was performed in 14 other patients who were thought to have PE based on other imaging studies. In a third group of 5 patients, MR pulmonary angiograms were performed in the sagittal and coronal planes with a multislice fast gradient recalled echo technique. All but one of the 217 MR venograms were technically adequate. In 72 patients with correlative imaging studies (venography and ultrasound) MR venography was 99% sensitive and 95% specific. On the basis of follow-up (mean 8.3 months), no false-negative MR venograms were detected in an additional 64 patients. In 11 other patients MR revealed a diagnosis other than DVT. Cine-MR showed PE in all 14 patients evaluated. MR pulmonary arteriography demonstrated filling defects consistent with acute PE in 2 of 3 patients with acute PE; in the third patient only a questionable filling defect was seen. Coarctations or webs were found in the pulmonary arteries of both patients with chronic PE. These preliminary data suggest that MR imaging may be able to evaluate both the peripheral venous and the pulmonary arterial component of venous thromboembolic disease. Further technical refinement and more extensive clinical experience will be required to establish the role of this method in diagnosing pulmonary embolism, but MR venography is now used routinely in our hospital for the diagnosis of deep venous thrombosis. (orig.)
Li, Maoqin; Sun, Jingxi; Li, Jiaqiong; Shi, Zaixiang; Xu, Jiyuan; Lu, Bo; Cheng, Shuli; Xu, Yanjun; Wang, Xiaomeng; Zhang, Xianjiang
2016-12-01
The clinical efficacy and safety of different combinations of non-bio artificial liver in the treatment of acute liver failure was examined. A total of 61 cases were selected under blood purification treatment from the patients with severe acute liver failure admitted to the severe disease department of the hospital from December, 2010 to December, 2015. Three types of artificial liver combinations were observed, i.e., plasma exchange plus hemoperfusion plus continuous venovenous hemodiafiltration (PE+HP+CVVHDF), PE+CVVHDF and HP+CVVHDF. The heart rate (HR), mean arterial pressure (MAP), respiratory index (PaO 2 /FiO 2 ), liver and kidney function indicator, as well as platelet and coagulation function were compared. A comparison before and after the treatment using the three methods, showed improvement in the HRs, MAPs, PaO 2 /FiO 2 , total bilirubins (TBIL) and alanine aminotransferases (ALT) (Prate of 62.3% (38/61), and a viral survival rate of 35.0% (7/20); with the non-viral survival rate being 75.6% (31/41). In conclusion, following the treatment of three types of artificial livers, the function was improved to varying degrees, with the PE+HP+CVVHDF and the PE+CVVHDF method being better. By contrast, after the treatment of non-viral liver failure, the survival rate was significantly higher than the patients with viral liver failure.
Newsom, Sean A; Brozinick, Joseph T; Kiseljak-Vassiliades, Katja; Strauss, Allison N; Bacon, Samantha D; Kerege, Anna A; Bui, Hai Hoang; Sanders, Phil; Siddall, Parker; Wei, Tao; Thomas, Melissa; Kuo, Ming Shang; Nemkov, Travis; D'Alessandro, Angelo; Hansen, Kirk C; Perreault, Leigh; Bergman, Bryan C
2016-06-01
Several recent reports indicate that the balance of skeletal muscle phosphatidylcholine (PC) and phosphatidylethanolamine (PE) is a key determinant of muscle contractile function and metabolism. The purpose of this study was to determine relationships between skeletal muscle PC, PE and insulin sensitivity, and whether PC and PE are dynamically regulated in response to acute exercise in humans. Insulin sensitivity was measured via intravenous glucose tolerance in sedentary obese adults (OB; n = 14), individuals with type 2 diabetes (T2D; n = 15), and endurance-trained athletes (ATH; n = 15). Vastus lateralis muscle biopsies were obtained at rest, immediately after 90 min of cycle ergometry at 50% maximal oxygen consumption (V̇o2 max), and 2-h postexercise (recovery). Skeletal muscle PC and PE were measured via infusion-based mass spectrometry/mass spectrometry analysis. ATH had greater levels of muscle PC and PE compared with OB and T2D (P insulin sensitivity (both P insulin sensitivity among the entire cohort (r = -0.43, P = 0.01). Muscle PC and PE were altered by exercise, particularly after 2 h of recovery, in a highly group-specific manner. However, muscle PC:PE ratio remained unchanged in all groups. In summary, total muscle PC and PE are positively related to insulin sensitivity while PC:PE ratio is inversely related to insulin sensitivity in humans. A single session of exercise significantly alters skeletal muscle PC and PE levels, but not PC:PE ratio. Copyright © 2016 the American Physiological Society.
Yu, Yuan; Li, Jialu; Zhu, Xuejun; Tang, Xiaowen; Bao, Yangyi; Sun, Xiang; Huang, Yuhui; Tian, Fang; Liu, Xiaomei; Yang, Lin
2017-01-01
Nanobodies, named as VHHs (variable domain of heavy chain of HCAb [heavy-chain antibodies]), are derived from heavy-chain-only antibodies that circulate in sera of camelids. Their exceptional physicochemical properties, possibility of humanization, and unique antigen recognition properties make them excellent candidates for targeted delivery of biologically active components, including immunotoxins. In our previous efforts, we have successfully generated the monovalent and bivalent CD7 nanobody-based immunotoxins, which can effectively trigger the apoptosis of CD7-positive malignant cells. To pursue the possibility of translating those immunotoxins into clinics, we humanized the nanobody sequences (designated as dhuVHH6) as well as further truncated the Pseudomonas exotoxin A (PE)-derived PE38 toxin to produce a more protease-resistant form, which is named as PE-LR, by deleting majority of PE domain II. Three new types of immunotoxins, dhuVHH6-PE38, dVHH6-PE-LR, and dhuVHH6-PE-LR, were successfully constructed. These recombinant immunotoxins were expressed in Escherichia coli and showed that nanobody immunotoxins have the benefits of easy soluble expression in a prokaryotic expression system. Flow cytometry results revealed that all immunotoxins still maintained the ability to bind specifically to CD7-positive T lymphocyte strains without binding to CD7-negative control cells. Laser scanning confocal microscopy revealed that these proteins can be endocytosed into the cytoplasm after binding with CD7-positive cells and that this phenomenon was not observed in CD7-negative cells. WST-8 experiments showed that all immunotoxins retained the highly effective and specific growth inhibition activity in CD7-positive cell lines and primary T-cell acute lymphoblastic leukemia (T-ALL) cells. Further in vivo animal model experiments showed that humanized dhuVHH6-PE38 immunotoxin can tolerate higher doses and extend the survival of NOD-Prkdc em26 Il2rg em26 Nju (NCG) mice
Impact of copeptin on diagnosis of acute coronary syndrome
Directory of Open Access Journals (Sweden)
Zeinab H. El Sayed
2014-07-01
Conclusion: In suspected acute coronary syndrome, determination of copeptin and cardiac troponin I provides a remarkable negative predictive value, which aids in early and safe ruling out of myocardial infarction.
M. Westwood (Marie); T. van Asselt (Thea); B.L.T. Ramaekers (Bram); P. Whiting (Penny); P. Thokala (Praveen); M.A. Joore (Manuela); N. Armstrong (Nigel); J. Ross (Janine); J.L. Severens (Hans); J. Kleijnen (Jos)
2015-01-01
textabstractBackground The primary indication for this assessment is the early rule-out of acute myocardial infarction (AMI) in people presenting with acute chest pain and suspected, but not confirmed, non-ST segment elevation myocardial infarction (NSTEMI). Cardiac troponins (cTns) I and T are used
Directory of Open Access Journals (Sweden)
Michael J. Drescher
2017-09-01
Full Text Available Introduction: Computerized decision support decreases the number of computed tomography pulmonary angiograms (CTPA for pulmonary embolism (PE ordered in emergency departments, but it is not always well accepted by emergency physicians. We studied a department-endorsed, evidence-based clinical protocol that included the PE rule-out criteria (PERC rule, multi-modal education using principles of knowledge translation (KT, and clinical decision support embedded in our order entry system, to decrease the number of unnecessary CTPA ordered. Methods: We performed a historically controlled observational before-after study for one year pre- and post-implementation of a departmentally-endorsed protocol. We included patients > 18 in whom providers suspected PE and who did not have a contraindication to CTPA. Providers entered clinical information into a diagnostic pathway via computerized order entry. Prior to protocol implementation, we provided education to ordering providers. The primary outcome measure was the number of CTPA ordered per 1,000 visits one year before vs. after implementation. Results: CTPA declined from 1,033 scans for 98,028 annual visits (10.53 per 1,000 patient visits (95% CI [9.9–11.2] to 892 scans for 101,172 annual visits (8.81 per 1,000 patient visits (95% CI [8.3–9.4] p<0.001. The absolute reduction in PACT ordered was 1.72 per 1,000 visits (a 16% reduction. Patient characteristics were similar for both periods. Conclusion: Knowledge translation clinical decision support using the PERC rule significantly reduced the number of CTPA ordered.
Active Bilayer PE/PCL Films for Food Packaging Modified with Zinc Oxide and Casein
Directory of Open Access Journals (Sweden)
Ana Rešček
2015-12-01
Full Text Available This paper studies the properties of active polymer food packaging bilayer polyethylene/polycaprolactone (PE/PCL films. Such packaging material consists of primary PE layer coated with thin film of PCL coating modified with active component (zinc oxide or zinc oxide/casein complex with intention to extend the shelf life of food and to maintain the quality and health safety. The influence of additives as active components on barrier, mechanical, thermal and antimicrobial properties of such materials was studied. The results show that, in comparison to the neat PE and PE/PCL films, some of PE/PCL bilayer films with additives exhibit improved barrier properties i.e. decreased water vapour permeability. Higher thermal stability of modified PE/PCL material is obtained due to a modified mechanism of thermal degradation. The samples with the additive nanoparticles homogeneously dispersed in the polymer matrix showed good mechanical properties. Addition of higher ZnO content contributes to the enhanced antibacterial activity of a material.
Spinal diffusion tensor tractography for differentiation of intramedullary tumor-suspected lesions
Energy Technology Data Exchange (ETDEWEB)
Egger, K., E-mail: karl.egger@uniklinik-freiburg.de [Department of Neuroradiology, University Medical Center Freiburg, Breisacher Straße 64, 79106 Freiburg (Germany); Hohenhaus, M. [Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, 79106 Freiburg (Germany); Van Velthoven, V. [Department of Neurosurgery, UZ Brussel, Laarbeeklaan 101, 1090 Brussel (Belgium); Heil, S.; Urbach, H. [Department of Neuroradiology, University Medical Center Freiburg, Breisacher Straße 64, 79106 Freiburg (Germany)
2016-12-15
Background and purpose: Primary MRI diagnosis of spinal intramedullary tumor-suspected lesions can be challenging and often requires spinal biopsy or resection with a substantial risk of neurological deficits. We evaluated whether Diffusion Tensor Imaging (DTI) tractography can facilitate the differential diagnosis. Materials and methods: Twenty-five consecutive patients with an intramedullary tumor-suspected lesion considered for spinal surgery were studied with a Diffusion-weighted multi-shot read out segmented EPI sequence (RESOLVE). White matter tracts (“streamlines”) were calculated using the FACT algorithm and visually co-registered to a T2-weighted 3D sequence. The fused images were assessed concerning spinal streamline appearance as normal, displaced or terminated. Definite diagnosis was verified by histological analysis or further clinical work-up. Results: All patients with normal appearing streamlines (n = 6) showed an acute inflammatory demyelinating pathology in the further clinical work-up. In 10 patients streamline displacing lesions were found from which 5 patients underwent a surgical treatment with histologically confirmed low-grade tumors like ependymomas and pilocytic astrocytomas. In nine patients streamlines were terminated, from which 6 patients received a histology proven diagnoses with a more heterogenous spectrum (3 cases of high grade tumor, 1 case of low grade tumor with intralesional hemorrhage and 2 cases with gliosis but no tumor cells). Conclusion: Using multi-shot DTI spinal tractography acute inflammatory lesions can be differentiated from other tumorous intramedullary lesions. The entity diagnosis of spinal tumors seems to be more challenging, primarily due to the variety of factors like invasivity, expansion or intralesional hemorrhage.
Can brain natriuretic peptide predict the outcome in patients with acute pulmonary embolism?
Directory of Open Access Journals (Sweden)
Ramadan Nafie
2012-10-01
Conclusion: An elevated plasma level of BNP is a prognostic factor for short-term mortality and overall short-term complicated clinical outcome, and it is a powerful indicator of RVD in patients with acute PE in the absence of left ventricular dysfunction (LVD.
Rapid and accurate diagnosis of acute cholecystitis with /sup 99m/Tc-HIDA cholescintigraphy
International Nuclear Information System (INIS)
Weissmann, H.S.; Frank, M.S.; Bernstein, L.H.; Freeman, L.M.
1979-01-01
Technetium-99m dimethyl acetanilide iminodiacetic acid (HIDA) cholescintigraphy was performed on 90 patients with suspected acute cholecytitis. Visualization of the gallbladder established patency of the cystic duct and excluded the diagnosis of acute cholecystitis in 50 of 52 patients. Nonvisualization of the gallbladder with visualization of the common bile duct was diagnostic of acute cholecystitis in 38 patients, all subsequently proven at surgery. The observed accuracy of this procedure is 98% and specificity is 100%. The false negative rate is 5% and false positive rate is zero. Technetium-99m-HILDA has many advantages which make it the procedure of choice in evaluating a patient for suspected acute cholecystitis. It is a rapid, simple, safe examination which provides functional as well as anatomic information about the hepatobiliary system in individuals with a serum bilirubin level up to 8 mg/100 ml
But I like PE: factors associated with enjoyment of physical education class in middle school girls.
Barr-Anderson, Daheia J; Neumark-Sztainer, Dianne; Schmitz, Kathryn H; Ward, Dianne S; Conway, Terry L; Pratt, Charlotte; Baggett, Chris D; Lytle, Leslie; Pate, Russell R
2008-03-01
The current study examined associations between physical education (PE) class enjoyment and sociodemographic, personal, and perceived school environment factors among early adolescent girls. Participants included 1,511 sixth-grade girls who completed baseline assessments for the Trial of Activity in Adolescent Girls, with 50% indicating they enjoyed PE class a lot. Variables positively associated with PE class enjoyment included physical activity level, perceived benefits of physical activity, self-efficacy for leisure time physical activity, and perceived school climate for girls' physical activity as influenced by teachers, while body mass index was inversely associated with PE class enjoyment. After adjusting for all variables in the model, PE class enjoyment was significantly greater in Blacks than in Whites. In model testing, with mutual adjustment for all variables, self-efficacy was the strongest correlate of PE class enjoyment, followed by perceived benefits, race/ethnicity, and teachers' support for girls' physical activity, as compared to boys, at school. The overall model explained 11% of the variance in PE class enjoyment. Findings suggest that efforts to enhance girls' self-efficacy and perceived benefits and to provide a supportive PE class environment that promotes gender equality can potentially increase PE class enjoyment among young girls.
Scintigraphic demonstration of acute myocardial infarcts
International Nuclear Information System (INIS)
Holman, B.L.; Lesch, M.
1976-01-01
The feasibility of acute infarct scintigraphy for the clinical evaluation of patients with known or suspected acute myocardial infarction is established. Further development of this methodologic approach may result in even better agents for the visualization of infarcts. Radiotracers with high affinity for the infarct, rapid blood clearance, and low concentrations in surrounding organs, such as liver and bone, would be more suitable than available radiopharmaceuticals for acute myocardial infarct scintigraphy. Ultimately, labeling these tracers and ultra-short-lived radionuclides will enable rapid sequential imaging to assess changes in the extent of infarction and to determine the efficacy of therapies aimed at limiting infarct size
Wicki, J; Perneger, TV; Junod, AF; Bounameaux, H; Perrier, A
2000-01-01
PURPOSE We aimed to develop a simple standardized clinical score to stratify emergency ward patients with clinically suspected PE into groups with a high, intermediate, or low probability of PE, in order to improve and simplify the diagnostic approach. METHODS Analysis of a database of 1090 consecutive patients admitted to the emergency ward for suspected PE, in whom diagnosis of PE was ruled in or out by a standard diagnostic algorithm. Logistic regression was used to predict clinical parameters associated with PE. RESULTS 296 out of 1090 patients (27%) were found to have PE. The optimal estimate of clinical probability was based on eight variables: recent surgery, previous thromboembolic event, older age, hypocapnia, hypoxemia, tachycardia, band atelectasis or elevation of a hemidiaphragm on chest X-ray. A probability score was calculated by adding points assigned to these variables. A cut-off score of 4 best identified patients with low probability of PE. 486 patients (49%) had a low clinical probability of PE (score 9). CONCLUSION This clinical score, based on easily available and objective variables, provides a standardized assessment of the clinical probability of PE. Applying this score to emergency ward patients suspected of PE could allow a more efficient diagnostic process.
Schwill, Simon; Kallenbach, Klaus; Beller, Carsten J; Karck, Matthias
2011-04-01
Acute aortic dissection type-A (AADA) is a life-threatening condition especially in patients with Marfan syndrome (MFS) simultaneously suffering from severe pectus excavatum (PE). We report on emergency surgery for combined treatment of PE and AADA in a patient with MFS using an alternative approach. It leads to excellent exposure of the dislocated heart and great vessels enabling Bentall procedure followed by funnel chest repair with modified technique of Adkins and Blades. We achieved favorable functional and cosmetic results. Therefore, we conclude the surgical approach presented is feasible for standard treatment of AADA and consecutive repair of PE.
Acute Appendagitis Presenting with Features of Appendicitis: Value of Abdominal CT Evaluation
Directory of Open Access Journals (Sweden)
Sukhpreet Dubb
2008-05-01
Full Text Available We report a case of acute appendagitis in a patient who presented initially with typical features of acute appendicitis. The diagnosis of acute appendagitis was made on pathognomonic signs on computed tomography (CT scan. Abdominal pain is a common surgical emergency. CT is not always done if there are clear features of acute appendicitis. The rare but important differential diagnosis of acute appendagitis must be borne in mind when dealing with patients with suspected acute appendicitis. A CT scan of the abdomen may avoid unnecessary surgery in these patients.
Toba, M; Nagaoka, T; Morio, Y; Sato, K; Uchida, K; Homma, N; Takahashi, K
2010-03-01
Acute pulmonary embolism (PE) is a life-threatening disease, and several vasoconstrictors, including endothelin-1 (ET-1), play a key role in vasoconstriction and hypoxemia during the development of PE. Rho kinase is activated by various vasoconstrictors resulting in vascular contraction and remodeling. Recent evidence has revealed an important role of Rho kinase in the pathogenesis of systemic and pulmonary vascular diseases. However, contribution of Rho kinase in PE remains unclear. We thus investigated the role of Rho kinase in the PE rat model induced by intrajugular administration of polystyrene microspheres (mean diameter, 26 microm). At 6 h following the administration of microspheres (1.5 ml/kg), right ventricular systolic pressure (RVSP) was higher in the PE than in the control rats (15.8 +/- 1.6 vs. 32.9 +/- 7.5 mmHg). Arterial oxygen tension was lower (92.3 +/- 12.5 vs. 66.0 +/- 17.7 Torr), and alveolar-arterial difference in oxygen partial pressure was higher (3.9 +/- 3.8 vs. 36.5 +/- 26.9 Torr) in the PE rats. Western blotting analysis revealed upregulation and downregulation in expression of vascular cell adhesion molecule-1 and endothelial nitric oxide synthase in lungs from the PE rats, respectively, and radioimmunoassay demonstrated an increase in plasma ET-1 levels. Lung Rho kinase alpha expression was greater in the PE rats. At 5 h following administration of microspheres (0.75 ml/kg), intravenous Rho kinase inhibitors HA1077 and Y27632 (3 mg/kg each) attenuated elevation of RVSP (22.0 +/- 3.7, 17.1 +/- 3.2, 14.3 +/- 2.6 mmHg, PE, PE+HA1077, PE+Y27632) and the severity of hypoxemia (66.3 +/- 16.2, 94.9 +/- 23.0, 89.1 +/- 8.5 Torr, PE, PE+HA1077, PE+Y27632) in the PE rats. These results suggest that pulmonary endothelial dysfunction and activation of Rho kinase may contribute to the potentiation of vasoconstriction and hypoxemia in the PE rats.
Directory of Open Access Journals (Sweden)
Yu Y
2017-03-01
all immunotoxins still maintained the ability to bind specifically to CD7-positive T lymphocyte strains without binding to CD7-negative control cells. Laser scanning confocal microscopy revealed that these proteins can be endocytosed into the cytoplasm after binding with CD7-positive cells and that this phenomenon was not observed in CD7-negative cells. WST-8 experiments showed that all immunotoxins retained the highly effective and specific growth inhibition activity in CD7-positive cell lines and primary T-cell acute lymphoblastic leukemia (T-ALL cells. Further in vivo animal model experiments showed that humanized dhuVHH6-PE38 immunotoxin can tolerate higher doses and extend the survival of NOD-Prkdcem26Il2rgem26Nju (NCG mice transplanted with CEM cells without any obvious decrease in body weight. Further studies on NCG mice model with patient-derived T-ALL cells, dhuVHH6-PE38 treatment, significantly prolonged mice survival with ~40% survival improvement. However, it was also noticed that although dhuVHH6-PE-LR showed strong antitumor effect in vitro, its in vivo antitumor efficacy was disappointing. Conclusion: We have successfully constructed a targeted CD7 molecule-modified nanobody (CD7 molecule-improved nanobody immunotoxin dhuVHH6-PE38 and demonstrated its potential for treating CD7-positive malignant tumors, especially T-cell acute lymphoblastic leukemia. Keywords: CD7, humanized nanobody, T-cell acute lymphoblastic leukemia, patient-derived xenograft model, recombinant immunotoxins, Pseudomonas exotoxin A
Environmental coupling and population dynamics in the PE545 light-harvesting complex
Energy Technology Data Exchange (ETDEWEB)
Aghtar, Mortaza; Kleinekathöfer, Ulrich, E-mail: u.kleinekathoefer@jacobs-university.de
2016-01-15
Long-lived quantum coherences have been shown experimentally in the Fenna–Matthews–Olson (FMO) complex of green sulfur bacteria as well as in the phycoerythrin 545 (PE545) photosynthetic antenna system of marine algae. A combination of classical molecular dynamics simulations, quantum chemistry and quantum dynamical calculations is employed to determine the excitation transfer dynamics in PE545. One key property of the light-harvesting system concerning the excitation transfer and dephasing phenomena is the spectral density. This quantity is determined from time series of the vertical excitation energies of the aggregate. In the present study we focus on the quantum dynamical simulations using the earlier QM/MM calculations as input. Employing an ensemble-averaged classical path-based wave packet dynamics, the excitation transfer dynamics between the different bilins in the PE545 complex is determined and analyzed. Furthermore, the nature of the environmental fluctuations determining the transfer dynamics is discussed. - Highlights: • Modeling of excitation energy transfer in the light-harvesting system PE545. • Combination of molecular dynamics simulations, quantum chemistry and quantum dynamics. • Spectral densities for bilins in the PE545 complex.
Brömstrup, Heiner
2012-01-01
English translation of the 3rd edition ""Rohrsysteme aus PE 100"". Because of the considerably increased performance, pipe and pipe systems made from 100 enlarge the range of applications in the sectors of gas and water supply, sewage disposal, industrial pipeline construction and in the reconstruction and redevelopment of defective pipelines (relining). This book applies in particular to engineers, technicians and foremen working in the fields of supply, disposal and industry. Subject matters of the book are all practice-relevant questions regarding the construction, operation and maintenance
Directory of Open Access Journals (Sweden)
Miika Korhonen
Full Text Available The left atrial appendage (LAA is the typical origin for intracardiac thrombus formation. Whether LAA morphology is associated with increased stroke/TIA risk is controversial and, if it does, which morphological type most predisposes to thrombus formation. We assessed LAA morphology in stroke patients with cryptogenic or suspected cardiogenic etiology and in age- and gender-matched healthy controls. LAA morphology and volume were analyzed by cardiac computed tomography in 111 patients (74 males; mean age 60 ± 11 years with acute ischemic stroke of cryptogenic or suspected cardiogenic etiology other than known atrial fibrillation (AF. A subgroup of 40 patients was compared to an age- and gender-matched control group of 40 healthy individuals (21 males in each; mean age 54 ± 9 years. LAA was classified into four morphology types (Cactus, ChickenWing, WindSock, CauliFlower modified with a quantitative qualifier. The proportions of LAA morphology types in the main stroke group, matched stroke subgroup, and control group were as follows: Cactus (9.0%, 5.0%, 20.0%, ChickenWing (23.4%, 37.5%, 10.0%, WindSock (47.7%, 35.0%, 67.5%, and CauliFlower (19.8%, 22.5%, 2.5%. The distribution of morphology types differed significantly (P<0.001 between the matched stroke subgroup and control group. The proportion of single-lobed LAA was significantly higher (P<0.001 in the matched stroke subgroup (55% than the control group (6%. LAA volumes were significantly larger (P<0.001 in both stroke study groups compared to controls patients. To conclude, LAA morphology differed significantly between stroke patients and controls, and single-lobed LAAs were overrepresented and LAA volume was larger in patients with acute ischemic stroke of cryptogenic or suspected cardiogenic etiology.
Clinical implications of glycometabolic disturbances in acute coronary
Timmer, Jorik Rudolf
2005-01-01
Prevalence of glycometabolic disturbances in patients with a suspected acute coronary syndrome is high. One in three patients has signs of disturbed glucose metabolism and this condition is associated with previous or newly diagnosed coronary artery disease. Zie: Summary
Performan reproduksi pada persilangan Kambing Boer dan Peranakan Etawah (PE
Directory of Open Access Journals (Sweden)
F. Parasmawati
2014-02-01
Full Text Available The study tends to evaluate the reproductive performances of Boer x PE goats crossbred in field laboratory “Sumber Sekar” of the Faculty of Animal Husbandry, Brawijaya University. Data covered the reproductive performance from 2010 – 2012 including data from 23 multipaorous does (11 does of pure Boer goats, 12 does of Boer x PE crossbred. The results shows that service per conception (S/C of the pure Boer was 3.09 ± 1.57 and 2.75± 1.35 for the crossbred (P>0.05. The days open (DO of the Boer goat was 202.71 ± 95.56 days this was not significantly difference to the crossbred goats (208.04 ±137.51days. The kidding interval (316.84 ± 125.64 days vs. 360.45 ± 148.96 days and the litter size (1.78 ±0.71 vs. 1.70 ± 0.86 were not significantly difference (P>0.05 between the respective groups. In conclusion, the crossing program between male Boer goats and male PE does did not influence the reproductive performances in both goats (pure Boer goats and their crosses with local PE goats. Key words: litter size, service per conception, days open, kidding interval, litter size
Ring ductility of irradiated Inconel 706 and Nimonic PE16
International Nuclear Information System (INIS)
Huang, F.H.; Fish, R.L.
1984-01-01
The tensile ductility of fast neutron-irradiated, precipitation-hardened alloys Inconel 706 and Nimonic PE16 has been observed to be very low for certain test conditions. Explanations for the low ductility behavior have been sought by examination of broken tensile specimens with microscopy and other similar techniques. A ring compression test provides a method of evaluating the ductility of irradiated cladding specimens. Unlike the conventional uniaxial tensile testing in which the tensile specimen is deformed uniformly, the ring specimen is subjected to localized bending where the crack is initiated. The ductility can be estimated through an analysis of the bending of a ring in terms of strain hardening. Ring sections from irradiated, solution-treated Inconel 706 and Nimonic PE16 were compressed in the diametral direction to provide load-deflection records over a wide range of irradiation and test temperatures. Results showed that ductility in both alloys decreased with increasing test temperatures. The poorest ductility was exhibited at different irradiation temperatures in the two alloys - near 550 0 C for PE16 and 460 to 520 0 C for Inconel 706. The ring ductility data indicate that the grain boundary strength is a major factor in controlling the ductility of the PE16 alloy
Pulsar Wind Nebulae inside Supernova Remnants as Cosmic-Ray PeVatrons
Ohira, Yutaka; Kisaka, Shota; Yamazaki, Ryo
2018-05-01
We propose that cosmic-ray PeVatrons are pulsar wind nebulae (PWNe) inside supernova remnants (SNRs). The PWN initially expands into the freely expanding stellar ejecta. Then, the PWN catches up with the shocked region of the SNR, where particles can be slightly accelerated by the back and forth motion between the PWN and the SNR, and some particles diffuse into the PWN. Afterwards the PWN is compressed by the SNR, where the particles in the PWN are accelerated by the adiabatic compression. Using a Monte Carlo simulation, we show that particles accelerated by the SNR to 0.1 PeV can be reaccelerated to 1 PeV until the end of the PWN compression.
van Beek, EJR; Brouwers, Elise M J; Song, B; Bongaerts, AHH; Oudkerk, M
To assess the diagnostic value of lung scintigraphy and helical computed tomography (hCT) in patients with suspected pulmonary embolism (PE), all English-language articles that described lung scintigraphy and hCT in patients with suspected PE were retrieved. Articles were assessed for strength of
PE-g-MMA polymer electrolyte membrane for lithium polymer battery
Energy Technology Data Exchange (ETDEWEB)
Gao Kun [Departments of Applied Chemistry, Harbin Institute of Technology, Harbin 150001 (China)]. E-mail: gaokun@hit.edu.cn; Hu Xinguo [Departments of Applied Chemistry, Harbin Institute of Technology, Harbin 150001 (China); Yi Tingfeng [Departments of Applied Chemistry, Harbin Institute of Technology, Harbin 150001 (China); Dai Changsong [Departments of Applied Chemistry, Harbin Institute of Technology, Harbin 150001 (China)
2006-10-25
PE-g-MMA membranes with different degrees of grafting (DG) were prepared by electron beam radiation-induced graft copolymerization of methylmethacrylate (MMA) monomer onto polyethylene (PE) separator. The grafted membranes (GMs) were characterized using SEM, FTIR. The new polymer electrolytes based on GMs were prepared through immersion in a solution of LiPF{sub 6}-EC/DMC (1:1 by volume). It was found that the GMs with different DG exhibited the different uptake and retention ability of liquid electrolyte. Moreover, the ion conductivities of activated polymer electrolytes (APEs) were also found to vary with the different DG and reached a magnitude of 10{sup -3} S cm{sup -1} at the DG of 42%. Compared with those containing PE separators, the LiCoO{sub 2}-MCMB coin cells containing GMs demonstrated better cycle life and excellent rate performance.
PE-g-MMA polymer electrolyte membrane for lithium polymer battery
International Nuclear Information System (INIS)
Gao Kun; Hu Xinguo; Yi Tingfeng; Dai Changsong
2006-01-01
PE-g-MMA membranes with different degrees of grafting (DG) were prepared by electron beam radiation-induced graft copolymerization of methylmethacrylate (MMA) monomer onto polyethylene (PE) separator. The grafted membranes (GMs) were characterized using SEM, FTIR. The new polymer electrolytes based on GMs were prepared through immersion in a solution of LiPF 6 -EC/DMC (1:1 by volume). It was found that the GMs with different DG exhibited the different uptake and retention ability of liquid electrolyte. Moreover, the ion conductivities of activated polymer electrolytes (APEs) were also found to vary with the different DG and reached a magnitude of 10 -3 S cm -1 at the DG of 42%. Compared with those containing PE separators, the LiCoO 2 -MCMB coin cells containing GMs demonstrated better cycle life and excellent rate performance
PE-g-MMA polymer electrolyte membrane for lithium polymer battery
Energy Technology Data Exchange (ETDEWEB)
Gao, Kun; Hu, Xinguo; Yi, Tingfeng; Dai, Changsong [Departments of Applied Chemistry, Harbin Institute of Technology, Harbin 150001 (China)
2006-10-25
PE-g-MMA membranes with different degrees of grafting (DG) were prepared by electron beam radiation-induced graft copolymerization of methylmethacrylate (MMA) monomer onto polyethylene (PE) separator. The grafted membranes (GMs) were characterized using SEM, FTIR. The new polymer electrolytes based on GMs were prepared through immersion in a solution of LiPF{sub 6}-EC/DMC (1:1 by volume). It was found that the GMs with different DG exhibited the different uptake and retention ability of liquid electrolyte. Moreover, the ion conductivities of activated polymer electrolytes (APEs) were also found to vary with the different DG and reached a magnitude of 10{sup -3}Scm{sup -1} at the DG of 42%. Compared with those containing PE separators, the LiCoO{sub 2}-MCMB coin cells containing GMs demonstrated better cycle life and excellent rate performance. (author)
Sule, Ashish Anil; Chin, Tay Jam; Sinnathamby, Letchumi; Lee, Hwei Khien; Earnest, Arul
2011-06-01
The purpose of this study was to assess the risk of venous thromboembolism (VTE) in patients admitted to the Tan Tock Seng Hospital (TTSH), Singapore during October and November 2009. The primary outcome assessed was mortality due to VTE, or development of deep vein thrombosis or pulmonary embolism (PE) within 3 months from the day of admission. Both univariate and multivariate analyses were performed for all-cause mortality and deaths associated with PE. Seven hundred twenty-one patients admitted to the 5th floor of the General Medicine Department, TTSH, during the 2 months were analyzed. There were 368 (51.04%) female patients and 353 (48.96%) male patients. As per race distribution, 566 (78.50%) patients were Chinese, 100 (13.86%) patients were Malaysians, 46 (6.38%) patients were Indians, and 9 (1.26%) were other races. Four hundred ninety-two (68.24%) were independent for activities of daily living (ADL) and 229 (31.76%) were dependent for all ADL. There were in all 42 deaths. There were definite PE deaths in 2 (4.76%) patients, probable PE deaths in 3 (7.14%) patients, and suspected PE deaths in 8 (19.05%) patients. Twenty (47.62%) deaths were due to pneumonia, 3 (7.14%) deaths were due to urinary tract infections, and 4 (9.52%) deaths were due to other infections. Two (4.76%) deaths were due to myocardial infarction. The risk of VTE was high in acutely ill patients admitted to the General Medicine Department, TTSH, Singapore. The factors that predispose patients to a very high risk are ADL dependence, acute heart failure, past history of VTE, or if they are clinically dehydrated and have acute renal failure. This warrants increased awareness and need for VTE prophylaxis.
Can, Mehmet Mustafa; Özveren, Olcay; Biteker, Murat; Şengül, Cihan; Uz, Ömer; Işılak, Zafer; Kırılmaz, Ata
2013-06-01
Pulmonary embolism (PE) and severe pulmonary stenosis (PS) are two distinct conditions accompanied by increased pressure load of the right ventricle (RV). Despite major advances in our understanding of the mechanisms of RV adaptation to the increased pressure, substantial gaps in our knowledge remain unsettled. One of much less known aspect of pressure overload of RV is its impact on electrocardiographic (ECG) changes. In this study, we aimed to study whether acute and chronic RV overload are accompanied by different ECG patterns. Thirty-eight patients with PE underwent ECG monitoring were compared with 20 matched patients with PS in this observational retrospective study. ECG abnormalities suggestive of RV overload were recorded and analyzed in both groups. Logistic regression analysis was used to define the predictors of chronic RV overload. Among the ECG changes studied, premature atrial contraction (OR-12.2, 95% CI, 1.3-107, p=0.008), right axis deviation (OR-20.4, 95% CI 4.2-98, poverload. Our data indicate that the ECG changes that attributed to the acute RV pressure loading states may be more prevalent in chronic RV overload as compared with acute RV overload.
Use of Mobile Testing System PeLe for Developing Language Skills
Titova, Svetlana
2015-01-01
One of the objectives of this paper is to investigate the pedagogical impact of both the mobile testing system PeLe (Norway, HiST) and the enquiry-based learning approach on language skills development in the context of mobile-assisted learning. The research aims to work out a methodological framework of PeLe implementation into the language…
Baron, M; Lozeron, P; Harel, S; Bengoufa, D; Vignon, M; Asli, B; Malphettes, M; Parquet, N; Brignier, A; Fermand, J P; Kubis, N; Arnulf, Bertrand
2017-06-01
Monoclonal IgM anti-myelin-associated glycoprotein (MAG) antibody-related peripheral neuropathy (anti-MAG neuropathy) is predominantly a demyelinating sensory neuropathy with ataxia and distal paresthesia. The clinical course of anti-MAG neuropathy is usually slowly progressive making difficult the identification of clear criteria to start a specific treatment. Although no consensus treatment is yet available, a rituximab-based regimen targeting the B-cell clone producing the monoclonal IgM may be proposed, alone or in combination with alkylating agents or purine analogs. However, in some rare cases, an acute and severe neurological deterioration can occur in few days leading to a rapid loss of autonomy. In these cases, a treatment rapidly removing the monoclonal IgM from the circulation might be useful before initiating a specific therapy. We report successful treatment with plasma exchanges (PE) in four patients presenting with acute neurological deterioration. PE allowed a dramatic and rapid neurological improvement in all patients. PE are safe and may be useful at the initial management of these cases of anti-MAG neuropathy.
Myocardial imaging in the noninvasive evaluation of patients with suspected ischemic heart disease
International Nuclear Information System (INIS)
Pitt, B.; Strauss, H.W.
1976-01-01
Three noninvasive radioactive tracer techniques for evaluating patients with ischemic heart disease are described: (1) myocardial perfusion imaging, (2) acute infarct imaging, and (3) the gated blood pool scan. Myocardial perfusion imaging with tracers that distribute in the myocardium in relation to regional blood flow allows detection of patients with transmural and nontransmural infarction by the finding of decreased tracer concentration in the affected region of the myocardium. If these tracers are injected at the time of maximal stress to patients with significant coronary arterial stenosis but without infarction, areas of transient ischemia can be identified as zones of decreased tracer concentration not found when an examination is performed at rest. Acute infarct imaging with tracers that localize in acutely damaged tissue permits separation of patients with acute myocardial necrosis from those without infarction and those with more chronic damage. The gated blood pool scan permits assessment of left ventricular function and regional wall motion. The measurement of ventricular volumes, ejection fraction and regional wall motion adds significantly to the determination of hemodynamic variables in assessing patients with acute infarction. The technique also permits detection of right ventricular dysfunction. Performance of a combination of these radioactive tracer techniques is often advantageous, particularly in patients with suspected infarction. The techniques can establish whether infarction is present, whether it is acute, where the damage is located and how extensive it is; they can also provide a measure of the effect of this damage on left ventricular function
SCoPE: an efficient method of Cosmological Parameter Estimation
International Nuclear Information System (INIS)
Das, Santanu; Souradeep, Tarun
2014-01-01
Markov Chain Monte Carlo (MCMC) sampler is widely used for cosmological parameter estimation from CMB and other data. However, due to the intrinsic serial nature of the MCMC sampler, convergence is often very slow. Here we present a fast and independently written Monte Carlo method for cosmological parameter estimation named as Slick Cosmological Parameter Estimator (SCoPE), that employs delayed rejection to increase the acceptance rate of a chain, and pre-fetching that helps an individual chain to run on parallel CPUs. An inter-chain covariance update is also incorporated to prevent clustering of the chains allowing faster and better mixing of the chains. We use an adaptive method for covariance calculation to calculate and update the covariance automatically as the chains progress. Our analysis shows that the acceptance probability of each step in SCoPE is more than 95% and the convergence of the chains are faster. Using SCoPE, we carry out some cosmological parameter estimations with different cosmological models using WMAP-9 and Planck results. One of the current research interests in cosmology is quantifying the nature of dark energy. We analyze the cosmological parameters from two illustrative commonly used parameterisations of dark energy models. We also asses primordial helium fraction in the universe can be constrained by the present CMB data from WMAP-9 and Planck. The results from our MCMC analysis on the one hand helps us to understand the workability of the SCoPE better, on the other hand it provides a completely independent estimation of cosmological parameters from WMAP-9 and Planck data
Concomitant coronary and pulmonary embolism associated with patent foramen ovale: A case report.
Chen, Zhongxiu; Li, Chen; Li, Yajiao; Tang, Hong; Rao, Li; Wang, Mian
2017-12-01
The differential diagnosis of acute chest pain is very important, and can sometimes be challenging. Related diseases share a number of risk factors, and occasionally, 1 condition causes another disease to develop. We described a 59-year-old man who presented to emergency department complaining of chest pain. He was suffered acute myocardial infarction (MI) and pulmonary embolism (PE) simultaneously. Dual antiplatelet therapy, statin, and low molecular weight heparin were administrated during his stay. The searches for cancers, autoimmune diseases, and hematologic diseases were unremarkable, ruling out a hypercoagulable state. Subsequent ultrasound scan revealed a thrombus in a vein of the lower left extremity. Thus, paradoxical embolism was highly suspected. Paradoxical embolism is a rare cause of acute MI, which may have occurred in our patient. This was evidenced by a previously unrecognized patent foramen ovale (PFO) with a right-to-left atrial shunt detected using contrast transesophageal echocardiography. Acute MI complicated with PE is not common in the clinical setting. The fatal condition is difficult to diagnose because of the similar symptoms and confusing causes. Paradoxical embolism can cause this phenomenon, and physicians should be highly vigilant in the search for a PFO in cases of paradoxical embolism. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
Guidelines for identifying suspect/counterfeit material
Energy Technology Data Exchange (ETDEWEB)
NONE
1995-09-01
These guidelines are intended to assist users of products in identifying: substandard, misrepresented, or fraudulently marked items. The guidelines provide information about such topics as: precautions, inspection and testing, dispositioning identified items, installed inspection and reporting suspect/counterfeit materials. These guidelines apply to users who are developing procurement documents, product acceptance/verification methods, company procedures, work instructions, etc. The intent of these SM guidelines in relation to the Quality Assurance Program Description (QAPD) and implementing company Management Control Procedures is not to substitute or replace existing requirements, as defined in either the QAPD or company implementing instructions (Management Control Procedures). Instead, the guidelines are intended to provide a consolidated source of information addressing the issue of Suspect/Counterfeit materials. These guidelines provide an extensive suspect component listing and suspect indications listing. Users can quickly check their suspect items against the list of manufacturers products (i.e., type, LD. number, and nameplate information) by consulting either of these listings.
Is it an acute Mastoiditis with Torticollis?
Directory of Open Access Journals (Sweden)
Antonio Greco
2014-03-01
Full Text Available Retropharyngeal abscess is uncommonly after acute pharyngitis,. We reported a case of a deep neck abscess with torticollis in a youngwoman, misdiagnosed. Retropharyngeal abscess with mediastinal extension is a rare life-threatening complication with a mortalityrate as high as 40%.When a patient shows a torticollis with fever we must suspect a deep neck infection could be present and it is necessary to perform aTC or MRI of the neck. A retropharyngeal abscess rarely occurs but must be suspected otherwise the abscess can advance toward themediastine and cause a mediastinitis that could be very dangerous for patient’s healthy.
Energy Technology Data Exchange (ETDEWEB)
Kaur, Inderjeet, E-mail: ij_kaur@hotmail.com [Department Chemistry, HPU Shimla 171005 (India); Gupta, Nitika; Kumari, Vandna [Department Chemistry, HPU Shimla 171005 (India)
2011-09-15
An attempt to develop biodegradable polyethylene film grafting of mixture of hydrophilic monomers methacrylic acid (MAAc) and acrylamide (AAm) onto PE film has been carried out by preirradiation method using benzoyl peroxide as the radical initiator. Since ether linkages are susceptible to easy cleavage during degradation process, PE film was irradiated before the grafting reactions by {gamma}-rays to introduce peroxidic linkages (PE-OO-PE) that offer sites for grafting. The effect of irradiation dose, monomer concentration, initiator concentration, temperature, time and amount of water on the grafting percent was determined. Maximum percentage of grafting of binary mixture (MAAc+AAm), (1792%) was obtained at a total concentration of binary monomer mixture=204.6x10{sup -2} mol/L ([MAAc]=176.5x10{sup -2} mol/L, [AAm]=28.1x10{sup -2} mol/L), [BPO]=8.3x10{sup -2} mol/L at 100 deg. C in 70 min. The grafted PE film was characterized by the Fourier Transform Infrared Spectroscopy (FTIR), Thermogravimetric Analysis (TGA) and Scanning Electron Microscopic (SEM) methods. Some selective properties of grafted films such as swelling studies, ion uptake and biodegradation studies have been investigated. The grafted films show good swelling in water, ion uptake studies shows promising results for desalination of brackish water and the soil burial test shows that PE film grafted with binary monomer mixture degrades up to 47% within 50 days. - Highlights: > Binary mixture of methacrylic acid (MAAc) and acrylamide (AAm) onto PE film by preirradiation method was carried out. > Graft copolymers of MAAc+AAm and PE film were characterized by FTIR, TGA and SEM studies and was found to be thermally stable. > Grafting of MAAc+AAm improved swelling behavior giving maximum swelling (485.71%) in water as against PE with 0% swelling. > The grafted PE-g-poly (MAAc-co-AAm) behaves as an excellent material for ion separation. > Biodegradation studies by soil burial test showed 47.19% of
Comparison of BIASI and Columbia CHF correlations using BODYFIT-2PE
International Nuclear Information System (INIS)
Chen, B.C.J.; Chien, T.H.; Sha, W.T.; Kim, J.H.
1984-01-01
This paper compares the BIASI critical heat flux (CHF) correlation with the Columbia CHF correlation by using both the homogeneous equilibrium two-phase model with algebraic slip and the drift flux model in BODYFIT-2PE. All calculations were compared with the GE 3 x 3 CHF experiment. This comparison serves as a qualification process for the CHF correlations in the framework of BODYFIT-2PE
International Nuclear Information System (INIS)
Ranji Amjad, Mina; Abbasi, Mehrshad; Farzanehfar, Saeed
2015-01-01
A 22-year-old woman presented with acute left-sided pleuritic chest pain and dyspnea 6 days after surgery for revision of the stenotic central aortopulmonary shunt. She had a history of tetralogy of Fallot (TOF), pulmonary valve stenosis, ventricular septal defect and major aortopulmonary collateral artery. Her Waterston shunt was placed when she was 5 years old and stented and re-dilated after stenosis. Acute pulmonary thromboemboli (PTE) was suspected and pulmonary perfusion scan was performed with 4 mCi 99m Technetium labeled macroaggregated albumin. The left lung was globally hypoperfused with evident uptake in the brain, renal parenchyma and thyroid. SPECT images revealed a segmental wedge-shaped peripheral defect in the posterior segment of the left upper lobe. The scan was interpreted as acute/chronic PTE or vascular abnormality. CT angiography excluded PTE; nevertheless the patient was treated with a therapeutic dose of heparin changed to warfarin and was discharged with improvement of the symptoms. Pulmonary artery angiography was not performed
Diagnostic value of serum creatine kinase-BB for acute meningitis in adults
Directory of Open Access Journals (Sweden)
Seyed Mohammad Alavi
2017-01-01
Full Text Available Objective: To find out an easy and feasible test instead of cerebrospinal fluid analysis for the diagnosis of acute meningitis. Methods: This cross-sectional study was conducted in 2013 in Ahvaz, a city located in the Southwest Iran including 75 patients with clinical diagnosis of fever, headache, vomiting and neck stiffness suspected to have acute meningitis based on cerebrospinal fluid analysis. In the beginning, the patients were divided into two categories as acute meningitis, and non-acute meningitis. Then, 5 L of blood was taken from each patient to determine serum creatine kinase isoenzyme-BB by using ELISA method. After that, the related data including demographics, clinical and laboratory results were analyzed by SPSS software version 16 using Chi-square test for qualitative variables and student’s t-test for quantitative variables. Results: Among the total 75 patients, 37 (49.3% were males and 38 (50.7% were females including 45 patients (60% with acute meningitis and 30 patients (40% without acute meningitis. On the other hand, CK-BB serum levels in acute meningitis and non-acute meningitis patients were 18.23 ± 7.56 and 2.67 ± 1.62, respectively, so significant difference was found between acute meningitis group and non-acute meningitis group (P < 0.000 1. Conclusions: Serum creatine kinase isoenzyme-BB test is a useful test to differentiate acute meningitis from non-acute meningitis among suspected cases of meningitis disease, so measuring the CK-BB serum level in Iran's health system with an expanded health setting especially in remote areas will be useful and helpful in prompt diagnosis and treatment of the acute meningitis.
Design of the PE-3 hot heavy oil loading line
Energy Technology Data Exchange (ETDEWEB)
Mayants, Alex; Lanan, Glenn; Janardhanan, K. [INTEC Engineering, Houston, TX (United States); Gomes, Marcelino; Garcia, Amaury [TRANSPETRO - PETROBRAS Transportes, Rio de Janeiro, RJ (Brazil)
2003-07-01
The leaking of the PE-2 pipeline into Guanabara Bay. Rio de Janeiro, during late 2000 attracted widespread attention in Brazil and around the world. The safe design and operation of pipelines transporting hot, heavy hydrocarbons is critical for avoiding future oil spills. Conventional methods for designing pipelines that transport hot products rely on soil overburden to control upheaval buckling. However, extremely poor soil strength, combined with sediment mobility, led to the failure of the PE-2 pipeline. The serious consequences led TRANSPETRO to specify that the highest standards (DNV Safety Class High) were to be applied to the design and fabrication of the replacement PE-3 pipeline. The design was also required to withstand a large number of operational cycles, i.e. three (3) hot to cold cycles per week for the entire 40 years of the pipeline's design life. To meet these design challenges, several pipeline configurations were examined. A unique zigzag configuration was selected for this pipeline project. (author)
Baker, Nancy A; Cook, James R; Redfern, Mark S
2009-01-01
This paper describes the inter-rater and intra-rater reliability, and the concurrent validity of an observational instrument, the Keyboard Personal Computer Style instrument (K-PeCS), which assesses stereotypical postures and movements associated with computer keyboard use. Three trained raters independently rated the video clips of 45 computer keyboard users to ascertain inter-rater reliability, and then re-rated a sub-sample of 15 video clips to ascertain intra-rater reliability. Concurrent validity was assessed by comparing the ratings obtained using the K-PeCS to scores developed from a 3D motion analysis system. The overall K-PeCS had excellent reliability [inter-rater: intra-class correlation coefficients (ICC)=.90; intra-rater: ICC=.92]. Most individual items on the K-PeCS had from good to excellent reliability, although six items fell below ICC=.75. Those K-PeCS items that were assessed for concurrent validity compared favorably to the motion analysis data for all but two items. These results suggest that most items on the K-PeCS can be used to reliably document computer keyboarding style.
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Giovanni Volpicelli
2007-10-01
Full Text Available Symptoms and signs of acute pyelonephritis sometimes are subtle and emergency physicians attending overcrowded and busy institutions could easily miss the right diagnosis. The presence of a renal damage is decisive in the therapeutic choice. Aims of our study are: 1 to assess prevalence of renal damage in patients presenting to our ED with symptoms and signs of primary urinary tract infection (UTI; 2 to evaluate the reliability of such symptoms and signs in predicting a renal damage; 3 to assess accuracy of the contrast enhanced ultrasound (CEUS in the ED diagnosis of renal damage due to acute uncomplicated pyelonephritis. We studied 54 patients with suspected UTI. Each patient underwent clinical examination, routine blood and urine sampling and conventional renal ultrasound (US. 23 patients had confirmation of acute primary UTI, and performed renal magnetic resonance (MR to rule out renal parenchymal involvement. In 16 patients (69,6% one or more parenchymal lesions were visualized at MR, and diagnosis of acute uncomplicated pyelonephritis was confirmed (group A. The other 7 patients had a diagnosis of UTI without renal involvement (group B. Some of 23 patients presented with few atypical symptoms. Lumbar pain was the most frequent symptom (n = 21, without a statistically significant difference between group A and B (P 0,958; p = 0,328. No other symptom or sign has demonstrated statistically valid in predicting the renal involvement. Renal US was positive in only 3 patients of group A (18,7%. During this first part of our study, CEUS was performed in a limited number of patients (n = 8, and in 7 examinations data were concordant with MR. In conclusion, analysis of our preliminary data confirms that a distinction between patients with different extension of the UTI is not possible through the simple clinical examination and routine tests. CEUS is very promising and its routine employment in the ED could simplify the diagnostic practice in
Targeting the Body and the Mind: Evaluation of a P.E. Curriculum Intervention for Adolescents
Loukaitou-Sideris, Anastasia
2015-01-01
P.E. classes are often the only opportunity for inner-city youth to engage in physical activity, but budget cuts and pressure to perform well on standardized tests has made P.E. an afterthought for many school administrators. This study evaluated the effectiveness of a new P.E. curriculum in five Los Angeles inner-city schools. Interviews were…
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Chung-Hsu Lai
2009-05-01
Conclusion: In southern Taiwan, acute Q fever is the most common rickettsiosis. QSM diseases should be suspected in febrile patients who present with relative bradycardia, hepatomegaly, and elevated serum aminotransferases, but without leukocytosis.
The new geographic information system in ETVA VI.PE.
Xagoraris, Zafiris; Soulis, George
2016-08-01
ETVA VI.PE. S.A. is a member of the Piraeus Bank Group of Companies and its activities include designing, developing, exploiting and managing Industrial Areas throughout Greece. Inside ETVA VI.PE.'s thirty-one Industrial Parks there are currently 2,500 manufacturing companies established, with 40,000 employees and € 2.5 billion of invested funds. In each one of the industrial areas ETVA VI.PE guarantees the companies industrial lots of land (sites) with propitious building codes and complete infrastructure networks of water supply, sewerage, paved roads, power supply, communications, cleansing services, etc. The development of Geographical Information System for ETVA VI.PE.'s Industrial Parks started at the beginning of 1992 and consists of three subsystems: Cadastre, that manages the information for the land acquisition of Industrial Areas; Street Layout - Sites, that manages the sites sold to manufacturing companies; Networks, that manages the infrastructure networks (roads, water supply, sewerage etc). The mapping of each Industrial Park is made incorporating state-of-the-art photogrammetric, cartographic and surveying methods and techniques. Passing through the phases of initial design (hybrid GIS) and system upgrade (integrated Gis solution with spatial database), the system is currently operating on a new upgrade (integrated gIS solution with spatial database) that includes redesigning and merging the system's database schemas, along with the creation of central security policies, and the development of a new web GIS application for advanced data entry, highly customisable and standard reports, and dynamic interactive maps. The new GIS bring the company to advanced levels of productivity and introduce the new era for decision making and business management.
Energy Technology Data Exchange (ETDEWEB)
Becker, Daniela; Coelho, Luiz Antonio Ferreira; Nack, Fernanda; Silva, Bruna Louise, E-mail: dep2db@joinville.udesc.br [Universidade do Estado de Santa Catarina (UDESC), Joinville, SC (Brazil). Centro de Ciencias Tecnologicas
2014-07-01
This study aims to evaluate the morphology and crystallization parameters of high density polyethylene (HDPE) with different concentrations of epoxy (DGEBA / OTBG), and the compatibility of this system was used and the copolymer polyethylene-block-poly (ethylene glycol) (PEG-co-PE). The blends were obtained by mechanical mixing on a torque rheometer (Haake). Determined the crystallization parameters of the test matrix differential scanning calorimetry (DSC) and by X-ray diffraction (XRD). The morphology of the system was analyzed by transmission electron microscopy (TEM). It was observed by XRD analysis that the addition of compatibilizer and epoxy resins do not interfere with the crystal structure of HDPE, indicating that the increase in crystallinity associated with the crystallization kinetics. It was observed that the compatibilizing helped the adhesion, reducing the size of the dispersed phase becomes a more stable morphology and obtaining a distribution of the dispersed epoxy phase. (author)
PE-TIRTHA-AN ASPEK RELIGI DALAM MASYARAKAT KUNINGAN JAWA BARAT
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Effie Latifundia
2016-07-01
Full Text Available Abstract This paper seeks to document and revealer of culture sacred water sources in relation to society Kuningan pe-tirtha-an late period of ancient Sunda. Data obtained based on the results of archaeological research in some area of Kuningan regency, West Java province from 2012 until 2015, with the survey methods include literature studies and interviews. Pe-tirtha-an one of the sacred buildings of ancient Javanese and Sundanese term kuna. In Hindu mythology, bodies of water, such as springs, ponds, lakes, rivers, seas and so is regarded as a gathering place of the gods, the playground of the gods and considered sacred in Hindu-Buddhist. Pe-tirtha-an late period of ancient Sunda simple shape, no further formed as well as the society of ancient Javanese Majapahit era (14-15 century AD. Based on the data collected can be concluded early that sacred water sources in the community Kuningan is a trust hereditary or ancestral (ancestor has the meaning of an equivalent or parallel pe-Tirtha's remains classical period Sundanese people kuna, which is believed to cure all illnesses, safety/blessing by way of purification used bathing, washing face/ablution, and water is taken after the prayer. Sacred water sources describe the elements of religion and belief system that continues to live in the community and a cultural value terms with the noble values of Islam continued in the future.
Echoviruses diagnosed in two Children presenting with Acute ...
African Journals Online (AJOL)
Discussion: AFP is a neurological condition primarily suspected as a poliomyelitis commonly seen in children below 15 years defined by sudden onset of weakness and floppiness affecting usually one or more limbs. Laboratory analysis has revealed other viruses including the Echovirus being associated with acute flaccid ...
Performan reproduksi pada persilangan Kambing Boer dan Peranakan Etawah (PE)
F. Parasmawati; Suyadi Suyadi; Sri Wahyuningsih
2014-01-01
The study tends to evaluate the reproductive performances of Boer x PE goats crossbred in field laboratory “Sumber Sekar” of the Faculty of Animal Husbandry, Brawijaya University. Data covered the reproductive performance from 2010 – 2012 including data from 23 multipaorous does (11 does of pure Boer goats, 12 does of Boer x PE crossbred). The results shows that service per conception (S/C) of the pure Boer was 3.09 ± 1.57 and 2.75± 1.35 for the crossbred (P>0.05). The days open (DO) of the B...
Performan Reproduksi Pada Persilangan Kambing Boer Dan Peranakan Etawah (PE)
Parasmawati, F; Suyadi, Suyadi; Wahyuningsih, Sri
2013-01-01
The study tends to evaluate the reproductive performances of Boer x PE goats crossbred in field laboratory “Sumber Sekar” of the Faculty of Animal Husbandry, Brawijaya University. Data covered the reproductive performance from 2010 – 2012 including data from 23 multipaorous does (11 does of pure Boer goats, 12 does of Boer x PE crossbred). The results shows that service per conception (S/C) of the pure Boer was 3.09 ± 1.57 and 2.75± 1.35 for the crossbred (P>0.05). The days open (DO) of th...
Dielectric Properties of PE/Clay Nanocomposites
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E. David
2013-01-01
Full Text Available Polyethylene/nanoclay specimens containing from 0 to 5% nanoclays were prepared from a commercially available premixed PE/nanoclay masterbatch containing 50% wt of nanoclay. The masterbatch was diluted to the desired concentration by adding PE along with various amounts of compatibilizer in order to achieve the best possible dispersion of the nanoclay platelets. The dielectric response of the compounded samples was investigated using a combination of time and frequency-domain spectroscopy in order to cover a wide frequency window. Both techniques were in good agreement when the time-domain data was transformed into frequency-domain data. Despite their low concentration, the addition of the dispersed nanoclays led to a significant alteration of the material dielectric response in the form of the appearance of various interfacial relaxation processes and an increase of charge carrier transport within the insulation material. Moreover, an onset of nonlinear charge transport process was observed at moderate fields for specimens containing a relatively low level of nanoclays. The high-field breakdown strength was shown to have been improved by the incorporation of the nanoparticles, particularly when the exfoliation was enhanced by the use of a maleic anhydride grafted polyethylene compatibilizer.
Wang, Tom Kai Ming; Chow, Kok-Lam; Lin, Aaron; Chataline, Alexei; White, Harvey; Dawes, Matthew; Gamble, Greg; Ellis, Chris
2018-03-09
To review the number, characteristics and clinical management of suspected ACS patients admitted to cardiology and non-cardiology services at Auckland City Hospital, to assess differences between these services and to assess the number who would potentially be enrolled in the All New Zealand Acute Coronary Syndrome (ACS) Quality Improvement Programme (ANZACS-QI) database. Auckland City Hospital patient data was extracted from the Australia and New Zealand ACS 'SNAPSHOT' audit, performed over 14 days in May 2012. There were 121 suspected ACS admissions to Auckland City hospital during the audit period, with 45 (37%) patients directly managed by the cardiology service, and 76 (63%) patients cared for by non-cardiology services. Based on the subsequent discharge diagnosis, the cardiology service had more patients with definite ACS than the non-cardiology services; 27/45 (60%) compared to 16/76 (21%), difference (95%CI) 39% (22-56), P<0.0001). Cardiology ACS patients were more likely to undergo echocardiography; 15/27 (56%) compared to 2/16 (13%), difference 42% (18-68), P=0.0089), coronary angiography; 21/27 (78%) compared to 3/16 (19%), difference (95%CI) 59% (34-84), P=0.0003), coronary revascularisation; 18/27 (67%) compared to 3/16 (19%), difference (95%CI) 48% (22-74), P=0.004, and be discharged on two antiplatelet agents; 18/26 (69%) compared to 3/15 (20%), difference (95%CI) 49% (22-76), P=0.0036, or an ACEI/ARB; 20/26 (77%) compared to 5/15 (33%), difference (95%CI) 44% (15-72), P=0.0088. In patients with a discharge diagnosis of definite ACS, those managed by non-cardiology services were less likely to receive guideline-recommended investigations, and management, in this relatively small cohort study. About one-third of all ACS patients are managed by non-cardiology services and would not be recorded by the ANZACS-QI database.
MRI use in acute appendicitis in pregnancy
International Nuclear Information System (INIS)
Maleeva, A.
2017-01-01
Acute appendicitis is the most common surgical emergency in pregnancy. The incidence of appendicitis in pregnancy was one in 766 births. The preoperative diagnosis was correct in 75% of the cases. Because of considerable fetal loss after appendectomy during pregnancy in the first and second trimester, surgeons decide to use diagnostic imaging to prove the diagnosis. The American College of Radiology (ACR) approves of MR imaging of the pregnant patient in any trimester, including the first. In this case -30 years old, pregnant 12 week gestation, present with right lower quadrant abdominal pain. Acute appendicitis is suspected, because of positive Romberg and ilio-psoas sign and high WBC and CRP. After MR imaging the diagnosis of acute appendicitis was proved together with intrauterine gestation. Key words: Acute Appendicitis. MRI. Pregnancy. Fetal Loss [bg
Acute cervicitis and vulvovaginitis may be associated with Cytomegalovirus.
Abou, Magali; Dällenbach, Patrick
2013-04-19
Cytomegalovirus (CMV) infection in immunocompetent hosts is generally asymptomatic or may present as a mononucleosic syndrome. Its association with acute cervicitis and vulvovaginitis has rarely been reported. A 24-year-old woman presented with pelvic pain, vulvodynia, abnormal vaginal discharge, burning with urination, fatigue, fever, vomiting and diarrhoea. The vulva and cervix were red with vesicular lesions on the cervix. Genital herpes simplex infection (HSV) was suspected and valacyclovir was given orally. However, serial viral cultures performed 7 weeks apart did not isolate HSV as suspected, but CMV was confirmed by immunofluorescence and early antigen research. Blood tests confirmed an acute CMV infection. Typical inclusions were found at histology. Symptoms resolved slowly with persistence of cervical lesions at 7 weeks from diagnosis. The frequency of CMV genital infection is probably underestimated. The infection is not always asymptomatic and might be confused with genital HSV infection. The clinical course is longer.
Thrombolytic therapy of acute myocardial infarction alters collagen metabolism
DEFF Research Database (Denmark)
Høst, N B; Hansen, S S; Jensen, L T
1994-01-01
The objective of the study was to monitor collagen metabolism after thrombolytic therapy. Sequential measurements of serum aminoterminal type-III procollagen propeptide (S-PIIINP) and carboxyterminal type-I procollagen propeptide (S-PICP) were made in 62 patients suspected of acute myocardial.......05). A less pronounced S-PIIINP increase was noted with tissue-plasminogen activator than with streptokinase. Thrombolytic therapy induces collagen breakdown regardless of whether acute myocardial infarction is confirmed or not. With confirmed acute myocardial infarction collagen metabolism is altered...... for at least 6 months. Furthermore, fibrin-specific and nonspecific thrombolytic agents appear to affect collagen metabolism differently....
ACUTE RESPIRATORY DISTRESS SYNDROME DAN ACUTE PNEUMONIA PADA NEAR DROWNING:SEBUAH LAPORAN KASUS
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Michelle Prinka Adyana
2014-02-01
Full Text Available Near drowning is a condition in which the victim survived the first 24 hours. The WorldHealth Organization (WHO , recorded worldwide in 2000 there were 400,000 incidentdrowned accidentally . That is, this figure ranks second only to traffic accidents.Aspiration pneumonia is a complication of near drwoning which occurred in 80 % ofcases of near drowning, while 50 % of patients sink into acute respiratory distresssyndrome ( ARDS . This case report discusses the acute respiratory distress syndromeand acute pneumonia in near drowning 24 years old , who had drowned at the beach for± 15 minutes , the chest x - ray obtained pulmonary edema dd / lung pnuemonia therepneuomothorax . Examination of multislice spiral computed tomography ( MSCT bilateral pneumothorax Thorax obtained major and minor fisuura right and left majorfissure , pneumomediastinum , pulmonary pneumonia contusio / suspected aspirationpneumonia , emphysema subcutis . In intensive care patients conducted for 9 days andreturn to akitivitas everyday
Shock Wave Speed and Transient Response of PE Pipe with Steel-Mesh Reinforcement
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Wuyi Wan
2016-01-01
Full Text Available A steel mesh can improve the tensile strength and stability of a polyethylene (PE pipe in a water supply pipeline system. However, it can also cause more severe water hammer hazard due to increasing wave speed. In order to analyze the influence of the steel mesh on the shock wave speed and transient response processes, an improved wave speed formula is proposed by incorporating the equivalent elastic modulus. A field measurement validates the wave speed formula. Moreover, the transient wave propagation and extreme pressures are simulated and compared by the method of characteristics (MOC for reinforced PE pipes with various steel-mesh densities. Results show that a steel mesh can significantly increase the shock wave speed in a PE pipe and thus can cause severe peak pressure and hydraulic surges in a water supply pipeline system. The proposed wave speed formula can more reasonably evaluate the wave speed and improve the transient simulation of steel-mesh-reinforced PE pipes.
Members of the European NORMAN Network of Environmental Laboratories (www.norman-network.com) have many substance lists, including targets, suspects, surfactants, perfluorinated substances and regulated, partially confidential data sets of complex mixtures. The NORMAN Suspect Lis...
Phelan, Jody
2016-01-01
Abstract Background Approximately 10Â % of the Mycobacterium tuberculosis genome is made up of two families of genes that are poorly characterized due to their high GC content and highly repetitive nature. The PE and PPE families are typified by their highly conserved N-terminal domains that incorporate proline-glutamate (PE) and proline-proline-glutamate (PPE) signature motifs. They are hypothesised to be important virulence factors involved with host-pathogen interactions, but their high genetic variability and complexity of analysis means they are typically disregarded in genome studies. Results To elucidate the structure of these genes, 518 genomes from a diverse international collection of clinical isolates were de novo assembled. A further 21 reference M. tuberculosis complex genomes and long read sequence data were used to validate the approach. SNP analysis revealed that variation in the majority of the 168 pe/ppe genes studied was consistent with lineage. Several recombination hotspots were identified, notably pe_pgrs3 and pe_pgrs17. Evidence of positive selection was revealed in 65 pe/ppe genes, including epitopes potentially binding to major histocompatibility complex molecules. Conclusions This, the first comprehensive study of the pe and ppe genes, provides important insight into M. tuberculosis diversity and has significant implications for vaccine development.
Aertker, Robert A; Cheong, Benjamin Y C; Lufschanowski, Roberto
2016-12-01
We present the case of a 63-year-old woman with a remote history of supraventricular tachycardia and hyperlipidemia, who presented with recurrent episodes of acute-onset chest pain. An electrocardiogram showed no evidence of acute coronary syndrome. A chest radiograph revealed a prominent right-sided heart border. A suspected congenital pericardial cyst was identified on a computed tomographic chest scan, and stranding was noted around the cyst. The patient was treated with nonsteroidal anti-inflammatory drugs, and the pain initially abated. Another flare-up was treated similarly. Cardiac magnetic resonance imaging was then performed after symptoms had resolved, and no evidence of the cyst was seen. The suspected cause of the patient's chest pain was acute inflammation of a congenital pericardial cyst with subsequent rupture and resolution of symptoms.
Magnetic resonance imaging in the evaluation of suspected osteonecrosis of the knee
Energy Technology Data Exchange (ETDEWEB)
Pollack, M S; Dalinka, M K; Kressel, H Y; Spritzer, C E; Lotke, P A
1987-02-01
Magnetic resonance imaging (MRI) was performed on 19 patients with suspected or proven osteonecrosis of the knee. The results were compared to radionuclide and plain radiographic studies when possible. The patients were grouped into one of three categories: patients with disease predisposing them to osteonecrosis (e.g. systemic lupus erythematosus (SLE), steroid use, and renal transplants), older patients without risk factors with acute onset of symptoms, and patients with knee pain months or years following trauma. In six patients with symptoms and predisposing diseases, MRI was abnormal in four cases, all of whom had bilateral abnormalities. In the ten older patients with classical symptoms, MRI was abnormal in seven, and bilateral abnormalities were present in three patients. The three patients with a history of antecedent trauma had normal MRI studies. Two patients with history and scintigraphic evidence of osteonecrosis had negative MRI scans. MRI may be of value in patients with suspected or proven osteonecrosis of the knee by demonstrating bilateral disease in patients with unilateral symptoms, showing the extent of involvement, and establishing the presence or absence of bone marrow changes in patients with positive bone scans and negative plain films.
Physical Education Students' Ownership, Empowerment, and Satisfaction With PE and Physical Activity.
Moore, E Whitney G; Fry, Mary D
2017-12-01
Individuals experiencing a highly caring, task-involving, and low ego-involving exercise climate have reported greater ownership in exercise class and empowerment to exercise in general. This study examined the relationship between ownership and empowerment in exercise, with 2 context-specific outcomes, satisfaction with physical education (PE) and physical activity, respectively. Given the mission of PE to foster individuals' lifelong physical activity habit, the perceptions of high school students were collected for this study. Ownership in exercise was hypothesized to be significantly, positively correlated with students reporting satisfaction in PE more than their satisfaction in physical activity, whereas empowerment in exercise was hypothesized to be more strongly, positively correlated with students' physical activity satisfaction. A second purpose of this study was to test the measurement quality of the updated Empowerment in Exercise Scale (EES; now 13 items). High school students (N = 502, 43% female) in a Midwestern U.S. school district completed a survey. Confirmatory factor analysis supported the internal measurement structure of the EES (λ = .62-.91; McDonald's omega = .89) across student gender (strong invariance). Additionally, the structural equation modeling analysis revealed only 1 parameter moderated by the students' gender (latent mean of ownership). The hypotheses were supported, such that ownership in exercise was more strongly correlated with PE satisfaction (r = .87) and empowerment in exercise had a stronger correlation with physical activity satisfaction (r = .92). These results support the beneficial effect a satisfying experience in PE can have on students' satisfaction with physical activity outside of school.
Pacifici, Lara
2011-01-01
This activity presents an option for covering biology content while engaging students in an investigation that highlights the spirit of Halloween. Students are engaged in the story line and have fun trying to solve the mystery kidnapping by using science skills to examine the evidence and eliminate some ghoulish suspects. (Contains 1 figure.)
Directory of Open Access Journals (Sweden)
Ke Mao
Full Text Available Cryptochromes are photolyase-like blue/UV-A light receptors that evolved from photolyases. In plants, cryptochromes regulate various aspects of plant growth and development. Despite of their involvement in the control of important plant traits, however, most studies on cryptochromes have focused on lower plants and herbaceous crops, and no data on cryptochrome function are available for forest trees. In this study, we isolated a cryptochrome gene, PeCRY1, from Euphrates poplar (Populus euphratica, and analyzed its structure and function in detail. The deduced PeCRY1 amino acid sequence contained a conserved N-terminal photolyase-homologous region (PHR domain as well as a C-terminal DQXVP-acidic-STAES (DAS domain. Secondary and tertiary structure analysis showed that PeCRY1 shares high similarity with AtCRY1 from Arabidopsis thaliana. PeCRY1 expression was upregulated at the mRNA level by light. Using heterologous expression in Arabidopsis, we showed that PeCRY1 overexpression rescued the cry1 mutant phenotype. In addition, PeCRY1 overexpression inhibited hypocotyl elongation, promoted root growth, and enhanced anthocyanin accumulation in wild-type background seedlings grown under blue light. Furthermore, we examined the interaction between PeCRY1 and AtCOP1 using a bimolecular fluorescence complementation (BiFc assay. Our data provide evidence for the involvement of PeCRY1 in the control of photomorphogenesis in poplar.
Preliminary experiments to estimate the PE.MA.M (PElagic MArine Mesocosm) offshore behaviour
Albani, Marta; Piermattei, Viviana; Stefanì, Chiara; Marcelli, Marco
2016-04-01
The phytoplankton community is controlled not only by local environmental conditions but also by physical processes occurring on different temporal and spatial scales. Hydrodynamic local conditions play an important role in marine ecosystems. Several studies have shown that hydrodynamic conditions can influence the phytoplankton settling velocity, vertical and horizontal distribution and formation of cyanobacterial blooms. Mesocosms are useful structures to simulate marine environment at mesoscale resolution; allowing to closely approximate biotic or abiotic parameters of interest directly in nature. In this work an innovative structure named PE.MA.M (PElagic MArine Mesocosm) is presented and tested. Laboratory experiments have been conducted in order to observe seasonal variations of biomass behaviour in two different hydrodynamic conditions: outside as well as whithin the PE.MA.M. We have evaluated whether it is possible to isolate a natural system from external water mass hydrodynamic exchanges and to assume that phytoplankton cells' transition is limited at the net and sea interface. Preliminary experiments test the isolating capacity of the net, to determine the currents' attenuation rate and to estimate the possible PE.MA.M. offshore behaviour. In the first investigation, we monitored the diffusion of phytoplankton cells. The PE.MA.M. exterior and interior were simulated using a plexiglass tank divided into two half-tanks (Aout-Bin) by a septum consisting of a net like a PE.MA.M. The tank was filled up with 10 L of water and only the half-tank Aout was filled up with 10 ml of phytoplankton culture (Clorella sp.). We monitored the chlorophyll concentrations for 24 hours. The two tanks had similar concentrations after 4 hours (2.70322 mg/m³ Aout and 2.37245 mg/m3 Bin) and this constant relationship was maintened until the end of the test. In the second investigation we used clod cards to measure water motions.We conducted two experiments within tank, the first
MRI diagnosis of suspected atlanto-occipital dissociation in childhood
International Nuclear Information System (INIS)
Grabb, B.C.; Frye, T.A.; Hedlund, G.L.; Vaid, Y.N.; Royal, S.A.; Grabb, P.A.
1999-01-01
Objective. To demonstrate the utility of magnetic resonance (MR) imaging in the diagnosis of complete and partial ligamentous injuries in patients with suspected atlanto-occipital dissociation (AOD). Materials and methods. Five patients with suspected AOD had MR imaging performed within an average of 4 days after injury. MR scans were reviewed with specific analysis of craniocervical ligamentous structures. Charts were reviewed to obtain clinical information regarding presentation, treatment, hospital course, and outcome. Results. Two patients demonstrated MR evidence of complete AOD. One had disruption of all visualized major ligamentous structures at the craniocervical junction with anterolisthesis and evidence of cord damage. The second had injuries to the tectorial membrane, superior band of the cruciform ligament, apical ligament, and interspinous ligament at C 1-2. The remaining three patients sustained incomplete severance of the ligamentous structures at the craniocervical junction. All patients demonstrated subtle radiographic findings suggestive of AOD, including soft tissue swelling at the craniocervical junction without fracture. The two patients with complete AOD died. The three patients with partial AOD were treated with stabilization. On follow-up, these three children were asymptomatic following their craniocervical injury. Conclusion. MR imaging of acute AOD provides accurate identification of the craniocervical ligaments injured, classification of full versus partial ligamentous disruption, and analysis of accompanying spinal cord injury. This information is important for early appropriate neurosurgical management and preservation of neurologic function in survivors. (orig.)
Lineup composition, suspect position, and the sequential lineup advantage.
Carlson, Curt A; Gronlund, Scott D; Clark, Steven E
2008-06-01
N. M. Steblay, J. Dysart, S. Fulero, and R. C. L. Lindsay (2001) argued that sequential lineups reduce the likelihood of mistaken eyewitness identification. Experiment 1 replicated the design of R. C. L. Lindsay and G. L. Wells (1985), the first study to show the sequential lineup advantage. However, the innocent suspect was chosen at a lower rate in the simultaneous lineup, and no sequential lineup advantage was found. This led the authors to hypothesize that protection from a sequential lineup might emerge only when an innocent suspect stands out from the other lineup members. In Experiment 2, participants viewed a simultaneous or sequential lineup with either the guilty suspect or 1 of 3 innocent suspects. Lineup fairness was varied to influence the degree to which a suspect stood out. A sequential lineup advantage was found only for the unfair lineups. Additional analyses of suspect position in the sequential lineups showed an increase in the diagnosticity of suspect identifications as the suspect was placed later in the sequential lineup. These results suggest that the sequential lineup advantage is dependent on lineup composition and suspect position. (c) 2008 APA, all rights reserved
Obradović, Slobodan; Džudović, Boris; Rusović, Siniša; Subota, Vesna; Obradović, Dragana
2016-09-01
Acute pulmonary embolism (PE) is a potentially life threating event, but there are scarce data about genderrelated differences in this condition. The aim of this study was to identify gender-specific differences in clinical presentation, the diagnosis and outcome between male and female patients with PE. We analysed the data of 144 consecutive patients with PE (50% women) and compared female and male patients regarding clinical presentation, electrocardiography (ECG) signs, basic laboratory markers and six-month outcome. All the patients confirmed PE by visualized thrombus on the multidetector computed tomography with pulmonary angiography (MDCTPA), ECG and echocardiographic examination at admission. Compared to the men, the women were older and a larger proportion of them was in the third tertile of age (66.0% vs 34.0%, p = 0.008). In univariate analysis the men more often had hemoptysis [OR (95% CI) 3.75 (1.16-12.11)], chest pain [OR (95% CI) 3.31 (1.57-7.00)] febrile state [OR (95% CI) 2.41 (1.12-5.22)] and pneumonia at PE presentation [OR (95% CI) 3.40 (1.25-9.22)] and less likely had heart decompensation early in the course of the disease [OR (95%CI) 0.48 (0.24-0.97)]. In the multivariate analysis a significant difference in the rate of pneumonia and acute heart failure between genders disappeared due to strong influence of age. There was no significant difference in the occurrence of typical ECG signs for PE between the genders. Women had higher level of admission glycaemia [7.7 mmol/L (5.5-8.2 mmol/L) vs 6.9 mmol/L (6.3-9.6 mmol/L), p = 0.006] and total number of leukocytes [10.5 x 109/L (8.8-12.7 x 109/L vs 8.7 x 109/L (7.0-11.6 x 109/L)), p = 0.007]. There was a trend toward higher plasma level of brain natriuretic peptide in women compared to men 127.1 pg/mL (55.0-484.0 pg/mL), p = 0.092] vs [90.3 pg/mL (39.2-308.5 pg/mL). The main 6-month outcomes, death and major bleeding, had similar frequencies in both sexes. There are several important differences
Absorbed energy for radiation crosslinking in stabilized PE systems
International Nuclear Information System (INIS)
Novakovic, Lj.; Gal, O.; Charlesby, A.
1990-01-01
A quantitative consideration on the absorbed energy consumption in various γ-irradiated polyethylene systems is given. On the base of the increased gel dose values for the PE systems containing antioxidant, relative to the gel doses for the pure polymers, the surplus of the absorbed energy due to the presence of the particular antioxidant is calculated. The increasing of the energy consumption in the stabilized systems depends on both the type and the content of the basic polymer. The surplus in the absorbed energy decreases with the radiation dose increasing, reflecting both the diminishing of the antioxidant concentration in the irradiating PE systems and the crosslinking level. The findings can be of interest in the estimation of the absorbed doses for the specific radiation crosslinking processes. (author)
Absorbed energy for radiation crosslinking in stabilized PE systems
Energy Technology Data Exchange (ETDEWEB)
Novakovic, Lj; Gal, O [Institut za Nuklearne Nauke Boris Kidric, Belgrade (Yugoslavia); Charlesby, A
1990-01-01
A quantitative consideration on the absorbed energy consumption in various {gamma}-irradiated polyethylene systems is given. On the base of the increased gel dose values for the PE systems containing antioxidant, relative to the gel doses for the pure polymers, the surplus of the absorbed energy due to the presence of the particular antioxidant is calculated. The increasing of the energy consumption in the stabilized systems depends on both the type and the content of the basic polymer. The surplus in the absorbed energy decreases with the radiation dose increasing, reflecting both the diminishing of the antioxidant concentration in the irradiating PE systems and the crosslinking level. The findings can be of interest in the estimation of the absorbed doses for the specific radiation crosslinking processes. (author).
Whole-School Management Issues Concerning the PE Department: "A Natural Division of Labour?"
Williams, Gareth Mark; Williams, Dean
2013-01-01
Utilising the labour ideas of Adam Smith and Emile Durkheim as a theoretical basis, the main objective of this study was to investigate the perception that Heads of Physical Education (HoPE) face unique management and leadership challenges. Results showed that HoPE believe that they are overburdened with tasks primarily involving the delegation of…
Acute Hemolysis Caused by Incidental Trichlorfon Exposure
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Ming-Ling Wu
2009-04-01
Full Text Available Trichlorfon (o-o-dimethyl-2,2,2-trichloro-hydroxyethylphosphate, an organophosphate, has a moderately potent anti-cholinesterase activity. Organophosphate poisoning is well known for its characteristic symptoms and signs, but acute hemolysis caused by trichlorfon is rarely reported. We present a patient who developed acute hemolysis and renal function impairment after percutaneous trichlorfon exposure. A 54-year-old man applied trichlorfon powder to his dog to kill its parasites. Half an hour later, the dog was suspected to die of cholinergic crisis and the patient felt abdominal cramping pain. Later, he developed severe nausea, vomiting, chills, high fever, and cold sweat. Laboratory work-up disclosed a picture of acute hemolysis, jaundice, renal function impairment and leukocytosis. However, there were no clinical features of acute cholinergic syndrome except gastrointestinal symptoms, and blood cholinesterase activities were also normal. He eventually had a full recovery. Trichlorfon should be added to the toxins known to cause acute hemolysis.
The PE Ratio and the Predicted Earnings Growth – the Case of Poland
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Kurach Radosław
2015-06-01
Full Text Available We examine the components of equity returns on the Polish capital market. To analyse the underlying complexity of returns we took into consideration the model designed by Leibowitz (1999. This model captures three factors: dividend yield, expected growth in earnings and expected change in price-to-earnings (PE ratio. We applied this model to analyse the average discount/premium not only to particular shares but to market averages as well. Firstly, we examined the variation of PE across the companies (as adapted from Penman (1996 to analyse the average rate of return and their striking distance of individual stocks from a ‘normal’ level. Then we checked the transitory earnings in the portfolios of high PE, whereby a fall in current earnings relative to sustainable level of earnings leads to a transitory high PE ratio. We expect that the effect of transience in current year earnings can be significant. Lastly, we analysed the individual companies in order to check what percentage of companies give a “correct” signal about future prospects.
Genetic characterization of plasmid pRJ5 of Staphylococcus aureus compared to plasmid pE194
International Nuclear Information System (INIS)
Oliveira, S.S. de; Freire Bastos, M.C. de
1993-01-01
The pRJ5, a naturally occurring constitutive macrolide, lincosamide and streptogramin B (MLS) resistance plasmid of Staphylococcus aureus, was compared to pE194, a plasmid that confers the inducible phenotype. pRJ5 was stable in all strains of S. aureus tested, even under growth at 43 O C, which distinguished it from pE194 which was shown to be thermo-sensitive for replication. pRJ5, like pE194, was highly unstable in Bacillus subtilis when the cells were grown in nonselective conditions. Multimeric forms of pRJ5 DNA were detected in the few cells of B. subtilis that retained this plasmid. pE194 was transduced by phages φ 11 and φ 443 at frequencies 400 and 20-fold higher, respectively, than pRJ5. Both plasmids were co-transduced with the plasmid pRJ4. pRJ5 was shown to be compatible with pE194. Therefore they belong to distinct Inc groups. Hybridization studies revealed that pRJ5 shares a 1.35 kb region of homology to pE194, which is limited to the erm gene, conferring MLS resistance. (author)
Reproducibility of [123I]PE2I binding to dopamine transporters with SPECT
DEFF Research Database (Denmark)
Ziebell, Morten; Thomsen, Gerda; Knudsen, Gitte M
2007-01-01
The iodinated cocaine derivative [(123)I]PE2I is a new selective ligand for in vivo studies of the dopamine transporter (DAT) with SPECT. Recently, a bolus/infusion (B/I) protocol for [(123)I]PE2I measurements of DAT density was established [Pinborg LH et al. J Nucl Med 2005;46:1119-271]. The aims...
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Ivo Casagranda
2013-10-01
Full Text Available The purpose of this document is to develop recommendations on the use of the latest generation of cardiac troponins in emergency room settings for the diagnosis of myocardial infarction in patients with suspected acute coronary syndrome without persistent ST-segment elevation (NSTE-ACS. The main points which have been addressed reaching a consensus are: i suitability and appropriateness of the terminology; ii appropriateness of the request; iii confirmation of the diagnosis of myocardial infarction (rule-in; iv exclusion of the diagnosis of myocardial infarction (rule-out. Each point has been analyzed by taking into account the evidence presented in medical publications. Recommendations were developed using the criteria adopted by the European Society of Cardiology and the American Heart Association/American College of Cardiology. Each point of the recommendation was submitted for validation to an external audit by a Group of Experts (named above.
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Jennings Jason
2010-01-01
Full Text Available Laparoscopic inguinal herniorraphy via a transabdominal preperitoneal (TAPP approach using Polypropylene Mesh (Mesh and staples is an accepted technique. Mesh induces a localised inflammatory response that may extend to, and involve, adjacent abdominal and pelvic viscera such as the appendix. We present an interesting case of suspected Mesh-induced appendicitis treated successfully with laparoscopic appendicectomy, without Mesh removal, in an elderly gentleman who presented with symptoms and signs of acute appendicitis 18 months after laparoscopic inguinal hernia repair. Possible mechanisms for Mesh-induced appendicitis are briefly discussed.
But I Like PE: Factors Associated With Enjoyment of Physical Education Class in Middle School Girls
Barr-Anderson, Daheia J.; Neumark-Sztainer, Dianne; Schmitz, Kathryn H.; Ward, Dianne S.; Conway, Terry L.; Pratt, Charlotte; Baggett, Chris D.; Lytle, Leslie; Pate, Russell R.
2008-01-01
The current study examined associations between physical education (PE) class enjoyment and sociodemographic, personal, and perceived school environment factors among early adolescent girls. Participants included 1,511 sixth-grade girls who completed baseline assessments for the Trial of Activity in Adolescent Girls, with 50% indicating they enjoyed PE class a lot. Variables positively associated with PE class enjoyment included physical activity level, perceived benefits of physical activity...
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Jose A. Peña-Zarza
2012-01-01
Full Text Available Objective. To assess the screening tools in snoring patients. Material and Methods. A retrospective review of data was conducted from children between 2 and 15 years old who were referred on suspicion of obstructive sleep apnea-hypopnea (OSAH between June 2008 and June 2011. We excluded patients with significant comorbidities. Pediatric Sleep Questionnaire (PSQ, physical exam (PE, and pulse-oximetry data were collected and correlated with the results of the nightly polygraph at home. Results. We selected 98 patients. The 22-item version of the PSQ had sensitivity of 96% and specificity of 36.8%. The overall value of the clinic predictor of OSAH (PSQ and PE together exhibited an increased specificity 57.6% with 94.6% of sensitivity. The nocturnal home oximetry method used alone was very specific, 92.1%, but had a lower sensitivity, 77.1%. The set of clinical assessment tools used together with pulse-oximetry screening provided excellent specificity 98.1% and a positive predictive value 94.1% globally. The performance of this screening tool is related with the severity of OSAH and accuracy is better in moderate and severe cases. Conclusion. The combination of clinical assessment and pulse-oximetry screening can provide a sufficient diagnostic approach for pediatric patients with suspected OSAH at least in moderate and severe cases.
Glutaric Aciduria type I and acute renal failure — Coincidence or causality?
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Ben Pode-Shakked
2014-01-01
Full Text Available Glutaric Aciduria type I (GA-I is a rare organic acidemia, caused by mutations in the GCDH gene, and characterized by encephalopathic crises with neurological sequelae. We report herein a patient with GA-I who presented with severe acute renal failure requiring dialysis, following an acute diarrheal illness. Histopathological evaluation demonstrated acute tubular necrosis, and molecular diagnosis revealed the patient to be homozygous for a previously unreported mutation, p.E64D. As renal impairment is not part of the clinical spectrum typical to GA-I, possible associations of renal failure and the underlying inborn error of metabolism are discussed, including recent advancements made in the understanding of the renal transport of glutaric acid and its derivatives during metabolic disturbance in GA-I.
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Branko M. Tešanović
2014-10-01
Full Text Available Peć za pečenje hleba u poljskim uslovima dodeljuje se jedinicama koje su po svom karakteru relativno stacionarne i kojima po veličini ne bi pripadale pokretne peći. Podesna je za pečenje hleba namenjenog jedinicama koje se nalaze u međunarodnim misijama, u uslovima otežanog snabdevanja, jer navike naših vojnika su da konzumiraju hleb, a ne keks. Peć je montažno-demontažnog tipa, prilagođena za korišćenje na svim vrstama terena. Jednostavne je konstrukcije, što omogućava da se demontira i lako prenosi sa mesta na mesto. / An oven for baking bread in field conditions is assigned to units that are by their nature relatively stationary and whose size does not require a movable bakery. It is intended for baking bread in our units located in international missions with supply difficulties, since our units have a habit od consuming bread instead of biscuits. The oven is of a prefabricated type, adapted for use in all types of terrains, simple design which makes it possible to be, dismantled and easily transported.
Severe Hypertriglyceridemia in Diabetic Ketoacidosis Accompanied by Acute Pancreatitis: Case Report
Hahn, Suk Jae; Park, Jung-hyun; Lee, Jong Ho; Lee, Jun Kyu; Kim, Kyoung-Ah
2010-01-01
We report a case of diabetic ketoacidosis (DKA) and hypertriglyceridemia (severely elevated to 15,240 mg/dL) complicated by acute pancreatitis, which was treated successfully with insulin therapy and conservative management. A 20-yr-old woman with a history of type 1 diabetes came to the emergency department 7 months after discontinuing insulin therapy. DKA, severe hypertriglyceridemia and acute pancreatitis were diagnosed, with DKA suspected of contributing to the development of the other co...
Seasonal variation among tuberculosis suspects in four countries
DEFF Research Database (Denmark)
Mabaera, Biggie; Naranbat, Nymadawa; Katamba, Achilles
2009-01-01
The objective of the study was to analyze monthly trends across a calendar year in tuberculosis suspects and sputum smear-positive cases based on nationally representative samples of tuberculosis laboratory registers from Moldova, Mongolia, Uganda and Zimbabwe. Out of the 47 140 suspects registered...... in the tuberculosis laboratory registers, 13.4% (6312) were cases. The proportion varied from country to country, Moldova having the lowest (9%) and Uganda the highest (21%). From the monthly proportion of suspects and cases among total suspects and cases, seasonal variations were most marked in Mongolia which, among...... attendance to diagnostic laboratory services, evidenced by the contrasting findings of Mongolia (extreme continental northern climate) compared to Uganda (equatorial climate). A combination of external and possibly endogenous factors seems to determine whether tuberculosis suspects and cases present...
Coupled Physics Environment (CouPE) library - Design, Implementation, and Release
Energy Technology Data Exchange (ETDEWEB)
Mahadevan, Vijay S. [Argonne National Lab. (ANL), Argonne, IL (United States)
2014-09-30
Over several years, high fidelity, validated mono-physics solvers with proven scalability on peta-scale architectures have been developed independently. Based on a unified component-based architecture, these existing codes can be coupled with a unified mesh-data backplane and a flexible coupling-strategy-based driver suite to produce a viable tool for analysts. In this report, we present details on the design decisions and developments on CouPE, an acronym that stands for Coupled Physics Environment that orchestrates a coupled physics solver through the interfaces exposed by MOAB array-based unstructured mesh, both of which are part of SIGMA (Scalable Interfaces for Geometry and Mesh-Based Applications) toolkit. The SIGMA toolkit contains libraries that enable scalable geometry and unstructured mesh creation and handling in a memory and computationally efficient implementation. The CouPE version being prepared for a full open-source release along with updated documentation will contain several useful examples that will enable users to start developing their applications natively using the native MOAB mesh and couple their models to existing physics applications to analyze and solve real world problems of interest. An integrated multi-physics simulation capability for the design and analysis of current and future nuclear reactor models is also being investigated as part of the NEAMS RPL, to tightly couple neutron transport, thermal-hydraulics and structural mechanics physics under the SHARP framework. This report summarizes the efforts that have been invested in CouPE to bring together several existing physics applications namely PROTEUS (neutron transport code), Nek5000 (computational fluid-dynamics code) and Diablo (structural mechanics code). The goal of the SHARP framework is to perform fully resolved coupled physics analysis of a reactor on heterogeneous geometry, in order to reduce the overall numerical uncertainty while leveraging
Selecting foils for identification lineups: matching suspects or descriptions?
Tunnicliff, J L; Clark, S E
2000-04-01
Two experiments directly compare two methods of selecting foils for identification lineups. The suspect-matched method selects foils based on their match to the suspect, whereas the description-matched method selects foils based on their match to the witness's description of the perpetrator. Theoretical analyses and previous results predict an advantage for description-matched lineups both in terms of correctly identifying the perpetrator and minimizing false identification of innocent suspects. The advantage for description-matched lineups should be particularly pronounced if the foils selected in suspect-matched lineups are too similar to the suspect. In Experiment 1, the lineups were created by trained police officers, and in Experiment 2, the lineups were constructed by undergraduate college students. The results of both experiments showed higher suspect-to-foil similarity for suspect-matched lineups than for description-matched lineups. However, neither experiment showed a difference in correct or false identification rates. Both experiments did, however, show that there may be an advantage for suspect-matched lineups in terms of no-pick and rejection responses. From these results, the endorsement of one method over the other seems premature.
Head movement during CT brain perfusion acquisition of patients with suspected acute ischemic stroke
International Nuclear Information System (INIS)
Fahmi, F.; Beenen, L.F.M.; Streekstra, G.J.; Janssen, N.Y.; Jong, H.W. de; Riordan, A.; Roos, Y.B.; Majoie, C.B.; Bavel, E. van; Marquering, H.A.
2013-01-01
Objective: Computed Tomography Perfusion (CTP) is a promising tool to support treatment decision for acute ischemic stroke patients. However, head movement during acquisition may limit its applicability. Information of the extent of head motion is currently lacking. Our purpose is to qualitatively and quantitatively assess the extent of head movement during acquisition. Methods: From 103 consecutive patients admitted with suspicion of acute ischemic stroke, head movement in 220 CTP datasets was qualitatively categorized by experts as none, minimal, moderate, or severe. The movement was quantified using 3D registration of CTP volume data with non-contrast CT of the same patient; yielding 6 movement parameters for each time frame. The movement categorization was correlated with National Institutes of Health Stroke Scale (NIHSS) score and baseline characteristic using multinomial logistic regression and student's t-test respectively. Results: Moderate and severe head movement occurred in almost 25% (25/103) of all patients with acute ischemic stroke. The registration technique quantified head movement with mean rotation angle up to 3.6° and 14°, and mean translation up to 9.1 mm and 22.6 mm for datasets classified as moderate and severe respectively. The rotation was predominantly in the axial plane (yaw) and the main translation was in the scan direction. There was no statistically significant association between movement classification and NIHSS score and baseline characteristics. Conclusions: Moderate or severe head movement during CTP acquisition of acute stroke patients is quite common. The presented registration technique can be used to automatically quantify the movement during acquisition, which can assist identification of CTP datasets with excessive head movement
Head movement during CT brain perfusion acquisition of patients with suspected acute ischemic stroke
Energy Technology Data Exchange (ETDEWEB)
Fahmi, F., E-mail: f.fahmi@amc.uva.nl [Department of Biomedical Engineering and Physics, AMC, Amsterdam (Netherlands); Beenen, L.F.M., E-mail: l.f.beenen@amc.uva.nl [Department of Radiology, AMC, Amsterdam (Netherlands); Streekstra, G.J., E-mail: g.j.streekstra@amc.uva.nl [Department of Biomedical Engineering and Physics, AMC, Amsterdam (Netherlands); Janssen, N.Y., E-mail: n.n.janssen@amc.uva.nl [Department of Biomedical Engineering and Physics, AMC, Amsterdam (Netherlands); Jong, H.W. de, E-mail: H.W.A.M.deJong@umcutrecht.nl [Department of Radiology, UMC Utrecht, 3584CX, Utrecht (Netherlands); Riordan, A., E-mail: alan.riordan@gmail.com [Department of Radiology, UMC Utrecht, 3584CX, Utrecht (Netherlands); Roos, Y.B., E-mail: y.b.roos@amc.uva.nl [Department of Neurology, AMC, Amsterdam (Netherlands); Majoie, C.B., E-mail: c.b.majoie@amc.uva.nl [Department of Radiology, AMC, Amsterdam (Netherlands); Bavel, E. van, E-mail: e.vanbavel@amc.uva.nl [Department of Biomedical Engineering and Physics, AMC, Amsterdam (Netherlands); Marquering, H.A., E-mail: h.a.marquering@amc.uva.nl [Department of Biomedical Engineering and Physics, AMC, Amsterdam (Netherlands); Department of Radiology, AMC, Amsterdam (Netherlands)
2013-12-01
Objective: Computed Tomography Perfusion (CTP) is a promising tool to support treatment decision for acute ischemic stroke patients. However, head movement during acquisition may limit its applicability. Information of the extent of head motion is currently lacking. Our purpose is to qualitatively and quantitatively assess the extent of head movement during acquisition. Methods: From 103 consecutive patients admitted with suspicion of acute ischemic stroke, head movement in 220 CTP datasets was qualitatively categorized by experts as none, minimal, moderate, or severe. The movement was quantified using 3D registration of CTP volume data with non-contrast CT of the same patient; yielding 6 movement parameters for each time frame. The movement categorization was correlated with National Institutes of Health Stroke Scale (NIHSS) score and baseline characteristic using multinomial logistic regression and student's t-test respectively. Results: Moderate and severe head movement occurred in almost 25% (25/103) of all patients with acute ischemic stroke. The registration technique quantified head movement with mean rotation angle up to 3.6° and 14°, and mean translation up to 9.1 mm and 22.6 mm for datasets classified as moderate and severe respectively. The rotation was predominantly in the axial plane (yaw) and the main translation was in the scan direction. There was no statistically significant association between movement classification and NIHSS score and baseline characteristics. Conclusions: Moderate or severe head movement during CTP acquisition of acute stroke patients is quite common. The presented registration technique can be used to automatically quantify the movement during acquisition, which can assist identification of CTP datasets with excessive head movement.
A case of thrombotic thrombocytopenic purpura induced by acute pancreatitis
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Arimoto M
2012-03-01
Full Text Available Miyoko Arimoto1, Yutaka Komiyama2, Fumiko Okamae1, Akemi Ichibe1, Setsuko Teranishi1, Hirohiko Tokunaga1, Keiko Nakaya3, Michie Fujiwara3, Manabu Yamaoka4, Shuji Onishi4, Rie Miyamoto5, Naoto Nakamichi5, Shosaku Nomura51Blood Transfusion Unit, Kansai Medical University Takii Hospital, 2Department of Clinical Sciences and Laboratory Medicine, Kansai Medical University, 3Clinical Medical Technology Unit, Kansai Medical University Takii Hospital, 4Blood Transfusion Unit, Kansai Medical University Hirakata Hospital, 5First Department of Internal Medicine, Kansai Medical University, Moriguchi, JapanAbstract: Thrombotic thrombocytopenic purpura (TTP is a multisystemic microvascular disorder that may be caused by an imbalance between unusually large von Willebrand factor multimers and the cleaving protease ADAMTS13. In acquired TTP, especially in secondary TTP with various underlying diseases, the diagnosis is difficult because there are many cases that do not exhibit severe deficiency of ADAMTS13 or raised levels of ADAMST13 inhibitors. It is well known that collagen disease, malignancy, and hematopoietic stem cell transplantation can be underlying conditions that induce TTP. However, TTP induced by acute pancreatitis, as experienced by our patient, has rarely been reported. Our patient completely recovered with treatments using steroids and plasma exchange (PE only. In cases where patients develop acute pancreatitis with no apparent causes for hemolytic anemia and thrombocytopenia, the possibility of TTP should be considered. Treatments for TTP including PE should be evaluated as soon as a diagnosis is made.Keywords: thrombotic thrombocytopenic purpura, ADAMTS13, acute pancreatitis, plasma exchange
D'Amico, G; Sinico, R; Fornasieri, A; Ferrario, F; Colasanti, G; Porri, M T; Paracchini, M L; Gibelli, A
1983-07-01
Ten adult patients with RPCGN (crescents in greater than 70% of glomeruli), primary in 6 and associated with systemic diseases in 4, were treated with PE, associated with oral steroids (P) and cyclophosphamide (C) in all cases and with intravenous methylprednisolone pulses (MP) in 7 cases. Four out of ten patients were anuric and needed dialysis treatment at the start of treatment. Therapeutic benefit, i.e. reversal of the trend to further deterioration and substantial improvement of GFR, was achieved in 8 out of 10 patients (80%), including 2 of 4 anuric patients, and in 7 of those (8) who had still active cellular crescents (87.5%). Similar therapeutic benefit had been achieved only in 10% of a comparable population of 10 patients with RPCGN treated before 1980 with P and C, without PE or MP pulses. It is difficult to establish whether the better therapeutic results in the more recently treated group were due to PE or to MP pulses of to both the new approaches, even though the clinical improvement obtained in all the 3 patients treated with PE without concomitant MP suggest a specific beneficial role for PE. RPCGN is a catastrophic illness characterized by progressive deterioration of kidney function, resulting in oliguria and uremia, usually within weeks or months. The most consistent histopathologic finding is the presence of extensive glomerular crescents resulting from proliferation of the extracapillary epithelial cell lining of Bowman's capsule. It is apparent that RPCGN is not a homogeneous entity, clinically, histologically or immunohistologically, but rather a clinicopathologic syndrome, the features of which may be seen in a variety of systemic disorders, including SLE, polyarteritis nodosa, Wegener's granulomatosis, Henoch-Schönlein purpura, cryoglobulinemia, and subacute bacterial endocarditis.(ABSTRACT TRUNCATED AT 250 WORDS)
International Nuclear Information System (INIS)
Shannon, L.; Peachey, T.; Skipper, N.; Adiotomre, E.; Chopra, A.; Marappan, B.; Kotnis, N.
2015-01-01
Aim: To assess the accuracy of the trauma team leader's clinical suspicion of injury in patients who have undergone whole-body computed tomography (WBCT) for suspected polytrauma, and to assess the frequency of unsuspected injuries and specific patterns of injury at WBCT. Materials and methods: Requests for patients who underwent WBCT for suspected polytrauma from April 2011 to March 2014 were reviewed and each body area that was clinically suspected to be injured was recorded. Body areas were divided into the following groups based on anatomical regions covered in each segment of the WBCT examination: head (including facial bones); neck (including cervical spine); chest (including thoracic spine); and abdomen/pelvis (including lumbar spine). The formal radiology report for each study was reviewed and injuries found at CT were grouped into the same body areas. For each patient, the number of clinically suspected injured areas was compared to the number of confirmed injured areas at WBCT. Results: Five hundred and eighty-eight patients were included in the study. Thirty-two percent (186/588) had a normal scan. Ninety-three percent (546/588) had fewer injured body areas at WBCT than suspected. Four percent (27/588) had the equivalent number of injured areas at WBCT as suspected. Three percent (15/588) had more injured areas at WBCT than suspected. Fifty percent (263/527) with clinically suspected chest injuries were confirmed to have chest injuries at WBCT. This was lower for other areas: abdomen/pelvis 31% (165/535); head 29% (155/533); neck 13% (66/513). Four percent of (24/588) patients had unsuspected injuries found at WBCT. Seventy-five percent (18/24) of unsuspected injuries were considered as serious, where failure to treat would have the potential for significant morbidity. Most of these patients had severe injuries to other body areas that were correctly suspected. Of the 165 with abdominal/pelvic region injuries, there were associated injuries in the
Non-alcoholic acute Wernicke's encephalopathy: Role of MRI in non typical cases
Energy Technology Data Exchange (ETDEWEB)
Elefante, Andrea, E-mail: aelefant@unina.it [Department of Neuroradiology, University of Naples “Federico II”, Naples (Italy); Puoti, Gianfranco [I Division of Neurology, General Medicine Department, Second University of Naples, Naples (Italy); Senese, Rossana [Department of Neuroradiology, University of Naples “Federico II”, Naples (Italy); Coppola, Cinzia [I Division of Neurology, General Medicine Department, Second University of Naples, Naples (Italy); Russo, Carmela [Department of Neuroradiology, University of Naples “Federico II”, Naples (Italy); Tortora, Fabio [Department of Neuroradiology, Second University of Naples, Naples (Italy); Divitiis, Oreste de [Department of Neurosurgery, University of Naples “Federico II”, Naples (Italy); Brunetti, Arturo [Department of Neuroradiology, University of Naples “Federico II”, Naples (Italy)
2012-12-15
Aim: Acute Wernicke's encephalopathy (WE) is a severe neurological disorder caused by thiamine deficiency, most commonly found in chronic alcoholics. It is not so easy to suspect acute WE when the clinical picture does not include all the typical symptoms and alcohol abuse is not reported. Three rare cases of Wernicke's encephalopathy (WE) in non-alcoholic patients are reported. Cases presentation: Two patients developed the disease following prolonged intravenous feeding, the third was carrying a gastric lymphoma. None of them presented with the classic clinical triad of WE (ophtalmoplegia/nystagmus, ataxia and consciousness disturbance), showing just one or two of the typical symptoms. Brain Magnetic Resonance Imaging (MRI) represented the key tool to suspect and define WE diagnosis, showing a picture characterized by bilaterally altered signal of the thalamic pulvinar, mesencephalic cup, mammillary bodies, periaqueductal grey matter and floor of fourth ventricle. All patients dramatically improved within 48 h after administration of thiamine. Conclusion: We emphasize that WE should be suspected in all patients showing typical MRI features presenting with at least one of the clinical triad of WE.
Severe hypertriglyceridemia in diabetic ketoacidosis accompanied by acute pancreatitis: case report.
Hahn, Suk Jae; Park, Jung-hyun; Lee, Jong Ho; Lee, Jun Kyu; Kim, Kyoung-Ah
2010-09-01
We report a case of diabetic ketoacidosis (DKA) and hypertriglyceridemia (severely elevated to 15,240 mg/dL) complicated by acute pancreatitis, which was treated successfully with insulin therapy and conservative management. A 20-yr-old woman with a history of type 1 diabetes came to the emergency department 7 months after discontinuing insulin therapy. DKA, severe hypertriglyceridemia and acute pancreatitis were diagnosed, with DKA suspected of contributing to the development of the other conditions. In Korea, two cases of DKA-induced hypertriglyceridemia and 13 cases of hypertriglyceridemia-induced acute pancreatitis have been previously reported separately.
Directory of Open Access Journals (Sweden)
Patrycja Anna Naesgaard
2016-02-01
Full Text Available Background: Several studies have demonstrated an association between low vitamin D levels and cardiovascular risk. Vitamin D cut off levels are still under debate. Objectives: To assess two cut-off levels, 40 nmol/L and 70 nmol/L, respectively, for vitamin D measured as 25-hydroxyvitamin D [25(OHD] in chest pain patients with suspected acute coronary syndrome.Methods: We investigated 1853 patients from coastal-Norway and inland Northern-Argentina. A similar database was used for pooling of data. 2-year follow-up data including all-cause mortality, cardiac death and sudden cardiac death in the total patient population were analyzed, applying univariate and multivariable analysis. Results: 255 patients with known vitamin D concentrations died. In the multivariable analysis, there was a decrease in total mortality above a cut-off level of 40 nmol/L and a decrease in cardiac death above a cut-off level of 70 nmol/L, [HRs of 0.66 (95% CI, 0.50 – 0.88, p = 0.004 and 0.46 (95% CI, 0.22 – 0.94, p = 0.034, respectively].Conclusion: Vitamin D cut-off levels of 40 nmol/L and 70 nmol/L, were related to total mortality and cardiac death, respectively.
Interviewing strategically to elicit admissions from guilty suspects.
Tekin, Serra; Granhag, Pär Anders; Strömwall, Leif; Giolla, Erik Mac; Vrij, Aldert; Hartwig, Maria
2015-06-01
In this article we introduce a novel interviewing tactic to elicit admissions from guilty suspects. By influencing the suspects' perception of the amount of evidence the interviewer holds against them, we aimed to shift the suspects' counterinterrogation strategies from less to more forthcoming. The proposed tactic (SUE-Confrontation) is a development of the Strategic Use of Evidence (SUE) framework and aims to affect the suspects' perception by confronting them with statement-evidence inconsistencies. Participants (N = 90) were asked to perform several mock criminal tasks before being interviewed using 1 of 3 interview techniques: (a) SUE-Confrontation, (b) Early Disclosure of Evidence, or (c) No Disclosure of Evidence. As predicted, the SUE-Confrontation interview generated more statement-evidence inconsistencies from suspects than the Early Disclosure interview. Importantly, suspects in the SUE-Confrontation condition (vs. Early and No disclosure conditions) admitted more self-incriminating information and also perceived the interviewer to have had more information about the critical phase of the crime (the phase where the interviewer lacked evidence). The findings show the adaptability of the SUE-technique and how it may be used as a tool for eliciting admissions. (c) 2015 APA, all rights reserved).
Copper nanoparticles functionalized PE: Preparation, characterization and magnetic properties
International Nuclear Information System (INIS)
Reznickova, A.; Orendac, M.; Kolska, Z.; Cizmar, E.; Dendisova, M.; Svorcik, V.
2016-01-01
Highlights: • Polyethylene (PE) surface was activated by argon plasma discharge. • Copper nanoparticles were coated on polyethylene via dithiol interlayer. • Prepared samples exhibit excellent structural and magnetic properties. • Studied properties may be utilized in design and fabrication of electronic devices. - Abstract: We report grafting of copper nanoparticles (CuNP) on plasma activated high density polyethylene (HDPE) via dithiol interlayer pointing out to the structural and magnetic properties of those composites. The as-synthesized Cu nanoparticles have been characterized by high-resolution transmission electron microscopy (HRTEM/TEM) and UV–vis spectroscopy. Properties of pristine PE and their plasma treated counterparts were studied by different experimental techniques: X-ray photoelectron spectroscopy (XPS), UV–vis spectroscopy, energy dispersive X-ray spectroscopy (EDS), zeta potential, electron spin resonance (ESR) and SQUID magnetometry. From TEM and HRTEM analyses, it is found that the size of high purity Cu nanoparticles is (12.2 ± 5.2) nm. It was determined that in the CuNPs, the copper atoms are arranged mostly in the (111) and (200) planes. Absorption in UV–vis region by these nanoparticles is ranging from 570 to 670 nm. EDS revealed that after 1 h of grafting are Cu nanoparticles homogeneously distributed over the whole surface and after 24 h of grafting Cu nanoparticles tend to aggregate slightly. The combined investigation of magnetic properties using ESR spectrometry and SQUID magnetometry confirmed the presence of copper nanoparticles anchored on PE substrate and indicated ferromagnetic interactions.
Copper nanoparticles functionalized PE: Preparation, characterization and magnetic properties
Energy Technology Data Exchange (ETDEWEB)
Reznickova, A., E-mail: alena.reznickova@vscht.cz [Department of Solid State Engineering, University of Chemistry and Technology, 166 28 Prague 6 (Czech Republic); Orendac, M., E-mail: martin.orendac@upjs.sk [Faculty of Science, P.J. Safarik University, Park Angelinum 9, 04013 Kosice (Slovakia); Kolska, Z., E-mail: zdenka.kolska@seznam.cz [Faculty of Science, J.E. Purkyne University, 400 96 Usti nad Labem (Czech Republic); Cizmar, E., E-mail: erik.cizmar@upjs.sk [Faculty of Science, P.J. Safarik University, Park Angelinum 9, 04013 Kosice (Slovakia); Dendisova, M., E-mail: vyskovsm@vscht.cz [Department of Physical Chemistry, University of Chemistry and Technology Prague, 166 28 Prague 6 (Czech Republic); Svorcik, V., E-mail: vaclav.svorcik@vscht.cz [Department of Solid State Engineering, University of Chemistry and Technology, 166 28 Prague 6 (Czech Republic)
2016-12-30
Highlights: • Polyethylene (PE) surface was activated by argon plasma discharge. • Copper nanoparticles were coated on polyethylene via dithiol interlayer. • Prepared samples exhibit excellent structural and magnetic properties. • Studied properties may be utilized in design and fabrication of electronic devices. - Abstract: We report grafting of copper nanoparticles (CuNP) on plasma activated high density polyethylene (HDPE) via dithiol interlayer pointing out to the structural and magnetic properties of those composites. The as-synthesized Cu nanoparticles have been characterized by high-resolution transmission electron microscopy (HRTEM/TEM) and UV–vis spectroscopy. Properties of pristine PE and their plasma treated counterparts were studied by different experimental techniques: X-ray photoelectron spectroscopy (XPS), UV–vis spectroscopy, energy dispersive X-ray spectroscopy (EDS), zeta potential, electron spin resonance (ESR) and SQUID magnetometry. From TEM and HRTEM analyses, it is found that the size of high purity Cu nanoparticles is (12.2 ± 5.2) nm. It was determined that in the CuNPs, the copper atoms are arranged mostly in the (111) and (200) planes. Absorption in UV–vis region by these nanoparticles is ranging from 570 to 670 nm. EDS revealed that after 1 h of grafting are Cu nanoparticles homogeneously distributed over the whole surface and after 24 h of grafting Cu nanoparticles tend to aggregate slightly. The combined investigation of magnetic properties using ESR spectrometry and SQUID magnetometry confirmed the presence of copper nanoparticles anchored on PE substrate and indicated ferromagnetic interactions.
Wen, Ruobing; Sui, Zhenghong; Zhang, Xuecheng; Zhang, Shuang; Qin, Song
2007-10-01
Phycoerythrin (PE) is one of the most important proteins involved in light capturing during photosynthesis in red algae. Its potential biological activities had gained wide concerns. In the present study, tumor cytotoxic and hydroxyl radical assay were preformed to detect the bioactivity of recombinant PE. Recombinant plasmids pGEX-PE and pBGL were transformed into E. coli BL21 to make two recombinant strains BEX (pGEX-PE) and BGL (pBGL). PE expressing in BEX (pGEX-PE) was validated by SDS-PAGE and Western blotting analysis. SDS-PAGE analysis indicated that the PE-GST fusion protein was mostly inclusion bodies. Specific expression of PE was confirmed by Western blotting analysis. The recombinant E. coli BEX (pGEX-PE) cells were collected and sonicated. The supernatants were reserved for the tumor cytotoxic experiments. The result of tumor cytotoxic assay indicated that the supernatants containing PE had the activity of inhibiting the growth of Hela cells and with the increase of protein concentration, the inhibiting rate increased from 37.31% to 63.26%, which showed significant difference from the control. Hydroxyl radical scavenging effect was tested with supernatants of BEX (pGEX-PE) and BGL (pBGL) cell lysates treated with sonication and heating. For the sonication samples, the scavenging rates of the supernatants of BEX (pGEX-PE) and BGL (pBGL) cell lysates were significantly higher than the negative control BL21(pGEX-4T) ( Pprotein content. For the heating samples, except for the 0.2 mg mL-1 BGL (pBGL) products, the scavenging effects of the supernatants of BEX (pGEX-PE) and BGL (pBGL) cell lysates were stronger than that of negative control BL21(pGEX-4T). However, the effect intensity was not positively correlated with the increase of the protein concentration. Though a partially decreased hydroxyl radical scavenging activity was led by heating, the biological activity was still retained and conspicuous. This research showed that phycoerythrin protein
Breathomics as a diagnostic tool for pulmonary embolism
Fens, N.; Douma, Renee; Sterk, P.J.; Kamphuisen, P.W.
2011-01-01
Rationale The majority of patients suspected of pulmonary embolism (PE) undergoes imaging tests, but PE will only be confirmed in a minority of patients. Consequently, there is a need for non-invasive, safe assessment aimed to accurately exclude PE. Exhaled breath molecular profiling by electronic
Energy Technology Data Exchange (ETDEWEB)
Inci, Ercan, E-mail: ercan_inci@mynet.com [Department of Radiology, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Incirli-Bakirkoy, Istanbul (Turkey); Hocaoglu, Elif; Aydin, Sibel; Palabiyik, Figen; Cimilli, Tan [Department of Radiology, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Incirli-Bakirkoy, Istanbul (Turkey); Turhan, Ahmet Nuray; Ayguen, Ersan [Department of Surgery, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul (Turkey)
2011-11-15
Purpose: The purpose of this study was to assess the diagnostic value of unenhanced magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis and compare with Alvarado scores and histopathological results. Materials and methods: The study included 85 consecutive patients (mean age, 26.5 {+-} 11.3 years) who were clinically suspected of having acute appendicitis. Each patients Alvarado scores were recorded and unenhanced MRI was performed, consisting of T1-weighted, T2-weighted and fat-suppressed T2-weighted fast spin-echo sequences. The MR images were prospectively reviewed in consensus for the presence of acute appendicitis by two radiologists who were blinded to the results of the Alvarado scores. The study population were divided into three subgroups based on the MRI findings: Group I: definitely not appendicitis, Group II: probably appendicitis, Group III: definitely appendicitis. All patients were divided into two subgroups according to Alvarado scores as Group A (low: 1-6), and Group B (high: 7-10). MR findings were compared with Alvarado scores and histopathological findings. Results: Sixty-six (77.6%) of the 85 patients with clinically suspected acute appendicitis, had undergone surgery. The diagnosis of appendicitis could be correctly achieved with MRI in 55 (83.3%) of 57 (86.4%) patients with histopathologically proven acute appendicitis. The sensitivity, specificity, positive predictive value and negative predictive value of MRI examination and Alvarado scoring system in the diagnosis of acute appendicitis were 96.49%, 66.67%, 94.83%, 75.0% and 84.21%, 66.67%, 94.12%, 40.0%, respectively. Conclusions: MRI is a valuable technique for detecting acute appendicitis even in the cases with low Alvarado scores. To increase the diagnostic accuracy and preventing unnecessary laparotomies for suspected appendicitis, shorter and cheaper unenhanced basic MRI may be performed.
International Nuclear Information System (INIS)
Inci, Ercan; Hocaoglu, Elif; Aydin, Sibel; Palabiyik, Figen; Cimilli, Tan; Turhan, Ahmet Nuray; Ayguen, Ersan
2011-01-01
Purpose: The purpose of this study was to assess the diagnostic value of unenhanced magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis and compare with Alvarado scores and histopathological results. Materials and methods: The study included 85 consecutive patients (mean age, 26.5 ± 11.3 years) who were clinically suspected of having acute appendicitis. Each patients Alvarado scores were recorded and unenhanced MRI was performed, consisting of T1-weighted, T2-weighted and fat-suppressed T2-weighted fast spin-echo sequences. The MR images were prospectively reviewed in consensus for the presence of acute appendicitis by two radiologists who were blinded to the results of the Alvarado scores. The study population were divided into three subgroups based on the MRI findings: Group I: definitely not appendicitis, Group II: probably appendicitis, Group III: definitely appendicitis. All patients were divided into two subgroups according to Alvarado scores as Group A (low: 1-6), and Group B (high: 7-10). MR findings were compared with Alvarado scores and histopathological findings. Results: Sixty-six (77.6%) of the 85 patients with clinically suspected acute appendicitis, had undergone surgery. The diagnosis of appendicitis could be correctly achieved with MRI in 55 (83.3%) of 57 (86.4%) patients with histopathologically proven acute appendicitis. The sensitivity, specificity, positive predictive value and negative predictive value of MRI examination and Alvarado scoring system in the diagnosis of acute appendicitis were 96.49%, 66.67%, 94.83%, 75.0% and 84.21%, 66.67%, 94.12%, 40.0%, respectively. Conclusions: MRI is a valuable technique for detecting acute appendicitis even in the cases with low Alvarado scores. To increase the diagnostic accuracy and preventing unnecessary laparotomies for suspected appendicitis, shorter and cheaper unenhanced basic MRI may be performed.
Energy Technology Data Exchange (ETDEWEB)
Oliveira, Suelem S.L.; Silva, Caio M.B.; Leal, Tania L; Carvalho, Laura H; Costa, Anna R.M. [Universidade Federal de Campina Grande (UFCG), PB (Brazil)], e-mail: tanlucleal@yahoo.com.br
2011-07-01
Interest in techniques of surface modification is evinced by the large number of studies in recent decades. In this work the internal surfaces of polymeric membranes of ultra high molecular weight polyethylene (UHMWPE) were modified by impregnation of HDPE/organoclay/PE-g-MA nanocomposite film. The addition of PE-g-MA aims to increase polymer/clay interaction and to control and/or modify surface characteristics of UHMWPE membranes, such as permeability and pore size, so as to make the membranes more efficient and/or appropriate for effluent treatment, more specifically in the treatment of oil contaminated water. The films were analyzed by infrared spectroscopy (FTIR), the modified membranes were characterized by scanning electron microscopy (SEM) and their performance (permeate flux and selectivity) were measured using distilled water and an oil in water dispersion. (author)
International Nuclear Information System (INIS)
Heredia, Vasco; Ramalho, Miguel; Zapparoli, Mauricio; Semelka, Richard C.
2010-01-01
Background: Multidetector computed tomography (MDCT) has become the first-line modality for imaging patients with suspected pulmonary embolism (PE). The disadvantages of MDCT, the use of ionizing radiation and iodinated contrast agents, are a reasonable cause of concern, especially in young patients, and therefore it is critical to understand the likelihood of PE in these patients to evaluate a risk benefit analysis. Purpose: To calculate the incidence of PE and other chest findings on MDCT in a young adult population investigated for PE. Material and Methods: 387 consecutive patients (age 31.5±13.5 years) underwent chest MDCT for clinically suspected PE between January 2004 and August 2006. Incidence of PE and other chest findings were calculated with a confidence interval of 95% using binomial distribution. Results: PE incidence was 5%; negative PE with other chest findings was 60%. In 89% of the patients with other chest findings, these included findings of the pleura and/or lung parenchyma. The main patterns of disease were lung opacification suggesting pneumonia (41%), atelectasis (12.4%), and nodular/mass findings (17.5%). In 34% of the patients, there was no PE and no other findings present. Conclusion: There is a low incidence of PE in young patients imaged for PE with MDCT
International Nuclear Information System (INIS)
Ralls, P.W.; Colletti, P.M.; Halls, J.M.; Siemsen, J.K.
1982-01-01
Prospective analysis of the efficacy of /sup 99m/Tc-IDA cholescintigraphy and cholecystosonography showed that both are excellent techniques for assessing patients with suspected acute cholecystitis (accuracy 84.7% and 88.1% respectively). Consequently, the choice of tests selected to evaluate patients with suspected acute cholecystitis depends on several factors including; (a.) quality of equipment available; (b.) capability of the technologist performing the examination; (c.) relative experience of the physician supervising the examination; and (d.) willingness of the surgical consultant to accept a positive examination as sufficient evidence to perform emergency surgery. The authors feel that cholecystosonography should be used to assess the presence of acute cholecystitis in jaundiced patients because of its capability in the assessment of bile duct dilatation, and because of the lower reliability of cholescintigraphy when bile duct obstruction is possible (i.e., in jaundice). Ancillary findings in cholecystosonography and cholescintigraphy can aid in the differential diagnosis of acute right upper quandrant pain syndromes
International Nuclear Information System (INIS)
Ralls, P.W.; Colletti, P.M.; Halls, J.M.; Siemsen, J.K.
1982-01-01
Prospective analysis of the efficacy of 99 /sup m/Tc-IDA cholescintigraphy and cholecystosonography showed that both are excellent techniques for assessing patients with suspected acute cholecystitis (accuracy 84.7% and 88.1% respectively). Consequently, the choice of tests selected to evaluate patients with suspected acute cholecystitis depends on several factors, including; (a.) quality of equipment available; (b.) capability of the technologist performing the examination; (c.) relative experience of the physician supervising the examination; and (d.) willingness of the surgical consultant to accept a positive examination as sufficient evidence to perform emergency surgery. The authors feel that cholecystosonography should be used to asses the presence of acute cholecystitis in jaundiced patients because of its capability in the assessment of bile duct dilation, and because of the lower reliability of cholescintigraphy when bile duct obstruction is possible (i.e., in jaundice). Ancillary findings in cholecystosonography and cholescintigraphy can aid in the differential diagnosis of acute right upper quadrant pain syndromes
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Branco Luis M
2011-10-01
Full Text Available Abstract Background Lassa fever (LF is a devastating hemorrhagic viral disease that is endemic to West Africa and responsible for thousands of human deaths each year. Analysis of humoral immune responses (IgM and IgG by antibody-capture ELISA (Ab-capture ELISA and Lassa virus (LASV viremia by antigen-capture ELISA (Ag-capture ELISA in suspected patients admitted to the Kenema Government Hospital (KGH Lassa Fever Ward (LFW in Sierra Leone over the past five years is reshaping our understanding of acute LF. Results Analyses in LF survivors indicated that LASV-specific IgM persists for months to years after initial infection. Furthermore, exposure to LASV appeared to be more prevalent in historically non-endemic areas of West Africa with significant percentages of reportedly healthy donors IgM and IgG positive in LASV-specific Ab-capture ELISA. We found that LF patients who were Ag positive were more likely to die than suspected cases who were only IgM positive. Analysis of metabolic and immunological parameters in Ag positive LF patients revealed a strong correlation between survival and low levels of IL-6, -8, -10, CD40L, BUN, ALP, ALT, and AST. Despite presenting to the hospital with fever and in some instances other symptoms consistent with LF, the profiles of Ag negative IgM positive individuals were similar to those of normal donors and nonfatal (NF LF cases, suggesting that IgM status cannot necessarily be considered a diagnostic marker of acute LF in suspected cases living in endemic areas of West Africa. Conclusion Only LASV viremia assessed by Ag-capture immunoassay, nucleic acid detection or virus isolation should be used to diagnose acute LASV infection in West Africans. LASV-specific IgM serostatus cannot be considered a diagnostic marker of acute LF in suspected cases living in endemic areas of West Africa. By applying these criteria, we identified a dysregulated metabolic and pro-inflammatory response profile conferring a poor
Branco, Luis M; Grove, Jessica N; Boisen, Matt L; Shaffer, Jeffrey G; Goba, Augustine; Fullah, Mohammed; Momoh, Mambu; Grant, Donald S; Garry, Robert F
2011-10-24
Lassa fever (LF) is a devastating hemorrhagic viral disease that is endemic to West Africa and responsible for thousands of human deaths each year. Analysis of humoral immune responses (IgM and IgG) by antibody-capture ELISA (Ab-capture ELISA) and Lassa virus (LASV) viremia by antigen-capture ELISA (Ag-capture ELISA) in suspected patients admitted to the Kenema Government Hospital (KGH) Lassa Fever Ward (LFW) in Sierra Leone over the past five years is reshaping our understanding of acute LF. Analyses in LF survivors indicated that LASV-specific IgM persists for months to years after initial infection. Furthermore, exposure to LASV appeared to be more prevalent in historically non-endemic areas of West Africa with significant percentages of reportedly healthy donors IgM and IgG positive in LASV-specific Ab-capture ELISA. We found that LF patients who were Ag positive were more likely to die than suspected cases who were only IgM positive. Analysis of metabolic and immunological parameters in Ag positive LF patients revealed a strong correlation between survival and low levels of IL-6, -8, -10, CD40L, BUN, ALP, ALT, and AST. Despite presenting to the hospital with fever and in some instances other symptoms consistent with LF, the profiles of Ag negative IgM positive individuals were similar to those of normal donors and nonfatal (NF) LF cases, suggesting that IgM status cannot necessarily be considered a diagnostic marker of acute LF in suspected cases living in endemic areas of West Africa. Only LASV viremia assessed by Ag-capture immunoassay, nucleic acid detection or virus isolation should be used to diagnose acute LASV infection in West Africans. LASV-specific IgM serostatus cannot be considered a diagnostic marker of acute LF in suspected cases living in endemic areas of West Africa. By applying these criteria, we identified a dysregulated metabolic and pro-inflammatory response profile conferring a poor prognosis in acute LF. In addition to suggesting that the
Dynamic behavior of PE-HD pipes grade
Czech Academy of Sciences Publication Activity Database
Trnka, Jan; Buchar, Jaroslav; Nezbedová, E.
2017-01-01
Roč. 373, č. 1 (2017), č. článku 1700038. ISSN 1022-1360 R&D Projects: GA MŠk(CZ) EF15_003/0000493 Institutional support: RVO:61388998 Keywords : dynamic behavior * PE-HD * split Hopkinson pressure bar test * strain rate Subject RIV: JI - Composite Materials OBOR OECD: Composites (including laminates, reinforced plastics, cermets, combined natural and synthetic fibre fabrics http://onlinelibrary.wiley.com/doi/10.1002/masy.201700038/full
Time delay of the PeV gamma ray burst after the October 1985 radio flare of Cygnus X-3
Energy Technology Data Exchange (ETDEWEB)
Berezinsky, V S
1988-08-11
Cygnus X-3 remains a puzzling and controversial source of ultra-high-energy radiation, E greater than or equal to 0.1 PeV. In existing data, TeV and sometimes PeV radiation has been seen episodically; such an episode is connected with the radio flare of Cyg X-3 in October 1985, when PeV radiation with no phase structure was seen. The PeV pulse was detected 3-5 days after the radio flare. The author proposes a natural explanation for the delay, in which gamma-photons of PeV energy are absorbed by radio radiation inside the source. After a delay, the gamma radiation emerges as the radio flux diminishes and absorption decreases.
Final report of the Peña Blanca natural analogue project
Energy Technology Data Exchange (ETDEWEB)
Levy, Schön S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Goldstein, Steven Joel [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Abdel-Fattah, Amr I. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Amato, Ronald S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Anthony, Elizabeth [Univ. of Texas, El Paso, TX (United States); Cook, Paul [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Dobson, Patrick F. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fayek, Mostafa [Univ. of Manitoba, Winnipeg (Canada); French, Diana [Univ. of Texas, El Paso, TX (United States); Garza, Rodrigo de [Univ. Autonoma de Chihuahua (Mexico); Ghezzehei, Teamrat [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goodell, Philip C. [Univ. of Texas, El Paso, TX (United States); Harder, Steven H. [Univ. of Texas, El Paso, TX (United States); Ku, Teh-Lung [Univ. of Southern California, Los Angeles, CA (United States); Luo, Shangde [Univ. of Southern California, Los Angeles, CA (United States); Murrell, Michael Tildon [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Norman, Deborah E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Nunn, Andrew J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Oliver, Ronald [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Pekar-Carpenter, Katrina [Univ. of Texas, El Paso, TX (United States); Rearick, Michael Sean [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Ren, Minghua [Univ. of Texas, El Paso, TX (United States); Reyes-Cortes, Ignacio [Univ. Autonoma de Chihuahua (Mexico); Pineda, Jose Alfredo [El Instituto de Ecologia (INECOL) (Mexico); Saulnier, George [AREVA Federal Services LLC, Charlotte, NC (United States); Tarimala, Sowmitri [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Walton, John [Univ. of Texas, El Paso, TX (United States)
2016-10-04
The Peña Blanca region, 50 km north of Chihuahua City, Chihuahua, México, was a target of uranium exploration and mining by the Mexican government. After mining ceased in 1981, researchers became interested in this region as a study area for subsurface uranium migration with relevance to geologic disposal of nuclear waste. Many studies related to this concept were conducted at the Nopal I mine site located on a cuesta (hill) of the Sierra Peña Blanca. This site has geologic, tectonic, hydrologic, and geochemical similarities to Yucca Mountain, Nevada, a formerly proposed site for a high-level nuclear-waste repository in the unsaturated zone. The U.S. Department of Energy (U.S. DOE), Office of Civilian Radioactive Waste Management (OCRWM), sponsored studies at Nopal I in the 1990s and supported the drilling of three research wells – PB1, PB2, and PB3 – at the site in 2003. Beginning in 2004, the Peña Blanca Natural Analogue Project was undertaken by U.S. DOE, OCRWM to develop a three-dimensional conceptual model of the transport of uranium and its radiogenic daughter products at the Nopal I site.
Computed Tomography Perfusion Improves Diagnostic Accuracy in Acute Posterior Circulation Stroke.
Sporns, Peter; Schmidt, Rene; Minnerup, Jens; Dziewas, Rainer; Kemmling, André; Dittrich, Ralf; Zoubi, Tarek; Heermann, Philipp; Cnyrim, Christian; Schwindt, Wolfram; Heindel, Walter; Niederstadt, Thomas; Hanning, Uta
2016-01-01
Computed tomography perfusion (CTP) has a high diagnostic value in the detection of acute ischemic stroke in the anterior circulation. However, the diagnostic value in suspected posterior circulation (PC) stroke is uncertain, and whole brain volume perfusion is not yet in widespread use. We therefore studied the additional value of whole brain volume perfusion to non-contrast CT (NCCT) and CT angiography source images (CTA-SI) for infarct detection in patients with suspected acute ischemic PC stroke. This is a retrospective review of patients with suspected stroke in the PC in a database of our stroke center (n = 3,011) who underwent NCCT, CTA and CTP within 9 h after stroke onset and CT or MRI on follow-up. Images were evaluated for signs and pc-ASPECTS locations of ischemia. Three imaging models - A (NCCT), B (NCCT + CTA-SI) and C (NCCT + CTA-SI + CTP) - were compared with regard to the misclassification rate relative to gold standard (infarction in follow-up imaging) using the McNemar's test. Of 3,011 stroke patients, 267 patients had a suspected stroke in the PC and 188 patients (70.4%) evidenced a PC infarct on follow-up imaging. The sensitivity of Model C (76.6%) was higher compared with that of Model A (21.3%) and Model B (43.6%). CTP detected significantly more ischemic lesions, especially in the cerebellum, posterior cerebral artery territory and thalami. Our findings in a large cohort of consecutive patients show that CTP detects significantly more ischemic strokes in the PC than CTA and NCCT alone. © 2016 S. Karger AG, Basel.
Morphology and parameters of crystallization the blend PE/Epoxy/PE-co-PEG
International Nuclear Information System (INIS)
Becker, Daniela; Coelho, Luiz Antonio Ferreira; Nack, Fernanda; Silva, Bruna Louise
2014-01-01
This study aims to evaluate the morphology and crystallization parameters of high density polyethylene (HDPE) with different concentrations of epoxy (DGEBA / OTBG), and the compatibility of this system was used and the copolymer polyethylene-block-poly (ethylene glycol) (PEG-co-PE). The blends were obtained by mechanical mixing on a torque rheometer (Haake). Determined the crystallization parameters of the test matrix differential scanning calorimetry (DSC) and by X-ray diffraction (XRD). The morphology of the system was analyzed by transmission electron microscopy (TEM). It was observed by XRD analysis that the addition of compatibilizer and epoxy resins do not interfere with the crystal structure of HDPE, indicating that the increase in crystallinity associated with the crystallization kinetics. It was observed that the compatibilizing helped the adhesion, reducing the size of the dispersed phase becomes a more stable morphology and obtaining a distribution of the dispersed epoxy phase. (author)
T1 bright appendix sign to exclude acute appendicitis in pregnant women.
Shin, Ilah; An, Chansik; Lim, Joon Seok; Kim, Myeong-Jin; Chung, Yong Eun
2017-08-01
To evaluate the diagnostic value of the T1 bright appendix sign for the diagnosis of acute appendicitis in pregnant women. This retrospective study included 125 pregnant women with suspected appendicitis who underwent magnetic resonance (MR) imaging. The T1 bright appendix sign was defined as a high intensity signal filling more than half length of the appendix on T1-weighted imaging. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the T1 bright appendix sign for normal appendix identification were calculated in all patients and in those with borderline-sized appendices (6-7 mm). The T1 bright appendix sign was seen in 51% of patients with normal appendices, but only in 4.5% of patients with acute appendicitis. The overall sensitivity, specificity, PPV, and NPV of the T1 bright appendix sign for normal appendix diagnosis were 44.9%, 95.5%, 97.6%, and 30.0%, respectively. All four patients with borderline sized appendix with appendicitis showed negative T1 bright appendix sign. The T1 bright appendix sign is a specific finding for the diagnosis of a normal appendix in pregnant women with suspected acute appendicitis. • Magnetic resonance imaging is increasingly used in emergency settings. • Acute appendicitis is the most common cause of acute abdomen. • Magnetic resonance imaging is widely used in pregnant population. • T1 bright appendix sign can be a specific sign representing normal appendix.
Molecular Cloning and Functional Analysis of UV RESISTANCE LOCUS 8 (PeUVR8 from Populus euphratica.
Directory of Open Access Journals (Sweden)
Ke Mao
Full Text Available Ultraviolet-B (UV-B; 280-315 nm light, which is an integral part of the solar radiation reaching the surface of the Earth, induces a broad range of physiological responses in plants. The UV RESISTANCE LOCUS 8 (UVR8 protein is the first and only light photoreceptor characterized to date that is specific for UV-B light and it regulates various aspects of plant growth and development in response to UV-B light. Despite its involvement in the control of important plant traits, most studies on UV-B photoreceptors have focused on Arabidopsis and no data on UVR8 function are available for forest trees. In this study, we isolated a homologue of the UV receptor UVR8 of Arabidopsis, PeUVR8, from Populus euphratica (Euphrates poplar and analyzed its structure and function in detail. The deduced PeUVR8 amino acid sequence contained nine well-conserved regulator of chromosome condensation 1 (RCC1 repeats and the region 27 amino acids from the C terminus (C27 that interact with COP1 (CONSTITUTIVELY PHOTOMORPHOGENIC1. Secondary and tertiary structure analysis showed that PeUVR8 shares high similarity with the AtUVR8 protein from Arabidopsis thaliana. Using heterologous expression in Arabidopsis, we showed that PeUVR8 overexpression rescued the uvr8 mutant phenotype. In addition, PeUVR8 overexpression in wild-type background seedlings grown under UV-B light inhibited hypocotyl elongation and enhanced anthocyanin accumulation. Furthermore, we examined the interaction between PeUVR8 and AtCOP1 using a bimolecular fluorescence complementation (BiFC assay. Our data provide evidence that PeUVR8 plays important roles in the control of photomorphogenesis in planta.
Gao, Pei; Zhang, Xiangyu; Wang, Hongzhi; Zhang, Qinghong; Li, He; Li, Yaogang; Duan, Yourong
2015-01-01
Calcium phosphate nanoparticles are safe and effective delivery vehicles for small interfering RNA (siRNA), as a result of their excellent biocompatibility. In this work, mPEG-PE (polyethylene glycol-L-?-phosphatidylethanolamine) was synthesized and used to prepare nanoparticles composed of mPEG-PE and calcium phosphate for siRNA delivery. Calcium phosphate and mPEG-PE formed the stable hybrid nanoparticles through self-assembly resulting from electrostatic interaction in water. The average s...
Torsion of an Epiploic Appendix Pretending as Acute Appendicitis
Directory of Open Access Journals (Sweden)
Kamran Ahmad Malik
2010-07-01
Full Text Available Torsion of an epiploic appendix is a rare surgical entity. Its unusual symptomatology, wide variation in physical findings and the absence of helpful laboratory and radiological studies makes it very difficult to diagnose pre-operatively. This is a report of this rare entity found in a patient upon diagnostic laparoscopy performed for suspected acute appendicitis
Strategies for diagnosis and treatment of suspected leptospirosis: a cost-benefit analysis.
Directory of Open Access Journals (Sweden)
Yupin Suputtamongkol
Full Text Available BACKGROUND: Symptoms and signs of leptospirosis are non-specific. Several diagnostic tests for leptospirosis are available and in some instances are being used prior to treatment of leptospirosis-suspected patients. There is therefore a need to evaluate the cost-effectiveness of the different treatment strategies in order to avoid misuse of scarce resources and ensure best possible health outcomes for patients. METHODS: The study population was adult patients, presented with uncomplicated acute febrile illness, without an obvious focus of infection or malaria or typical dengue infection. We compared the cost and effectiveness of 5 management strategies: 1 no patients tested or given antibiotic treatment; 2 all patients given empirical doxycycline treatment; patients given doxycycline when a patient is tested positive for leptospirosis using: 3 lateral flow; 4 MCAT; 5 latex test. The framework used is a cost-benefit analysis, accounting for all direct medical costs in diagnosing and treating patients suspected of leptospirosis. Outcomes are measured in length of fever after treatment which is then converted to productivity losses to capture the full economic costs. FINDINGS: Empirical doxycycline treatment was the most efficient strategy, being both the least costly alternative and the one that resulted in the shortest duration of fever. The limited sensitivity of all three diagnostic tests implied that their use to guide treatment was not cost-effective. The most influential parameter driving these results was the cost of treating patients with complications for patients who did not receive adequate treatment as a result of incorrect diagnosis or a strategy of no-antibiotic-treatment. CONCLUSIONS: Clinicians should continue treating suspected cases of leptospirosis on an empirical basis. This conclusion holds true as long as policy makers are not prioritizing the reduction of use of antibiotics, in which case the use of the latex test would be
PeTTSy: a computational tool for perturbation analysis of complex systems biology models.
Domijan, Mirela; Brown, Paul E; Shulgin, Boris V; Rand, David A
2016-03-10
Over the last decade sensitivity analysis techniques have been shown to be very useful to analyse complex and high dimensional Systems Biology models. However, many of the currently available toolboxes have either used parameter sampling, been focused on a restricted set of model observables of interest, studied optimisation of a objective function, or have not dealt with multiple simultaneous model parameter changes where the changes can be permanent or temporary. Here we introduce our new, freely downloadable toolbox, PeTTSy (Perturbation Theory Toolbox for Systems). PeTTSy is a package for MATLAB which implements a wide array of techniques for the perturbation theory and sensitivity analysis of large and complex ordinary differential equation (ODE) based models. PeTTSy is a comprehensive modelling framework that introduces a number of new approaches and that fully addresses analysis of oscillatory systems. It examines sensitivity analysis of the models to perturbations of parameters, where the perturbation timing, strength, length and overall shape can be controlled by the user. This can be done in a system-global setting, namely, the user can determine how many parameters to perturb, by how much and for how long. PeTTSy also offers the user the ability to explore the effect of the parameter perturbations on many different types of outputs: period, phase (timing of peak) and model solutions. PeTTSy can be employed on a wide range of mathematical models including free-running and forced oscillators and signalling systems. To enable experimental optimisation using the Fisher Information Matrix it efficiently allows one to combine multiple variants of a model (i.e. a model with multiple experimental conditions) in order to determine the value of new experiments. It is especially useful in the analysis of large and complex models involving many variables and parameters. PeTTSy is a comprehensive tool for analysing large and complex models of regulatory and
Directory of Open Access Journals (Sweden)
Thomas Nash
2013-06-01
Full Text Available Shavers, B. (2013. Placing the Suspect behind the Keyboard: Using Digital Forensics and Investigative Techniques to Identify Cybercrime Suspects. Waltham, MA: Elsevier, 290 pages, ISBN-978-1-59749-985-9, US$51.56. Includes bibliographical references and index.Reviewed by Detective Corporal Thomas Nash (tnash@bpdvt.org, Burlington Vermont Police Department, Internet Crime against Children Task Force. Adjunct Instructor, Champlain College, Burlington VT.In this must read for any aspiring novice cybercrime investigator as well as the seasoned professional computer guru alike, Brett Shaver takes the reader into the ever changing and dynamic world of Cybercrime investigation. Shaver, an experienced criminal investigator, lays out the details and intricacies of a computer related crime investigation in a clear and concise manner in his new easy to read publication, Placing the Suspect behind the Keyboard. Using Digital Forensics and Investigative techniques to Identify Cybercrime Suspects. Shaver takes the reader from start to finish through each step of the investigative process in well organized and easy to follow sections, with real case file examples to reach the ultimate goal of any investigation: identifying the suspect and proving their guilt in the crime. Do not be fooled by the title. This excellent, easily accessible reference is beneficial to both criminal as well as civil investigations and should be in every investigator’s library regardless of their respective criminal or civil investigative responsibilities.(see PDF for full review
T1 bright appendix sign to exclude acute appendicitis in pregnant women
International Nuclear Information System (INIS)
Shin, Ilah; An, Chansik; Lim, Joon Seok; Kim, Myeong-Jin; Chung, Yong Eun
2017-01-01
To evaluate the diagnostic value of the T1 bright appendix sign for the diagnosis of acute appendicitis in pregnant women. This retrospective study included 125 pregnant women with suspected appendicitis who underwent magnetic resonance (MR) imaging. The T1 bright appendix sign was defined as a high intensity signal filling more than half length of the appendix on T1-weighted imaging. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the T1 bright appendix sign for normal appendix identification were calculated in all patients and in those with borderline-sized appendices (6-7 mm). The T1 bright appendix sign was seen in 51% of patients with normal appendices, but only in 4.5% of patients with acute appendicitis. The overall sensitivity, specificity, PPV, and NPV of the T1 bright appendix sign for normal appendix diagnosis were 44.9%, 95.5%, 97.6%, and 30.0%, respectively. All four patients with borderline sized appendix with appendicitis showed negative T1 bright appendix sign. The T1 bright appendix sign is a specific finding for the diagnosis of a normal appendix in pregnant women with suspected acute appendicitis. (orig.)
T1 bright appendix sign to exclude acute appendicitis in pregnant women
Energy Technology Data Exchange (ETDEWEB)
Shin, Ilah; An, Chansik; Lim, Joon Seok; Kim, Myeong-Jin; Chung, Yong Eun [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Severance Hospital, 50-1 Yonsei-ro, Seodaemun-gu, Seoul (Korea, Republic of)
2017-08-15
To evaluate the diagnostic value of the T1 bright appendix sign for the diagnosis of acute appendicitis in pregnant women. This retrospective study included 125 pregnant women with suspected appendicitis who underwent magnetic resonance (MR) imaging. The T1 bright appendix sign was defined as a high intensity signal filling more than half length of the appendix on T1-weighted imaging. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the T1 bright appendix sign for normal appendix identification were calculated in all patients and in those with borderline-sized appendices (6-7 mm). The T1 bright appendix sign was seen in 51% of patients with normal appendices, but only in 4.5% of patients with acute appendicitis. The overall sensitivity, specificity, PPV, and NPV of the T1 bright appendix sign for normal appendix diagnosis were 44.9%, 95.5%, 97.6%, and 30.0%, respectively. All four patients with borderline sized appendix with appendicitis showed negative T1 bright appendix sign. The T1 bright appendix sign is a specific finding for the diagnosis of a normal appendix in pregnant women with suspected acute appendicitis. (orig.)
International Nuclear Information System (INIS)
Bokhari, S.N.H.; Naeem, M.
2002-01-01
Objective: A number of supportive laboratory tests such as ECG, Chest x-ray, ABGs SLDH, SGOT, S. Bilirubin and D-dimer with variable sensitivity and specificity are available to facilitate the clinical diagnosis of acute Pulmonary Embolism (PE). Serum Angiotensin Converting Enzyme (SACE) which is produced mainly by the pulmonary vascular endothelial cells, is found altered during a variety of diffuse lung diseases. This study was designed to evaluate the validity of SACE level as a marker for hypoxic damage to the pulmonary endothelium in PE. Design: A prospective study carried out on forty patients with high clinical suspicion of PE. Besides routine diagnostic tests mentioned above all of them had ventilation Perfusion isotope (v/q) scans (as a diagnostic test) and SACE level checked. Setting: Shaikh Zayed Hospital Lahore. Results: Among forty consecutive patients with age range 25-59 years (mean: 42 Yr). Twenty six patients (65%) with abnormal scans reported as High probability were included in group-A (True Positive), whereas 14(35)% patients having low-probability (suspected or Normal scan were included in group-b, low SACE level (<28iu/l) was found in 19/26 (sensitivity of 73% in group-A (positive Predictive Value: 47%) and 9/14(sensitivity of 64%) in Group-B. Whereas mean levels for both groups were 34.55 and 54.84 respectively. Rise in LDH was pronounced in group A. Only chest x-ray and ECGS were found to be more sensitive for group-A than group-B. Changes in ABGs (type-1 resp. Failure) had low sensitivity. Conclusion: Among clinically suspected cases of PE, fall in SACE level can be used as a sensitive and reliable diagnostic marker as more than 75% of the enzyme in produced in the lungs compared with other enzymes which have extra-pulmonary source. (author)
International Nuclear Information System (INIS)
Pandiyaraj, Krishnasamy Navaneetha; Yoganand, Paramasivam; Selvarajan, Vengatasamy; Deshmukh, Rajendrasing R.; Balasubramanian, Suresh; Maruthamuthu, Sundaram
2013-01-01
The present work deals with the change in surface properties of polyethylene (PE) film using DC low pressure glow discharge air plasma and makes it useful for technical applications. The change in hydrophilicity of the modified PE film surface was investigated by measuring contact angle and surface energy as a function of exposure time. Changes in the morphological and chemical composition of PE films were analyzed by atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS). The improvement in adhesion was studied by measuring T-peel and lap-shear strength. The results show that the wettability and surface energy of the PE film has been improved due to the introduction of oxygen-containing polar groups and an increase in surface roughness. The XPS result clearly shows the increase in concentration of oxygen content and the formation of polar groups on the polymer surface. The AFM observation on PE film shows that the roughness of the surface increased due to plasma treatment. The above morphological and chemical changes enhanced the adhesive properties of the PE film surfaces, which was confirmed by T-peel and lap-shear tests.
Tsai, Richard; Raptis, Constantine; Fowler, Kathryn J; Owen, Joseph W; Mellnick, Vincent M
2017-11-01
To determine the degree of interradiologist agreement between the MRI features of appendicitis during pregnancy, the outcomes associated with an indeterminate interpretation and the negative predictive value of non-visualization of the appendix. Our study was approved by the institutional review board at the Washington University in St. Louis, Missouri (WUStL) and was HIPAA (Health Insurance Portability and Accountability Act of 1996)-compliant. The informed consent requirement was waived. Cases of suspected appendicitis during pregnancy evaluated using MRI were retrospectively identified using search queries. Scans were re-reviewed by two radiologists (7 and 9 years experience, respectively) to evaluate the interradiologist agreement of different MRI features of appendicitis during pregnancy (visualization of the appendix, appendiceal diameter, appendiceal wall thickening, periappendiceal fat stranding, fluid-filled appendix and periappendiceal fluid). The radiologists were blinded to patient outcome, patient intervention, laboratory data, demographic data and the original MRI reports. Clinical outcomes were documented by surgical pathology or clinical observation. Interradiologist agreement was analysed using Cohen's κ, while patient demographic and clinical data was analysed using Student's t-testing. 233 females with suspected appendicitis during pregnancy were evaluated using MRI over a 13-year period (mean age, 28.4 years; range, 17-38 years). There were 14 (6%) positive examinations for appendicitis during pregnancy, including 1 patient whose MRI was interpreted as negative, proven by surgical pathology. The presence of periappendiceal soft-tissue stranding and the final overall impression had the most interradiologist agreement (к = 0.81-1). There were no pregnant patients found to have acute appendicitis who had an indeterminate MR interpretation or when the appendix could not be visualized. The final impression by the two retrospectively reviewing
Cardiac computed tomography in patients with acute coronary syndrome
International Nuclear Information System (INIS)
Schlett, C.L.; Bamberg, F.
2014-01-01
Currently, cardiac computed tomography (CT) is increasingly being implemented into clinical algorithms, primarily due to substantial technical advances over the last decade. Its use in the setting of suspected acute coronary syndrome is of particular relevance, given the high degree of accumulating scientific evidence of improving patient outcomes. Performing cardiac CT requires specific knowledge on the available scan acquisitions and patient preparation. Also, expertise is required in order to interpret the coronary and extra-coronary findings adequately. The present article provides an overview of the different aspects on the use of cardiac CT in the setting of acute coronary syndrome.
van Aart, I.; Hartman, E.; Elferink-Gemser, M.; Mombarg, R.; Visscher, C.
Background: Many children aged 9-12 appear to have low levels of fundamental movement skills (FMS). Physical education (PE) is important because PE-teachers can teach children a variety of FMS and can influence PE-motivation. However, declined levels of PE-motivation are reported in the final grades
International Nuclear Information System (INIS)
Kurth, M.
1990-01-01
Ultra high molecular weight polyethylene (PE-UHMW) is used in most artificial joint replacement devices. Prior to implantation in biological environment, radiatin sterilization by 60 Co or electron beam is common. It is well known that polyethylene exposed to ionizing radiation of any sort undergo physical changes due to chain scission and/or crosslinking. PE-UHMW sheets, 8 mm thick, were either 60 Co or electron beam irradiated, in the range of 10-150 kGy under air or nitrogen atmoshere. The crystallinity of the irradiated samples increases with the irradiation dose. The chain scission/crosslinking events ratio determine the network structure and the sol/gel ratio. The latter was found to depend on irradiation dose, radiation atmosphere and sample thickness. Moreover 60 Co-irradiation is about 5 times more effective in forming PE-UHMW gel than electron-irradiation. Besides the degree of crosslinking, the molecular weight distribution is the main determinant of the structural properties of PE-UHMW. Low molecular weight fractions were also found. Using a dose of 30 kGy ( 60 Co in air), the average molecular weight of the soluble part after extraction decreased from originally 2.3 million g/mol to 170.000 g/mol, corresponding to a factor of about 10. These changes in molecular weight have a strong influence on the mechanical properties of PE-UHMW. Crosslinking slightly increases the yield strength, while the elongation at break decreases. Long-term compressive creep is reduced if the material is irradiated. Obviously, increased crystallinity after oxidative chain scission affects a higher deformation resistance. Radiation crosslinked structures cause a significant increase in abrasion resistance. The above described structural changes occur even upon irradiation of very low doses as used during sterilization. This study will enable to reduce the radiation sterilization damage and thus to gain long term stability of PE-UHMW medical devices. (orig./BBR)
PET imaging of dopamine transporters with [18F]FE-PE2I: Effects of anti-Parkinsonian drugs
International Nuclear Information System (INIS)
Bang, Ji-In; Jung, In Soon; Song, Yoo Sung; Park, Hyun Soo; Moon, Byung Seok; Lee, Byung Chul; Kim, Sang Eun
2016-01-01
Purpose: This study aimed to assess the striatal [ 18 F]FE-PE2I binding and the immunohistochemical stain of tyrosine hydroxylase (TH) in the striatum, and to evaluate the effects of therapeutic drugs on [ 18 F]FE-PE2I binding. Methods: Dynamic PET/CT of [ 18 F]FE-PE2I was performed in Parkinson’s disease (PD) rat models, induced by the unilateral injection of 6-OHDA into the striatum. A simplified reference tissue model method was used to calculate the striatal binding potential (striatal BP ND ). Each of the four normal rats was pretreated with pramipexole, amantadine, and escitalopram 30 min before [ 18 F]FE-PE2I injection. The effect of L-DOPA combined with benserazide was assessed in the normal and PD rats. Results: The BP ND was significantly lower in the lesioned striatum than in the striatum of the normal rats. After the pretreatment with pramipexole, amantadine, and escitalopram, the values of the striatal BP ND did not differ from those of the controls. The pretreatment with L-DOPA/benserazide, however, significantly reduced the striatal BP ND . The striatal BP ND of the PD rats with L-DOPA/benserazide pretreatment was not different from that of the same PD rats with placebo treatment. Conclusion: [ 18 F]FE-PE2I may be used as a radioligand for the in-vivo imaging of the DAT. In the normal rats, [ 18 F]FE-PE2I binding is unaffected by pramipexole, amantadine, and escitalopram. L-DOPA/benserazide does not affect the striatal [ 18 F]FE-PE2I binding in PD rats
MELAS syndrome presenting as an acute surgical abdomen.
Dindyal, S; Mistry, K; Angamuthu, N; Smith, G; Hilton, D; Arumugam, P; Mathew, J
2014-01-01
MELAS (mitochondrial cytopathy, encephalomyopathy, lactic acidosis and stroke-like episodes) is a syndrome in which signs and symptoms of gastrointestinal disease are uncommon if not rare. We describe the case of a young woman who presented as an acute surgical emergency, diagnosed as toxic megacolon necessitating an emergency total colectomy. MELAS syndrome was suspected postoperatively owing to persistent lactic acidosis and neurological symptoms. The diagnosis was later confirmed with histological and genetic studies. This case highlights the difficulties in diagnosing MELAS because of its unpredictable presentation and clinical course. We therefore recommend a high index of suspicion in cases of an acute surgical abdomen with additional neurological features or raised lactate.
Unilateral RS3PE in a Patient of Seronegative Rheumatoid Arthritis
Directory of Open Access Journals (Sweden)
Ankur Nandan Varshney
2013-01-01
Full Text Available Remitting seronegative symmetrical synovitis with pitting edema (RS3PE is a rare but well-reported clinical entity. It is classically described as symmetrical involvement of both upper extremities. Asymmetrical involvement had also been reported, but unilateral presentation is very rare. We hereby report a case of unilateral RS3PE in a patient of seronegative rheumatoid arthritis which was initially misdiagnosed as cellulitis and was given high dose antibiotics without any significant improvement. Later a rheumatologic consultation leads to a prompt diagnosis, and treatment with steroids leads to dramatic reversal of symptoms. This case demonstrates the rare presentation of this rare clinical entity and highlights the necessity of awareness regarding unilateral disease to clinicians.
Horii-Hayashi, Noriko; Nishi, Mayumi
2018-02-27
Although the hypothalamus is classified into more than 10 compartments, it still contains uncharacterized areas. In this study, we identified a new triangular-shaped area between the paraventricular hypothalamic nucleus (PVN) and the fornix area in the mouse anterior hypothalamus, which is enriched in chondroitin sulfate proteoglycans (CSPGs). We designated this region as the perifornical area of the anterior hypothalamus (PeFAH) based on its anatomical location. As evidenced by Nissl staining, the PeFAH was distinguishable as an area of relatively low density. Immunohistochemical and DNA microarray analyses indicated that PeFAH contains sparsely distributed calretinin-positive neurons and densely clustered enkephalin-positive neurons. Furthermore, the PeFAH was shown to have bidirectional neural connections with the lateral septum. Indeed, we confirmed enkephalinergic projections from PeFAH neurons to the lateral septum, and inversely, calbindin-positive lateral septum neurons as afferents to the PeFAH. Finally, c-Fos expression analysis revealed that the activity of certain PeFAH neuronal populations tended to be increased by psychological stressors, but not that of enkephalinergic neurons. We proposed PeFAH as a new region in the AH.
Disinfection in Wastewater Treatment Plants: Evaluation of Effectiveness and Acute Toxicity Effects
Directory of Open Access Journals (Sweden)
Maria Cristina Collivignarelli
2017-09-01
Full Text Available In Italy, urban wastewater disinfection is regulated in the third part of Legislative Decree n. 152/2006, which states that wastewater treatment plants (WWTPs must include a disinfection unit, with a capacity exceeding 2000 Population Equivalent (PE. This treatment shall ensure microbial quality and health security. The legislation provides the following limits for wastewater: Escherichia coli (E. coli concentration below 5000 CFU 100 mL−1 (recommended value, active chlorine concentration below 0.2 mg L−1 and lack of acute toxicity. The compliance with these conditions is shown by means of the study of correct disinfectant dosage, which also depends on wastewater characteristics. An investigation at the regional level (from 2013 to 2016 shows a correlation between acute toxicity discharge and disinfection treatment through chemical reagents (mainly with the use of chlorine compounds and peracetic acid. The experimental work concerns two active sludge WWTPs in northern Italy with small capacity (10,000–12,000 PE. The activities provide the assessment of microbiological quality and toxicity of WWTPs effluents in relation to the dosage of sodium hypochlorite and peracetic acid, by means of the use of batch tests. The results show that with similar disinfectant dosage and comparable initial E. coli concentration, peracetic acid exhibits the best performance in terms of microbial removal (with removal yields up to 99.99%. Moreover, the acute toxicity was evident at higher doses and therefore with higher residuals of peracetic acid (2.68 mg L−1 compared to the free residual chlorine (0.17 mg L−1.
Aspectos discursivos em As Bruxas de Salem: peça e filme
Pinheiro, Eder Sergio
2009-01-01
Esta pesquisa, cujo título é Aspectos Discursivos em As Bruxas de Salem: eça e Filme, propõe discutir a transposição da linguagem escrita, neste caso, as rubricas da peça de teatro para a linguagem fílmica, devido a problemática das duas linguagens se diferenciarem, convergirem-se e cruzarem-se ao mesmo tempo. Deste modo, dois fragmentos foram escolhidos para análise, sendo eles: um trecho da peça escrita As Bruxas de Salem (1953) e outro do filme (1976), ambos os trechos são correspondent...
Outcomes of patients calling emergency medical services for suspected acute cardiovascular disease
DEFF Research Database (Denmark)
Schoos, Mikkel Malby; Sejersten, Maria Sejersten; Baber, Usman
2015-01-01
Adequate health care is increasingly dependent on prehospital systems and cardiovascular (CV) disease remains the most common cause for hospital admission. However the prevalence of CV dispatches of emergency medical services (EMS) is not well reported and survival data described in clinical trials......, this study emphasizes the need for an efficient prehospital phase with focus on CV disease and proper triage of patients suitable for invasive evaluation if the outcomes of acute heart disease are to be improved further in the current international context of hospitals merging into highly specialized...
Proceedings of the Inaugural Pediatric Dermatology Research Alliance (PeDRA) Conference
Siegel, Dawn H.; Choate, Keith; Drolet, Beth A.; Frieden, Ilona J.; Teng, Joyce M.; Tom, Wynnis; Williams, Mary; Eichenfield, Lawrence F.; Paller, Amy S.
2014-01-01
Abstract/Statement of the problem Skin disease research involving children currently faces several major hurdles and as a result, many therapies are only available for off-label use in children and many of the most pressing clinical needs of our pediatric population remain unsolved. A strategic planning committee of the Society for Pediatric Dermatology (SPD) identified the need for an organized, inclusive research alliance to augment the resources of individual practitioners and pre-existing smaller collaborative groups and facilitate robust, multicenter basic, translational, and clinical research and therapeutic trials. A December 2011 National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Roundtable on Pediatric Dermatology further detailed the therapeutic gaps and barriers to translation of scientific advances to clinical practice. Building on these forums, in July 2012, a group of interested investigators met in Monterey, CA to develop the infrastructure for collaborative pediatric skin research, now called the Pediatric Dermatology Research Alliance (PeDRA). The vision of PeDRA is to create sustainable collaborative research networks to better understand, prevent, treat and cure dermatologic diseases in children. From that starting point, subcommittees and expert members were added, stakeholders identified, and seed funding garnered, with the first PeDRA stand-alone research meeting* realized in Chicago, IL in October 2013. PMID:25318428
Energy Technology Data Exchange (ETDEWEB)
Patel, R.; Mishkin, F.S.
1986-10-01
Technetium-99m pyrophosphate (Tc-PYP) imaging was performed in five patients with acute renal failure associated with nontraumatic rhabdomyolysis. Four patients had phencyclidine intoxication and one had viral pneumonia. During the acute phase, marked uptake of pyrophosphate was seen in all patients in several muscle groups, but always in the thigh adductors. The results show that phencyclidine intoxication can result in diffuse muscle uptake of Tc-PYP without overt evidence of muscle injury. Tc-PYP imaging may provide a clue to the cause of acute renal failure in patients with suspected rhabdomyolysis in whom elevations of serum creatine phosphokinase concentrations are equivocal.
International Nuclear Information System (INIS)
Patel, R.; Mishkin, F.S.
1986-01-01
Technetium-99m pyrophosphate (Tc-PYP) imaging was performed in five patients with acute renal failure associated with nontraumatic rhabdomyolysis. Four patients had phencyclidine intoxication and one had viral pneumonia. During the acute phase, marked uptake of pyrophosphate was seen in all patients in several muscle groups, but always in the thigh adductors. The results show that phencyclidine intoxication can result in diffuse muscle uptake of Tc-PYP without overt evidence of muscle injury. Tc-PYP imaging may provide a clue to the cause of acute renal failure in patients with suspected rhabdomyolysis in whom elevations of serum creatine phosphokinase concentrations are equivocal
PeRL: A circum-Arctic Permafrost Region Pond and Lake database
Muster, Sina; Roth, Kurt; Langer, Moritz; Lange, Stephan; Cresto Aleina, Fabio; Bartsch, Annett; Morgenstern, Anne; Grosse, Guido; Jones, Benjamin; Sannel, A.B.K.; Sjoberg, Ylva; Gunther, Frank; Andresen, Christian; Veremeeva, Alexandra; Lindgren, Prajna R.; Bouchard, Frédéric; Lara, Mark J.; Fortier, Daniel; Charbonneau, Simon; Virtanen, Tarmo A.; Hugelius, Gustaf; Palmtag, J.; Siewert, Matthias B.; Riley, William J.; Koven, Charles; Boike, Julia
2017-01-01
Ponds and lakes are abundant in Arctic permafrost lowlands. They play an important role in Arctic wetland ecosystems by regulating carbon, water, and energy fluxes and providing freshwater habitats. However, ponds, i.e., waterbodies with surface areas smaller than 1. 0 × 104 m2, have not been inventoried on global and regional scales. The Permafrost Region Pond and Lake (PeRL) database presents the results of a circum-Arctic effort to map ponds and lakes from modern (2002–2013) high-resolution aerial and satellite imagery with a resolution of 5 m or better. The database also includes historical imagery from 1948 to 1965 with a resolution of 6 m or better. PeRL includes 69 maps covering a wide range of environmental conditions from tundra to boreal regions and from continuous to discontinuous permafrost zones. Waterbody maps are linked to regional permafrost landscape maps which provide information on permafrost extent, ground ice volume, geology, and lithology. This paper describes waterbody classification and accuracy, and presents statistics of waterbody distribution for each site. Maps of permafrost landscapes in Alaska, Canada, and Russia are used to extrapolate waterbody statistics from the site level to regional landscape units. PeRL presents pond and lake estimates for a total area of 1. 4 × 106 km2 across the Arctic, about 17 % of the Arctic lowland ( s.l.) land surface area. PeRL waterbodies with sizes of 1. 0 × 106 m2 down to 1. 0 × 102 m2 contributed up to 21 % to the total water fraction. Waterbody density ranged from 1. 0 × 10 to 9. 4 × 101 km−2. Ponds are the dominant waterbody type by number in all landscapes representing 45–99 % of the total waterbody number. The implementation of PeRL size distributions in land surface models will greatly improve the investigation and projection of surface inundation and carbon fluxes in permafrost lowlands. Waterbody maps, study area
van Aart, I.; Hartman, E.; Elferink-Gemser, M.; Mombarg, R.; Visscher, C.
2017-01-01
Background: Many children aged 9-12 appear to have low levels of fundamental movement skills (FMS). Physical education (PE) is important because PE-teachers can teach children a variety of FMS and can influence PE-motivation. However, declined levels of PE-motivation are reported in the final grades of elementary school. Therefore, more insight in…
Putri, A. R. I.; Ciptadi, G.; Warih, A. P.
2018-02-01
Chromosome characteristics of Peranakan Etawa (PE) goat needs to be analyzed because information about Indonesian goat races is very limited. The purpose of this research was to determine the characteristics of PE goat chromosome as basic data as one of the genetic local resources. Blood was collected from pair of PE goat at Sumber Sekar Field Laboratory, Faculty of Animal Husbandry, Brawijaya University, Malang. Blood cultured using standard cytogenetic technique and stained with G-Banding. Observations being done in metaphase cells and analyzed using Genus Cytovision Image. Chromosomes arranged and numbered by standard goat karyotype. The result of this research showed that PE goat had number of chromosomes 2n=60, consisting of 29 pairs of autosome and a pair of sex chromosomes. Female goat had average of total length (TL) of autosome ranged from 47.91 µm±6.46 to 22.12 µm±3.33. TL of chromosome X are 45.96 µm±4,59 and 44.45 µm±3,96. Centromeric index (Ci) of chromosome X, 31,74 and 32,80. PE goat had average of TL of autosome ranged from 58.20µm±6.72 to 18.97µm±2.82. TL of chromosome X is 56,42µm±7,38 and Y chromosome is 15,80 µm±3,24. Ci in chromosome X and Y are 19.34 and 46.84. These results concluded that the total of goat chromosome was 60 with types of autosomal chromosomes were acrocentric as many as 58 chromosomes and pair of sex chromosomes XX and XY, X classified as subtelocentric and Y submetacentric.
Discriminative capacity of biomarkers for acute stroke in the emergency department.
Glickman, Seth W; Phillips, Samantha; Anstrom, Kevin J; Laskowitz, Daniel T; Cairns, Charles B
2011-09-01
Acute ischemic stroke remains largely a clinical diagnosis. To assess the potential of several biomarkers to distinguish acute ischemic stroke from mimics in the emergency department (ED). In this prospective study, 63 patients with suspected acute stroke were enrolled. Blood samples were collected at ED presentation and assayed for B-type natriuretic peptide, C-reactive protein (CRP), matrix metalloproteinase 9 (MMP-9), D-dimer, and protein S100B. Final diagnosis of stroke was rendered by blinded independent stroke experts after review of all clinical, imaging, and conventional laboratory data during admission. Logistic regression and bootstrapping models were used to evaluate the association between biomarker values and acute stroke. Thirty-four patients had a final diagnosis of stroke and 29 with mimics. The initial ED values of CRP, MMP-9, and S100B (C-indices of 0.808, 0.811, and 0.719, respectively) and the National Institutes of Health Stroke Scale (NIHSS) (C-index 0.887) predicted acute cerebral ischemia. CRP levels added discriminative value over clinical variables alone in the diagnosis of stroke. When the levels of CRP were added to the NIHSS, the combination was highly predictive of stroke (bootstrap mean C-index 0.951, 90% Confidence Interval 0.903-0.991, likelihood test p = 0.004). Biomarker testing with CRP and potentially MMP-9 and S100B, may add valuable and time-sensitive diagnostic information in the early evaluation of patients with suspected stroke in the ED. Future prospective evaluations are necessary to validate the diagnostic capability of these biomarkers for acute ischemic stroke in the ED before they should be considered for use in clinical practice. Copyright © 2011 Elsevier Inc. All rights reserved.
Diagnostic yield of multidetector computed tomography in patients with acute spondylodiscitis
Energy Technology Data Exchange (ETDEWEB)
Rausch, Vanessa Hanna; Bannas, Peter; Well, Lennart; Regier, Marc; Adam, Gerhard; Henes, Frank Oliver Gerhard [Univ. Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology and Nuclearmedicine; Schoen, Gerhard [Univ. Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Medical Biometry and Epidemiology; Froelich, Andreas [Univ. Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Neuroradiology
2017-04-15
To determine the value of multidetector computed tomography (MDCT) in patients with acute spondylodiscitis. For data acquisition, we searched our radiological database for all patients who had undergone magnetic resonance imaging (MRI) for suspected spondylodiscitis between 2007 and 2015 (n = 325). For further analyses, we included all patients (n = 67) who initially underwent MDCT prior to MRI. Overall accuracy, sensitivity, specificity and positive and negative predictive values were calculated for MDCT and, separately, for contrast-enhanced CT (CECT, n = 36) and for non-enhanced CT (NECT, n = 31). MRI together with clinical evaluation served as the standard of reference. Results: In 34 of 43 patients with acute spondylodiscitis on MRI, correct diagnosis was already made by the initial MDCT scan. The specificity and positive predictive value were 100% for MDCT. The sensitivity was 79% and the negative predictive value was 72%. The overall accuracy was 87%. Accuracy was higher for CECT (89%) than for NECT (84%), however without statistical significance (p = 0.55). MDCT detected 90% of paravertebral abscesses (34/38), but only 6% of epidural abscesses (2/36). MDCT has moderate sensitivity, but high specificity for acute spondylodiscitis. Thus, if MDCT is positive for spondylodiscitis, treatment can be started without further delay. However, MRI should be added to both MDCT negative and positive cases to rule out complications such as epidural abscesses that cannot reliably be detected by MDCT. Key Points: Patients with acute spondylodiscitis are often initially suspected of having other differential diagnosis because of nonspecific symptoms. Therefore, MDCT is frequently performed prior to MRI in patients with acute spondylodiscitis. MDCT proved moderate sensitivity but high specificity for the diagnosis of acute spondylodiscitis. Paravertebral abscess is a strong indicator for the presence of spondylodiscitis on MDCT. However, MRI is crucial to rule out epidural
Chu, Yu-Feng; Meng, Mei; Zeng, Juan; Zhou, Hai-Yan; Jiang, Jin-Jiao; Ren, Hong-Sheng; Zhang, Ji-Cheng; Zhu, Wen-Ying; Wang, Chun-Ting
2012-06-01
Acute fatty liver of pregnancy (AFLP) is a rare disease of progressive hepatic insufficiency and secondary systemic complications that induce significant maternal risk. The application of combining plasma exchange (PE) and continuous hemodiafiltration (CHDF) is a novel concept for patients with AFLP. Since 2002, we have utilized the combination of PE with CHDF as adjunctive medical therapy for 11 AFLP patients with multiple organ dysfunction. Before PE and CHDF initiation, four patients had signs and symptoms of encephalopathy, four required ventilatory support, and all 11 were developing liver failure, significant renal compromise, and coagulopathy. PE combined with CHDF for patients was initiated a mean of 2 days postpartum (range, days 0-3). Daily or every other day PE combined with CHDF was undertaken on two to eight occasions for each of the 11 patients. Ten patients responded with composite clinical and laboratory improvement and were discharged to the ward, then cured and discharged from hospital; one patient died of septic shock. Average duration of hospitalization was 17 days (range, days 9-38) from time of admission to discharge; the average duration of intensive care unit was 10 days (range, days 4-23). No significant PE- and CHDF-related complications occurred. These results indicate that combing PE and CHDF in a series-parallel circuit is an effective and safe treatment for patients with severe AFLP. This finding may have important implications for the development of an effective treatment for patients with AFLP suffering multiple organ dysfunction. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
48 CFR 403.303 - Reporting suspected antitrust violations.
2010-10-01
... Antitrust Violations 403.303 Reporting suspected antitrust violations. Contracting officers shall report the circumstances of suspected violations of antitrust laws to the Office of Inspector General in accordance with... antitrust violations. 403.303 Section 403.303 Federal Acquisition Regulations System DEPARTMENT OF...
International Nuclear Information System (INIS)
Cobben, Lodewijk; Groot, Ingrid; Kingma, Lucas; Coerkamp, Emile; Puylaert, Julien; Blickman, Johan
2009-01-01
To establish the value of breathhold magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis. Over a 14-month period, 138 patients clinically suspected of having appendicitis were evaluated prospectively with MRI and comprised the study group. Fast turbo spin-echo breathhold T1, T2 and T2 fat suppression sequences were used in coronal and axial planes. The imaging results were recorded separately and subsequently correlated with clinical, radiological and histopathological follow-up. The effect of imaging strategies in patients suspected of appendicitis on hospital resources was calculated. Sixty-two of the 138 patients had a histopathologically proven appendicitis. MRI determined appendicitis in 63 patients, with one examination being false positive. The resulting sensitivity and specificity were 100% and 99%, respectively. MRI showed an alternative diagnosis in 41 of the 75 remaining patients. In 22 of the remaining 34 patients, a normal appendix was depicted with MRI. In two patients, where MRI showed no appendicitis, an alternative diagnosis or normal appendix, an unnecessary appendectomy was performed. The overall effect of using MRI in patients suspected of appendicitis on the use of hospital resources could have been a net saving between EUR 55,746 and EUR 72,534. MRI has a high accuracy in detecting and excluding appendicitis, an alternative diagnosis or showing the normal appendix, and can be a valuable and cost-effective tool in the workup of patients clinically suspected of having appendicitis. (orig.)
Energy Technology Data Exchange (ETDEWEB)
Cobben, Lodewijk [Medisch Centrum Haaglanden, Department of Radiology, Leidschendam (Netherlands); Groot, Ingrid [Medisch Centrum Haaglanden, Department of Surgery, Leidschendam (Netherlands); Kingma, Lucas; Coerkamp, Emile; Puylaert, Julien [Medisch Centrum Haaglanden, Department of Radiology, Den Haag (Netherlands); Blickman, Johan [Universitair Medisch Centrum St Radboud, Department of Radiology, Geert Grooteplein 10, GA, Nijmegen (Netherlands)
2009-05-15
To establish the value of breathhold magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis. Over a 14-month period, 138 patients clinically suspected of having appendicitis were evaluated prospectively with MRI and comprised the study group. Fast turbo spin-echo breathhold T1, T2 and T2 fat suppression sequences were used in coronal and axial planes. The imaging results were recorded separately and subsequently correlated with clinical, radiological and histopathological follow-up. The effect of imaging strategies in patients suspected of appendicitis on hospital resources was calculated. Sixty-two of the 138 patients had a histopathologically proven appendicitis. MRI determined appendicitis in 63 patients, with one examination being false positive. The resulting sensitivity and specificity were 100% and 99%, respectively. MRI showed an alternative diagnosis in 41 of the 75 remaining patients. In 22 of the remaining 34 patients, a normal appendix was depicted with MRI. In two patients, where MRI showed no appendicitis, an alternative diagnosis or normal appendix, an unnecessary appendectomy was performed. The overall effect of using MRI in patients suspected of appendicitis on the use of hospital resources could have been a net saving between EUR 55,746 and EUR 72,534. MRI has a high accuracy in detecting and excluding appendicitis, an alternative diagnosis or showing the normal appendix, and can be a valuable and cost-effective tool in the workup of patients clinically suspected of having appendicitis. (orig.)
Water cycle research associated with the CaPE hydrometeorology project (CHymP
Duchon, Claude E.
1993-01-01
One outgrowth of the Convection and Precipitation/Electrification (CaPE) experiment that took place in central Florida during July and August 1991 was the creation of the CaPE Hydrometeorology Project (CHymP). The principal goal of this project is to investigate the daily water cycle of the CaPE experimental area by analyzing the numerous land and atmosphere in situ and remotely sensed data sets that were generated during the 40-days of observations. The water cycle comprises the atmospheric branch. In turn, the atmospheric branch comprises precipitation leaving the base of the atmospheric volume under study, evaporation and transpiration entering the base, the net horizontal fluxes of water vapor and cloud water through the volume and the conversion of water vapor to cloud water and vice-versa. The sum of these components results in a time rate of change in the water and liquid water (or ice) content of the atmospheric volume. The components of the land branch are precipitation input to and evaporation and transpiration output from the surface, net horizontal fluxes of surface and subsurface water, the sum of which results in a time rate of change in surface and subsurface water mass. The objective of CHymP is to estimate these components in order to determine the daily water budget for a selected area within the CaPE domain. This work began in earnest in the summer of 1992 and continues. Even estimating all the budget components for one day is a complex and time consuming task. The discussions below provides a short summary of the rainfall quality assessment procedures followed by a plan for estimating the horizontal moisture flux.
van Aart, Ingrid; Hartman, E.; Elferink-Gemser, Marije; Mombarg, Remo; Visscher, Chris
2015-01-01
: Many children aged 9–12 appear to have low levels of fundamental movement skills (FMS). Physical education (PE) is important because PE-teachers can teach children a variety of FMS and can influence PE-motivation. However, declined levels of PE-motivation are reported in the final grades of
International Nuclear Information System (INIS)
Engelke, C.; Schmidt, S.; Auer, F.; Rummeny, E.J.; Marten, K.
2010-01-01
Aim: To prospectively assess the value of computer-aided detection (CAD) for the computed tomography (CT) severity assessment of acute pulmonary embolism (PE). Materials and methods: CT angiographic scans of 58 PE-positive patients (34-89 years, mean 66 years) were analysed by four observers for PE severity using the Mastora index, and by CAD. Patients were stratified to three PE risk groups and results compared to an independent reference standard. Interobserver agreement was tested by Bland and Altman and extended kappa (Ke) statistics. Mastora index changes after CAD data review were tested by Wilcoxon signed ranks. Results: CAD detected 343 out of 1118 emboli within given arterial segments and a total of 155 out of 218 polysegmental emboli (segmental vessel-based sensitivity = 30.7%, embolus-based sensitivity = 71.2% false-positive rate = 4.1/scan). Interobserver agreement on PE severity [95% limits of agreement (LOA) = -19.7-7.5% and-5.5-3% for reader pairs 1 versus 2 and 3 versus 4, respectively was enhanced by consensus with CAD data (LOA = -6.5-5.4% and-3.7-2% for reader pairs 1 versus 2 and 3 versus 4, respectively). Simultaneously, the percentual scoring errors (PSE) were significantly decreased (PSE = 35.4 ± 31.8% and 5.1 ± 8.9% for readers1/2 and 2/3, respectively, and PSE = 27.6 ± 31% and 3.8 ± 6.2%, respectively, after CAD consensus; p ≤ 0.005). Misclassifications to PE risk groups occurred in 27.6, 24.1, 5.2, and 5.2% of patients for readers 1-4, respectively, (Ke = 0.74) and were corrected by CAD consensus in 56.3, 36, 33.3, and 33.3% of misclassified patients, respectively (Ke = 0.83; p < 0.05). Conclusion: Radiologists may benefit from consensus with CAD data that improve PE severity scores and stratification to PE risk groups.
Imaging findings of upper abdominal involvement by acute megakaryoblastic leukaemia
Energy Technology Data Exchange (ETDEWEB)
Amemiya, Shiori; Akahane, Masaaki; Ohtomo, Kuni [University of Tokyo, Department of Radiology, Graduate School of Medicine, Tokyo (Japan); Takita, Junko; Igarashi, Takashi [University of Tokyo, Department of Paediatrics, Graduate School of Medicine, Tokyo (Japan)
2008-04-15
Acute megakaryoblastic leukaemia (AMKL), a relatively rare type of acute myeloid leukaemia, is characterized by frequent involvement of the liver, spleen and lymph nodes in addition to myelofibrosis in children. Diagnosis is difficult both clinically and pathologically, and the hepatic or lymph node involvement is not uncommonly misinterpreted as solid tumour. We report the imaging findings of upper abdominal involvement by AMKL in an infant. The hepatic lesion, initially suspected to be hepatoblastoma, showed a distinctive appearance on MRI suggesting its infiltrative nature. With the association of splenic lesion and lymphadenopathy, the imaging findings were considered indicative of a haematological disorder. (orig.)
Believable Suspect Agents: Response and Interpersonal Style Selection for an Artificial Suspect
Bruijnes, Merijn
2016-01-01
The social skills necessary to properly and successfully conduct a police interrogation can and need to be trained. In the thesis I will describe the steps I took towards a virtual character that can play the role of a suspect in a police interrogation training. Students of the police academy will
Holland, Thomas L; O'Riordan, William; McManus, Alison; Shin, Elliot; Borghei, Ali; File, Thomas M; Wilcox, Mark H; Torres, Antoni; Dryden, Matthew; Lodise, Thomas; Oguri, Toyoko; Corey, G Ralph; McLeroth, Patrick; Shukla, Rajesh; Huang, David B
2018-05-01
Iclaprim is a novel diaminopyrimidine antibiotic that may be an effective and safe treatment for serious skin infections. The safety and effectiveness of iclaprim were assessed in a global phase 3, double-blind, randomized, active-controlled trial. Six hundred thirteen adults with acute bacterial skin and skin structure infections (ABSSSIs) suspected or confirmed to be due to Gram-positive pathogens were randomized to iclaprim (80 mg) or vancomycin (15 mg/kg of body weight), both of which were administered intravenously every 12 h for 5 to 14 days. The primary endpoint was a ≥20% reduction in lesion size compared with that at the baseline at 48 to 72 h after the start of administration of study drug in the intent-to-treat population. Among patients randomized to iclaprim, 78.3% (231 of 295) met this primary endpoint, whereas 76.7% (234 of 305) of those receiving vancomycin met this primary endpoint (difference, 1.58%; 95% confidence interval, -5.10% to 8.26%). This met the prespecified 10% noninferiority margin. Iclaprim was well tolerated, with most adverse events being categorized as mild. In conclusion, iclaprim was noninferior to vancomycin in this phase 3 clinical trial for the treatment of acute bacterial skin and skin structure infections. On the basis of these results, iclaprim may be an efficacious and safe treatment for skin infections suspected or confirmed to be due to Gram-positive pathogens. (This trial has been registered at ClinicalTrials.gov under identifier NCT02607618.). Copyright © 2018 American Society for Microbiology.
Active Bilayer PE/PCL Films for Food Packaging Modified with Zinc Oxide and Casein
Rešček, Ana; Kratofil Krehula, Ljerka; Katančić, Zvonimir; Hrnjak-Murgić, Zlata
2015-01-01
This paper studies the properties of active polymer food packaging bilayer polyethylene/polycaprolactone (PE/PCL) films. Such packaging material consists of primary PE layer coated with thin film of PCL coating modified with active component (zinc oxide or zinc oxide/casein complex) with intention to extend the shelf life of food and to maintain the quality and health safety. The influence of additives as active components on barrier, mechanical, thermal and antimicrobial properties of such m...
Díaz-Barrientos, C Z; Aquino-González, A; Heredia-Montaño, M; Navarro-Tovar, F; Pineda-Espinosa, M A; Espinosa de Santillana, I A
2018-02-06
Acute appendicitis is the first cause of surgical emergencies. It is still a difficult diagnosis to make, especially in young persons, the elderly, and in reproductive-age women, in whom a series of inflammatory conditions can have signs and symptoms similar to those of acute appendicitis. Different scoring systems have been created to increase diagnostic accuracy, and they are inexpensive, noninvasive, and easy to use and reproduce. The modified Alvarado score is probably the most widely used and accepted in emergency services worldwide. On the other hand, the RIPASA score was formulated in 2010 and has greater sensitivity and specificity. There are very few studies conducted in Mexico that compare the different scoring systems for appendicitis. The aim of our article was to compare the modified Alvarado score and the RIPASA score in the diagnosis of patients with abdominal pain and suspected acute appendicitis. An observational, analytic, and prolective study was conducted within the time frame of July 2002 and February 2014 at the Hospital Universitario de Puebla. The questionnaires used for the evaluation process were applied to the patients suspected of having appendicitis. The RIPASA score with 8.5 as the optimal cutoff value: ROC curve (area .595), sensitivity (93.3%), specificity (8.3%), PPV (91.8%), NPV (10.1%). Modified Alvarado score with 6 as the optimal cutoff value: ROC curve (area .719), sensitivity (75%), specificity (41.6%), PPV (93.7%), NPV (12.5%). The RIPASA score showed no advantages over the modified Alvarado score when applied to patients presenting with suspected acute appendicitis. Copyright © 2018 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.
48 CFR 1403.303 - Reporting suspected antitrust violations.
2010-10-01
... Antitrust Violations 1403.303 Reporting suspected antitrust violations. (a) Reports on suspected violations of antitrust laws as required by FAR 3.303 shall be prepared by the CO, reviewed by the SOL, and... antitrust violations. 1403.303 Section 1403.303 Federal Acquisition Regulations System DEPARTMENT OF THE...
Gulmarg estimate of PeV photon flux from Cygnus X-3 and its relevance
International Nuclear Information System (INIS)
Bhat, C.L.; Sapru, M.L.; Razdan, H.
1986-01-01
An analysis of atmospheric Cerenkov pulses recorded during January 1976 - December 1977, by a wide-angle photomultiplier system at Gulmarg (India), reveals a phase-dependent component exhibiting the characteristic Cygnus X-3 modulation period of 4.8h. Its amplitude, given by the number of excess events in the phase peak relative to the total phase-independent events, is found to be (1.8 ± 0.4)per cent, corresponding to a detected average flux of (1.6 ± 0.4) x 10 -12 γcm -2 s -1 above 0.5 PeV (1PeV = 10 15 eV). Taken together with the spectral data for the following years from several other experiments, there is the suggestion of a long-term reduction in the luminosity of the PeV source by a factor of ∼ 1.5 y -1 (exponential decay law with a time constant of ∼ 2.3y). This intriguing possibility is further strengthened by an examination of the Haverah Park phase-histograms of Cygnus X-3 for the period January 1979 to December 1984 and the Plateau Rosa data recorded between December 1981 - March 1985, which display analogous long-term behaviour at > 10 15 eV and > 2 x 10 13 eV respectively. After accounting for losses in the PeV photon beam due to γ-γ interactions with the 2.7deg K microwave background, a comparison of the ultra high energy photon fluxes from Cygnus X-3 with those in 10 11 - 10 12 eV energy region shows that the latter are significant by lower. This suggests that the TeV photons undergo servere circumstellar abnsorption through interactions with optical/infrared photons or/and have a production spectrum which differs in some significant manner from the one responsible for generating the PeV flux. (author)
Hyperthyroidism: A rare cause of pulmonary embolism: Report of two cases
Directory of Open Access Journals (Sweden)
Sonia Grine
2013-01-01
Full Text Available Several disorders of coagulation and fibrinolysis have been widely reported in patients with hyperthyroidism. Most reports have focused on only the venous thromboembolism risk, and few of them have studied specifically the association between hyperthyroidism and pulmonary embolism (PE. We report two cases of Graves′ disease complicated by PE. The first patient is a 32 year-old man, and the second patient is a 23-year-old female. PE was suspected on the basis of pulmonary hypertension in patient one, and clinical presentation in the other patient. The first patient had also right heart failure. PE was confirmed in both patients by a lung perfusion-ventilation scan test. Thrombophilia screen revealed normal findings in the first patient and an elevation in coagulation factor VIII in the second one. Both patients received heparin, followed by oral anticoagulant therapy. In addition, they were treated with radioactive iodine resulting in partial recovery from hyperthyroidismforpatient oneand clinical euthyroidism for patient two.The former died of acute heart failure secondary to a chest infection, while the later was lost to follow-up. In conclusion, hyperthyroidism is associated with increased risk of venous thromboembolism, including PE. Potential mechanisms involved in this association include endothelial dysfunction, decreased fibrinolytic activity, and increased coagulation factors levels. Thyroid evaluation is recommended in patients with unprovoked venous thromboembolic events. Conversely, the diagnosis of venous thromboembolism should be considered in patients with hyperthyroidism, particularly if additional prothrombotic risk factors are present.
Hedner, Charlotta; Sundgren, Pia C; Kelly, Aine Marie
2013-09-01
The purpose of this study was to assess if the presence of information including the pretest probability (Wells score), other known risk factors, and symptoms given on referrals for computed tomography (CT) pulmonary angiography correlated with prevalence rates for pulmonary embolism (PE). Also, to evaluate for differences between a university and a regional hospital setting regarding patient characteristics, amount of relevant information provided on referrals, and prevalence rates for pulmonary embolism. Retrospective review of all consecutive referrals (emergency room, inpatient, and outpatient) for CT performed on children and adults for suspected PE from two sites: a tertiary (university) hospital (site 1) and a secondary (regional) hospital (site 2) over a 5-year period. The overall prevalence rate was 510/3641 or 14% of all referrals. Significantly higher number of males had a positive CT compared to women (18% versus 12%, P relevant information on the referral and the probability for positive finding existed, a slight trend was noted (P = .09). In two categories, "hypoxia" and "signs of deep vein thrombosis," the presence of this information conferred a higher probability for pulmonary embolism, P information conferred a higher probability for pulmonary embolism. The amount of relevant clinical information on the request did not correlate with prevalence rates, which may reflect a lack of documentation on the part of emergency physicians who may use a "gestalt" approach. Request forms likely did not capture all relevant patient risks and many factors may interact with each other, both positively and negatively. Pretest probability estimations were rarely performed, despite their inclusion in major society guidelines. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.
Liang, Nathan L; Avgerinos, Efthymios D; Singh, Michael J; Makaroun, Michel S; Chaer, Rabih A
2017-03-01
Systemic thrombolysis (ST) and catheter-directed intervention (CDI) are both used in the treatment of acute pulmonary embolism (PE), but the comparative outcomes of these two therapies remain unclear. The objective of this study was to compare short-term mortality and safety outcomes between the two treatments using a large national database. Patients presenting with acute PE were identified in the National Inpatient Sample (NIS) from 2009 to 2012. Comorbidities, clinical characteristics, and invasive procedures were identified using International Classification of Diseases, Ninth Revision (ICD) codes and the Elixhauser comorbidity index. To adjust for anticipated baseline differences between the two treatment groups, propensity score matching was used to create a matched ST cohort with clinical and comorbid characteristics similar to those of the CDI cohort. Subgroups of patients with and without hemodynamic shock were analyzed separately. Primary outcomes were in-hospital mortality, overall bleeding risk, and hemorrhagic stroke risk. Of 263,955 subjects with acute PE, 1.63% (n = 4272) received ST and 0.55% (n = 1455) received CDI. ST subjects were older, had more chronic comorbidities, and had higher rates of respiratory failure (ST, 27.9% [n = 1192]; CDI, 21.2% [n = 308]; P mortality (ST, 16.7% [n = 714]; CDI, 9.4% [n = 136]; P hemorrhagic stroke rates (ST, 2.2% [n = 96]; CDI, 1.4% [n = 20]; P = .041). After propensity matching, 1430 patients remained in each cohort; baseline characteristics of the matched cohorts did not differ significantly using standardized difference comparisons. Analysis of the matched cohorts did not demonstrate a significant effect of CDI on in-hospital mortality or overall bleeding risk but did show a significant protective effect against hemorrhagic stroke compared with ST (odds ratio, 0.47; 95% confidence interval, 0.27-0.82; P = .01). Subgroup analysis showed decreased odds of hemorrhagic stroke for CDI in the nonshock
Westerbeek, R E; Van Rooden, C J; Tan, M; Van Gils, A P G; Kok, S; De Bats, M J; De Roos, A; Huisman, M V
2008-07-01
Accurate diagnosis of acute recurrent deep vein thrombosis (DVT) is relevant to avoid improper diagnosis and unnecessary life-long anticoagulant treatment. Compression ultrasound has high accuracy for a first episode of DVT, but is often unreliable in suspected recurrent disease. Magnetic resonance direct thrombus imaging (MR DTI) has been shown to accurately detect acute DVT. The purpose of this prospective study was to determine the MR signal change during 6 months follow-up in patients with acute DVT. This study was a prospective study of 43 consecutive patients with a first episode of acute DVT demonstrated by compression ultrasound. All patients underwent MR DTI. Follow-up was performed with MR-DTI and compression ultrasound at 3 and 6 months respectively. All data were coded, stored and assessed by two blinded observers. MR direct thrombus imaging identified acute DVT in 41 of 43 patients (sensitivity 95%). There was no abnormal MR-signal in controls, or in the contralateral extremity of patients with DVT (specificity 100%). In none of the 39 patients available at 6 months follow-up was the abnormal MR-signal at the initial acute DVT observed, whereas in 12 of these patients (30.8%) compression ultrasound was still abnormal. Magnetic resonance direct thrombus imaging normalizes over a period of 6 months in all patients with diagnosed DVT, while compression ultrasound remains abnormal in a third of these patients. MR-DTI may potentially allow for accurate detection in patients with acute suspected recurrent DVT, and this should be studied prospectively.
Kanji, Akbar; Hasan, Zahra; Ali, Asho M.; McNerney, Ruth; Mallard, Kim E.; Coll, Francesc; Hill-Cawthorne, Grant A.; Pain, Arnab; Nair, Mridul; Clark, Taane G.; Zaver, Ambreen; Jafri, Sana M Wasim; Hasan, Rumina
2015-01-01
Background: Mycobacterium tuberculosis (MTB) PE_PGRS genes belong to the PE multi-gene family. Although the function of the members of the PE_PGRS multi-gene family is not yet known, it is hypothesized that the PE_PGRS genes may be associated
Sudden unexpected death under acute influence of cannabis.
Hartung, Benno; Kauferstein, Silke; Ritz-Timme, Stefanie; Daldrup, Thomas
2014-04-01
The acute toxicity of cannabinoids is said to be low and there is little public awareness of the potentially hazardous cardiovascular effects of cannabis, e.g. marked increase in heart rate or supine blood pressure. We describe the cases of two young, putative healthy men who died unexpectedly under the acute influence of cannabinoids. To our knowledge, these are the first cases of suspected fatal cannabis intoxications where full postmortem investigations, including autopsy, toxicological, histological, immunohistochemical and genetical examinations, were carried out. The results of these examinations are presented. After exclusion of other causes of death we assume that the young men experienced fatal cardiovascular complications evoked by smoking cannabis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Wind Transport of Radionuclide- Bearing Dust, Peña Blanca, Chihuahua, Mexico
Velarde, R.; Goodell, P. C.; Gill, T. E.; Arimoto, R.
2007-05-01
This investigation evaluates radionuclide fractionation during wind erosion of high-grade uranium ore storage piles at Peña Blanca (50km north of Chihuahua City), Chihuahua, Mexico. The aridity of the local environment promotes dust resuspension by high winds. Although active operations ceased in 1983, the Peña Blanca mining district is one of Mexico`s most important uranium ore reserves. The study site contains piles of high grade ore, left loose on the surface, and separated by the specific deposits from which they were derived (Margaritas, Nopal I, and Puerto I). Similar locations do not exist in the United States, since uranium mining sites in the USA have been reclaimed. The Peña Blanca site serves as an analog for the Yucca Mountain project. Dust deposition is collected at Peña Blanca with BSNE sediment catchers (Fryrear, 1986) and marble dust traps (Reheis, 1999). These devices capture windblown sediment; subsequently, the sample data will help quantify potentially radioactive short term field sediment loss from the repository surface and determine sediment flux. Aerosols and surface materials will be analyzed and radioactivity levels established utilizing techniques such as gamma spectroscopy. As a result, we will be able to estimate how much radionuclide contaminated dust is being transported or attached geochemically to fine grain soils or minerals (e.g., clays or iron oxides). The high-grade uranium-bearing material is at secular equilibrium, thus the entire decay series is present. Of resulting interest is not only the aeolian transport of uranium, but also of the other daughter products. These studies will improve our understanding of geochemical cycling of radionuclides with respect to sources, transport, and deposition. The results may also have important implications for the geosciences and homeland security, and potential applications to public health. Funding for this project is provided in part via a NSF grant to Arimoto.
Bhatt, Shuchi; Ahmad, Mohammad; Batra, Prerna; Tandon, Anupama; Roy, Satarupa; Mandal, Samrat
2017-09-01
Acute swelling and discoloration of scrotum in new born can have many localized causes like testicular torsion, inguinal hernia, scrotal or testicular edema, hydrocele, or even remote causes like adrenal hemorrhage. We report a neonate of adrenal hemorrhage presenting clinically as acute scrotum misguiding the clinician to rule out a local scrotal pathology. As the local clinical examination is not reliable in a newborn, it definitely requires an imaging evaluation to establish the diagnosis. This case report emphasizes being aware of the clinical association of acute adrenal hemorrhage and an acute scrotum and the role of ultrasonography in the evaluation of the various differential diagnoses leading to an acute scrotum. An optimum sonographic examination helps in suspecting an abdominal pathology as a cause of acute scrotum and in establishing the specific diagnosis of adrenal hemorrhage to avoid an unnecessary surgical exploration.
Case of acute orbital myositis which was difficult to diagnose at first
Energy Technology Data Exchange (ETDEWEB)
Yamamoto, Kiyoshi; Terabayashi, Tadasu; Mori, Hiroshi; Niida, Hirohito; Sugiyama, Yoshiaki; Nakagawa, Masato
1988-02-01
We report a case of acute orbital myositis. A 61-year-old woman exhibited acute orbital pain, diplopia, and left proptosis. Examination revealed a 5-mm left proptosis, left chemosis, and limitations in all directions of the movement of the left eye. Visual acuity was unimpaired, however, and the neurological examination was otherwise normal. CT demonstrated a left inferior orbital mass. We suspected an acute orbital pseudotumor based on the rapid onset and the clinical symptoms. We treated her with systemic corticosteroids. Four weeks later CT documented a reduced left orbital mass; there seemed to be left only an inferior rectus muscle enlargement. We diagnosed acute orbital myositis, a subgroup of orbital pseudotumors, based upon the rapid clinical presentation, the CT features, and the resolution after treatment with systemic corticosteroids.
Suspects in criminal investigations of rape
Directory of Open Access Journals (Sweden)
Marinković Darko
2014-01-01
Full Text Available Investigations of sexual assaults mostly focus on victims and their credibility, which may cause lack of firm evidence in relation to suspects. Given the fact that the criminal offence of rape is characterised by a high incidence of false reports and accusations, frequently indicating specific persons as the perpetrators, certain caution is necessary in the investigation in order to avoid false accusations and/or convictions. As regards the personality of the rapist and motives for committing a forcible sexual act, certain types or rather certain categories of perpetrators can be distinguished, although it should be noted that a large number of rapists do not belong to one category only, but rather combine characteristics of several different types. During a criminal investigation it is of vital importance to differentiate between a rape as a surprise attack and a rape as abuse of trust, as they are compatible with the nature of the suspect's defence. The suspect shall be subjected to a forensic examination in the course of the investigation in order to find traces which prove vaginal, anal or oral penetration, coerced sexual intercourse and identity of the rapist. While conducting an interrogation of a suspected rapist, a crime investigating officer shall use either factual or emotional approach to his interviewee, depending on his psychological and motivational characteristics. In this regard, the factual approach is believed to be more efficient with anger rapists and sadistic rapists, whereas the compassionate approach gives good results with the gentlemen-rapists and partly with the power asserting rapists.
Investigation of properties of (U)HMW-PE under the influence of gamma irradiation
Energy Technology Data Exchange (ETDEWEB)
Ehe, K. von der; Wolff, D.; Boehning, M. [BAM Federal Institute for Materials Research and Testing, Berlin (Germany)
2012-11-01
High molecular weight polyethylene (HMW-PE) and ultra high molecular weight polyethylene (UHMW-PE) are high performance materials, which are predestinated for a wide range of applications due to characteristics like high chemical resistance, low wear, and high hydrogen content. In addition to the application of (U)HMW-PE as sports equipment (sliding surface of snowboards, skis) and in mechanical engineering (materials for spur gears and chain guides) these polymers are used in two other and even more demanding areas: as implant material in medical technology and as a component for neutron shielding purposes in casks for storage and transport of radioactive waste. In these two cases, gamma irradiation and its impact on the molecular structure of polyethylene play an important role. In the first case, irradiation is applied for sterilization purposes and in the second one it exists as a side-effect of inserting the radioactive material in the cask. Specifically concerning their use in the field of medical technology, different types of UHMW-PE have been intensively studied. It is generally accepted that two concurrent and competitive processes, based on initial chain scission and subsequent reactions of C-centered radicals and molecular fragments, occur in PE as a consequence of radiation: radical recombination accounts for crosslinking, together with some disproportionation, formation of low molecular weight fragments, and recrystallization. Furthermore, formation of oxygenated structures in the presence of traces of oxygen is a competitive process to those mentioned above. Radiation induced scission preferentially takes place in the amorphous phase and noncrystalline surface of the crystallites and results in shorter polymer chains, fewer entanglements, and consequently, increased molecular mobility. The latter enables folding of polymer segments and thus, crystal growth and increased perfection in the crystal lamellae. With regard to the long-term application of
Measurement of γ'precipitates in nimonic PE16
International Nuclear Information System (INIS)
Baker, C.; Lobb, R.C.
1977-09-01
γ' precipitates in Nimonic PE16 have been examined using bright and dark field imaging techniques in an electron microscope. The validity of these techniques to determine mean precipitate diameters, precipitate density and volume fraction is discussed. It is concluded that bright field imaging techniques are sufficiently accurate to measure γ' precipitate diameters but it is essential to use dark field imaging techniques to determine γ' precipitate density or volume fraction. (author)
Pulmonary embolism in pregnancy: is nuclear medicine imaging still a valid option?
LENUS (Irish Health Repository)
Ezwawah, O
2008-10-01
In this study we demonstrate our Radiology Department\\'s experience in utilizing low dose (half the normal dose) lung perfusion radionuclide scanning for pregnant patients as the initial investigation for suspected pulmonary embolism (PE). Secondly; we highlight the radiation dose reduction advantages of nuclear medicine imaging over multi-detector computed tomography in this group. We performed a retrospective study of 21 consecutive pregnant women who presented with suspected PE. These patients underwent either lung perfusion scanning or CT pulmonary angiography (CTPA), over a two-year period (May 2005 to July 2007). 19 patients of the cohort studied underwent low dose perfusion-only scintigraphy, with half the usual dose of radionuclide activity. All scans were considered of diagnostic quality. No patient in our study required a ventilation scan. No patient with a negative perfusion scan represented during the 3 month follow up period with PE. We conclude, nuclear medicine imaging is an effective initial investigation for pregnant patients with suspected PE. While scinitigraphy is associated with a greater fetal radiation dose than CTPA, it imparts a lower maternal dose and significantly lower dose to radiosensitive tissues such as breast.
Intraocular Ossification in the GSP/pe Chicken With Imperfect Albinism.
Shibuya, K; Kinoshita, K; Mizutani, M; Oshima, A; Yamashita, R; Matsuda, Y
2015-07-01
The eyes of 2 male and 2 female GSP/pe chickens, the imperfect albino strain, were investigated at 52 weeks of age. Aged chickens of the GSP/pe colony became blind with bilateral ocular enlargement and opaque lenses. Affected eyes (bilateral in 2 males and unilateral in 2 females) were hard and difficult to section; histologic specimens were processed after decalcification. A large portion of the posterior chamber was occupied by cancellous bone containing fibrous and cartilaginous foci. Osseous tissues developed adjacent to the choroid, and no retinal pigment epithelium (RPE) was detected between osseous tissues and the choroid. Small segments of degenerate neuronal retina were scattered in the osseous tissue. The irises and ciliary bodies were deformed by osseous tissue, and the lenses had severe cataracts. These observations suggest that the intraocular osseous tissue may be derived from RPE in the hereditary incomplete-albino strain of chickens. © The Author(s) 2014.
Lu, Xin; Dun, Hui; Lian, Conglong; Zhang, Xiaofei; Yin, Weilun; Xia, Xinli
2017-06-01
Plant miR164 family is highly conserved and miR164 members regulate conserved targets belonging to NAC transcription factors. Our previous studies have revealed that peu-miR164a-e and its target gene POPTR_0007s08420 participate in abiotic stress response in Populus euphratica according to deep sequencing and degradome sequencing. In this study, miR164 family comprises six members that generate two mature products (miR164a-e and miR164f) and target seven NAC genes in P. euphratica. Co-expression in Nicotiana benthamiana and 5' RACE confirmed that peu-miR164 directs PeNAC070, PeNAC012 and PeNAC028 mRNAs cleavage. Expression profiles of primary peu-miR164 a/b/c/d/e bear similarity to those of peu-miR164a-e, whereas PeNAC070 and PeNAC081 showed inverse expression patterns with peu-miR164a-e under abiotic stresses. Existence of cis-acting elements in PeNAC070 promoter (ABRE,MBs, Box-W1, GC-motif, and W-box) and in peu-MIR164b promoter (HSE) further confirmed different responses of peu-miR164 and PeNAC070 to abiotic stresses. Histochemical β-glucuronidase (GUS) staining revealed that GUS activities increased when Pro PeNAC070 ::GUS transgenic Arabidopsis plants were exposed to NaCl, mannitol and abscisic acid (ABA), whereas GUS activity of Pro peu-MIR164b ::GUS plants decreased under ABA treatment. Subcellular localization and transactivation assays showed that PeNAC070 protein was localized to the nucleus and exhibited transactivation activity at the C-terminal. Overexpression of PeNAC070 in Arabidopsis promoted lateral root development, delayed stem elongation, and increased sensitivity of transgenic plants to drought and salt stresses. This study aids in understanding the adaptability of P. euphratica to extreme drought and salt environment by analysing tissue-specific expression patterns of miR164-regulated and specific promoter-regulated PeNAC genes. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Synergistic anticancer effects of the 9.2.27PE immunotoxin and ABT-737 in melanoma.
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Karianne Risberg
Full Text Available In cancer, combinations of drugs targeting different cellular functions is well accepted to improve tumor control. We studied the effects of a Pseudomonas exotoxin A (PE-based immunotoxin, the 9.2.27PE, and the BH-3 mimetic compound ABT-737 in a panel of melanoma cell lines. The drug combination resulted in synergistic cytotoxicity, and the cell death observed was associated with apoptosis, as activation of caspase-3, inactivation of Poly (ADP-ribose polymerase (PARP and increased DNA fragmentation could be prevented by pre-treatment with caspase and cathepsin inhibitors. We further show that ABT-737 caused endoplasmic reticulum (ER stress with increased GRP78 and phosphorylated eIF2α protein levels. Moreover, treatment with ABT-737 increased the intracellular calcium levels, an effect which was enhanced by 9.2.27PE, which as a single entity drug had minimal effect on calcium release from the ER. In addition, silencing of Mcl-1 by short hairpin RNA (shRNA enhanced the intracellular calcium levels and cytotoxicity caused by ABT-737. Notably, the combination of 9.2.27PE and ABT-737 caused growth delay in a human melanoma xenograft mice model, supporting further investigations of this particular drug combination.
Directory of Open Access Journals (Sweden)
Laura de Moraes Gomes
2006-02-01
alone. Among the 23 cases of PE, 15 (65.2% had concomitant DVT whereas 8 (34.8% had only PE. Among the 24 cases of DVT, 15 (62.5% had associated PE and 9 (37.5% had DVT alone. CONCLUSION: The results showed a strong relationship between PE and DVT, as well as the importance of investigating DVT in cases with suspected PE and the benefits of performing indirect CT venography after pulmonary CT angiography as a single examination alternative method for simultaneous investigation of PE and DVT.
PeRL: a circum-Arctic Permafrost Region Pond and Lake database
Muster, Sina; Roth, Kurt; Langer, Moritz; Lange, Stephan; Cresto Aleina, Fabio; Bartsch, Annett; Morgenstern, Anne; Grosse, Guido; Jones, Benjamin; Sannel, A. Britta K.; Sjöberg, Ylva; Günther, Frank; Andresen, Christian; Veremeeva, Alexandra; Lindgren, Prajna R.; Bouchard, Frédéric; Lara, Mark J.; Fortier, Daniel; Charbonneau, Simon; Virtanen, Tarmo A.; Hugelius, Gustaf; Palmtag, Juri; Siewert, Matthias B.; Riley, William J.; Koven, Charles D.; Boike, Julia
2017-06-01
Ponds and lakes are abundant in Arctic permafrost lowlands. They play an important role in Arctic wetland ecosystems by regulating carbon, water, and energy fluxes and providing freshwater habitats. However, ponds, i.e., waterbodies with surface areas smaller than 1. 0 × 104 m2, have not been inventoried on global and regional scales. The Permafrost Region Pond and Lake (PeRL) database presents the results of a circum-Arctic effort to map ponds and lakes from modern (2002-2013) high-resolution aerial and satellite imagery with a resolution of 5 m or better. The database also includes historical imagery from 1948 to 1965 with a resolution of 6 m or better. PeRL includes 69 maps covering a wide range of environmental conditions from tundra to boreal regions and from continuous to discontinuous permafrost zones. Waterbody maps are linked to regional permafrost landscape maps which provide information on permafrost extent, ground ice volume, geology, and lithology. This paper describes waterbody classification and accuracy, and presents statistics of waterbody distribution for each site. Maps of permafrost landscapes in Alaska, Canada, and Russia are used to extrapolate waterbody statistics from the site level to regional landscape units. PeRL presents pond and lake estimates for a total area of 1. 4 × 106 km2 across the Arctic, about 17 % of the Arctic lowland ( pangaea.de/10.1594/PANGAEA.868349" target="_blank">https://doi.pangaea.de/10.1594/PANGAEA.868349.
Energy Technology Data Exchange (ETDEWEB)
Luetkens, Julian A.; Schlesinger-Irsch, Ulrike; Kuetting, Daniel L.; Dabir, Darius; Homsi, Rami; Schmeel, Frederic C.; Sprinkart, Alois M.; Naehle, Claas P.; Schild, Hans H.; Thomas, Daniel [University of Bonn, Department of Radiology, Bonn (Germany); Doerner, Jonas [University Hospital Cologne, Department of Radiology, Cologne (Germany); Fimmers, Rolf [University of Bonn, Department of Medical Biometry, Informatics, and Epidemiology, Bonn (Germany)
2017-11-15
To investigate the diagnostic value of cardiac magnetic resonance (CMR) feature-tracking (FT) myocardial strain analysis in patients with suspected acute myocarditis and its association with myocardial oedema. Forty-eight patients with suspected acute myocarditis and 35 control subjects underwent CMR. FT CMR analysis of systolic longitudinal (LS), circumferential (CS) and radial strain (RS) was performed. Additionally, the protocol allowed for the assessment of T1 and T2 relaxation times. When compared with healthy controls, myocarditis patients demonstrated reduced LS, CS and RS values (LS: -19.5 ± 4.4% vs. -23.6 ± 3.1%, CS: -23.0 ± 5.8% vs. -27.4 ± 3.4%, RS: 28.9 ± 8.5% vs. 32.4 ± 7.4%; P < 0.05, respectively). LS (T1: r = 0.462, P < 0.001; T2: r = 0.436, P < 0.001) and CS (T1: r = 0.429, P < 0.001; T2: r = 0.467, P < 0.001) showed the strongest correlations with T1 and T2 relaxations times. Area under the curve of LS (0.79) was higher compared with those of CS (0.75; P = 0.478) and RS (0.62; P = 0.008). FT CMR myocardial strain analysis might serve as a new tool for assessment of myocardial dysfunction in the diagnostic work-up of patients suspected of having acute myocarditis. Especially, LS and CS show a sufficient diagnostic performance and were most closely correlated with CMR parameters of myocardial oedema. (orig.)
International Nuclear Information System (INIS)
Luetkens, Julian A.; Schlesinger-Irsch, Ulrike; Kuetting, Daniel L.; Dabir, Darius; Homsi, Rami; Schmeel, Frederic C.; Sprinkart, Alois M.; Naehle, Claas P.; Schild, Hans H.; Thomas, Daniel; Doerner, Jonas; Fimmers, Rolf
2017-01-01
To investigate the diagnostic value of cardiac magnetic resonance (CMR) feature-tracking (FT) myocardial strain analysis in patients with suspected acute myocarditis and its association with myocardial oedema. Forty-eight patients with suspected acute myocarditis and 35 control subjects underwent CMR. FT CMR analysis of systolic longitudinal (LS), circumferential (CS) and radial strain (RS) was performed. Additionally, the protocol allowed for the assessment of T1 and T2 relaxation times. When compared with healthy controls, myocarditis patients demonstrated reduced LS, CS and RS values (LS: -19.5 ± 4.4% vs. -23.6 ± 3.1%, CS: -23.0 ± 5.8% vs. -27.4 ± 3.4%, RS: 28.9 ± 8.5% vs. 32.4 ± 7.4%; P < 0.05, respectively). LS (T1: r = 0.462, P < 0.001; T2: r = 0.436, P < 0.001) and CS (T1: r = 0.429, P < 0.001; T2: r = 0.467, P < 0.001) showed the strongest correlations with T1 and T2 relaxations times. Area under the curve of LS (0.79) was higher compared with those of CS (0.75; P = 0.478) and RS (0.62; P = 0.008). FT CMR myocardial strain analysis might serve as a new tool for assessment of myocardial dysfunction in the diagnostic work-up of patients suspected of having acute myocarditis. Especially, LS and CS show a sufficient diagnostic performance and were most closely correlated with CMR parameters of myocardial oedema. (orig.)
Preliminary study on radiation crosslinking of PE-NBR multiple phase system
International Nuclear Information System (INIS)
Wang Hong; Zhang Wanxi; Sun Jiazhen
1989-01-01
The effect of radiation crosslinking on the structure and properties of PE-NBR (polyethylene-acrylonitrile-butadiene rubber) multiple phase system was studied in this paper. The relationship of sol fraction and irradiated dose to multiplephase system was demonstrated
Kanji, Akbar
2015-01-21
Background Mycobacterium tuberculosis (MTB) PE_PGRS genes belong to the PE multigene family. Although the function of PE_PGRS genes is unknown, it is hypothesized that the PE_PGRS genes may be associated with antigenic variability in MTB. Material and methods Whole genome sequencing analysis was performed on (n = 37) extensively drug-resistant (XDR) MTB strains from Pakistan, which included Lineage 1 (East African Indian, n = 2); Other lineage 1 (n = 3); Lineage 3 (Central Asian, n = 24); Other lineage 3 (n = 4); Lineage 4 (X3, n = 1) and T group (n = 3) MTB strains. Results There were 107 SNPs identified from the analysis of 42 PE_PGRS genes; of these, 13 were non-synonymous SNPs (nsSNPs). The nsSNPs identified in PE_PGRS genes – 6, 9 and 10 – were common in all EAI, CAS, Other lineages (1 and 3), T1 and X3. Deletions (DELs) in PE_PGRS genes – 3 and 19 – were observed in 17 (80.9%) CAS1 and 6 (85.7%) in Other lineages (1 and 3) XDR MTB strains, while DELs in the PE_PGRS49 were observed in all CAS1, CAS, CAS2 and Other lineages (1 and 3) XDR MTB strains. All CAS, EAI and Other lineages (1 and 3) strains showed insertions (INS) in PE_PGRS6 gene, while INS in the PE_PGRS genes 19 and 33 were observed in 20 (95.2%) CAS1, all CAS, CAS2, EAI and Other lineages (1 and 3) XDR MTB strains. Conclusion Genetic diversity in PE_PGRS genes contributes to antigenic variability and may result in increased immunogenicity of strains. This is the first study identifying variations in nsSNPs and INDELs in the PE_PGRS genes of XDR-TB strains from Pakistan. It highlights common genetic variations which may contribute to persistence.
Kanji, Akbar
2015-03-01
Background: Mycobacterium tuberculosis (MTB) PE_PGRS genes belong to the PE multi-gene family. Although the function of the members of the PE_PGRS multi-gene family is not yet known, it is hypothesized that the PE_PGRS genes may be associated with genetic variability. Material and methods: Whole genome sequencing analysis was performed on (n= 37) extensively drug resistant (XDR) MTB strains from Pakistan which included Central Asian (n= 23), East African Indian (n= 2), X3 (n= 1), T group (n= 3) and Orphan (n= 8) MTB strains. Results: By analyzing 42 PE_PGRS genes, 111 SNPs were identified, of which 13 were non-synonymous SNPs (nsSNPs). The nsSNPs identified in the PE_PGRS genes were as follows: 6, 9, 10 and 55 present in each of the CAS, EAI, Orphan, T1 and X3 XDR MTB strains studied. Deletions in PE_PGRS genes: 19, 21 and 23 were observed in 7 (35.0%) CAS1 and 3 (37.5%) in Orphan XDR MTB strains, while deletions in the PE_PGRS genes: 49 and 50 were observed in 36 (95.0%) CAS1 and all CAS, CAS2 and Orphan XDR MTB strains. An insertion in PE_PGRS6 gene was observed in all CAS, EAI3 and Orphan, while insertions in the PE_PGRS genes 19 and 33 were observed in 19 (95%) CAS1 and all CAS, CAS2, EAI3 and Orphan XDR MTB strains. Conclusion: Genetic diversity in PE_PGRS genes contributes to antigenic variability and may result in increased immunogenicity of strains. This is the first study identifying variations in nsSNPs, Insertions and Deletions in the PE_PGRS genes of XDR-TB strains from Pakistan. It highlights common genetic variations which may contribute to persistence.
Directory of Open Access Journals (Sweden)
Naofumi Chinen
2016-01-01
Full Text Available A 34-year-old woman with primary antiphospholipid syndrome was admitted to the Gastroenterology Department of our hospital with fever, acute abdomen, watery diarrhea, and extremely high levels of inflammatory parameters. She had a history of left lower limb deep vein thrombosis and pulmonary embolism and was taking warfarin potassium. Acute gastroenteritis was suspected and an antibiotic was administered, but symptoms progressed. Abdominal ultrasonography showed occlusion of the left hepatic vein and the middle hepatic vein and her D-dimer level was high. Accordingly, Budd-Chiari syndrome was diagnosed and high-dose intravenous infusion of heparin was initiated. Her abdominal symptoms improved and the levels of inflammatory parameters and D-dimer decreased rapidly. It is known that antiphospholipid syndrome can be complicated by Budd-Chiari syndrome that usually occurs as subacute or chronic onset, but acute onset is rare. It is difficult to diagnose acute Budd-Chiari syndrome complicating antiphospholipid syndrome and this complication generally has a poor outcome. However, the present case can get early diagnosis and successful treatment with tight anticoagulant therapy.
Inclusion of children with autism and ADHD in physical education (PE) at primary school in Denmark
DEFF Research Database (Denmark)
Bentholm, Anette Lisbeth
Inclusion of children with autism and ADHD in physical education (PE) at primary school in DenmarkMore children diagnosed with autism and ADHD have been included in primary school by law in Denmark over the last years (L379, 2012). In a new School reform (L406, 2014) the children have to particip......Inclusion of children with autism and ADHD in physical education (PE) at primary school in DenmarkMore children diagnosed with autism and ADHD have been included in primary school by law in Denmark over the last years (L379, 2012). In a new School reform (L406, 2014) the children have...... to participate in physical activities at least 45 minutes each school day. Autism and ADHD are disabling conditions that affects social communication and interaction, and often also their motor skills and cognition (Harvey & Reid, 2003; Verret, 2010). Therefore these children can be challenge to participate...... a process-oriented methodology (Baur & Ernst, 2011).The methods of the research are primarily based on qualitative methods: Analysis of the curriculum for PE from the Danish ministry of Education and political strategies of inclusion, field observations primarily in PE, interviews with the 11 children...
Acute bacterial prostatitis and abscess formation.
Lee, Dong Sup; Choe, Hyun-Sop; Kim, Hee Youn; Kim, Sun Wook; Bae, Sang Rak; Yoon, Byung Il; Lee, Seung-Ju
2016-07-07
The purpose of this study was to identify risk factors for abscess formation in acute bacterial prostatitis, and to compare treatment outcomes between abscess group and non-abscess group. This is a multicenter, retrospective cohort study. All patients suspected of having an acute prostatic infection underwent computed tomography or transrectal ultrasonography to discriminate acute prostatic abscesses from acute prostatitis without abscess formation. A total of 31 prostate abscesses were reviewed among 142 patients with acute prostatitis. Univariate analysis revealed that symptom duration, diabetes mellitus and voiding disturbance were predisposing factors for abscess formation in acute prostatitis. However, diabetes mellitus was not related to prostate abscess in multivariate analysis. Patients with abscesses 20 mm who underwent transurethral resection had a shorter duration of antibiotic treatment than did those who did not have surgery. Regardless of surgical treatment, both the length of hospital stay and antibiotic treatment were longer in patients with prostatic abscesses than they were in those without abscesses. However, the incidence of septic shock was not different between the two groups. A wide spectrum of microorganisms was responsible for prostate abscesses. In contrast, Escherichia coli was the predominant organism responsible for acute prostatitis without abscess. Imaging studies should be considered when patients with acute prostatitis have delayed treatment and signs of voiding disturbance. Early diagnosis is beneficial because prostatic abscesses require prolonged treatment protocols, or even require surgical drainage. Surgical drainage procedures such as transurethral resection of the prostate were not necessary in all patients with prostate abscesses. However, surgical intervention may have potential merits that reduce the antibiotic exposure period and enhance voiding function in patients with prostatic abscess.
Role of radionuclide imaging in the diagnosis of acute osteomyelitis
International Nuclear Information System (INIS)
Demopulos, G.A.; Bleck, E.E.; McDougall, I.R.
1988-01-01
Over the last decade, the role of nuclear medicine studies in the diagnosis of acute osteomyelitis has been discussed in depth in the literature. Yet, the respective roles played in this setting by each of the commonly used radionuclide studies often are confusing. In an attempt to develop a cogent diagnostic strategy, we reviewed the literature published within the last 12 years pertaining to the use of radiophosphate bone scintigraphy as well as gallium and indium WBC imaging in the diagnosis of this condition. Based on our findings, we propose an alternative approach to the evaluation of a patient with suspected acute osteomyelitis. 63 references
A peça radiofônica alemã dos últimos sessenta anos
Directory of Open Access Journals (Sweden)
Klaus Eggensperger
2009-06-01
Full Text Available O artigo aborda a trajetória da peça radiofônica alemã do pós-guerra. Depois de uma introdução ao gênero da radiopeça, são comentados três peças exemplares: Träume de Günter Eich, NWDR 1951, como exemplo típico de uma radiopeça literária, e Träume 1951 - Musikalischer Epilog de Hans Schüttler, NDR, do ano 2007, uma obra representativa da Audio-Art contemporânea. O último exemplo é de uma radiopeça pop, Eisstadt, WDR 2005, de Schorsch Kamerun. Eisstadt, uma bricolagem com a mesma pretensão política de Träume, mistura a cultura erudita com a cultura de massa e combina os mais diversos estilos de língua e de música. Ultimamente, com a valorização do audio na Alemanha, a peça radiofônica está passando por uma fase de revitalização, porém sob condições diversas daquelas dos anos cinquenta.
Performance of IN-706 and PE-16 cladding in mixed-oxide fuel pins
International Nuclear Information System (INIS)
Makenas, B.J.; Lawrence, L.A.; Jensen, B.W.
1982-05-01
Iron-nickel base, precipitation-strengthened alloys, IN-706 and PE-16, advanced alloy cladding considered for breeder reactor applications, were irradiated in mixed-oxide fuel pins in the HEDL-P-60 subassembly in EBR-II. Initial selection of candidate advanced alloys was done using only nonfueled materials test results. However, to establish the performance characteristics of the candidate cladding alloys, i.e., dimensional stability and structural integrity under conditions of high neutron flux, elevated temperature, and applied stress, it was necessary to irradiate fuel pins under typical operating conditions. Fuel pins were clad with solution treated IN-706 and PE-16 and irradiated to peak fluences of 6.1 x 10 22 n/cm 2 (E > .1 MeV) and 8.8 x 10 22 n/cm 2 (E > .1 MeV) respectively. Fabrication and operating parameters for the fuel pins with the advanced cladding alloy candidates are summarized. Irradiation of HEDL-P-60 was interrupted with the breach of a pin with IN-706 cladding at 5.1 at % and the test was terminated with cladding breach in a pin with PE-16 cladding at 7.6 at %
Nettis, E; Colanardi, M C; Ferrannini, A; Tursi, A
2003-12-01
Tartrazine has been frequently linked to several diseases. However, a cause-and-effect role for tartrazine in these illnesses, especially in urticaria, has not always been established. The aim of this study is to determine the incidence of intolerance to tartrazine among subjects who experienced an acute episode of urticaria/angioedema following the ingestion of a meal or a product containing this substance. This was a retrospective study based on analysis of data of patients reported to have experienced episodes of urticaria and/or angioedema after ingesting meals or products containing tartrazine. At the first visit to the outpatients clinic, a careful anamnesis had been taken. Patients had then been submitted to the following diagnostic tests: IgE tests to common inhalant allergens and food allergens and a double-blind placebo-controlled challenge with tartrazine. A total of 102 subjects were enrolled in the study: 19 (18.6%) showed at least one relevant positive reaction to an IgE test for food allergy. Only one subject (1%) had reactions after ingestion of 5 mg of tartrazine, given on day 5. She did not have adverse reactions to placebo. This study shows that the percentage of acute urticaria and/or angioedema induced by tartrazine is very low (1%). In view of our results, we suggest that all physicians with patients who have suffered adverse reactions that could be attributed to tartrazine should also carefully evaluate other possible causes.
Application of the PE method to up-slope sound propagation
DEFF Research Database (Denmark)
Rasmussen, Karsten Bo; Arranz, Marta Galindo
1995-01-01
of sloping interfaces in one-way PE models introduces a fundamental problem of energy conservation. This is generated at the lower boundary condition. The ground is assumed to be a locally reacting surface where the ground impedance is defined as the ratio of pressure to the normal component of particle...
Acute appendicitis in a premature baby
International Nuclear Information System (INIS)
Beluffi, Giampiero; Alberici, Elisa
2002-01-01
A case of acute appendicitis in a premature baby in whom diagnosis was suggested on plain films of the abdomen is presented. In this baby air in a hollow viscus suspected of being an enlarged appendix was the clue to diagnosis. The diagnostic dilemma of this rare and life-threatening condition in premature babies and newborns is underlined. The relevance of different imaging modalities and of different findings in this age group is discussed. Awareness of this rare condition and possible differential diagnosis in newborns and premature babies is stressed. (orig.)
Acute Hepatic Allograft Rejection in Pediatric Recipients: Effective Factors.
Dehghani, S M; Shahramian, I; Afshari, M; Bahmanyar, M; Ataollahi, M; Sargazi, A
2018-01-01
Acute cellular rejection (ACR), a reversible process, can affect the graft survival. To evaluate the relation between ACR and clinical factors in recipients of allograft liver transplantation. 47 recipients of liver were consecutively enrolled in a retrospective study. Their information were retrieved from their medical records and analyzed. Of the 47 recipients, 38 (81%) experienced acute rejection during 24 months of the transplantation. None of the studied factors for occurring transplant rejection, i.e ., blood groups, sex, age, familial history of disease, receiving drugs and blood products, type of donor, Child score, and Child class, was not found to be significant. During a limited follow-up period, we did not find any association between ACR and suspected risk factors.
The role of imaging in children with suspected appendicitis: the UK perspective
International Nuclear Information System (INIS)
Lander, Anthony
2007-01-01
The diagnosis of uncomplicated acute appendicitis is often straightforward, allowing timely appendicectomy without the need for expensive tests or imaging. Repeated clinical examination by an experienced surgeon has traditionally been the key to making the diagnosis in both straightforward and difficult cases. Nonetheless, all surgeons will remove some normal appendices. Sometimes it can be particularly difficult to make the diagnosis, especially in the child under 5 years of age, in teenage girls, in young women and in the elderly. When difficult to make, the diagnosis may be significantly delayed and since the pathology is progressive, the patient may suffer potentially avoidable complications. This paper looks at two potential roles for imaging. Firstly, can imaging, applied selectively, help make the difficult diagnosis less difficult and so reduce delays and morbidity? Secondly, could imaging all patients with suspected appendicitis reduce the number of normal appendices removed from children who seem to have all the signs and symptoms of straightforward uncomplicated acute appendicitis but who actually have presumed self-resolving non-appendiceal pathology? The answer to these questions may depend on three factors that are not entirely independent: a surgical unit's current audited negative appendicectomy rate, population base/case mix and the expertise of the examining surgeon. Individual surgeons and some surgical units, by policy, use modern imaging techniques with quite different frequencies that may be appropriate depending on these three factors. This article argues that a careful history and repeated clinical examination is the key to making the diagnosis, with imaging, primarily ultrasonography, being used in patients with a palpable mass or in those having had 48 h of hospital observation without progress. In Europe, imaging has played a limited role in the investigation of the child with suspected appendicitis with the diagnosis relying on repeated
The clinical course of patients with suspected pulmonary embolism
van Beek, E. J.; Kuijer, P. M.; Büller, H. R.; Brandjes, D. P.; Bossuyt, P. M.; ten Cate, J. W.
1997-01-01
BACKGROUND: The outcome of patients with suspected pulmonary embolism is known to a limited extent only. OBJECTIVE: To address this limited knowledge in a cohort in whom pulmonary embolism was proved or ruled out. METHODS: Consecutive patients with clinically suspected pulmonary embolism underwent
Acute anterior myocardial infarction seen on conventional iodine-contrast CT
Directory of Open Access Journals (Sweden)
Christian Hagdrup, MD
2017-09-01
Full Text Available Diagnosis of acute myocardial infarction (AMI is based on clinical symptoms of chest pain and dyspnea in combination with electrocardiographic changes and a raise in myocardial-specific biomarkers. Imaging is by echocardiography and magnetic resonance. The preferred technique for identification of previous myocardial infarction (MI is magnetic resonance imaging with late gadolinium technique, but in the acute patient echocardiography is applied. In selected cases, important information can be obtained from other imaging modalities. We describe a case of a patient first suspected of an abdominal catastrophe in whom acute MI was diagnosed from a computerized tomography (CT scan with iodine contrast. Our case together with a few other cases reported in the literature demonstrate that contrast enhancement of the myocardium can be important to follow in the acute patient because the CT scans sometimes give a unique opportunity to recognize findings consistent with MI even though the CT scan was performed for another reason.
DEFF Research Database (Denmark)
Møller, Kirsten; Høgh, Peter; Larsen, Fin Stolze
2000-01-01
Mechanical hyperventilation is often instituted in patients with acute bacterial meningitis when increased intracranial pressure is suspected. However, the effect on regional cerebral blood flow (CBF) is unknown. In this study, we measured regional CBF (rCBF) in patients with acute bacterial...... meningitis before and during short-term hyperventilation. In 17 patients with acute bacterial meningitis, absolute rCBF (in ml/100 g min-1) was measured during baseline ventilation and hyperventilation by single-photon emission computed tomography (SPECT) using intravenous 133Xe bolus injection. Intravenous...... in the frontal and parietal cortex as well as in the basal ganglia. Focal perfusion abnormalities were present in 10 of 12 patients. Regional cerebral blood flow abnormalities are frequent in patients with acute bacterial meningitis. Short-term hyperventilation does not enhance these abnormalities....
A case of acute orbital myositis which was difficult to diagnose at first
International Nuclear Information System (INIS)
Yamamoto, Kiyoshi; Terabayashi, Tadasu; Mori, Hiroshi; Niida, Hirohito; Sugiyama, Yoshiaki; Nakagawa, Masato
1988-01-01
We report a case of acute orbital myositis. A 61-year-old woman exhibited acute orbital pain, diplopia, and left proptosis. Examination revealed a 5-mm left proptosis, left chemosis, and limitations in all directions of the movement of the left eye. Visual acuity was unimpaired, however, and the neurological examination was otherwise normal. CT demonstrated a left inferior orbital mass. We suspected an acute orbital pseudotumor based on the rapid onset and the clinical symptoms. We treated her with systemic corticosteroids. Four weeks later CT documented a reduced left orbital mass; there seemed to be left only an inferior rectus muscle enlargement. We diagnosed acute orbital myositis, a subgroup of orbital pseudotumors, based upon the rapid clinical presentation, the CT features, and the resolution after treatment with systemic corticosteroids. (author)
Unfair Lineups Make Witnesses More Likely to Confuse Innocent and Guilty Suspects.
Colloff, Melissa F; Wade, Kimberley A; Strange, Deryn
2016-09-01
Eyewitness-identification studies have focused on the idea that unfair lineups (i.e., ones in which the police suspect stands out) make witnesses more willing to identify the police suspect. We examined whether unfair lineups also influence subjects' ability to distinguish between innocent and guilty suspects and their ability to judge the accuracy of their identification. In a single experiment (N = 8,925), we compared three fair-lineup techniques used by the police with unfair lineups in which we did nothing to prevent distinctive suspects from standing out. Compared with the fair lineups, doing nothing not only increased subjects' willingness to identify the suspect but also markedly impaired subjects' ability to distinguish between innocent and guilty suspects. Accuracy was also reduced at every level of confidence. These results advance theory on witnesses' identification performance and have important practical implications for how police should construct lineups when suspects have distinctive features. © The Author(s) 2016.
The use of psychoactive prescription drugs among DUI suspects.
Karjalainen, Karoliina; Haukka, Jari; Lintonen, Tomi; Joukamaa, Matti; Lillsunde, Pirjo
2015-10-01
The study seeks to increase understanding of the use of psychoactive prescription drugs among persons suspected of driving under the influence (DUI). We studied whether the use of prescribed psychoactive medication was associated with DUI, and examined the difference in the use of prescription drugs between DUI recidivists and those arrested only once. In this register-based study, persons suspected of DUI (n=29470) were drawn from the Register of DUI suspects, and an age- and gender-matched reference population (n=30043) was drawn from the Finnish general population. Data on prescription drug use was obtained by linkage to the National Prescription Register. The associations of DUI arrest and use of psychoactive prescription drugs in different DUI groups (findings for alcohol only, prescription drugs, prescription drugs and alcohol, illicit drugs) were estimated by using mixed-effect logistic regression. The use of psychoactive prescription drugs and DUI appeared to be strongly associated, with DUI suspects significantly more likely to use psychoactive prescription drugs compared to the reference population. Gender differences existed, with the use of benzodiazepines being more common among female DUI suspects. Moreover, DUI recidivists were more likely to use psychoactive prescription drugs compared to those arrested only once. In addition to alcohol and/or illicit drug use, a significant proportion of DUI suspects were using psychoactive prescription drugs. When prescribing psychoactive medication, especially benzodiazepines, physicians are challenged to screen for possible substance use problems and also to monitor for patients' alcohol or illicit drug use while being medicated. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
A blueprint for radioanalytical metrology CRMs, intercomparisons, and PE
International Nuclear Information System (INIS)
Inn, Kenneth G.W.; Kurosaki, Hiromu; Frechou, Carole; Gilligan, Chris; Jones, Robert; LaMont, Stephen; Leggitt, Jeff; Li Chunsheng; McCroan, Keith; Swatski, Ronald
2008-01-01
A workshop was held from 28 February to 2 March 2006 at the National Institute of Standards and Technology (NIST) to evaluate the needs for new directions for complex matrix reference materials certified for radionuclide content, interlaboratory comparisons and performance evaluation (PE) programs. The workshop identified new radioanalytical metrology thrust areas needed for environmental, radiobioassay, emergency consequence management, and nuclear forensics, attribution, nonproliferation, and safeguards
Entrevista a Guillermo de la Peña
Directory of Open Access Journals (Sweden)
Lydia Rodríguez Cuevas
2006-05-01
Full Text Available Guilllermo de la Peña es uno de los más prestigiosos antropólogos mexicanos. Doctor en antropología por la Universidad de Manchester (Gran Bretaña, es miembro de la Academia Mexicana de Ciencias y ha recibido premios y becas del Consejo Nacional de Ciencia y Tecnología, la Fundación Ford, la Fundación Edward Larocque Tinker, la Asociación Mexicana de Estudios de Población y la Fundación Conmemorativa de John Simon Guggenheim. En 1991 recibió el Premio Nacional de Investigación Urbana y Regional, y en 1994 recibió el Premio Jalisco en el Area de Ciencia. Actualmente es profesor-investigador de la Unidad Occidente del Centro de Investigaciones y Estudios Superiores en Antropología Social (CIESAS, institución donde ha recibido en tres ocasiones (1993, 1995 y 1998 el premio al mejor artículo de investigación. Ha realizado más de 140 publicaciones científicas. La presente entrevista tuvo lugar en la ciudad de Washington, tras la participación del Doctor de la Peña en el panel sobre Performing Sovereignties: Strategies for Representing Indigenous Land and Political Claims in Latin American, durante el 104 encuentro de la American Anthropological Association.
A moso bamboo WRKY gene PeWRKY83 confers salinity tolerance in transgenic Arabidopsis plants.
Wu, Min; Liu, Huanlong; Han, Guomin; Cai, Ronghao; Pan, Feng; Xiang, Yan
2017-09-15
The WRKY family are transcription factors, involved in plant development, and response to biotic and abiotic stresses. Moso bamboo is an important bamboo that has high ecological, economic and cultural value and is widely distributed in the south of China. In this study, we performed a genome-wide identification of WRKY members in moso bamboo and identified 89 members. By comparative analysis in six grass genomes, we found the WRKY gene family may have experienced or be experiencing purifying selection. Based on relative expression levels among WRKY IIc members under three abiotic stresses, PeWRKY83 functioned as a transcription factor and was selected for detailed analysis. The transgenic Arabidopsis of PeWRKY83 showed superior physiological properties compared with the WT under salt stress. Overexpression plants were less sensitive to ABA at both germination and postgermination stages and accumulated more endogenous ABA under salt stress conditions. Further studies demonstrated that overexpression of PeWRKY83 could regulate the expression of some ABA biosynthesis genes (AtAAO3, AtNCED2, AtNCED3), signaling genes (AtABI1, AtPP2CA) and responsive genes (AtRD29A, AtRD29B, AtABF1) under salt stress. Together, these results suggested that PeWRKY83 functions as a novel WRKY-related TF which plays a positive role in salt tolerance by regulating stress-induced ABA synthesis.
[Acute pancreatitis associated with hypercalcaemia].
Tun-Abraham, Mauro Enrique; Obregón-Guerrero, Gabriela; Romero-Espinoza, Larry; Valencia-Jiménez, Javier
2015-01-01
Hypercalcaemia due to primary hyperparathyroidism is a rare cause of acute pancreatitis, with a reported prevalence of 1.5 to 8%. There is no clear pathophysiological basis, but elevated parathyroid hormone and high serum calcium levels could be responsible for calcium deposit in the pancreatic ducts and activation of pancreatic enzymes, which may be the main risk factor for developing acute pancreatitis. The aim of this report is to describe four cases. Four cases are reported of severe pancreatitis associated with hypercalcaemia secondary to primary hyperparathyroidism; three of them with complications (two pseudocysts and one pancreatic necrosis). Cervical ultrasound, computed tomography, and scintigraphy using 99mTc-Sestambi, studies showed the parathyroid adenoma. Surgical resection was the definitive treatment in all four cases. None of the patients had recurrent acute pancreatitis events during follow-up. Acute pancreatitis secondary to hypercalcaemia of primary hyperparathyroidism is rare; however, when it occurs it is associated with severe pancreatitis. It is suspected in patients with elevated serum calcium and high parathyroid hormone levels. Imaging techniques such as cervical ultrasound, computed tomography, and scintigraphy using 99mTc-Sestambi, should be performed, to confirm clinical suspicion. Surgical resection is the definitive treatment with excellent results. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.
Hsu, Yu-Chuan; Yang, Fu-Chi; Perng, Cherng-Lih; Tso, An-Chen; Wong, Lee-Jun C; Hsu, Chang-Hung
2012-09-01
Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a rare mitochondrial disorder with a wide range of multisystemic symptoms. Epileptic seizures are common features of both MELAS and meningoencephalitis and are typically treated with anticonvulsants. To provide the reader with a better understanding of MELAS and the adverse effects of valproic acid. A 47-year-old man with a history of diabetes, hearing loss, sinusitis, and otitis media was brought to our emergency department due to acute onset of fever, headache, generalized seizure, and agitation. Because acute meningoencephalitis was suspected, the patient was treated with antibiotics on an empirical basis. The seizure activity was aggravated by valproic acid and abated after its discontinuation. MELAS was suspected and the diagnosis was confirmed by the presence of a nucleotide 3243 A→G mutation in the mitochondrial DNA. Detailed history-taking and systematic review help emergency physicians differentiate MELAS from meningoencephalitis in patients with the common presentation of epileptic seizures. Use of valproic acid to treat epilepsy in patients suspected of having mitochondrial disease should be avoided. Underlying mitochondrial disease should be suspected if seizure activity worsens with valproic acid therapy. Copyright © 2012 Elsevier Inc. All rights reserved.
Jin, Michael; Sanchez, Thomas R; Lamba, Ramit; Fananapazir, Ghaneh; Corwin, Michael T
2017-09-01
The purpose of this article is to determine the accuracy and radiation dose reduction of limited-range CT prescribed from the top of L2 to the top of the pubic symphysis in children with suspected acute appendicitis. We performed a retrospective study of 210 consecutive pediatric patients from December 11, 2012, through December 11, 2014, who underwent abdominopelvic CT for suspected acute appendicitis. Two radiologists independently reviewed the theoretic limited scans from the superior L2 vertebral body to the top of the pubic symphysis, to assess for visualization of the appendix, acute appendicitis, alternative diagnoses, and incidental findings. Separately, the same parameters were assessed on the full scan by the same two reviewers. Whole-body effective doses were determined for the full- and limited-range scans and were compared using the paired t test. The appendix or entire cecum was visualized on the limited scan in all cases, and no cases of acute appendicitis were missed on the simulated limited scan compared with the full scan. Two alternative diagnoses were missed with the limited scan: one case of hydronephrosis and one of acute acalculous cholecystitis. The mean effective dose for the original scan was 5.6 mSv and that for the simulated limited scan was 3.0 mSv, resulting in a dose reduction of 46.4% (p appendicitis and reduces the dose by approximately 46%.
Guo, Jingjing; Wu, Gang; Chen, Xiaojun; Li, Xiaodong
2014-01-01
The gastrointestinal tract is the most common site for extranodal involvement by non-Hodgkin's lymphoma. However, primary appendiceal lymphomas presenting as perforated acute appendicitis are very rare: they occur in only 0.015% of all gastrointestinal lymphoma cases. The management of this condition is still controversial, and a multimodality approach (e.g., surgery, radiation therapy, and chemotherapy) is the optimal treatment. In these cases, appendiceal non-Hodgkin's lymphomas typically manifest with acute symptoms in patients with no prior lymphoma history. Additionally, we treated our patient with a right hemicolectomy and postoperative multiagent chemotherapy.
Borah, Debasish; Dasgupta, Arnab; Dey, Ujjal Kumar; Patra, Sudhanwa; Tomar, Gaurav
2017-09-01
We consider a simple extension of the minimal left-right symmetric model (LRSM) in order to explain the PeV neutrino events seen at the IceCube experiment from a heavy decaying dark matter. The dark matter sector is composed of two fermions: one at PeV scale and the other at TeV scale such that the heavier one can decay into the lighter one and two neutrinos. The gauge annihilation cross sections of PeV dark matter are not large enough to generate its relic abundance within the observed limit. We include a pair of real scalar triplets Ω L,R which can bring the thermally overproduced PeV dark matter abundance into the observed range through late time decay and consequent entropy release thereby providing a consistent way to obtain the correct relic abundance without violating the unitarity bound on dark matter mass. Another scalar field, a bitriplet under left-right gauge group is added to assist the heavier dark matter decay. The presence of an approximate global U(1) X symmetry can naturally explain the origin of tiny couplings required for long-lived nature of these decaying particles. We also show, how such an extended LRSM can be incorporated within a non-supersymmetric SO(10) model where the gauge coupling unification at a very high scale naturally accommodate a PeV scale intermediate symmetry, required to explain the PeV events at IceCube.
Importance of organized energy efficiency introduction and improvement in PE EPS
Directory of Open Access Journals (Sweden)
Nikolić Aleksandar
2015-01-01
Full Text Available The energy management system (EnMS introduction into companies that are significant energy consumers has been initiated after adoption of the Law of efficient energy usage. Due to the fact that sectors for production, transmission and distribution of electrical and heat energy are also implied by this law, it is clear that PE EPS is also obligated to implement EnMS and to carry out the requirements defined by legislation. In this paper, the results of first-phase introduction of the system for supervision and improvement of energy efficiency in PE EPS in production of coal, and production and distribution of electrical and heat energy, are given. Recommended measures for energy efficiency improvement with stress on larger energy, financial savings and a lower rate of investment return are emphasised. Such systematic measures should also serve as a good basis for further stages of energy management introduction and implementation.
Retrospective audit of the investigation of patients with suspected acute subarachnoid haemorrhage
International Nuclear Information System (INIS)
Muhammed, O.; Teubnet, D.; Jones, D.N.; Slavotinek, J.P.
2010-01-01
Recommended investigational care (RIC) of emergency department (ED) patients with suspected subarachnoid haemorrhage comprises lumbar puncture (LP) to detect xanthochromia if the preceding CT scan is negative. Retrospective audit of the investigational care of 100 consecutive ED patients presenting with possible subarachnoid haemorrhage. Of the 100 patients, 91 had negative CT, and 36 (39.6%) of these patients had an LP performed to detect xanthochromia (i.e. RIC). Fifty-five of 91 (60.4%) patients did not receive RIC. Of the 55 patients who did not receive RIC, 25 (45.5%) had a documented senior clinical decision not to perform an LP; 15 (27.3%) had no documented reason; five (9.1%) refused consent; two (3.6%) had an LP but no xanthochromia requested, one patient did not have an LP because of technical issues, six patients underwent CT angiography (CTA), and one patient underwent magnetic resonance angiography (MRA), in the absence of a LP, following a negative CT. Two patients underwent CTA following a negative xanthochromia result. Patients admitted to the emergency extended care unit had 6.85 times the odds of receiving RIC (95% CI 2.20-21.4). Fifty-five (55) of 91 (60%) ED patients did not receive RIC. Fifteen of the 55 did not have any documented justification for not performing an LP with xanthochromia testing. Admission to an emergency extended care unit was a predictor of receiving RIC. Inappropriate use of CTA and MRA was identified. These findings have important implications for patient safety. Multifaceted strategies are required to close this evidence-practice gap.
Directory of Open Access Journals (Sweden)
Funda H. SEZGIN
2010-01-01
Full Text Available The price to earnings ratio (P/E is widely used, particularly by practitioners, as a measure of relative stock valuation. Price to earnings is an indicator which indicates current mood of investors how much they are willing to pay per unit of company earnings. Traditionally, the P/E ratio has been assumed to be an indicator of the quality of an investment; a relatively low P/E ratio implies a good investment, whereas a relatively high P/E ratio indicates a “poor” investment prospect. The aim of this study is to identify relationship among market stock return, dividend yields and price to earnings ratio affect in the period 2000.01-2009.12. Therefore, to determine long-run and short-run relationship, Johansen cointegration tests, error-correction models and Granger causality tests are used.
DEFF Research Database (Denmark)
Althof, Stanley E; McMahon, Chris G; Waldinger, Marcel D
2014-01-01
INTRODUCTION: In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient...... for the diagnosis and treatment of PE for family practice clinicians as well as sexual medicine experts. METHOD: A comprehensive literature review was performed. RESULTS: This article contains the report of the second ISSM PE Guidelines Committee. It offers a new unified definition of PE and updates the previous...... of their patients. CONCLUSION: Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual...
Parents with Schizophrenia – Insights from notifications of suspected child abuse and neglect
DEFF Research Database (Denmark)
Wulf-Andersen, Trine Østergaard; Ranning, Anne
2016-01-01
Children of parents with acute symptoms of schizophrenia are at high risk of being exposed to adverse environmental circumstances known to predict future mental and physical illness. To ensure a healthy development of children human services must address the needs of children of patients...... with schizophrenia. In this study, notifications of suspected child abuse and neglect was used to elicit difficulties in parental role functioning in schizophrenia patients. Qualitative text analysis was used to elicit common themes in 49 written documents from social workers at mental health centres expressing...... concerns about the wellbeing of children of patients with schizophrenia. We found the most recurring themes to be “parents’ delusions”, “parents being absorbed in their private reality”, “parents’ distress as a result of symptoms”, “fierce or violent scenes in the home” and “burden on other caretakers...
Acute renal failure after ingestion of guaifenesin and dextromethorphan.
Small, Evan; Sandefur, Benjamin J
2014-07-01
Guaifenesin is a common nonprescription medication that has been implicated in drug-induced nephrolithiasis. Dextromethorphan, a nonprescription antitussive found in some guaifenesin-containing preparations, is increasingly recognized as a substance of abuse by many youth and young adults. Renally excreted medications known to have poor solubility in urine have the potential to precipitate when ingested in large quantity, leading to acute obstruction of the ureters and renal failure. We describe the case of a 22-year-old male who developed severe bilateral flank pain, hematuria, and oliguria after an isolated recreational ingestion of guaifenesin and dextromethorphan. The patient was found to have bilateral ureteral obstruction and acute renal failure, suspected to be secondary to precipitation of medication metabolites in the urine. This case highlights the potential for acute renal failure secondary to guaifenesin and dextromethorphan abuse. Copyright © 2014 Elsevier Inc. All rights reserved.
Inhaled mycotoxins lead to acute renal failure.
Di Paolo, N; Guarnieri, A; Garosi, G; Sacchi, G; Mangiarotti, A M; Di Paolo, M
1994-01-01
Mysterious deaths of archeologists after opening Egyptian tombs have been suspected, but never proved, to be secondary to inhalation of mycotoxin. We observed a case of acute renal failure (ARF) due to inhalation of ochratoxin A produced by a mould of the species Aspergillus ochraceus. After working 8 h in a granary closed for several months, a farmer and his wife suffered respiratory distress; the woman developed non-oliguric ARF and biopsy revealed tubulonecrosis. A strain of Aspergillus ochraceus producing ochratoxin was isolated from the wheat.
[ACUTE MESENTEROAXIAL GASTRIC VOLVULUS: A REPORT ON ONE CASE
Díaz, Juan; Martell, Alex; Ramírez, Lisbeth; Ulloa, Delia
1998-01-01
Acute gastric volvulus in children is uncommon. This paper reports a case presented in a 14-year-old female whose diagnosis was suspected preoperatively taking into account the Brouchardt triad (vomiting, epigastric pain and inability to pass the nasogastric tube into the stomach). The child underwent laparatomy and the final diagnosis was mesenteroaxial gastric volvulus complicated with gastric perforation. Closure of the perforation and gastropexy were performed and the operative results were satisfactory.
DEFF Research Database (Denmark)
Jess, T; Jess, Per
2001-01-01
University Hospital during the period 1976-1998 were diagnosed as having ATI while undergoing surgery for suspected acute appendicitis. The patients were followed up, and both Yersinia titers and the development of Crohn's disease were registered. Results: Forty-four patients (83%) were tested for Yersinia...
Balaji, Arunpandian; Jaganathan, Saravana Kumar; Supriyanto, Eko; Muhamad, Ida Idayu; Khudzari, Ahmad Zahran Md
2015-01-01
Developing multifaceted, biocompatible, artificial implants for tissue engineering is a growing field of research. In recent times, several works have been reported about the utilization of biomolecules in combination with synthetic materials to achieve this process. Accordingly, in this study, the ability of an extract obtained from Aloe vera, a commonly used medicinal plant in influencing the biocompatibility of artificial material, is scrutinized using metallocene polyethylene (mPE). The process of coating dense fibrous Aloe vera extract on the surface of mPE was carried out using microwaves. Then, several physicochemical and blood compatibility characterization experiments were performed to disclose the effects of corresponding surface modification. The Fourier transform infrared spectrum showed characteristic vibrations of several active constituents available in Aloe vera and exhibited peak shifts at far infrared regions due to aloe-based mineral deposition. Meanwhile, the contact angle analysis demonstrated a drastic increase in wettability of coated samples, which confirmed the presence of active components on glazed mPE surface. Moreover, the bio-mimic structure of Aloe vera fibers and the influence of microwaves in enhancing the coating characteristics were also meticulously displayed through scanning electron microscopy micrographs and Hirox 3D images. The existence of nanoscale roughness was interpreted through high-resolution profiles obtained from atomic force microscopy. And the extent of variations in irregularities was delineated by measuring average roughness. Aloe vera-induced enrichment in the hemocompatible properties of mPE was established by carrying out in vitro tests such as activated partial thromboplastin time, prothrombin time, platelet adhesion, and hemolysis assay. In conclusion, the Aloe vera-glazed mPE substrate was inferred to attain desirable properties required for multifaceted biomedical implants.
Non-isothermal irradiation creep of nickel alloys Inconel 706 and PE-16
International Nuclear Information System (INIS)
Gilbert, E.R.; Chin, B.A.
1984-06-01
The results of in-reactor step temperature change experiments conducted on two nickel alloys, PE-16 and Inconel 706, were evaluated to determine the creep behavior under nonisothermal conditions. The effect of the temperature changes was found to be significantly different for the two alloys. Following a step temperature change, the creep rate of PE-16 adjusted to the rate found in isothermal tests at the new temperature. In contrast for Inconel 706, a reduction in temperature from 540 to 425 0 C produced a 300% increase in creep above that measured at 540 0 C in isothermal tests. The response of in-reactor creep in Inconel 706 to temperature changes was attributed to the dissolution of the gamma double-prime phase and subsequent loss of precipitation-strengthening at temperatures below 500 C
Value of multi-slice spiral CT MPVR reconstruction in the diagnosis of acute appendicitis
International Nuclear Information System (INIS)
Wang Kang; Zhao Zehua; Wang Zhi; Wang Weizhong; Xu Songsen; Zhang Miao; Liu Wenjin; Zhang Guozhen; Feng Dianxu
2005-01-01
Objective: To investigate the value of multi-slice spiral CT MPVR reconstruction in the diagnosis of acute appendicitis. Methods: A total of 39 patients with clinically suspected acute appendicitis underwent surgery from February, 2002 to September, 2003. They were prospectively examined before surgery with routine CT scanning and MPVR reconstruction spiral CT. 31 cases of appendicitis were confirmed after appendectomy. CT scans and surgery-pathology reports were evaluated on a five-grade scale from hyperemic-edematous appendix to abscess (normal appendix: 0 grade). Results: The results of spiral CT MPVR reconstruction were compared with the surgical and pathologic findings at appendectomy, yielding an accuracy of 87.2%, sensitivity of 90.3%, specificity of 75%, positive predictive value of 93.3%, and negative predictive value of 66.7%, respectively. Results of routine CT yielded an accuracy of 38.5%, sensitivity of 38.7%, specificity of 37.5%, positive predictive value of 70.6%, and negative predictive value of 13.6%, respectively. MPVR reconstruction signs of 28 patients with acute appendicitis included enlarged appendix ( > 6 mm) (96.4%), appendicoliths (26.7%), caecal apical thickening (36.7%), periappendiceal inflammation (71.4%), and abscess (10.7%). Conclusion: The use of spiral CT MPVR reconstruction in patients with equivocal clinical presentation suspected of having acute appendicitis can lead to a significant improvement in the preoperative diagnosis and maybe a decrease in surgical-pathologic severity of appendiceal disease. (authors)
Directory of Open Access Journals (Sweden)
D. P. Ramaema
2014-01-01
Full Text Available Introduction. Pleuroperitoneal leak is an uncommon complication of continuous ambulatory peritoneal dialysis (CAPD, with an estimated incidence of 1.6%. It should be suspected in these patients when they present with recurrent unilateral pleural effusions and/or acute shortness of breath following dialysate infusion. Case Presentation. We present the case of a 25-year-old female patient who had acute hydrothorax as a result of pleuroperitoneal leak complicating continuous ambulatory peritoneal dialysis (CAPD, which was confirmed on peritoneal scintigraphy. Conclusion. Continuous ambulatory peritoneal dialysis patients presenting with acute shortness of breath and/or recurrent unilateral pleural effusion should be investigated with peritoneal scintigraphy to exclude pleuroperitoneal leak.
PE on YouTube--Investigating Participation in Physical Education Practice
Quennerstedt, Mikael
2013-01-01
Background: In this article, students' diverse ways of participating in physical education (PE) practice shown in clips on YouTube were investigated. YouTube is the largest user-generated video-sharing website on the Internet, where different video content is presented. The clips on YouTube, as used in this paper, can be seen as a user-generated…
Perfusion scintigraphy in acute myocardial infarction
International Nuclear Information System (INIS)
Schricke, U.; Schwaiger, M.; Kastrati, A.; Schoemig, A.
1999-01-01
The Tc-99m sestamibi perfusion SPECT scintigraphy in acute myocardial infarction is a feasible method to assess the size of area at risk and the residual blood flow to this area as the most important determinants of final infarct size without any delay in treatment. In combination with a follow-up study final infarct size as well as myocardial salvage can be quantified. Clinical indications for the use of Tc-99m sestamibi scintigraphy are the noninvasive identification of arterial occlusion in patients suspected to acute myocardial infarction without electrocardiographic ST-elevation and the assessment of reperfusion success. In clinical trials Tc-99m sestamibi scintigraphy has proven to be a useful method to assess the impact of varying reperfusion therapies. The present review article discusses the indication, the study protocol, the interpretation of results and the clinical and scientifically importance of this method. (orig.) [de
Li, Yingchao; Mi, Chen; Li, Weizhi; She, Junjun
2016-11-01
Acute appendicitis is the most common abdominal emergency, but the diagnosis of appendicitis remains a challenge. Endoscopic retrograde appendicitis therapy (ERAT) is a new and minimally invasive procedure for the diagnosis and treatment of acute appendicitis. To investigate the diagnostic value of ERAT for acute appendicitis by the combination of colonoscopy and endoscopic retrograde appendicography (ERA). Twenty-one patients with the diagnosis of suspected uncomplicated acute appendicitis who underwent ERAT between November 2014 and January 2015 were included in this study. The main outcomes, imaging findings of acute appendicitis including colonoscopic direct-vision imaging and fluoroscopic ERA imaging, were retrospectively reviewed. Secondary outcomes included mean operative time, mean hospital stay, rate of complication, rate of appendectomy during follow-up period, and other clinical data. The diagnosis of acute appendicitis was established in 20 patients by positive ERA (5 patients) or colonoscopy (1 patient) alone or both (14 patients). The main colonoscopic imaging findings included mucosal inflammation (15/20, 75 %), appendicoliths (14/20, 70 %), and maturation (5/20, 25 %). The key points of ERA for diagnosing acute appendicitis included radiographic changes of appendix (17/20, 85 %), intraluminal appendicoliths (14/20, 70 %), and perforation (1/20, 5 %). Mean operative time of ERAT was 49.7 min, and mean hospital stay was 3.3 days. No patient converted to emergency appendectomy. Perforation occurred in one patient after appendicoliths removal was not severe and did not require invasive procedures. During at least 1-year follow-up period, only one patient underwent laparoscopic appendectomy. ERAT is a valuable procedure of choice providing a precise yield of diagnostic information for patients with suspected acute appendicitis by combination of colonoscopy and ERA.
Acute sensorineural hearing loss and severe otalgia due to scrub typhus
Directory of Open Access Journals (Sweden)
Kim Dong-Min
2009-10-01
Full Text Available Abstract Background Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. Case presentations We encountered a patient with sensorineural hearing loss complicating scrub typhus, and three patients with scrub typhus who complained of otalgia, which was sudden onset, severe, paroxysmal, intermittent yet persistent pain lasting for several seconds, appeared within 1 week after the onset of fever and rash. The acute sensorineural hearing loss and otalgia were resolved after antibiotic administration. Conclusion When patients in endemic areas present with fever and rash and have sensorineural hearing loss or otalgia without otoscopic abnormalities, clinicians should suspect scrub typhus and consider empirical antibiotic therapy.
Energy Technology Data Exchange (ETDEWEB)
Takagi, Hitoshi; Sone, Takahito [Ogaki Municipal Hospital, Gifu (Japan)
1998-01-01
SPECT on acute and chronic period of {sup 99m}Tc-tetrofosmin on 46 patients with acute myocardial infarction were analyzed to evaluate about usefulness of quantitative analysis method used by unfolding image that was gotten by Bull`s eye analysis on reperfusion therapy in acute myocardial infarction, and we could get undermentioned results. 60% black out area in resional of interested was best on the obstacle myocardium using analysis of unfolding image. Significantly betterment from acute to chronic phase on the obstacle area of myocardium and the mean uptake ratio of the obstacle area was confirmed by this method. The relation between myocardial salvage and factors of myocardial damage, for example reperfusion time TIMI grade, rentrop grade and reperfusion phenomenon could be analyzed by this method. This method was suspected to underestimate the areas of obstacle myocardium on the cases of defect of apex. Error of analysis was suspected on the case of accumulation of TF to other than myocardium. The problems were minimised by some techniques mention in this paper. (author)
Acute Bacterial Prostatitis: Diagnosis and Management.
Coker, Timothy J; Dierfeldt, Daniel M
2016-01-15
Acute bacterial prostatitis is an acute infection of the prostate gland that causes pelvic pain and urinary tract symptoms, such as dysuria, urinary frequency, and urinary retention, and may lead to systemic symptoms, such as fevers, chills, nausea, emesis, and malaise. Although the true incidence is unknown, acute bacterial prostatitis is estimated to comprise approximately 10% of all cases of prostatitis. Most acute bacterial prostatitis infections are community acquired, but some occur after transurethral manipulation procedures, such as urethral catheterization and cystoscopy, or after transrectal prostate biopsy. The physical examination should include abdominal, genital, and digital rectal examination to assess for a tender, enlarged, or boggy prostate. Diagnosis is predominantly made based on history and physical examination, but may be aided by urinalysis. Urine cultures should be obtained in all patients who are suspected of having acute bacterial prostatitis to determine the responsible bacteria and its antibiotic sensitivity pattern. Additional laboratory studies can be obtained based on risk factors and severity of illness. Radiography is typically unnecessary. Most patients can be treated as outpatients with oral antibiotics and supportive measures. Hospitalization and broad-spectrum intravenous antibiotics should be considered in patients who are systemically ill, unable to voluntarily urinate, unable to tolerate oral intake, or have risk factors for antibiotic resistance. Typical antibiotic regimens include ceftriaxone and doxycycline, ciprofloxacin, and piperacillin/tazobactam. The risk of nosocomial bacterial prostatitis can be reduced by using antibiotics, such as ciprofloxacin, before transrectal prostate biopsy.
Pharaon, Shad K; Schoch, Shawn; Marchand, Lucas; Mirza, Amer; Mayberry, John
2018-01-01
Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury. Fractures are usually fixed urgently, but some multiply injured patients are better served with a damage control strategy. Extremity compartment syndrome should be suspected in all critically injured patients with or without fractures and a low threshold for compartment pressure measurements or empiric fasciotomy maintained. Acute care surgeons performing rib fracture fixation and other chest wall injury reconstructions should follow the principles of open fracture reduction and stabilization.
Pharaon, Shad K; Schoch, Shawn; Marchand, Lucas; Mirza, Amer
2018-01-01
Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury. Fractures are usually fixed urgently, but some multiply injured patients are better served with a damage control strategy. Extremity compartment syndrome should be suspected in all critically injured patients with or without fractures and a low threshold for compartment pressure measurements or empiric fasciotomy maintained. Acute care surgeons performing rib fracture fixation and other chest wall injury reconstructions should follow the principles of open fracture reduction and stabilization. PMID:29766123
Risk model for suspected acute coronary syndrome is of limited value in an emergency department
DEFF Research Database (Denmark)
Mogensen, Christian Backer; Christiansen, Maja; Jørgensen, Jess Bjerre
2015-01-01
INTRODUCTION: Among patients with acute chest pain, acute coronary syndrome (ACS) is seen only in a minority of the patients, which raises the question, whether it is possible to separate a group with a high risk of ACS for admission to a cardiac care unit (CCU) from those with a low risk who would...... be treated at an emergency department (ED). The aim of this study was to describe a risk stratification model for a Danish context. METHODS: This was a historic prospective cohort study of patients with suspicion of ACS. The patient was defined as a low-risk patient and admitted to the ED if: 1....... RESULTS: We included a total of 488 patients with suspicion of ACS, 50% of whom were low-risk patients. 17% had a verified ACS; 10% of those in the low-risk group and 24% of those in the high-risk group (p = 0.0001). Among the verified ACS cases, 71% went primarily to the CCU. The odds ratio for an ACS...
Michiels, J J; Pattynama, P M
2000-01-01
A negative rapid ELISA D-dimer test alone in out-patients with a low to moderate clinical probability (CP) on pulmonary embolism (PE) is predicted to safely exclude pulmonary embolism. The combination of a negative rapid ELISA D-dimer test and a low to moderate CP on PE followed by compression ultrasonography (CUS) for the detection of deep vein thrombosis (DVT) is safe and cost-effective as it reduces the need for noninvasive imaging techniques to about 50% to 60% of outpatients with suspected PE. A high probability ventilation-perfusion (VP) scan or a positive spiral CT consistent with PE and the detection of DVT by CUS are currently considered to be clear indications for anticoagulant treatment. Subsequent pulmonary angiography (PA) is the gold standard diagnostic strategy to exclude or diagnose PE in suspected outpatients with a negative CUS, a positive rapid ELISA D-dimer test, and a nondiagnostic VP scan or negative spiral CT to prevent overtreatment with anticoagulants. However, the willingness of clinicians and the availability of resources to perform PA is restricted, a fact that has provided an impetus for clinical investigators to search for alternative noninvasive strategies to exclude or detect venous thromboembolism (VTE). Serial CUS testing for the detection of DVT in patients with a low to moderate CP on PE and a nondiagnostic VP scan or negative spiral CT is predicted to be safe and will reduce the need for PA to less than 10% or even less than 5%. This noninvasive serial CUS strategy restricts the need for invasive PA to a minor group of patients (spiral CT and a high CP on PE. Prospective evaluations are warranted to implement and to validate the advantages and the disadvantages of the various combinations of noninvasive strategies and to compare serial CUS testing versus PA in randomized clinical management studies of outpatients with suspected pulmonary embolism.
Incidence of complicated acute appendicitis: a single-centre retrospective study
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Aneta Piotrowska
2017-12-01
Full Text Available Introduction : Abdominal pain has been one of the most common reasons patients seek medical care for centuries. Nowadays, together with laboratory diagnostics and imaging, we are able to make an early diagnosis. This leads to the introduction of early adequate treatment. Aim of the research : To analyse the incidence and causes of complicated acute appendicitis in one medical centre in between 2004 and 2016. Material and methods : A retrospective study covered the period from December 23, 2004 to November 07, 2016. It included 2048 cases of children between 0 and 18 years of age undergoing surgery for suspected acute appendicitis. Demographic and clinical characteristics as well as length of hospitalisation, antibiotics schemes, and intraoperative diagnosis were reviewed. Complicated acute appendicitis cases were distinguished and compared with the incidence in world literature. Results : The percentage of complicated acute appendicitis ranged from 39% to 60%. Complicated acute appendicitis occurs much more often in children under 5 years of age. Conclusions : The delay and failure in diagnosis of acute appendicitis results in higher incidence of complicated acute appendicitis; consequently, there are higher costs of treatment. Improving the awareness of parents and primary care physicians may allow faster diagnosis and treatment of acute appendicitis. It was noted that the reform of the National Emergency Medical Services in Poland contributed to a reduction in the incidence of complicated appendicitis.
Depiction of residual emboli following pulmonary embolism with thrombotic scintigraphy
International Nuclear Information System (INIS)
Takahashi, Keiko; Ohnishi, Mamoru; Hiromoto, Kenji; Ueda, Atsunori; Ohyanagi, Mitsumasa; Naruse, Hitoshi
2005-01-01
In the treatment of pulmonary embolism (PE), the presence of residual emboli is known to seriously affect the recurrence and prognosis. We attempted to depict the residual emboli in the subacute stage of PE using indium-111-oxine labeled platelet scintigraphy (In-plt). In-plt was performed on 22 patients with PE who showed an improvement according to lung perfusion scintigraphy. Their accumulation was assessed along with the blood coagulation ability measured on the same day. In addition, radioisotope venography (RI-veno) was performed simultaneously with In-plt to measure the circulatory findings in the lower limb for comparison. All patients received systemic heparin during the acute stage and received warfarin at the time of testing. Accumulation of In-plt was observed in 7 patients (32%), and positive signals were found in the lower limbs or pelvic cavity in all cases. Two patients were suspected of having poor lower limb circulation from their RI-veno findings, and these findings were largely consistent with the areas of In-plt accumulation. Some emboli persist after extensive anti-coagulation therapy. The use of In-plt is effective in determining the therapeutic measures and assessing the prognosis as this method allows us to clearly depict the existence of such emboli. (author)
Haywood, Kirstie; Lyddiatt, Anne; Brace-McDonnell, Samantha J; Staniszewska, Sophie; Salek, Sam
2017-06-01
Active patient engagement is increasingly viewed as essential to ensuring that patient-driven perspectives are considered throughout the research process. However, guidance for patient engagement (PE) in HRQoL research does not exist, the evidence-base for practice is limited, and we know relatively little about underpinning values that can impact on PE practice. This is the first study to explore the values that should underpin PE in contemporary HRQoL research to help inform future good practice guidance. A modified 'World Café' was hosted as a collaborative activity between patient partners, clinicians and researchers: self-nominated conference delegates participated in group discussions to explore values associated with the conduct and consequences of PE. Values were captured via post-it notes and by nominated note-takers. Data were thematically analysed: emergent themes were coded and agreement checked. Association between emergent themes, values and the Public Involvement Impact Assessment Framework were explored. Eighty participants, including 12 patient partners, participated in the 90-min event. Three core values were defined: (1) building relationships; (2) improving research quality and impact; and (3) developing best practice. Participants valued the importance of building genuine, collaborative and deliberative relationships-underpinned by honesty, respect, co-learning and equity-and the impact of effective PE on research quality and relevance. An explicit statement of values seeks to align all stakeholders on the purpose, practice and credibility of PE activities. An innovative, flexible and transparent research environment was valued as essential to developing a trustworthy evidence-base with which to underpin future guidance for good PE practice.
Pulmonary embolism in intensive care unit: Predictive factors, clinical manifestations and outcome
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Bahloul Mabrouk
2010-01-01
Full Text Available Objective : To determine predictive factors, clinical and demographics characteristics of patients with pulmonary embolism (PE in ICU, and to identify factors associated with poor outcome in the hospital and in the ICU. Methods : During a four-year prospective study, a medical committee of six ICU physicians prospectively examined all available data for each patient in order to classify patients according to the level of clinical suspicion of pulmonary thromboembolism. During the study periods, all patients admitted to our ICU were classified into four groups. The first group includes all patients with confirmed PE; the second group includes some patients without clinical manifestations of PE; the third group includes patients with suspected and not confirmed PE and the fourth group includes all patients with only deep vein thromboses (DVTs without suspicion of PE. The diagnosis of PE was confirmed either by a high-probability ventilation/perfusion (V/Q scan or by a spiral computed tomography (CT scan showing one or more filling defects in the pulmonary artery or in its branches. The diagnosis was also confirmed by echocardiography when a thrombus in the pulmonary artery was observed. Results : During the study periods, 4408 patients were admitted in our ICU. The diagnosis of PE was confirmed in 87 patients (1.9%. The mean delay of development of PE was 7.8 ± 9.5 days. On the day of PE diagnosis, clinical examination showed that 50 patients (57.5% were hypotensive, 63 (72.4% have SIRS, 15 (17.2% have clinical manifestations of DVT and 71 (81.6% have respiratory distress requiring mechanical ventilation. In our study, intravenous unfractionated heparin was used in 81 cases (93.1% and low molecular weight heparins were used in 4 cases (4.6%. The mean ICU stay was 20.2 ± 25.3 days and the mean hospital stay was 25.5 ± 25 days. The mortality rate in ICU was 47.1% and the in-hospital mortality rate was 52.9%. Multivariate analysis showed that
Electron microscopy observations of helium bubble-void transition effects in nimonic PE16 alloys
International Nuclear Information System (INIS)
Mazey, D.J.; Nelson, R.S.
1980-01-01
High-nickel alloys based on the Nimonic PE16 composition have been injected at temperatures of 525 0 C and 625 0 C with 1000 ppm helium to produce a high gas-bubble concentration and subsequently irradiated with 36 MeV nickel ions. Extensive heterogeneous nucleation of bubbles is observed on faulted interstitial loops and dislocations. Evidence is found in standard PE16 alloy for bimodal bubble plus void distributions which persist during nickel-ion irradiation to 30 and 60 dpa at 625 0 C and result in a low void volume swelling of approximately 1%. The observations can be correlated with the critical bubble/void transition radius which is calculated from theory to be approximately 4.4 nm. Pre-injection of helium into a 'matrix' PE16 (low Si, Ti and Al) alloy produced an initial bubble population whose average size was above the calculated transition radius such that all bubbles eventually grew as voids during subsequent nickel-ion irradiation up to 60 dpa at 625 0 C where the void volume swelling reached approximately 12%. The observations are discussed briefly and related to theoretical predictions of the bubble/void transition radius. (author)
Matsumoto, Hiroaki; Miki, Takanori; Miyaji, Yuki; Minami, Hiroaki; Masuda, Atsushi; Tominaga, Shogo; Yoshida, Yasuhisa; Yamaura, Ikuya; Matsumoto, Shigeo; Natsume, Shigeatsu; Yoshida, Kozo
2012-01-01
Context Acute hemiparesis is a common initial presentation of ischemic stroke. Although hemiparesis due to spontaneous spinal epidural hematoma (SSEH) is an uncommon symptom, a few cases have been reported and misdiagnosed as cerebral infarction. Design Case reports of SSEH with acute hemiparesis. Findings In these two cases, acute stroke was suspected initially and administration of intravenous alteplase therapy was considered. In one case, the presentation was neck pain and in the other case, it was Lhermitte's sign; brain magnetic resonance imaging (MRI) and magnetic resonance angiography were negative for signs of ischemic infarction, hemorrhage, or arterial dissection. Cervical MRI was performed and demonstrated SSEH. Conclusion Clinicians who perform intravenous thrombolytic treatment with alteplase need to be aware of this possible contraindication. PMID:22925753
Hyndman, Brendon P.
2017-01-01
Identifying and understanding the perceptions of pre-service teachers (PSTs) is vital to informing teaching practices. The purpose of the "Generalist Entry into Teaching Physical Education" (GET-PE) study was to investigate Australian generalist PSTs' perceptions of the barriers to teaching physical education (PE) classes. A…
International Nuclear Information System (INIS)
Staskiewicz, Grzegorz; Czekajska-Chehab, Elżbieta; Uhlig, Sebastian; Przegalinski, Jerzy; Maciejewski, Ryszard; Drop, Andrzej
2013-01-01
Purpose: Diagnosis of right ventricular dysfunction in patients with acute pulmonary embolism (PE) is known to be associated with increased risk of mortality. The aim of the study was to calculate a logistic regression model for reliable identification of right ventricular dysfunction (RVD) in patients diagnosed with computed tomography pulmonary angiography. Material and methods: Ninety-seven consecutive patients with acute pulmonary embolism were divided into groups with and without RVD basing upon echocardiographic measurement of pulmonary artery systolic pressure (PASP). PE severity was graded with the pulmonary obstruction score. CT measurements of heart chambers and mediastinal vessels were performed; position of interventricular septum and presence of contrast reflux into the inferior vena cava were also recorded. The logistic regression model was prepared by means of stepwise logistic regression. Results: Among the used parameters, the final model consisted of pulmonary obstruction score, short axis diameter of right ventricle and diameter of inferior vena cava. The calculated model is characterized by 79% sensitivity and 81% specificity, and its performance was significantly better than single CT-based measurements. Conclusion: Logistic regression model identifies RVD significantly better, than single CT-based measurements
A study on the effect of P/E and PEG ratios on stock returns: Evidence from Tehran Stock Exchange
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Seyyed Ali Lajevardi
2014-07-01
Full Text Available This paper studies the effect of the ratios of P/E and PEG on stock returns of the firms accepted on Tehran Stock Exchange. The study uses regression and Pearson Correlation Coefficient based on the performance of 138 firms over the period 2004- 2009 according to the Iranian calendar to investigate the effects of P/E and PEG on stock returns. The study also uses the models originally proposed by Chahin and Choudhry (2010 [Chahin, S., & Choudhry, T. (2010. Price to earnings, growth radio and value growth based strategies. Social Science Research Network, 19(4.] to discuss the strategies of investing on stocks. The results show that the ratio of P/E had more effect on stock returns than the ratio of PEG and stocks returns had a direct relationship with P/E and an inverse relationship with PEG. In addition, the returns of growth stock were more than value stock.
Análise de peças anatômicas preservadas com resina de poliester para estudo em anatomia humana
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Ítalo Martins de Oliveira
Full Text Available OBJETIVO: avaliar o uso da resina de poliéster na preservação de peças anatômicas para estudo da anatomia humana. MÉTODOS: foram utilizadas 150 peças anatômicas, sendo as mesmas não fixadas (frescas, fixadas em formol a 10% e moldes vasculares de órgãos injetados com acetato de vinil e a resina de poliéster. A solução utilizada foi composta de resina de poliéster com seu diluente monômero de estireno e catalisador (peroxol. Foram obtidos, após a inclusão nesta solução, modelos em resina transparente, que permitiam a plena observação das estruturas e conservação da peça utilizada. RESULTADOS: na avaliação das peças, foi observado grau de extrema transparência, promovendo uma completa visualização das estruturas com a perfeita preservação da anatomia. A duração média para a completa finalização da inclusão foi 48 horas. Apenas 14 peças (9,3% foram inutilizadas durante o preparo. CONCLUSÃO: a resina de poliéster pode ser utilizada para a preservação de peças anatômicas para o ensino da anatomia humana, de maneira prática, estética e duradoura.
Konference Regionálne disparity v Strednej Európe
Czech Academy of Sciences Publication Activity Database
Vajdová, Zdenka
2007-01-01
Roč. 43, č. 5 (2007), s. 1071-1072 ISSN 0038-0288. [Regionálne disparity v Strednej Európe. Bratislava, 25.10.2007-26.10.2007] R&D Projects: GA MŠk 2D06001 Institutional research plan: CEZ:AV0Z70280505 Keywords : regional disparities * regional policy * international conference Subject RIV: AO - Sociology, Demography Impact factor: 0.169, year: 2007
OBSERVATIONAL SEARCH FOR PeV-EeV TAU NEUTRINO FROM GRB081203A
International Nuclear Information System (INIS)
Aita, Y.; Aoki, T.; Asaoka, Y.; Chonan, T.; Jobashi, M.; Masuda, M.; Morimoto, Y.; Noda, K.; Sasaki, M.; Asoh, J.; Ishikawa, N.; Ogawa, S.; Learned, J. G.; Matsuno, S.; Olsen, S.; Binder, P.-M.; Hamilton, J.; Sugiyama, N.; Watanabe, Y.
2011-01-01
We report the first observational search for tau neutrinos (ν τ ) from gamma-ray bursts (GRBs) using one of the Ashra light collectors. The Earth-skimming ν τ technique of imaging Cherenkov τ showers was applied as a detection method. We set stringent upper limits on the ν τ fluence in PeV-EeV region for 3780 s (between 2.83 and 1.78 hr before) and another 3780 s (between 21.2 and 22.2 hr after) surrounding GRB081203A triggered by the Swift satellite. This first search for PeV-EeV ν τ complements other experiments in energy range and methodology, and suggests the prologue of 'multi-particle astronomy' with a precise determination of time and location.
Talking heads : interviewing suspects from a cultural perspective
Beune, K.
2009-01-01
Although the literature on the interviewing of suspects has increased over the past decade, research on the use and effectiveness of police strategies and their boundary conditions is very rare. The present dissertation aims to fill this void by identifying behaviors that appeal to and persuade suspects to talk (i.e., influencing behavior), focusing on the effects of such behaviors and their dependency on cultural context (low-context vs. high-context). In doing so, we depart from a theoretic...
Zuidam, Samantha; Roessingh, Carel
This article describes how small entrepreneurs in the tourism industry of Las Peñitas, Nicaragua, try to cope with contextual changes caused by the development of tourism. The research method for this article is ethnographic. During the fieldwork in Las Peñitas, multi-qualitative research methods
Management of acute gastric varices bleeding
Directory of Open Access Journals (Sweden)
Chen-Jung Chang
2013-10-01
Full Text Available Gastroesophageal varices bleeding is a major complication in patients with cirrhosis. Gastric varices (GVs occur in approximately 20% of patients with portal hypertension. However, GV bleeding develops in only 25% of patients with GV and requires more transfusion and has higher mortality than esophageal variceal (EV bleeding. The best strategy for managing acute GV bleeding is similar to that of acute EV bleeding, which involves airway protection, hemodynamic stabilization, and intensive care. Blood transfusion should be cautiously administered in order to avoid rebleeding. Vasoactive agents such as terlipressin or somatostatin should be used when GV bleeding is suspected. Routine use of prophylactic antibiotics reduces bacterial infection and lowers rebleeding rates. By administering endoscopic cyanoacrylate injection, the initial hemostasis rate achieved is at least 90% in most cases; the average mortality rate of GV bleeding is approximately 10–30% and the rebleeding rate is between 22% and 37%. Although endoscopic injection of cyanoacrylate is superior to sclerotherapy and band ligation, and has remained the treatment of choice for treating acute GV bleeding, the outcome of this treatment is still unsatisfactory. New treatment options, such as thrombin injection, transjugular intrahepatic portosystemic shunts, or balloon-occluded retrograde transvenous obliteration, have shown promising results for acute GV bleeding. However, randomized controlled trials are needed to compare the efficacy of these therapies with cyanoacrylate.
Neighborhood Peñarol: modern, industrial, singular. Hereditalization and reutilization
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Manuel Alfonso Esmoris Isoleri
2012-03-01
Full Text Available Between 1890 and 1907, Central Uruguay Railway (CUR company founded a railway town in Peñarol, a rural place at that time, 10 kilometers up north of Montevideo bay. Over 17 hectares, 33.000 square meters of workshops, train stations, houses, grocery stores, meeting places and a theater, were built. In 1910 the workshops already employed 2.000 workers. Peñarol lived like an industrial town until it gradually became another Montevideo’s neighborhood. In this article those implementations and their uses are described, since the beginning until its current deindustrialization stage. It describes the heritage activation process started seven years ago by the Municipality of Montevideo in accordance with the Railway National Administration. Complementary it exposes the reuse alternatives for the idle capacities that the railway shrinkage brought upon the area. Hereditalization and reutilization are the keys to a development project, to a new calling for the installments and properties of the national railway company that, though shrunken, keeps on operating. Historical buildings, important parts of the industrial machinery and, in consequence, the industrial tradition, remain.
DEFF Research Database (Denmark)
Kobel, Marie Cæcilie; Nielsen, Tommy Kjærgaard; Graumann, Ole
Percutaneous drainage proved to be successful in managing a renal subcapsular haematoma that was causing acute renal failure and hypertension in a 74-year-old woman. The patient presented with oliguria, nausea and malaise 2 days after a ureteronephroscopic procedure with biopsies of a suspected u...
Two cases of acute leukemia developed after therapeutic radiation for malignant tumors
International Nuclear Information System (INIS)
Takahashi, Naoki; Matsuo, Kakaru; Yamaguchi, Hiroshi; Tsuno, Sumio; Toyoda, Shigeki
1978-01-01
Report was made as to two cases of acute leukemia developed after therapeutic radiation for malignant tumors. Both cases were exposed to atomic-bomb at the places 4 and 3 km far from the center of explosion, and they did not suffer from injuries and acute symptoms due to radiation. Case 1. -A 78 year old man had a mass in a right hypogastric region in April of 1975. In March of 1976, he received laparotomy and was diagnosed as malignant schwannoma. He received radiation therapy with 4,600 R and MFC therapy. In February of 1977, a clinical diagnosis of erythroleukemia was made according to the findings by bone marrow puncture, and he died in March. Postmortem examination revealed that main lesions were malignant schwannoma, its metastases, and leukemia. Case 2. -A 51 year old woman had a finger-tip sized tumor in the left breast in November of 1965, and had a radical operation on the basis of a diagnosis of comedo sarcoma. After that she received 60 Co irradiation with 18,800 R, and she was admitted in December of 1971, because she was suspected of having leukemia. She died in January of 1972. Postmortem examination revealed acute myelocytic leukemia. It is suspected that the onset of erythroleukemia within one year after irradiation would be influenced by MFC therapy in addition to radiotherapy. It was thought that leukemia in Case 2 was influenced by radiotherapy rather than atomic-bomb radioactivity. (Serizawa, K.)
Spada, E; Proverbio, D; Priolo, V; Ippolito, D; Baggiani, L; Perego, R; Pennisi, M G
2017-04-01
We sought to determine the prevalence of dog erythrocyte antigen (DEA) 1, 4 and 7 and naturally occurring anti-DEA7 antibodies in Italian Corso dogs. In addition, we correlated DEAs with different epidemiologic variables, compared the prevalence of DEAs against other canine populations and assessed the risk of sensitisation and transfusion reactions (TRs) following unmatched transfusion. Blood samples from 100 Corso dogs were evaluated for DEA 1, 4, 7 and naturally occurring anti-DEA 7 antibodies. Seventy-one percent of samples were DEA 1-negative, 100% tested DEA 4-positive, and 95% tested DEA 7-negative. Suspected anti-DEA7 antibodies were found in 32% dogs. The DEA 1 and 7-negative phenotypes were significantly more common than in most canine populations. When a previously tested Italian canine population was considered as blood donors for Corso dogs, the risk of DEA 1 sensitisation using DEA 1 untyped blood was 29%, and of acute haemolytic TRs after a second untyped DEA 1-incompatible transfusion was 8%. The potential for delayed TRs between DEA 7-negative Corso dogs with suspected naturally occurring anti-DEA 7 antibodies receiving untyped DEA 7-positive blood was 11%. Conversely, when Corso dogs were blood donors for the same population, the risk of DEA 1 sensitisation was 17% and the risk of an acute haemolytic TR after a second DEA 1-incompatible blood transfusion was 3%. Corso dogs can be suitable blood donors. Additional studies are needed to clarify whether the high prevalence of naturally occurring anti-DEA 7 antibodies in this breed could increase their risk of delayed TRs when they are blood recipients. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Daofang Zhu
2017-01-01
Full Text Available Premature ejaculation (PE is one of the most common sexual dysfunctions, which were associated with prostatitis-like symptoms (PLS. We intended to explore the prevalence of prostatitis-like symptoms and outcomes of National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI scores in outpatients with lifelong (LPE and acquired premature ejaculation (APE. From December 2013 to December 2015, a total of 498 consecutive heterosexual men with PE and 322 male healthy subjects without PE were enrolled. Each of them completed a detailed questionnaire on demographics information, sexual and medical histories, and the NIH-CPSI. Assessment of NIH-CPSI and definition of PLS and PE were used to measure the PLS and NIH-CPSI scores and ejaculatory function for all subjects. Finally, a total of 820 subjects (including 498 men in PE group and 322 men in control group were enrolled in our study. The mean ages were significantly different between PE and no PE groups. Men with PE reported worse PLS and higher NIH-CPSI scores (P < 0.001 for all. Similar findings were also observed between men with LPE and APE. Men with APE also reported higher rates of PLS and scores of NIH-CPSI (P < 0.001 for all. Multivariate analysis showed that PLS and NIH-CPSI scores were significantly associated with PE.
Zhu, Daofang; Dou, Xianming; Tang, Liang; Tang, Dongdong; Liao, Guiyi; Fang, Weihua; Zhang, Xiansheng
2017-01-01
Premature ejaculation (PE) is one of the most common sexual dysfunctions, which were associated with prostatitis-like symptoms (PLS). We intended to explore the prevalence of prostatitis-like symptoms and outcomes of National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores in outpatients with lifelong (LPE) and acquired premature ejaculation (APE). From December 2013 to December 2015, a total of 498 consecutive heterosexual men with PE and 322 male healthy subjects without PE were enrolled. Each of them completed a detailed questionnaire on demographics information, sexual and medical histories, and the NIH-CPSI. Assessment of NIH-CPSI and definition of PLS and PE were used to measure the PLS and NIH-CPSI scores and ejaculatory function for all subjects. Finally, a total of 820 subjects (including 498 men in PE group and 322 men in control group) were enrolled in our study. The mean ages were significantly different between PE and no PE groups. Men with PE reported worse PLS and higher NIH-CPSI scores ( P < 0.001 for all). Similar findings were also observed between men with LPE and APE. Men with APE also reported higher rates of PLS and scores of NIH-CPSI ( P < 0.001 for all). Multivariate analysis showed that PLS and NIH-CPSI scores were significantly associated with PE.
Sestava pečenega piščančjega mesa različnih rej
Korenčan, Nina
2017-01-01
Namen diplomskega dela je bil ugotoviti, kako način reje piščancev (intenzivna (kontrola), ekološka reja (Eko) in z dodanim selenom, vezanim na organske spojine (Se)) vpliva na različne kakovostne parametre presnega mesa in mesa po pečenju, in sicer na masno razmerje meso, kosti in koža, na osnovno kemijsko sestavo, na izgubo mase med pečenjem ter na instrumentalne parametre in senzorične lastnosti kosov (prsi in bedra) piščančjega mesa. V poskusu smo analizirali devet trupov piščancev brez d...
International Nuclear Information System (INIS)
Jain, R.; Sawhney, S.; Rizvi, S.G.
2008-01-01
Aim: To prove the hypothesis that acute bone infarcts in sickle cell disease are caused by sequestration of red blood cells (RBCs) in bone marrow, and to evaluate the unenhanced T1 fat-saturated (fs) sequence in the differentiation of acute bone infarction from acute osteomyelitis in patients with sickle-cell disease. Materials and methods: Two studies were undertaken: an experimental study using in-vitro packed red blood cells and normal volunteers, and a retrospective clinical study of 86 magnetic resonance imaging (MRI) studies. For the experimental study containers of packed RBCs were placed between the knees of four healthy volunteers with a saline bag under the containers as an additional control, and were scanned with the pre-contrast T1-fs sequence. Signal intensity (SI) ratios were obtained for packed RBCs:skeletal muscle and packed RBCs:saline. For the clinical study, the SIs of normal bone marrow, packed RBCs, bone and/or soft-tissue lesions, and normal skeletal muscle of 74 patients (86 MRI studies) were measured using unenhanced, T1 fat-saturated MRI. The ratios of the above SIs to normal skeletal muscle were calculated and subjected to statistical analysis. Results: Fifty-one of 86 MRI studies were included in the final analysis. The ratios of SIs for normal bone marrow, packed red cells, bone infarction, acute osteomyelitis, and soft-tissue lesions associated with bone infarct, compared with normal skeletal muscle were (mean ± SD) 0.9 ± 0.2, 2.1 ± 0.7, 1.7 ± 0.5, 1.0 ± 0.3, and 2.2 ± 0.7, respectively. The difference in the ratio of SIs of bone infarcts and osteomyelitis was significant (p = 0.003). The final diagnoses were bone infarction (n = 50), acute osteomyelitis (n = 1), and co-existent bone infarction and osteomyelitis (n = 2). Seven patients who had suspected osteomyelitis underwent image-guided aspiration. Conclusion: Acute bone infarcts in sickle cell disease are caused by sequestration of red blood cells in the bone marrow. The
Combined CT Angiography and CT Venography in Thromboembolic disease: clinical impact
International Nuclear Information System (INIS)
Bouzas, R.; Migueles, Y.; Gomez, S.; Mallo, R.; Garcia-Tejedor, J. L.; Diaz Vega, M. J.
2002-01-01
Combined CT Venography and Pulmonary Angiography was described in 1998 as a tool for diagnostic Thromboembolic Disease. The purpose is to relate our own experience with this technique in a population with suspected pulmonary embolism. 46 consecutive patients with suspected pulmonary embolism underwent combined CT Venography after Pulmonary CT Angiography to depict Deep Venous Thrombosis (DVT). CT Venography where obtained with a 3 minutes delay from injection, without additional intravenous contrast, from upper abdomen to fibular head. A prospective study from emergency reports where used. The reports where aimed by nine different radiologist at diary emergency room (images where not retrospective review). We report if a pulmonary embolus or deep venous thrombus or another alternative diagnostic where done. An endo luminal thrombus in any pulmonary arteries was assessed as a positive study for PE. A Thrombus in the leg veins or in an abdominal vein without diminished size of vein was assessed as an acute DVT. In those patients with a CT negative to Thromboembolic Disease was the clinician who decide if more proves where needed. Those patients without evidence in CT of Thromboembolic Disease where asked for symptoms related to the episode in a 3 months period after initial CT. Patients free of symptoms for 3 months without anticoagulation therapy where considered true negative for CT. CT shows Thromboembolic Disease in 23 of 46 patients. 21PE, 14 DVT 2 of 14 patients with DVT don't show PE, CT excluded thromboembolic disease in 23 patients and in 15 of those patients an alternative diagnostic was shown. In 22 of those 23 patients CT excluded correctly Thromboembolic Disease. One patient result in a false negative CT, Pulmonary Angiography of that patient shows us a subsegmentary embolus. (Author) 9 refs
Energy Technology Data Exchange (ETDEWEB)
Bouzas, R.; Migueles, Y.; Gomez, S.; Mallo, R.; Garcia-Tejedor, J. L.; Diaz Vega, M. J. [Complejo Hospitalario Xerar-Cies. Vigo. Pontevedra (Spain)
2002-07-01
Combined CT Venography and Pulmonary Angiography was described in 1998 as a tool for diagnostic Thromboembolic Disease. The purpose is to relate our own experience with this technique in a population with suspected pulmonary embolism. 46 consecutive patients with suspected pulmonary embolism underwent combined CT Venography after Pulmonary CT Angiography to depict Deep Venous Thrombosis (DVT). CT Venography where obtained with a 3 minutes delay from injection, without additional intravenous contrast, from upper abdomen to fibular head. A prospective study from emergency reports where used. The reports where aimed by nine different radiologist at diary emergency room (images where not retrospective review). We report if a pulmonary embolus or deep venous thrombus or another alternative diagnostic where done. An endo luminal thrombus in any pulmonary arteries was assessed as a positive study for PE. A Thrombus in the leg veins or in an abdominal vein without diminished size of vein was assessed as an acute DVT. In those patients with a CT negative to Thromboembolic Disease was the clinician who decide if more proves where needed. Those patients without evidence in CT of Thromboembolic Disease where asked for symptoms related to the episode in a 3 months period after initial CT. Patients free of symptoms for 3 months without anticoagulation therapy where considered true negative for CT. CT shows Thromboembolic Disease in 23 of 46 patients. 21PE, 14 DVT 2 of 14 patients with DVT don't show PE, CT excluded thromboembolic disease in 23 patients and in 15 of those patients an alternative diagnostic was shown. In 22 of those 23 patients CT excluded correctly Thromboembolic Disease. One patient result in a false negative CT, Pulmonary Angiography of that patient shows us a subsegmentary embolus. (Author) 9 refs.
International Nuclear Information System (INIS)
Wildberger, J.E.; Mahnken, A.H.; Stargardt, A.; Haage, P.; Guenther, R.W.; Sinha, A.M.; Schaller, S.
2002-01-01
Purpose: To establish a differentiated protocol for multi-slice CT (MSCT) examinations in cases of clinically suspected pulmonary embolism (PE) using pulmonary CT-angiography (CTA) and indirect CT-phlebography (CTP). Materials and Methods: 161 patients with suspected PE were examined using an MSCT (SOMATOM Volume Zoom; Siemens, Forchheim, Germany). After intravenous administration of 120 ml of contrast material, a thin collimation chest-CT scan was performed (120 kV, 100 mAs, collimation: 4 x 1 mm). If PE was present, or previous examinations and clinical signs suggested deep venous thrombosis (DVT), a CTP was subsequently completed. CTPs were performed using a 4 x 5 mm protocol (120 kV, 170 mAs). Venous phase scanning, starting from the pelvic crest, was completed in the popliteal fossa three minutes after contrast material injection. In 73 extremities, CTP were compared to the results of ultrasound, phlebography and autopsy. Scan ranges were documented in all patients. Cumulative doses were calculated for male and female subgroups. Results: 62 patients in our series suffered from PE and in 47 of these patients deep venous thrombosis was seen additionally. Of the 99 patients without PE, 47 also received indirect CTP. CTP confirmed the suspicion and extent of DVT in 8 patients. Only in 2 of 39 patients (5.1%) was previously unknown DVT found, despite the exclusion of PE. Regarding DVT, sensitivity was 94.3% and specificity was 92.1% for indirect CTP. Cumulative chest CT doses averaged 3.3 mSv for males and 4.2 mSv for females, the calculated CTP dosage was 9.3 mSv (according to ICRP 60). Conclusions: the examination protocol presented its suitable for clinical usage in patients with suspected PE. If PE is confirmed, indirect CTP is justified, so that detailed information of the venous system can be obtained. However, the relatively high radiation dosage of an additional CTP requires a strict indication regiment in patients with a negative CTA. (orig.) [de
Miguel Sánchez Peña (1925-2009) organizer of the space activities in Argentina
de León, Pablo; Sánchez Peña, Miguel Alejandro
2011-11-01
One of the most important and active pioneers of the space activities in Argentina was Miguel Sánchez Peña, an aeronautical engineer and an officer of the Argentine Air Force. Sánchez Peña was the organizer of Argentina's governmental space program in the 1970s and part of the 80s, and contributed immeasurably to the Nation's sounding rocket program. Born in Mendoza, Argentina in 1925, Sánchez Peña attended the Military Aviation School (Escuela de Aviación Militar) in Córdoba, and later the Air Force Engineering School. Graduated as an engineer in 1959 he was sent to the University of Michigan in the United States to complete his graduate studies earning a Masters of Science degree in Aerospace Engineering. There he had the opportunity to study with several future NASA astronauts such as Theodore Freeman, Edward White and James McDivitt. After his return to Argentina in 1961 he was put in charge of the Space Development Group (Grupo de Desarrollos Espaciales) of the Air Force in Córdoba. While with the Air Force he managed the development of a family of various sounding rockets for high altitude research. Sánchez Peña was also in charge of the first Argentine rockets launched from Antarctica in 1965, as well as the first tests on an Argentine-fabricated rocket (Orión) from Wallops Island in the United States, in 1966. The Orion was the first operational sounding rocket constructed in South America. In the middle of the 1970s Miguel Sánchez Peña was named president of the CNIE (National Space Research Commission). Starting with just a modest one-desk office at the Argentine Air Force headquarters, in only a few years he turned CNIE into a multi-center organization with several hundred employees, three operational launch centers across the country and a family of research rockets open to the international scientific community. He was also actively representing Argentina in many IAF congresses, and was a member of the International Academy of
Value of ultrasonography in the diagnosis of acute appendicitis
International Nuclear Information System (INIS)
Sohn, Seok Ho; Jung, Kun Sik; Kim, Jung Sik; Woo, Seong Ku; Chung, Ki Yong; Kim, Hee Jin
1993-01-01
During a 12-month period high-resolution, real-time ultrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complications. US visualization of a fluid-filled, non-compressed appendix or a decompressed, thick-walled appendix was the primary criterion for a diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-ups in the remainder. US was found to be accurate in the diagnosis of acute appendicitis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%. The predictive value of a positive test was 97.7%; that of a negative test was 96.7%. There were two false-positive examinations in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively. There were six false-negative examinations in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis (n=5) and perforated appendicitis (n=1). Our results show that high-resolution, real-time US is an accurate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complications
Sagittarius A* as an origin of the Galactic PeV cosmic rays?
Energy Technology Data Exchange (ETDEWEB)
Fujita, Yutaka [Department of Earth and Space Science, Graduate School of Science, Osaka University, Toyonaka, Osaka 560-0043 (Japan); Murase, Kohta; Kimura, Shigeo S., E-mail: fujita@vega.ess.sci.osaka-u.ac.jp, E-mail: murase@psu.edu, E-mail: szk323@psu.edu [Center for Particle and Gravitational Astrophysics, Department of Physics, Department of Astronomy and Astrophysics, The Pennsylvania State University, University Park, PA 16802 (United States)
2017-04-01
Supernova remnants (SNRs) have commonly been considered as a source of the observed PeV cosmic rays (CRs) or a Galactic PeV particle accelerator ('Pevatron'). In this work, we study Sagittarius A* (Sgr A*), which is the low-luminosity active galactic nucleus of the Milky Way Galaxy, as another possible canditate of the Pevatron, because it sometimes became very active in the past. We assume that a large number of PeV CRs were injected by Sgr A* at the outburst about 10{sup 7} yr ago when the Fermi bubbles were created. We constrain the diffusion coefficient for the CRs in the Galactic halo on the condition that the CRs have arrived on the Earth by now, while a fairly large fraction of them have escaped from the halo. Based on a diffusion-halo model, we solve a diffusion equation for the CRs and compare the results with the CR spectrum on the Earth. The observed small anisotropy of the arrival directions of CRs may be explained if the diffusion coefficient in the Galactic disk is smaller than that in the halo. Our model predicts that a boron-to-carbon ratio should be energy-independent around the knee, where the CRs from Sgr A* become dominant. It is unlikely that the spectrum of the CRs accelerated at the outburst is represented by a power-law similar to the one for those responsible for the gamma-ray emission from the central molecular zone (CMZ) around the Galactic center.
International Nuclear Information System (INIS)
Bonfiglioli, Rachele; Nanni, Cristina; Morigi, Joshua James; Ambrosini, Valentina; Fanti, Stefano; Graziosi, Maddalena; Rapezzi, Claudio; Trapani, Filippo; Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi; Ferretti, Alice; Rubello, Domenico
2013-01-01
Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. 18 F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of 18 F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE). Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent 18 F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures. Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24 %) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures. PET/CT detected unexpected extra sites of infection in 24 % of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications. (orig.)
Testing the Dark Matter Scenario for PeV Neutrinos Observed in IceCube.
Murase, Kohta; Laha, Ranjan; Ando, Shin'ichiro; Ahlers, Markus
2015-08-14
Late time decay of very heavy dark matter is considered as one of the possible explanations for diffuse PeV neutrinos observed in IceCube. We consider implications of multimessenger constraints, and show that proposed models are marginally consistent with the diffuse γ-ray background data. Critical tests are possible by a detailed analysis and identification of the sub-TeV isotropic diffuse γ-ray data observed by Fermi and future observations of sub-PeV γ rays by observatories like HAWC or Tibet AS+MD. In addition, with several-year observations by next-generation telescopes such as IceCube-Gen2, muon neutrino searches for nearby dark matter halos such as the Virgo cluster should allow us to rule out or support the dark matter models, independently of γ-ray and anisotropy tests.
Method for detection of a suspect viral deoxyribonucleic acid in an acellular biological fluid
Energy Technology Data Exchange (ETDEWEB)
Berninger, M S
1982-10-06
A method for evaluating an acellular biological fluid for the presence of a suspect viral DNA, such as DNA of the Hepatitis-B virus, is described. The acellular biological fluid is treated to immobilize in denatured form the DNAs including the suspect viral DNA on a solid substrate. This substrate is contacted with a solution including radioisotopically-labelled suspect viral denatured DNA to renature the immobilized suspect viral native DNA. The solid substrate is then evaluated for radioisotopically-labelled suspect viral renatured DNA.
Directory of Open Access Journals (Sweden)
Michiaki Okuda
Full Text Available In tauopathies, a neural microtubule-associated protein tau (MAPT is abnormally aggregated and forms neurofibrillary tangle. Therefore, inhibition of the tau aggregation is one of the key approaches for the treatment of these diseases. Here, we have identified a novel tau aggregation inhibitor, PE859. An oral administration of PE859 resulted in the significant reduction of sarkosyl-insoluble aggregated tau along with the prevention of onset and progression of the motor dysfunction in JNPL3 P301L-mutated human tau transgenic mice. These results suggest that PE859 is useful for the treatment of tauopathies.
DEFF Research Database (Denmark)
Stengaard, Carsten; Sørensen, Jacob Thorsted; Andersen, M.P.
2011-01-01
, Department of Cardiology, Heart Center - Tampere - Finland, 5Duke University Medical Center, Department of Medicine, Division of Cardiology - Durham - United States of America, Topic(s): Infarction acute phase STEMI Citation: European Heart Journal ( 2011 ) 32 ( Abstract Supplement ), 1054 Purpose: A global...... occlusion of 4.3%. Mortality in patients with GIP was significantly higher compared to patients without GIP (preports...
Not Your Father's PE: Obesity, Exercise, and the Role of Schools
Cawley, John; Meyerhoefer, Chad; Newhouse, David
2006-01-01
American children are gaining weight at an alarming rate. Since the 1960s, according to the Centers for Disease Control and Prevention (CDC), the percentage of American six- to eleven-year-olds who fall into the CDC's highest weight classification for children has almost quadrupled. Requiring more physical education (PE) seems like a logical…
International Nuclear Information System (INIS)
Ribeiro, Maria-Joao; Ricard, Marcel; Lievre, Marie-Angele; Bourgeois, Sandrine; Emond, Patrick; Gervais, Philippe; Dolle, Frederic; Syrota, Andre
2007-01-01
Introduction: This study reports on the biodistribution and radiation dosimetry of a cocaine analog, the (E)-N-(3-iodoprop-2-enyl)-2β-carbomethoxy-3β-(4'-tolyl)nortropane (PE2I), labeled with carbon 11 ([ 11 C]PE2I). [ 11 C]PE2I is used in positron emission tomography (PET) for examination of the dopamine neuronal transporter (DAT). DAT radioligands are often used to evaluate the progression of Parkinson's disease or the efficiency of neuroprotective therapeutics, and, typically, these studies required several successive PET scans. Methods: In three healthy male volunteers, whole-body scans were performed up to 2 h following intravenous injection of 321±6 MBq of [ 11 C]PE2I. For each subject, regions of interest were defined over all visible organs to generate time-activity curves and calculate the percentage of injected activity. Time-activity data were fitted to a monoexponential model, as an uptake phase followed by a mono-exponential washout, or bi-exponential model to obtain residence times. With the use of the MIRD method, several source organs were considered in estimating residence time and mean effective radiation absorbed doses. Results: Blood pressure and ECG findings remained unchanged after radioligand injection. The primary route of clearance was renal. Ten minutes after injection, high activities were observed in the kidneys, urinary-bladder, stomach, liver, salivary glands and brain. The urine bladder wall, stomach and liver received the highest absorbed doses. The average effective dose of [ 11 C]PE2I was estimated to be 6.4±0.6 μSv/MBq. Conclusion: The amount of [ 11 C]PE2I required for adequate DAT PET imaging results in an acceptable effective dose equivalent permitting two or three repeated cerebral PET studies, with the injection of 222 MBq for each study
Detection of Rabies antigen in brains of suspected Rabid dogs ...
African Journals Online (AJOL)
Objective: To detect the presence of rabies antigen in brains of suspected rabid dogs. Materials and Methods: Ninety six (96) brain specimens from suspected rabid dogs were examined for the presence of rabies antigen using Seller's staining technique and enzyme immunoassay. Results: The two techniques were both ...
Energy Technology Data Exchange (ETDEWEB)
Schlett, C.L. [Universitaetsklinikum, Heidelberg (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie; Alkadhi, H. [Universitaetsspital, Zuerich (Switzerland); Bamberg, F. [Universitaetsklinikum, Tuebingen (Germany). Diagnostische und Interventionelle Radiologie
2014-09-15
Currently, cardiac computed tomography (CT) is increasingly being implemented into clinical algorithms, primarily due to substantial technical advances over the last decade. Its use in the setting of suspected acute coronary syndrome is of particular relevance, given the high degree of accumulating scientific evidence of improving patient outcomes. Performing cardiac CT requires specific knowledge on the available scan acquisitions and patient preparation. Also, expertise is required in order to interpret the coronary and extra-coronary findings adequately. The present article provides an overview of the different aspects on the use of cardiac CT in the setting of acute coronary syndrome.
Directory of Open Access Journals (Sweden)
Fernando de Oliveira Mota Filho
2007-10-01
Full Text Available Cladonia verticillaris used in this study was collected in the cerrado vegetation of Saloá (PE, Brazil and transplanted in plastic containers on soil from the collection place to Belo Jardim (PE that possesses lead smelters and battery industries. The experiments were disposed at eleven different places for evaluating the dispersion of pollutants and their effects on the biomonitor. The exposed lichens were collected over eight months and submitted to thin layer and high performance liquid chromatographies, and scanning electron microscopy. C. verticillaris placed in the vicinity of the emission sources demonstrated alteration in its metabolism, decreasing the production of its major compound, fumarprotocetraric acid, and deterioration of its external and internal surfaces.
Method for detection of a suspect viral deoxyribonucleic acid in an acellular biological fluid
International Nuclear Information System (INIS)
Berninger, M.S.
1982-01-01
A method for evaluating an acellular biological fluid for the presence of a suspect viral DNA, such as DNA of the Hepatitis-B virus, is described. The acellular biological fluid is treated to immobilize in denatured form the DNAs including the suspect viral DNA on a solid substrate. This substrate is contacted with a solution including radioisotopically-labelled suspect viral denatured DNA to renature the immobilized suspect viral native DNA. The solid substrate is then evaluated for radioisotopically-labelled suspect viral renatured DNA. (author)
PeRL: a circum-Arctic Permafrost Region Pond and Lake database
Directory of Open Access Journals (Sweden)
S. Muster
2017-06-01
Full Text Available Ponds and lakes are abundant in Arctic permafrost lowlands. They play an important role in Arctic wetland ecosystems by regulating carbon, water, and energy fluxes and providing freshwater habitats. However, ponds, i.e., waterbodies with surface areas smaller than 1. 0 × 104 m2, have not been inventoried on global and regional scales. The Permafrost Region Pond and Lake (PeRL database presents the results of a circum-Arctic effort to map ponds and lakes from modern (2002–2013 high-resolution aerial and satellite imagery with a resolution of 5 m or better. The database also includes historical imagery from 1948 to 1965 with a resolution of 6 m or better. PeRL includes 69 maps covering a wide range of environmental conditions from tundra to boreal regions and from continuous to discontinuous permafrost zones. Waterbody maps are linked to regional permafrost landscape maps which provide information on permafrost extent, ground ice volume, geology, and lithology. This paper describes waterbody classification and accuracy, and presents statistics of waterbody distribution for each site. Maps of permafrost landscapes in Alaska, Canada, and Russia are used to extrapolate waterbody statistics from the site level to regional landscape units. PeRL presents pond and lake estimates for a total area of 1. 4 × 106 km2 across the Arctic, about 17 % of the Arctic lowland ( < 300 m a.s.l. land surface area. PeRL waterbodies with sizes of 1. 0 × 106 m2 down to 1. 0 × 102 m2 contributed up to 21 % to the total water fraction. Waterbody density ranged from 1. 0 × 10 to 9. 4 × 101 km−2. Ponds are the dominant waterbody type by number in all landscapes representing 45–99 % of the total waterbody number. The implementation of PeRL size distributions in land surface models will greatly improve the investigation and projection of surface inundation and carbon fluxes in permafrost lowlands
Acute auditory agnosia as the presenting hearing disorder in MELAS.
Miceli, Gabriele; Conti, Guido; Cianfoni, Alessandro; Di Giacopo, Raffaella; Zampetti, Patrizia; Servidei, Serenella
2008-12-01
MELAS is commonly associated with peripheral hearing loss. Auditory agnosia is a rare cortical auditory impairment, usually due to bilateral temporal damage. We document, for the first time, auditory agnosia as the presenting hearing disorder in MELAS. A young woman with MELAS (A3243G mtDNA mutation) suffered from acute cortical hearing damage following a single stroke-like episode, in the absence of previous hearing deficits. Audiometric testing showed marked central hearing impairment and very mild sensorineural hearing loss. MRI documented bilateral, acute lesions to superior temporal regions. Neuropsychological tests demonstrated auditory agnosia without aphasia. Our data and a review of published reports show that cortical auditory disorders are relatively frequent in MELAS, probably due to the strikingly high incidence of bilateral and symmetric damage following stroke-like episodes. Acute auditory agnosia can be the presenting hearing deficit in MELAS and, conversely, MELAS should be suspected in young adults with sudden hearing loss.
Energy Technology Data Exchange (ETDEWEB)
Zhang, Hanfei; Liao, Meiyan; Chen, Jie; Zhu, Dongyong; Byanju, Sama [ZhongNan Hospital of Wuhan University, Department of Radiology, Wuhan (China)
2017-02-15
There is no established consensus about the relative accuracies of US, CT and MRI in childhood appendicitis. To compare, through meta-analysis, the accuracies of US, CT and MRI for clinically suspected acute appendicitis in children. PubMed, Embase, Web of Science and the Cochrane Library were searched. After study selection, data extraction and quality assessment, the sensitivity, specificity and the area under the curve of summary receiver operating characteristic were calculated and compared. Twenty-seven articles including 29 studies met the inclusion criteria, including 19 studies (9,170 patients) of US, 6 studies (928 patients) of CT and 4 studies (990 patients) of MRI. The analysis showed that the area under the receiver operator characteristics curve of MRI (0.995) was a little higher than that of US (0.987) and CT (0.982; P > 0.05). US, CT and MRI have high diagnostic accuracies of clinically suspected acute appendicitis in children overall with no significant difference. (orig.)
Husain, Muhammad Ishrat; Chaudhry, Imran B; Rahman, Raza R; Hamirani, Munir M; Mehmood, Nasir; Haddad, Peter M; Hodsoll, John; Young, Allan H; Naeem, Farooq; Husain, Nusrat
2017-12-01
Despite the use of maintenance medication, recurrence rates in bipolar affective disorder (BPAD) are high. To date, there are no clinical trials that have investigated the use of psychological interventions in bipolar disorder in Pakistan. The purpose of the study was to assess the feasibility and acceptability of a culturally adapted bipolar psychoeducation programme (CaPE) in Pakistan. Thirty-four euthymic bipolar I and II outpatients were randomized to either 12 weekly sessions of individual psychoeducation plus Treatment As Usual (Intervention) or Treatment As Usual (TAU) (Control). Outcomes were assessed using the Young Mania Rating Scale (YMRS), Beck Depression Inventory (BDI), EuroQoL (EQ-5D), Bipolar Knowledge and Attitudes and Questionnaire (BKAQ), and a self-reported measure of medication adherence (Morisky Medication Adherence Scale-4 items, MMAS-4). Effect sizes were derived from baseline adjusted standardized regression coefficients. Retention in the study was good, 80% of patients in the TAU follow-up assessment and 100% of patients in the CaPE group attended all 12 sessions. Patient satisfaction was higher in the CaPE group relative to control (ES = 1.41). Further, there were large effect sizes shown for CaPE versus TAU for medication adherence (MMAS-4: ES = 0.81), knowledge and attitudes towards bipolar (BKAQ: ES = 0.68), mania (YMRS: ES = 1.18), depression (BDI: ES = 1.17) and quality of life measures (EQ-5D: ES ⇒ 0.88). Culturally adapted psychoeducation intervention is acceptable and feasible, and can be effective in improving mood symptoms and knowledge and attitudes to BPAD when compared with TAU. Larger scale studies are needed to confirm our findings. Clinicaltrials.gov identifier NCT02210390.
Utility of morphine-augmented hepatobiliary scanning in evaluation of acute cholecystitis
International Nuclear Information System (INIS)
Kistler, A.M.; Ziessman, H.A.; Gooch, D.; Bitterman, P.
1989-01-01
The authors review experience with morphine sulfate-augmented cholescintigraphy in suspected acute cholecystitis. MS has been recommended to reduce study time while maintaining accuracy of hepatobiliary scans. Patients received 5-mCi injections of Tc-99m mebrofenin and imaged on a low-field-view gamma camera. In 32 patients with nonvisualization of the gallbladder at 30-40 minutes after injection, 2 mg MS was given intravenously, and imaging continued for an additional 30 minutes
Acute renal failure from inhalation of mycotoxins.
Di Paolo, N; Guarnieri, A; Loi, F; Sacchi, G; Mangiarotti, A M; Di Paolo, M
1993-01-01
Mysterious deaths of archeologists after opening Egyptian tombs have been suspected to be secondary to inhalation of mycotoxin, however, the hypothesis has never been verified. Recently, we observed a case of acute renal failure (ARF) undeniably due to inhalation of ochratoxin of Aspergillus ochraceus. After spending 8 h in a granary which had been closed for several months, a farmer and his wife suffered temporary respiratory distress; 24 h later, the woman developed nonoliguric ARF and biopsy revealed tubulonecrosis which healed in 24 days. Toxic substances were not found, but a strain of A. ochraceus producing ochratoxin was isolated from the wheat.
CT diagnosis of acute appendicitis in children
International Nuclear Information System (INIS)
Kimura, Kenya; Matsuda, Masao; Iyomasa, Shinsuke
2001-01-01
Enhanced and 5 mm collimation CT was performed in patients suspected of having appendicitis. CT clearly showed the swollen appendix, appendolith, periappendiceal inflammation, fluid collection, and abscess in patients with phlegmonous or gangrenous appendicitis. These findings were not observed in patients with catarrhal appendicitis or normal appendix. To decide on operative indications of acute appendicitis in children, the following findings are important: the diameter of the swollen appendix exceeds 8 mm; on appendolith is observed; periappendiceal fluid collection and abscess is observed. We emphasize that enhanced CT is useful to diagnose appendicitis which is not obvious with US. (author)
Phelan, Jody E.; Coll, Francesc; Bergval, Indra; Anthony, Richard M.; Warren, Rob; Sampson, Samantha L.; Gey van Pittius, Nicolaas C.; Glynn, Judith R.; Crampin, Amelia C.; Alves, Adriana; Bessa, Theolis Barbosa; Campino, Susana; Dheda, Keertan; Grandjean, Louis; Hasan, Rumina; Hasan, Zahra; Miranda, Anabela; Moore, David; Panaiotov, Stefan; Perdigao, Joao; Portugal, Isabel; Sheen, Patricia; de Oliveira Sousa, Erivelton; Streicher, Elizabeth M.; van Helden, Paul D.; Viveiros, Miguel; Hibberd, Martin L.; Pain, Arnab; McNerney, Ruth; Clark, Taane G.
2016-01-01
. tuberculosis complex genomes and long read sequence data were used to validate the approach. SNP analysis revealed that variation in the majority of the 168 pe/ppe genes studied was consistent with lineage. Several recombination hotspots were identified
International Nuclear Information System (INIS)
Gauthier, H.; Rosso, J.; Charbonnier, B.; Meignan, M.
1997-01-01
FRAXODI, an European multi-center program (n=70), allowed to compare the efficiency of Fraxiparin (20 500 UI AXa/mL) once a day with the conventional treatment by Fraxiparin (10 250 UI AXa/mL) twice a day by sub-cutaneous injection in patients with a PVT of inferior limbs without clinical signs of PE. A pulmonary scintigraphy has been performed at registration in 622 patients (delay ≤ 48 h): a sole perfusion with at least 4 incidences of which 2 were posterior oblique incidences or coupled to a ventilation scintigraphy (Xe-133, Kr-81 or aerosols) in 379 patients. Three diagnostic categories were defined: no PE in case of normal examination or under-segmentary perfusion anomalies (≤ 3); high probability (HP) of PE if at least a defect of normally ventilated segmentary perfusion existed; non-contributing examination in all the other cases. On the ensemble of the group, 367 patients have had at least a defect of segmentary perfusion, 296 patients had two or more. One hundred and forty one patients have had solely defects of sub-segmentary perfusion; 77 patients have had 3 or less then 3. One hundred and fourteen patients have had a normal examination. In the sub-group of ventilation scintigraphy, 235 patients have had at least one defect of segmentary perfusion, 88 patients have had defects of sub-segmentary perfusion and 56 patients have had a normal examination. The diagnosis analysis showed that 42% of patients have had a HP scintigraphy, 30% a non-contributive scintigraphy and the PE could be eliminated in 27% of patients. These results: 1 - demonstrated the extreme frequency of HP aspects of PE in patients afflicted with PVT; 2 - allowed estimating in this patients, as a function of the results of the PIOPED study, the frequency of asymptomatic PE in more then 50%; 3 - allowed recommending in the systematic practice a perfusion scintigraphy in case of PVT without clinical signs of PE providing the over-estimation of secondary PE occurrence during the
Acute pancreatitis induced by mycophenolate mofetil in a kidney transplant patient
Directory of Open Access Journals (Sweden)
Einollahi Behzad
2015-04-01
Full Text Available Acute pancreatitis is a rare life-threatening complication in patients after kidney transplantation. Here we described a 56-year-old man who had received a living related kidney transplant for an end-stage renal disease. In his regular follow-up, his serum creatinine was gradually increased and he underwent an allograft biopsy, which revealed an interstitial nephritis/tubular atrophy grade II. Mycophenolate mofetil (MMF was prescribed to control chronic allograft nephropathy. He presented with complaints of severe abdominal pain, vomiting, loss of appetite and fever requiring hospital admission twelve days later. Acute pancreatitis was diagnosed on the basis of laboratory data and imaging findings during hospital admission. There was no history of alcohol consumption in our patient. Unfortunately he died one week later and autopsy findings demonstrated acute necrotizing pancreatitis. The bladder drainage of this patients was normal. Laboratory findings in this patient did not endorse infections and other possibilities regarding the etiology of acute pancreatitis in this patient. Therefore, we concluded that acute pancreatitis in near the patient was induced by drugs and basis on our evidence, MMF is the most important suspect. This study suggests that acute pancreatitis can be considered as a side effect of MMF.
Spatial epidemiology of suspected clinical leptospirosis in Sri Lanka.
Robertson, C; Nelson, T A; Stephen, C
2012-04-01
Leptospirosis is one of the most widespread zoonoses in the world. A large outbreak of suspected human leptospirosis began in Sri Lanka during 2008. This study investigated spatial variables associated with suspected leptospirosis risk during endemic and outbreak periods. Data were obtained for monthly numbers of reported cases of suspected clinical leptospirosis for 2005-2009 for all of Sri Lanka. Space-time scan statistics were combined with regression modelling to test associations during endemic and outbreak periods. The cross-correlation function was used to test association between rainfall and leptospirosis at four locations. During the endemic period (2005-2007), leptospirosis risk was positively associated with shorter average distance to rivers and with higher percentage of agriculture made up of farms <0·20 hectares. Temporal correlation analysis of suspected leptospirosis cases and rainfall revealed a 2-month lag in rainfall-case association during the baseline period. Outbreak locations in 2008 were characterized by shorter distance to rivers and higher population density. The analysis suggests the possibility of household transmission in densely populated semi-urban villages as a defining characteristic of the outbreak. The role of rainfall in the outbreak remains to be investigated, although analysis here suggests a more complex relationship than simple correlation.
Computer-Assisted Detection of Acute Pulmonary Embolism
Wittenberg, R.
2012-01-01
Pulmonary embolism (PE) is a common and often potentially life threatening disease. Severe morbidity and mortality can be prevented if PE is diagnosed and treated in time. CT pulmonary angiography (CTPA) has emerged as an effective method for diagnosis of PE, but interpreting a CTPA is complicated
Mechanical characterisation of the TorPeDO: a low frequency gravitational force sensor
McManus, D. J.; Forsyth, P. W. F.; Yap, M. J.; Ward, R. L.; Shaddock, D. A.; McClelland, D. E.; Slagmolen, B. J. J.
2017-07-01
Newtonian noise is likely to be a future challenge at low frequencies for Advanced LIGO and other second generation gravitational wave detectors. We present the TorPeDO system: a dual torsion pendulum sensor designed to measure local gravitational forces to high precision. Gravitational forces induce a differential rotation between the two torsion beams, which is measured with an optical read-out. Both torsion pendulums have a common suspension point, tunable centre of mass, and resonant frequency. This produces a high level of mechanical common mode noise cancellation. We report on a controls prototype of the TorPeDO system, presenting the frequency response and tuning range of both pendulums. A noise budget and mechanical cross-coupling model for this system are also presented. We demonstrate frequency tuning of the two torsion pendulums to a difference of 4.3 μHz.
Heavy right-handed neutrino dark matter and PeV neutrinos at IceCube
Energy Technology Data Exchange (ETDEWEB)
Dev, P.S. Bhupal [Max-Planck-Institut für Kernphysik,Saupfercheckweg 1, D-69117 Heidelberg (Germany); Kazanas, D. [Astrophysics Science Division, NASA Goddard Space Flight Center,Greenbelt, MD 20771 (United States); Mohapatra, R.N. [Maryland Center for Fundamental Physics, Department of Physics, University of Maryland,College Park, MD 20742 (United States); Teplitz, V.L. [Astrophysics Science Division, NASA Goddard Space Flight Center,Greenbelt, MD 20771 (United States); Department of Physics, Southern Methodist University,Dallas, TX 75205 (United States); Zhang, Yongchao [Service de Physique Théorique, Université Libre de Bruxelles,Boulevard du Triomphe, CP225, 1050 Brussels (Belgium); School of Physics, Sun Yat-Sen University,Guangzhou 510275 (China)
2016-08-17
We discuss a simple non-supersymmetric model based on the electroweak gauge group SU(2){sub L}×SU(2){sup ′}×U(1){sub B−L} where the lightest of the right-handed neutrinos, which are part of the leptonic doublet of SU(2){sup ′}, play the role of a long-lived unstable dark matter with mass in the multi-PeV range. We use a resonant s-channel annihilation to obtain the correct thermal relic density and relax the unitarity bound on dark matter mass. In this model, there exists a 3-body dark matter decay mode producing tau leptons and neutrinos, which could be the source for the PeV cascade events observed in the IceCube experiment. The model can be tested with more precise flavor information of the highest-energy neutrino events in future data.
[Aquatic insects and water quality in Peñas Blancas watershed and reservoir].
Mora, Meyer Guevara
2011-06-01
The aquatic insects have been used to evaluate water quality of aquatic environments. The population of aquatic insects and the water quality of the area were characterized according to the natural and human alterations present in the study site. During the monthly-survey, pH, DO, temperature, water level, DBO, PO4 and NO3 were measured. Biological indexes (abundance, species richness and the BMWP-CR) were used to evaluate the water quality. No relation between environmental and aquatic insects was detected. Temporal and spatial differences attributed to the flow events (temporal) and the presence of Peñas Blancas reservoir (spatial). In the future, the investigations in Peñas Blancas watershed need to be focused on determining the real influence of the flows, sediment release and the possible water quality degradation because of agriculture activities.
Representing Valued Bodies in PE: A Visual Inquiry with British Asian Girls
Hill, Joanne; Azzarito, Laura
2012-01-01
Background: Status or value in sport and physical education (PE) contexts is often associated with performances of highly proficient sporting bodies, which produce hierarchies of privileged and marginalised gendered and racialised positions. This may be communicated through text and images shared within school, physical cultures and media that…
Using Internet Artifacts to Profile a Child Pornography Suspect
Marcus K. Rogers; Kathryn C. Seigfried-Spellar
2014-01-01
Digital evidence plays a crucial role in child pornography investigations. However, in the following case study, the authors argue that the behavioral analysis or “profiling” of digital evidence can also play a vital role in child pornography investigations. The following case study assessed the Internet Browsing History (Internet Explorer Bookmarks, Mozilla Bookmarks, and Mozilla History) from a suspected child pornography user’s computer. The suspect in this case claimed to be conducting an...
International Nuclear Information System (INIS)
Peng Sen; Ye Wenwei; Luo Zhongrao; Yang Zenian; Zhang Zhongwei; Li Ziping
2006-01-01
Objective: To evaluate the value of diffusion weighted imaging (DWI) in acute cerebral infarction using permanent type MR scanner. Methods: DWI and conventional MRI sequences were done in 77 patients suspected with cerebral infarction. The sensitivity of DWI and conventional MRI was comparatively evaluated on lesion signal intensity and size. The characteristics and orderliness of lesions were studied. Results: (1) DWI has higher sensitivity than conventional MRI. (2) The higher b value was applied in the imaging, the higher signal intensity of acute cerebral infarction was revealed. The lesions were easier to identify on DWI images than on conventional MRI. Conclusion: DWI of permanent type MR imager is a feasible imaging modality, which is valuable in early diagnosis and management of acute cerebral infarction. (authors)
Azzarito, Laura
2016-06-01
The current neoliberal context of schools presents difficult challenges in addressing persistent issues of social inequalities. In this article, first, I argue that because of today's market-driven education, the rise of fitness testing in school physical education (PE) can be seriously detrimental to young people in general and to ethnic-minority young people's embodied identity in particular. Second, I explain how the racialization process circulated by the body-at-risk discourse, sustained by the media, and reproduced by high-stakes testing in PE forces ethnic-minority young people to construct their identities through White eyes, which alienates them from a consciousness of their own identity. Third, I explore the possible uses and pitfalls of Spivak's theoretical notion of "strategic essentialism" to put forward strategies to build a positive image of the "other" while attempting to avoid the erasure of difference. Fourth, I conclude the article by suggesting how Spivak's notion of strategic essentialism can be useful in rethinking current PE fitness practices.
Banciu, D
2007-01-01
Proiectului CEEX, SINRED ?i-a propus s? defineasc? ?i s? realizeze un sistem na?ional unitar de management al resurselor digitale în ?tiin?? ?i tehnologie bazat pe structuri GRID. Partenerii din consor?iu sunt: Universitatea din Bucure?ti; Universitatea Politehnica Bucure?ti; Universitatea Tehnic? din Cluj-Napoca; Institutul National de Informare ?i Documentar; Universitatea de Vest din Timi?oara. Problematica propus? spre rezolvare se circumscrie urm?toarelor obiective specifice: definirea ?i fundamentarea solu?iilor privind constituirea unei biblioteci digitale bazate pe re?eaua bibliotecilor universitare, publice ?i academic;definirea metodelor ?i metodologiilor de creare a unui sistem unitar la nivel na?ional în domeniul info-documentar bazat pe documente digital; analiza ?i testarea modalit??ilor de valorificare a tehnologiilor GRID în domeniul info-documentar;definirea unor proceduri de construire a bazelor de date digitale în acord cu normele ?i reglement?rile na?ionale ?i interna?ionale în domeni...
Hyperthyroidism: A rare cause of pulmonary embolism: Report of two cases
Sonia Grine; Nadia Charfi; Mahdi Kamoun; Fatma Mnif; Basma Ben Naceur; Nabila Rekik; Mouna Mnif; Mohamed Abid
2013-01-01
Several disorders of coagulation and fibrinolysis have been widely reported in patients with hyperthyroidism. Most reports have focused on only the venous thromboembolism risk, and few of them have studied specifically the association between hyperthyroidism and pulmonary embolism (PE). We report two cases of Graves’ disease complicated by PE. The first patient is a 32 year-old man, and the second patient is a 23-year-old female. PE was suspected on the basis of pulmonary hypertension in pati...
Croston, Amanda
2013-01-01
Background: This paper examines physical education (PE) teachers' perceptions of talent in PE and sport within the context of English policy, where the process of identifying talent has been formalised and supported through specific resources (YST 2009). English policy has merged educational and sporting targets, which has resulted in a shift in…
International Nuclear Information System (INIS)
Kaidu, Motoki; Oyamatu, Manabu; Sato, Kenji; Saitou, Akira; Yamamoto, Satoshi; Yoshimura, Norihiko; Sasai, Keisuke
2008-01-01
The aim of this retrospective analysis was to evaluate the accuracy of 10 mm thickness single helical computed tomography (CT) examination for confirming the diagnosis of appendicitis or providing a diagnosis other than appendicitis, including underlying periappendical neoplasms. From April 1, 2001 to March 30, 2005, a total of 272 patients with suspected appendicitis underwent CT examinations. Of the 272 patients, 106 (39%) underwent surgery. Seven CT examinations for seven patients were excluded because of inconsistency of the CT protocol. We therefore reviewed 99 CT images (99 patients) with correlation to surgical-pathological findings to clarify the diagnostic accuracy of CT examinations. We compared the postoperative diagnosis with the preoperative CT report. The final diagnoses were confirmed by macroscopic findings at surgery and pathological evaluations if necessary. Of the 99 patients, 87 had acute appendicitis at surgery. The sensitivity, specificity, and accuracy of CT were 98.9%, 75.0%, and 96.0%, respectively. The positive predictive value and negative predictive value were 96.6% and 90.0%, respectively. Among nine patients in the true-negative category, five had colon cancers; and among three patients in the false-positive category, two had cancer of the cecal-appendiceal region as the underlying disease. CT examination is useful for patients with suspected appendicitis, but radiologists should be aware of the limitation of thick-sliced single helical CT. They should also be aware of the possibility of other diseases, including coincident abdominal neoplasms and underlying cecal-appendiceal cancer. (author)
Energy Technology Data Exchange (ETDEWEB)
Bonfiglioli, Rachele; Nanni, Cristina; Morigi, Joshua James; Ambrosini, Valentina; Fanti, Stefano [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Nuclear Medicine, Bologna (Italy); Graziosi, Maddalena; Rapezzi, Claudio [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Cardiology, Bologna (Italy); Trapani, Filippo; Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Infective Diseases, Bologna (Italy); Ferretti, Alice; Rubello, Domenico [Azienda Ospedaliera S. Maria della Misericordia, Nuclear Medicine, Radiology, Neuroradiology, Medical Physics, Rovigo (Italy)
2013-08-15
Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. {sup 18}F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of {sup 18}F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE). Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent {sup 18}F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures. Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24 %) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures. PET/CT detected unexpected extra sites of infection in 24 % of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications. (orig.)
Directory of Open Access Journals (Sweden)
Annette Wessmann
2015-06-01
Full Text Available Case summary A 10-year-old cat presented 5 days after a traumatic event with acute recumbency followed by some clinical improvement. The neuroanatomical localisation was the C1–C5 spinal cord segments. Initial survey radiographs, including lateral flexed views, showed no convincing abnormalities. Magnetic resonance imaging (MRI revealed a marked focal intramedullary lesion at the level of the dens and suspected oedema extending over C2–C3 vertebrae, suggesting early syrinx formation. The cat made an initial excellent recovery on restricted exercise without medical treatment. The MRI changes largely resolved on follow-up MRI 4 weeks later yet recurred following a relapse 4 months later. At this stage, a post-traumatic syrinx had developed. Moreover, the suspected atlantoaxial instability was finally diagnosed on radiography with fully flexed lateral views. A hyperflexion injury causing tearing of the atlantoaxial ligaments was considered most likely given the lack of malformations or fractures. The cat made a full recovery on conservative management. Relevance and novel information This is the first report of sequential MRI findings in a cat with atlantoaxial instability. Moreover, post-traumatic syringomyelia formation following atlantoaxial injury has not been reported. Sequential MRI aids in the diagnosis of hyperflexion injury if survey radiographs fail to identify atlantoaxial instability.
Prime Suspect, Second Row Center
Laird, Ellen A.
2011-01-01
His father had been hacked to death in his own bed with an ax the previous November. His mother was similarly brutalized and left for dead with her husband but survived. On the last Monday of that August, after several months and many investigative twists, turns, and fumbles, there sat the son--the prime suspect--in Ellen Laird's literature class,…
Testing the Equivalence Principle and Lorentz Invariance with PeV Neutrinos from Blazar Flares.
Wang, Zi-Yi; Liu, Ruo-Yu; Wang, Xiang-Yu
2016-04-15
It was recently proposed that a giant flare of the blazar PKS B1424-418 at redshift z=1.522 is in association with a PeV-energy neutrino event detected by IceCube. Based on this association we here suggest that the flight time difference between the PeV neutrino and gamma-ray photons from blazar flares can be used to constrain the violations of equivalence principle and the Lorentz invariance for neutrinos. From the calculated Shapiro delay due to clusters or superclusters in the nearby universe, we find that violation of the equivalence principle for neutrinos and photons is constrained to an accuracy of at least 10^{-5}, which is 2 orders of magnitude tighter than the constraint placed by MeV neutrinos from supernova 1987A. Lorentz invariance violation (LIV) arises in various quantum-gravity theories, which predicts an energy-dependent velocity of propagation in vacuum for particles. We find that the association of the PeV neutrino with the gamma-ray outburst set limits on the energy scale of possible LIV to >0.01E_{pl} for linear LIV models and >6×10^{-8}E_{pl} for quadratic order LIV models, where E_{pl} is the Planck energy scale. These are the most stringent constraints on neutrino LIV for subluminal neutrinos.
Energy Technology Data Exchange (ETDEWEB)
Ribeiro, Maria-Joao [Service Hospitalier Frederic Joliot, Institut d' Imagerie Biomedicale, Direction des Sciences du Vivant, Commissariat a l' Energie Atomique, F-91406 Orsay (France)]. E-mail: maria-joao.ribeiro@cea.fr; Ricard, Marcel [Service de Physique, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France); Lievre, Marie-Angele [Service Hospitalier Frederic Joliot, Institut d' Imagerie Biomedicale, Direction des Sciences du Vivant, Commissariat a l' Energie Atomique, F-91406 Orsay (France); Bourgeois, Sandrine [Service Hospitalier Frederic Joliot, Institut d' Imagerie Biomedicale, Direction des Sciences du Vivant, Commissariat a l' Energie Atomique, F-91406 Orsay (France); Emond, Patrick [INSERM U316, Laboratoire de Biophysique medicale et pharmaceutique, UFR des Sciences Pharmaceutiques, 37200 Tours (France); Gervais, Philippe [Service Hospitalier Frederic Joliot, Institut d' Imagerie Biomedicale, Direction des Sciences du Vivant, Commissariat a l' Energie Atomique, F-91406 Orsay (France); Dolle, Frederic [Service Hospitalier Frederic Joliot, Institut d' Imagerie Biomedicale, Direction des Sciences du Vivant, Commissariat a l' Energie Atomique, F-91406 Orsay (France); Syrota, Andre [Service Hospitalier Frederic Joliot, Institut d' Imagerie Biomedicale, Direction des Sciences du Vivant, Commissariat a l' Energie Atomique, F-91406 Orsay (France)
2007-05-15
Introduction: This study reports on the biodistribution and radiation dosimetry of a cocaine analog, the (E)-N-(3-iodoprop-2-enyl)-2{beta}-carbomethoxy-3{beta}-(4'-tolyl)nortropane (PE2I), labeled with carbon 11 ([{sup 11}C]PE2I). [{sup 11}C]PE2I is used in positron emission tomography (PET) for examination of the dopamine neuronal transporter (DAT). DAT radioligands are often used to evaluate the progression of Parkinson's disease or the efficiency of neuroprotective therapeutics, and, typically, these studies required several successive PET scans. Methods: In three healthy male volunteers, whole-body scans were performed up to 2 h following intravenous injection of 321{+-}6 MBq of [{sup 11}C]PE2I. For each subject, regions of interest were defined over all visible organs to generate time-activity curves and calculate the percentage of injected activity. Time-activity data were fitted to a monoexponential model, as an uptake phase followed by a mono-exponential washout, or bi-exponential model to obtain residence times. With the use of the MIRD method, several source organs were considered in estimating residence time and mean effective radiation absorbed doses. Results: Blood pressure and ECG findings remained unchanged after radioligand injection. The primary route of clearance was renal. Ten minutes after injection, high activities were observed in the kidneys, urinary-bladder, stomach, liver, salivary glands and brain. The urine bladder wall, stomach and liver received the highest absorbed doses. The average effective dose of [{sup 11}C]PE2I was estimated to be 6.4{+-}0.6 {mu}Sv/MBq. Conclusion: The amount of [{sup 11}C]PE2I required for adequate DAT PET imaging results in an acceptable effective dose equivalent permitting two or three repeated cerebral PET studies, with the injection of 222 MBq for each study.
Energy Technology Data Exchange (ETDEWEB)
Kellner, Markus; Rohrmoser, Michaela [Department of Molecular Epigenetics, Helmholtz Center Munich, Center for Integrated Protein Science Munich (CIPSM), Marchioninistr. 25, Munich 81377 (Germany); Forné, Ignasi [Adolf Butenandt Institute, Ludwig Maximilians University of Munich, Center for Integrated Protein Science Munich (CIPSM), Schillerstr. 44, Munich 80336 (Germany); Voss, Kirsten; Burger, Kaspar; Mühl, Bastian; Gruber-Eber, Anita [Department of Molecular Epigenetics, Helmholtz Center Munich, Center for Integrated Protein Science Munich (CIPSM), Marchioninistr. 25, Munich 81377 (Germany); Kremmer, Elisabeth [Institute of Molecular Immunology, Helmholtz Center Munich, Marchioninistr. 25, Munich 81377 (Germany); Imhof, Axel [Adolf Butenandt Institute, Ludwig Maximilians University of Munich, Center for Integrated Protein Science Munich (CIPSM), Schillerstr. 44, Munich 80336 (Germany); Eick, Dirk, E-mail: eick@helmholtz-muenchen.de [Department of Molecular Epigenetics, Helmholtz Center Munich, Center for Integrated Protein Science Munich (CIPSM), Marchioninistr. 25, Munich 81377 (Germany)
2015-05-15
PeBoW, a trimeric complex consisting of pescadillo (Pes1), block of proliferation (Bop1), and the WD repeat protein 12 (WDR12), is essential for processing and maturation of mammalian 5.8S and 28S ribosomal RNAs. Applying a mass spectrometric analysis, we identified the DEAD-box helicase DDX27 as stably associated factor of the PeBoW-complex. DDX27 interacts with the PeBoW-complex via an evolutionary conserved F×F motif in the N-terminal domain and is recruited to the nucleolus via its basic C-terminal domain. This recruitment is RNA-dependent and occurs independently of the PeBoW-complex. Interestingly, knockdown of DDX27, but not of Pes1, induces the accumulation of an extended form of the primary 47S rRNA. We conclude that DDX27 can interact specifically with the Pes1 and Bop1 but fulfils critical function(s) for proper 3′ end formation of 47S rRNA independently of the PeBoW-complex. - Highlights: • DEAD-box helicase DDX27 is a new constituent of the PeBoW-complex. • The N-terminal F×F motif of DDX27 interacts with the PeBoW components Pes1 and Bop1. • Nucleolar anchoring of DDX27 via its basic C-terminal domain is RNA dependent. • Knockdown of DDX27 induces a specific defect in 3′ end formation of 47S rRNA.
PE are a large family of compounds used in a wide array of products from medical tubing to pharmaceuticals to cables. Studies have shown that in utero treatment with PE such as diethyl hexyl phthalate (DEHP) during the critical period of fetal reproductive development produced ma...
CONSIDERAŢII PRIVIND IMPORTANŢA METODEI DE CALCULAŢIE A COSTULUI PE COMENZI
Directory of Open Access Journals (Sweden)
Svetlana MIHAILA
2016-12-01
Full Text Available În acest articol este prezentată o modalitate de organizare a contabilităţii de gestiune şi a calculaţiei costurilor prin metoda pe comenzi. Sunt tratate etapele de derulare a metodei de calculaţie a costului pe comenzi, respectiv rolul contabilului de gestiune în derularea şi implementarea acestei metode. Din punct de vedere teoretic şi aplicativ, sunt abordate etapele metodologice parcurse în contabilitatea de gestiune şi calculaţia costurilor.Concluziile formulate vizează organizarea contabilităţii de gestiune; entitatea trebuie să aplice cea mai eficientă metodă de calculaţie, ba chiar şi o combinaţie de metode de calculaţie – clasice şi moderne, în concordanţă cu particularităţile tehnologiei şi organizării producţiei, precum şi cu cerinţele unei administrări eficiente. Totodată, sunt abordate şi avantajele pe care le oferă metoda pe comenzi, de unde derivă şi importanţa acestui subiect. CONSIDERATIONS ON THE IMPORTANCE OF THE JOB-ORDER COSTING SYSTEM The authors present a method for the organization of the management accounting and job-order costing. Consideration has been given to the stages of the job-order costing system, as well as to the role of the accountant in the application and implementation of such method. The authors have adopted a theoretical and applicative approach in regard to the methodological stages covered by the management accounting and the costing method.The article ends with the authors' conclusions regarding the organization of the management accounting. In this respect, it outcomes that an entity is to apply the most efficient costing method and, moreover, a combination of classical and modern costing methods, in accordance with the specific features of the manufacturing process and production engineering, as well as the efficient management requirements. The authors have also shed light on the advantages offered by the job-order costing system, and the resulting
International Nuclear Information System (INIS)
Sohn, Joon Yong; Shin, Jun Hwa; Nho, Young Chang
2010-01-01
PVDF-HFP (binder)/silylated alumina (inorganic particle)-coated PE (polyethylene)separators were with various compositions of binder and inorganic particle were prepared by a dip-coating process with humidity control (R.H. 25% and 50%) using electron beam irradiation. The morphology of the coated PVDF-HFP/AI 2 O 3 layer with various compositions of PVDF-HFP and AI 2 O 3 , and humidity condition was found to be an important factor in determining ionic conductivity of the prepared separators. The PVDF-HFP/AI 2 O 3 (5/5)-coated PE separator prepared at R.H. 50% followed by electron beam irradiation at 200 kGy was applied for lithium-ion polymer battery and cell test results showed improved high-rate discharge performance and better cyclic stability compared to the cells with the bare PE and the PVDF-HFP-coated PE separators
Kohay, Hagay; Sarisozen, Can; Sawant, Rupa; Jhaveri, Aditi; Torchilin, Vladimir P; Mishael, Yael G
2017-06-01
A novel drug delivery system for doxorubicin (DOX), based on organic-inorganic composites was developed. DOX was incorporated in micelles (M-DOX) of polyethylene glycol-phosphatidylethanolamine (PEG-PE) which in turn were adsorbed by the clay, montmorillonite (MMT). The nano-structures of the PEG-PE/MMT composites of LOW and HIGH polymer loadings were characterized by XRD, TGA, FTIR, size (DLS) and zeta measurements. These measurements suggest that for the LOW composite a single layer of polymer intercalates in the clay platelets and the polymer only partially covers the external surface, while for the HIGH composite two layers of polymer intercalate and a bilayer may form on the external surface. These nanostructures have a direct effect on formulation stability and on the rate of DOX release. The release rate was reversely correlated with the degree of DOX interaction with the clay and followed the sequence: M-DOX>HIGH formulation>LOW formulation>DOX/MMT. Despite the slower release from the HIGH formulation, its cytotoxicity effect on sensitive cells was as high as the "free" DOX. Surprisingly, the LOW formulation, with the slowest release, demonstrated the highest cytotoxicity in the case of Adriamycin (ADR) resistant cells. Confocal microscopy images and association tests provided an insight into the contribution of formulation-cell interactions vs. the contribution of DOX release rate. Internalization of the formulations was suggested as a mechanism that increases DOX efficiency, particularly in the ADR resistant cell line. The employment of organic-inorganic hybrid materials as drug delivery systems, has not reached its full potential, however, its functionality as an efficient tunable release system was demonstrated. DOX PEG-PE/clay formulations were design as an efficient drug delivery system. The main aim was to develop PEG-PE/clay formulations of different structures based on various PEG-PE/clay ratios in order to achieve tunable release rates, to control
Effect of maleic anhydride on the physico-mechanical properties of NR/PE blends
International Nuclear Information System (INIS)
Yehia, A.A.; El Elnashar, D.
2005-01-01
Blending of two or more polymers is considered as a new technique to produce new materials with new properties at low production cost and investment. Rubber / Rubber blends are well known in tire industry. In the last decade rubber and plastic blending attract the interest of many researchers and technologists. In the present work NR and LLDPE was blended in presence of maleic anhydride (MA) on a Brabender premixed at different conditions and namely temperature and time. The obtained blends were cured with sulphur and peroxide curing systems. Peroxide can crosslink both NR and PE, but the sulphur system crosslinks only the rubber phase in the blend. The data showed also that the addition of MA greatly improved the physico-mechanical properties of NR/PE blends. The surface morphology of the blends under investigation was studied by SEM. The results will be presented and discussed in detail
Xiong, Bing; Zhong, Weibing; Zhu, Qing; Liu, Ke; Li, Mufang; Sun, Gang; Wang, Dong
2017-12-14
The development of electronics towards a more functions-integrated, flexible and stretchable direction requires mechanically flexible substrates with high thermal and dimensional stability and optical transparency. Herein, rolls of an optically transparent PVA-co-PE nanofibrous membrane/epoxy composite with synergistically enhanced thermal stability, very low CTE, and outstanding mechanical properties are reported. The nanoscale size, the unique inter-stack structure, and the strong interfacial interactions between the PVA-co-PE nanofibers and the epoxy contribute to the synergistic effects. Because of the match between the refractive index (RI) of the PVA-co-PE nanofibers and the epoxy matrix, the visible light transmittance of nanocomposite film could be as high as 85% and the composite film was still optically transparent with a nanofiber loading content of up to 61.7 wt%. The break strength and compliance matrix of the composite film with a high fiber loading of 61.7 wt% increased by 2.3 times of that of the neat epoxy film and exceeded 3000 m 2 N -1 , respectively. PVA-co-PE nanofibers have a very low CTE value (3.634 × 10 -6 K -1 ) and could be applicable as a reinforcement to reduce the thermal expansion of epoxy. Furthermore, we developed a flexible alternating current electroluminescent (ACEL) device based on the transparent composite film and the experimental results showed that the transparent composite film could serve as substrate for flexible electronic devices. In addition, their electrical and optical properties were evaluated.
Unfair lineups make witnesses more likely to confuse innocent and guilty suspects
Colloff, Melissa F.; Wade, Kimberley A.; Strange, D.
2016-01-01
Eyewitness-identification studies have focused on the idea that unfair lineups (i.e., ones in which the police suspect stands out) make witnesses more willing to identify the police suspect. We examined whether unfair lineups also influence subjects’ ability to distinguish between innocent and guilty suspects and their ability to judge the accuracy of their identification. In a single experiment (N = 8,925), we compared three fair-lineup techniques used by the police with unfair lineups in wh...
Indications and radiological findings of acute otitis media and its complications.
Pont, Elena; Mazón, Miguel
Most cases of acute otitis media resolve with antibiotics and imaging is not required. When treatment fails or a complication is suspected, imaging plays a crucial role. Since the introduction of antibiotic treatment, the complication rate has decreased dramatically. Nevertheless, given the critical clinical relevance of complications, the importance of early diagnosis is vital. Our objective was to review the clinical and radiological features of acute otitis media and its complications. They were classified based on their location, as intratemporal or intracranial. Imaging makes it possible to diagnose the complications of acute otitis media and to institute appropriate treatment. Computed tomography is the initial technique of choice and, in most cases, the ultimate. Magnetic resonance is useful for evaluating the inner ear and when accurate evaluation of disease extent or better characterization of intracranial complications is required. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.
Incidence and etiology of hospitalized acute respiratory infections in the Egyptian Delta
Rowlinson, Emily; Dueger, Erica; Mansour, Adel; Azzazy, Nahed; Mansour, Hoda; Peters, Lisa; Rosenstock, Summer; Hamid, Sarah; Said, Mayar M.; Geneidy, Mohamed; Abd Allah, Monier; Kandeel, Amr
2016-01-01
Introduction Acute Respiratory Infections (ARI) are responsible for nearly two million childhood deaths worldwide. A limited number of studies have been published on the epidemiology of viral respiratory pathogens in Egypt. Methods A total of 6113 hospitalized patients >1?month of age with suspected ARI were enrolled between June 23, 2009 and December 31, 2013. Naso? and oropharyngeal specimens were collected and tested for influenza A and B, respiratory syncytial virus, human metapneumovirus...
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Dan-Jie Guo
2015-01-01
Full Text Available Background: Pulmonary embolism (PE can be difficult to diagnose in elderly patients because of the coexistent diseases and the combination of drugs that they have taken. We aimed to compare the clinical diagnostic values of the Wells score, the revised Geneva score and each of them combined with D-dimer for suspected PE in elderly patients. Methods: Three hundred and thirty-six patients who were admitted for suspected PE were enrolled retrospectively and divided into two groups based on age (≥65 or <65 years old. The Wells and revised Geneva scores were applied to evaluate the clinical probability of PE, and the positive predictive values of both scores were calculated using computed tomography pulmonary arteriography as a gold standard; overall accuracy was evaluated by the area under the curve (AUC of receiver operator characteristic curve; the negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were calculated. Results: Ninety-six cases (28.6% were definitely diagnosed as PE among 336 cases, among them 56 cases (58.3% were ≥65 years old. The positive predictive values of Wells and revised Geneva scores were 65.8% and 32.4%, respectively (P < 0.05 in the elderly patients; the AUC for the Wells score and the revised Geneva score in elderly was 0.682 (95% confidence interval [CI]: 0.612-0.746 and 0.655 (95% CI: 0.584-0.722, respectively (P = 0.389. The negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were 93.7%, 100%, and 100% in the elderly, respectively. Conclusions: The diagnostic value of the Wells score was higher than the revised Geneva score for the elderly cases with suspected PE. The combination of either the Wells score or the revised Geneva score with a normal D-dimer concentration is a safe strategy to rule out PE.
International Nuclear Information System (INIS)
Tannheimer, Stacey L; Rehemtulla, Alnawaz; Ethier, Stephen P
2000-01-01
The fibroblast growth factor receptor (FGFR)2 gene has been shown to be amplified in 5-10% of breast cancer patients. A breast cancer cell line developed in our laboratory, SUM-52PE, was shown to have a 12-fold amplification of the FGFR2 gene, and FGFR2 message was found to be overexpressed 40-fold in SUM-52PE cells as compared with normal human mammary epithelial (HME) cells. Both human breast cancer (HBC) cell lines and HME cells expressed two FGFR2 isoforms, whereas SUM-52PE cells overexpressed those two isoforms, as well as several unique FGFR2 polypeptides. SUM-52PE cells expressed exclusively FGFR2-IIIb isoforms, which are high-affinity receptors for fibroblast growth factor (FGF)-1 and FGF-7. Differences were identified in the expression of the extracellular Ig-like domains, acid box and carboxyl termini, and several variants not previously reported were isolated from these cells. The FGFR family of receptor tyrosine kinases includes four members, all of which are highly alternatively spliced and glycosylated. For FGFR2, alternative splicing of the second half of the third Ig-like domain, involving exons IIIb and IIIc, is a mutually exclusive choice that affects ligand binding specificity and affinity [1,2,3]. It appears that the second half of the third Ig-like domain can dictate high affinity for FGF-2 or keratinocyte growth factor (KGF), whereas affinity for FGF-1 appears to remain the same [3]. Alternative splicing of the carboxyl terminus has been shown to involve at least two different exons that can produce at least three different variants. The C1-type and C2-type carboxyl termini are encoded by the same exon, and have two different splice acceptor sites, whereas the C3-type carboxyl terminus is encoded by a separate exon [4]. The biologic significance of the C1 carboxyl terminus, as compared with the shorter C3 variant found primarily in tumorigenic samples, has been studied in NIH3T3 transfection assays, in which C3 variants were able to produce
Magnetic resonance angiography in suspected cerebral vasculitis
International Nuclear Information System (INIS)
Demaerel, Philippe; De Ruyter, Nele; Wilms, Guido; Maes, Frederik; Velghe, Beatrijs
2004-01-01
The purpose of this study was to determine the technical capacity and diagnostic accuracy of 3D time-of-flight magnetic resonance angiography (MRA) in suspected cerebral vasculitis in a retrospective analysis of MRA and digital subtraction angiography (DSA) in 14 young patients with clinical and/or radiological suspicion of cerebral vasculitis. A total of nine arteries were evaluated in each patient. Consensus review of DSA by three observers was the reference standard. The sensitivity for detecting a stenosis varied from 62 to 79% for MRA and from 76 to 94% for DSA, depending on the observer. The specificity for detecting a stenosis varied from 83 to 87% for MRA and from 83 to 97% for DSA. Using the criterion ''more than two stenoses in at least two separate vascular distributions'' to consider the examination as being true positive, the false-positive rates for MRA and DSA were comparable. MRA plays a role as the first angiographical examination in the diagnostic work-up of suspected cerebral vasculitis. When more than two stenoses in at least two separate vascular distributions are depicted on MRA, DSA is not expected to add a significant diagnostic contribution in a patient with suspected cerebral vasculitis. DSA remains necessary when MRA is normal or when less than three stenoses are seen. (orig.)
Magnetic resonance angiography in suspected cerebral vasculitis
Energy Technology Data Exchange (ETDEWEB)
Demaerel, Philippe; De Ruyter, Nele; Wilms, Guido [Department of Radiology, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Maes, Frederik [Department of Medical Imaging Computing, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Velghe, Beatrijs [Department of Radiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk (Belgium)
2004-06-01
The purpose of this study was to determine the technical capacity and diagnostic accuracy of 3D time-of-flight magnetic resonance angiography (MRA) in suspected cerebral vasculitis in a retrospective analysis of MRA and digital subtraction angiography (DSA) in 14 young patients with clinical and/or radiological suspicion of cerebral vasculitis. A total of nine arteries were evaluated in each patient. Consensus review of DSA by three observers was the reference standard. The sensitivity for detecting a stenosis varied from 62 to 79% for MRA and from 76 to 94% for DSA, depending on the observer. The specificity for detecting a stenosis varied from 83 to 87% for MRA and from 83 to 97% for DSA. Using the criterion ''more than two stenoses in at least two separate vascular distributions'' to consider the examination as being true positive, the false-positive rates for MRA and DSA were comparable. MRA plays a role as the first angiographical examination in the diagnostic work-up of suspected cerebral vasculitis. When more than two stenoses in at least two separate vascular distributions are depicted on MRA, DSA is not expected to add a significant diagnostic contribution in a patient with suspected cerebral vasculitis. DSA remains necessary when MRA is normal or when less than three stenoses are seen. (orig.)
Unsuspected Dengue as a Cause of Acute Febrile Illness in Children and Adults in Western Nicaragua.
Directory of Open Access Journals (Sweden)
Megan E Reller
2016-10-01
Full Text Available Dengue is an emerging infectious disease of global significance. Suspected dengue, especially in children in Nicaragua's heavily-urbanized capital of Managua, has been well documented, but unsuspected dengue among children and adults with undifferentitated fever has not.To prospectively study dengue in semi-urban and rural western Nicaragua, we obtained epidemiologic and clinical data as well as acute and convalescent sera (2 to 4 weeks after onset of illness from a convenience sample (enrollment Monday to Saturday daytime to early evening of consecutively enrolled patients (n = 740 aged ≥ 1 years presenting with acute febrile illness. We tested paired sera for dengue IgG and IgM and serotyped dengue virus using reverse transcriptase-PCR. Among 740 febrile patients enrolled, 90% had paired sera. We found 470 (63.5% were seropositive for dengue at enrollment. The dengue seroprevalance increased with age and reached >90% in people over the age of 20 years. We identified acute dengue (serotypes 1 and 2 in 38 (5.1% patients. Only 8.1% (3/37 of confirmed cases were suspected clinically.Dengue is an important and largely unrecognized cause of fever in rural western Nicaragua. Since Zika virus is transmitted by the same vector and has been associated with severe congenital infections, the population we studied is at particular risk for being devastated by the Zika epidemic that has now reached Central America.
Management performance warehousing in PE 'Post Serbia'
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Vidović Dragana R.
2016-01-01
Full Text Available The paper presents a general model for the strategic management of postal infrastructure and resources, focused on development of warehousing service. The model was developed according to the characteristics of the public enterprise 'Pošte Srbije'. A set of indicators is developed for the purpose of analysis of external and internal environment of PE 'Post Serbia'. For positioning the focal postal enterprise among other, selected European posts, the benchmarking method is used, whereby indicators are determined by using eigenvalues and eigenvectors. Analysis of internal environment additionally includes survey and Delphi method to obtain the values of coefficients in the model. With small modifications, the model could be applicable to all postal operators and logistics companies which consider to develop warehouse service in logistics market.
International Nuclear Information System (INIS)
1991-08-01
Revision 2 of the OGR Work Breakdown Structure and Dictionary -- Development and Evaluation Phase (PE-02) supersedes Revision 1, August 1989, in its entirety. The revision is to delete the ''Exploratory Shaft Facility'' work scape and replace it with ''Exploratory Studies Facility'' work scape
Imaging trends in suspected appendicitis-a Canadian perspective.
Tan, Victoria F; Patlas, Michael N; Katz, Douglas S
2017-06-01
The purpose of our study was to assess trends in the imaging of suspected appendicitis in adult patients in emergency departments of academic centers in Canada. A questionnaire was sent to all 17 academic centers in Canada to be completed by a radiologist who works in emergency radiology. The questionnaires were sent and collected over a period of 4 months from October 2015 to February 2016. Sixteen centers (94%) responded to the questionnaire. Eleven respondents (73%) use IV contrast-enhanced computed tomography (CT) as the imaging modality of choice for all patients with suspected appendicitis. Thirteen respondents (81%) use ultrasound as the first modality of choice in imaging pregnant patients with suspected appendicitis. Eleven respondents (69%) use ultrasound (US) as the first modality of choice in patients younger than 40 years of age. Ten respondents (67%) use ultrasound as the first imaging modality in female patients younger than 40 years of age. When CT is used, 81% use non-focused CT of the abdomen and pelvis, and 44% of centers use oral contrast. Thirteen centers (81%) have ultrasound available 24 h a day/7 days a week. At 12 centers (75%), ultrasound is performed by ultrasound technologists. Four centers (40%) perform magnetic resonance imaging (MRI) in suspected appendicitis in adult patients at the discretion of the attending radiologist. Eleven centers (69%) have MRI available 24/7. All 16 centers (100%) use unenhanced MRI. Various imaging modalities are available for the work-up of suspected appendicitis. Although there are North American societal guidelines and recommendations regarding the appropriateness of the multiple imaging modalities, significant heterogeneity in the first-line modalities exist, which vary depending on the patient demographics and resource availability. Imaging trends in the use of the first-line modalities should be considered in order to plan for the availability of the imaging examinations and to consider plans for