WorldWideScience

Sample records for suspected counterfeit products

  1. Counterfeit-Product Trade.

    OpenAIRE

    Grossman, Gene M; Shapiro, Carl

    1988-01-01

    We analyze a two-country model of trade in both legitimate and counterfeit products. Domestic firms own trademarks and establish reputations for delivering high-quality products in a steady-state equilibrium. Foreign suppliers export legitimate low-quality merchandise and counterfeits of domestic brand-name goods. Heterogeneous home consumers either purchase low-quality imports or buy brand-name products, rationally expecting some degree of counterfeiting of the latter. We characterize a coun...

  2. Counterfeit Product Trade

    OpenAIRE

    Grossman, Gene

    1986-01-01

    We analyze a two-country model of trade in both legitimate and counterfeit products. Domestic firms own trademarks and establish reputations for delivering high-quality products in a steady-state equilibrium. Foreign suppliers export legitimate low-quality merchandise and counterfeits of domestic brand-name goods. Heterogeneous home consumers either purchase low-quality imports or buy brand-name products, rationally expecting some degree of counterfeiting of the latter. We characterize a coun...

  3. B Plant/WESF suspect/counterfeit parts identification program

    Energy Technology Data Exchange (ETDEWEB)

    Mertz, D.W.

    1996-01-12

    This document describes a suspect/counterfeit parts inspection program required by DOE conducted in accordance with Internal Memo 16710-94-DWM-048, J.A. O`Brien to J. N. Nansen, B Plant Suspect/ Counterfeit Parts Action Plan, dated May 24, 1994. The program included: physical inspection of all spare parts inventories within the plant; screening of installed B Plant/WESF (Waste Encapsulation and Storage Facility) systems for applications where the use and subsequent potential failure of suspect/counterfeit parts could have critical consequences; and a physical inspection based upon this screening.

  4. Suspect/Counterfeit Items Information Guide for Subcontractors/Suppliers

    Energy Technology Data Exchange (ETDEWEB)

    Tessmar, Nancy D. [Los Alamos National Laboratory; Salazar, Michael J. [Los Alamos National Laboratory

    2012-09-18

    Counterfeiting of industrial and commercial grade items is an international problem that places worker safety, program objectives, expensive equipment, and security at risk. In order to prevent the introduction of Suspect/Counterfeit Items (S/CI), this information sheet is being made available as a guide to assist in the implementation of S/CI awareness and controls, in conjunction with subcontractor's/supplier's quality assurance programs. When it comes to counterfeit goods, including industrial materials, items, and equipment, no market is immune. Some manufactures have been known to misrepresent their products and intentionally use inferior materials and processes to manufacture substandard items, whose properties can significantly cart from established standards and specifications. These substandard items termed by the Department of Energy (DOE) as S/CI, pose immediate and potential threats to the safety of DOE and contractor workers, the public, and the environment. Failure of certain systems and processes caused by an S/CI could also have national security implications at Los Alamos National Laboratory (LANL). Nuclear Safety Rules (federal Laws), DOE Orders, and other regulations set forth requirements for DOE contractors to implement effective controls to assure that items and services meet specified requirements. This includes techniques to implement and thereby minimizing the potential threat of entry of S/CI to LANL. As a qualified supplier of goods or services to the LANL, your company will be required to establish and maintain effective controls to prevent the introduction of S/CI to LANL. This will require that your company warrant that all items (including their subassemblies, components, and parts) sold to LANL are genuine (i.e. not counterfeit), new, and unused, and conform to the requirements of the LANL purchase orders/contracts unless otherwise approved in writing to the Los Alamos National Security (LANS) contract administrator

  5. Control of Suspect/Counterfeit and Defective Items

    Energy Technology Data Exchange (ETDEWEB)

    Sheriff, Marnelle L.

    2013-09-03

    This procedure implements portions of the requirements of MSC-MP-599, Quality Assurance Program Description. It establishes the Mission Support Alliance (MSA) practices for minimizing the introduction of and identifying, documenting, dispositioning, reporting, controlling, and disposing of suspect/counterfeit and defective items (S/CIs). employees whose work scope relates to Safety Systems (i.e., Safety Class [SC] or Safety Significant [SS] items), non-safety systems and other applications (i.e., General Service [GS]) where engineering has determined that their use could result in a potential safety hazard. MSA implements an effective Quality Assurance (QA) Program providing a comprehensive network of controls and verification providing defense-in-depth by preventing the introduction of S/CIs through the design, procurement, construction, operation, maintenance, and modification of processes. This procedure focuses on those safety systems, and other systems, including critical load paths of lifting equipment, where the introduction of S/CIs would have the greatest potential for creating unsafe conditions.

  6. Conspicuous consumption, luxury products and counterfeit market in the UK

    Directory of Open Access Journals (Sweden)

    Trang Huyen My Pham

    2016-05-01

    Full Text Available The fast growth of fashion brands and the popularity of counterfeit goods has posed certain challenges to the existing and new luxury fashion brand players. This study elaborates on the factors driving the market for counterfeit products in the UK. The data collected by means of survey questionnaires from 306 respondents and empirical techniques including descriptive and inferential statistics (correlation and multiple regression analysis, have shown that the consumers have a negative attitude towards counterfeit luxury products. However, they showed fewer tendencies to seek for a brand whose counterfeit cannot easily be found and preferred to buy a genuine rather than a counterfeit. In terms of frequency of purchase, reversion to counterfeit has negative impact, unlike the tendency to seek a brand whose counterfeit is hard to find. The overall results show that the attitude and acceptance of counterfeit do not greatly prevail in the market. However, about 27% of respondents demonstrated either a positive or a neutral tendency towards counterfeit products, which could have serious implications for the luxury goods market.

  7. Independent oversight review of the Department of Energy Quality Assurance Program for suspect/counterfeit parts. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-01

    To address the potential threat that suspect/counterfeit parts could pose to DOE workers and the public, the Office of the Deputy Assistant Secretary for Oversight initiated a number of activities beginning in mid-1995. Oversight placed increased emphasis on the field`s quality assurance-suspect/counterfeit parts programs during safety management evaluations, in keeping with the Office of Environment, Safety and Health (EH) oversight responsibilities, which include oversight of the Department`s quality assurance (QA) programs. In addition, Oversight reviewed relevant policy documents and occurrence reports to determine the nature and magnitude of the problem within the Department. The results of that review, contained in an Office of Oversight report, Independent Oversight Analysis of Suspect/Counterfeit Parts Within the Department of Energy (November 1995), indicate a lack of consistency and comprehensiveness in the Department`s QA-suspect/counterfeit parts program. A detailed analysis of the causes and impacts of the problem was recommended. In response, this review was initiated to determine the effectiveness of the Department`s QA program for suspect/counterfeit parts. This study goes beyond merely assessing and reporting the status of the program, however. It is the authors intention to highlight the complex issues associated with suspect/counterfeit parts in the Department today and to present approaches that DOE managers might consider to address these issues.

  8. Consumer Adoption of Counterfeit Products in a Developing Country

    NARCIS (Netherlands)

    M.M. Lede (Madesta)

    2013-01-01

    markdownabstract__Abstract__ With an increase in global trade, currently involving almost all countries in the world (expect for a few autarkic ones), there is a growing interest in studying various aspects of trade in counterfeit products. As almost every type of good has been counterfeited

  9. Avoid Counterfeit Pesticide Products for Dogs and Cats

    Science.gov (United States)

    EPA is aware of counterfeit pet pesticides designed to look like legitimately registered pesticide products. The information on this page is intended to help consumers avoid unregistered pet products.

  10. Screening suspected counterfeit Viagra and imitations of Viagra with near-infrared spectroscopy.

    NARCIS (Netherlands)

    Vredenbregt, M J; Blok-Tip, L; Hoogerbrugge, Ronald; Barends, D M; Kaste, D de

    2006-01-01

    We describe a near-infrared spectroscopy (NIRS) method for fast-screening Viagra tablets, counterfeit Viagra tablets, and imitations of Viagra. The method can (1) check the homogeneity of a batch; (2) distinguish counterfeits and imitations from authentic Viagra; (3) screen for the presence of

  11. Social power, product conspicuousness, and the demand for luxury brand counterfeit products.

    Science.gov (United States)

    Bian, Xuemei; Haque, Sadia; Smith, Andrew

    2015-03-01

    The aim of this article is twofold: (1) to achieve a better understanding of the psychological determinants of the demand for luxury brand counterfeit products (LBCP) through exploring the effects of social power; (2) to extend power literature by identifying boundary conditions of the relationship between social power and compensatory consumption identified by Rucker and Galinsky (2008, J. Consum. Res., 35, 257-267) and Rucker and Galinsky (2009, J. Exp. Soc. Psychol., 45, 549-555). Findings from three experiments demonstrate that social power holds key insights into understanding consumers' purchase propensity for LBCP; product conspicuousness moderates the effects of social power on purchase propensity for status products; these moderation effects are only observed when the status products are LBCP but not genuine products. This article, therefore, contributes to the literature regarding the demand for counterfeits as well as the social power and compensatory consumption literature. © 2014 The British Psychological Society.

  12. Combatting Falsification and Counterfeiting Of Medicinal Products in the European Union

    DEFF Research Database (Denmark)

    Kohli, Vishv Priya

    and falsification of medicinal products meets the social objectives of public health (Articles 9 and 168) and consumer protection (Articles 12 and 169), as envisaged by the Treaty on the Function of the European Union. The thesis establishes that the problem of counterfeiting and falsification of medicinal products...... lies at the intersection of three spheres of law - IP law, Medicine law, and Criminal law. This insight provides the foundation for the understanding of the weaknesses in the legal regime that contains tools for combatting counterfeiting and falsification of medicines in the EU....

  13. Exploring the Robin Hood effect: Moral profiteering motives for purchasing counterfeit products

    National Research Council Canada - National Science Library

    Poddar, Amit; Foreman, Jeff; Banerjee, Syagnik (Sy); Ellen, Pam Scholder

    2012-01-01

    Counterfeiting is one of the most serious problems facing luxury fashion brands. This study demonstrates that the impact of price differentials on counterfeit purchases varies according to the perceived corporate citizenship (PCC...

  14. Explaining Counterfeit Alcohol Purchases in Russia.

    Science.gov (United States)

    Kotelnikova, Zoya

    2017-04-01

    Alcohol is a common target of counterfeiting in Russia. Counterfeit alcohol is defined here as the manufacture, distribution, unauthorized placement (forgery) of protected commodity trademarks, and infringement of the exclusive rights of the registered trademark holders of alcoholic beverages. It is often argued that the expansion of the counterfeit product market is due to the steady demand of economically disadvantaged people for low-priced goods. The situation becomes more complicated once deceptive and nondeceptive forms of counterfeiting are taken into account. This study aimed to identify markers of risky behavior associated with the purchase of counterfeit alcohol in Russia. The analysis relied on consumer self-reports of alcohol use and purchase collected nationwide by the Russia Longitudinal Monitoring Survey (RLMS-HSE) in 2012 to 2014. I used a generalized linear mixed-model logistic regression to identify predictors of risky behavior by consumers who purchased counterfeit alcohol, either knowingly or unknowingly, during the 30 days preceding the survey. Purchases of counterfeit alcohol declined slightly from 2012 to 2014, mainly due to a decrease in consumers mistakenly purchasing counterfeit products. Predictors of counterfeit alcohol purchases differed between consumers who knowingly and unknowingly purchased counterfeit products. Nondeceptive purchase of counterfeit alcohol was related primarily to an indifference to alcohol brands. Consumers with social networks that include drinkers of nonbeverage alcohol and producers of homemade alcohol were highly likely to consume counterfeit alcohol deliberately. Problem drinking was significantly associated with a higher risk of both deceptive and nondeceptive purchases of counterfeit alcohol. Poverty largely contributed to nondeceptive counterfeiting. The literature has overestimated the impact of low prices on counterfeit alcohol consumption. Problem drinking and membership in social networks of consumers

  15. Biodegradable Microparticles for Simultaneous Detection of Counterfeit and Deteriorated Edible Products.

    Science.gov (United States)

    Rehor, Ivan; van Vreeswijk, Sophie; Vermonden, Tina; Hennink, Wim E; Kegel, Willem K; Eral, Huseyin Burak

    2017-10-01

    In an era of globalized trade relations where food and pharmaceutical products cross borders effortlessly, consumers face counterfeit and deteriorated products at elevated rates. This paper presents multifunctional, biodegradable hydrogel microparticles that can provide information on the authenticity and the potential deterioration of the tagged food or pharmaceutical formulations. These microparticles integrate spatially patterned authenticity code with two sensors-the first one detects possible presence of pathogenic microbes through monitoring pH while the second one identifies products stored above optimal temperatures via optical monitoring of the microparticle degradation. Particles are synthesized from a biocompatible polymer and a photoinitiator, dextran modified with 2-hydroxyethylmethacrylate and riboflavin, respectively, using a continuous, high throughput method stop-flow lithography. The proposed synthesis approach also enables crosslinking with visible light bringing about additional flexibility to flow lithography. Model liquid and solid food and pharmaceutical products are successfully labeled with microparticles and the functionality of the sensors in aqueous solutions is demonstrated. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Counterfeit Goods and Income Inequality

    OpenAIRE

    Stefania Scandizzo

    2001-01-01

    This paper examines the effect of counterfeit goods in a world where consumers are differentiated by level of income and innovation is quality enhancing. Counterfeit goods are defined as products with the same characteristics as “originals”, but of lower quality. The effect of imitation on firms’ profits and consumer welfare depends on the distribution of income within the country. In particular, the greater the level of income inequality the larger the increase in consumer welfare due to the...

  17. Combating the counterfeits with web portal technology

    Science.gov (United States)

    Ting, S. L.; Ip, W. H.

    2015-10-01

    Due to the globalisation of counterfeiting activities, the penetration of fake products in open market is growing. So far, the technologies to combat counterfeiting are mostly applied to high-value products (e.g. premium wine and branded handbags); however, in the medium- and low-value products' perspective, there is no secure way for consumers to identify whether the purchased items are genuine or not. To address the counterfeiting problems effectively, a platform for identifying authenticated products and promoting anti-counterfeit activities is very important. The aim of this paper is to design and develop an anti-counterfeit platform which includes two functions: providing customers a secure network to ascertain the genuineness of their purchased product and increasing public awareness of the current counterfeit problems and updated anti-counterfeit solutions. By combining these two functions, it enables public to fight against fake and beware of counterfeit. Results of adopting portal technology in anti-counterfeiting show high accuracy in product checking and improved creditability. This reveals that the applicability and advantage of the proposed methodology are satisfactory.

  18. ATR-FTIR spectroscopy and chemometrics: An interesting tool to discriminate and characterize counterfeit medicines.

    Science.gov (United States)

    Custers, D; Cauwenbergh, T; Bothy, J L; Courselle, P; De Beer, J O; Apers, S; Deconinck, E

    2015-08-10

    Counterfeit medicines pose a huge threat to public health worldwide. High amounts of counterfeit pharmaceuticals enter the European market and therefore detection of these products is essential. Attenuated Total Reflection Fourier-Transform infrared spectroscopy (ATR-FTIR) might be useful for the screening of counterfeit medicines since it is easy to use and little sample preparation is required. Furthermore, this approach might be helpful to customs to obtain a first evaluation of suspected samples. This study proposes a combination of ATR-FTIR and chemometrics to discriminate and classify counterfeit medicines. A sample set, containing 209 samples in total, was analyzed using ATR-FTIR and the obtained spectra were used as fingerprints in the chemometric data-analysis which included Principal Component Analysis (PCA), k-Nearest Neighbours (k-NN), Classification and Regression Trees (CART) and Soft Independent Modelling of Class Analogy (SIMCA). First it was verified whether the mentioned techniques are capable to distinguish samples containing different active pharmaceutical ingredients (APIs). PCA showed a clear tendency of discrimination based on the API present; k-NN, CART and SIMCA were capable to create suitable prediction models based on the presence of different APIs. However k-NN performs the least while SIMCA performs the best. Secondly, it was tested whether these three models could be expanded to discriminate between genuine and counterfeit samples as well. k-NN was not able to make the desired discrimination and therefore it was not useful. CART performed better but also this model was less suited. SIMCA, on the other hand, resulted in a model with a 100% correct discrimination between genuine and counterfeit drugs. This study shows that chemometric analysis of ATR-FTIR fingerprints is a valuable tool to discriminate genuine from counterfeit samples and to classify counterfeit medicines. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Health risks of counterfeit pharmaceuticals.

    Science.gov (United States)

    ten Ham, Martijn

    2003-01-01

    Pharmaceutical products are not exempt from the practice of counterfeiting. In recent years, many reports have become available demonstrating the presence of fake medicines on the market. Several studies have demonstrated that they are quite often of bad quality. It is estimated that 5% of all world trade in branded goods is counterfeit, leading to huge financial losses for the pharmaceutical industry. But much more important, from a public health point of view, is that history has shown that such products may lead to a great health risk. The essence of counterfeit products and the reason they are so dangerous is the complete absence of quality control, since they are often indistinguishable from the genuine product. The existence of counterfeit drugs has long been ignored both by the pharmaceutical industry and by drug regulatory authorities. At present initiatives are being taken, nationally and internationally, to curb counterfeiting. It is now realised that a strong regulatory agency is essential, but the initiatives can only be successful if all parties concerned actively co-operate.

  20. Counterfeiting in China: a Great Challenge in Intellectual Property Protection

    OpenAIRE

    Lusita, Lusita

    2012-01-01

    Counterfeiting is an increasing problem for Intellectual Property Rights (“IPR”) protection throughout the world. Counterfeiting activities are generally related to trademark infringements as the counterfeiters are trying to generate instant benefits from the established trademarks around the world by using such marks without consent. Counterfeit products manufactured in People's Republic of China (“PRC”) might be considered as the greatest evidence of IPR law contravention. The national gove...

  1. CONSUMER BEHAVIOR TOWARD COUNTERFEIT SPORTING GOODS

    National Research Council Canada - National Science Library

    Chiu, Weisheng; Lee, Kwang-Yong; Won, Doyeon

    2014-01-01

    .... These findings open a new direction for understanding CSGs purchasing behavior. Keywords: counterfeit sporting goods, theory of planned behavior, consumer behavior, price-quality inference, risk averseness, purchase intention. Counterfeit goods are defined as illegally made products that resemble the genuine goods but are typically of lower quali...

  2. Detection and chemical profiling of medicine counterfeits by Raman spectroscopy and chemometrics.

    Science.gov (United States)

    Dégardin, Klara; Roggo, Yves; Been, Frederic; Margot, Pierre

    2011-10-31

    Raman spectroscopy combined with chemometrics has recently become a widespread technique for the analysis of pharmaceutical solid forms. The application presented in this paper is the investigation of counterfeit medicines. This increasingly serious issue involves networks that are an integral part of industrialized organized crime. Efficient analytical tools are consequently required to fight against it. Quick and reliable authentication means are needed to allow the deployment of measures from the company and the authorities. For this purpose a method in two steps has been implemented here. The first step enables the identification of pharmaceutical tablets and capsules and the detection of their counterfeits. A nonlinear classification method, the Support Vector Machines (SVM), is computed together with a correlation with the database and the detection of Active Pharmaceutical Ingredient (API) peaks in the suspect product. If a counterfeit is detected, the second step allows its chemical profiling among former counterfeits in a forensic intelligence perspective. For this second step a classification based on Principal Component Analysis (PCA) and correlation distance measurements is applied to the Raman spectra of the counterfeits. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. TRANSPORT OF COUNTERFEIT GOODS

    Directory of Open Access Journals (Sweden)

    Dagmar Babčanová

    2014-09-01

    Full Text Available The paper is focused on a current problem of transport of counterfeit goods in the European Union. Counterfeiting has a strong influence on the distribution organizations worldwide because most of counterfeit goods threaten the health and safety of consumers. Counterfeiting is a serious problem in the world economy today. The purpose of this paper is to point out the danger of counterfeiting in connection with the transport of Intellectual Property (IP rights - infringing goods. Background of the paper’s content is based on secondary data research of publicly available sources - international statistics and world reports.

  4. Consumption Of Counterfeit Alcohol In Contemporary Russia: The Role Of Cultural And Structural Factors

    OpenAIRE

    Zoya Kotelnikova

    2014-01-01

    The majority of Russians believe that counterfeit alcohol may cause death. Nevertheless, alcohol is a common target of counterfeiting in contemporary Russia as are branded clothes, accessories and audio products. This paper aims to reveal whether counterfeit alcohol consumers are distinctive in terms of structure and culture. It investigates the prevalence and structure of counterfeit alcohol purchasing and consumption; attitudes and beliefs about counterfeit alcohol; and predictors of counte...

  5. LC-MS method for the simultaneous determination of six glucocorticoids in pharmaceutical formulations and counterfeit cosmetic products.

    Science.gov (United States)

    Fiori, Jessica; Andrisano, Vincenza

    2014-03-01

    A screening method based on liquid chromatography-electrospray mass spectrometry for the simultaneous determination of six corticosteroids (betamethasone 17-valerate BM 17-V, beclomethasone BC, beclomethasone dipropionate BCDP, methylprednisolone MP, budesonide BD, flunisolide FN) was developed in order to control their illegal use in cosmetic and natural products. Indeed, despite corticosteroids are banned in cosmetics, counterfeit products might be present on the market, representing a health hazard. Therefore, effective analytical methods are required to rapidly screen over the counter products in health care shops for counterfeit corticosteroids. The analytical method involves the employment of a Waters Synergy C18 column (150mm×2.0mm I.D.) by using the following mobile phase: A (0.1% formic acid in acetonitrile), B (0.1% formic acid in water) in a linear gradient (from A-B 25:75, v/v to A-B 95:5, v/v in 30min) at the flow rate of 0.3mL/min. The detection was performed with an ion trap (IT) mass spectrometer in positive polarity, total ion current (TIC) and tandem mass modalities for qualitative purpose; single ion monitoring (SIM) mode was used for quantitative analysis on the ESI generated most abundant ion for each steroid. The method was fully validated in terms of precision, detection and quantification limits, linearity, recovery, and it was applied to the identification and quantification of corticosteroids in pharmaceutical formulations and cosmetic products. The mean recovery of BM 17-V, BC, BCDP, MP, BD and FN were found to be 101.3, 101.5, 98.8, 98.9, 98.1, 99.0%, respectively. Limits of quantitation (LOQ) were comprised in the range 29-95ng/mL. To the best of our knowledge, for the first time this mix of glucocorticoids were simultaneously determined in cosmetic products by using a fully validated method. BMV, in its two isomeric forms BM 17-V and BM 21-V, was found to be illegally present in one cream sample (A) with the total concentration level

  6. Assessment of the effectiveness of the CD3+ tool to detect counterfeit and substandard anti-malarials.

    Science.gov (United States)

    Batson, JaCinta S; Bempong, Daniel K; Lukulay, Patrick H; Ranieri, Nicola; Satzger, R Duane; Verbois, Leigh

    2016-02-25

    The US FDA recently developed CD3+, a counterfeit detection tool that is based on sample illumination at specific wavelengths of light and visual comparison of suspect sample and packaging materials to an authentic sample. To test performance of the CD3+ in field conditions, a study was conducted in Ghana which compared the CD3+ side-by-side with two existing medicine quality screening technologies-TruScan™ Portable Raman spectrometer and GPHF Minilab(®). A total of 84 anti-malarial test samples comprising artemether-lumefantrine tablets and artesunate-amodiaquine tablets were used. The technologies were evaluated for sensitivity in determining counterfeit/substandard (The term counterfeit or falsified is used in this article to refer to medicines that carry a false representation of identity or source or both. The term substandard is used to refer to medicines that do not meet the quality specifications given in the accepted pharmacopeia.) medicines, specificity in determining authentic products, and reliability of the results. Authentic samples obtained from manufacturers were used as reference standards. HPLC analysis data was used as the "gold standard" for decisions regarding a sample being authentic or substandard/counterfeit. CD3+ had a sensitivity of 1.00 in detecting counterfeit/substandard products compared to Minilab (0.79) and TruScan (0.79). CD3+ had a lower specificity (0.53) in determining authentic products compared to the specificities reached by Minilab (0.99) and TruScan (1.00). High sensitivity in this context means that the technology is effective in identifying substandard/counterfeit products whereas the low specificity means that the technique can sometimes mischaracterize good products as substandard/counterfeit. Examination of dosage units only (and not packaging) using CD3+ yielded improved specificity 0.64. When only assessment of sample identification was done, the TruScan provided sensitivity (1.00) and specificity (0.99); and the

  7. Ecdysteroid-containing food supplements from Cyanotis arachnoidea on the European market: evidence for spinach product counterfeiting.

    Science.gov (United States)

    Hunyadi, Attila; Herke, Ibolya; Lengyel, Katalin; Báthori, Mária; Kele, Zoltán; Simon, András; Tóth, Gábor; Szendrei, Kálmán

    2016-12-08

    Phytoecdysteroids like 20-hydroxyecdysone ("ecdysterone") can exert a mild, non-hormonal anabolic/adaptogenic activity in mammals, and as such, are frequently used in food supplements. Spinach is well-known for its relatively low ecdysteroid content. Cyanotis arachnoidea, a plant native in China, is among the richest sources of phytoecdysteroids, and extracts of this plant are marketed in tons per year amounts via the internet at highly competitive prices. Here we report the investigation of a series of food supplements produced in Germany and claimed to contain spinach extracts. Twelve ecdysteroids including two new compounds were isolated and utilized as marker compounds. A comparative analysis of the products with Cyanotis and spinach extracts provides evidence that they were manufactured from Cyanotis extracts instead of spinach as stated. Based on the chromatographic fingerprints, 20-hydroxyecdysone 2- and 3-acetate are suggested as diagnostic markers for related quality control. This case appears to represent an unusual type of dietary supplement counterfeiting: undeclared extracts from alternative plants would supposedly 'guarantee' product efficacy.

  8. Ecdysteroid-containing food supplements from Cyanotis arachnoidea on the European market: evidence for spinach product counterfeiting

    Science.gov (United States)

    Hunyadi, Attila; Herke, Ibolya; Lengyel, Katalin; Báthori, Mária; Kele, Zoltán; Simon, András; Tóth, Gábor; Szendrei, Kálmán

    2016-12-01

    Phytoecdysteroids like 20-hydroxyecdysone (“ecdysterone”) can exert a mild, non-hormonal anabolic/adaptogenic activity in mammals, and as such, are frequently used in food supplements. Spinach is well-known for its relatively low ecdysteroid content. Cyanotis arachnoidea, a plant native in China, is among the richest sources of phytoecdysteroids, and extracts of this plant are marketed in tons per year amounts via the internet at highly competitive prices. Here we report the investigation of a series of food supplements produced in Germany and claimed to contain spinach extracts. Twelve ecdysteroids including two new compounds were isolated and utilized as marker compounds. A comparative analysis of the products with Cyanotis and spinach extracts provides evidence that they were manufactured from Cyanotis extracts instead of spinach as stated. Based on the chromatographic fingerprints, 20-hydroxyecdysone 2- and 3-acetate are suggested as diagnostic markers for related quality control. This case appears to represent an unusual type of dietary supplement counterfeiting: undeclared extracts from alternative plants would supposedly ‘guarantee’ product efficacy.

  9. Perceptions and practices of pharmaceutical wholesalers surrounding counterfeit medicines in a developing country: a baseline survey.

    Science.gov (United States)

    Khan, Mohiuddin H; Akazawa, Manabu; Dararath, Eav; Kiet, Heng B; Sovannarith, Tey; Nivanna, Nam; Yoshida, Naoko; Kimura, Kazuko

    2011-11-11

    belief on reliability of pharmaceutical products of certain manufacturing country during procurement (Chi-square: 12.951, P = 0.002). When wholesalers divide medicines from larger packs into smaller ones, 54.8% use packaging purchased from local markets. A number of wholesalers think counterfeit medicines are medicines without registration, and/or do not have any uniform ideas on the issue and what to do, when they find or suspect counterfeits. Furthermore, their strict adherence to anti-counterfeiting measures is urgently needed. © 2011 Khan et al; licensee BioMed Central Ltd.

  10. Perceptions and practices of pharmaceutical wholesalers surrounding counterfeit medicines in a developing country: a baseline survey

    Directory of Open Access Journals (Sweden)

    Khan Mohiuddin H

    2011-11-01

    from their packs/containers and who consider their belief on reliability of pharmaceutical products of certain manufacturing country during procurement (Chi-square: 12.951, P = 0.002. When wholesalers divide medicines from larger packs into smaller ones, 54.8% use packaging purchased from local markets. Conclusion A number of wholesalers think counterfeit medicines are medicines without registration, and/or do not have any uniform ideas on the issue and what to do, when they find or suspect counterfeits. Furthermore, their strict adherence to anti-counterfeiting measures is urgently needed.

  11. [Counterfeit pharmaceuticals in Peru].

    Science.gov (United States)

    Exebio, Luis E Moreno; Rodríguez, Javier; Sayritupac, Freddy

    2010-02-01

    To determine the quantity of counterfeit pharmaceutical drugs found by the National Quality Control Center (Centro Nacional de Control de Calidad (CNCC), Instituto Nacional de Salud, Peru) during the period from 2005&2008, and the types and properties of these drugs. A form was created to amass the relevant data collected directly from CNCC reports. The reports underwent a review and analysis process, and where counterfeiting was confirmed, it was categorized by type into one of four groups. The percentage of counterfeit drugs relative to the total drugs evaluated was: 3.0% in 2005, 5.0% in 2006, 7.3% in 2007, and 9.2% in 2008. The main groups of counterfeit drugs, classified according to the World Health Organization Anatomical Therapeutic Chemical Classification System, were: alimentary tract and metabolism, 34.5% (29.1%-39.8%); antiinfectives for systemic use, 21.1% (16.5%-25.7%); nervous system, 17.1% (12.8%-21.3%); and musculo-skeletal system, 15.4% (11.3%-19.5%). The most common type of forgery occurred in cases where the drug contained the correct amount of active ingredients, but the manufacturer was one other than the one indicated (62.4% of the total counterfeit drugs); and medications that did not contain any active ingredient (22.4%). Of the counterfeit drugs, 61.0% (56.0%-67.0%) were national brands and 39.0%, (33.0%-44.0%) were imported. The pharmaceutical formulations with the highest rate of forgery were tablets, 66.0% (60.0%-71.0%); injectables, 19.0% (14.0%-23.0%); and capsules 7.0% (4.0%-10.0%). From 2005-2008, drug counterfeiting had an average annual variation of 45%. Drug counterfeiting was shown to be most prevalent among national brands - as opposed to imported medications - although the types and formulations of the fake drugs attest to a certain level of sophistication employed in the forgery process. The counterfeiting of life-saving drugs, such as antimicrobials, signifies a serious public health threat.

  12. Counterfeit drug demand: perceptions of policy makers and community pharmacists in Sudan.

    Science.gov (United States)

    Alfadl, Abubakr A; Hassali, Mohamed A; Ibrahim, Mohamed Izham M

    2013-01-01

    The counterfeit drug trade has become widespread and has developed into a substantial threat to both the public's health and the pharmaceutical industry. The aim of this study was to seek insights into the determining factors of counterfeit drug purchases among health policy makers and community pharmacists in a developing country. In-depth qualitative interviews with Sudanese policy makers and community pharmacists were undertaken in 2 Sudanese states, namely Khartoum and Gadaref. A semistructured interview guide was developed by incorporating information from existing literature. A purposive sample of knowledgeable policy makers and community pharmacists was interviewed. Thematic content analysis of the interviews identified 8 major themes: understanding the term "counterfeit drug," presence of counterfeit drugs in the Sudanese market, vulnerability to counterfeit drugs, price-quality inference, awareness of societal consequences of counterfeit drugs, subjective social norms, difference in vulnerability according to demographic characteristics, and education pertaining to counterfeit drugs. Unaffordability of medicines and desperate need were emphasized by both policy makers and community pharmacists as major influencing factors that increased consumers' vulnerability to counterfeit drugs. This study concluded that high prices and the unaffordability of medicines have a major role in increasing vulnerability to counterfeit drugs, in addition to lack of knowledge about counterfeiting and the implications of use of these products. Because very limited studies have been conducted in developing countries to explore perceptions about counterfeit drugs, the present study provides information from which policy makers and key stakeholders in the supply chain can benefit. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Substandard/counterfeit antimicrobial drugs.

    Science.gov (United States)

    Kelesidis, Theodoros; Falagas, Matthew E

    2015-04-01

    Substandard/counterfeit antimicrobial drugs are a growing global problem. The most common substandard/counterfeit antimicrobials include beta-lactams (among antibiotics) and chloroquine and artemisin derivatives (among antimalarials). The most common type of substandard/counterfeit antimicrobial drugs have a reduced amount of the active drug, and the majority of them are manufactured in Southeast Asia and Africa. Counterfeit antimicrobial drugs may cause increased mortality and morbidity and pose a danger to patients. Here we review the literature with regard to the issue of substandard/counterfeit antimicrobials and describe the prevalence of this problem, the different types of substandard/counterfeit antimicrobial drugs, and the consequences for the individuals and global public health. Local, national, and international initiatives are required to combat this very important public health issue. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  14. Identifying counterfeit cigarette packs using ultraviolet irradiation and light microscopy.

    Science.gov (United States)

    Kurti, Marin; He, Yi; von Lampe, Klaus; Li, Yanlei

    2017-01-01

    Develop a method that yields high rates of sensitivity and specificity for determination of counterfeit cigarette packs for three popular brands: Newport, Marlboro ('Red') and Marlboro Gold. Using systematic keyword searches, we identified industry documents from the University of California, San Francisco's Legacy Tobacco Documents Library that describe the use of ultraviolet (UV) irradiation and close examination of printing quality to distinguish between counterfeit and genuine cigarette packs. Guided by these documents, we identified six markers for counterfeit cigarettes across three popular brands using counterfeit cigarette packs (N=68) seized by law enforcement agencies in the USA. We assessed the diagnostic test accuracy of these markers and tested it against genuine packs (N=22) using receiver operating characteristic curves analysis. We find that counterfeit cigarette packs fluoresce to long-wave UV irradiation and display poor printing quality. The optimal cut-off value varies among the three brands. For example, counterfeit Newport and Marlboro packaging can be reliably classified with two of six characteristics, while Marlboro Gold requires four. Researchers who conduct littered pack and pack swap studies are urged to include this method to assess the share of counterfeit cigarettes, and compare the result against tobacco industry figures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Fingerprints on counterfeit currency

    Science.gov (United States)

    Lin, Tao; Menzel, E. R.

    1996-03-01

    A number of techniques, including 5-methoxyninhydrin/ZnCl2, DFO, DMAC, physical developer, colloidal gold, membrane transfer and vapor development, have been explored in an attempt to distinguish between fingerprints on counterfeit currency before and after the inking. Color copying and offset printing counterfeiting were considered. The printing ink proves to be too permeable to permit ready distinction between 'before' and 'after' fingerprints. There are subtle differences between before and after fingerprint fluorescence spectra (5-methoxyninhydrin/ZnCl2). However, given that one has to contend with finger contamination, the spectroscopy is at present not practically useful, but it shows potential if the fingerprint fluorescence spectrum can be correlated quantitatively with the ink absorption spectrum. Time-resolved spectroscopy in concert with rare-earth-based fingerprint development strategies may be useful as well.

  16. Counterfeit and substandard antimalarial drugs in Cambodia.

    Science.gov (United States)

    Lon, C T; Tsuyuoka, R; Phanouvong, S; Nivanna, N; Socheat, D; Sokhan, C; Blum, N; Christophel, E M; Smine, A

    2006-11-01

    Counterfeit and substandard antimalarial drugs can cause death and contribute to the growing malaria drug resistance problem, particularly in Southeast Asia. Since 2003 in Cambodia the quality of antimalarial drugs both in the public and private health sector is regularly monitored in sentinel sites. We surveyed 34% of all 498 known facilities and drug outlets in four provinces. We collected 451 drug samples; 79% of these were not registered at the Cambodia Department of Drugs and Food (DDF). Twenty-seven percent of the samples failed the thin layer chromatography and disintegration tests; all of them were unregistered products. Immediate action against counterfeit drugs was taken by the National Malaria Control Program (NMCP) and the DDF. They communicated with the Provincial Health Department about the presence of counterfeit antimalarial drugs through alert letters, a manual, annual malaria conferencing and other training occasions. Television campaigns to alert the population about counterfeit drugs were conducted. Moreover, the NMCP has been promoting the use of good quality antimalarial drugs of a blister co-packaged combination of artesunate and mefloquine in public and private sectors. Appropriate strategies need to be developed and implemented by relevant government agencies and stakeholders to strengthen drug quality assurance and control systems in the country.

  17. “Fake product? Why not!” Attitudes toward the consumption of counterfeit goods in CEE as shown on the example of Slovakia

    Directory of Open Access Journals (Sweden)

    Denisa Kasl Kollmannová

    2012-09-01

    Full Text Available This article focuses on the increasing consumption trend of counterfeit goods in the countries of CEE and on the consequences for the global market. Counterfeiting is not longer typical only for the luxury market, where branding together with genuine source plays a crucial role and the business of top luxury is rising during the crisis. New categories of counterfeit goods are emerging constantly, including electronics and computer parts, pharmaceuticals, even FMCG such as food, beverages or cosmetics. This article presents data from GfK research on attitudes towards counterfeit goods in Slovakia and puts it to the context of other CEE countries. It gives clear managerial implications on how to communicate the importance of originality, benefits for the consumer when consuming original goods and social marketing of ethical consumption.

  18. Incidence of anabolic steroid counterfeiting in Brazil.

    Science.gov (United States)

    da Justa Neves, Diana Brito; Marcheti, Ravane Gracy Ament; Caldas, Eloisa Dutra

    2013-05-10

    This retrospective study reports data obtained from the National Institute of Criminalistics of the Brazilian Federal Police Department (DPF) on 3676 anabolic products seized between 2006 and 2011. Anabolic androgenic steroids (AAS) were declared on the labels of 96.2% of the products. About one third of the products declared to be from Paraguay, and 14.3% from Brazil. Stanozolol, testosterone and nandrolone were the substances most declared on the labels. Package and qualitative chemical analyses (performed on 2818 products) found that 31.7% of the seized products were counterfeit, with an increase in the counterfeit detection rate during the period. Almost half of the fake products did not contain the declared substances, and 28.3% had only non-declared substances. Testosterone and its esters were responsible for 45% of the 582 cases of non-declared drug detection. Package analysis alone was responsible for the identification of 4.6% of all counterfeit products. These results indicate the need for a continuous effort by the government aimed at decreasing the availability of these products in the country. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. AVOID BECOMING A VICTIM OF COUNTERFEIT ITEMS

    Energy Technology Data Exchange (ETDEWEB)

    WARRINER RD

    2011-07-13

    In today's globalized economy, we cannot live without imported products. Most people do not realize how thin the safety net of regulation and inspection really is. Less than three percent of imported products receive any form of government inspection prior to sale. Avoid flea markets, street vendors and deep discount stores. The sellers of counterfeit wares know where to market their products. They look for individuals who are hungry for a brand name item but do not want to pay a brand name price for it. The internet provides anonymity to the sellers of counterfeit products. Unlike Europe, U.S. law does not hold internet-marketing organizations, responsible for the quality of the products sold on their websites. These organizations will remove an individual vendor when a sufficient number of complaints are lodged, but they will not take responsibility for the counterfeit products you may have purchased. EBay has a number of counterfeit product guides to help you avoid being a victim of the sellers of these products. Ten percent of all medications taken worldwide are counterfeit. If you do buy medications on-line, be sure that the National Association of Boards of Pharmacy Verified Internet Pharmacy Practice Sites (VIPPS) recommends the pharmacy you choose to use. Inspect all medication purchases and report any change in color, shape, imprinting or odor to your pharmacist. If you take generic medications these attributes may change from one manufacturer to another. Your pharmacist should inform you of any changes when you refill your prescription. If they do not, get clarification prior to taking the medication. Please note that the Federal Drug Administration (FDA) does not regulate supplements. The FDA only steps in when a specific supplement proves to cause physical harm or contains a regulated ingredient. Due to counterfeiting, Underwriters Laboratories (UL) changed their label design three times since 1996. The new gold label should be attached to the cord

  20. Fashion Counterfeiting: Consumer Behavior Issues

    Science.gov (United States)

    Cheek, Wanda K.; Easterling, Cynthia R.

    2008-01-01

    Counterfeiting, which has always been somewhat of a problem in several different industry settings, has recently become an epidemic in the fashion industry. Widespread and seemingly endless counterfeiting of fashion goods is costing the industry millions of dollars in lost profits and tarnishing the image of many luxury brands. This article…

  1. Counterfeit medicines in Peru: a retrospective review (1997-2014).

    Science.gov (United States)

    Medina, Edwin; Bel, Elvira; Suñé, Josep María

    2016-04-04

    To consolidate and assess information on counterfeit medicines subject to pharmaceutical alerts issued by the Peruvian Medicines Regulatory Authority over 18 years (1997-2014) of health monitoring and enforcement. A retrospective review of drug alerts. A search of the website of the General Directorate of Medicines, Supplies and Drugs (DIGEMID) of the Ministry of Health of Peru for drug alerts issued between 1997 and 2014. Drug alerts related to counterfeit medicines. A total of 669 DIGEMID alerts were issued during the study period, 354 (52.91%) of which cover 1738 cases of counterfeit medicines (many alerts deal with several cases at a time). 1010 cases (58.11%) involved pharmaceutical establishments and 349 (20.08%) involved non-pharmaceutical commercial outlets. In 126 cases (7.25%), counterfeit medicines were seized in an unauthorised trade (without any marketing authorisation); in 253 cases (14.56%) the type of establishment or business associated with the seized product was not identified. Counterfeit medicines are a serious public health problem in Peru. A review of the data cannot determine whether counterfeit medicines in Peru increased during the study period, or if monitoring by different government health agencies highlighted the magnitude of the problem by providing more evidence. The problem is clearly structural, since the majority of cases (58.11% of the total) were detected in legitimate supply chains. Most counterfeit medicines involve staple pharmaceutical products and common dosage forms. Considerable work remains to be done to control the serious problem of counterfeit medicines in Peru. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. [Suspected anaphylaxis by wound treatment with polyhexanide derivate wound products].

    Science.gov (United States)

    Schrøder, Morten A; Kirketerp-Møller, Klaus; Winther, Lone

    2014-12-15

    Only four cases of anaphylaxis triggered by polyhexanide have been reported in the literature. We report a case of anaphylaxis in a Danish patient treated with polyhexanide derivate (Prontosan) wound products. We emphasise the importance of intramuscular injection of adrenaline as part of the treatment protocol in the initial phase of anaphylaxis and stress the importance of being aware of polyhexanide as a potential trigger of anaphylaxis.

  3. Suspected Adulteration of Commercial Kratom Products with 7-Hydroxymitragynine.

    Science.gov (United States)

    Lydecker, Alicia G; Sharma, Abhisheak; McCurdy, Christopher R; Avery, Bonnie A; Babu, Kavita M; Boyer, Edward W

    2016-12-01

    Kratom (Mitragyna speciosa), a plant native to Southeast Asia, has been used for centuries for its stimulant and opium-like effects. Mitragynine and 7-hydroxymitragynine, exclusive to M. speciosa, are the alkaloids primary responsible for Kratom's biologic and psychoactive profile, and likely contribute to its problematic use. We purchased several commercially available Kratom analogs for analysis and through our results, present evidence of probable adulteration with the highly potent and addictive plant alkaloid, 7-hydroxymitragynine. A simple and sensitive LC-MS/MS method was developed for simultaneous quantification of mitragynine and 7-hydroxymitragynine in methanol extract of marketed Kratom supplements. We found multiple commercial Kratom products to have concentrations of 7-hydroxymitragynine that are substantially higher than those found in raw M. speciosa leaves. We have found multiple packaged commercial Kratom products likely to contain artificially elevated concentrations of 7-hydroxymitragynine, the alkaloid responsible for M. speciosa's concerning mechanistic and side effect profile. This study describes a unique form of product adulteration, which stresses the importance of increased dietary supplement oversight of Kratom-containing supplements.

  4. Role of the pharmacist in preventing distribution of counterfeit medications.

    Science.gov (United States)

    Chambliss, Walter G; Carroll, Wesley A; Kennedy, Daniel; Levine, Donald; Moné, Michael A; Ried, L Douglas; Shepherd, Marv; Yelvigi, Mukund

    2012-01-01

    To provide an overview of the counterfeit medication problem and recommendations of a joint American Pharmacists Association (APhA) Academy of Pharmaceutical Research and Science and APhA Academy of Pharmacy Practice and Management taskforce. SciFinder and PubMed were searched from 1980 to March 2011 using the following keywords: counterfeit drug product, counterfeit medications, drug product authentication, drug product verification, and track-and-trace. Publications, presentations, and websites of organizations that research the counterfeit medication problem in the United States and other countries were reviewed. A representative from the security division of a pharmaceutical manufacturer and a representative from a supplier of anticounterfeiting technologies gave presentations to the taskforce. The taskforce recommends that pharmacists (1) purchase medications from known, reliable sources; (2) warn patients of the dangers of purchasing medications over the Internet; (3) confirm with distributors that products were purchased from manufacturers or other reliable sources; (4) monitor counterfeit product alerts; (5) examine products for suspicious appearance; (6) work with the pharmaceutical industry, distributors, and the Food and Drug Administration (FDA) to close gaps in the supply chain, especially for drugs in short supply; (7) use scanning technology in the pharmacy as part of a prescription verification process; (8) educate themselves, coworkers, and patients about the risks of counterfeit medications; and (9) report suspicious medications to FDA, the distributor, and the manufacturer. The consequence of a patient receiving a counterfeit medication in the United States could be catastrophic, and pharmacists must play an active role in preventing such an event from occurring.

  5. Identification of Counterfeit Alcoholic Beverages Using Cluster Analysis in Principal-Component Space

    Science.gov (United States)

    Khodasevich, M. A.; Sinitsyn, G. V.; Gres'ko, M. A.; Dolya, V. M.; Rogovaya, M. V.; Kazberuk, A. V.

    2017-07-01

    A study of 153 brands of commercial vodka products showed that counterfeit samples could be identified by introducing a unified additive at the minimum concentration acceptable for instrumental detection and multivariate analysis of UV-Vis transmission spectra. Counterfeit products were detected with 100% probability by using hierarchical cluster analysis or the C-means method in two-dimensional principal-component space.

  6. Counterfeits or Shanzhai? The Role of Face and Brand Consciousness in Luxury Copycat Consumption.

    Science.gov (United States)

    Jiang, Ling; Shan, Juan

    2016-08-01

    This study responds to the emergence of the Shanzhai phenomenon in the international marketplace and introduces the Shanzhai phenomenon into the consumer behavior literature by defining it and comparing it with well-known concepts like luxury counterfeits. More specifically, it examines how consumers' face and brand consciousness influence their willingness to buy luxury counterfeits rather than Shanzhai products. The results show that consumers who are more face conscious are more likely to choose luxury counterfeits than Shanzhai products. In addition, consumers' face consciousness elicits a high concern for well-known brands, which also in turn leads to a more favorable attitude toward luxury counterfeits than Shanzhai products. These findings enable researchers to better understand consumers' responses toward both Shanzhai and counterfeit products and help companies that are protecting their original brands to tailor their consumer-directed measures more effectively. © The Author(s) 2016.

  7. Trick or Treat? An Examination of Marketing Relationships in a Nondeceptive Counterfeit Market

    Science.gov (United States)

    Xiao, Sarah Hong; Nicholson, Michael

    2010-01-01

    Who is most responsible for the proliferation of counterfeit goods--the illicit purveyor of such products or the consumer who procures them? This paper seeks to address this question by presenting a behavior analysis of counterfeit marketing firms in China and the interdependent relationships between legitimate retailers, consumers, and the…

  8. Counterfeit pharmaceuticals: current status and future projections.

    Science.gov (United States)

    Wertheimer, Albert I; Chaney, Nicole M; Santella, Thomas

    2003-01-01

    To examine the problem of counterfeit drugs and its effects around the world, to consider the likely directions the problem will take, and to propose options for controlling or mitigating the problem. Recently published clinical literature identified through review of articles abstracted at MEDLINE. Search terms were counterfeiting, counterfeit drugs, substandard drugs, fake drugs, world counterfeiting, and counterfeit pharmaceuticals. Further information was abstracted from an array of informational sources, including magazines such as Business Week, newspapers such as the International Herald Tribune, National Public Radio news reports, pharmaceutical company press releases, and information from the World Health Organization. Multiple reviewers were used to retrieve relevant and current data. Relevant data were extracted independently by multiple reviewers. Traditionally, the problem of counterfeit pharmaceuticals has been limited to developing nations in Asia and Africa. Now, drug counterfeiting is rapidly becoming a worldwide concern, and counterfeit drugs are reaching the U.S. market. This article defines the problem of counterfeit drugs in its many forms and discusses the extent of the problem, with particular attention to the respective rates of counterfeiting across the globe and the origins of counterfeit drugs. Technologic advances have worsened the counterfeit drug problem. Because drug counterfeiting is a worldwide concern, worldwide action is needed to combat the problem.

  9. Progress in counterfeit deterrence: the contribution of information exchange

    Science.gov (United States)

    Lancaster, Ian M.; Kontnik, Lewis T.

    1996-03-01

    In this paper we establish the need for communication between organizations involved in the fight against counterfeiting crime. We also examine the paradox in providing information that could serve the criminal as well as those attempting to protect themselves from criminal activity. Counterfeiting is estimated to account for over 5% of world trade. It is a global operation with no respect for international borders. It is increasingly sophisticated and increasingly the province of organized crime, which applies the techniques developed for drug distribution to the production and distribution of counterfeit articles. To fight this crime there is an increasing plethora of authenticating features and technologies available. Many companies do not recognize the problem and the number of anticounterfeit technologies can be confusing for potential users. There is therefore a need for information about them, their comparative characteristics, to be easily available. At present there is inadequate communication between those who develop and produce anti-counterfeiting devices and those who use them, notwithstanding the marketing efforts of the former. Communication which stimulates and encourages the spread of information between those engaged in the fight against counterfeit crime can only help in that fight. But what we term 'the communication paradox' requires circumspection and care in the content and the distribution of such information. The communication paradox is that the better the channels of communication, the easier it is for criminals to get hold of that information. The challenge is to institute communications which are effective but restrictive. More communication of information between those engaged in counterfeit deterrence will enhance individual companies' and organizations' anticounterfeit efforts and thus contribute to an overall improvement in the fight against counterfeit crime.

  10. Triacylglycerol "hand-shape profile" of Argan oil. Rapid and simple UHPLC-PDA-ESI-TOF/MS and HPTLC methods to detect counterfeit Argan oil and Argan-oil-based products.

    Science.gov (United States)

    Pagliuca, Giordana; Bozzi, Carlotta; Gallo, Francesca Romana; Multari, Giuseppina; Palazzino, Giovanna; Porrà, Rita; Panusa, Alessia

    2017-12-02

    The marketing of new argan-based products is greatly increased in the last few years and consequently, it has enhanced the number of control analysis aimed at detecting counterfeit products claiming argan oil as a major ingredient. Argan oil is produced in Morocco and it is quite expensive. Two simple methods for the rapid screening of pure oil and argan-oil based products, focused on the analysis of the triacylglycerol profile, have been developed. A three-minute-run by UHPLC-PDA allows the identification of a pure argan oil, while the same run with the MS detector allows also the analysis of products containing the oil down to 0.03%. On the other hand, by HPTLC the simultaneous analysis of twenty samples, containing argan oil down to 0.5%, can be carried out in a forty-five-minute run. The triglyceride profile of the most common vegetable fats such as almond, coconut, linseed, wheat germ, sunflower, peanut, olive, soybean, rapeseed, hemp oils as well as shea butter used either in cosmetics or commonly added for the counterfeiting of argan oil, has been also investigated. Over sixty products with different formulations and use have been successfully analyzed and argan oil in the 2.4-0.06% concentration range has been quantified. The methods are suitable either for a rapid screening or for quantifying argan oil in different formulations. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Future prospects of luminescent nanomaterial based security inks: from synthesis to anti-counterfeiting applications

    Science.gov (United States)

    Kumar, Pawan; Singh, Satbir; Gupta, Bipin Kumar

    2016-07-01

    Counterfeiting of valuable documents, currency and branded products is a challenging problem that has serious economic, security and health ramifications for governments, businesses and consumers all over the world. It is estimated that counterfeiting represents a multi-billion dollar underground economy with counterfeit products being produced on a large scale every year. Counterfeiting is an increasingly high-tech crime and calls for high-tech solutions to prevent and deter the acts of counterfeiting. The present review briefly outlines and addresses the key challenges in this area, including the above mentioned concerns for anti-counterfeiting applications. This article describes a unique combination of all possible kinds of security ink formulations based on lanthanide doped luminescent nanomaterials, quantum dots (semiconductor and carbon based), metal organic frameworks as well as plasmonic nanomaterials for their possible use in anti-counterfeiting applications. Moreover, in this review, we have briefly discussed and described the historical background of luminescent nanomaterials, basic concepts and detailed synthesis methods along with their characterization. Furthermore, we have also discussed the methods adopted for the fabrication and design of luminescent security inks, various security printing techniques and their anti-counterfeiting applications.

  12. Counterfeiting: Education Influences Ethical Decision Making

    Science.gov (United States)

    Kozar, Joy M.; Marcketti, Sara B.

    2008-01-01

    The purpose of this article is to address the relationship between the purchase of counterfeit apparel goods by college students and their knowledge and concern of counterfeiting. Additionally, students' beliefs regarding the legality of manufacturing, distributing, and purchasing counterfeit goods are examined. This topic is important because…

  13. Piracy And Counterfeiting - The Price Of Marketing Success ...

    African Journals Online (AJOL)

    In recent times Nigeria has become a huge dumping ground for all types of substandard goods manufactured in the Far East. This article indicates what product categories brands are vulnerable to pirating and counterfeiting, and gives data on the extent of product piracy in Nigeria. Making special reference to the ...

  14. Characterization of the structure and properties of authentic and counterfeit polypropylene surgical meshes.

    Science.gov (United States)

    McDermott, M K; Isayeva, I S; Thomas, T M; Lee, A S; Lucas, A D; Witkowski, C N; Hutter, J C

    2006-04-01

    A counterfeit version of the Ethicon Prolene polypropylene mesh was distributed to hospitals and clinics and unintentionally implanted into patients undergoing tension-free hernia repair. On December 19, 2003, the Food and Drug Administration (FDA) issued a public health web notification indicating that the counterfeit mesh was not sterile or safe to use. To develop safety recommendations for patients with the counterfeit mesh implant, we compared the counterfeit's structural, physical, chemical and mechanical properties with polypropylene meshes previously cleared by FDA. The mesh fibers for all the products tested were found to have similar chemical and physical properties. The mechanical properties were directly related to the knitted structure (loop size, repeat distance, fabric tightness) and the porosity. Extracts from the counterfeit mesh passed cytotoxicity screening tests. The FDA further recommended that if the mesh had been inadvertently implanted, then those patients should be monitored as would be the practice for any patient with an implanted surgical mesh.

  15. Microstructure-Based Counterfeit Detection in Metal Part Manufacturing

    Science.gov (United States)

    Dachowicz, Adam; Chaduvula, Siva Chaitanya; Atallah, Mikhail; Panchal, Jitesh H.

    2017-11-01

    Counterfeiting in metal part manufacturing has become a major global concern. Although significant effort has been made in detecting the implementation of such counterfeits, modern approaches suffer from high expense during production, invasiveness during manufacture, and unreliability in practice if parts are damaged during use. In this paper, a practical microstructure-based counterfeit detection methodology is proposed, which draws on inherent randomness present in the microstructure as a result of the manufacturing process. An optical Physically Unclonable Function (PUF) protocol is developed which takes a micrograph as input and outputs a compact, unique string representation of the micrograph. The uniqueness of the outputs and their robustness to moderate wear and tear is demonstrated by application of the methodology to brass samples. The protocol is shown to have good discriminatory power even between samples manufactured in the same batch, and runs on the order of several seconds per part on inexpensive machines.

  16. RFID in the pharmaceutical industry: addressing counterfeits with technology.

    Science.gov (United States)

    Taylor, Douglas

    2014-11-01

    The use of Radio Frequency Identification (RFID) in the pharmaceutical industry has grown in recent years. The technology has matured from its specialized tracking and retail uses to a systemic part of supply chain management in international pharmaceutical production and distribution. Counterfeit drugs, however, remain a significant challenge for governments, pharmaceutical companies, clinicians, and patients and the use of RFID to track these compounds represents an opportunity for development. This paper discusses the medical, technological, and economic factors that support widespread adoption of RFID technology in the pharmaceutical industry in an effort to prevent counterfeit medicines from harming patients and brand equity.

  17. Safeguarding against substandard/counterfeit drugs: mitigating a macroeconomic pandemic.

    Science.gov (United States)

    Wertheimer, Albert I; Norris, Jeremiah

    2009-03-01

    Counterfeiting and the sale of substandard pharmaceutical products can no longer be ignored. At 10% of global trade, counterfeiting is affecting many countries, causing serious downstream expenses and resource shortages. To describe the nature and impact of drug product counterfeiting and substandard product sale and to present strategies that may have value in ameliorating these phenomena. A literature review was conducted, supplemented by interviews of key leaders/experts in the field and the search of relevant web sites. All of the data were combined, integrated, and coordinated to present the complete picture of this problem. In addition to known corruption in some of the least developed countries, the trail through developed countries was detected. This report identifies means to detect faulty products and describes efforts toward resisting and ending these corrupt practices. Counterfeit drugs, if not stopped, can be responsible for a macroeconomic pandemic where major portions of some populations may be too ill to work and where the health sector resources are completely overwhelmed, as with the case of HIV/AIDS.

  18. Counterfeit drugs and medical devices in developing countries

    Directory of Open Access Journals (Sweden)

    Glass BD

    2014-03-01

    Full Text Available Beverley D GlassSchool of Pharmacy and Molecular Sciences, James Cook University, Townsville, QLD, AustraliaAbstract: The World Health Organization has reported that counterfeit medicines potentially make up more than 50% of the global drug market, with a significant proportion of these fake products being encountered in developing countries. This occurrence is attributed to a lack of effective regulation and a weak enforcement capacity existing in these countries, with an increase in this trade resulting from the growing size and sophistication of drug counterfeiters. In addition, due to both cost and lack of availability of medicines, consumers in developing countries are more likely to seek out these inexpensive options. The World Health Organization is mindful of the impact of counterfeit drugs on consumer confidence in health care systems, health professionals, the supply chain, and genuine suppliers of medicines and medical devices. Antibiotics, antituberculosis drugs, and antimalarial and antiretroviral drugs are frequently targeted, with reports of 60% of the anti-infective drugs in Asia and Africa containing active pharmaceutical ingredients outside their pharmacopoeial limits. This has obvious public health implications of increasing drug resistance and negating all the efforts that have already gone into the provision of medicines to treat these life threatening conditions in the developing world. This review, while focusing on counterfeit medicines and medical devices in developing countries, will present information on their impact and how these issues can be addressed by regulation and control of the supply chain using technology appropriate to the developing world. The complexity of the problem will also be highlighted in terms of the definition of counterfeit and substandard medicines, including gray pharmaceuticals. Although this issue presents as a global public health problem, outcomes in developing countries where counterfeit

  19. Contra Davidson on Counterfeiting, Round Two

    Directory of Open Access Journals (Sweden)

    Walter E. Block

    2013-12-01

    Full Text Available Libertarians and non libertarians alike agree that counterfeiting legitimate money owned by innocent people is illicit.  But what about counterfeiting counterfeit money owned by the guiltless? Davidson and I, both libertarians, take the position that this would be a rights violation; that this would violate the rights of innocent owners of currency, who would be victimized by such fraudulent behavior of counterfeiters, even those who limit themselves to counterfeiting counterfeit funds. But what about counterfeiting counterfeit money owned by those who are guilty of crimes? Davidson (2013 opines, in effect, that there are no such people. The counterfeiter of counterfeit money is thus himself a criminal, she avers. I argue, very much to the contrary, that the relevant population consists mostly of guilty people, and thus they are not in a logical position to object to what would otherwise be considered victimization. As for the few innocents among them, they demonstrate their innocence to a large degree by not objecting to the counterfeiting of counterfeit money. If they do object, and take actions to prevent this practice, they act in a manner incompatible with the libertarian non aggression principle (NAP and thus enter the ranks of the guilty. I find Davidson’s (2013 economic analysis impeccable; her understanding of libertarianism highly problematic.In the interests of full disclosure, I should make it clear that the present paper contains the radical suggestion that we should do away with our established monetary- and financial system. If need be, and this is by no means my first choice, we are entitled to do so by means of massive counterfeiting of established currencies (which is justified by deontological considerations and libertarian principles. Of course, this is illegal in extant nations, and I would not want to be imprisoned for committing a crime. So, for purposes of our discussion, we will be considering only the imaginary

  20. Recent developments in counterfeits and imitations of Viagra, Cialis and Levitra. A 2005-2006 update

    NARCIS (Netherlands)

    Venhuis BJ; Barends DM; Zwaagstra ME; Kaste D de; Douane Laboratorium; KCF

    2007-01-01

    A strong trend is observed towards increasingly professional counterfeits and imitations of Viagra, Cialis and Levitra, with regard to the appearance of tablets, capsules and packaging. The professional presentation will deceive potential consumers into assuming these products are legal, efficacious

  1. The Influence of Ethics and Materialism of Consumer Buying Interest in Counterfeit Fashion Goods

    OpenAIRE

    Meydi Yusuf Dwiyanto

    2011-01-01

    The purpose of this paper is to examine how does the consumer ethic, level of materialism and consumer buying interest in counterfeit fashion goods; to help company create effective anti-piracy strategy. Data is collected using random sampling method spread questionnaires to college student in Bandung. Multiple linear regression are conducted using Statistical Product and Service Solution (SPSS). The main contributor of the paper is to show consumer intention to buy counterfeited product are ...

  2. Identification and characterization of tebuconazole transformation products in soil by combining suspect screening and molecular typology.

    Science.gov (United States)

    Storck, Veronika; Lucini, Luigi; Mamy, Laure; Ferrari, Federico; Papadopoulou, Evangelia S; Nikolaki, Sofia; Karas, Panagiotis A; Servien, Remi; Karpouzas, Dimitrios G; Trevisan, Marco; Benoit, Pierre; Martin-Laurent, Fabrice

    2016-01-01

    Pesticides generate transformation products (TPs) when they are released into the environment. These TPs may be of ecotoxicological importance. Past studies have demonstrated how difficult it is to predict the occurrence of pesticide TPs and their environmental risk. The monitoring approaches mostly used in current regulatory frameworks target only known ecotoxicologically relevant TPs. Here, we present a novel combined approach which identifies and categorizes known and unknown pesticide TPs in soil by combining suspect screening time-of-flight mass spectrometry with in silico molecular typology. We used an empirical and theoretical pesticide TP library for compound identification by both non-target and target time-of-flight (tandem) mass spectrometry, followed by structural proposition through a molecular structure correlation program. In silico molecular typology was then used to group TPs according to common molecular descriptors and to indirectly elucidate their environmental parameters by analogy to known pesticide compounds with similar molecular descriptors. This approach was evaluated via the identification of TPs of the triazole fungicide tebuconazole occurring in soil during a field dissipation study. Overall, 22 empirical and 12 yet unknown TPs were detected, and categorized into three groups with defined environmental properties. This approach combining suspect screening time-of-flight mass spectrometry with molecular typology could be extended to other organic pollutants and used to rationalize the choice of TPs to be investigated towards a more comprehensive environmental risk assessment scheme. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Counterfeit integrated circuits detection and avoidance

    CERN Document Server

    Tehranipoor, Mark (Mohammad); Forte, Domenic

    2015-01-01

    This timely and exhaustive study offers a much-needed examination of the scope and consequences of the electronic counterfeit trade.  The authors describe a variety of shortcomings and vulnerabilities in the electronic component supply chain, which can result in counterfeit integrated circuits (ICs).  Not only does this book provide an assessment of the current counterfeiting problems facing both the public and private sectors, it also offers practical, real-world solutions for combatting this substantial threat.   ·      Helps beginners and practitioners in the field by providing a comprehensive background on the counterfeiting problem; ·      Presents innovative taxonomies for counterfeit types, test methods, and counterfeit defects, which allows for a detailed analysis of counterfeiting and its mitigation; ·      Provides step-by-step solutions for detecting different types of counterfeit ICs; ·      Offers pragmatic and practice-oriented, realistic solutions to counterfeit IC d...

  4. Vietnamese Attitudes and Behavioural Patterns towards Counterfeit Brands

    Directory of Open Access Journals (Sweden)

    Giang Huynh

    2014-12-01

    Full Text Available This study examines Vietnamese female consumers’ attitudes towards counterfeit branded products; by investigating the influence of brand image, product involvement and price advantage towards decision-making processes associated with purchasing and ownership. An inductive anti-positivist approach was adopted, employing qualitative methods; drawing from in-depth interviews distilled and synthesized using Word Cloud software, as Geographic Information System (GIS based Spatial Analyses. Findings suggest that Price Advantage plays a determining and predominant role in encouraging consumers’ purchase intention of a counterfeit product. In addition, Brand Image has positive effect on the purchase intention as well; while product involvement plays no significant role in the process. Further observations point to there being paucity of literature that focuses on Vietnamese and ASEAN markets. With this is mind, a new conceptual framework was developed to reflect the nuances of the Vietnamese consumer experience; which it is suggested will be of value to scholars, practitioners and further studies.

  5. Investigating the Dynamic Effects of Counterfeits with a Random Changepoint Simultaneous Equation Model

    OpenAIRE

    Yi Qian; Hui Xie

    2011-01-01

    Using a unique panel dataset and a new model, this article investigates the dynamic effects of counterfeit sales on authentic-product price dynamics. We propose a Bayesian random-changepoint simultaneous equation model that simultaneously takes into account three important features in empirical studies: (1) Endogeneity of a market entry, (2) Nonstationarity of the entry effects and (3) Heterogeneity of the firms' response behaviors. Besides accounting for the endogeneity of counterfeiting, th...

  6. Fake and Counterfeit Drug: A review

    African Journals Online (AJOL)

    World Health Organization. Counterfeit medicines. World Health Organization. Fact sheet No 275 revised 2006. 5. Burns W. News: WHO launches taskforce to fight counterfeit drugs. Bull World Health Organization,. 2006; 84:689-90. 6. Rozendaal J. Fake anti-malarials circulating in. Cambodia. Bull Mekong Malaria Forum, ...

  7. Overview of suspected adverse reactions to veterinary medicinal products reported in South Africa (March 2002 – February 2003

    Directory of Open Access Journals (Sweden)

    V. Naidoo

    2003-07-01

    Full Text Available The Veterinary Pharmacovigilance and Medicines Information Centre is responsible for the monitoring of veterinary adverse drug reactions in South Africa. An overview of reports of suspected adverse drug reactions received by the centre during the period March 2002 to February 2003 is given. In total, 40 reports were received. This had declined from the previous year. Most reports involved suspected adverse reactions that occurred in dogs and cats. Most of the products implicated were Stock Remedies. The animal owner predominantly administered these products. Only 1 report was received from a veterinary pharmaceutical company. Increasing numbers of reports are being received from veterinarians.

  8. Authentication Based Solutions to Counterfeiting of Manufactured Goods

    OpenAIRE

    Kilcullen, Joseph

    2015-01-01

    Counterfeiting of manufactured goods is presented as the theft of intellectual property, patents, copyright etc. accompanied by identity theft. The purpose of the identity theft is to facilitate the intellectual property theft. Without it the intellectual property theft would be obvious and the products would be confiscated and destroyed. Authentication solutions, to prevent identity theft, were then developed for the two categories of manufactured goods i.e. goods which can be subjected to d...

  9. Investigation of lead and cadmium in counterfeit cigarettes seized in the United States.

    Science.gov (United States)

    He, Yi; von Lampe, Klaus; Wood, Laura; Kurti, Marin

    2015-07-01

    Information of toxic elements such as lead (Pb) and cadmium (Cd) in counterfeit cigarettes offers insight on the potential public health impact of consuming counterfeit cigarettes and the technology used by counterfeiters in the illicit cigarette trade. In this study, the concentration of Pb and Cd in twenty-three packs of counterfeit cigarettes seized in the US by various law enforcement agencies were evaluated and compared with their genuine equivalents using microwave digestion followed by inductively coupled plasma - mass spectrometry (ICP-MS) analysis. Both Pb and Cd concentration in counterfeit cigarettes were markedly higher than those in their genuine equivalents, and exhibited greater sample to sample variability. The average Pb and Cd mass fraction values in counterfeit cigarettes were (5.13 ± 2.50) mg/kg (n = 23) and (5.13 ± 1.95) mg/kg (n = 23) respectively, compared with (0.59 ± 0.08) mg/kg (n = 9) and (1.08 ± 0.08) mg/kg (n = 9) respectively in the genuine equivalents. Results suggest that counterfeit cigarettes may impose higher risks to public health. Studying these toxic elements could provide important information regarding the illicit trade, including the level of organization among counterfeiters, who broker between availability of supplies and consumer demand for a cheaper product that is assumed to be genuine. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Detecting special nuclear materials in suspect containers using high-energy gamma rays emitted by fission products

    Science.gov (United States)

    Norman, Eric B [Oakland, CA; Prussin, Stanley G [Kensington, CA

    2009-01-27

    A method and a system for detecting the presence of special nuclear materials in a suspect container. The system and its method include irradiating the suspect container with a beam of neutrons, so as to induce a thermal fission in a portion of the special nuclear materials, detecting the gamma rays that are emitted from the fission products formed by the thermal fission, to produce a detector signal, comparing the detector signal with a threshold value to form a comparison, and detecting the presence of the special nuclear materials using the comparison.

  11. Update on counterfeit antibiotics worldwide; public health risks.

    Science.gov (United States)

    Delepierre, A; Gayot, A; Carpentier, A

    2012-06-01

    Antibiotics are the most counterfeited medicines and account for 28% of global counterfeit medicines. Counterfeit antibiotics are estimated at 5% of the global antibiotic market. No area in the world seems to be spared from counterfeiting of antibiotics. However, these are rare in developed countries, whereas the strong demand for antibiotics in emerging countries creates a highly attractive market for counterfeiters. Thus, 78% of counterfeit antibiotics come from South-East Asia and their destination is mainly emerging countries (South-East Asia: 44%; sub-Saharan Africa: 30%; Europe, North America: 9%; others: 16%). Counterfeit antibiotics are antibiotics that have been commonly used for years (beta-lactams: 50%; quinolones: 12%; macrolides, lincosamides, and synergistins: 1%; cyclins: 7%; others: 20%). The main counterfeit formulations (77%) concern oral administration (tablets, syrup, capsules) whereas injected drugs account for only 17% of counterfeit formulations, and eye drops and ointments 6%. The kind of counterfeiting for antibiotics is similar to that of other drugs (no active ingredients: 43%; bad quality: 24%; insufficient quantity of active ingredients: 21%; wrong active ingredients: 7%; counterfeit packaging: 5%). Beyond the harmful effects for patients, counterfeit medicines favor the emergence of bacterial resistance with a worldwide impact. Great efforts have been made to fight global counterfeiting of medicines since 1985. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  12. Rapid Color Test Identification System for Screening of Counterfeit Fluoroquinolone

    Directory of Open Access Journals (Sweden)

    B. K. Singh

    2009-01-01

    Full Text Available The protocol of rapid identification system consists of three chemical color reactions; two group tests for fluoroquinolone class and a compound specific test each for norfloxacin, ciprofloxacin, gatifloxacin, ofloxacin, levofloxacin and sparfloxacin. The group color reactions are based on (a Oxidizing behavior of quinolone and (b Fluorine functional groups, both of which are characteristic of fluoroquinolone class. The compound specific color reactions are developed taking into consideration unique chemical behavior of each compound. The proposed chemical color tests have high selectivity⁄specificity, are ideal for screening purpose. The color of each test was defined by two standard color systems namely CIE lab and Munsell color. A suspected counterfeit tablet of any of the above mentioned drugs can be identified within 10-15 min using this rapid identification system.

  13. Problems Associated With Substandard And Counterfeit Drugs In ...

    African Journals Online (AJOL)

    Problems Associated With Substandard And Counterfeit Drugs In Developing Countries: A Review Article On Global Implications Of Counterfeit Drugs In The Era Of Anti-Retroviral (ARVS) Drugs In A Free Market Economy.

  14. Prevalence of counterfeit anthelminthic medicines: a cross-sectional survey in Cambodia.

    Science.gov (United States)

    Khan, Mohiuddin Hussain; Okumura, Junko; Sovannarith, Tey; Nivanna, Nam; Akazawa, Manabu; Kimura, Kazuko

    2010-05-01

    To assess the prevalence of counterfeit anthelminthic medicines in Cambodia, and to determine influential factors. Commonly used anthelminthic medicines were collected from private drug outlets. Medicines were carefully observed including their registration labelling, and their authenticity was investigated with the manufacturers and the Medicines Regulatory Authorities. Samples were analysed by High-Performance Liquid Chromatography at the National Health Product Quality Control Centre, Cambodia. Two hundred and three samples of anthelminthics were collected from 137 drug stores. Domestic products constituted 36.9%. Of 196 samples which were verified for registration, 15.8% were not registered. Of 165 samples successfully investigated for their authenticity, 7 (4.2%) were identified as counterfeit. All of these medicines were purchased in open packs or containers, and most of them were foreign manufactured and/or without registration. The results of our survey urge strict implementation of drug registration and vigilance on the availability of unregistered medicines to combat counterfeit medicines in Cambodia.

  15. A validated GC-MS method for the determination and quantification of residual solvents in counterfeit tablets and capsules

    OpenAIRE

    Deconinck, Eric; Canfyn, Michaël; Sacre, Pierre-Yves; Baudewyns, Sébastien; Courselle, Patricia; De Beer, Jacques O.

    2012-01-01

    A fast headspace GC-MS method was developed and validated for the detection and quantification of residual solvents of all three ICH-classes in counterfeit tablets and capsules. The method was validated for ten solvents, selected based on an initial screening of counterfeit medicinal products. The considered solvents were ethanol, 2-propanol, acetone, ethylacetate, chloroform, carbon tetrachloride, benzene, toluene, dichloromethane and ethylbenzene. The proposed method uses a Phenomenex 624 c...

  16. Smart printing technology for counterfeit deterrence

    Science.gov (United States)

    Harrop, Peter J.

    1996-03-01

    Smart (intelligent) printing is the creation of useful patterns beyond alphanumerics and graphics immediately obvious to the human eye. It employs smart inks, patterns, surfaces and substrates. Recent proliferation of color copiers, personal computers and scanners has facilitated a tenfold increase in counterfeiting in many countries over the past three years. Banknotes, cheques, academic certificates, art work, visitors passes, venue tickets and many other artifacts have been compromised. Paradoxically, the best counterfeits produced by some foreign governments and organized crime are rarely the main problem. The secret services of many countries use forensic science to great effect in pursuing these fairly readily identified sources of limited number. Bad counterfeits usually made on color copiers or computers, with or without color scanners, are the most difficult to combat because they are made by very large numbers of casual counterfeiters who may never commit crime again. For instance, counterfeit banknotes intercepted by the Bundesbank have been photocopies in a fluctuating range of 50 - 84% of cases in the last four reported years. Cheque and other document fraud is also inflated by these burgeoning bad copies and here we must add amateurish alterations using copiers or scanners. For instance, a better academic degree can mean a better job, an interbank transfer form can be 'raised' in value by enormous amounts. The issuer of a 'bad' counterfeit does not mind that it is usually picked up on a second transferral. They are long gone by then or, with banknotes, they can deny that they issued it. First priority in reversing the upward trend of counterfeiting must not therefore be the creation of better secret features traceable by forensic laboratories over extended periods of time. Rather we need better and more obvious optically unique features, not easily emulated, that can be spotted in the split second when several, say, banknotes are handed over in a

  17. Roman sophisticated surface modification methods to manufacture silver counterfeited coins

    Science.gov (United States)

    Ingo, G. M.; Riccucci, C.; Faraldi, F.; Pascucci, M.; Messina, E.; Fierro, G.; Di Carlo, G.

    2017-11-01

    By means of the combined use of X-ray photoelectron spectroscopy (XPS), optical microscopy (OM) and scanning electron microscopy (SEM) coupled with energy dispersive X-ray spectroscopy (EDS) the surface and subsurface chemical and metallurgical features of silver counterfeited Roman Republican coins are investigated to decipher some aspects of the manufacturing methods and to evaluate the technological ability of the Roman metallurgists to produce thin silver coatings. The results demonstrate that over 2000 ago important advances in the technology of thin layer deposition on metal substrates were attained by Romans. The ancient metallurgists produced counterfeited coins by combining sophisticated micro-plating methods and tailored surface chemical modification based on the mercury-silvering process. The results reveal that Romans were able systematically to chemically and metallurgically manipulate alloys at a micro scale to produce adherent precious metal layers with a uniform thickness up to few micrometers. The results converge to reveal that the production of forgeries was aimed firstly to save expensive metals as much as possible allowing profitable large-scale production at a lower cost. The driving forces could have been a lack of precious metals, an unexpected need to circulate coins for trade and/or a combinations of social, political and economic factors that requested a change in money supply. Finally, some information on corrosion products have been achieved useful to select materials and methods for the conservation of these important witnesses of technology and economy.

  18. Chemical Analysis of Counterfeit Hepatitis C Drug Found in Japan.

    Science.gov (United States)

    Uchiyama, Nahoko; Kamakura, Hiroyuki; Masada, Sayaka; Tsujimoto, Takashi; Hosoe, Junko; Tokumoto, Hiroko; Maruyama, Takuro; Goda, Yukihiro; Hakamatsuka, Takashi

    2017-10-01

    In January 2017, counterfeits of the hepatitis C drug 'HARVONI® Combination Tablets' (HARVONI®) were found at a pharmacy chain through unlicensed suppliers in Japan. A total of five lots of counterfeit HARVONI® (samples 1-5) bottles were found, and the ingredients of the bottles were all in tablet form. Among them, two differently shaped tablets were present in two of the bottles (categorized as samples 2A, 2B, 4A, and 4B). We analyzed the total of seven samples by high-resolution LC-MS, GC-MS and NMR. In samples 2A, 3 and 4B, sofosbuvir, the active component of another hepatitis C drug, SOVALDI® Tablets 400 mg (SOVALDI®), was detected. In sample 4A, sofosbuvir and ledipasvir, the active components of HARVONI®, were found. A direct comparison of the four samples and genuine products showed that three samples (2A, 3, 4B) are apparently SOVALDI® and that sample 2A is HARVONI®. In samples 1 and 5, several vitamins but none of the active compounds usually found in HARVONI® (i.e., sofosbuvir and ledipasvir) were detected. Our additional investigation indicates that these two samples are likely to be a commercial vitamin supplement distributed in Japan. Sample 2B, looked entirely different from HARVONI® and contained several herbal constitutents (such as ephedrine and glycyrrhizin) that are used in Japanese Kampo formulations. A further analysis indicated that sample 2B is likely to be a Kampo extract tablet of Shoseiryuto which is distributed in Japan. Considering this case, it is important to be vigilant to prevent a recurrence of distribution of counterfeit drugs.

  19. Spooky Suspects

    Science.gov (United States)

    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.)

  20. Limited indications of tax stamp discordance and counterfeiting on cigarette packs purchased in tobacco retailers, 97 counties, USA, 2012.

    Science.gov (United States)

    Lee, Joseph G L; Golden, Shelley D; Ribisl, Kurt M

    2017-12-01

    Increasing the per-unit cost of tobacco products is one of the strongest interventions for tobacco control. In jurisdictions with higher taxes in the U.S., however, cigarette pack litter studies show a substantial proportion of littered packs lack the appropriate tax stamp. More limited but still present counterfeiting also exists. We sought to examine the role of tobacco retailers as a source for untaxed and counterfeit products. Data collectors purchased Newport Green (menthol) or Marlboro Red cigarette packs in a national probability-based sample of tobacco retailers (in 97 counties) from June-October 2012. They made no effort to buy counterfeit or untaxed cigarettes. In this cross-sectional study, we assessed the presence, tax authority, and type (low-tech thermal vs. encrypted) of cigarette pack tax stamps; concordance of tax stamps with where the pack was purchased; and, for Marlboro cigarettes, publicly available visible indicators of counterfeiting. We purchased 2147 packs of which 2033 had tax stamps. Packs missing stamps were in states that do not require them. We found very limited discordance between store location and tax stamp(s) (cigarette packs had damaged tax stamps (13%). This occurred entirely with low-tech tax stamps and was not identified with encrypted tax stamps. We found no clear evidence of counterfeit products. Almost all tax stamps matched the location of purchase. Litter studies may be picking up legal tax avoidance instead of illegal tax evasion or, alternatively, purchase of illicit products requires special request by the purchaser.

  1. Counterfeit Electronics Detection Using Image Processing and Machine Learning

    Science.gov (United States)

    Asadizanjani, Navid; Tehranipoor, Mark; Forte, Domenic

    2017-01-01

    Counterfeiting is an increasing concern for businesses and governments as greater numbers of counterfeit integrated circuits (IC) infiltrate the global market. There is an ongoing effort in experimental and national labs inside the United States to detect and prevent such counterfeits in the most efficient time period. However, there is still a missing piece to automatically detect and properly keep record of detected counterfeit ICs. Here, we introduce a web application database that allows users to share previous examples of counterfeits through an online database and to obtain statistics regarding the prevalence of known defects. We also investigate automated techniques based on image processing and machine learning to detect different physical defects and to determine whether or not an IC is counterfeit.

  2. Dangerous medicines: unproven AIDS cures and counterfeit antiretroviral drugs

    National Research Council Canada - National Science Library

    Amon, Joseph J

    2008-01-01

    .... Although a range of legislative and regulatory measures have been adopted by some governments, and technical assistance has been provided by international agencies to address counterfeit medicines...

  3. The health and economic effects of counterfeit drugs.

    Science.gov (United States)

    Blackstone, Erwin A; Fuhr, Joseph P; Pociask, Steve

    2014-06-01

    Counterfeit drugs comprise an increasing percentage of the US drug market and even a larger percentage in less developed countries. Counterfeit drugs involve both lifesaving and lifestyle drugs. To review the health and economic consequences of counterfeit drugs on the US public and on the healthcare system as a whole. This comprehensive review of the literature encompassed a search of MEDLINE/PubMed, Google Scholar, and ProQuest using the keywords "counterfeit drugs," "counterfeit medicines," "fake drugs," and "fake medicines." A search of the various FiercePharma daily newsletter series on the healthcare market was also conducted. In addition, the US Food and Drug Administration and the World Health Organization websites were reviewed for additional information. The issue of counterfeit drugs has been growing in importance in the United States, with the supply of these counterfeit drugs coming from all over the world. Innovation is important to economic growth and US competitiveness in the global marketplace, and intellectual property protections provide the ability for society to prosper from innovation. Especially important in terms of innovation in healthcare are the pharmaceutical and biopharmaceutical industries. In addition to taking income from consumers and drug companies, counterfeit drugs also pose health hazards to patients, including death. The case of bevacizumab (Avastin) is presented as one recent example. Internet pharmacies, which are often the source of counterfeit drugs, often falsely portray themselves as Canadian, to enhance their consumer acceptance. Adding to the problems are drug shortages, which facilitate access for counterfeits. A long and convoluted supply chain also facilitates counterfeits. In addition, the wholesale market involving numerous firms is a convenient target for counterfeit drugs. Trafficking in counterfeits can be extremely profitable; detection of counterfeits is difficult, and the penalties are modest. Counterfeit

  4. Counterfeit Parts Prevention Strategy Guide Product Overview

    Science.gov (United States)

    2014-05-08

    Scott Anderson Seaker scott.anderson@seaker.com Aaron Apruzzese ATK aaron.apruzzese@atk.com Chic Arey NRO areyc@nro.mil Brent Armand Orbital...Sheffield SSL jonathan.sheffield@sslmda.com Andrew Shroyer Ball ashroyer@ball.com Fredic Silverman HSTC fsilverman@hstc.com Rob Singh SSL rob.singh

  5. Silver and tin plating as medieval techniques of producing counterfeit coins and their identification by means of micro-XRF

    Science.gov (United States)

    Hložek, M.; Trojek, T.

    2017-08-01

    Archaeological surveys and metal detector prospecting yield a great amount of coins from the medieval period. Naturally, some of these are counterfeit which an experienced numismatist can determine without using chemical methods. The production of counterfeit coins in the middle ages took place in castles, caves or other remote areas where waste from this activity can still be found today - copper sheets, technical ceramics and counterfeit coins. Until recently, it has been assumed that medieval counterfeit coins are made by silver-plating copper blanks using an amalgam. However, the performed analyses reveal that there are many more techniques of counterfeiting of coins. Other techniques were based on e.g. tin amalgam plating of the blanks or alloying so-called white metal with silver-like appearance from which the coins were minted. Current chemical analyses indicate that the coins were often tinned by hot dipping with no amalgamation. Micro-X-ray fluorescence analysis has been chosen as a suitable non-destructive method to identify present chemical elements in investigated artifacts and to quantify their concentrations. In addition, a quick technique telltale the plating was applied. This technique utilizes the detected fluorescence ratio Kα/Kβ of copper, which is the main ingredient of a lot of historical metallic materials.

  6. Counterfeit Currency Identification System - A Case Study on ...

    African Journals Online (AJOL)

    Counterfeit notes came into circulation right from the time of existence of genuine notes. A number of techniques like first line inspection methods, second line inspection methods and smart money counterfeit detector are being used in many countries to identify the genuine notes from the fake ones. The other method is ...

  7. Identification of Counterfeit Drugs by Community Pharmacists in ...

    African Journals Online (AJOL)

    Purpose: The problem of fake and counterfeit drugs is real and constitutes a major threat to the health and safety of the Nigerian population. A descriptive study was carried out to assess the methods of identification of counterfeit drugs by community pharmacists in Lagos State. Methods: The research instrument was a ...

  8. 19 CFR 133.21 - Articles bearing counterfeit trademarks.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Articles bearing counterfeit trademarks. 133.21... Recorded Trademarks or Recorded Trade Names § 133.21 Articles bearing counterfeit trademarks. (a... substantially indistinguishable from, a registered trademark. (b) Seizure. Any article of domestic or foreign...

  9. Growth of Scytalidium sp. in a counterfeit bevacizumab bottle

    Directory of Open Access Journals (Sweden)

    Gerardo Garcia-Aguirre

    2013-01-01

    Full Text Available After drawing a dose from an closed bevacizumab (Avastin bottle, a fungus-like foreign body was observed inside. Samples from the vial were cultured in Sabouraud Emmons media. Growth of multiple light brown colonies with dark pigment was observed after 10 days. The species was identified as Scytalidium sp.Vial, analysis reported that the seal was lacking proper identification measures and that the label, batch number and expiry date did not correspond to a genuine product. Chemical analysis showed no protein, but 3% of polyethylene glycol, citrate and ethanol. Counterfeit bevacizumab is a real situation that poses a significant risk for ophthalmology and oncology patients. The medical community should be aware of this situation in order to enforce adequate preventive measures.

  10. Mass spectrometric analysis of innovator, counterfeit, and follow-on recombinant human growth hormone.

    Science.gov (United States)

    Jiang, Haitao; Wu, Shiaw-Lin; Karger, Barry L; Hancock, William S

    2009-01-01

    We have performed a detailed characterization of recombinant human growth hormone that included the identification of the entire sequence with disulfide linkages as well as subtle modifications by a sensitive liquid chromatography coupled online with tandem mass spectrometry (LC-MS) approach using the accurate peptide mass (FTICR MS) and sequence assignment (MS/MS measurement). The extent of oxidation, deamidation, and chain cleavages were measured by the ratio of peak areas of the nonmodified peptide vs. the sum of peak area of the nonmodified and modified peptides in the same LC-MS analysis. The subtle but distinct differences were found in the recombinant human growth from the three manufacturers (the follow-on, counterfeit, and the original innovator products). In relative comparison, the follow-on product had the highest degree of oxidation at methionine residues, followed by the counterfeit product, and the original innovator product had the least amount of oxidation at all three sites with the similar oxidation order. In cases, the oxidation order was Met14 > Met125 > Met170. In contrast, the follow-on had the least amount of deamidation at aspargine (Asn149), and the counterfeit had the highest degree of deamidation at this site. For the chain cleavage, the follow-on product had the highest cleavage occurring at T 10 peptide (between Asn99 and Ser100), the counterfeit had the highest cleavage on T4 peptide, (between Glu30 and Phe31), and the original innovator product with the least amount of cleavages on both sites. These subtle but distinct differences are likely because of nonidentical manufacturing, formulation procedures, and storage conditions.

  11. Testing of complementarity of PDA and MS detectors using chromatographic fingerprinting of genuine and counterfeit samples containing sildenafil citrate.

    Science.gov (United States)

    Custers, Deborah; Krakowska, Barbara; De Beer, Jacques O; Courselle, Patricia; Daszykowski, Michal; Apers, Sandra; Deconinck, Eric

    2016-02-01

    Counterfeit medicines are a global threat to public health. High amounts enter the European market, which is why characterization of these products is a very important issue. In this study, a high-performance liquid chromatography-photodiode array (HPLC-PDA) and high-performance liquid chromatography-mass spectrometry (HPLC-MS) method were developed for the analysis of genuine Viagra®, generic products of Viagra®, and counterfeit samples in order to obtain different types of fingerprints. These data were included in the chemometric data analysis, aiming to test whether PDA and MS are complementary detection techniques. The MS data comprise both MS1 and MS2 fingerprints; the PDA data consist of fingerprints measured at three different wavelengths, i.e., 254, 270, and 290 nm, and all possible combinations of these wavelengths. First, it was verified if both groups of fingerprints can discriminate between genuine, generic, and counterfeit medicines separately; next, it was studied if the obtained results could be ameliorated by combining both fingerprint types. This data analysis showed that MS1 does not provide suitable classification models since several genuines and generics are classified as counterfeits and vice versa. However, when analyzing the MS1_MS2 data in combination with partial least squares-discriminant analysis (PLS-DA), a perfect discrimination was obtained. When only using data measured at 254 nm, good classification models can be obtained by k nearest neighbors (kNN) and soft independent modelling of class analogy (SIMCA), which might be interesting for the characterization of counterfeit drugs in developing countries. However, in general, the combination of PDA and MS data (254 nm_MS1) is preferred due to less classification errors between the genuines/generics and counterfeits compared to PDA and MS data separately.

  12. Challenging Near InfraRed Spectroscopy discriminating ability for counterfeit pharmaceuticals detection

    Energy Technology Data Exchange (ETDEWEB)

    Storme-Paris, I. [Groupe de Chimie Analytique de Paris-Sud, EA 4041, IFR 141, School of Pharmacy, Univ Paris-Sud, 5 rue Jean Baptiste Clement, 92296 Chatenay-Malabry (France); Rebiere, H. [Laboratories and Control Department, French Health Products Safety Agency (AFSSAPS), 635 rue de la Garenne, 34740 Vendargues (France); Matoga, M. [Groupe de Chimie Analytique de Paris-Sud, EA 4041, IFR 141, School of Pharmacy, Univ Paris-Sud, 5 rue Jean Baptiste Clement, 92296 Chatenay-Malabry (France); Civade, C.; Bonnet, P.-A.; Tissier, M.H. [Laboratories and Control Department, French Health Products Safety Agency (AFSSAPS), 635 rue de la Garenne, 34740 Vendargues (France); Chaminade, P., E-mail: pierre.chaminade@u-psud.fr [Groupe de Chimie Analytique de Paris-Sud, EA 4041, IFR 141, School of Pharmacy, Univ Paris-Sud, 5 rue Jean Baptiste Clement, 92296 Chatenay-Malabry (France)

    2010-01-25

    This study was initiated by the laboratories and control department of the French Health Products Safety Agency (AFSSAPS) as part of the fight against the public health problem of rising counterfeit and imitation medicines. To test the discriminating ability of Near InfraRed Spectroscopy (NIRS), worse cases scenarios were first considered for the discrimination of various pharmaceutical final products containing the same Active Pharmaceutical Ingredient (API) with different excipients, such as generics of proprietary medicinal products (PMP). Two generic databases were explored: low active strength hard capsules of Fluoxetine and high strength tablets of Ciprofloxacin. Then 4 other cases involving suspicious samples, counterfeits and imitations products were treated. In all these cases, spectral differences between samples were studied, giving access to API or excipient contents information, and eventually allowing manufacturing site identification. A chemometric background is developed to explain the optimisation methodology, consisting in the choices of appropriate pretreatments, algorithms for data exploratory analyses (unsupervised Principal Component Analysis), and data classification (supervised cluster analysis, and Soft Independent Modelling of Class Analogy). Results demonstrate the high performance of NIRS, highlighting slight differences in formulations, such as 2.5% (w/w) in API strength, 1.0% (w/w) in excipient and even coating variations (<1%, w/w) with identical contents, approaching the theoretical limits of NIRS sensitivity. All the different generic formulations were correctly discriminated and foreign PMP, constituted of formulations slightly different from the calibration ones, were also all discriminated. This publication addresses the ability of NIRS to detect counterfeits and imitations and presents the NIRS as an ideal tool to master the global threat of counterfeit drugs.

  13. Survey of counterfeit melamine tableware available on the market in Thailand, and its migration.

    Science.gov (United States)

    Poovarodom, N; Tangmongkollert, P; Jinkarn, T; Chonhenchob, V

    2011-02-01

    A simple measurement of sample density by adopting the principles of buoyancy could help screen counterfeit melamine ware if the density was below 1.50 g cm⁻³. However, samples with a density exceeding 1.50 g cm⁻³ were not necessarily made from melamine formaldehyde. FTIR analysis showed that all counterfeit products were made of urea formaldehyde and coated on the food-contact side with melamine formaldehyde, a tactic probably intended to cover up the true product features. The overall migration of real and counterfeit melamine samples complied with both European Union and Thai regulations, as the exposure layers in both cases were melamine formaldehyde. Formaldehyde migration failed to comply with Thai standards, but this was not the case for European Union standards. However, the results showed a significant inconsistency between individual items of the same brand and between individual exposures of the same test specimen. This indicated the inherent inhomogeneity between individual items, which mainly resulted from the manufacturing process: for instance, insufficient temperature and time to obtain complete polycondensation of monomers. Therefore, it is recommended that constant surveillance be conducted on melamine articles available in the marketplace in terms of quality and safety.

  14. Detection of Counterfeit Tequila by Fluorescence Spectroscopy

    Directory of Open Access Journals (Sweden)

    José Manuel de la Rosa Vázquez

    2015-01-01

    Full Text Available An ultraviolet (UV light induced fluorescence study to discriminate fake tequila from genuine ones is presented. A portable homemade system based on four light emitting diodes (LEDs from 255 to 405 nm and a miniature spectrometer was used. It has been shown that unlike fake and silver tequila, which produce weak fluorescence signal, genuine mixed, rested, and aged tequilas show high fluorescence emission in the range from 400 to 750 nm. The fluorescence intensity grows with aging in 100% agave tequila. Such fluorescence differences can even be observed with naked eyes. The presented results demonstrate that the fluorescence measurement could be a good method to detect counterfeit tequila.

  15. Characterization of counterfeit artesunate antimalarial tablets from southeast Asia.

    Science.gov (United States)

    Hall, Krystyn Alter; Newton, Paul N; Green, Michael D; De Veij, Marleen; Vandenabeele, Peter; Pizzanelli, David; Mayxay, Mayfong; Dondorp, Arjen; Fernandez, Facundo M

    2006-11-01

    In southeast Asia, the widespread high prevalence of counterfeits tablets of the vital antimalarial artesunate is of great public health concern. To assess the seriousness of this problem, we quantified the amount of active ingredient present in artesunate tablets by liquid chromatography coupled to mass spectrometry. This method, in conjunction with analysis of the packaging, classified tablets as genuine, substandard, or fake and validated results of the colorimetric Fast Red TR test. Eight (35%) of 23 fake artesunate samples contained the wrong active ingredients, which were identified as different erythromycins and paracetamol. Raman spectroscopy identified calcium carbonate as an excipient in 9 (39%) of 23 fake samples. Multivariate unsupervised pattern recognition results indicated two major clusters of artesunate counterfeits, those with counterfeit foil stickers and containing calcium carbonate, erythromycin, and paracetamol, and those with counterfeit holograms and containing starch but without evidence of erythromycin or paracetamol.

  16. North Korean Counterfeiting of U.S. Currency

    National Research Council Canada - National Science Library

    Perl, Raphael F; Nanto, Dick K

    2006-01-01

    .... Although Pyongyang denies complicity in any counterfeiting operation, at least $45 million in such supernotes of North Korean origin have been detected in circulation, and estimates are that the country earns from $15...

  17. Limited indications of tax stamp discordance and counterfeiting on cigarette packs purchased in tobacco retailers, 97 counties, USA, 2012

    Directory of Open Access Journals (Sweden)

    Joseph G.L. Lee

    2017-12-01

    Full Text Available Increasing the per-unit cost of tobacco products is one of the strongest interventions for tobacco control. In jurisdictions with higher taxes in the U.S., however, cigarette pack litter studies show a substantial proportion of littered packs lack the appropriate tax stamp. More limited but still present counterfeiting also exists. We sought to examine the role of tobacco retailers as a source for untaxed and counterfeit products. Data collectors purchased Newport Green (menthol or Marlboro Red cigarette packs in a national probability-based sample of tobacco retailers (in 97 counties from June–October 2012. They made no effort to buy counterfeit or untaxed cigarettes. In this cross-sectional study, we assessed the presence, tax authority, and type (low-tech thermal vs. encrypted of cigarette pack tax stamps; concordance of tax stamps with where the pack was purchased; and, for Marlboro cigarettes, publicly available visible indicators of counterfeiting. We purchased 2147 packs of which 2033 had tax stamps. Packs missing stamps were in states that do not require them. We found very limited discordance between store location and tax stamp(s (<1%. However, a substantial minority of cigarette packs had damaged tax stamps (13%. This occurred entirely with low-tech tax stamps and was not identified with encrypted tax stamps. We found no clear evidence of counterfeit products. Almost all tax stamps matched the location of purchase. Litter studies may be picking up legal tax avoidance instead of illegal tax evasion or, alternatively, purchase of illicit products requires special request by the purchaser.

  18. Inkjet Printing Based Mono-layered Photonic Crystal Patterning for Anti-counterfeiting Structural Colors

    Science.gov (United States)

    Nam, Hyunmoon; Song, Kyungjun; Ha, Dogyeong; Kim, Taesung

    2016-08-01

    Photonic crystal structures can be created to manipulate electromagnetic waves so that many studies have focused on designing photonic band-gaps for various applications including sensors, LEDs, lasers, and optical fibers. Here, we show that mono-layered, self-assembled photonic crystals (SAPCs) fabricated by using an inkjet printer exhibit extremely weak structural colors and multiple colorful holograms so that they can be utilized in anti-counterfeit measures. We demonstrate that SAPC patterns on a white background are covert under daylight, such that pattern detection can be avoided, but they become overt in a simple manner under strong illumination with smartphone flash light and/or on a black background, showing remarkable potential for anti-counterfeit techniques. Besides, we demonstrate that SAPCs yield different RGB histograms that depend on viewing angles and pattern densities, thus enhancing their cryptographic capabilities. Hence, the structural colorations designed by inkjet printers would not only produce optical holograms for the simple authentication of many items and products but also enable a high-secure anti-counterfeit technique.

  19. A Framework for Counterfeit Smart Grid Device Detection

    Energy Technology Data Exchange (ETDEWEB)

    Babun, Leonardo [Florida Intl Univ., Miami, FL (United States); Aksu, Hidayet [Florida Intl Univ., Miami, FL (United States); Uluagac, A. Selcuk [Florida Intl Univ., Miami, FL (United States)

    2016-10-19

    The core vision of the smart grid concept is the realization of reliable two-­way communications between smart devices (e.g., IEDs, PLCs, PMUs). The benefits of the smart grid also come with tremendous security risks and new challenges in protecting the smart grid systems from cyber threats. Particularly, the use of untrusted counterfeit smart grid devices represents a real problem. Consequences of propagating false or malicious data, as well as stealing valuable user or smart grid state information from counterfeit devices are costly. Hence, early detection of counterfeit devices is critical for protecting smart grid’s components and users. To address these concerns, in this poster, we introduce our initial design of a configurable framework that utilize system call tracing, library interposition, and statistical techniques for monitoring and detection of counterfeit smart grid devices. In our framework, we consider six different counterfeit device scenarios with different smart grid devices and adversarial seZings. Our initial results on a realistic testbed utilizing actual smart-­grid GOOSE messages with IEC-­61850 communication protocol are very promising. Our framework is showing excellent rates on detection of smart grid counterfeit devices from impostors.

  20. Improving global health governance to combat counterfeit medicines: a proposal for a UNODC-WHO-Interpol trilateral mechanism

    National Research Council Canada - National Science Library

    Mackey, Tim K; Liang, Bryan A

    2013-01-01

    ... as "counterfeit medicines", now endemic in the global drug supply chain. Counterfeit medicines are prevalent everywhere, from traditional healthcare settings to unregulated sectors, including the Internet...

  1. DOD Supply Chain: Suspect Counterfeit Electronic Parts Can Be Found on Internet Purchasing Platforms

    Science.gov (United States)

    2012-02-01

    markings, further suggesting re- marking. SEM showed evidence of lapping . Delidding revealed die that were consistent with the authentic part, but...15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT Same as Report (SAR) 18. NUMBER OF PAGES 23 19a. NAME OF...investigation into the purchase and authenticity testing of selected, military-grade electronic parts that may enter the DOD supply chain. As requested

  2. Aspects concerning counterfeiting and piracy in the European Union

    Directory of Open Access Journals (Sweden)

    Gabor, S.

    2012-01-01

    Full Text Available The global problem of counterfeiting and piracy has increased in European Union though there are special laws defending Intellectual Properties Rights. The aim of this paper is to point out the aspects on the topic of counterfeiting and piracy inside the European Union Single Market. Analysing the information gathered, we can conclude that there are evident facts of growing and increasingly dangerous phenomena in the European Union, with significant impact on the economic and social sectors. European Commission is the one that identifies strategies and effective practices to help rightful owners protect their Intellectual Property Rights.

  3. An exploration of counterfeit medicine surveillance strategies guided by geospatial analysis: lessons learned from counterfeit Avastin detection in the US drug supply chain

    National Research Council Canada - National Science Library

    Cuomo, Raphael E; Mackey, Tim K

    2014-01-01

    To explore healthcare policy and system improvements that would more proactively respond to future penetration of counterfeit cancer medications in the USA drug supply chain using geospatial analysis...

  4. An Examination of Income Effect on Consumers' Ethical Evaluation of Counterfeit Drugs Buying Behaviour: A Cross-Sectional Study in Qatar and Sudan.

    Science.gov (United States)

    Alfadl, Abubakr Abdelraouf; Ibrahim, Mohamed Izham Mohamed; Maraghi, Fatima Abdulla; Mohammad, Khadijah Shhab

    2016-09-01

    There are limited studies on consumer behaviour toward counterfeit products and the determining factors that motivate willingness to purchase counterfeit items. This study aimed to fill this literature gap through studying differences in individual ethical evaluations of counterfeit drug purchase and whether that ethical evaluation affected by difference in income. It is hypothesized that individuals with lower/higher income make a more/less permissive evaluation of ethical responsibility regarding counterfeit drug purchase. To empirically test the research assumption, a comparison was made between people who live in the low-income country Sudan and people who live in the high-income country Qatar. The study employed a face-to-face structured interview survey methodology to collect data from 1,170 subjects and the Sudanese and Qatari samples were compared using independent t-test at alpha level of 0.05 employing SPSS version 22.0. Sudanese and Qatari individuals were significantly different on all items. Sudanese individuals scored below 3 for all Awareness of Societal Consequences (ASC) items indicating that they make more permissive evaluation of ethical responsibility regarding counterfeit drug purchase. Both groups shared a basic positive moral agreement regarding subjective norm indicating that influence of income is not evident. Findings indicate that low-income individuals make more permissive evaluation of ethical responsibility regarding counterfeit drugs purchase when highlighting awareness of societal consequences used as a deterrent tool, while both low and high-income individuals share a basic positive moral agreement when subjective norm dimension is exploited to discourage unethical buying behaviour.

  5. An Examination of Income Effect on Consumers’ Ethical Evaluation of Counterfeit Drugs Buying Behaviour: A Cross-Sectional Study in Qatar and Sudan

    Science.gov (United States)

    Alfadl, Abubakr Abdelraouf; Maraghi, Fatima Abdulla; Mohammad, Khadijah Shhab

    2016-01-01

    Introduction There are limited studies on consumer behaviour toward counterfeit products and the determining factors that motivate willingness to purchase counterfeit items. Aim This study aimed to fill this literature gap through studying differences in individual ethical evaluations of counterfeit drug purchase and whether that ethical evaluation affected by difference in income. It is hypothesized that individuals with lower/higher income make a more/less permissive evaluation of ethical responsibility regarding counterfeit drug purchase. Materials and Methods To empirically test the research assumption, a comparison was made between people who live in the low-income country Sudan and people who live in the high-income country Qatar. The study employed a face-to-face structured interview survey methodology to collect data from 1,170 subjects and the Sudanese and Qatari samples were compared using independent t-test at alpha level of 0.05 employing SPSS version 22.0. Results Sudanese and Qatari individuals were significantly different on all items. Sudanese individuals scored below 3 for all Awareness of Societal Consequences (ASC) items indicating that they make more permissive evaluation of ethical responsibility regarding counterfeit drug purchase. Both groups shared a basic positive moral agreement regarding subjective norm indicating that influence of income is not evident. Conclusion Findings indicate that low-income individuals make more permissive evaluation of ethical responsibility regarding counterfeit drugs purchase when highlighting awareness of societal consequences used as a deterrent tool, while both low and high-income individuals share a basic positive moral agreement when subjective norm dimension is exploited to discourage unethical buying behaviour. PMID:27790465

  6. North Korean Counterfeiting of U.S. Currency

    Science.gov (United States)

    2009-06-12

    cigarettes, pharmaceuticals, and $100 bills. See Frederik Balfour et. al., “Fakes,” Business Week, February 7, 2005. Criminal indictments subsequently ensued...Squassoni. North Korean Counterfeiting of U.S. Currency Congressional Research Service 13 “ declaration of war” and indicated that it no longer is bound

  7. Fake and Counterfeit Drug: A review | Buowari | Afrimedic Journal

    African Journals Online (AJOL)

    ... significance in view of rapid globalisation and is assuming a dangerous dimension in most countries. METHODOLOGY: A review of literature on counterfeit drug and it impact was done. The articles were accessed from public libraries, as well as online through internet search engines and relevant information extracted.

  8. Discriminant function for classification of genuine and counterfeit ...

    African Journals Online (AJOL)

    A derivation of the appropriate measure of the separation of the two groups was made. Discriminant analysis technique was used to construct a discriminant function. Test for the significance of differences between the mean values of the variables for each of the two groups (counterfeit and genuine) of the ₦1000 notes was ...

  9. NIR spectrometry for counterfeit drug detection - A feasibility study

    DEFF Research Database (Denmark)

    Rodionova, O.Y.; Houmøller, Lars P.; Pomerantsev, A.L.

    2005-01-01

    Express-methods for detection of counterfeit drugs are of vital necessity. Visual control, dissociating tests or simple color reaction tests reveal only very rough forgeries. The feasibility of information-rich NIR-measurements as an analytical method together with multivariate calibration...

  10. Weighing Designs to Detect a Single Counterfeit Coin

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 21; Issue 2. Weighing Designs to Detect a Single Counterfeit Coin. Jyotirmoy Sarkar Bikas K Sinha. General Article Volume 21 Issue 2 February 2016 pp 125-150. Fulltext. Click here to view fulltext PDF. Permanent link:

  11. The use of the isotopic composition of individual compounds for correlating spilled oils and refined products in the environment with suspected sources

    Energy Technology Data Exchange (ETDEWEB)

    Philp, R.P.; Allen, J.; Kuder, T. [Oklahoma Univ., Norman, OK (United States). School of Geology and Geophysics

    2002-07-01

    Gas chromatography (GC) and gas chromatography/mass spectrometry (CGMS) are two methods generally used to correlate crude oils and refined products found in the environment with their suspected pollution sources. In certain cases, this can be done with bulk carbon isotope compositions, but with crude condensates, or refined products, the lack of biomarkers prohibits the successful use for making unique correlations. Such products can be correlated using an alternative method which makes use of combined gas chromatography-isotope ratio and mass spectrometry (GCIRMS). This method makes it possible to determine the carbon and hydrogen isotopic composition of individual compounds in crude oil, thus producing isotopic fingerprints that could be used in correlation studies. The feasibility of using of GCIRMS to correlate various spilled products in different environments was the main focus of this study. The authors are not proposing that this method will replace GC or GCMS, but are suggesting that it is a powerful tool that could be used in conjunction with the early methods. Carbon and hydrogen isotopic fractionation has been reported for light components such as benzene and toluene. Higher carbon numbered compounds do not seem to undergo major carbon isotopic fractionation as a result of weathering. Hydrogen variations are currently undergoing investigation for compounds with a carbon number greater than C10. Also, isotopic fractionation for refined products has the potential to attenuate naturally. 33 refs., 6 figs.

  12. Determination of counterfeit medicines by Raman spectroscopy: Systematic study based on a large set of model tablets.

    Science.gov (United States)

    Neuberger, Sabine; Neusüß, Christian

    2015-08-10

    In the last decade, counterfeit pharmaceutical products have become a widespread issue for public health. Raman spectroscopy which is easy, non-destructive and information-rich is particularly suitable as screening method for fast characterization of chemicals and pharmaceuticals. Combined with chemometric techniques, it provides a powerful tool for the analysis and determination of counterfeit medicines. Here, for the first time, a systematic study of the benefits and limitations of Raman spectroscopy for the analysis of pharmaceutical samples on a large set of model tablets, varying with respect to chemical and physical properties, was performed. To discriminate between the different mixtures, a combination of dispersive Raman spectroscopy performing in backscattering mode and principal component analysis was used. The discrimination between samples with different coatings, a varying amount of active pharmaceutical ingredients and a diversity of excipients were possible. However, it was not possible to distinguish between variations of the press power, mixing quality and granulation. As a showcase, the change in Raman signals of commercial acetylsalicylic acid effervescent tablets due to five different storage conditions was monitored. It was possible to detect early small chemical changes caused by inappropriate storage conditions. These results demonstrate that Raman spectroscopy combined with multivariate data analysis provides a powerful methodology for the fast and easy characterization of genuine and counterfeit medicines. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Near-infrared microscopy imaging for quantitative analysis of active component in counterfeit imidacloprid

    Science.gov (United States)

    Huang, Yue; Cao, Jinli; Ye, Shengfeng; Duan, Jia; Wu, Lijun; Li, Qianqian; Min, Shungeng

    2012-01-01

    Near-infrared (NIR) imaging systems simultaneously record spectral and spatial information. Near-infrared imaging was applied to the identification of imidacloprid in both artificially mixed samples and commercial formulation in this study. The distributions of technical imidacloprid and additive in the heterogeneous counterfeit were obtained by the relationship imaging (RI) mode. Furthermore a series of samples which consisted of different contents of uniformly distributed imidacloprid were prepared and three data cubes were generated at each content. Extracted spectra from those images were imported to establish the partial least squares model. The model's results were: R2 99.21%, RMSEC 0.0306, RMSECV 0.0183, RMSECV/mean value 0.0348 and RSEP 0.0784. The prediction relative error of commercial formulation is 0.0680, indicating the predicted value was correlated to the real content. Lastly the chemical value reconstruction image of imidacloprid formulation products was calculated by MATLAB program. NIR microscopy imaging manifests herein its potential in qualitatively identifying the active component in counterfeit pesticide and quantifying the active component in scanned image.

  14. Evaluation of a new handheld instrument for the detection of counterfeit artesunate by visual fluorescence comparison.

    Science.gov (United States)

    Ranieri, Nicola; Tabernero, Patricia; Green, Michael D; Verbois, Leigh; Herrington, James; Sampson, Eric; Satzger, R Duane; Phonlavong, Chindaphone; Thao, Khamxay; Newton, Paul N; Witkowski, Mark R

    2014-11-01

    There is an urgent need for accurate and inexpensive handheld instruments for the evaluation of medicine quality in the field. A blinded evaluation of the diagnostic accuracy of the Counterfeit Detection Device 3 (CD-3), developed by the US Food and Drug Administration Forensic Chemistry Center, was conducted in the Lao People's Democratic Republic. Two hundred three samples of the oral antimalarial artesunate were compared with authentic products using the CD-3 by a trainer and two trainees. The specificity (95% confidence interval [95% CI]), sensitivity (95% CI), positive predictive value (95% CI), and negative predictive value (95% CI) of the CD-3 for detecting counterfeit (falsified) artesunate were 100% (93.8-100%), 98.4% (93.8-99.7%), 100% (96.2-100%), and 97.4% (90.2-99.6%), respectively. Interobserver agreement for 203 samples of artesunate was 100%. The CD-3 holds promise as a relatively inexpensive and easy to use instrument for field evaluation of medicines, potentially empowering drug inspectors, customs agents, and pharmacists. © The American Society of Tropical Medicine and Hygiene.

  15. ASPECTS RELATED TO THE PRODUCING OF EVIDENCES IN TRADEMARK COUNTERFEITING CASES IN ROMANIA

    OpenAIRE

    ALEXANDRU LUCIAN ARJOCA

    2012-01-01

    The study contains a presentation of evidences and meanings of evidence used in civil and penal trademark counterfeiting cases in Romania. The study analyses the evidences (concept, object, importance, the burden of evidence), means of evidence used in trademark counterfeiting cases, the estimating of the value of the evidence by instance or by prosecutors, new aspects related to the burden of evidences in penal trademark counterfeiting cases in Romania.

  16. ASPECTS RELATED TO THE PRODUCING OF EVIDENCES IN TRADEMARK COUNTERFEITING CASES IN ROMANIA

    Directory of Open Access Journals (Sweden)

    ALEXANDRU LUCIAN ARJOCA

    2012-05-01

    Full Text Available The study contains a presentation of evidences and meanings of evidence used in civil and penal trademark counterfeiting cases in Romania. The study analyses the evidences (concept, object, importance, the burden of evidence, means of evidence used in trademark counterfeiting cases, the estimating of the value of the evidence by instance or by prosecutors, new aspects related to the burden of evidences in penal trademark counterfeiting cases in Romania.

  17. China Customs: a wall to keep counterfeits in?

    DEFF Research Database (Denmark)

    Elsmore, Matthew James; Hurvitz, Aaron D.

    2012-01-01

    This article describes, analyses and evaluates the role and likely impact of using China trade mark and customs law and procedure in the fight against global trade in counterfeited trade mark goods. A fresh look at the geographical source of the global counterfeit industry is well timed amid...... legislative and judicial developments in the EU; though China is not legally obligated under public international law to provide for control of potentially illegal exports–like trade mark infringing goods, it does so anyway; China Customs oversee the exports of the country with the largest base...... of manufacturers of infringing goods in the world. By outlining the pros and cons of what we call a source-strategy and drawing in the experience of IP lawyers working in China, this article which has an audience of European trade mark owners in mind, offers a practical alternative tool for anti...

  18. Destruction of illegal things and devices to contrast the counterfeiting

    Directory of Open Access Journals (Sweden)

    Dr.Sc. Mario Antinucci

    2016-01-01

    Full Text Available The movement of goods illegal and counterfeit in the circuit of the economy and the labor market, has put in place of criminal policy internal supranational and a primary need of confiscation and destruction in relation to safety issues transnational linked to all forms of counterfeiting, piracy agro-food to fraud in industrial brands of high fashion et similia: from here the major node of the procedure of destruction of goods illegal and counterfeit subject to seizure and confiscation and respect of guarantees communities of the criminal process, especially in the light of the amendment of art. 260, co. 3 bis and ter, c.p.p. with the d.l. 23-5-2008, n. 92 and subsequent amendments (so-called Safety Package. In line with the criminal policy of ''security'', in l. 23-7-2009, n. 99, the so-called Decree Development, between the ''darrangements for the development and the internationalization of enterprises, as well as in the field of energy'' and  wanted to redesign, with analytical provisions of particular edge, the perimeter of the criminal-law protection ''Dei property rights industrial'' through the introduction of four new hypothesis of offenses of counterfeiting (artt. 473, 474, 474 b and c, 517 b and c, c.p. and related hypothesis of obligatory confiscation (art. 474 bis and 517 ter c.p., with implications concerning the regime differentiated penitentiary (art. 4 bis, co. 1 ter, ord. penit. in relation to the cases of belonging to criminal association aimed to commit new offenses referred to in articles 473-474 c.p. (arts. 416 bis, 6º Co., c.p. and 51, co. 3 bis, c.p.p., as well as the regulatory body containing the so-called ''responsability of administrative entities'', within the meaning of art. 19, d.lg. 8-6-2001, n. 231.

  19. Iranian pharmacists' knowledge, attitude and practice regarding counterfeit drugs.

    Science.gov (United States)

    Shahverdi, Shieda; Hajimiri, Mirhamed; Pourmalek, Farshad; Torkamandi, Hassan; Gholami, Kheirollah; Hanafi, Somayeh; Ashrafi Shahmirzadi, Nikinaz; Javadi, Mohammadreza

    2012-01-01

    Background Awareness of pharmacists about counterfeit drugs is necessary for health improvement in community. The purpose of the present study is to assess the knowledge and measure the professional attitude and practice of Iranian pharmacist about counterfeit drugs. In August 2008, a knowledge, attitude and practice (KAP) study was performed in a national sample of 794 pharmacists who participated in an Iranian Pharmacist Association congress. A questionnaire was prepared to collect Demographic and professional characteristics, Knowledge, attitude and practice of pharmacists regarding counterfeit drugs. The mean percent of participants who answer each practice questions correctly is 13.62% and none of questions have more than 14.7% of correct answer, while the participants' attitude towards the subject is at high level. None of demographic factors represented a significant relationship with knowledge and the only related parameters with attitude, were age and gender. Increasing age of pharmacists resulted in attitude improvement (p = 0.013) and women›s attitudes were better than men (p = 0.05).The only related parameters with practice, were the number of working hours per a week and attitude. Increasing the number of working hours per a week, resulted in decreasing the desirable practice (p = 0.041) and attitude also had a direct relationship with practice (p = 0.011). Conclusion The most important finding in the present study was the pharmacists› low knowledge and practice level about counterfeit drugs, while their attitude towards this subject was at a high level. The results point out the need for designing and implementing educational programs.

  20. Adulteration and Counterfeiting of Online Nutraceutical Formulations in the United States: Time for Intervention?

    Science.gov (United States)

    Nounou, Mohamed Ismail; Ko, Yamin; Helal, Nada A; Boltz, Jeremy F

    2017-10-11

    Global prevalence of nutraceuticals is noticeably high. The American market is flooded with nutraceuticals claiming to be of natural origin and sold with a therapeutic claim by major online retail stores such as Amazon and eBay. The objective of this commentary is to highlight the possible problems of online-sold nutraceuticals in the United States with respect to claim, adulterants, and safety. Furthermore, there is a lack of strict regulatory laws governing the sales, manufacturing, marketing, and label claims of nutraceutical formulations currently sold in the U.S. market. Major online retail stores and Internet pharmacies aid the widespread sale of nutraceuticals. Finally, according to the literature, many of these products were found to be either counterfeit or adulterated with active pharmaceutical ingredients (API) and mislabeled as being safe and natural. Therefore, regulatory authorities along with the research community should intervene to draw attention to these products and their possible effects.

  1. An exploration of counterfeit medicine surveillance strategies guided by geospatial analysis: lessons learned from counterfeit Avastin detection in the US drug supply chain.

    Science.gov (United States)

    Cuomo, Raphael E; Mackey, Tim K

    2014-12-02

    To explore healthcare policy and system improvements that would more proactively respond to future penetration of counterfeit cancer medications in the USA drug supply chain using geospatial analysis. A statistical and geospatial analysis of areas that received notices from the Food and Drug Administration (FDA) about the possibility of counterfeit Avastin penetrating the US drug supply chain. Data from FDA warning notices were compared to data from 44 demographic variables available from the US Census Bureau via correlation, means testing and geospatial visualisation. Results were interpreted in light of existing literature in order to recommend improvements to surveillance of counterfeit medicines. This study analysed 791 distinct healthcare provider addresses that received FDA warning notices across 30,431 zip codes in the USA. Statistical outputs were Pearson's correlation coefficients and t values. Geospatial outputs were cartographic visualisations. These data were used to generate the overarching study outcome, which was a recommendation for a strategy for drug safety surveillance congruent with existing literature on counterfeit medication. Zip codes with greater numbers of individuals age 65+ and greater numbers of ethnic white individuals were most correlated with receipt of a counterfeit Avastin notice. Geospatial visualisations designed in conjunction with statistical analysis of demographic variables appeared more capable of suggesting areas and populations that may be at risk for undetected counterfeit Avastin penetration. This study suggests that dual incorporation of statistical and geospatial analysis in surveillance of counterfeit medicine may be helpful in guiding efforts to prevent, detect and visualise counterfeit medicines penetrations in the US drug supply chain and other settings. Importantly, the information generated by these analyses could be utilised to identify at-risk populations associated with demographic characteristics

  2. Assessment of the effectiveness of the CD3+ tool to detect counterfeit and substandard anti-malarials

    National Research Council Canada - National Science Library

    Batson, JaCinta S; Bempong, Daniel K; Lukulay, Patrick H; Ranieri, Nicola; Satzger, R Duane; Verbois, Leigh

    2016-01-01

    .... The technologies were evaluated for sensitivity in determining counterfeit/substandard (The term counterfeit or falsified is used in this article to refer to medicines that carry a false representation of identity or source...

  3. Nanotag luminescent fingerprint anti-counterfeiting technology

    DEFF Research Database (Denmark)

    Radziwon, Michal Jędrzej; Rubahn, Horst-Günter; Johansen, Stefan

    2012-01-01

    . This fingerprint can be transferred on an adhesive tape as a label of a product, imaged using low magnification microscopy, digitalised and stored in a database. Infrared surface heating, enforced cooling and load lock transfer makes the fabrication process fast and scalable to mass production....

  4. 19 CFR 133.27 - Civil fines for those involved in the importation of merchandise bearing a counterfeit mark.

    Science.gov (United States)

    2010-04-01

    ... of merchandise bearing a counterfeit mark. 133.27 Section 133.27 Customs Duties U.S. CUSTOMS AND... § 133.27 Civil fines for those involved in the importation of merchandise bearing a counterfeit mark. In... merchandise for sale or public distribution that bears a counterfeit mark resulting in a seizure of the...

  5. Counterfeit Drug Penetration into Global Legitimate Medicine Supply Chains: A Global Assessment

    Science.gov (United States)

    Mackey, Tim K.; Liang, Bryan A.; York, Peter; Kubic, Thomas

    2015-01-01

    Counterfeit medicines are a global public health risk. We assess counterfeit reports involving the legitimate supply chain using 2009–2011 data from the Pharmaceutical Security Institute Counterfeit Incident System (PSI CIS) database that uses both open and nonpublic data sources. Of the 1,510 identified CIS reports involving counterfeits, 27.6% reported China as the source country of the incident/detection. Further, 51.3% were reported as counterfeit but the specific counterfeit subcategory was not known or verifiable. The most prevalent therapeutic category was anti-infectives (21.1%) with most reports originating from health-related government agencies. Geographically, Asian and Latin American regions and, economically, middle-income markets were most represented. A total of 127 (64.8%) of a total of 196 countries had no legitimate supply chain CIS counterfeit reports. Improvements in surveillance, including detection of security breaches, data collection, analysis, and dissemination are urgently needed to address public health needs to combat the global counterfeit medicines trade. PMID:25897059

  6. Screening of counterfeit corticosteroid in creams and ointments by NMR spectroscopy.

    Science.gov (United States)

    McEwen, Ian; Elmsjö, Albert; Lehnström, Angelica; Hakkarainen, Birgit; Johansson, Monika

    2012-11-01

    It has been shown that NMR spectroscopy is an effective analytical method to rapidly screen creams and ointments for counterfeit corticosteroids. Extraction and NMR procedures have been developed. Ten over the counter creams and ointments sold in health care shops were screened and two creams were found to contain counterfeited corticosteroids. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. Integrated circuit authentication hardware Trojans and counterfeit detection

    CERN Document Server

    Tehranipoor, Mohammad; Zhang, Xuehui

    2013-01-01

    This book describes techniques to verify the authenticity of integrated circuits (ICs). It focuses on hardware Trojan detection and prevention and counterfeit detection and prevention. The authors discuss a variety of detection schemes and design methodologies for improving Trojan detection techniques, as well as various attempts at developing hardware Trojans in IP cores and ICs. While describing existing Trojan detection methods, the authors also analyze their effectiveness in disclosing various types of Trojans, and demonstrate several architecture-level solutions. 

  8. Optical security--making life expensive for the counterfeiter

    Science.gov (United States)

    Phillips, Nicholas J.

    1990-04-01

    Optical security printing has reached a high level of sophistication as a result of intense activity in world markets within which the potential for the crook to make money by counterfeiting has reached astronomical levels. Each commercial company that involves itself in the security printing business has its own secrets which it must not divulge. A plenary talk such as this is perforce confined to discuss matters of vision, materials, optical recording and visual psychology which lie outside the specifics of individual commercial approaches. We look at new optical ideas and especially the influences of materials developments in this fascinating field of research.

  9. Medicines informal market in Congo, Burundi and Angola: counterfeit and sub-standard antimalarials

    Directory of Open Access Journals (Sweden)

    Bertocchi Paola

    2007-02-01

    Full Text Available Abstract Background The presence of counterfeits and sub-standards in African medicines market is a dramatic problem that causes many deaths each year. The increase of the phenomenon of pharmaceutical counterfeiting is due to the rise of the illegal market and to the impossibility to purchase branded high cost medicines. Methods In this paper the results of a quality control on antimalarial tablet samples purchased in the informal market in Congo, Burundi and Angola are reported. The quality control consisted in the assay of active substance by means of validated liquid chromatographic methods, uniformity of mass determination, disintegration and dissolution tests. Moreover, a general evaluation on label and packaging characteristics was performed. Results The results obtained on thirty antimalarial tablet samples containing chloroquine, quinine, mefloquine, sulphadoxine and pyrimethamine showed the presence of different kinds of problems: a general problem concerning the packaging (loose tablets, packaging without Producer name, Producer Country and sometimes without expiry date; low content of active substance (in one sample; different, non-declared, active substance (in one sample; sub-standard technological properties and very low dissolution profiles (in about 50% of samples. This last property could affect the bioavailability and bioequivalence in comparison with branded products and could be related to the use of different excipients in formulation or bad storage conditions. Conclusion This paper evidences that the most common quality problem in the analysed samples appears to be the low dissolution profile. Here it is remarked that the presence of the right active substance in the right quantity is not a sufficient condition for a good quality drug. Dissolution test is not less important in a quality control and often evidences in vitro possible differences in therapeutic efficacy among drugs with the same active content. Dissolution

  10. Low-cost, high-speed identification of counterfeit antimalarial drugs on paper.

    Science.gov (United States)

    Koesdjojo, Myra T; Wu, Yuanyuan; Boonloed, Anukul; Dunfield, Elizabeth M; Remcho, Vincent T

    2014-12-01

    With the emergence of artesunate antimalarial counterfeiting in Southeast Asia and sub-Saharan Africa, we present the production of a rapid, inexpensive and simple colorimetric-based testing kit for the detection of counterfeit artesunate in order to preserve life and prevent the development of multi-drug resistant malaria. The kit works based on paper microfluidics which offer several advantages over conventional microfluidics, and has great potential to generate inexpensive, easy-to-use, rapid and disposable diagnostic devices. Here, we have developed a colorimetric assay that is specific to artesunate and turns yellow upon addition of the sample. The test can be done within minutes, and allows for a semi-quantitative analysis of the artesunate tablets by comparing the developed yellow color on the paper test to a color-coded key chart that comes with the kit. A more accurate and precise analysis is done by utilizing a color analyzer on an iPhone camera that measures the color intensity of the developed color on the paper chip. A digital image of the chip was taken and analyzed by measuring the average gray intensity of the color developed on the paper circle. A plot of the artesunate concentration versus the average gray scale intensity was generated. Results show that the intensity of the yellow color developed on the paper test was consistent and proportional to the amount of artesunate present in the sample. With artesunate concentrations ranging from 0.0 to 20mg/mL, a linear calibration plot was obtained with a detection limit of 0.98 mg/mL. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. The novel approach to enhance seed security: dual anti-counterfeiting methods applied on tobacco pelleted seeds.

    Directory of Open Access Journals (Sweden)

    Yajing Guan

    Full Text Available Seed security is of prime importance for agriculture. To protect true seeds from being faked, more secure dual anti-counterfeiting technologies for tobacco (Nicotiana tabacum L. pelleted seed were developed in this paper. Fluorescein (FR, rhodamine B (RB, and magnetic powder (MP were used as anti-counterfeiting labels. According to their different properties and the special seed pelleting process, four dual-labeling treatments were conducted for two tobacco varieties, MS Yunyan85 (MSYY85 and Honghua Dajinyuan (HHDJY. Then the seed germination and seedling growth status were investigated, and the fluorescence in cracked pellets and developing seedlings was observed under different excitation lights. The results showed that FR, RB, and MP had no negative effects on the germination, seedling growth, and MDA content of the pelleted seeds, and even some treatments significantly enhanced seedling dry weight, vigor index, and shoot height in MS YY85, and increased SOD activity and chlorophyll content in HHDJY as compared to the control. In addition, the cotyledon tip of seedlings treated with FR and MP together represented bright green fluorescence under illumination of blue light (478 nm. And the seedling cotyledon vein treated with RB and MP together showed red fluorescence under green light (546 nm. All seeds pelleted with magnetic powder of proper concentration could be attracted by a magnet. Thus, it indicated that those new dual-labeling methods that fluorescent compound and magnetic powder simultaneously applied in the same seed pellets definitely improved anti-counterfeiting technology and enhanced the seed security. This technology will ensure that high quality seed will be used in the crop production.

  12. Pediatric glaucoma suspects

    Directory of Open Access Journals (Sweden)

    Kooner K

    2014-06-01

    Full Text Available Karanjit Kooner,1 Matthew Harrison,1 Zohra Prasla,1 Mohannad Albdour,1 Beverley Adams-Huet21Department of Ophthalmology, 2Department of Clinical Sciences, Division of Biostatistics, University of Texas Southwestern Medical Center, Dallas, TX, USAPurpose: To report demographic and ocular features of pediatric glaucoma suspects in an ethnically diverse population of North Central Texas.Design: Retrospective cross-sectional chart review.Participants: Subjects included 75 (136 eyes pediatric glaucoma suspects. Patients with one or more of the following risk factors were included: cup-to disc (C/D ratio of ≥0.6; intraocular pressure (IOP ≥21 mmHg; family history of glaucoma; congenital glaucoma in the opposite eye; history of blunt trauma to either eye; and presence of either Sturge–Weber or Axenfeld–Rieger syndrome, or oculodermal melanocytosis.Methods: Data were extracted from electronic patient medical records. Patient records with incomplete data were excluded. The main outcome measures were race, sex, age, IOP, C/D, family history of glaucoma; and glaucoma treatment.Results: Subjects included 28 (37.3% Hispanics, 20 (26.6% African Americans, 20 (26.6% Caucasians, and seven (9.3% Asians. Forty (53.3% of the patients were male. Suspicious optic disc was seen in 57 (76%; elevated IOP in 25 (33.3%; presence of family history in 13 (17.3%, and Sturge–Weber syndrome in nine (12% patients. The average C/D ratio was 0.58±0.2. The C/D ratios of African American (0.65±0.2, Hispanic (0.63±0.2, and Asian (0.62±0.15 patients were significantly greater than those of Caucasians (0.43±0.18; P=0.0004, 0.0003, and 0.0139, respectively. Caucasian patients were the youngest (7.9±4.8 years. Eleven cases (14.7% required medication.Conclusion: Thirty-three point seven percent of patients seen in the glaucoma clinic were glaucoma suspects. The most common risk factors for suspected glaucoma were suspicious optic discs, elevated IOP, and family history

  13. FDA, companies test RFID tracking to prevent drug counterfeiting.

    Science.gov (United States)

    James, John S

    2005-12-01

    The U.S. has an apparently growing problem with fake, counterfeit drugs entering the mainstream drug supply, and being fraudulently sold at full price in regular pharmacies and hospitals; some have no active ingredient, or too little, or substitute a cheap drug for an expensive one. The FDA has asked drug manufacturers to develop technology to track all shipments electronically as they move through the distribution chain; currently, RFID (radio frequency identification) is the preferred method for doing so. This article explains what is happening, and why we do not believe that this use of RFID is a privacy threat--though other privacy issues are among the most important questions we face today.

  14. THE EFFECT OF FACE CONSCIOUSNESS ON CONSUMPTION OF COUNTERFEIT LUXURY GOODS

    National Research Council Canada - National Science Library

    Yun-Qing Chen; Hong Zhu; Meng Le; Yi-Zhen Wu

    2014-01-01

    ... (132 and 136, respectively) to investigate the moderating role of brand prominence. The results showed that participants' face consciousness had a significant positive influence on intention to purchase counterfeit luxury goods...

  15. 31 CFR 101.4 - Extraction of gold bullion from the counterfeit coins.

    Science.gov (United States)

    2010-07-01

    ... Bureau of the Mint where, if economically feasible, the gold bullion will be extracted from the counterfeit coins. The Bureau of the Mint will then return the bullion to the Assistant Secretary. ...

  16. THE EFFECT OF FACE CONSCIOUSNESS ON CONSUMPTION OF COUNTERFEIT LUXURY GOODS

    National Research Council Canada - National Science Library

    Yun-Qing Chen; Hong Zhu; Meng Le; Yi-Zhen Wu

    2014-01-01

      The authors have conducted 3 laboratory experiments to determine how face consciousness influences the consumption of counterfeit luxury goods, along with the moderating roles of usage occasion and brand prominence...

  17. THE EFFECT OF FACE CONSCIOUSNESS ON CONSUMPTION OF COUNTERFEIT LUXURY GOODS

    National Research Council Canada - National Science Library

    Yun-Qing Chen; Hong Zhu; Meng Le; Yi-Zhen Wu

    2014-01-01

    .... The participants in the first study were 138 Chinese undergraduates who were allocated to a 2 x 2 design to evaluate their intention to purchase a counterfeit luxury item that would be used either...

  18. La falsificación: un delito grave que pasa desapercibido/Counterfeiting: a serious crime that goes unnoticed

    Directory of Open Access Journals (Sweden)

    Sandro Calvani (Italia

    2015-01-01

    Full Text Available La asociación a la delincuencia organizada es en sí misma un “factor de riesgo” para la seguridad de los ciudadanos y para el orden público. La falsificación es una actividad delictiva peligrosa porque, al copiar productos, los falsificadores causan enormes daños al mercado y ponen en grave riesgo a los consumidores. Una de las consecuencias negativas de las economías son el resultado de la pérdida de ventas que sufren los legítimos productores cmoo0 resultado de la pérdida de ventas. Otras de las consecuencias: pérdidas de puestos de trabajo e incluso disminución de las oportunidades de desarrollo e innovación. The association of the organized crime is in itself a "risk factor" for the security of citizens and the public order. Counterfeiting is a dangerous criminal activity because copying products, counterfeiters cause enormous damage to the market and puts consumers at serious risk. One of the negative consequences of economies are the result of the loss of sales suffer lost sales result cmoo0 legitimate producers. Other consequences: losses of jobs and even decrease the opportunities of development and innovation.

  19. Characterization of suspected illegal skin whitening cosmetics.

    Science.gov (United States)

    Desmedt, B; Van Hoeck, E; Rogiers, V; Courselle, P; De Beer, J O; De Paepe, K; Deconinck, E

    2014-03-01

    An important group of suspected illegal cosmetics consists of skin bleaching products, which are usually applied to the skin of the face, hands and décolleté for local depigmentation of hyper pigmented regions or more importantly, for a generalized reduction of the skin tone. These cosmetic products are suspected to contain illegal active substances that may provoke as well local as systemic toxic effects, being the reason for their banning from the EU market. In that respect, illegal and restricted substances in cosmetics, known to have bleaching properties, are in particular hydroquinone, tretinoin and corticosteroids. From a legislative point of view, all cosmetic products containing a prohibited whitening agent are illegal and must be taken off the EU market. A newly developed screening method using ultra high performance liquid chromatography-time off flight-mass spectrometry allows routine analysis of suspected products. 163 suspected skin whitening cosmetics, collected by Belgian inspectors at high risk sites such as airports and so-called ethnic cosmetic shops, were analyzed and 59% were classified as illegal. The whitening agents mostly detected were clobetasol propionate and hydroquinone, which represent a serious health risk when repeatedly and abundantly applied to the skin. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. Technology and the Glaucoma Suspect

    National Research Council Canada - National Science Library

    Blumberg, Dana M; De Moraes, Carlos Gustavo; Liebmann, Jeffrey M; Garg, Reena; Chen, Cynthia; Theventhiran, Alex; Hood, Donald C

    2016-01-01

    ...), stereoscopic disc photographs, and automated perimetry as assessed by a group of glaucoma specialists in differentiating individuals with early glaucoma from suspects. Forty-six eyes (46 patients...

  1. The location and recognition of anti-counterfeiting code image with complex background

    Science.gov (United States)

    Ni, Jing; Liu, Quan; Lou, Ping; Han, Ping

    2017-07-01

    The order of cigarette market is a key issue in the tobacco business system. The anti-counterfeiting code, as a kind of effective anti-counterfeiting technology, can identify counterfeit goods, and effectively maintain the normal order of market and consumers' rights and interests. There are complex backgrounds, light interference and other problems in the anti-counterfeiting code images obtained by the tobacco recognizer. To solve these problems, the paper proposes a locating method based on Susan operator, combined with sliding window and line scanning,. In order to reduce the interference of background and noise, we extract the red component of the image and convert the color image into gray image. For the confusing characters, recognition results correction based on the template matching method has been adopted to improve the recognition rate. In this method, the anti-counterfeiting code can be located and recognized correctly in the image with complex background. The experiment results show the effectiveness and feasibility of the approach.

  2. Medicines counterfeiting is a complex problem: a review of key challenges across the supply chain.

    Science.gov (United States)

    Tremblay, Michael

    2013-02-01

    The paper begins by asking why there is a market for counterfeit medicines, which in effect creates the problem of counterfeiting itself. Contributing factors include supply chain complexity and the lack of whole-systems thinking. These two underpin the author's view that counterfeiting is a complex (i.e. wicked) problem, and that corporate, public policy and regulatory actions need to be mindful of how their actions may be causal. The paper offers a problem-based review of key components of this complexity, viz., the knowledge end-users/consumers have of medicines; whether restrictive information policies may hamper information provision to patients; the internet's direct access to consumers; internet-enabled distribution of unsafe and counterfeit medicines; whether the internet is a parallel and competitive supply chain to legitimate routes; organised crime as an emerging medicines manufacturer and supplier and whether substandard medicines is really the bigger problem. Solutions respect the perceived complexity of the supply chain challenges. The paper identifies the need to avoid technologically-driven solutions, calling for 'technological agnosticism'. Both regulation and public policy need to reflect the dynamic nature of the problem and avoid creating perverse incentives; it may be, for instance, that medicines pricing and reimbursement policies, which affect consumer/patient access may act as market signals to counterfeiters, since this creates a cash market in cheaper drugs.

  3. Current means for raising efficiency of counteraction to counterfeit goods trafficking

    Directory of Open Access Journals (Sweden)

    Dronova O.B.

    2014-12-01

    Full Text Available The urgency of counteraction to counterfeit goods trafficking is shown. Annual loss due to counterfeit goods producing and trafficking reaches several billion dollars. There remains a danger of buying low-quality and counterfeit goods despite implementing new producing techniques and protective elements. Measures, taken by law enforcement agencies, state authorities and public human rights organizations have not led to systematic suppression of producing and trafficking of such goods. Creation of new information and reference resource, containing information blocks of protective symbols on goods and packages and illustrated materials comprising patterns of discovered counterfeit goods, can assist to increase public awareness and to give necessary information to law enforcement agencies. Organizations, realizing state and social protection of consumers and entrepreneurs, along with producers, rightholders’ representatives and law enforcement bodies can accept the responsibility of creating and functioning this information and reference system in the Internet. Such level of cooperation of all interested organizations will allow to raise efficiency of measures for counteraction to trafficking goods with violated consumer properties. The author proves the necessity to organize functioning of information and reference resource for a wide range of users. Operation of such resource should comply with main principles of generating any information resource, notably full scale, authenticity and relevance of information. The author proposes the algorithm of creating such system which provides cooperation of law enforcement agencies, producers and consumers for the purpose of preventing counterfeit goods trafficking and investigating committed crimes.

  4. Perfume fingerprinting by easy ambient sonic-spray ionization mass spectrometry: nearly instantaneous typification and counterfeit detection.

    Science.gov (United States)

    Haddad, Renato; Catharino, Rodrigo Ramos; Marques, Lygia Azevedo; Eberlin, Marcos Nogueira

    2008-11-01

    Perfume counterfeiting is an illegal worldwide practice that involves huge economic losses and potential consumer risk. EASI is a simple, easily performed and rapidly implemented desorption/ionization technique for ambient mass spectrometry (MS). Herein we demonstrate that EASI-MS allows nearly instantaneous perfume typification and counterfeit detection. Samples are simply sprayed onto a glass rod or paper surface and, after a few seconds of ambient drying, a profile of the most polar components of the perfume is acquired. These components provide unique and reproducible chemical signatures for authentic perfume samples. Counterfeiting is readily recognized since the exact set and relative proportions of the more polar chemicals, sometimes at low concentrations, are unknown or hard to reproduce by the counterfeiters and hence very distinct and variable EASI-MS profiles are observed for the counterfeit samples.

  5. Problems associated with substandard and counterfeit drugs in developing countries: a review article on global implications of counterfeit drugs in the era of antiretroviral (ARVs) drugs in a free market economy.

    Science.gov (United States)

    Nsimba, Stephen E D

    2008-12-01

    To review the global implications associated with the use of substandard and or counterfeit drugs in developing and may be developed countries. The focus of this review is particularly on antiretroviral (ARVs), antimalarials and other drugs. Review of various literatures through Pub-Med, Medline, Google and Internet search to retrieve and download published materials was done by the author of this review paper. When patients receive a counterfeit medicines, they are subjected to multiple risks. They often suffer more than just an inconvenience; as they become victims of fraud medicines and are all put at risk of adverse effects from unprescribed medicines or substandard ingredients. Additionally, patients may lose confidence in health care professionals including their physician and pharmacist, and potentially modern medicine or the pharmaceutical industry in general. Counterfeit or substandard (poor quality) drugs pose threats to society; not only to the individual in terms of the health side effects experienced, but also to the public in terms of trade relations, economic implications, and the effects on global pandemics. It is vital for suppliers, providers, and patients to be aware of current trends in counterfeiting in order to best prepare for encounters with suspicious products. Furthermore, this is an issue that needs to be continually dealt with on national and international policy levels. Developing countries should try their level best to establish good laboratories for monitoring and checking quality of all pharmaceuticals manufactured locally and those imported or donated to these countries. The Ministries of Health and all stakeholders involved in this issue must ensure that all drugs meet the set or established international standards and national standards. Failure to do so will be to misuse the hard earned forex that is normally borrowed from banks for the procurement and distribution of drugs to its people. Indeed sub-standard medications do more

  6. Counterfeit and their museums: observation of the aesthetic categories of the pirate consumption

    Directory of Open Access Journals (Sweden)

    Eneus Trindade Barreto

    2013-09-01

    Full Text Available This paper arises from discussions about consumption and piracy,analyzing the role of counterfeit museums, and their paradoxes in the way they communicating the ambivalences of meaning e types of commercial piracy; based on Lipovetsky’s thought (2004; 2007, the articles illustrates the debate about consumption and piracy with 3 museum cases in Thailand, Italy and France.

  7. Medicine authentication technology as a counterfeit medicine-detection tool: a Delphi method study to establish expert opinion on manual medicine authentication technology in secondary care.

    Science.gov (United States)

    Naughton, Bernard; Roberts, Lindsey; Dopson, Sue; Brindley, David; Chapman, Stephen

    2017-05-06

    This study aims to establish expert opinion and potential improvements for the Falsified Medicines Directive mandated medicines authentication technology. A two-round Delphi method study using an online questionnaire. Large National Health Service (NHS) foundation trust teaching hospital. Secondary care pharmacists and accredited checking technicians. Seven-point rating scale answers which reached a consensus of 70-80% with a standard deviation (SD) of <1.0. Likert scale questions which reached a consensus of 70-80%, a SD of <1.0 and classified as important according to study criteria. Consensus expert opinion has described database cross-checking technology as quick and user friendly and suggested the inclusion of an audio signal to further support the detection of counterfeit medicines in secondary care (70% consensus, 0.9 SD); other important consensus with a SD of <1.0 included reviewing the colour and information in warning pop up screens to ensure they were not mistaken for the 'already dispensed here' pop up, encouraging the dispenser/checker to act on the warnings and making it mandatory to complete an 'action taken' documentation process to improve the quarantine of potentially counterfeit, expired or recalled medicines. This paper informs key opinion leaders and decision makers as to the positives and negatives of medicines authentication technology from an operator's perspective and suggests the adjustments which may be required to improve operator compliance and the detection of counterfeit medicines in the secondary care sector. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Physical profile of counterfeit tablets Viagra® and Cialis®

    Directory of Open Access Journals (Sweden)

    Rafael Scorsatto Ortiz

    2012-09-01

    Full Text Available The profile of tablets containing an active pharmacological ingredient can be obtained using different sets of properties, including physical and chemical aspects. The first measurements carried out on tablets are the physical characteristics also called post-tabletting batch (post-TB characteristics. These data may be valuable to assist in the detection of pharmaceutical product forgery and may also be used in a forensic intelligence perspective when inserted into databases. This work is focused on the physical characteristics of Cialis® and Viagra® tablets seized by the Brazilian Federal Police in the Rio Grande do Sul state. Using the F-test (ANOVA, all samples of counterfeit Viagra® (n = 28 and Cialis® (n = 40 were well distinguished from authentic samples by the following post-TB characteristics: length (major and minor, thickness, and mass. Using the exploratory statistical technique of Hierarchical Cluster Analysis (HCA, tablets with similar physical profiles were grouped. This result may indicate a common illicit production. We observed the validity of using post-TB properties to generate - in a fast and reliable manner and with no sample preparation - a technological profile that joins itself to the other analytical methods assisting in routine forensic detection of counterfeit Viagra® and Cialis®.Perfil para medicamentos na forma farmacêutica comprimidos contendo uma substância ativa pode ser obtido usando diferentes conjuntos de propriedades, incluindo aspectos físicos e químicos. As primeiras medições realizadas em comprimidos são de características físicas, também chamadas características pós-compressão. Tais dados podem ser valiosos para auxiliar na detecção de falsificações de medicamentos e ser utilizados em uma perspectiva de inteligência forense, quando inseridos em bancos de dados. Este trabalho está focado nas características físicas dos comprimidos de Cialis® e Viagra® apreendidos pela Pol

  9. A systematic review of counterfeit and substandard medicines in field quality surveys

    Directory of Open Access Journals (Sweden)

    Alghannam AFA

    2014-09-01

    Full Text Available Abdulaziz Fahad Abdulaziz Alghannam, Zoe Aslanpour, Sara Evans, Fabrizio Schifano Department of Pharmacy, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom Objectives: Counterfeit and substandard medicines pose a great threat to public health and the economy worldwide. Reports suggest their prevalence is increasing and can no longer be ignored. A detailed account on the current nature of the problem and identification of knowledge limitations in terms of geographical location, medicine classes, and type of medicine analysis performed is not available. Our objective was to systematically review articles that have reported investigations of counterfeit and substandard medicines. Design: Systematic review. Data sources: PubMed, Scopus, and ISI Web of Knowledge. Data Selection: Prospective field quality surveys on counterfeit and substandard medicines were selected from all available records within the selected databases up to December 31, 2013. All prospective studies performing chemical analysis on medicine samples were identified using the key search terms “counterfeit” or “substandard” and “medicine” or “drug” or “pharmaceutical.” The title, abstract, and/or full articles were reviewed for relevance according to a predetermined set of inclusion and exclusion criteria. Medicines procured from the Internet are beyond the scope of this review. Results: Sixty-six research articles were found that fulfilled our inclusion criteria. The majority of medicine quality surveys were conducted in specific areas of Africa and Asia. Within these two continents, medicine quality reports covering the Northern part of Africa and the Western part of Asia in the Middle East are extremely scarce. Other continents such as North or South America and Europe were covered in limited articles, whereas the Australian continent had no reports. Moreover, most studies examined medicines that treat infectious diseases; very few articles

  10. Discrimination of whisky brands and counterfeit identification by UV-Vis spectroscopy and multivariate data analysis.

    Science.gov (United States)

    Martins, Angélica Rocha; Talhavini, Márcio; Vieira, Maurício Leite; Zacca, Jorge Jardim; Braga, Jez Willian Batista

    2017-08-15

    The discrimination of whisky brands and counterfeit identification were performed by UV-Vis spectroscopy combined with partial least squares for discriminant analysis (PLS-DA). In the proposed method all spectra were obtained with no sample preparation. The discrimination models were built with the employment of seven whisky brands: Red Label, Black Label, White Horse, Chivas Regal (12years), Ballantine's Finest, Old Parr and Natu Nobilis. The method was validated with an independent test set of authentic samples belonging to the seven selected brands and another eleven brands not included in the training samples. Furthermore, seventy-three counterfeit samples were also used to validate the method. Results showed correct classification rates for genuine and false samples over 98.6% and 93.1%, respectively, indicating that the method can be helpful for the forensic analysis of whisky samples. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. The role of individual characteristics on consumers’ counterfeit purchasing intentions: research in fashion industry

    OpenAIRE

    Turkyilmaz, Ceyda Aysuna; Uslu, Aypar

    2014-01-01

       Counterfeits   are   one   of   the   most   important   threats   for   organizations   that   have  orijinal   brands   as   their   most   valuable   assets.   In   order   to   increase   their   brands’  value,  organizations  make  several  sacrifices  and  ongoing  investments.  However,  the  demand   for   counterfeits   is   rising   all   around   the   world   which   creates   negative  consequences   for   these   organizations.   In   this   context,   knowing   the   factor...

  12. Electrospray ionization mass spectrometry fingerprinting of perfumes: Rapid classification and counterfeit detection.

    Science.gov (United States)

    Marques, Lygia de Azevedo; Catharino, Rodrigo Ramos; Bruns, Roy E; Eberlin, Marcos N

    2006-01-01

    A fast procedure to classify perfumes and identify counterfeit samples is described. Dilution of a few microL of the sample in a 1:1 methanol/water solution is followed by detection of its major polar components via direct infusion electrospray ionization mass spectrometry (ESI-MS) in the positive ion mode. As proof-of-principle cases, three famous brands of perfumes were used. The ESI+-MS fingerprints of authentic samples were very characteristic, showing distinctive sets of polar markers for each sample. Principal component analysis (PCA) placed samples of the three perfume brands in well-defined groups. Counterfeit samples were also clearly detected owing to contrasting ESI-MS fingerprints, with PCA placing these samples far away from the authentic samples. Copyright 2006 John Wiley & Sons, Ltd.

  13. Several criminal, phenomenological and etiological features of criminal offences of counterfeiting money in Kosovo

    Directory of Open Access Journals (Sweden)

    MSc. Milot Krasniqi

    2012-12-01

    Full Text Available The Republic of Kosovo is making efforts as a young state to strengthen rule of law and efficiently combat criminality in general, and specifically organized crime, as a condition for its journey towards European integration perspectives.  For a normal functioning of the economic system, the safety and protection of controlled circulation of money are of vital importance. In this direction, the state takes actions and measures to ensure that manufacturing and emissions of banknotes and bonds are undertaken by competent authorities, such as the Central Bank, and render impossible the counterfeiting of money. In Kosovo, money counterfeiting is not widely studied. Consequently, there are no recent research papers over the time when these offences have marked rather high records. This circumstance, and especially the fact that these offences are rather frequent in Kosovo, made me enter the research of this type of criminality.    Apart from principles and rules stipulated by special laws of the field of economy, protection of the economic system is also helped by the Criminal Code, which incriminates the act of counterfeit money as a criminal offence against the economic system, thereby ensuring general prevention of potential offenders, and repressive measures against confirmed offenders. Protection of economic and monetary systems is also provided upon by numerous international acts.  The paper is permeated by conclusions, analysis and independent recommendations, which I believe will contribute de lege ferrenda to criminal policies in preventing and combating this type of crime. In researching the criminal offences of counterfeiting money, I have used the method of historical materialism, dogmatic law method, statistical methods, surveys and interviews, and studies of individual cases.    From the research of this type of crime, I have concluded that these criminal offences are a serious type of crime, which may result in major individual

  14. Counterfeit Parts: DOD Needs to Improve Reporting and Oversight to Reduce Supply Chain Risk

    Science.gov (United States)

    2016-02-01

    apply to prime contractors subject to cost accounting standards on acquisitions other than small business set-asides. The cost accounting standards are...being reverse - engineered from stolen intellectual property. In addition to testing parts and working to identify emerging counterfeit threats, Naval...February 2016 GAO-16-236 United States Government Accountability Office United States Government Accountability Office Highlights of GAO-16-236, a

  15. A systematic review of counterfeit and substandard medicines in field quality surveys

    OpenAIRE

    Alghannam, Abdulaziz; Evans,Sara; Schifano,Fabrizio; Aslanpour,Zoe

    2014-01-01

    Abdulaziz Fahad Abdulaziz Alghannam, Zoe Aslanpour, Sara Evans, Fabrizio Schifano Department of Pharmacy, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom Objectives: Counterfeit and substandard medicines pose a great threat to public health and the economy worldwide. Reports suggest their prevalence is increasing and can no longer be ignored. A detailed account on the current nature of the problem and identification of knowledge limitations in terms of geographical locat...

  16. Binary temporal upconversion codes of Mn2+-activated nanoparticles for multilevel anti-counterfeiting.

    Science.gov (United States)

    Liu, Xiaowang; Wang, Yu; Li, Xiyan; Yi, Zhigao; Deng, Renren; Liang, Liangliang; Xie, Xiaoji; Loong, Daniel T B; Song, Shuyan; Fan, Dianyuan; All, Angelo H; Zhang, Hongjie; Huang, Ling; Liu, Xiaogang

    2017-10-12

    Optical characteristics of luminescent materials, such as emission profile and lifetime, play an important role in their applications in optical data storage, document security, diagnostics, and therapeutics. Lanthanide-doped upconversion nanoparticles are particularly suitable for such applications due to their inherent optical properties, including large anti-Stokes shift, distinguishable spectroscopic fingerprint, and long luminescence lifetime. However, conventional upconversion nanoparticles have a limited capacity for information storage or complexity to prevent counterfeiting. Here, we demonstrate that integration of long-lived Mn2+ upconversion emission and relatively short-lived lanthanide upconversion emission in a particulate platform allows the generation of binary temporal codes for efficient data encoding. Precise control of the particle's structure allows the excitation feasible both under 980 and 808 nm irradiation. We find that the as-prepared Mn2+-doped nanoparticles are especially useful for multilevel anti-counterfeiting with high-throughput rate of authentication and without the need for complex time-gated decoding instrumentation.Luminescent materials that are capable of binary temporal coding are desirable for multilevel anti-counterfeiting. Here, the authors engineer nanoparticles that produce binary color codes on different timescales by combining the long-lived luminescence of Mn2+ with the relatively short-lived emission of lanthanides.

  17. Traceability and Risk Analysis Strategies for Addressing Counterfeit Electronics in Supply Chains for Complex Systems.

    Science.gov (United States)

    DiMase, Daniel; Collier, Zachary A; Carlson, Jinae; Gray, Robin B; Linkov, Igor

    2016-10-01

    Within the microelectronics industry, there is a growing concern regarding the introduction of counterfeit electronic parts into the supply chain. Even though this problem is widespread, there have been limited attempts to implement risk-based approaches for testing and supply chain management. Supply chain risk management tends to focus on the highly visible disruptions of the supply chain instead of the covert entrance of counterfeits; thus counterfeit risk is difficult to mitigate. This article provides an overview of the complexities of the electronics supply chain, and highlights some gaps in risk assessment practices. In particular, this article calls for enhanced traceability capabilities to track and trace parts at risk through various stages of the supply chain. Placing the focus on risk-informed decision making through the following strategies is needed, including prioritization of high-risk parts, moving beyond certificates of conformance, incentivizing best supply chain management practices, adoption of industry standards, and design and management for supply chain resilience. © 2016 Society for Risk Analysis.

  18. Improving global health governance to combat counterfeit medicines: a proposal for a UNODC-WHO-Interpol trilateral mechanism.

    Science.gov (United States)

    Mackey, Tim K; Liang, Bryan A

    2013-10-31

    Perhaps no greater challenge exists for public health, patient safety, and shared global health security, than fake/falsified/fraudulent, poor quality unregulated drugs, also commonly known as "counterfeit medicines", now endemic in the global drug supply chain. Counterfeit medicines are prevalent everywhere, from traditional healthcare settings to unregulated sectors, including the Internet. These dangerous medicines are expanding in both therapeutic and geographic scope, threatening patient lives, leading to antimicrobial resistance, and profiting criminal actors. Despite clear global public health threats, surveillance for counterfeit medicines remains extremely limited, with available data pointing to an increasing global criminal trade that has yet to be addressed appropriately. Efforts by a variety of public and private sector entities, national governments, and international organizations have made inroads in combating this illicit trade, but are stymied by ineffectual governance and divergent interests. Specifically, recent efforts by the World Health Organization, the primary international public health agency, have failed to adequately incorporate the broad array of stakeholders necessary to combat the problem. This has left the task of combating counterfeit medicines to other organizations such as UN Office of Drugs and Crime and Interpol in order to fill this policy gap. To address the current failure of the international community to mobilize against the worldwide counterfeit medicines threat, we recommend the establishment of an enhanced global health governance trilateral mechanism between WHO, UNODC, and Interpol to leverage the respective strengths and resources of these organizations. This would allow these critical organizations, already engaged in the fight against counterfeit medicines, to focus on and coordinate their respective domains of transnational crime prevention, public health, and law enforcement field operations. Specifically, by

  19. Exploring Consumer and Patient Knowledge, Behavior, and Attitude Toward Medicinal and Lifestyle Products Purchased From the Internet: A Web-Based Survey.

    Science.gov (United States)

    Assi, Sulaf; Thomas, Jordan; Haffar, Mohamed; Osselton, David

    2016-07-18

    In recent years, lifestyle products have emerged to help improve people's physical and mental performance. The Internet plays a major role in the spread of these products. However, the literature has reported issues regarding the authenticity of medicines purchased from the Internet and the impact of counterfeit medicines on public health. Little or no data are available on the authenticity of lifestyle products and actual toxicity associated with their use and misuse. Our aim was to investigate consumer and patient attitudes toward the purchase of lifestyle products from the Internet, their knowledge of product authenticity and toxicity, and their experiences with counterfeit lifestyle products. A Web-based study was performed between May 2014 and May 2015. Uniform collection of data was performed through an anonymous online questionnaire. Participants were invited worldwide via email, social media, or personal communication to complete the online questionnaire. A total of 320 participants completed the questionnaire. The results of the questionnaire showed that 208 (65.0%) participants purchased lifestyle products from the Internet mainly due to convenience and reduced cost. More than half (55.6%, 178/320) of participants purchased cosmetic products, whereas only a minority purchased medicinal products. Yet, 62.8% (201/320) of participants were aware of the presence of counterfeit lifestyle products from the Internet, and 11.9% (38/320) experienced counterfeit products. In only 0.9% (3/320) of those cases were counterfeit lifestyle products reported to authorities. Moreover, 7.2% (23/320) of the participants experienced adverse effects due to counterfeit lifestyle products. In summary, patients experienced counterfeit lifestyle products that resulted in adverse effects on their health. Although certain adverse effects were reported in this study, counterfeit products were underreported to authorities. Further public awareness campaigns and patient education are

  20. Exploring Consumer and Patient Knowledge, Behavior, and Attitude Toward Medicinal and Lifestyle Products Purchased From the Internet: A Web-Based Survey

    Science.gov (United States)

    Thomas, Jordan

    2016-01-01

    Background In recent years, lifestyle products have emerged to help improve people’s physical and mental performance. The Internet plays a major role in the spread of these products. However, the literature has reported issues regarding the authenticity of medicines purchased from the Internet and the impact of counterfeit medicines on public health. Little or no data are available on the authenticity of lifestyle products and actual toxicity associated with their use and misuse. Objective Our aim was to investigate consumer and patient attitudes toward the purchase of lifestyle products from the Internet, their knowledge of product authenticity and toxicity, and their experiences with counterfeit lifestyle products. Methods A Web-based study was performed between May 2014 and May 2015. Uniform collection of data was performed through an anonymous online questionnaire. Participants were invited worldwide via email, social media, or personal communication to complete the online questionnaire. A total of 320 participants completed the questionnaire. Results The results of the questionnaire showed that 208 (65.0%) participants purchased lifestyle products from the Internet mainly due to convenience and reduced cost. More than half (55.6%, 178/320) of participants purchased cosmetic products, whereas only a minority purchased medicinal products. Yet, 62.8% (201/320) of participants were aware of the presence of counterfeit lifestyle products from the Internet, and 11.9% (38/320) experienced counterfeit products. In only 0.9% (3/320) of those cases were counterfeit lifestyle products reported to authorities. Moreover, 7.2% (23/320) of the participants experienced adverse effects due to counterfeit lifestyle products. Conclusions In summary, patients experienced counterfeit lifestyle products that resulted in adverse effects on their health. Although certain adverse effects were reported in this study, counterfeit products were underreported to authorities. Further

  1. Over-the-counter sales of out-of-state and counterfeit tax stamp cigarettes in New York City.

    Science.gov (United States)

    Silver, Diana; Giorgio, Margaret M; Bae, Jin Yung; Jimenez, Geronimo; Macinko, James

    2016-09-01

    New York City (NYC) has strict minimum cigarette price and tax stamp laws, but evidence regarding the extent of evasion of such laws in over-the-counter sales is scarce. 830 packs were purchased at licensed tobacco retailers at 92 randomly selected neighbourhoods in NYC in spring and fall 2014, following the establishment of NYC's minimum price law. The χ(2) analyses of illegal tax stamps on pack, by retailer type and data collection period, are presented. Over 15% of packs purchased had out-of-state (4.5%) or counterfeit tax stamps (10.6%). Purchases resulted in at least one illegal pack obtained in 70% of neighbourhoods, largely from independent stores. In 21.5% of sampled neighbourhoods, it was possible to purchase an illegal pack each collection period. Enhanced enforcement of retail sales of cigarettes is needed to ensure the full benefit of existing tobacco control laws in NYC. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Novel techniques with multiphoton microscopy: Deep-brain imaging with microprisms, neurometabolism of epilepsy, and counterfeit paper money detection

    Science.gov (United States)

    Chia, Thomas H.

    Multiphoton microscopy is a laser-scanning fluorescence imaging method with extraordinary potential. We describe three innovative multiphoton microscopy techniques across various disciplines. Traditional in vivo fluorescence microscopy of the mammalian brain has a limited penetration depth (epilepsy. Results indicated significant changes in the neurometabolism of astrocytes and neuropil in the cell and dendritic layers of the hippocampus when compared to control tissue. Data obtained with NADH FLIM were subsequently interpreted based on the abnormal activity reported in epileptic tissue. Genuine U.S. Federal Reserve Notes have a consistent, two-component intrinsic fluorescence lifetime. This allows for detection of counterfeit paper money because of its significant differences in fluorescence lifetime when compared to genuine paper money. We used scanning multiphoton laser excitation to sample a ˜4 mm2 region from 54 genuine Reserve Notes. Three types of counterfeit samples were tested. Four out of the nine counterfeit samples fit to a one-component decay. Five out of nine counterfeit samples fit to a two-component model, but are identified as counterfeit due to significant deviations in the longer lifetime component compared to genuine bills.

  3. 9 CFR 354.123 - Segregation of suspects on ante-mortem inspection.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Segregation of suspects on ante-mortem inspection. 354.123 Section 354.123 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... Inspection Procedures; Ante-Mortem Inspections § 354.123 Segregation of suspects on ante-mortem inspection...

  4. 9 CFR 381.72 - Segregation of suspects on ante mortem inspection.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Segregation of suspects on ante mortem inspection. 381.72 Section 381.72 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT... Inspection § 381.72 Segregation of suspects on ante mortem inspection. (a) All birds, except ratites, that on...

  5. Substandard, Spurious, Falsely-Labelled, Falsified and Counterfeit (SSFFC Drugs: Time to Take a Bitter Pill

    Directory of Open Access Journals (Sweden)

    Geetha Mani

    2016-10-01

    Full Text Available Substandard, Spurious, Falsely-Labelled, Falsified and Counterfeit (SSFFC drugs are an emerging public health concern in India. With one of the huge pharmaceutical sectors in the world, India has a varied prevalence of SSSFC drugs ranging from 0.04% to 34% according to various studies. Apart from severe health consequences, SSSFC drugs also weaken community's trust in the health care system. India is tackling the epidemic of SSSFC drugs through various existing and new regulatory measures. Considering the calamitous consequences of this silent epidemic, it is time to prescribe a bitter pill.

  6. Los medicamentos falsificados en Perú Counterfeit pharmaceuticals in Peru

    Directory of Open Access Journals (Sweden)

    Luis E. Moreno Exebio

    2010-02-01

    cierta sofisticación en el proceso de falsificación. La falsificación de medicamentos que salvan vidas, como los antimicrobianos, representa un peligro serio de salud pública.OBJECTIVE: To determine the quantity of counterfeit pharmaceutical drugs found by the National Quality Control Center (Centro Nacional de Control de Calidad (CNCC, Instituto Nacional de Salud, Peru during the period from 2005&2008, and the types and properties of these drugs. METHODS: A form was created to amass the relevant data collected directly from CNCC reports. The reports underwent a review and analysis process, and where counterfeiting was confirmed, it was categorized by type into one of four groups. RESULTS: The percentage of counterfeit drugs relative to the total drugs evaluated was: 3.0% in 2005, 5.0% in 2006, 7.3% in 2007, and 9.2% in 2008. The main groups of counterfeit drugs, classified according to the World Health Organization Anatomical Therapeutic Chemical Classification System, were: alimentary tract and metabolism, 34.5% (29.1%&39.8%; antiinfectives for systemic use, 21.1% (16.5%&25.7%; nervous system, 17.1% (12.8%&21.3%; and musculo-skeletal system, 15.4% (11.3%&19.5%. The most common type of forgery occurred in cases where the drug contained the correct amount of active ingredients, but the manufacturer was one other than the one indicated (62.4% of the total counterfeit drugs; and medications that did not contain any active ingredient (22.4%. Of the counterfeit drugs, 61.0% (56.0%&67.0% were national brands and 39.0%, (33.0%&44.0% were imported. The pharmaceutical formulations with the highest rate of forgery were tablets, 66.0% (60.0%&71.0%; injectables, 19.0% (14.0%&23.0%; and capsules 7.0% (4.0%&10.0%. CONCLUSIONS: From 2005&2008, drug counterfeiting had an average annual variation of 45%. Drug counterfeiting was shown to be most prevalent among national brands& as opposed to imported medications&although the types and formulations of the fake drugs attest to a

  7. The economics of counterfeit Avastin: a geospatial and statistical analysis of demographic correlates to FDA warning letters.

    Science.gov (United States)

    Cuomo, Raphael E; Mackey, Tim K; Stigler, Paula

    2015-07-01

    In 2012, the Food and Drug Administration (FDA) sent warning notices to clinics and medical practitioners that may have purchased or administered counterfeited versions of the angiogenesis cancer drug Avastin Genentech, South San Francisco, California, USA. The purpose of this study was to explore potential differences in demographic, economic, and healthcare coverage characteristics between areas that received these counterfeit warning notices and those that did not receive notices. The aims of this study are to improve future counterfeit drug surveillance and better assess potential risk factors associated with counterfeit cancer drugs. Addresses for warning notices sent to healthcare practitioners were obtained from the FDA and then geocoded using arcgis. Variables chosen for statistical and geospatial analyses were then identified and assessed based on their potential association with Avastin access and affordability. These variables included demographic and economic factors (percent below the poverty line, percent uninsured, and median household income) and healthcare coverage data (percent Medicare enrollees) available from the US Center for Medicare and Medicaid Services. All variables were analyzed at the US county level. Our analysis uncovered 401 distinct US counties where the FDA sent at least one counterfeit Avastin warning notice. A hot spot analysis of notices and variables was carried out using arcgis software to identify and visualize risk features with high and low values of clustering. In a multiple logistic regression model reassessing visually observed geospatial associations, the receipt of a notice was not significantly associated with percent uninsured (p = 0.3121), but was significantly associated with percent Medicare enrollees (OR = 0.874 per 10% increase; p = 0.0121), individuals below federal poverty line (OR = 2.990 per 10% increase; p economic and demographic factors are potentially associated with counterfeit Avastin

  8. Addressing Counterfeit Parts in the DoD Supply Chain

    Science.gov (United States)

    2014-03-01

    foreign parts. Yet objections to “buying foreign” are voiced repeatedly within American defense circles, wasting valuable time and resources...burgeoning practice of harvesting and, often, repurposing electronic waste or “e- waste ” (e.g., discarded computers, office electronic equipment...not recuperate given current policy. Holding contractors liable for parts and product nonconformance and improving contractor oversight through the

  9. Drug-laden 3D biodegradable label using QR code for anti-counterfeiting of drugs.

    Science.gov (United States)

    Fei, Jie; Liu, Ran

    2016-06-01

    Wiping out counterfeit drugs is a great task for public health care around the world. The boost of these drugs makes treatment to become potentially harmful or even lethal. In this paper, biodegradable drug-laden QR code label for anti-counterfeiting of drugs is proposed that can provide the non-fluorescence recognition and high capacity. It is fabricated by the laser cutting to achieve the roughness over different surface which causes the difference in the gray levels on the translucent material the QR code pattern, and the micro mold process to obtain the drug-laden biodegradable label. We screened biomaterials presenting the relevant conditions and further requirements of the package. The drug-laden microlabel is on the surface of the troches or the bottom of the capsule and can be read by a simple smartphone QR code reader application. Labeling the pill directly and decoding the information successfully means more convenient and simple operation with non-fluorescence and high capacity in contrast to the traditional methods. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. International, European and U.S. perspectives on the negotiation and adoption of the Anti-Counterfeiting Trade Agreement (ACTA)

    NARCIS (Netherlands)

    Eckes, C.; Fahey, E.; Kanetake, M.

    2012-01-01

    The negotiation and conclusion of the Anti-Counterfeiting Trade Agreement (ACTA) has generated fierce controversy and political protest around the globe. Its main aim is the improvement of the domestic enforcement of intellectual property (IP) rights. This paper analyzes in detail the secretive

  11. Suspected levamisole intoxication in calves.

    Science.gov (United States)

    Müller, K R; Dwyer, C

    2016-07-01

    A group of 32 Friesian and four Hereford calves, 3-4 months old with body weights between 100-120 kg, were purchased from a weaner sale. On arrival at the property the Hereford calves were treated with a combination anthelmintic containing 2 g/L abamectin and 80 g/L levamisole hydrochloride. Shortly afterwards they developed tremors and frothing from the mouth, and two died overnight. The Friesian calves were treated with the same anthelmintic on the following day, when some showed hypersalivation and frothing from the mouth. Examination of the three most severely affected Friesian calves revealed severe nicotinic-type symptoms including hypersalivation, frothing from the mouth, muscle tremors, recumbency, rapid respiration, hyperaesthesia, and central nervous system depression. Other calves showed mild to moderate signs of intoxication including restlessness, tail switching, salivation, tremors, frequent defaecation, mild colic and jaw chomping. Two calves died shortly afterwards. An adverse drug event investigation revealed that the formulation and quality of the anthelmintic was within the correct specification, and that the drench gun was functioning correctly. Suspected levamisole intoxication due to a combination of possible overdosing, dehydration, and stress caused by transportation and prolonged yarding. Susceptibility to levamisole toxicity in New Zealand calves can be increased if factors like dehydration or stress are present. Levamisole has a narrow margin of safety, and overdosing in calves can easily occur if the dose rate is not based on their actual weight or health status.

  12. Three-dimensional quick response code based on inkjet printing of upconversion fluorescent nanoparticles for drug anti-counterfeiting

    Science.gov (United States)

    You, Minli; Lin, Min; Wang, Shurui; Wang, Xuemin; Zhang, Ge; Hong, Yuan; Dong, Yuqing; Jin, Guorui; Xu, Feng

    2016-05-01

    Medicine counterfeiting is a serious issue worldwide, involving potentially devastating health repercussions. Advanced anti-counterfeit technology for drugs has therefore aroused intensive interest. However, existing anti-counterfeit technologies are associated with drawbacks such as the high cost, complex fabrication process, sophisticated operation and incapability in authenticating drug ingredients. In this contribution, we developed a smart phone recognition based upconversion fluorescent three-dimensional (3D) quick response (QR) code for tracking and anti-counterfeiting of drugs. We firstly formulated three colored inks incorporating upconversion nanoparticles with RGB (i.e., red, green and blue) emission colors. Using a modified inkjet printer, we printed a series of colors by precisely regulating the overlap of these three inks. Meanwhile, we developed a multilayer printing and splitting technology, which significantly increases the information storage capacity per unit area. As an example, we directly printed the upconversion fluorescent 3D QR code on the surface of drug capsules. The 3D QR code consisted of three different color layers with each layer encoded by information of different aspects of the drug. A smart phone APP was designed to decode the multicolor 3D QR code, providing the authenticity and related information of drugs. The developed technology possesses merits in terms of low cost, ease of operation, high throughput and high information capacity, thus holds great potential for drug anti-counterfeiting.Medicine counterfeiting is a serious issue worldwide, involving potentially devastating health repercussions. Advanced anti-counterfeit technology for drugs has therefore aroused intensive interest. However, existing anti-counterfeit technologies are associated with drawbacks such as the high cost, complex fabrication process, sophisticated operation and incapability in authenticating drug ingredients. In this contribution, we developed a

  13. Newton and the counterfeiter the unknown detective career of the world's greatest scientist

    CERN Document Server

    Levenson, Thomas

    2010-01-01

    In 1695, Isaac Newton-already renowned as the greatest mind of his age-made a surprising career change. He left quiet Cambridge, where he had lived for thirty years and made his earth-shattering discoveries, and moved to London to take up the post of Warden of His Majesty's Mint. Newton was preceded to the city by a genius of another kind, the budding criminal William Chaloner. Thanks to his preternatural skills as a counterfeiter, Chaloner was rapidly rising in London's highly competitive underworld, at a time when organized law enforcement was all but unknown and money in the modern sense was just coming into being. Then he crossed paths with the formidable new warden. In the courts and streets of London-and amid the tremors of a world being transformed by the ideas Newton himself had set in motion-the two played out an epic game of cat and mouse.

  14. Diffusion of counterfeit drugs in developing countries and stability of galenics stored for months under different conditions of temperature and relative humidity

    National Research Council Canada - National Science Library

    Baratta, Francesca; Germano, Antonio; Brusa, Paola

    2012-01-01

    To investigate the diffusion of counterfeit medicines in developing countries and to verify the stability of galenic dosage forms to determine the stability of galenics prepared and stored in developing countries...

  15. Enhanced anti-counterfeiting measures for additive manufacturing: coupling lanthanide nanomaterial chemical signatures with blockchain technology

    Energy Technology Data Exchange (ETDEWEB)

    Kennedy, Zachary C.; Stephenson, David E.; Christ, Josef F.; Pope, Timothy R.; Arey, Bruce W.; Barrett, Christopher A.; Warner, Marvin G.

    2017-08-18

    The significant rise of additive manufacturing (AM) in recent years is in part due to the open sourced nature of the printing processes and reduced cost and capital barriers relative to traditional manufacturing. However, this democratization of manufacturing spurs an increased demand for producers and end-users to verify the authenticity and quality of individual parts. To this end, we introduce an anti-counterfeiting method composed of first embedding engineered nanomaterials into features of a 3D-printed part followed by non-destructive interrogation of these features to quantify a chemical signature profile. The part specific chemical signature data is then linked to a securitized, distributed, and time-stamped blockchain ledger entry. To demonstrate the utility of this approach, lanthanide-aspartic acid nanoscale coordination polymers (Ln3+- Asp NCs) / poly(lactic) acid (PLA) composites were formulated and transformed into a filament feedstock for fused deposition modeling (FDM) 3D printing. In the present case, a quick-response (QR) code containing the doped Ln3+-Asp NCs was printed using a dual-extruder FDM printer into pure PLA parts. The QR code provides a searchable reference to an Ethereum-based blockchain entry. The QR code physical features also serve as defined areas to probe the signatures arising from the embedded Ln3+-Asp NCs. Visible fluorescence emission with UV-excitation was quantified in terms of color using a smartphone camera and incorporated into blockchain entries. Ultimately, linking unique chemical signature data to blockchain databases is anticipated to make the costs of counterfeiting AM materials significantly more prohibitive and transactions between those in the supply chain more trustworthy.

  16. A case of suspect “cyanosis”

    OpenAIRE

    Elisabetta Antonucci; Matteo Conte; Michele Di Pumpo; Giuseppe Antonucci

    2013-01-01

    CLINICAL CASE A 70-year old woman was admitted to our hospital because of fever, asthenia and a suspected stroke. Her medical history showed a congenital cardiopathy (Patent Foramen Ovale, PFO). Skin and oral mucosa pigmentation, orthostatic hypotension, hypoglycemia and hyponatriemia arose the suspect of Addison’s disease. The diagnosis was confirmed by the evaluation of basal levels of plasma ACTH and serum cortisol, and serum cortisol levels after ACTH stimulation. Abdominal CT scan showed...

  17. Not All Parts Are Created Equal: The Impact Of Counterfeit Parts In The Air Force Supply Chain

    Science.gov (United States)

    2017-04-06

    Supply Chain. (Center for Public Policy and Private Enterprise . College Park, MD: University of Maryland, 2014), 5. 6 Senate Committee On Armed...Public Policy and Private Enterprise . College Park, MD: University of Maryland, 2014. Global Intellectual Property Center. Measuring the magnitude of...AIR WAR COLLEGE AIR UNIVERSITY NOT ALL PARTS ARE CREATED EQUAL. THE IMPACT OF COUNTERFEIT PARTS IN THE AIR FORCE SUPPLY CHAIN by

  18. Use of CdS quantum dot-functionalized cellulose nanocrystal films for anti-counterfeiting applications.

    Science.gov (United States)

    Chen, L; Lai, C; Marchewka, R; Berry, R M; Tam, K C

    2016-07-21

    Structural colors and photoluminescence have been widely used for anti-counterfeiting and security applications. We report for the first time the use of CdS quantum dot (QD)-functionalized cellulose nanocrystals (CNCs) as building blocks to fabricate nanothin films via layer-by-layer (LBL) self-assembly for anti-counterfeiting applications. Both negatively- and positively-charged CNC/QD nanohybrids with a high colloidal stability and a narrow particle size distribution were prepared. The controllable LBL coating process was characterized by scanning electron microscopy and ellipsometry. The rigid structure of CNCs leads to nanoporous structured films on poly(ethylene terephthalate) (PET) substrates with high transmittance (above 70%) over the entire range of visible light and also resulted in increased hydrophilicity (contact angles of ∼40 degrees). Nanothin films on PET substrates showed good flexibility and enhanced stability in both water and ethanol. The modified PET films with structural colors from thin-film interference and photoluminescence from QDs can be used in anti-counterfeiting applications.

  19. CUE: counterfeit-resistant usable eye movement-based authentication via oculomotor plant characteristics and complex eye movement patterns

    Science.gov (United States)

    Komogortsev, Oleg V.; Karpov, Alexey; Holland, Corey D.

    2012-06-01

    The widespread use of computers throughout modern society introduces the necessity for usable and counterfeit-resistant authentication methods to ensure secure access to personal resources such as bank accounts, e-mail, and social media. Current authentication methods require tedious memorization of lengthy pass phrases, are often prone to shouldersurfing, and may be easily replicated (either by counterfeiting parts of the human body or by guessing an authentication token based on readily available information). This paper describes preliminary work toward a counterfeit-resistant usable eye movement-based (CUE) authentication method. CUE does not require any passwords (improving the memorability aspect of the authentication system), and aims to provide high resistance to spoofing and shoulder-surfing by employing the combined biometric capabilities of two behavioral biometric traits: 1) oculomotor plant characteristics (OPC) which represent the internal, non-visible, anatomical structure of the eye; 2) complex eye movement patterns (CEM) which represent the strategies employed by the brain to guide visual attention. Both OPC and CEM are extracted from the eye movement signal provided by an eye tracking system. Preliminary results indicate that the fusion of OPC and CEM traits is capable of providing a 30% reduction in authentication error when compared to the authentication accuracy of individual traits.

  20. The phenomenology of specialization of criminal suspects.

    Directory of Open Access Journals (Sweden)

    Michele Tumminello

    Full Text Available A criminal career can be either general, with the criminal committing different types of crimes, or specialized, with the criminal committing a specific type of crime. A central problem in the study of crime specialization is to determine, from the perspective of the criminal, which crimes should be considered similar and which crimes should be considered distinct. We study a large set of Swedish suspects to empirically investigate generalist and specialist behavior in crime. We show that there is a large group of suspects who can be described as generalists. At the same time, we observe a non-trivial pattern of specialization across age and gender of suspects. Women are less prone to commit crimes of certain types, and, for instance, are more prone to specialize in crimes related to fraud. We also find evidence of temporal specialization of suspects. Older persons are more specialized than younger ones, and some crime types are preferentially committed by suspects of different ages.

  1. The counterfeit anti-malarial is a crime against humanity: a systematic review of the scientific evidence.

    Science.gov (United States)

    Karunamoorthi, Kaliyaperumal

    2014-06-02

    The counterfeiting of anti-malarials represents a form of attack on global public health in which fake and substandard anti-malarials serve as de facto weapons of mass destruction, particularly in resource-constrained endemic settings, where malaria causes nearly 660,000 preventable deaths and threatens millions of lives annually. It has been estimated that fake anti-malarials contribute to nearly 450,000 preventable deaths every year. This crime against humanity is often underestimated or ignored. This study attempts to describe and characterize the direct and indirect effects of counterfeit anti-malarials on public health, clinical care and socio-economic conditions. A search was performed using key databases, WHO documents, and English language search engines. Of 262 potential articles that were identified using a fixed set of criteria, a convenience sample of 105 appropriate articles was selected for this review. Artemisinin-based combination therapy (ACT) is an important tool in the fight against malaria, but a sizable number of patients are unable to afford to this first-line treatment. Consequently, patients tend to procure cheaper anti-malarials, which may be fake or substandard. Forensic palynology reveals that counterfeits originate in Asia. Fragile drug regulations, ineffective law-enforcement agencies and corruption further burden ailing healthcare facilities. Substandard/fake anti-malarials can cause (a) economic sabotage; (b) therapeutic failure; (c) increased risk of the emergence and spread of resistant strains of Plasmodium falciparum and Plasmodium vivax; (d) an undermining of trust/confidence in healthcare stakeholders/systems; and, (e) serious side effects or death. Combating counterfeit anti-malarials is a complex task due to limited resources and poor techniques for the detection and identification of fake anti-malarials. This situation calls for sustainable, global, scientific research and policy change. Further, responsible stakeholders in

  2. A case of suspect “cyanosis”

    Directory of Open Access Journals (Sweden)

    Elisabetta Antonucci

    2013-05-01

    Full Text Available CLINICAL CASE A 70-year old woman was admitted to our hospital because of fever, asthenia and a suspected stroke. Her medical history showed a congenital cardiopathy (Patent Foramen Ovale, PFO. Skin and oral mucosa pigmentation, orthostatic hypotension, hypoglycemia and hyponatriemia arose the suspect of Addison’s disease. The diagnosis was confirmed by the evaluation of basal levels of plasma ACTH and serum cortisol, and serum cortisol levels after ACTH stimulation. Abdominal CT scan showed atrophy and calcification of adrenal glands. CONCLUSIONS In most cases, Addison’s disease is provoked by autoimmune destruction of the adrenal cortex; however, in our reported patient, tuberculosis could be a possible cause.

  3. Identification of Microorganisms Isolated From Counterfeit and Unapproved Decorative Contact Lenses.

    Science.gov (United States)

    Land, Adrian D; Penno, Katie L; Brzezinski, Jennifer L

    2017-05-24

    All contact lenses (corrective/noncorrective) are considered Class II or Class III medical devices under the Federal Food, Drug, and Cosmetic Act, which also states that contact lenses can only be obtained with a prescription. The Forensic Chemistry Center of the US Food & Drug Administration has examined over 300 decorative, noncorrective contact lenses obtained without a prescription. Our observations indicate that 60% of the counterfeit lenses and 27% of the unapproved lenses examined were positive for microbial contamination. Twenty-nine different brands of noncorrective contact lenses were examined, and 48% of them had at least one sample positive for microbial contamination. Each microorganism was further identified using DNA sequencing. Contaminated contact lenses are associated with numerous health risks, including ocular infections and conjunctivitis leading to permanent visual impairment or blindness. These results support the contention that acquiring contact lenses without a prescription is a considerable threat to consumer health and safety. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  4. A simple and rapid liquid chromatographic assay for evaluation of potentially counterfeit Tamiflu.

    Science.gov (United States)

    Lindegårdh, N; Hien, T T; Farrar, J; Singhasivanon, P; White, N J; Day, N P J

    2006-10-11

    A simple and rapid liquid chromatographic assay for the evaluation of potentially counterfeit oseltamivir (Tamiflu has been developed and assessed. The assay uses approximately 1mg Tamiflu powder when used for authentication and content estimate. The procedure was validated using 50 replicates analysed during five independent series with a total R.S.D. of 11.2%. The assay can also be used to monitor the exact content of oseltamivir in Tamiflu capsules. One Tamiflu capsule was transferred to a 250mL volumetric flask and 150mL water was added. The flask was placed in an ultrasonic bath at 40 degrees C for 20min to dissolve the capsule. The solution was allowed to cool to room temperature before the flask was filled up to the mark (250mL). A small aliquot was centrifuged and then directly injected into the LC-system for quantification. Oseltamivir was analysed by liquid chromatography with UV detection on a Hypersil Gold column (150mmx4.6mm) using a mobile phase containing methanol-phosphate buffer (pH 2.5; 0.1M) (50:50, v/v) at a flow rate of 1.0mL/min. The assay was implemented for the analysis of Tamiflu purchased over the Internet and at local pharmacies in Thailand and Vietnam.

  5. Validated spectrophotometric methods for the evaluation of Oseltamivir counterfeit pharmaceutical capsules

    Directory of Open Access Journals (Sweden)

    Rasha M. Youssef

    2014-06-01

    Full Text Available Four rapid, reliable and economical spectrophotometric methods have been established for the quantitative determination of Oseltamivir phosphate (OST without the interference of ascorbic acid (ASC found in some of its counterfeit capsules. The first method involves the use of derivative spectrophotometry with the zero-crossing technique where OST was easily determined using its 1D (Δλ = 3 at 219 nm. The second method is based on a first-order derivative ratio spectrophotometry (1DD, Δλ = 5 where 218 nm was selected for its quantification, while the third method applies a more advanced spectrophotometric method based on the ratio difference spectrophotometry (RD in which the difference in absorbance ratio was measured between 217 and 210 nm. In the fourth method, difference spectrophotometric method (ΔA is applied by subtracting absorbance at 252 from that at 263 nm where the difference in absorbance was zero for ASC. The proposed methods were validated for linearity, accuracy, precision and selectivity. Synthetic mixtures of different proportions and commercial capsules were assayed by the proposed methods and the results revealed good accuracy and repeatability of the developed methods.

  6. Quantitative energy-dispersive x-ray diffraction for identification of counterfeit medicines: a preliminary study

    Science.gov (United States)

    Crews, Chiaki C. E.; O'Flynn, Daniel; Sidebottom, Aiden; Speller, Robert D.

    2015-06-01

    The prevalence of counterfeit and substandard medicines has been growing rapidly over the past decade, and fast, nondestructive techniques for their detection are urgently needed to counter this trend. In this study, energy-dispersive X-ray diffraction (EDXRD) combined with chemometrics was assessed for its effectiveness in quantitative analysis of compressed powder mixtures. Although EDXRD produces lower-resolution diffraction patterns than angular-dispersive X-ray diffraction (ADXRD), it is of interest for this application as it carries the advantage of allowing the analysis of tablets within their packaging, due to the higher energy X-rays used. A series of caffeine, paracetamol and microcrystalline cellulose mixtures were prepared with compositions between 0 - 100 weight% in 20 weight% steps (22 samples in total, including a centroid mixture), and were pressed into tablets. EDXRD spectra were collected in triplicate, and a principal component analysis (PCA) separated these into their correct positions in the ternary mixture design. A partial least-squares (PLS) regression model calibrated using this training set was validated using both segmented cross-validation, and with a test set of six samples (mixtures in 8:1:1 and 5⅓:2⅓:2⅓ ratios) - the latter giving a root-mean square error of prediction (RMSEP) of 1.30, 2.25 and 2.03 weight% for caffeine, paracetamol and cellulose respectively. These initial results are promising, with RMSEP values on a par with those reported in the ADXRD literature.

  7. Percutaneous cholecystocentesis in cats with suspected hepatobiliary disease.

    Science.gov (United States)

    Byfield, Victoria L; Callahan Clark, Julie E; Turek, Bradley J; Bradley, Charles W; Rondeau, Mark P

    2017-12-01

    Objectives The objective was to evaluate the safety and diagnostic utility of percutaneous ultrasound-guided cholecystocentesis (PUC) in cats with suspected hepatobiliary disease. Methods Medical records of 83 cats with suspected hepatobiliary disease that underwent PUC were retrospectively reviewed. Results At the time of PUC, at least one additional procedure was performed in 79/83 cats, including hepatic aspiration and/or biopsy (n = 75) and splenic aspiration (n = 18). Complications were noted in 14/83 cases, including increased abdominal fluid (n = 11), needle-tip occlusion (n = 1), failed first attempt to penetrate the gall bladder wall (n = 1) and pneumoperitoneum (n = 1). There were no reports of gall bladder rupture, bile peritonitis or hypotension necessitating treatment with vasopressor medication. Blood products were administered to 7/83 (8%) cats. Seventy-two cats (87%) survived to discharge. Of the cats that were euthanized (9/83) or died (2/83), none were reported as a definitive consequence of PUC. Bacteria were identified cytologically in 10/71 samples (14%); all 10 had a positive aerobic bacterial culture. Bile culture was positive in 11/80 samples (14%). Of the cases with a positive bile culture, cytological description of bacteria corresponded to the organism cultured in fewer than 50% of cases. The most common cytologic diagnosis was hepatic lipidosis (49/66). The most common histopathologic diagnosis was cholangitis (10/21). Conclusions and relevance PUC was safe in this group of cats with suspected hepatobiliary disease. Complications were likely associated with ancillary procedures performed at the time of PUC. Bile analysis yielded an abnormal result in nearly one-third of cats with suspected hepatobiliary disease. Complete agreement between bile cytology and culture was lacking. Further evaluation of the correlation between bile cytology and bile culture is warranted.

  8. Congenital Malaria Among Newborns Admitted for Suspected ...

    African Journals Online (AJOL)

    Background: Signs and symptoms of congenital malaria do not differ much from those of neonatal sepsis: both can co-exist, and most times very difficult to differentiate clinically. Objective: To document the prevalence, risk factors for congeni tal malar ia among neonates admitted for suspected neonatal sepsis, and ...

  9. Congenital Malaria Among Newborns Admitted for Suspected ...

    African Journals Online (AJOL)

    None of the clinical feature had good sensitivity, specificity or predictive value for congenital malaria, and only 1.6% death was recorded in a baby with high parasite density. Conclusion: Congenital malaria is common in newborns with suspected neonatal sepsis. History of peripartum pyrexia, prematurity and intrauterine ...

  10. MRI for clinically suspected appendicitis during pregnancy.

    NARCIS (Netherlands)

    Cobben, L.P.; Groot, I.; Haans, L.; Blickman, J.G.; Puylaert, J.

    2004-01-01

    OBJECTIVE: The purpose of this study was to evaluate whether MRI can be used to accurately diagnose or exclude appendicitis in pregnant patients with clinically suspected appendicitis. CONCLUSION: Our results suggest that MRI is helpful in the examination and diagnosis of acute appendicitis in

  11. Biomechanical properties of keratoconus suspect eyes.

    Science.gov (United States)

    Saad, Alain; Lteif, Yara; Azan, Elodie; Gatinel, Damien

    2010-06-01

    Measuring corneal biomechanical properties may help detect keratoconus suspect corneas and eliminate the risk of ectasia after LASIK. Data of 504 eyes separated into three groups were retrospectively reviewed: normal (n = 252), keratoconus suspect (n = 80), and keratoconus (n = 172). Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured with an ocular biomechanics analyzer. Mean corneal hysteresis was 10.6 +/- 1.4 (SD) mm Hg in the normal group, compared with 10.0 +/- 1.6 mm Hg in the keratoconus suspect group and 8.1 +/- 1.4 mm Hg in the keratoconus group. The mean CRF was 10.6 +/- 1.6 mm Hg in the normal group compared with 9.7 +/- 1.7 in the keratoconus suspect group and 7.1 +/- 1.6 mm Hg in the keratoconus group. Mean CH and CRF were significantly different between the three groups (P corneas. Analyzing signal curves obtained with the biomechanics analyzer may provide additional valuable information for selecting qualified patients for refractive surgery.

  12. Suspecting Neurological Dysfunction From E Mail Messages ...

    African Journals Online (AJOL)

    A non medical person suspected and confirmed neurological dysfunction in an individual, based only on e mail messages sent by the individual. With email communication becoming rampant “peculiar” email messages may raise the suspicion of neurological dysfunction. Organic pathology explaining the abnormal email ...

  13. Serialization, where automation and it collide: if your company has a serialization project, or is starting one, to prevent counterfeits, ensure the manufacturing IT and automation groups are involved early in the project

    National Research Council Canada - National Science Library

    Brandl, Dennis

    2014-01-01

    ..., and engine oil in olive oil. Mechanical device counterfeits can also be deadly when they are used in automobiles, trucks, ships, airplanes, turbines, and rotating machinery. For example, the Automotive Component Manufacturers Association of India has reported that up to 20% of all road accidents that occur in India are due to counterfeit auto...

  14. GC-MS quantitative analysis of black market pharmaceutical products containing anabolic androgenic steroids seized by the Brazilian Federal Police.

    Science.gov (United States)

    Neves, Diana Brito da Justa; Caldas, Eloisa Dutra

    2017-06-01

    The use of counterfeit or substandard medicines can have an important health impact, resulting in therapeutic failure, be toxic or even cause death. Anabolic steroids are a frequent target for counterfeiters worldwide, being the second most frequent counterfeited class in Brazil. The aims of this work were to optimize and validate a GC-MS method for the quantitative determination of anabolic steroids in tablet, aqueous suspension and oil solution forms, and to analyze pharmaceutical products sent to Brazilian Federal Police (BFP) for forensic analysis. Sample preparation included extraction with methanol in ultrasonic bath followed by centrifugation. The method was successfully validated and 345 samples of pharmaceutical products were analyzed (328 medicines and 17 dietary supplements). About 42% of the medicines were counterfeits, 28.7% of tablets, 12.0% of suspensions and 65.2% of oil solutions; 11% were considered substandards. Five dietary supplements contained undeclared anabolic steroids, including two containing methandrostenolone at 5.4 and 5.8mg/capsule, equivalent to levels found in medicines. The proposed method is suitable for implementation in routine analysis for identification of counterfeits and substandard products. The analytical results show the need to raise awareness of consumers over the risks from the consumption of anabolic steroids from the clandestine market and for more incisive actions from government agencies aiming at decreasing the availability of these products. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Suspected poisoning of domestic animals by pesticides.

    Science.gov (United States)

    Caloni, Francesca; Cortinovis, Cristina; Rivolta, Marina; Davanzo, Franca

    2016-01-01

    A retrospective study was carried out by reviewing all suspected cases of domestic animal poisoning attributed to pesticides, reported to the Milan Poison Control Centre (MPCC) between January 2011 and December 2013. During this period, pesticides were found to be responsible for 37.3% of all suspected poisoning enquiries received (815). The most commonly species involved was the dog (71.1% of calls) followed by the cat (15.8%), while a limited number of cases involved horses, goats and sheep. Most cases of exposure (47.1%) resulted in mild to moderate clinical signs. The outcome was reported in 59.9% of these cases, with death occurring in 10.4% of them. Insecticides (40.8%) proved to be the most common group of pesticides involved and exposure to pyrethrins-pyrethroids accounted for the majority of calls. According to the MPCC data, there has been a decrease in the number of suspected poisonings cases attributed to pesticides that have been banned by the EU, including aldicarb, carbofuran, endosulfan and paraquat. In contrast, there has been an increase of suspected poisoning cases attributed to the neonicotinoids, imidacloprid and acetamiprid, probably due to their widespread use in recent years. Cases of suspected poisoning that involved exposure to rodenticides accounted for 27.6% of calls received by the MPCC and anticoagulant rodenticides were the primary cause of calls, with many cases involving brodifacoum and bromadiolone. Herbicides were involved in 14.2% of calls related to pesticides and glyphosate was the main culprit in cases involving dogs, cats, horses, goats and sheep. As far as exposure to molluscicides (11.5%) and fungicides (5.9%), most of the cases involved dogs and the suspected poisoning agents were metaldehyde and copper compounds respectively. The data collected are useful in determining trends in poisoning episodes and identifying newly emerging toxicants, thus demonstrating the prevalence of pesticides as causative agents in animal

  16. A test of counterfeit deviance: a comparison of sexual knowledge in groups of sex offenders with intellectual disability and controls.

    Science.gov (United States)

    Michie, Amanda M; Lindsay, William R; Martin, Victoria; Grieve, Alan

    2006-07-01

    Several authors have suggested that lack of sexual knowledge is a primary reason for inappropriate sexual behaviour in men with intellectual disabilities. This hypothesis, counterfeit deviance, is tested in the current report with two separate cohorts comparing sex offenders and controls, both with intellectual disability. The Socio-Sexual Knowledge and Attitudes Test was completed on all participants and any significant differences between groups indicated that the sex offender cohort had a higher level of knowledge. The hypothesis has not been supported. In addition, a positive relationship was found between intellectual ability and knowledge for the control cohort but not for the sex offender cohort.

  17. Lithographically encoded polymer microtaggant using high-capacity and error-correctable QR code for anti-counterfeiting of drugs.

    Science.gov (United States)

    Han, Sangkwon; Bae, Hyung Jong; Kim, Junhoi; Shin, Sunghwan; Choi, Sung-Eun; Lee, Sung Hoon; Kwon, Sunghoon; Park, Wook

    2012-11-20

    A QR-coded microtaggant for the anti-counterfeiting of drugs is proposed that can provide high capacity and error-correction capability. It is fabricated lithographically in a microfluidic channel with special consideration of the island patterns in the QR Code. The microtaggant is incorporated in the drug capsule ("on-dose authentication") and can be read by a simple smartphone QR Code reader application when removed from the capsule and washed free of drug. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. Herbal hepatotoxicity: suspected cases assessed for alternative causes.

    Science.gov (United States)

    Teschke, Rolf; Schulze, Johannes; Schwarzenboeck, Alexander; Eickhoff, Axel; Frenzel, Christian

    2013-09-01

    Alternative explanations are common in suspected drug-induced liver injury (DILI) and account for up to 47.1% of analyzed cases. This raised the question of whether a similar frequency may prevail in cases of assumed herb-induced liver injury (HILI). We searched the Medline database for the following terms: herbs, herbal drugs, herbal dietary supplements, hepatotoxic herbs, herbal hepatotoxicity, and herb-induced liver injury. Additional terms specifically addressed single herbs and herbal products: black cohosh, Greater Celandine, green tea, Herbalife products, Hydroxycut, kava, and Pelargonium sidoides. We retrieved 23 published case series and regulatory assessments related to hepatotoxicity by herbs and herbal dietary supplements with alternative causes. The 23 publications comprised 573 cases of initially suspected HILI; alternative causes were evident in 278/573 cases (48.5%). Among them were hepatitis by various viruses (9.7%), autoimmune diseases (10.4%), nonalcoholic and alcoholic liver diseases (5.4%), liver injury by comedication (DILI and other HILI) (43.9%), and liver involvement in infectious diseases (4.7%). Biliary and pancreatic diseases were frequent alternative diagnoses (11.5%), raising therapeutic problems if specific treatment is withheld; pre-existing liver diseases including cirrhosis (9.7%) were additional confounding variables. Other diagnoses were rare, but possibly relevant for the individual patient. In 573 cases of initially assumed HILI, 48.5% showed alternative causes unrelated to the initially incriminated herb, herbal drug, or herbal dietary supplement, calling for thorough clinical evaluations and appropriate causality assessments in future cases of suspected HILI.

  19. The evaluation of suspected child physical abuse.

    Science.gov (United States)

    Christian, Cindy W

    2015-05-01

    Child physical abuse is an important cause of pediatric morbidity and mortality and is associated with major physical and mental health problems that can extend into adulthood. Pediatricians are in a unique position to identify and prevent child abuse, and this clinical report provides guidance to the practitioner regarding indicators and evaluation of suspected physical abuse of children. The role of the physician may include identifying abused children with suspicious injuries who present for care, reporting suspected abuse to the child protection agency for investigation, supporting families who are affected by child abuse, coordinating with other professionals and community agencies to provide immediate and long-term treatment to victimized children, providing court testimony when necessary, providing preventive care and anticipatory guidance in the office, and advocating for policies and programs that support families and protect vulnerable children. Copyright © 2015 by the American Academy of Pediatrics.

  20. 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.

  1. Glaucoma suspect & Humphrey Field Analyzer a correlation

    Directory of Open Access Journals (Sweden)

    P Dahal

    2012-09-01

    Full Text Available Glaucoma originally meant "clouded", in Greek.The term glaucoma refers to a group of diseases that have in common characteristic optic neuropathy with associated visual field loss for which elevated intraocular pressure is one of the primary risk factor. The purpose of the study is to correlate the clinically diagnosed cases of glaucoma suspect with the Humphrey Field Analyzer (HFA. Fifty cases of glaucoma suspect who attended the glaucoma clinic of Nepal Eye Hospital Tripureswor, Kathmandu, Nepal and who meets at least two criteria, among the four types of glaucoma suspects were advised for the HFA for the study. In this study out of 50 patient, 36 (72% patients had normal visual field. 14 (28% patients had thinning of the neural retinal rim (NRR in both eyes. The significant relation with thinning of neural retina rim and glaucomatous hemifield test was found in the study. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 23-28 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6822

  2. Tocolytics for suspected intrapartum fetal distress.

    Science.gov (United States)

    Kulier, R; Hofmeyr, G J

    2000-01-01

    Prophylactic tocolysis with betamimetics and other agents has become widespread as a treatment for fetal distress. Uterine relaxation may improve placental blood flow and therefore fetal oxygenation. However there may also be adverse maternal cardiovascular effects. The objective of this review was to assess the effects of tocolytic therapy for suspected fetal distress on fetal, maternal and perinatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: February 1999. Randomised trials comparing tocolytic therapy with no treatment or treatment with another tocolytic agent for suspected fetal distress. Two reviewers assessed trial quality and extracted data. Three studies were included. Compared with no treatment, there were fewer failed improvements in fetal heart rate abnormalities with tocolytic therapy (relative risk 0.26, 95% 0.13 to 0.53). Betamimetic therapy compared with magnesium sulphate showed a non-significant trend towards reduced uterine activity (relative risk 0.07, 95% confidence interval 0.00 to 1.10). Betamimetic therapy appears to be able to reduce the number of fetal heart rate abnormalities and perhaps reduce uterine activity. However there is not enough evidence based on clinically important outcomes to evaluate the use of betamimetics for suspected fetal distress.

  3. Patch Testing in Suspected Allergic Contact Dermatitis to Cosmetics

    Science.gov (United States)

    Paulose, Rekha

    2014-01-01

    Background. Increasing use of cosmetics has contributed to a rise in the incidence of allergic contact dermatitis (ACD) to cosmetics. It is estimated that 1–5.4% of the population is sensitized to a cosmetic ingredient. Patch testing helps to confirm the presence of an allergy and to identify the actual allergens which are chemical mixtures of various ingredients. Objectives. The aims of this study are to perform patch testing in suspected ACD to cosmetics and to identify the most common allergen and cosmetic product causing dermatitis. Methods. Fifty patients with suspected ACD to cosmetics were patch-tested with 38 antigens of the Indian Cosmetic Series and 12 antigens of the Indian Standard Series. Results. The majority (58%) of patients belonged to the 21–40 years age group. The presence of ACD to cosmetics was confirmed in 38 (76%) patients. Face creams (20%), hair dyes (14%), and soaps (12%) were the most commonly implicated. The most common allergens identified were gallate mix (40%), cetrimide (28%), and thiomersal (20%). Out of a total of 2531 patches applied, positive reactions were obtained in 3.75%. Conclusion. Incidence of ACD to cosmetics was greater in females. Face creams and hair dyes were the most common cosmetic products implicated. The principal allergens were gallate mix, cetrimide, and thiomersal. PMID:25295057

  4. Scale development on consumer behavior toward counterfeit drugs in a developing country: a quantitative study exploiting the tools of an evolving paradigm.

    Science.gov (United States)

    Alfadl, Abubakr A; Ibrahim, Mohamed Izham b Mohamed; Hassali, Mohamed Azmi Ahmad

    2013-09-11

    Although desperate need and drug counterfeiting are linked in developing countries, little research has been carried out to address this link, and there is a lack of proper tools and methodology. This study addresses the need for a new methodological approach by developing a scale to aid in understanding the demand side of drug counterfeiting in a developing country. The study presents a quantitative, non-representative survey conducted in Sudan. A face-to-face structured interview survey methodology was employed to collect the data from the general population (people in the street) in two phases: pilot (n = 100) and final survey (n = 1003). Data were analyzed by examining means, variances, squared multiple correlations, item-to-total correlations, and the results of an exploratory factor analysis and a confirmatory factor analysis. As an approach to scale purification, internal consistency was examined and improved. The scale was reduced from 44 to 41 items and Cronbach's alpha improved from 0.818 to 0.862. Finally, scale items were assessed. The result was an eleven-factor solution. Convergent and discriminant validity were demonstrated. The results of this study indicate that the "Consumer Behavior Toward Counterfeit Drugs Scale" is a valid, reliable measure with a solid theoretical base. Ultimately, the study offers public health policymakers a valid measurement tool and, consequently, a new methodological approach with which to build a better understanding of the demand side of counterfeit drugs and to develop more effective strategies to combat the problem.

  5. Transforming the Addicted Person's Counterfeit Quest for Wholeness through Three Stages of Recovery: A Wilber Transpersonal Spectrum of Development Clinical Perspective

    Science.gov (United States)

    Nixon, Gary

    2012-01-01

    In this article, we look at how an addicted person can through the therapeutic process replace the addiction "short cut" counterfeit quest for wholeness with an authentic quest for wholeness using Wilber' transpersonal spectrum of development model by working through different developmental levels during three stages of recovery. The first stage…

  6. Prevalence of glaucoma suspects and pattern of intra-ocular ...

    African Journals Online (AJOL)

    Background: Glaucoma is the commonest cause of irreversible blindness in the world. Some glaucoma patients start out as glaucoma suspects for years. Aim: To determine the prevalence of glaucoma suspects and pattern of intra-ocular pressure distribution in glaucoma suspects. Methods: This survey was carried out in ...

  7. Nuclear Pedigree Criteria of Suspected HNPCC

    Directory of Open Access Journals (Sweden)

    Kładny Józef

    2003-01-01

    Full Text Available Abstract The criteria for the diagnosis of HNPCC established by the ICG-HNPCC are very restrictive as they do not allow for the diagnosis of a large number of "suspected HNPCC" cases - these are families which do no fulfill the strict diagnostic "Amsterdam criteria", but do present with several pedigree and clinical features characteristic for HNPCC. Several series of families suspected of harboring germline mutations in DNA mismatch repair genes have been studied for germline changes in DNA mismatch repair genes and a mutation rate of somewhere between 8-60% was found. Therefore a subgroup of members of the ICG-HNPCC has been working on pedigree/clinical diagnostic criteria for suspected HNPCC. Materials and methods Part I The study was based on two series of colorectal cancer (CRC cases: 1 HNPCC - this group comprised 190 patients affected by CRC from randomly selected families which fulfilled the Amsterdam II criteria registered in Düsseldorf, Germany (102 cases of CRC, Denmark (18 CRCs, Leiden, Holland (23 CRCs and Szczecin, Poland (47 CRCs. 2 Consecutive CRCs - this group comprised 629 (78.0% of 806 individuals with CRC diagnosed in 1991-1997 in the city of Szczecin (ca. 400,000 of inhabitants, Poland. Nuclear pedigrees in both groups were compared for frequency of occurrence of clinical features, that have been shown to be associated with HNPCC. Part II 52 consecutive CRC cases from Szczecin, matching the criteria recognized in part I as appropriate for diagnosis of cases "suspected of HNPCC" were studied for the occurrence of germline hMSH2/hMLH1 constitutional mutations using "exon by exon" sequencing. Results The combination of features - i.e. the occurrence of an HNPCC associated cancer (CRC or cancer of the endometrium, small bowel or urinary tract in a 1st degree relative of a CRC patient; at least one of the patients being diagnosed under age of 50 - appeared to be strongly associated to HNPCC with an OR - 161. Constitutional

  8. Suspected Adulteration of Commercial Kratom Products with 7-Hydroxymitragynine

    National Research Council Canada - National Science Library

    Lydecker, Alicia G; Sharma, Abhisheak; McCurdy, Christopher R; Avery, Bonnie A; Babu, Kavita M; Boyer, Edward W

    2016-01-01

    .... Mitragynine and 7-hydroxymitragynine, exclusive to M. speciosa, are the alkaloids primary responsible for Kratom's biologic and psychoactive profile, and likely contribute to its problematic use...

  9. Seroprevalance of brucellosis among suspected cases in Malaysia.

    Science.gov (United States)

    Jama'ayah, M Z; Heu, J Y; Norazah, A

    2011-06-01

    Brucellosis is a zoonotic disease which can be transmitted by direct or indirect contact with infected animal or their products. It is an important public health problem but little is known on brucellosis in the Malaysian population. The aim of this study was to determine the presence of Brucella antibodies using commercial Brucella IgG and IgM ELISA kits (Vircell, SL, Barcelona Spain). A total of 184 sera from suspected patients were received from 16 hospitals in Malaysia over the years 2004 to 2009. Only 10 serum samples (5.4%) were positive for Brucella antibodies in which 5 showed the presence of both IgM and IgG. Most of the positive patients were occupationally involved with animals. This study suggests the seroprevalance of brucellosis among individuals who have contact with infected animals in Malaysia is low.

  10. Magnetic resonance imaging of suspected atrial tumors.

    Science.gov (United States)

    Menegus, M A; Greenberg, M A; Spindola-Franco, H; Fayemi, A

    1992-05-01

    Two-dimensional echocardiography has become the standard technique for evaluation of cardiac and paracardiac mass lesions. We have used magnetic resonance imaging (MRI) as an independent assessment of cardiac-associated masses in patients with echocardiograms demonstrating sessile atrial tumors. MRI was performed in seven patients, ages 33 to 84, whose echocardiographic diagnoses included left atrial mass (five), right atrial mass (one), and interatrial mass (one). In four of the patients with a diagnosis of left atrial mass, MRI showed extracardiac compression of the atrium, simulating a tumor (hiatal hernia, tortuous descending aorta, bronchogenic cyst). MRI was entirely normal in one patient with an apparent left atrial mass. MRI elucidated extension of an extracavitary mass into the interatrial septum in two patients. One of these patients with an echocardiographic right atrial mass had extension of a lipoma into the interatrial septum without atrial tumor. MRI confirmed the echocardiographic diagnosis of an interatrial mass in the other patient. We conclude that MRI, because of its ability to define anatomic relationships and tissue characteristics, is a powerful noninvasive tool for evaluating suspected cardiac mass lesions. Although echocardiography remains the primary screening test for the detection of cardiac masses, MRI is a more specific modality for precise diagnosis. Correct MRI interpretation may obviate the need for invasive studies or surgery.

  11. The internet trade of counterfeit spirits in Russia – an emerging problem undermining alcohol, public health and youth protection policies? [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Maria Neufeld

    2017-06-01

    Full Text Available Counterfeit alcohol belongs to the category of unrecorded alcohol not reflected in official statistics. The internet trade of alcoholic beverages has been prohibited by the Russian Federation since 2007, but various sellers still offer counterfeit spirits (i.e., forged brand spirits over the internet to Russian consumers, mostly in a non-deceptive fashion at prices up to 15 times lower than in regular sale. The public health issues arising from this unregulated trade include potential harm to underage drinkers, hazards due to toxic ingredients such as methanol, but most importantly alcohol harms due to potentially increased drinking volumes due to low prices and high availability on the internet. The internet sale also undermines existing alcohol policies such as restrictions of sale locations, sale times and minimum pricing. The need to enforce measures against counterfeiting of spirits, but specifically their internet trade should be implemented as key elements of alcohol policies to reduce unrecorded alcohol consumption, which is currently about 33 % of total consumption in Russia.

  12. The internet trade of counterfeit spirits in Russia – an emerging problem undermining alcohol, public health and youth protection policies? [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Maria Neufeld

    2017-04-01

    Full Text Available Counterfeit alcohol belongs to the category of unrecorded alcohol not reflected in official statistics. The internet trade of alcoholic beverages has been prohibited by the Russian Federation since 2007, but various sellers still offer counterfeit spirits (i.e., forged brand spirits over the internet to Russian consumers, mostly in a non-deceptive fashion at prices up to 15 times lower than in regular sale. The public health issues arising from this unregulated trade include potential harm to underage drinkers, hazards due to toxic ingredients such as methanol, but most importantly alcohol harms due to potentially increased drinking volumes due to low prices and high availability on the internet. The internet sale also undermines existing alcohol policies such as restrictions of sale locations, sale times and minimum pricing. The need to enforce measures against counterfeiting of spirits, but specifically their internet trade should be implemented as key elements of alcohol policies to reduce unrecorded alcohol consumption, which is currently about 33 % of total consumption in Russia.

  13. 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 ...

  14. 48 CFR 803.806 - Processing suspected violations.

    Science.gov (United States)

    2010-10-01

    ... GENERAL IMPROPER BUSINESS PRACTICES AND PERSONAL CONFLICTS OF INTEREST Limitation on the Payment of Funds to Influence Federal Transactions 803.806 Processing suspected violations. A VA employee must report suspected violations of 31 U.S.C. 1352, Limitation on Use of Appropriated Funds to Influence Certain Federal...

  15. The clinical course of patients with suspected pulmonary embolism

    NARCIS (Netherlands)

    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

  16. 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...

  17. Prediction of Suspect Location Based on Spatiotemporal Semantics

    Directory of Open Access Journals (Sweden)

    Lian Duan

    2017-06-01

    Full Text Available The prediction of suspect location enables proactive experiences for crime investigations and offers essential intelligence for crime prevention. However, existing studies have failed to capture the complex social location transition patterns of suspects and lack the capacity to address the issue of data sparsity. This paper proposes a novel location prediction model called CMoB (Crime Multi-order Bayes model based on the spatiotemporal semantics to enhance the prediction performance. In particular, the model groups suspects with similar spatiotemporal semantics as one target suspect. Then, their mobility data are applied to estimate Markov transition probabilities of unobserved locations based on a KDE (kernel density estimating smoothing method. Finally, by integrating the total transition probabilities, which are derived from the multi-order property of the Markov transition matrix, into a Bayesian-based formula, it is able to realize multi-step location prediction for the individual suspect. Experiments with the mobility dataset covering 210 suspects and their 18,754 location records from January to June 2012 in Wuhan City show that the proposed CMoB model significantly outperforms state-of-the-art algorithms for suspect location prediction in the context of data sparsity.

  18. Depth profiling of inks in authentic and counterfeit banknotes by electrospray laser desorption ionization/mass spectrometry.

    Science.gov (United States)

    Kao, Yi-Ying; Cheng, Sy-Chyi; Cheng, Chu-Nian; Shiea, Jentaie

    2016-01-01

    Electrospray laser desorption ionization is an ambient ionization technique that generates neutrals via laser desorption and ionizes those neutrals in an electrospray plume and was utilized to characterize inks in different layers of copy paper and banknotes of various currencies. Depth profiling of inks was performed on overlapping color bands on copy paper by repeatedly scanning the line with a pulsed laser beam operated at a fixed energy. The molecules in the ink on a banknote were desorbed by irradiating the banknote surface with a laser beam operated at different energies, with results indicating that different ions were detected at different depths. The analysis of authentic $US100, $100 RMB and $1000 NTD banknotes indicated that ions detected in 'color-shifting' and 'typography' regions were significantly different. Additionally, the abundances of some ions dramatically changed with the depth of the aforementioned regions. This approach was used to distinguish authentic $1000 NTD banknotes from counterfeits. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  19. THE NON-QUALITY OF COUNTERFEIT PRODUCTS AND THEIR EFFECT ON CONSUMERS AND THE INTELLECTUAL PROPERTY RIGHT

    OpenAIRE

    Emilia PASCU; Petronela-Sonia NEDEA; Oana-Maria MILEA

    2012-01-01

    Breaking the intellectual property rights (IPR) has huge effects on the free movement of merchandise and of the occupying degree of work places, affecting both economic development and consumers’ health, and the rightful trademark owners and the companies which legally exploit them are the main “actors” to undertake the effects of this phenomenon which, in the last few years, has grown with more than 1000% according to data published by the World Trade Organization. In the last 20 years, the ...

  20. Suspected vitreous seeding of uveal melanoma: relevance of diagnostic vitrectomy.

    Science.gov (United States)

    Metz, Claudia H D; Bornfeld, Norbert; Metz, Klaus A; Gök, Mete

    2016-05-01

    To review all cases of suspected vitreous seeding of treated or untreated uveal melanoma at our clinic and to compare clinical, cytological and histological findings with patients' survival. Retrospective non-randomised study of 23 patients with consecutive uveal melanoma who underwent diagnostic vitrectomy in our clinic between January 2000 and November 2013. Reason for vitrectomy was suspected dissemination of tumour cells inside the eye. Treated as well as treatment-naïve primary uveal melanomas were included in this study. Follow-up data of all patients were collected. The study included 23 patients with a mean age of 66 years. Four patients presented pigmented vitreous debris at initial presentation prior to treatment of the uveal melanoma. All but one of these four patients has been enucleated as a consequence of cytology-proven vitreous spreading of vital melanoma cells. The remaining 19 patients presented pigmented vitreous debris at a mean of 60 months following local tumour treatment. Thirteen of these patients had been treated with a ruthenium plaque (mean scleral dose 1295 Gy, mean apex dose 152 Gy), three with binuclid plaque (mean scleral dose 1005 Gy, mean apex dose 70 Gy) and three with proton beam radiation. Of the 19 patients, 10 showed only melanophages in the vitreous specimen, while the remaining 9 patients had vital tumour cells in vitreous cytology. Four out of these nine patients have been enucleated in the course of follow-up. During follow-up of our cohort of 23 patients, 4 patients died, but only 1 of them due to metastatic disease. The outcome of this small cohort study shows that obtaining a vitreous specimen helps to distinguish melanophages from vital tumour cells. We could not observe an increased risk of metastasis in patients who showed melanoma cell dissemination inside the eye, compared with those patients only showing melanophages. We therefore suggest to carefully re-evaluate the necessity of enucleation in every

  1. Development of a selective HPLC-DAD/ELSD method for the qualitative and quantitative assessment of commercially available Eurycoma longifolia products and plant extracts.

    Science.gov (United States)

    Mutschlechner, Benjamin; Schwaiger, Stefan; Tran, Thi Van Anh; Stuppner, Hermann

    2018-01-01

    Aqueous extracts of the roots of Eurycoma longifolia are traditionally used to improve sexual performance, to treat infertility and other sexual dysfunctions but also to increase muscle strength. Nowadays, many different products are commercially available which are promoted as E. longifolia extracts and claim to possess beneficial aphrodisiac effects. Since such herbal aphrodisiac preparations have been recently the target of fraudulent product counterfeiting and because eurycomanone, one of the main quassinoids of E. longifolia, is suspected to possess toxic effects at higher concentrations, a highly selective HPLC-DAD/ELSD method has been established to analyze commercially available products and extracts of plant material. The presented method was established by the use of a mixture of 27 reference compounds for qualitative issues and fully validated according to the ICH guidelines for the quantification of three quassinoides: laurycolactone A, longilactone, and eurycomanone. The calibration curves of these showed a linearity over a range of 0.05 to 1.0mg/ml, with a regression coefficient not lower than R 2 =0.9969. The inter-day and intra-day precision (indicated as relative standard deviation) of the developed method was <2.9%. The recovery ranged from -3.3% to +6.0%. Eight randomly purchased products have been analyzed with this method, but only five of them contained E. longifolia compounds in detectable amounts. The concentration of eurycomanone in these products varied from 0.22±0.002mg eurycomanone per capsule to 1.84±0.08mg corresponding to a maximal recommended daily intake of 0.76±0.02 to 31.90±0.21mg. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Resource factor in production of quality and safe flavored food

    Directory of Open Access Journals (Sweden)

    Наталія Епінетівна Фролова

    2015-07-01

    Full Text Available Research of methods for establishing authenticity of essential oil of cumin and dill based on optical isomerism of components is presented in the article.In modern food technology more often used frozen raw, concentrates fruit and vegetables, growing issue of healthy products and this all require the use of flavors. Synthetic flavors can be dangerous to the human body. Usage of counterfeit natural flavors is dangerous.

  3. Stopping and Questioning Suspected Shoplifters Without Creating Civil Liability

    Science.gov (United States)

    Reed, Jack R., Jr.

    1977-01-01

    Legal problems concerned with shoplifting suspects are addressed, including common law, criminal penalties, and the merchant's liability. Tangential questions and answers are presented along with discussion of pertinent court cases. (LBH)

  4. ALGORITHM OF MANAGEMENT OF PATIENTS WITH SUSPECTED BLUNT CARDIAC TRAUMA

    Directory of Open Access Journals (Sweden)

    S. R. Gilarevsky

    2013-01-01

    Full Text Available Abstract. Contemporary algorithm of diagnostic examination of patients with suspected blunt cardiac trauma is presented. General aspects of monitoring and treatment of such patients are also discussed. 

  5. Suspect confession of child sexual abuse to investigators.

    Science.gov (United States)

    Lippert, Tonya; Cross, Theodore P; Jones, Lisa; Walsh, Wendy

    2010-05-01

    Increasing the number of suspects who give true confessions of sexual abuse serves justice and reduces the burden of the criminal justice process on child victims. With data from four communities, this study examined confession rates and predictors of confession of child sexual abuse over the course of criminal investigations (final N = 282). Overall, 30% of suspects confessed partially or fully to the crime. This rate was consistent across the communities and is very similar to the rates of suspect confession of child sexual abuse found by previous research, although lower than that from a study focused on a community with a vigorous practice of polygraph testing. In a multivariate analysis, confession was more likely when suspects were younger and when more evidence of abuse was available, particularly child disclosure and corroborative evidence. These results suggest the difficulty of obtaining confession but also the value of methods that facilitate child disclosure and seek corroborative evidence, for increasing the odds of confession.

  6. The Global Threat of Counterfeit Drugs: Why Industry and Governments Must Communicate the Dangers

    OpenAIRE

    Robert Cockburn; Newton, Paul N.; E. Kyeremateng Agyarko; Dora Akunyili; White, Nicholas J

    2005-01-01

    The production of substandard and fake drugs is a vast and underreported problem, particularly affecting poorer countries. Cockburn and colleagues argue that the pharmaceutical industry and governments must both take action

  7. Suspect aggression and victim resistance in multiple perpetrator rapes.

    Science.gov (United States)

    Woodhams, Jessica; Cooke, Claire

    2013-11-01

    Several research studies have reported an elevated level of aggression in rapes committed by multiple perpetrators compared to rapes committed by lone suspects. Several factors that have been linked to elevated aggression in generic samples of rape were examined for the first time with a sample of multiple perpetrator rapes. Factors that might be associated with victim resistance were also investigated. Victim and offender characteristics, as well as the behaviors displayed by victims and offenders, were extracted from the police files of 89 multiple perpetrator stranger rapes perpetrated against female victims in the United Kingdom. These behaviors were rated for their level of suspect (non-sexual) aggression and victim resistance, respectively. Degree of victim resistance was significantly and positively associated with suspect aggression. Older victims were the recipients of significantly higher levels of suspect aggression. Victims who were incapacitated from drugs and/or alcohol were less likely to be the recipients of suspect aggression. Group leaders displayed more aggression towards the victim than the followers in the groups. The number of perpetrators was significantly related to the degree of resistance displayed by the victim with offences perpetrated by fewer suspects being characterized by more victim resistance. Research regarding cognitive appraisal during criminal interactions and the respective roles of offenders is referred to in considering these relationships.

  8. Interviewing strategically to elicit admissions from guilty suspects.

    Science.gov (United States)

    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).

  9. Combining two-dimensional diffusion-ordered nuclear magnetic resonance spectroscopy, imaging desorption electrospray ionization mass spectrometry, and direct analysis in real-time mass spectrometry for the integral investigation of counterfeit pharmaceuticals.

    Science.gov (United States)

    Nyadong, Leonard; Harris, Glenn A; Balayssac, Stéphane; Galhena, Asiri S; Malet-Martino, Myriam; Martino, Robert; Parry, R Mitchell; Wang, May Dongmei; Fernández, Facundo M; Gilard, Véronique

    2009-06-15

    During the past decade, there has been a marked increase in the number of reported cases involving counterfeit medicines in developing and developed countries. Particularly, artesunate-based antimalarial drugs have been targeted, because of their high demand and cost. Counterfeit antimalarials can cause death and can contribute to the growing problem of drug resistance, particularly in southeast Asia. In this study, the complementarity of two-dimensional diffusion-ordered (1)H nuclear magnetic resonance spectroscopy (2D DOSY (1)H NMR) with direct analysis in real-time mass spectrometry (DART MS) and desorption electrospray ionization mass spectrometry (DESI MS) was assessed for pharmaceutical forensic purposes. Fourteen different artesunate tablets, representative of what can be purchased from informal sources in southeast Asia, were investigated with these techniques. The expected active pharmaceutical ingredient was detected in only five formulations via both nuclear magnetic resonance (NMR) and mass spectrometry (MS) methods. Common organic excipients such as sucrose, lactose, stearate, dextrin, and starch were also detected. The graphical representation of DOSY (1)H NMR results proved very useful for establishing similarities among groups of samples, enabling counterfeit drug "chemotyping". In addition to bulk- and surface-average analyses, spatially resolved information on the surface composition of counterfeit and genuine antimalarial formulations was obtained using DESI MS that was performed in the imaging mode, which enabled one to visualize the homogeneity of both genuine and counterfeit drug samples. Overall, this study suggests that 2D DOSY (1)H NMR, combined with ambient MS, comprises a powerful suite of instrumental analysis methodologies for the integral characterization of counterfeit antimalarials.

  10. Presumed prevalence analysis on suspected and highly suspected breast cancer lesions in São Paulo using BIRADS® criteria

    Directory of Open Access Journals (Sweden)

    Vivian Milani

    Full Text Available CONTEXT AND OBJECTIVE: Breast cancer screening programs are critical for early detection of breast cancer. Early detection is essential for diagnosing, treating and possibly curing breast cancer. Since there are no data on the incidence of breast cancer, nationally or regionally in Brazil, our aim was to assess women by means of mammography, to determine the prevalence of this disease. DESIGN AND SETTING: The study protocol was designed in collaboration between the Department of Diagnostic Imaging (DDI, Institute of Diagnostic Imaging (IDI and São Paulo Municipal Health Program. METHODS: A total of 139,945 Brazilian women were assessed by means of mammography between April 2002 and September 2004. Using the American College of Radiology (ACR criteria (Breast Imaging Reporting and Data System, BIRADS®, the prevalence of suspected and highly suspected breast lesions were determined. RESULTS: The prevalence of suspected (BIRADS® 4 and highly suspected (BIRADS® 5 lesions increased with age, especially after the fourth decade. Accordingly, BIRADS® 4 and BIRADS® 5 lesions were more prevalent in the fourth, fifth, sixth and seventh decades. CONCLUSION: The presumed prevalence of suspected and highly suspected breast cancer lesions in the population of São Paulo was 0.6% and it is similar to the prevalence of breast cancer observed in other populations.

  11. Genetic and geochemical signatures to prevent frauds and counterfeit of high-quality asparagus and pistachio.

    Science.gov (United States)

    Zannella, Carmela; Carucci, Francesca; Aversano, Riccardo; Prohaska, Thomas; Vingiani, Simona; Carputo, Domenico; Adamo, Paola

    2017-12-15

    A fingerprinting strategy based on genetic (simple sequence repeat) and geochemical (multielement and 87 Sr/ 86 Sr ratio) analysis was tested to prove the geographical origin of high-quality Italian products "White Asparagus from Bassano del Grappa" and "Green Pistachio from Bronte". Genetic analysis generated many polymorphic alleles and different specific amplified fragments in both agriproducts. In addition, a core set of markers was defined. According to variability within production soils and products, potential candidate elements linking asparagus (Zn, P, Cr, Mg, B, K) and pistachio (Mn, P, Cr, Mg, Ti, B, K, Sc, S) to the production areas were identified. The Sr isotopic signature was an excellent marker when Italian asparagus was compared with literature data for Hungarian and Peruvian asparagus. This work reinforces the use of Sr isotope composition in the soil bioavailable fraction, as assessed by 1mol/L NH 4 NO 3 , to distinguish white asparagus and pistachio originating from different geographical areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Enhanced antitumor efficacy and counterfeited cardiotoxicity of combinatorial oral therapy using Doxorubicin- and Coenzyme Q10-liquid crystalline nanoparticles in comparison with intravenous Adriamycin

    DEFF Research Database (Denmark)

    Swarnakar, Nitin K; Thanki, Kaushik; Jain, Sanyog

    2014-01-01

    and strong synergism for combination at 1:10 dose ratio owing to higher cellular uptake, nuclear colocalization, higher apoptotic index and 8-OHdG levels. The prophylactic antitumor efficacy of the CoQ10-LCNPs was also established using tumor induction and progression studies. Finally, therapeutic antitumor......, with Dox-induced-cardiotoxicity was completely counterfeited in combination. In nutshell, LCNPs pose great potential in improving the therapeutic efficacy of drugs by oral route of administration. FROM THE CLINICAL EDITOR: This study describes the use of liquid crystalline nanoparticles containing coenzyme...

  13. Suspected citrus pulp toxicosis in dairy cattle.

    Science.gov (United States)

    Saunders, G K; Blodgett, D J; Hutchins, T A; Prater, R M; Robertson, J L; Friday, P A; Scarratt, W K

    2000-05-01

    Thirteen lactating dairy cows from a herd of 650 died over a 6-week period. Most animals were down in milk production at 1 milking and were found dead at the next milking. Two cows had elevated heart rate and enlarged mandibular lymph nodes. Two others had azotemia, elevated heart rate, hyperglycemia, and weight loss. Necropsy of 10 cows revealed hemorrhages on the intestinal serosa and epicardium, lymphadenopathy, interstitial nephritis, small intestinal hemorrhage, and interstitial pneumonia. Histopathology showed lymphocytic to lymphogranulomatous inflammation in the heart, spleen, kidney, lymph nodes, liver, lung, pancreas, and adrenal gland. Phlebitis was present in 2 livers. The lesions resembled those of hairy vetch toxicosis, but no vetch was being fed. Similar lesions have been reported with the feeding of citrus pulp. Citrus pulp was being fed to the lactating cows and had been added to the diet 6 weeks before the first death. The syndrome resolved with elimination of citrus pulp from the diet.

  14. Micro/Nano-Structured Flexible Foils for Anti-Counterfeiting Purposes

    DEFF Research Database (Denmark)

    Okulova, Nastasia

    2016-01-01

    that the polymer is molten to begin with, and cools rapidly by contact with the cooling roller. Previously a large area replication at high throughput of patterns both on micrometer- and nanometer scale in thermoplastic foils using standard industrial extrusion coating equipment and standard thermoplastic polymers......Up to date there have been found many ways of producing samples with functional nano-pattering, however for mass production of such samples the method of fabrication of the surface structure must be fast and cheap. A recently developed method suggests using extrusion coating of polymer materials...... in a roll-to roll process, where the functional micro-/nano- surface structures are imprinted directly onto the surface of a polymer foil. This new technology can both answer the requirement for being fast and cheap. The aim of this project is implementation of the technology for mass production...

  15. Computed tomography versus magnetic resonance imaging versus bone scintigraphy for clinically suspected scaphoid fractures in patients with negative plain radiographs

    NARCIS (Netherlands)

    Mallee, Wouter H.; Wang, Junfeng; Poolman, Rudolf W.; Kloen, Peter; Maas, Mario; de Vet, Henrica C. W.; Doornberg, Job N.

    2015-01-01

    In clinically suspected scaphoid fractures, early diagnosis reduces the risk of non-union and minimises loss in productivity resulting from unnecessary cast immobilisation. Since initial radiographs do not exclude the possibility of a fracture, additional imaging is needed. Computed tomography (CT),

  16. The use of psychoactive prescription drugs among DUI suspects.

    Science.gov (United States)

    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.

  17. Book Review: Placing the Suspect behind the Keyboard: Using Digital Forensics and Investigative Techniques to Identify Cybercrime Suspects

    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

  18. Suspected Rhinolithiasis Associated With Endodontic Disease in a Cat.

    Science.gov (United States)

    Ng, Kevin; Fiani, Nadine; Peralta, Santiago

    2017-12-01

    Rhinoliths are rare, intranasal, mineralized masses formed via the precipitation of mineral salts around an intranasal nidus. Clinical signs are typically consistent with inflammatory rhinitis and nasal obstruction, but asymptomatic cases are possible. Rhinoliths may be classified as exogenous or endogenous depending on the origin of the nidus, with endogenous rhinoliths reportedly being less common. This case report describes a suspected case of endogenous rhinolithiasis in a cat which was detected as an incidental finding during radiographic assessment of a maxillary canine tooth with endodontic disease. Treatment consisted of removal of the suspected rhinolith via a transalveolar approach after surgical extraction of the maxillary canine tooth.

  19. 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...... 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...

  20. Symptomatic Patency Capsule Retention in Suspected Crohn's Disease

    DEFF Research Database (Denmark)

    Rasmussen, Bjørn; Nathan, Torben; Jensen, Michael Dam

    2016-01-01

    The main limitation of capsule endoscopy is the risk of capsule retention. In patients with suspected Crohn's disease, however, this complication is rare, and if a small bowel stenosis is not reliably excluded, small bowel patency can be confirmed with the Pillcam patency capsule. We present two...... patients examined for suspected Crohn's disease who experienced significant symptoms from a retained patency capsule. Both patients had Crohn's disease located in the terminal ileum. In one patient, the patency capsule caused abdominal pain and vomiting and was visualized at magnetic resonance enterography...

  1. An Evaluation of Indian Consumers' Reporting of Suspected Adverse Drug Reactions with a Designated Reporting Form.

    Science.gov (United States)

    Rehan, Harmeet Singh; Sah, Ravinder; Gupta, Anubhuti; Nagar, Parvesh

    2017-01-01

    The Pharmacovigilance Program of India recently initiated a process for direct patient reporting of Adverse Drug Reactions (ADRs) with a designated form. A survey of 200 patients reporting ADRs filling the form. Forms were analysed for patient data, the suspected medication(s), ADRs and possible causality. 54.3% of respondents provided their contact information; the implicated medicine was mentioned in 60% and the description of ADRs in 80% although 46.2% were not interpretable. The severity of ADRs was mentioned in 73.5%. No responder filled the expiry date component of the implicated modification and a causality assessment from most forms was unclassifiable (57%) or unclassified (26%). Details of concomitant drugs were missing. Missing information was a deterrent in analysing the consumer ADR reports for signal detection. It is recommended that the following fields are highlighted in the form: consumer's initials, address, date suspected reaction started, description of event, name, dose, and the reason for the use the medication as well as its expiry date. These should be mandatory in the existing form and new fields added for weight and height, batch number for vaccines and biological products, de challenge and rechallenge results to the suspected medicine and concomitantly used medicines. To improve the quality of information in the consumer reporting form an awareness campaign is also suggested. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  2. PMS2 Involvement in Patients Suspected of Lynch Syndrome

    NARCIS (Netherlands)

    Niessen, Renee C.; Kleibeuker, Jan H.; Westers, Helga; Jager, Paul O. J.; Rozeveld, Dennie; Bos, Krista K.; Boersma-van Ek, Wytske; Hollema, Harry; Sijmons, Rolf H.; Hofstra, Robert M. W.

    It is well-established that germline mutations in the mismatch repair genes MLH1, MSH2, and MSH6 cause Lynch syndrome. However, mutations in these three genes do not account for all Lynch syndrome (suspected) families. Recently, it was shown that germline mutations in another mismatch repair gene,

  3. Faecal Calprotectin in Suspected Paediatric Inflammatory Bowel Disease

    NARCIS (Netherlands)

    Degraeuwe, Pieter L. J.; Beld, Monique P. A.; Ashorn, Merja; Canani, Roberto Berni; Day, Andrew S.; Diamanti, Antonella; Fagerberg, Ulrika L.; Henderson, Paul; Kolho, Kaija-Leena; Van de Vijver, Els; van Rheenen, Patrick F.; Wilson, David C.; Kessels, Alfons G. H.

    Objectives: The diagnostic accuracy of faecal calprotectin (FC) concentration for paediatric inflammatory bowel disease (IBD) is well described at the population level, but not at the individual level. We reassessed the diagnostic accuracy of FC in children with suspected IBD and developed an

  4. Stabilization of the spine in patients with suspected cervical spine ...

    African Journals Online (AJOL)

    Stabilization of the spine in patients with suspected cervical spine injury in Mulago Hospital. BM Ndeleva, T Beyeza. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/eaoj.v5i1.67487 · AJOL African Journals ...

  5. Talking heads : interviewing suspects from a cultural perspective

    NARCIS (Netherlands)

    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

  6. Nonreferral of Nursing Home Patients With Suspected Breast Cancer

    NARCIS (Netherlands)

    Hamaker, Marije E.; Hamelinck, Victoria C.; van Munster, Barbara C.; Bastiaannet, Esther; Smorenburg, Carolien H.; Achterberg, Wilco P.; Liefers, Gerrit-Jan; de Rooij, Sophia E.

    2012-01-01

    Introduction: People with suspected breast cancer who are not referred for diagnostic testing remain unregistered and are not included in cancer statistics. Little is known about the extent of and motivation for nonreferral of these patients. Methods: A Web-based survey was sent to all elderly care

  7. DNA typing from vaginal smear slides in suspected rape cases

    Directory of Open Access Journals (Sweden)

    Dayse Aparecida da Silva

    Full Text Available In an investigation of suspected rape, proof of sexual assault with penetration is required. In view of this, detailed descriptions of the genitalia, the thighs and pubic region are made within the forensic medical service. In addition, vaginal swabs are taken from the rape victim and some of the biological material collected is then transferred to glass slides. In this report, we describe two rape cases solved using DNA typing from cells recovered from vaginal smear slides. In 1999, two young women informed the Rio de Janeiro Police Department that they had been victims of sexual assaults. A suspect was arrested and the victims identified him as the offender. The suspect maintained that he was innocent. In order to elucidate these crimes, vaginal smear slides were sent to the DNA Diagnostic Laboratory for DNA analysis three months after the crimes, as unique forensic evidence. To get enough epithelial and sperm cells to perform DNA analysis, we used protocols modified from the previously standard protocols used for DNA extraction from biological material fixed on glass slides. The quantity of cells was sufficient to perform human DNA typing using nine short tandem repeat (STR loci. It was 3.3 billion times more probable that it was the examined suspect who had left sperm cells in the victims, rather than any other individual in the population of Rio de Janeiro.

  8. Cognitive Linguistic Performances of Multilingual University Students Suspected of Dyslexia

    Science.gov (United States)

    Lindgren, Signe-Anita; Laine, Matti

    2011-01-01

    High-performing adults with compensated dyslexia pose particular challenges to dyslexia diagnostics. We compared the performance of 20 multilingual Finnish university students with suspected dyslexia with 20 age-matched and education-matched controls on an extensive test battery. The battery tapped various aspects of reading, writing, word…

  9. Differential Diagnosis of Children with Suspected Childhood Apraxia of Speech

    Science.gov (United States)

    Murray, Elizabeth; McCabe, Patricia; Heard, Robert; Ballard, Kirrie J.

    2015-01-01

    Purpose: The gold standard for diagnosing childhood apraxia of speech (CAS) is expert judgment of perceptual features. The aim of this study was to identify a set of objective measures that differentiate CAS from other speech disorders. Method: Seventy-two children (4-12 years of age) diagnosed with suspected CAS by community speech-language…

  10. A suspected case of Addison’s disease in cattle

    OpenAIRE

    Lambacher, Bianca; Wittek, Thomas

    2015-01-01

    A 4.75-year old Simmental cow was presented with symptoms of colic and ileus. The clinical signs and blood analysis resulted in the diagnosis of suspected primary hypoadrenocorticism (Addison’s disease). Although Addison’s disease has been frequently described in other domestic mammals, to our knowledge, this disease has not previously been reported in cattle.

  11. Is extended biopsy protocol justified in all patients with suspected ...

    African Journals Online (AJOL)

    Objective: To determine the significance of an extended 10-core transrectal biopsy protocol in different categories of patients with suspected prostate cancer using digital guidance. Materials and Methods: We studied 125 men who were being evaluated for prostate cancer. They all had an extended 10-core digitally guided ...

  12. Correlates and Suspected Causes of Obesity in Children

    Science.gov (United States)

    Crothers, Laura M.; Kehle, Thomas J.; Bray, Melissa A.; Theodore, Lea A.

    2009-01-01

    The correlates and suspected causes of the intractable condition obesity are complex and involve environmental and heritable, psychological and physical variables. Overall, the factors associated with and possible causes of it are not clearly understood. Although there exists some ambiguity in the research regarding the degree of happiness in…

  13. Medical Evaluation of Suspected Child Sexual Abuse: 2011 Update

    Science.gov (United States)

    Adams, Joyce A.

    2011-01-01

    The medical evaluation of children with suspected sexual abuse includes more than just the physical examination of the child. The importance of taking a detailed medical history from the parents and a history from the child about physical sensations following sexual contact has been emphasized in other articles in the medical literature. The…

  14. Selective screening in neonates suspected to have inborn errors of ...

    African Journals Online (AJOL)

    Background: Inborn errors of metabolism (IEM) have a high morbidity and mortality in neonates. Unfortunately, there is no nationwide neonatal screen in Egypt, so several cases may be missed. Objective: The aim of this work was to detect the prevalence of IEM among neonates with suspected IEM, and to diagnose IEM as ...

  15. Sexual Health Before Treatment in Women with Suspected Gynecologic Malignancy.

    Science.gov (United States)

    Bretschneider, C Emi; Doll, Kemi M; Bensen, Jeannette T; Gehrig, Paola A; Wu, Jennifer M; Geller, Elizabeth J

    2017-08-22

    Sexual health in survivors of gynecologic cancer has been studied; however, sexual health in these women before treatment has not been thoroughly evaluated. The objective of our study was to describe the pretreatment characteristics of sexual health of women with suspected gynecologic cancer before cancer treatment. We performed a cross-sectional analysis of women with a suspected gynecologic cancer, who were prospectively enrolled in a hospital-based cancer survivorship cohort from August 2012 to June 2013. Subjects completed the validated Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction Questionnaire. Pretreatment sexual health was assessed in terms of sexual interest, desire, lubrication, discomfort, orgasm, enjoyment, and satisfaction. Of 186 eligible women with suspected gynecologic cancer, 154 (82%) completed the questionnaire pretreatment. Mean age was 58.1 ± 13.3 years. Sexual health was poor: 68.3% reported no sexual activity, and 54.7% had no interest in sexual activity. When comparing our study population to the general U.S. population, the mean pretreatment scores for the subdomains of lubrication and vaginal discomfort were similar, while sexual interest was significantly lower and global satisfaction was higher. In a linear regression model, controlling for cancer site, age remained significantly associated with sexual function while cancer site did not. Problems with sexual health are prevalent in women with suspected gynecologic malignancies before cancer treatment. Increasing awareness of the importance of sexual health in this population will improve quality of life for these women.

  16. Use of budesonide Turbuhaler in young children suspected of asthma

    DEFF Research Database (Denmark)

    Bisgaard, H; Pedersen, S; Nikander, K

    1994-01-01

    The question addressed in this study was the ability of young children to use a dry-powder inhaler, Turbuhaler. One hundred and sixty five children suspected of asthma, equally distributed in one year age-groups from 6 months to 8 yrs, inhaled from a Pulmicort Turbuhaler, 200 micrograms budesonid...

  17. Doppler ultrasound in the assessment of suspected intra-uterine ...

    African Journals Online (AJOL)

    Ramakantb

    obesity with hypertension and non-insulin-dependent diabetes mellitus.[3] In this review, a brief discussion about the ultrasound diagnosis of suspected IUGR, and thereafter about the use of Doppler ultrasound in the diagnosis of IUGR, will be ... before that, all fetuses have relatively larger heads, which will mask the brain-.

  18. Candida meningitis in a suspected immunosuppressive patient - A ...

    African Journals Online (AJOL)

    Candida meningitis in a suspected immunosuppressive patient - A case report. EO Sanya, NB Ameen, BA Onile. Abstract. No Abstract. West African Journal of Medicine Vol. 25 (1) 2006: pp.79-81. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  19. Ajmaline challenge in young individuals with suspected Brugada syndrome

    NARCIS (Netherlands)

    Sorgente, A.; Sarkozy, A.; Asmundis, C. de; Chierchia, G.B.; Capulzini, L.; Paparella, G.; Henkens, S.; Brugada, P.

    2011-01-01

    BACKGROUND: The clinical characteristics and the results of ajmaline challenge in young individuals with suspected Brugada syndrome (BS) have not been systematically investigated. METHODS: Among a larger series of patients included in the BS database of our Department, 179 patients undergoing

  20. A Diagnostic Program for Patients Suspected of Having Lung Cancer

    NARCIS (Netherlands)

    Stigt, Jos A.; Uil, Steven M.; Oostdijk, Ad H.; Boers, James E.; van den Berg, Jan-Willem K.; Groen, Harry J. M.

    2012-01-01

    In 297 patients suspected of having lung cancer, invasive diagnostic procedures followed positron emission tomography/computed tomography (PET-CT) on the same day. For patients with a diagnosis of malignancy (215/297), investigations were finalized on 1 day in 85%, and bronchoscopy was performed in

  1. Use of Chest Radiography In Patients Suspected of Pulmonary ...

    African Journals Online (AJOL)

    may be rushed into treatfng all cases of cough, fever and weight loss with negative sputums as PTB, and other diagnoses may be overlooked. A cheaper, quicker way of screening TB suspects would help con- siderably in this common problem. In Febuary 1991, the Norwegian Government do- nated two Odelka camer;l,s to ...

  2. Opioid analgesic administration in patients with suspected drug use.

    Science.gov (United States)

    Kreling, Maria Clara Giorio Dutra; Mattos-Pimenta, Cibele Andrucioli de

    2017-01-01

    To identify the prevalence of patients suspected of drug use according to the nursing professionals' judgement, and compare the behavior of these professionals in opioid administration when there is or there is no suspicion that patient is a drug user. A cross-sectional study with 507 patients and 199 nursing professionals responsible for administering drugs to these patients. The Chi-Square test, Fisher's Exact and a significance level of 5% were used for the analyzes. The prevalence of suspected patients was 6.7%. The prevalence ratio of administration of opioid analgesics 'if necessary' is twice higher among patients suspected of drug use compared to patients not suspected of drug use (p = 0.037). The prevalence of patients suspected of drug use was similar to that of studies performed in emergency departments. Patients suspected of drug use receive more opioids than patients not suspected of drug use. Identificar a prevalência de pacientes com suspeita de uso de drogas conforme opinião de profissionais de enfermagem e comparar a conduta desses profissionais na administração de opioides quando há ou não suspeita de que o paciente seja usuário de drogas. Estudo transversal com 507 pacientes e 199 profissionais de enfermagem responsáveis pela administração de medicamentos a esses pacientes. Para as análises foram utilizados os testes de Qui-Quadrado, Exato de Fisher e um nível de significância de 5%. A prevalência de pacientes suspeitos foi 6,7%. A razão de prevalência de administração de analgésicos opioides "se necessário" é duas vezes maior entre os pacientes suspeitos em relação aos não suspeitos (p=0,037). A prevalência de suspeitos foi semelhante à de estudos realizados em departamentos de emergência. Os suspeitos de serem usuários de drogas recebem mais opioides do que os não suspeitos.

  3. Exploring Consumer and Patient Knowledge, Behavior, and Attitude Toward Medicinal and Lifestyle Products Purchased From the Internet: A Web-Based Survey.

    OpenAIRE

    Assis, Sulaf; Thomas, J; Haffar, Mohamed; Osselton, David M.

    2016-01-01

    BACKGROUND: In recent years, lifestyle products have emerged to help improve people's physical and mental performance. The Internet plays a major role in the spread of these products. However, the literature has reported issues regarding the authenticity of medicines purchased from the Internet and the impact of counterfeit medicines on public health. Little or no data are available on the authenticity of lifestyle products and actual toxicity associated with their use and misuse. OBJECTIVE: ...

  4. Magnetic resonance imaging versus bone scintigraphy in suspected scaphoid fracture

    Energy Technology Data Exchange (ETDEWEB)

    Tiel-van Buul, M.M.C. [Dept. of Nuclear Medicine, Academic Medical Center, Univ. of Amsterdam (Netherlands); Roolker, W. [Dept. of Nuclear Medicine, Academic Medical Center, Univ. of Amsterdam (Netherlands); Verbeeten, B.W.B. Jr. [Dept. of Radiology, Academic Medical Center, Univ. of Amsterdam (Netherlands); Broekhuizen, A.H. [Dept. of Traumatology, Academic Medical Center, Univ. of Amsredam (Netherlands)

    1996-08-01

    Magnetic resonance imaging (MRI) has become increasingly useful in the evaluation of musculoskeletal problems, including those of the wrist. In patients with a wrist injury, MRI is used mainly to assess vascularity of scaphoid non-union. However, the use of MRI in patients in the acute phase following carpal injury is not common. Three-phase bone scintigraphy is routinely performed from at least 72 h after injury in patients with suspected scaphoid fracture and negative initial radiographs. We evaluated MRI in this patient group. The bone scan was used as the reference method. Nineteen patients were included. Bone scintigraphy was performed in all 19 patients, but MRI could be obtained in only 16 (in three patients, MRI was stopped owing to claustrophobia). In five patients, MRI confirmed a scintigraphically suspected scaphoid fracture. In one patient, a perilunar luxation, without a fracture, was seen on MRI, while bone scintigraphy showed a hot spot in the region of the lunate bone, suspected for fracture. This was confirmed by surgery. In two patients, a hot spot in the scaphoid region was suspected for scaphoid fracture, and immobilization and employed for a period of 12 weeks. MRI was negative in both cases; in one of them a scaphoid fracture was retrospectively proven on the initial X-ray series. In another two patients, a hot spot in the region of MCP I was found with a negative MRI. In both, the therapy was adjusted. In the remaining six patients, both modalities were negative. We conclude that in the diagnostic management of patients with suspected scaphoid fracture and negative initial radiographs, the use of MRI may be promising, but is not superior to three-phase bone scintigraphy. (orig.)

  5. A rational clinical approach to suspected insulin allergy

    DEFF Research Database (Denmark)

    Bødtger, Uffe; Wittrup, M

    2005-01-01

    AIMS: Allergy to recombinant human (rDNA) insulin preparations is a rare complication of insulin therapy. However, insulin preparations contain several allergens, and several disorders can resemble insulin allergy. Studies evaluating the diagnostic procedures on suspected insulin allergy...... technique (n = 5), skin disease (n = 3) and other systemic allergy (n = 1). Nine other patients were found to be allergic to protamine (n = 3) or rDNA insulin (n = 6), and specific treatment was associated with relief in 8 patients (89%). Four patients had local reactions of unknown causes but symptom...... relief was obtained in three cases by unspecific therapy. Overall, 20 (91%) reported relief of symptoms. CONCLUSION: Our standardized investigative procedure of suspected insulin preparation (IP) allergy was associated with relief of symptoms in > 90% of patients. IP allergy was diagnosed in 41...

  6. Interdisciplinary action of nurses to children with suspected sexual abuse

    Directory of Open Access Journals (Sweden)

    Lia Leão Ciuffo

    2014-04-01

    Full Text Available Objective. Understanding the role of nurses as members of interdisciplinary teams in the care of children with suspected sexual abuse. Methodology. This is a qualitative research based on the sociological phenomenology of Alfred Schutz. In 2008 were interviewed eleven nurses who worked in reference institutions for the care of child victims of sexual abuse in Rio de Janeiro. Results. The category called 'Interacting with other professionals in child care' emerged from the analysis of performance of professionals. The intersubjective relations between the nurses and the interdisciplinary team will enable to understand the intent of care from the perspective of social, emotional and psychological needs of children and their families. Conclusion. Interdisciplinarity favored the development of actions based on acceptance, listening and agreements on possible solutions in the care of children with suspected sexual abuse.

  7. Atlantoaxial subluxation and nasopharyngeal necrosis complicating suspected granulomatosis with polyangiitis.

    Science.gov (United States)

    Mohapatra, Anand; Holekamp, Terrence F; Diaz, Jason A; Zebala, Lukas; Brasington, Richard

    2015-04-01

    Granulomatosis polyangiitis (GPA, formerly Wegener granulomatosis) is a vasculitis that typically involves the upper respiratory tract, lungs, and kidneys. The 2 established methods to confirm a suspicion of GPA are the antineutrophil cytoplasmic antibody (ANCA) test and biopsy. However, ANCA-negative cases have been known to occur, and it can be difficult to find biopsy evidence of granulomatous disease.We report a case of suspected granulomatosis with polyangiitis limited to the nasopharynx. With a negative ANCA and no histological evidence, our diagnosis was founded on the exclusion of other diagnoses and the response to cyclophosphamide therapy. This case is unique because the patient's lesion resulted in atlantoaxial instability, which required a posterior spinal fusion at C1-C2. This is the first reported case of suspected GPA producing damage to the cervical spine and threatening the spinal cord.

  8. Suspected side effects to the quadrivalent human papilloma vaccine

    DEFF Research Database (Denmark)

    Brinth, Louise; Theibel, Ann Cathrine; Pors, Kirsten

    2015-01-01

    INTRODUCTION: The quadrivalent vaccine that protects against human papilloma virus types 6, 11, 16 and 18 (Q-HPV vaccine, Gardasil) was included into the Danish childhood vaccination programme in 2009. During the past years, a collection of symptoms primarily consistent with sympathetic nervous...... system dysfunction have been described as suspected side effects to the Q-HPV vaccine. METHODS: We present a description of suspected side effects to the Q-HPV vaccine in 53 patients referred to our Syncope Unit for tilt table test and evaluation of autonomic nervous system function. RESULTS: All...... consistency in the reported symptoms as well as between our findings and those described by others. Our findings neither confirm nor dismiss a causal link to the Q-HPV vaccine, but they suggest that further research is urgently warranted to clarify the pathophysiology behind the symptoms experienced...

  9. Radiological (scintigraphic) evaluation of patients with suspected pulmonar thromboembolism

    Energy Technology Data Exchange (ETDEWEB)

    Biello, D.R.

    1987-06-19

    The optimal strategy for diagnostic evaluation of patients with suspected pulmonary thromboembolism (PE) is subject of controversial and often conflicting opinions. If untreated, as many as 30% of patients with PE may die. Conversely, anticoagulant therapy significantly decreases mortality from PE, but bleeding complications occur. Underdiagnosis may result in a preventable death, and overdiagnosis may lead to significant hemorrhage from unnecessary anticoagulant therapy. This article outlines a practical guide for the use of pulmonary ventilation-perfusion (V-P) scintigraphy in patients with suspected PE. Perfusion imaging involves the intravenous injection of radiolabeled particles ranging from 10 to 60 ..mu..m in diameter (technetium Tc 99m macroaggregated albumin or technetium Tc 99m serum albumin microspheres); these particles are trapped in the capillaries and precapillary arterioles of the lung. The radiolabeled particles are distributed to the lungs in proportion to regional pulmonary blood flow. The correspondence of perfusion defects to bronchopulmonary segments is best appreciated in the posterior oblique views.

  10. Radiotherapy in three suspect cases of feline thymoma.

    Science.gov (United States)

    Kaser-Hotz, B; Rohrer, C R; Fidel, J L; Nett, C S; Hörauf, A; Hauser, B

    2001-01-01

    Radiation therapy for three cases of suspect feline thymoma is described. The thymoma was controlled for 4 years in case no. 1. Case no. 2 responded well to radiation therapy but was euthanized after 2 months because of a nasal adenocarcinoma. Case no. 3 continues to do well more than 8 months after radiotherapy. Difficulties in diagnosing feline thymomas are discussed, and biological behavior as well as different treatment modalities of feline and human thymomas are compared.

  11. Interviewing strategically to elicit admissions from guilty suspects

    OpenAIRE

    Tekin, Serra; Granhag, Pär Anders; Strömwall, Leif; Giolla, Erik Mac; Vrij, Aldert; Hartwig, Maria

    2015-01-01

    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 incons...

  12. MRI for clinically suspected pediatric appendicitis: case interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Brian, James M.; Methratta, Sosamma T.; Hulse, Michael A.; Choudhary, Arabinda K.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Division of Pediatric Radiology, Department of Radiology, Hershey, PA (United States)

    2014-05-15

    As utilization of MRI for clinically suspected pediatric appendicitis becomes more common, there will be increased focus on case interpretation. The purpose of this pictorial essay is to share our institution's case interpretation experience. MRI findings of appendicitis include appendicoliths, tip appendicitis, intraluminal fluid-debris level, pitfalls of size measurements, and complications including abscesses. The normal appendix and inguinal appendix are also discussed. (orig.)

  13. MRI for clinically suspected pediatric appendicitis: an implemented program

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Gustas, Cristy N.; Choudhary, Arabinda K.; Methratta, Sosamma T.; Hulse, Michael A.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Department of Radiology, Mail Code H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Geeting, Glenn [Penn State Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, PA (United States)

    2012-09-15

    Emergent MRI is now a viable alternative to CT for evaluating appendicitis while avoiding the detrimental effects of ionizing radiation. However, primary employment of MRI in the setting of clinically suspected pediatric appendicitis has remained significantly underutilized. To describe our institution's development and the results of a fully implemented clinical program using MRI as the primary imaging evaluation for children with suspected appendicitis. A four-sequence MRI protocol consisting of coronal and axial single-shot turbo spin-echo (SS-TSE) T2, coronal spectral adiabatic inversion recovery (SPAIR), and axial SS-TSE T2 with fat saturation was performed on 208 children, ages 3 to 17 years, with clinically suspected appendicitis. No intravenous or oral contrast material was administered. No sedation was administered. Data collection includes two separate areas: time parameter analysis and MRI diagnostic results. Diagnostic accuracy of MRI for pediatric appendicitis indicated a sensitivity of 97.6% (CI: 87.1-99.9%), specificity 97.0% (CI: 93.2-99.0%), positive predictive value 88.9% (CI: 76.0-96.3%), and negative predictive value 99.4% (CI: 96.6-99.9%). Time parameter analysis indicated clinical feasibility, with time requested to first sequence obtained mean of 78.7 +/- 52.5 min, median 65 min; first-to-last sequence time stamp mean 14.2 +/- 8.8 min, median 12 min; last sequence to report mean 57.4 +/- 35.2 min, median 46 min. Mean age was 11.2 +/- 3.6 years old. Girls represented 57% of patients. MRI is an effective and efficient method of imaging children with clinically suspected appendicitis. Using an expedited four-sequence protocol, sensitivity and specificity are comparable to CT while avoiding the detrimental effects of ionizing radiation. (orig.)

  14. Epidemiology of suspected wrist joint infection versus inflammation.

    Science.gov (United States)

    Skeete, Kshamata; Hess, Erik P; Clark, Tod; Moran, Steven; Kakar, Sanjeev; Rizzo, Marco

    2011-03-01

    To determine the cumulative prevalence of septic arthritis presenting to the emergency department of an academic medical center and evaluate the use of clinical data to diagnose infection versus inflammation. We conducted a records review of a single institution with 80,000 annual emergency room visits. We included a consecutive series of patients with suspected wrist infection from January 1, 2007, to December 31, 2008. Adults complaining of atraumatic wrist pain with either erythema or swelling on physical examination or a final diagnosis of septic arthritis, gout, pseudogout, cellulitis, wrist hematoma/edema, or wrist arthritic flare were suspected to have infection. We collected data using a standardized data abstraction form. We reviewed 804 patient records. A total of 104 patients meeting inclusion criteria for suspected wrist joint infection during the 2-year study period were included. Mean age was 62.5 years (SD, 20.2 y); 63 were men. There were 12 patients with a history of gout, 4 with a history of pseudogout, and 19 with a history of diabetes. Wrist arthrocentesis was performed in 31 patients, and 11 underwent surgical treatment. There were 16 patients with a final diagnosis of gout, 11 with pseudogout, 43 with cellulitis, 13 with upper extremity hematoma/edema, and 15 with wrist arthritic flare. The cumulative prevalence of septic arthritis was 5%. In this series of emergency department patients with suspected wrist joint infection, gout, pseudogout, and cellulitis were the most common etiologies. The cumulative incidence of septic wrist arthritis was low. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  15. Suspected spinocellular carcinoma of the inferior eyelid resulted multiple chalazion.

    Science.gov (United States)

    Onesti, Maria Giuseppina; Troccola, Antonietta; Maruccia, Michele; Conversi, Andrea; Scuderi, Gianluca

    2013-01-01

    Chalazion is a subacute granulomatous inflammation of the eyelid caused by retention of tarsal gland secretions and it's the most common inflammatory lesion of the eyelid. In cases of doubtful clinical presentation the diagnosis with a biopsy and a histopathological examination is important because it can orientate an appropriate surgical treatment. We report a case of a 64-years-old diabetic man, suspected for a spinocellular lesion of the inferior eyelid of the left eye, it resulted unexpectedly a chalazion.

  16. CT-guided biopsy of suspected malignancy: A potential pitfall

    Directory of Open Access Journals (Sweden)

    Steven Henderson

    2013-11-01

    Full Text Available Paragangliomas are rare catecholamine-secreting neuro-endocrine tumours that can arise from sympathetic or parasympathetic tissue. Any manipulation of these tumours, without appropriate medical therapy, can result in excess catecholamine release leading to a catecholamine crisis. Neuro-endocrine tumours must be considered prior to interventional biopsy of an unknown soft-tissue mass, and appropriate biochemical investigations should be performed in suspected cases to prevent catastrophic complications.

  17. [Three cases of suspected re-infection of mumps virus].

    Science.gov (United States)

    Hatanaka, Akio; Kamada, Tomoko; Honda, Keiji; Tazaki, Akihisa; Kishine, Naomi; Kawashima, Yoshiyuki

    2012-08-01

    A 32-year-old woman, 5-year-old girl, and 33-year-old man visited our otorhinolaryngology outpatient clinic with tumentia of the unilateral parotid gland. A high titer of serum IgG antibodies against the mumps virus was detected. Around the same time, other members of their families had the same parotid tumentia, and they were diagnosed as having their first mumps infection. Therefore, the diagnosis of the three cases was strongly suspected to be re-infection with mumps. In Japan, it was classically believed that the mumps virus infection occurs only once in patients and reinfection doesn't occur. However, some pediatricians in Japan have reported that re-infection with mumps is strongly suspected when high titers of serum IgG antibodies against the mumps virus are found at the initial visit. It is now believed many more examples of mumps re-infection cases have existed than we previously believed. When high titers of serum IgG antibodies against the mumps virus are detected at an initial visit in patients who have had mumps previously, re-infection should be strongly suspected. And to make it certain, we suggest that the mumps IgG antibodies should be checked twice to confirm the diagnosis. If elevation of the IgG antibodies persist, the diagnosis will be much more certain.

  18. Ten-day observation of live rabies suspected dogs.

    Science.gov (United States)

    Tepsumethanon, V; Wilde, H; Sitprija, V

    2008-01-01

    This study aimed at analyzing a ten-day observation period of rabies suspected dogs and cats according to six criteria. Dogs and cats suspected of being rabid were brought for observation when they had either bitten a person or another animal or when abnormal behaviour or unusual illness was observed. Between 1985 and 2005, retrospective and prospective data from 1,222 dogs and 303 cats was collected during the ten-day observation period. If an animal had died, brain examination using fluorescent antibody testing was routinely performed. If an animal had survived for > or =10 days, it was released to its owner or transferred to the municipal dog shelter. A total of 644 dogs and 58 cats found rabid died within 10 days of observation. In addition, for 208 dogs confirmed rabid with laboratory tests between 1997 and 2005, six criteria were analysed from the day of submission. This experience with the implemented 10-day observation period confirms the WHO recommendation on identifying suspected rabid dogs or cats under veterinary supervision following a human exposure.

  19. MR delayed enhancement imaging findings in suspected acute myocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Gahide, Gerald [CHU de Montpellier, Radiologie centrale - Pole Cardiovasculaire et Thoracique, Montpellier (France); Centre Hospitalo-Universitaire de Montpellier, Hopital A de Villeneuve, Montpellier (France); Bertrand, D.; Dacher, J.N. [CHU de Rouen, Radiologie centrale - Hopital Charles Nicolle, Rouen (France); Roubille, F.; Skaik, S.; Piot, C.; Leclerq, F. [CHU de Montpellier, Departement de Cardiologie - Pole Cardiovasculaire et Thoracique, Montpellier (France); Tron, C.; Cribier, A. [CHU de Rouen, Departement de Cardiologie - Hopital Charles Nicolle, Rouen (France); Vernhet, H. [CHU de Montpellier, Radiologie centrale - Pole Cardiovasculaire et Thoracique, Montpellier (France)

    2010-01-15

    The purpose of the study was to prospectively assess the clinical impact of routinely performed delayed enhancement imaging in suspected acute myocarditis. A two-centre prospective study was performed in patients with suspected acute myocarditis. The protocol included horizontal long axis, vertical long axis and short axis cine MR and delayed enhancement imaging after Gd-DTPA infusion (0.2 mmol/kg). Sixty consecutive patients were enrolled (aged 49.4{+-}17.8 years). MRI demonstrated delayed enhancement sparing the subendocardicardial layer in 51.6% of patients, concordant with the diagnosis of acute myocarditis; 16.7% of patients exhibited delayed enhancement involving the subendocardial layer with irregular margins, concordant with the diagnosis of acute myocardial infarction; 31.7% of patients had delayed enhancement imaging that was considered normal. Routine imaging to identify delayed enhancement provided crucial information in suspected acute myocarditis by reinforcing the diagnosis in 51.6% of patients and correcting a misdiagnosed acute myocardial infarction in 16.7% of patients. (orig.)

  20. Low dose computed tomography in suspected acute renal colic.

    Science.gov (United States)

    Meagher, T; Sukumar, V P; Collingwood, J; Crawley, T; Schofield, D; Henson, J; Lakin, K; Connolly, D; Giles, J

    2001-11-01

    To evaluate whether computed tomography (CT) of the renal tract in suspected renal colic using reduced exposure factors maintains diagnostic accuracy. Prospective multi-centre cohort study. Patients with suspected renal colic were examined using computed tomography (CT) of the renal tract followed by intravenous urography (IVU) in four different centres with five different CT systems. Sixty-nine patients with suspected renal colic had CT of the renal tract followed by IVU. CT was performed with reduced exposure factors, giving a mean CT effective dose of 3.5 (range 2.8-4.5) mSv compared with 1.5 mSv for IVU. Ureteric calculi were detected in 43 patients: CT and IVU detected 40 (93%) ureteric calculi. CT identified other lesions causing symptoms in five patients and identified renal calculi in 24 patients. IVU identified renal calculi in six patients and made false positive diagnosis of renal calculi in seven patients. Mean examination time for CT was 5 minutes and for IVU was 80 minutes. CT examination at reduced exposure factors maintains the diagnostic accuracy recorded in other series. Copyright 2001 The Royal College of Radiologists.

  1. The economics of cardiac biomarker testing in suspected myocardial infarction.

    Science.gov (United States)

    Goodacre, Steve; Thokala, Praveen

    2015-03-01

    Suspected myocardial infarction (MI) is a common reason for emergency hospital attendance and admission. Cardiac biomarker measurement is an essential element of diagnostic assessment of suspected MI. Although the cost of a routinely available biomarker may be small, the large patient population and consequences in terms of hospital admission and investigation mean that the economic impact of cardiac biomarker testing is substantial. Economic evaluation involves comparing the estimated costs and effectiveness (outcomes) of two or more interventions or care alternatives. This process creates some difficulties with respect to cardiac biomarkers. Estimating the effectiveness of cardiac biomarkers involves identifying how they help to improve health and how we can measure this improvement. Comparison to an appropriate alternative is also problematic. New biomarkers may be promoted on the basis of reducing hospital admission or length of stay, but hospital admission for low risk patients may incur significant costs while providing very little benefit, making it an inappropriate comparator. Finally, economic evaluation may conclude that a more sensitive biomarker strategy is more effective but, by detecting and treating more cases, is also more expensive. In these circumstances it is unclear whether we should use the more effective or the cheaper option. This article provides an introduction to health economics and addresses the specific issues relevant to cardiac biomarkers. It describes the key concepts relevant to economic evaluation of cardiac biomarkers in suspected MI and highlights key areas of uncertainty and controversy. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  2. Limitation of personal freedom by detention of suspect

    Directory of Open Access Journals (Sweden)

    Knežević Saša

    2011-01-01

    Full Text Available The right of personal freedom is one of the most important right from the set of basic human rights and freedoms, contained in the most important acts of international legal character, and the constitutions of states based on the rule of law. This right is directly related to the very human existence, and, therefore, it is necessary to make its legal articulation. Personal freedom means the right to security of the citizen, that he will not be arrested and detained in prison by the state authorities, as well as the right to be free to move and inhabit. However, from the very nature of Criminal Law protection of social values, arises the need to limit the right to personal freedom in exceptional circumstances, including the detention of the suspect. Keeping the suspect is a measure of procedural compulsion, by which, through the police decision, detained prison is temporarily imprisoned, for gathering information and hearing. The basic principles of humanity require that the detained suspect retains all the rights, derived from the principle of personal liberty.

  3. MIBG in the evaluation of suspected pheochromocytoma: Mayo Clinic experience

    Energy Technology Data Exchange (ETDEWEB)

    Brown, M.L.; Sheps, S.G.; Sizemore, G.; Swensen, S.J.; Gharib, H.; Grant, C.S.; van Heerden, J.A.

    1984-01-01

    Work done at the University of Michigan has shown that I-131 metaiodobenzylguanidine (MIBG) is an effective agent for the diagnosis and localization of pheochromocytoma. A recent report questioned the sensitivity of this test. In 1983, 40 patients at Mayo Clinic had 42 scans during the workup of suspected spontaneous pheochromocytoma or metastatic pheochromocytoma. All patients were given 500 ..mu..Ci I-131 MIBG supplied by the University of Michigan. The final diagnosis of pheochromocytoma (true positive (TP) and false negative (FN) and false positive (FP)) was made by surgery and pathology. True negative (TN) diagnosis was made by normal plasma and urinary catecholamines, and in many patients CT. There were 15 TP studies (six spontaneous pheochrocytoma, nine metastatic or recurrent pheochromoctyoma), and 22 TN studies. There was one FP study of recurrent paraganglioma near the bladder (CT was also FP) and four FN studies (two spontaneous and two metastatic) where one CT was also FN. This results in a sensitivity of 79%, specificity of 96%, and accuracy of 88%. MIBG is very useful in the workup of patients with known or suspected recurrent or metastatic pheochromocytoma and is helpful in the evaluation of the patient suspected of having a spontaneous pheochromocytoma when CT is normal.

  4. Falsificação de medicamentos no Brasil Falsificación de medicamentos en Brasil Counterfeiting of drugs in Brazil

    Directory of Open Access Journals (Sweden)

    Joseane Ames

    2012-02-01

    ,9% y 5,7%, respectivamente. La mayor parte de los medicamentos falsos fue incautada en los estados Paraná, Sao Paulo y Santa Catarina, con incremento superior a 200% en el número de medicamentos inauténticos encaminados a la pericia en el período. Hubo aumento en las incautaciones de medicamentos contrabandeados arrecadados en conjunto con los falsos, 67% de las incautaciones incluyeron al menos un medicamento contrabandeado. CONCLUSIONES: La falsificación de medicamentos es un grave problema de salud pública. La identificación de las clases de medicamentos falsos en Brasil y los principales estados brasileños con esta problemática pueden facilitar acciones futuras de prevención y represión por los órganos brasileños responsables.OBJECTIVE: To identify the main counterfeit drugs seized by the Brazilian Federal Police and the states where seizures have been made. METHODS: A retrospective descriptive study on expert reports produced by criminal investigators of the Federal Police between January 2007 and September 2010, in relation to counterfeit drugs, was carried out. RESULTS: The drugs with greatest numbers of seizures were selective phosphodiesterase-5 inhibitors that are used for treating male erectile dysfunction (Cialis® and Viagra®, mean = 66% , followed by anabolic steroids (Durateston® and Hemogenin®: 8.9% and 5.7%, respectively. The greatest proportions of the counterfeit drugs were seized in the states of Paraná, Santa Catarina (both Southeastern Brazil and São Paulo (Southeastern, and the number of non-authentic drugs sent for investigation increased by more than 200% over the study period. There were increases in seizures of smuggled drugs found together with counterfeit drugs: 67% of the seizures included at least one smuggled drug. CONCLUSIONS: Counterfeiting of drugs is a severe public health problem. Identification of the classes of counterfeit drugs present in Brazil and the main Brazilian states with this problem may facilitate

  5. Imaging trends in suspected appendicitis-a Canadian perspective.

    Science.gov (United States)

    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

  6. Predictors of bacteremia in emergency department patients with suspected infection.

    Science.gov (United States)

    Chase, Maureen; Klasco, Richard S; Joyce, Nina R; Donnino, Michael W; Wolfe, Richard E; Shapiro, Nathan I

    2012-11-01

    The goal of this study is to identify clinical variables associated with bacteremia. Such data could provide a rational basis for blood culture testing in emergency department (ED) patients with suspected infection. This is a secondary analysis of a prospective cohort of ED patients with suspected infection. Data collected included demographics, vital signs, medical history, suspected source of infection, laboratory and blood culture results and outcomes. Bacteremia was defined as a positive blood culture by Centers for Disease Control criteria. Clinical variables associated with bacteremia on univariate logistic regression were entered into a multivariable model. There were 5630 patients enrolled with an average age of 59.9 ± 19.9 years, and 54% were female. Blood cultures were obtained on 3310 (58.8%). There were 409 (12.4%) positive blood cultures, of which 68 (16.6%) were methicillin-resistant Staphylococcus aureus (MRSA) and 161 (39.4%) were Gram negatives. Ten covariates (respiratory failure, vasopressor use, neutrophilia, bandemia, thrombocytopenia, indwelling venous catheter, abnormal temperature, suspected line or urinary infection, or endocarditis) were associated with all-cause bacteremia in the final model (c-statistic area under the curve [AUC], 0.71). Additional factors associated with MRSA bacteremia included end-stage renal disease (odds ratio [OR], 3.9; 95% confidence interval [CI], 1.9-7.8) and diabetes (OR, 2.0; 95% CI, 1.1-3.6) (AUC, 0.73). Factors strongly associated with Gram-negative bacteremia included vasopressor use in the ED (OR, 2.8; 95% CI, 1.7-4.6), bandemia (OR, 3.5; 95% CI, 2.3-5.3), and suspected urinary infection (OR, 4.0; 95% CI, 2.8-5.8) (AUC, 0.75). This study identified several clinical factors associated with bacteremia as well as MRSA and Gram-negative subtypes, but the magnitude of their associations is limited. Combining these covariates into a multivariable model moderately increases their predictive value. Copyright

  7. 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

  8. Isolation & characterization of Brucella melitensis isolated from patients suspected for human brucellosis in India.

    Science.gov (United States)

    Barua, Anita; Kumar, Ashu; Thavaselvam, Duraipandian; Mangalgi, Smita; Prakash, Archana; Tiwari, Sapana; Arora, Sonia; Sathyaseelan, Kannusamy

    2016-05-01

    Brucellosis is endemic in the southern part of India. A combination of biochemical, serological and molecular methods is required for identification and biotyping of Brucella. The present study describes the isolation and biochemical, molecular characterization of Brucella melitensis from patients suspected for human brucellosis. The blood samples were collected from febrile patients suspected to have brucellosis. A total of 18 isolates were obtained from 102 blood samples subjected to culture. The characterization of these 18 isolates was done by growth on Brucella specific medium, biochemical reactions, CO2 requirement, H2S production, agglutination with A and M mono-specific antiserum, dye sensitivity to basic fuchsin and thionin. Further, molecular characterization of the isolates was done by amplification of B. melitensis species specific IS 711 repetitive DNA fragment and 16S (rRNA) sequence analysis. PCR-restriction fragment length polymorphism (RFLP) analysis of omp2 locus and IS711 gene was also done for molecular characterization. All 102 suspected samples were subjected to bacteria isolation and of these, 18 isolates could be recovered on blood culture. The biochemical, PCR and PCR-RFLP and 16s rRNA sequencing revealed that all isolates were of B. melitensis and matched exactly with reference strain B. melitensis 16M. The present study showed an overall isolation rate of 17.64 per cent for B. melitensis. There is a need to establish facilities for isolation and characterization of Brucella species for effective clinical management of the disease among patients as well as surveillance and control of infection in domestic animals. Further studies are needed from different geographical areas of the country with different level of endemicity to plan and execute control strategies against human brucellosis.

  9. Prognostic importance of quantitative echocardiographic evaluation in patients suspected of first non-massive pulmonary embolism

    DEFF Research Database (Denmark)

    Kjaergaard, Jesper; Schaadt, Bente Krogsgaard; Lund, Jens Otto

    2008-01-01

    AIMS: Patients suspected of acute pulmonary embolism (PE) frequently undergo echocardiography as a part of the initial work-up. Prognostic implication of routine echocardiography in patients suspected of PE remain to be established. METHODS AND RESULTS: Transthoracic echocardiography, including...

  10. Icare rebound tonometry in children with known and suspected glaucoma.

    Science.gov (United States)

    Flemmons, Meghan S; Hsiao, Ya-Chuan; Dzau, Jacqueline; Asrani, Sanjay; Jones, Sarah; Freedman, Sharon F

    2011-04-01

    Accurate intraocular pressure (IOP) measurement, important in managing pediatric glaucoma, often presents challenges. The Icare rebound tonometer shows promise for screening healthy children and has been reported comparable with Goldmann applanation in adults with glaucoma. The purpose of this study was to evaluate the Icare tonometer against Goldmann applanation for clinic IOP measurement in pediatric glaucoma. This was a prospective study comparing Icare versus Goldmann tonometry in pediatric glaucoma. Children with known or suspected glaucoma were recruited from scheduled clinic visits. IOP was measured with the Icare tonometer by a clinician and subsequently measured with Goldmann applanation tonometry (GAT) by a different single masked clinician. A total of 71 eyes of 71 children with known or suspected glaucoma were included. IOP by GAT ranged from 9 to 36 mm Hg. Icare readings ranged from 11 to 44 mm Hg. Mean difference between Icare and GAT was 2.3 ± SD 3.7 mm Hg, p IOPs were within ± 3 mm Hg of GAT in 63%. Icare IOPs were ≥GAT IOPs in 75%. The following factors were not associated with Icare IOPs greater than GAT: child's age, glaucoma diagnosis, strabismus, nystagmus, central corneal thickness, Icare instrument-reported reliability, number of glaucoma surgeries or medications, corneal abnormalities, and visual acuity. IOP by Icare tonometry was within 3 mm Hg of IOP by GAT in 63% and greater than GAT in 75%. This device may be reasonable to estimate IOP in selected children with known or suspected glaucoma whose IOP cannot otherwise be obtained in clinic; however, correlation of Icare IOPs with clinical findings must continue to be considered in each case. Copyright © 2011 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  11. Benefits of sonography in diagnosing suspected uncomplicated acute diverticulitis.

    Science.gov (United States)

    King, Welfur C; Shuaib, Waqas; Vijayasarathi, Arvind; Fajardo, Carlos G; Cabrera, Waldo E; Costa, Juan L

    2015-01-01

    Despite evidence demonstrating equivalent accuracy of sonography and computed tomography (CT) in the workup of mild/uncomplicated acute diverticulitis, CT is overwhelmingly performed as the initial diagnostic test, particularly in the acute setting. Our study evaluated potential radiation and turnaround time savings associated with performing sonography instead of CT as the initial diagnostic examination in the workup of suspected uncomplicated acute diverticulitis. We retrospectively reviewed medical records from January 2010 to December 2012 for patients presenting with clinical symptoms of acute diverticulitis. Patients were categorized as a whole and subgrouped by age (>40 and 40 years and 121 diverticulitis. © 2015 by the American Institute of Ultrasound in Medicine.

  12. A Suspected Pelvic Aneurysmal Bone Cyst in Pregnancy

    Directory of Open Access Journals (Sweden)

    Rayan Elkattah

    2013-01-01

    Full Text Available Albeit rare, the majority of identified bone lesions in pregnancy spare the pelvis. Once encountered with a pelvic bone lesion in pregnancy, the obstetrician may face a challenging situation as it is difficult to determine and predict the effects that labor and parturition impart on the pelvic bones. Bone changes and pelvic bone fractures have been well documented during childbirth. The data regarding clinical outcomes and management of pregnancies complicated by pelvic ABCs is scant. Highly suspected to represent an aneurysmal bone cyst, the clinical evaluation of a pelvic lesion in the ilium of a pregnant individual is presented, and modes of delivery in such a scenario are discussed.

  13. Patch Testing in Suspected Allergic Contact Dermatitis to Cosmetics

    OpenAIRE

    Pramod Kumar; Rekha Paulose

    2014-01-01

    Background. Increasing use of cosmetics has contributed to a rise in the incidence of allergic contact dermatitis (ACD) to cosmetics. It is estimated that 1–5.4% of the population is sensitized to a cosmetic ingredient. Patch testing helps to confirm the presence of an allergy and to identify the actual allergens which are chemical mixtures of various ingredients. Objectives. The aims of this study are to perform patch testing in suspected ACD to cosmetics and to identify the most common alle...

  14. Investigation of suspected chronic fatigue syndrome/myalgic encephalopathy.

    Science.gov (United States)

    Owe, Jone Furlund; Næss, Halvor; Gjerde, Ivar Otto; Bødtker, Jørn Eilert; Tysnes, Ole-Bjørn

    2016-02-09

    Chronic fatigue is a frequently occurring problem in both the primary and specialist health services. The Department of Neurology at Haukeland University Hospital has established a standard assessment for patients referred with suspected CFS/ME. This study reports diagnoses and findings upon assessment, and considers the benefit of supplementary examinations. Diagnoses and findings from examinations of 365 patients assessed for suspected CFS/ME are retrospectively reported. A total of 48 patients (13.2%) were diagnosed with CFS/ME, while a further 18 patients (4.9%) were diagnosed with post-infectious fatigue. Mental and behavioural disorders were diagnosed in 169 patients (46.3%), and these represented by far the largest group. Serious, but unrecognised somatic illness was discovered in two patients, while changes of uncertain significance were identified by MRI and lumbar puncture in a few patients. Fatigue is a frequently occurring symptom in the population. Thorough somatic and psychiatric investigation is necessary before referral to the specialist health services. Mental disorders and reactions to life crises are common and important differential diagnoses for CFS/ME. Long waiting times in the specialist health services may result in delayed diagnosis for these patients.

  15. Perioperative sexual interest in women with suspected gynecologic malignancies.

    Science.gov (United States)

    Bretschneider, C E; Bensen, Jeannette T; Geller, Elizabeth J; Gehrig, Paola A; Wu, Jennifer M; Doll, Kemi M

    2017-07-01

    For women with gynecologic cancer, the impact of surgery on sexual interest and desire in the immediate and later postoperative period is not well characterized. The objective of this study was to report the perioperative trends of changing sexual interest and desire in a cohort of women undergoing surgery for suspected gynecologic malignancies. This is an ancillary analysis of a cohort study analyzing health-related outcomes in women who underwent primary surgical management of a suspected gynecologic malignancy between 10/2013 and 10/2014. Subjects completed the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction Questionnaire (PROMIS-SFQ) preoperatively and questions on sexual interest and desire at one, three, and six months postoperatively. Bivariate tests and multiple linear regression were used to analyze data. Of 231 women who completed a baseline PROMIS-SFQ, 187 (81%) completed one-month, 170 (74%) three-month, and 174 (75%) six-month follow-up interviews. Following surgery, 71% of enrolled subjects were diagnosed with a malignancy. Women age women age >55 (-5.5±1.0 vs -2.3±0.9, p=0.02). In a multivariable analysis, age women of all ages (-5.6, 95% CI: -9.6, -1.5). This study provides new data regarding the timing and magnitude of changes in sexual interest following gynecologic oncology procedures. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. MRI diagnosis of suspected atlanto-occipital dissociation in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Grabb, B.C.; Frye, T.A.; Hedlund, G.L.; Vaid, Y.N.; Royal, S.A. [Department of Radiology, The Children`s Hospital of Alabama, Birmingham (United States); Grabb, P.A. [Department of Neurosurgery, University of Alabama at Birmingham (United States)

    1999-04-01

    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.) With 7 figs., 1 tab., 14 refs.

  17. MRI diagnosis of suspected atlanto-occipital dissociation in childhood.

    Science.gov (United States)

    Grabb, B C; Frye, T A; Hedlund, G L; Vaid, Y N; Grabb, P A; Royal, S A

    1999-04-01

    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). 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. 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. 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.

  18. CT Pulmonary Angiography and Suspected Acute Pulmonary Embolism

    Energy Technology Data Exchange (ETDEWEB)

    Enden, T.; Kloew, N.E. [Ullevaal Univ. Hospital, Oslo (Norway). Dept. of Cardiovascular Radiology

    2003-05-01

    Purpose: To evaluate the use and quality of CT pulmonary angiography in our department, and to relate the findings to clinical parameters and diagnoses. Material and Methods: A retrospective study of 324 consecutive patients referred to CT pulmonary angiography with clinically suspected pulmonary embolism (PE). From the medical records we registered clinical parameters, blood gases, D-dimer, risk factors and the results of other relevant imaging studies. Results: 55 patients (17%) had PE detected on CT. 39 had bilateral PE, and 8 patients had isolated peripheral PE. 87% of the examinations showing PE had satisfactory filling of contrast material including the segmental pulmonary arteries, and 60% of the subsegmental arteries. D-dimer test was performed in 209 patients, 85% were positive. A negative D-dimer ruled out PE detected at CT. Dyspnea and concurrent symptoms or detection of deep vein thrombosis (DVT), contraceptive pills and former venous thromboembolism (VTE) were associated with PE. The presence of only one clinical parameter indicated a negative PE diagnosis (p < 0.017), whereas two or more suggested a positive PE diagnosis (p < 0.002). CT also detected various ancillary findings such as consolidation, pleural effusion, nodule or tumor in nearly half of the patients; however, there was no association with the PE diagnosis. Conclusion: The quality of CT pulmonary angiography was satisfactory as a first-line imaging of PE. CT also showed additional pathology of importance in the chest. Our study confirmed that a negative D-dimer ruled out clinically suspected VTE.

  19. Ocular lesions following suspected lightning injury in a horse.

    Science.gov (United States)

    Evans, Paige M; Armour, Micki D; Dubielzig, Richard R

    2012-07-01

      To describe the gross and histopathological ocular findings in a horse following suspected lightning injury.   The eyes of a 2-year-old thoroughbred gelding were clinically and histopathologically evaluated following a severe lightning storm following euthanasia because of visual impairment.   Severe corneal edema and hydrops were noted clinically oculus dexter. Indirect ophthalmoscopy revealed bilateral symmetrical raised hyporeflective peripapillary geographic lesions. Histopathologic evaluation revealed corneal edema in the right eye with normal corneal endothelium. Posterior segment evaluation revealed localized, pericentral choroidal lesions characterized by the presence of hemorrhage, early fibrosis, and minimal lymphoplasmacytic, neutrophilic, and histiocytic inflammation with spindle cell proliferation. The retinas overlying the choroidal lesions were necrotic and mostly absent. Peripheral to the focal lesion, the retina abruptly returned to normal architecture peripheral to a zone of apoptotic photoreceptors. Centrally, swollen axons extended into the optic disc.   There have been few descriptions of ocular lesions in animals following suspected lightning injury. We believe these findings to be unique because of the type of thermal injury that may be characteristic of lightening injury. We do not know whether these lesions would have progressed over time. © 2011 American College of Veterinary Ophthalmologists.

  20. Suspected side effects to the quadrivalent human papilloma vaccine.

    Science.gov (United States)

    Brinth, Louise; Theibel, Ann Cathrine; Pors, Kirsten; Mehlsen, Jesper

    2015-04-01

    The quadrivalent vaccine that protects against human papilloma virus types 6, 11, 16 and 18 (Q-HPV vaccine, Gardasil) was included into the Danish childhood vaccination programme in 2009. During the past years, a collection of symptoms primarily consistent with sympathetic nervous system dysfunction have been described as suspected side effects to the Q-HPV vaccine. We present a description of suspected side effects to the Q-HPV vaccine in 53 patients referred to our Syncope Unit for tilt table test and evaluation of autonomic nervous system function. All patients had symptoms consistent with pronounced autonomic dysfunction including different degrees of orthostatic intolerance, severe non-migraine-like headache, excessive fatigue, cognitive dysfunction, gastrointestinal discomfort and widespread pain of a neuropathic character. We found consistency in the reported symptoms as well as between our findings and those described by others. Our findings neither confirm nor dismiss a causal link to the Q-HPV vaccine, but they suggest that further research is urgently warranted to clarify the pathophysiology behind the symptoms experienced in these patients and to evaluate the possibility and the nature of any causal link and hopefully establish targeted treatment options. not relevant. not relevant.

  1. Feline toxicological emergencies: when to suspect and what to do.

    Science.gov (United States)

    Grave, Tobias W; Boag, Amanda K

    2010-11-01

    Confirmed or suspected intoxications with a wide variety of agents represent a small but important group of feline emergency cases. Generally it is thought that toxicities are less common in cats compared with dogs, with a higher proportion relating to dermal as opposed to oral exposure. Once toxicity is suspected or diagnosed, it must be recognised that treatment regimes may need modification compared with those established for dogs. Different drugs or different dosages may be warranted and the choice of available drugs may be reduced. This review draws on published studies, case reports and clinical experience to summarise key features of the general management of the intoxicated feline patient before describing some of the more serious and common intoxications in more detail. The focus throughout the review is on the peculiarities of feline metabolism and how they may impact on presentation and treatment. The aim is to assist companion animal and feline practitioners, who are in the frontline when it comes to managing these emergency cases. Copyright © 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

  2. Influenza Illness among Case-Patients Hospitalized for Suspected Dengue, El Salvador, 2012.

    Directory of Open Access Journals (Sweden)

    Rafael Chacon

    Full Text Available We estimate the proportion of patients hospitalized for suspected dengue that tested positive for influenza virus in El Salvador during the 2012 influenza season. We tested specimens from 321 hospitalized patients: 198 patients with SARI and 123 patients with suspected dengue. Among 121 hospitalized suspected dengue (two co-infected excluded patients, 28% tested positive for dengue and 19% positive for influenza; among 35 with suspected dengue and respiratory symptoms, 14% were positive for dengue and 39% positive for influenza. One percent presented co-infection between influenza and dengue. Clinicians should consider the diagnosis of influenza among patients with suspected dengue during the influenza season.

  3. Influenza Illness among Case-Patients Hospitalized for Suspected Dengue, El Salvador, 2012.

    Science.gov (United States)

    Chacon, Rafael; Clara, Alexey Wilfrido; Jara, Jorge; Armero, Julio; Lozano, Celina; El Omeiri, Nathalie; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo

    2015-01-01

    We estimate the proportion of patients hospitalized for suspected dengue that tested positive for influenza virus in El Salvador during the 2012 influenza season. We tested specimens from 321 hospitalized patients: 198 patients with SARI and 123 patients with suspected dengue. Among 121 hospitalized suspected dengue (two co-infected excluded) patients, 28% tested positive for dengue and 19% positive for influenza; among 35 with suspected dengue and respiratory symptoms, 14% were positive for dengue and 39% positive for influenza. One percent presented co-infection between influenza and dengue. Clinicians should consider the diagnosis of influenza among patients with suspected dengue during the influenza season.

  4. Productivity

    DEFF Research Database (Denmark)

    Spring, Martin; Johnes, Geraint; Hald, Kim Sundtoft

    Productivity is increasingly critical for developed economies. It has always been important: as Paul Krugman puts it, “Productivity isn’t everything, but in the long run it is almost everything. A country’s ability to improve its standard of living over time depends almost entirely on its ability...... to raise its output per worker”(Krugman, 1994). Analyses of productivity have, by and large, been the preserve of economists. Operations Management (OM) is rooted in a similar concern for the efficient use of scarce resources; Management Accounting (MA) is concerned with the institutionalised measurement...... and management of productivity. Yet the three perspectives are rarely connected. This paper is a sketch of a literature review seeking to identify, contrast and reconcile these three perspectives. In so doing, it aims to strengthen the connections between policy and managerial analyses of productivity....

  5. Using Internet Artifacts to Profile a Child Pornography Suspect

    Directory of Open Access Journals (Sweden)

    Marcus K. Rogers

    2014-03-01

    Full Text Available 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 ad hoc law enforcement investigation. After the URLs were classified (Neutral; Adult Porn; Child Porn; Adult Dating sites; Pictures from Social Networking Profiles; Chat Sessions; Bestiality; Data Cleaning; Gay Porn, the Internet history files were statistically analyzed to determine prevalence and trends in Internet browsing. First, a frequency analysis was used to determine a baseline of online behavior. Results showed 54% (n = 3205 of the URLs were classified as “neutral” and 38.8% (n = 2265 of the URLs were classified as a porn website. Only 10.8% of the URLs were classified as child pornography websites. However when the IE history file was analyzed by visit, or “hit,” count, the Pictures/Profiles (31.5% category had the highest visit count followed by Neutral (19.3%, Gay Porn (17%, and Child Porn (16.6%. When comparing the frequency of URLs to the Hit Count for each pornography type, it was noted that the accused was accessing gay porn, child porn, chat rooms, and picture profiles (i.e., from Facebook more often than adult porn and neutral websites. The authors concluded that the suspect in this case was in fact a child pornography user and not an ad hoc investigator, and the findings from the behavioral analysis were admitted as evidence in the sentencing hearing for this case. The authors believe this case study illustrates the ability to conduct a behavioral analysis of digital evidence. More work is required to further validate the

  6. Teicoplanin versus vancomycin for proven or suspected infection.

    Science.gov (United States)

    Cavalcanti, Alexandre B; Goncalves, Anderson R; Almeida, Claudia S; Bugano, Diogo Dg; Silva, Eliezer

    2010-06-16

    Vancomycin and teicoplanin are commonly used to treat gram-positive infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA). There is uncertainty regarding the effects of teicoplanin compared to vancomycin on kidney function with some previous studies suggesting teicoplanin is less nephrotoxic than vancomycin. To investigate the efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. We searched the Cochrane Renal Group's Specialised Register, CENTRAL, MEDLINE, EMBASE, reference lists of nephrology textbooks, review articles with relevant studies and sent letters seeking information about unpublished or incomplete studies to investigators involved in previous studies. We searched for randomised controlled trials (RCTs) in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Two authors independently evaluated methodological quality and extracted data using standardised data extraction forms. Study investigators were contacted for information not available in the original manuscripts. Random effects model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). We included 24 studies (2,610 patients) in this review. Teicoplanin reduced the risk of nephrotoxicity compared to vancomycin (RR 0.66, 95% CI 0.48 to 0.90).The effects of teicoplanin or vancomycin were similar for clinical cure (RR 1.03, 95% CI 0.98 to 1.08), microbiological cure (RR 0.98, 95% CI 0.93 to 1.03) and mortality (RR 1.02, 95% CI 0.79 to1.30). Six studies reported no cases of acute kidney injury (AKI) needing dialysis. Adverse events were less frequent with teicoplanin including cutaneous rash (RR 0.57, 95% CI 0.35 to 0.92), red man syndrome (RR 0.21, 95% CI 0.08 to 0.59) and total adverse events (RR 0.73, 95% CI 0.53 to 1.00). A lower risk of nephrotoxicity with teicoplanin was observed in patients either with (RR 0.51, 95% CI 0.30 to 0.88) or

  7. Suspected neurotoxicity due to Clostridium perfringens type B in a tiger (Panthera tigris).

    Science.gov (United States)

    Zeira, Offer; Briola, Chiara; Konar, Martin; Dumas, Maria Pia; Wrzosek, Marcin Adam; Papa, Valentina

    2012-09-01

    A 4-yr-old tiger (Panthera tigris) was referred with acute onset of severe abnormal consciousness. Neurological evaluation showed normal palpebral and corneal reflexes, normal pupil diameter with normal direct and consensual papillary light reflex, and absent menace response bilaterally. Diffuse forebrain lesion or focal lesion affecting the ascending reticular activating system was suspected. Complete blood examination and cerebrospinal fluid analysis were normal. Magnetic resonance imaging of the brain showed an empty sella as the only result. Clostridium perfringens 10(4) to 10(7) colony-forming units/g were detected in fecal flora samples. Multiplex polymerase chain reaction assay identified serotype B counts with production of epsilon toxin. This toxin specifically accumulates in the central nervous system, where it causes acute neurological signs in humans, domestic animals, and wildlife. In this communication, the acute onset of neurological signs without evidence of trauma, vascular, metabolic, or inflammatory diseases may be caused by neurotoxicity due to C. perfringens.

  8. Acoustic and Perceptual Correlates of Stress in Nonwords Produced by Children with Suspected Developmental Apraxia of Speech and Children with Phonological Disorder.

    Science.gov (United States)

    Munson, Benjamin; Bjorum, Elissa M.; Windsor, Jennifer

    2003-01-01

    This study examined whether accuracy in producing linguistic stress reliably distinguished between five children with suspected developmental apraxia of speech (sDAS) and five children with phonological disorder (PD). No group differences in the production of stress were found; however, listeners judged that nonword repetitions of the children…

  9. Pararenal splenosis encountered during the evaluation of a suspected pheochromocytoma.

    Science.gov (United States)

    Brown, Joel D; Kwee, Sandi

    2010-11-01

    The authors describe a patient in whom pararenal splenosis nodules were initially interpreted as probable pheochromocytoma. A 22-year-old man with chronic glomerulonephritis, hypertension and a childhood history of splenectomy was hospitalized for a hypertensive emergency. He did not improve with aggressive antihypertensive therapy. A pheochromocytoma was suspected, and a renal ultrasound and a magnetic resonance imaging showed 2 left pararenal masses. Laboratory evaluation for pheochromocytoma and aldosteronoma were negative. Biopsies of the masses were planned, but the masses were subsequently shown to be splenic tissue by a (99m)technnetium heat-damaged red blood cell scan. Ectopic splenic masses, eg, splenosis or accessory spleens, should be considered in patients with undiagnosed abdominal or kidney masses and a history of splenectomy.

  10. 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...

  11. CT diagnosis of suspected acute appendicitis in adult patients

    Energy Technology Data Exchange (ETDEWEB)

    Yamase, Hiroshi; Sahashi, Kiyomi; Kawai, Masayuki; Kishida, Yoshihiko; Sumida, Kei; Kawamura, Ken-ichi [Gifu Syakaihoken Hospital (Japan)

    1998-06-01

    In order to assess the CT diagnosis of suspected acute appendicitis, we performed abdominal contrasted CT measurements in 77 patients from 20 to 86 years old, and of 50 men and 27 women from June 1993 to June 1996. The surgical findings were compared with the preoperative CT findings. By the preoperative CT imaging, we can know the degree and the position of inflammation in appendix vermiformis and the degree and the spread of periappendicular inflammation in the case of appendicitis, and can make a differential diagnosis of diverticulitis or gynecological diseases from appendicitis. It is important to make a preoperative diagnosis by the objectively excellent abdominal CT imaging and to avoid unnecessary surgery. (K.H.)

  12. Cost-effectiveness of routine imaging of suspected appendicitis.

    Science.gov (United States)

    D'Souza, N; Marsden, M; Bottomley, S; Nagarajah, N; Scutt, F; Toh, S

    2018-01-01

    Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

  13. Reliability of Examination Findings in Suspected Community-Acquired Pneumonia.

    Science.gov (United States)

    Florin, Todd A; Ambroggio, Lilliam; Brokamp, Cole; Rattan, Mantosh S; Crotty, Eric J; Kachelmeyer, Andrea; Ruddy, Richard M; Shah, Samir S

    2017-09-01

    The authors of national guidelines emphasize the use of history and examination findings to diagnose community-acquired pneumonia (CAP) in outpatient children. Little is known about the interrater reliability of the physical examination in children with suspected CAP. This was a prospective cohort study of children with suspected CAP presenting to a pediatric emergency department from July 2013 to May 2016. Children aged 3 months to 18 years with lower respiratory signs or symptoms who received a chest radiograph were included. We excluded children hospitalized ≤14 days before the study visit and those with a chronic medical condition or aspiration. Two clinicians performed independent examinations and completed identical forms reporting examination findings. Interrater reliability for each finding was reported by using Fleiss' kappa (κ) for categorical variables and intraclass correlation coefficient (ICC) for continuous variables. No examination finding had substantial agreement (κ/ICC > 0.8). Two findings (retractions, wheezing) had moderate to substantial agreement (κ/ICC = 0.6-0.8). Nine findings (abdominal pain, pleuritic pain, nasal flaring, skin color, overall impression, cool extremities, tachypnea, respiratory rate, and crackles/rales) had fair to moderate agreement (κ/ICC = 0.4-0.6). Eight findings (capillary refill time, cough, rhonchi, head bobbing, behavior, grunting, general appearance, and decreased breath sounds) had poor to fair reliability (κ/ICC = 0-0.4). Only 3 examination findings had acceptable agreement, with the lower 95% confidence limit >0.4: wheezing, retractions, and respiratory rate. In this study, we found fair to moderate reliability of many findings used to diagnose CAP. Only 3 findings had acceptable levels of reliability. These findings must be considered in the clinical management and research of pediatric CAP. Copyright © 2017 by the American Academy of Pediatrics.

  14. Investigating suspected acute pulmonary embolism - what are hospital clinicians thinking?

    Energy Technology Data Exchange (ETDEWEB)

    McQueen, A.S. [Department of Radiology, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom)], E-mail: andrewmcqueen7@hotmail.com; Worthy, S. [Department of Radiology, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom); Keir, M.J. [Department of Medical Physics, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom)

    2008-06-15

    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

  15. Role of DR-70 immunoassay in suspected malignant pleural effusion

    Science.gov (United States)

    Sengupta, Amitabha; Saha, Kaushik; Jash, Debraj; Banerjee, Sourindra Nath; Biswas, Nirendra Mohan; Dey, Atin

    2013-01-01

    Context: A good proportion of patients with undiagnosed pleural effusion (PE) turn into malignancy over a period of time. Identification of positive biomarker may help in selecting the individuals who require close follow-up. Aims: The aims of this study were to evaluate the role of DR-70 immunoassay in suspected malignant PE. Settings and Design: We conducted a cross-sectional study among 89 patients of suspected malignant PE and 50 normal subjects (NS) were taken as control. Materials and Methods: Patients with exudative PE; who had pleural fluid lymphocyte count greater than 50% and adenosine deaminase less than 30 U/L were taken as cases. We had selected NSs among relatives of patients having normal blood chemistry and radiological investigations. Sensitivity and specificity of the test to differentiate malignant and non-malignant PE and also to identify PE with underlying malignancy was analyzed. Results: Mean value of DR-70 in NS was found to be 0.83 ± 0.273 mg/L without any significant difference between males (0.82 mg/L) and females (0.85 mg/L). Mean value of DR-70 in PE with underlying cancer was 5.03 ± 3.79 mg/L. Sensitivity (80%) and specificity (77.78%) of the test was maximum in PE with underlying cancer using cut-off value of 2 mg/L. Mean value DR-70 in malignant PE was 5.18 ± 3.75 mg/L and in non-malignant PE was 3.73 ± 3.74 mg/L without any statistically significant difference (P = 0.08). Conclusions: DR-70 assay has high sensitivity in detecting underlying lung cancer, but has no role in differentiating malignant PE from non-malignant PE. PMID:24339491

  16. production

    African Journals Online (AJOL)

    South African Society of Animal Production, Transkei,. 15-17 April, 1986. N.M. Tainton. Department of ... association with grazing and browsing animals, whilst of course its general degradation in recent years can be ... physiology, anatomy, histology, pathology and animal pro- ducts technology required by Animal Science ...

  17. Pre-admission antibiotics for suspected cases of meningococcal disease.

    Science.gov (United States)

    Sudarsanam, Thambu D; Rupali, Priscilla; Tharyan, Prathap; Abraham, Ooriapadickal Cherian; Thomas, Kurien

    2013-08-02

    Meningococcal disease can lead to death or disability within hours after onset. Pre-admission antibiotics aim to reduce the risk of serious disease and death by preventing delays in starting therapy before confirmation of the diagnosis. To study the effectiveness and safety of pre-admission antibiotics versus no pre-admission antibiotics or placebo, and different pre-admission antibiotic regimens in decreasing mortality, clinical failure and morbidity in people suspected of meningococcal disease. We updated searches of CENTRAL (2013, Issue 4), MEDLINE (1966 to April week 4, 2013), EMBASE (1980 to May 2013), Web of Science (1985 to May 2013), CAB Abstracts (1985 to May 2013), LILACS (1982 to May 2013) and prospective trials registries to May 2013. Randomised controlled trials (RCTs) or quasi-RCTs comparing antibiotics versus placebo or no intervention, in people with suspected meningococcal infection, or different antibiotics administered before admission to hospital or confirmation of the diagnosis. Two review authors independently assessed trial quality and extracted data from the search results. We calculated the risk ratio (RR) and 95% confidence interval (CI) for dichotomous data. We included only one trial so data synthesis was not performed. We assessed the overall quality of the evidence using the GRADE approach. We found no RCTs that compared pre-admission antibiotics versus no pre-admission antibiotics or placebo. One open-label, non-inferiority RCT, conducted during an epidemic in Niger, evaluated a single dose of intramuscular ceftriaxone versus a single dose of intramuscular long-acting (oily) chloramphenicol. Ceftriaxone was not inferior to chloramphenicol in reducing mortality (RR 1.2, 95% CI 0.6 to 2.6; N = 503; 308 confirmed meningococcal meningitis; 26 deaths; moderate-quality evidence), clinical failures (RR 0.8, 95% CI 0.3 to 2.2; N = 477, 18 clinical failures; moderate-quality evidence) or neurological sequelae (RR 1.3, 95% CI 0.6 to 2.6; N

  18. Cost analysis of inappropriate treatments for suspected dermatomycoses

    Directory of Open Access Journals (Sweden)

    Emanuela Fiammenghi

    2015-06-01

    Full Text Available Superficial mycoses are estimated to affect more than 20-25% of the world’s population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1 to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2 to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital “ Federico II” in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination were defined as inappropriate: (1 cortisone in a patient with at least one positive site; (2 antifungals in (a patients with all negative sites or (b ineffective antifungal treatment (in terms of drug chosen, dose or duration in those with all positive sites; or (3 antibiotics; (4 antivirals or (5 antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease

  19. Additional Information for E-Area Vault Performance Assessment, Appendix I `Suspect Soil Performance` - Results of Modeling the Effects of Organic Matter on the Mobility of Radionuclides as it Relates to the Disposal of Wood Products in E-Area Slit Trenches

    Energy Technology Data Exchange (ETDEWEB)

    Serkiz, S.M. [Westinghouse Savannah River Company, AIKEN, SC (United States); Myers, J.L.

    1996-04-24

    Numerous laboratory and field studies have shown that the chemical form (i.e., speciation) of many metals and radionuclides is affected by the presence of naturally occurring organic matter (OM) and its degradation products. The effects of OM (e.g., wood products) on the speciation and, therefore, the mobility of Am, Bk, Cf, Cm, Cs, Ni, NpO{sub 2}, Rb, Sr. UO{sub 2}, and Zr were estimated through use of geochemical and groundwater flow modeling. Due to the complex mixture nature of naturally occurring OM, the OM system was simplified through use of surrogate compounds (citric acid and ethylenedinitrilotetraacetic acid (EDTA)) to estimate effects of OM on radionuclide mobility. Using this approach, OM was found to have no effect on the inventory limits for Cs, NpO{sub 2}, Rb and Zr. The inventory limits for the isotopes of Am, Bk, Cf, Cm, Ni, Pd, PuO{sub 2}, Sr, and UO{sub 2} calculated in the presence of OM decreased over a range of 26 percent for U-233 to 48 percent for Pu-240. The information in this report will be included in the next revision of the E-Area Vaults Performance Assessment.

  20. The prevalence of marijuana in suspected impaired driving cases in Washington state.

    Science.gov (United States)

    Couper, Fiona J; Peterson, Brianna L

    2014-10-01

    In December 2012, the possession and private use of limited quantities of marijuana and marijuana products became legal in the state of Washington. At the same time, the state's driving under the influence statutes were amended to include a per se level of 5 ng/mL delta(9)-tetrahydrocannabinol (THC) in whole blood for drivers aged 21 years and older. The aim of this study was to assess the effect of marijuana legalization on the prevalence of marijuana in suspected impaired driving cases. The prevalence of both active THC and its metabolite carboxy-THC detected in such cases pre-legalization was compared with the prevalence post-legalization. In 2009-2012, the average yearly percentage of cases positive for THC and carboxy-THC was 19.1% (range: 18.2-20.2%) and 27.9% (range: 26.3-28.6%), respectively. In 2013, the percentages had significantly increased to 24.9 and 40.0%, respectively (P 5 ng/mL over the 5-year period. The prevalence of alcohol and the majority of other drugs in this same population of suspected impaired drivers submitted for testing did not change during this same 5-year period-marijuana was the only drug to show such an increase in frequency. Further, this observed increase remained after the data had been normalized to account for changes in laboratory testing procedures that occurred during this time period. Future studies need be conducted to ascertain whether the observed increase has had any effect on the incidence of crashes, serious injuries and/or traffic fatalities. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. [Suspected pathogenic mutation identified in two cases with oculocutaneous albinism].

    Science.gov (United States)

    He, Jiangmei; Zheng, Meiling; Zhang, Guilin; Hua, Ailing

    2015-08-01

    To detect potential mutations in genes related with non-syndromic oculocutaneous albinism I-IV and ocular albinism type I in two couples who had given births to children with albinism. All exons of the non-syndromic albinism related genes TYR, OCA2, TYRP-1, MITF, SLC45A2 and GPR143 were subjected to deep sequencing. The results were verified with Sanger sequencing. For the two female carriers, the coding region of the TYR gene was found to harbor a frameshift mutation c.925_926insC, which was also suspected to have been pathogenic. In one of the male partners, a nonsense mutations c.832C>T was found, which was also known to be pathogenic. Another male partner was found to harbor a TYR gene mutation c.346C>T, which was also known to be a pathogenic nonsense mutation. The coding region of the TYR gene c.925_926insC (p.Thr309ThrfsX9) probably underlies the OCA1 disease phenotype.

  2. Chest pain and behavior in suspected coronary artery disease.

    Science.gov (United States)

    Young, L D; Barboriak, J J; Anderson, A J

    1988-01-01

    This study assessed behavioral activity, dietary and emotional variables among patient cohorts with angina pectoris, atypical chest pain, and no chest pain in whom coronary disease is suspected. Questionnaire responses of 3,899 employed male patients at the time of coronary arteriography were analyzed. Patients with angina pectoris had high levels of coronary-prone and neurotic attitudes, and fatigue variables including feeling unrested on awakening, easy fatiguability, reducing activity at work and arriving home tired. Atypical chest pain patients showed coronary-prone and neurotic attitudes similar to the angina pectoris group but had less coronary occlusion and lower levels of fatigue variables. Compared to the other groups, atypical chest pain patients were more likely to skip breakfast and showed a trend to eat fast. These findings suggest that including assessment of activity levels, fatiguability, eating behavior, neurotic traits and coronary-prone attitudes at time of coronary arteriography can have some limited value for patients with chest pain who may seek cardiac treatment but could benefit from alternative approaches.

  3. Acute aortic dissection in patient with suspected pheochromocytoma

    Directory of Open Access Journals (Sweden)

    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.

  4. [Predictive value of procalcitonin in children with suspected sepsis].

    Science.gov (United States)

    Bustos B, Raúl; Padilla P, Oslando

    2015-01-01

    The use of biomarkers could be a tool for diagnosis, prognosis and stratifying children with sepsis. Our main goal was to analyze the value of procalcitonin (PCT), C reactive protein (CRP) and lactate in predicting mortality, septic shock and the stratification in children with suspected sepsis Prospective study in 81 patients. Plasma levels of PCT, CRP and lactate were measured at admission in the pediatric intensive care unit. Patients were categorized into systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock. Concentrations of PCT (ng/mL) increased significantly according to the severity of sepsis: 0.36 (0-1.2) for systemic inflammatory response syndrome; 1.96 (0.4-3.5) for sepsis; 7.5 (3.9-11.1) for severe sepsis; and 58.9 (35.1-82.7) for septic shock (P<.001). Compared to CRP and lactate, the area under the ROC curve revealed a good discriminative power of PCT to predict septic shock and mortality, 0.91 (95% CI: 0.83-0.97) and 0.80 (95% CI: 0.69-0.88), respectively. In contrast to CRP and lactate, the determination of PCT in pediatric intensive care unit admission is a good predictor of mortality and septic shock and can stratify patients according to severity of sepsis. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. The optimal diagnostic workup for children with suspected food allergy.

    Science.gov (United States)

    Berni Canani, Roberto; Di Costanzo, Mara; Troncone, Riccardo

    2011-10-01

    Food allergy is defined as an abnormal immunologic reaction to food proteins that causes an adverse clinical reaction. In addition to well-known acute allergic reactions and anaphylaxis triggered by immunoglobulin E antibody-mediated immune responses to food proteins, there is an increasing recognition of cell-mediated disorders such as eosinophilic esophagitis and food protein-induced enterocolitis syndrome. More than 90% of food allergies in childhood are caused by eight foods: cow's milk, hen's egg, soy, peanuts, tree nuts, wheat, fish, and shellfish. The diagnostic workup for a child with suspected food allergy includes a detailed medical history, physical examination, food allergy screening tests, and responses to an elimination diet and an oral food challenge. None of the screening tests, alone or in combination, can definitely diagnose or exclude a food allergy. Novel diagnostic methods including those that focus on immune responses to specific food proteins or epitopes of specific proteins are under active study. Unconventional diagnostic methods are increasingly used, but they lack scientific rationale, standardization, and reproducibility. In selected cases, such as eosinophilic esophageal gastroenteropathies or food protein-induced gastroesophageal reflux disease, invasive procedures are mandatory for an accurate diagnosis. Properly done, an oral food challenge is still the gold standard in the diagnostic workup. An incorrect diagnosis is likely to result in unnecessary dietary restrictions, which, if prolonged, may adversely affect the child's nutritional status and growth. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Defense Supplier Base: DOD Should Leverage Ongoing Initiatives in Developing Its Program to Mitigate Risk of Counterfeit Parts

    Science.gov (United States)

    2010-03-01

    titanium, used in fighter jet engine mounts. Brake shoes Brake shoes were made with substandard materials, including seaweed . Source: DOD. DOD does...15The Center for Advanced Life Cycle Engineering is an electronic products and systems research center...company. These brake shoes were made with various materials, including seaweed . U.S. customs agents had already seized the brake shoes and DOD never

  7. 76 FR 48905 - United States Government Inter-Agency Anti-Counterfeiting Working Group: Request for Public...

    Science.gov (United States)

    2011-08-09

    ... confidential business information that supports your comments, please contact Michael Lewis at... marking products/packages with globally unique item identifiers (UIIs) using international standards, and... Upload File'' field. If you want to submit confidential business information that supports your comments...

  8. Physical profiling and IR spectroscopy: simple and effective methods to discriminate between genuine and counterfeit samples of Viagra® and Cialis®.

    Science.gov (United States)

    Custers, Deborah; Vandemoortele, Suzanne; Bothy, Jean-Luc; De Beer, Jacques O; Courselle, Patricia; Apers, Sandra; Deconinck, Eric

    2016-01-01

    Counterfeit medicines are a global threat to public health. High amounts enter the European market, enforcing the need for simple techniques to help customs detect these pharmaceuticals. This study focused on physical profiling and IR spectroscopy to obtain a prime discrimination between genuine and illegal Viagra® and Cialis® medicines. Five post-tableting characteristics were explored: colour, mass, long length, short length, and thickness. Hypothesis testing showed that most illegal samples (between 60 and 100%) significantly differ from the genuine medicines, in particular for mass and long length. Classification and Regression Trees (CART) analysis resulted in a good discrimination between genuine and illegal medicines (98.93% correct classification rate for Viagra®, 99.42% for Cialis®). Moreover, CART confirmed the observation that mass and long length are the key physical characteristics which determine the observed discrimination. IR analysis was performed on tablets without blister and on tablets in intact blister. These data were analyzed using Soft Independent Modelling of Class Analogy (SIMCA) and Partial Least Squares - Discriminant Analysis (PLS-DA). Supervised techniques needed to be applied since Principal Component Analysis (PCA) was not able to generate the desired discrimination. Our study shows that a perfect discrimination between genuine and illegal medicines can be made by both SIMCA and PLS-DA without removing the tablets from the blister. This approach has the advantage of keeping the blister intact. Our study demonstrates that these user friendly techniques are reliable methods to aid customs to obtain a prime distinction between genuine and illegal samples on the spot. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Prevalence of IgE sensitization in Danish children with suspected asthma

    DEFF Research Database (Denmark)

    Hoffmann-Petersen, Benjamin; Høst, Arne; Larsen, Kirsten Toksvig

    2013-01-01

    OBJECTIVE: The aim of this article was to estimate the prevalence of IgE sensitization in Danish children with suspected asthma and to characterize the pattern of sensitization. STUDY DESIGN: We performed a cross-sectional study including 1744 children from 0 to 15 yr suspected of asthma who were...

  10. Diagnostic accuracy and patient acceptance of MRI in children with suspected appendicitis

    NARCIS (Netherlands)

    Thieme, Mai E.; Leeuwenburgh, Marjolein M. N.; Valdehueza, Zaldy D.; Bouman, Donald E.; de Bruin, Ivar G. J. M.; Schreurs, W. Hermien; Houdijk, Alexander P. J.; Stoker, Jaap; Wiarda, Bart M.

    2014-01-01

    To compare magnetic resonance imaging (MRI) and ultrasound in children with suspected appendicitis. In a single-centre diagnostic accuracy study, children with suspected appendicitis were prospectively identified at the emergency department. All underwent abdominal ultrasound and MRI within 2 h,

  11. D-dimer test in cancer patients with suspected acute pulmonary embolism

    NARCIS (Netherlands)

    Di Nisio, M.; Sohne, M.; Kamphuisen, P. W.; Büller, H. R.

    2005-01-01

    Background: The safety of a D-dimer (DD) measurement in cancer patients with clinically suspected pulmonary embolism (PE) is unclear. Objectives: The aim of this study was to assess the accuracy of the DD test in consecutive patients with clinically suspected PE with and without cancer. Methods: The

  12. D-Dimer test in cancer patients with suspected acute pulmonary embolism.

    NARCIS (Netherlands)

    Nisio, M. Di; Sohne, M.; Kamphuisen, P.W.; Buller, H.R.

    2005-01-01

    BACKGROUND: The safety of a D-dimer (DD) measurement in cancer patients with clinically suspected pulmonary embolism (PE) is unclear. OBJECTIVES: The aim of this study was to assess the accuracy of the DD test in consecutive patients with clinically suspected PE with and without cancer. METHODS: The

  13. The Lawyer in the Dutch Interrogation Room: Influence on Police and Suspect

    NARCIS (Netherlands)

    W-J. Verhoeven (Willem-Jan); L. Stevens (Lonneke)

    2012-01-01

    textabstractIn many European countries, providing a suspect in custody with legal aid before the first police interrogation is a heavily debated issue. In this paper, we report on an exploratory study on the use of coercion by the police and the use of the right to silence by suspects in 70 Dutch

  14. Occurrence of antibodies to Anaplasma phagocytophilum in patients with suspected tick-borne encephalitis

    Directory of Open Access Journals (Sweden)

    Zuzana Kalinová

    2015-09-01

    None of the examined patients with suspected TBE had the disease confirmed. Hoever, as shown by the results, the relative risk of occurrence of anaplasmosis is higher in people examined for some another vector-borne disease (in this case TBE. Therefore, the performance of screening examinations in patients suspected of having any tick-borne disease is very important.

  15. Screening for keratoconus suspects among candidates for refractive surgery.

    Science.gov (United States)

    McMonnies, Charles W

    2014-11-01

    This review examines methods for estimating the risk of post-surgical ectasia in candidates for refractive surgery by establishing a diagnosis of keratoconus suspect as a contraindication for proceeding with surgery. Notwithstanding the desirability of achieving 100 per cent sensitivity, any associated reduction in specificity and increased numbers of false positives might deny some candidates the opportunity to proceed with refractive surgery. The introduction of a model for the risk of ectasia involving both pre- and post-surgical findings has been followed by a plethora of attempts to achieve the same purpose based on topographic and/or tomographic evaluation before surgery. The desirability of being able to depend on objective assessment using one type of instrument needs to be weighed against the possibility that subjective assessments may contribute significantly to screening success. For example, consideration of ethnicity, family history of keratoconus, a history of atopy or ocular allergies in particular, a history of significant exposure to corneal trauma associated with abnormal rubbing habits or with vocational, leisure or geographically increased exposure to ultraviolet radiation or with contact lens wear trauma or a history of significant exposure to activities which elevate intraocular pressure may improve screening success. To the extent that these factors could contribute to increased risk of the development of keratoconus, they may be useful in estimating the risk of post-surgical ectasia. If any combination of these factors helps to explain the development of keratoconus in normal or even thicker than normal corneas, they may have more significance for those corneas, which have been thinned surgically. © 2014 The Author. Clinical and Experimental Optometry © 2014 Optometrists Association Australia.

  16. Investigation of a suspected outbreak of lipoatrophia semicircularis in children.

    Science.gov (United States)

    Rius, Cristina; Baselga, Eulalia; Tizón, Jorge; Fuentes, Paulina; Muñoz-Garza, Fania Zamantta; Roigé, Glòria; Llebaria, Xavier; Caylà, Joan A

    2017-08-10

    Recent reports of outbreaks of lipoatrophia semicircularis (LS) in various countries have generated discussion regarding the potential role of the environmental characteristics of office workplaces in new buildings. The objective of this study was to investigate a suspected outbreak of LS among children in a public school in Barcelona, which generated tremendous alarm. We performed an epidemiological assessment including descriptive and prevalence analyses, and an environmental investigation followed by a psychiatric assessment according to Small's criteria. We compared the prevalence of LS and its 95% confidence interval between children and staff attending the day-care centre under study and other centres. Among 86 children attending a day-care centre we detected 11 confirmed and 2 possible cases of LS (15.1%) while among 41 children attending other day-care centres we identified 8 cases and 4 possible cases (29.3%) (P=.10). Among 12 day-care staff, we detected 8 cases of LS (66.7%) while among 19 women working different jobs we identified 14 with the same condition as the staff (73.7%) (P=.98). All lesions were finally classified as indentations with different locations. The environmental evaluation didn't identify any exposure factors with a significant role in the onset of the outbreak. The outbreak shared 13 of Small's 16 criteria regarding epidemic somatoform disorder ("mass hysteria"). The presence of indentations can be considered a normal variant in the lower extremities of children. The characteristic development of the process leads us to the conclusion that this outbreak was an epidemic somatoform disorder. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  17. [Breath tests in children with suspected lactose intolerance].

    Science.gov (United States)

    Parra, P Ángela; Furió, C Simone; Arancibia, A Gabriel

    2015-01-01

    Up to 70% of the world population is lactose intolerance. However, there are no epidemiological studies among Chilean pediatric population affected by this condition. Clinical characterization of a series of children who underwent the lactose intolerance breath test for lactose intolerance study, establishing intolerance and malabsorption frequencies, the most frequent symptoms, and test performance depending on the origin. Patients under 18 years old who took the lactose intolerance breath test in the Gastroenterology Laboratory of the Catholic University of Chile, and who were admitted due to clinically suspected lactose intolerance. Malabsorption was considered when there was as an increase of ≥20ppm above the baseline (H2) or ≥34ppm of H2 and methane (CH4) combined. Intolerance was considered when the above was associated with a symptom intensity score ≥7 during registration. The analysis included194 patients aged 1 to17 years of age. Of these, 102 (53%) presented with malabsorption, and 53 (27%) were intolerant. The frequency of lactose intolerance varied from 7.1 to 45.4%, and it occurred more frequently at older ages. The most common reported symptoms were abdominal pain, bloating and rumbling. Lactose malabsorption and intolerance can be investigated from the first years of life using the lactose breath test plus a symptom questionnaire. An increase in the frequency of intolerance with age, and a greater number of positive tests, if they were requested by a gastroenterologist, were observed. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    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.

  19. Suspected dog bite associated HIV horizontal transmission in Swaziland

    Directory of Open Access Journals (Sweden)

    Ganizani Mlawanda

    2013-01-01

    Full Text Available Background: Dog bites may lead to transmission of bacteria and viruses over and above tetanus and rabies. Theoretically human immunodeficiency virus (HIV, Hepatitis B and Hepatitis C may be transmitted after dog bites where transfer of blood from one victim to another occur in clinical practice HIV, Hepatitis B and Hepatitis C are not considered when making treatment decisions, nor adequate patient history taken to consider all potential risks after dog bites in succession.Objective: To present case of suspected HIV transmission after dog bites in close succession involving two HIV sero-discordant victims.Management and outcome: HIV rapid test and/or HIV Ribonucleic acid (RNA polymerasechain reaction (PCR results for the victim(s at presentation and a month later.Results: Two night patrol guards presented to casualty after dog bites in close succession by the same dog. They were managed according to the dog bite protocol. Thinking out of the box, the first victim was found to be HIV positive by rapid test whilst the second victim was negative based on both HIV rapid test and HIV RNA PCR. One month after the dogbites, a case of HIV sero-conversion was confirmed in the second victim despite post-exposure prophylaxis (PEP.Discussion: Although an isolated case, shouldn’t clinicians re-think the significance of HIV transmission after animal bites where there is repeated blood exposure in several people insuccession?Conclusion: Clinicians should be aware of the potential of HIV, Hepatitis B and C transmission, when faced with dog bites in succession. 

  20. Contact sensitization in patients with suspected cosmetic intolerance: results of the IVDK 2006-2011.

    Science.gov (United States)

    Dinkloh, A; Worm, M; Geier, J; Schnuch, A; Wollenberg, A

    2015-06-01

    Ingredients of leave-on cosmetics and body care products may sensitize. However, not every case of cosmetic intolerance is due to contact sensitization. To describe the frequency of contact sensitization due to cosmetics in a large clinic population, and a possible particular allergen pattern. Retrospective analysis of data from the Information Network of Departments of Dermatology, 2006-2011. Of 69 487 patients tested, 'cosmetics, creams, sunscreens' was the only suspected allergen source category in 10 124 patients (14.6%). A final diagnosis 'allergic contact dermatitis' was stated in 2658 of these patients (26.3%).Compared to a control group, there were significantly more reactions to fragrance mixes I and II, balsam of Peru, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and lanolin alcohols. No special pattern of fragrance sensitization could be identified. Among the preservatives, MI was by far the leading allergen, while sensitization to other widely used compounds like parabens or phenoxyethanol was rare. True allergic reactions to cosmetic ingredients are rarer than generally assumed. Limitation of exposure to MI in leave-on cosmetics and body care products is urgently needed. © 2014 European Academy of Dermatology and Venereology.

  1. Investigation of Clinical Relevance of Bacterial Colonization in Patients With Suspected Viral Respiratory Tract Infection By Using Multiplex PCR Method

    Directory of Open Access Journals (Sweden)

    Vedat Turhan

    2013-02-01

    Full Text Available Numerous viral and bacterial pathogens have been reported causing acute respiratory tract infection (ARTI. Nasopharyngeal swab (NPS specimens from 351 patients (278 children, 73 adults with suspected upper and lower ARTI were submitted during the study period from Jan. 2005 to Dec. 2006. Organism-specific nucleic acids were detected using TemPlex technology (ResPlex I and II, Genaco Biomedical Products, Huntsville, AL. Amplified products were identified using a suspension array for multiplex detection performed on a Luminex 100 instrument (Luminex, Austin, TX. A total of 221 viral and bacterial respiratory agents were detected in 148 patients (135 [48.5%] of the 278 children and 13 [17.8%] of the 73 adults with suspected ARTI. A single respiratory pathogen was detected in 89 patients [25.35%], whereas mixed infection with two or three pathogens was found in 59 [16.8%] of 351 suspected patients. S. pneumonia was the most frequently isolated strain (54 [15.3%] of 351 patients, followed by H. influenzae (37 [10.5%], rhinoviruses (35 [9.9%], influenza A virus (23 [6.5%], enteroviruses (19 [5.4%], hMPV (14 [3.9%], PIV-1 (12 [3.4%], PIV-3 (11 [3.1%], RSV (10 [2.8%], and influenza B virus (6 [1.7%]. Mixed infections were more frequent in children (56 [20.1%] of 278 than adult patients (3 [4.1%] of 73 patients. The detection rate of the bacteria peaked in the spring season (37 [40.6%] of 91 bacteria, followed by winter (24 infections, autumn (18 infections and summer (12 infections. The prevalence of co-infection is ~40%, finding a much higher incidence of co-infection with more than one agent than that reported previously. [Dis Mol Med 2013; 1(1.000: 2-7

  2. When to suspect lactose intolerance. Symptomatic, ethnic, and laboratory clues.

    Science.gov (United States)

    Srinivasan, R; Minocha, A

    1998-09-01

    Lactose intolerance is widespread, with adult-type hypolactasia being the predominant cause of lactose malabsorption. Daily ingestion of less than 240 mL of milk is well tolerated by most lactose-intolerant adults. Some persons with normal lactase activity may become symptomatic on consumption of products containing lactose. Lactose maldigestion may coexist in adults with irritable bowel syndrome and in children with recurrent abdominal pain. Management consists primarily of dietary changes. People who avoid dairy products should receive calcium supplementation and should be advised to read ingredient labels carefully. Several lactase replacement products are available, but their efficacy varies.

  3. Qualitative and Semiquantitative Analysis of Doping Products Seized at the Swiss Border.

    Science.gov (United States)

    Weber, Christina; Krug, Oliver; Kamber, Matthias; Thevis, Mario

    2017-05-12

    Substances developed for therapeutic use are also known to be misused by athletes as doping agents and, outside of regulated sport, for image-enhancement. This has generated a market for counterfeit doping substances. Counterfeit doping agents may be of poor pharmaceutical quality and therefore constitute health risks to consumers. This study aims to investigate the pharmaceutical quality of 1,190 doping products seized at the Swiss border. Swiss customs authorities seize incoming shipments potentially containing doping agents. Qualitative and semiquantitative analyses were performed in order to test for prohibited doping substances. The main analytical methods utilized for characterizing confiscated compounds were liquid chromatography-high resolution mass spectrometry, polyacrylamide gel electrophoresis with subsequent in-gel tryptic digestion and identification of peptidic compounds using nanoliquid chromatography-tandem mass spectrometry, and electrochemiluminescence immuno assay. For 889 (75%) of the analyzed products, the label suggested the content of anabolic agents, for 146 samples (12%) peptide hormones or growth factors, and for 113 items (9%) antiestrogens, aromatase inhibitors or other metabolic modulators. For the majority of the investigated products, the pharmaceutical quality was an unsatisfactory standard: nonapproved substances were detected and less than 20% of the products contained the claimed substance in the respective amount. A comprehensive sample of confiscated doping products was analyzed, allowing for monitoring of developments regarding the use of doping substances in Switzerland and for anticipating future trends and challenges in sports drug testing. An alarming number of tested products was of substandard pharmaceutical quality.

  4. Investigations regarding the lowering of specific intellectual property risks identified in the production process

    Directory of Open Access Journals (Sweden)

    Pakocs Ramona

    2017-01-01

    Full Text Available The main purpose of this research is to decrease the emergence of specific intellectual property risks within the production process as well as increasing risk management performance of IP by preventing them. In order to achieve this, previous studies regarding the main specific intellectual property risks from industrial companies were analyzed together with their managerial methods as well as the possibility of reducing their emergence. As a result of the research conducted were identified five types of intellectual property risks that have a high potential of emergence in the production process, namely: the risk of production of goods in violation of IP rights; the know-how, production knowledge and trade secret disclosure risk; the technological risk of unprotected utility models; the technological risk of unprotected integrated circuits topographies and finally the risk of product counterfeit. In order to achieve the main purpose of our investigation, we have proposed new formulas for estimating the specific intellectual property risks identified in the production process. Their purpose was to minimalize the risk’s negative effects on industrial companies and to increase the managerial performance from the intellectual property domain through a new type of management appropriately named: intellectual property management. The research is finalized with a case study regarding the lapse of rights of a patented invention. Based on a case analysis, it was proved that the exploitation of an invention without a contract represents a counterfeit.

  5. 48 CFR 3.303 - Reporting suspected antitrust violations.

    Science.gov (United States)

    2010-10-01

    ... increases or follow-the-leader pricing; (4) Rotation of bids or proposals, so that each competitor takes a... contracts let by certain agencies, or for contracts in certain geographical areas, or on certain products...

  6. The value of recognizing suspect diagnoses in the triple diagnosis of giant cell tumor of bone

    Directory of Open Access Journals (Sweden)

    Kotru Mrinalini

    2007-01-01

    Full Text Available Giant cell tumor (GCT of bone is the most frequently over-diagnosed neoplasm in orthopedic pathology because giant cells are a common component of many neoplastic and nonneoplastic conditions of bone. Triple diagnosis, requiring substantial individual and collective inputs by orthopedic surgeons, radiologists and pathologists, is the preferred method for the workup of patients with suspected bone neoplasms. At each stage in triple diagnosis, deviations from the typical must be regarded as clues to alternate diagnoses: the greater the deviation, the more a diagnosis of GCT must be considered suspect. A suspect diagnosis must trigger renewed analysis of the available data and a diligent search to exclude alternate diagnoses.

  7. Health effects associated with indoor swimming pools: a suspected toxic chloramine exposure.

    Science.gov (United States)

    Kaydos-Daniels, S Cornelia; Beach, Michael J; Shwe, Thein; Magri, Julie; Bixler, Danae

    2008-02-01

    A cohort and environmental study tested the hypothesis that suspected exposure to chloramines (by-products of chlorine for disinfection and ammonia from human sources) from a hotel's indoor swimming pool was associated with an outbreak among children who had attended a party at the pool. Retrospective cohort study. A case was defined as any hotel guest/visitor on 5-6 October 2002 who experienced three or more symptoms typical of chloramine exposure on either day after visiting the hotel. A cohort study and an environmental assessment were performed to determine the association between pool exposure and illness. Of 128 individuals interviewed, 32 met the case definition. Common symptoms among case patients were cough (84%), eye irritation (78%) and rash (34%). Illness was associated with entering the pool area [odds ratio (OR) 19.9; 95% confidence interval (CI) 2.3-172], but more strongly with swimming (OR 72.0; 95% CI 9.1-568). Pool chloramine levels on 6 October 2002 were > or = 0.7ppm (optimal level=0ppm; state maximum=0.5ppm). The pool operator lacked formal training in pool maintenance. High chloramine levels may have caused illness in individuals who were either in or near the pool. This outbreak underscores the need for regular pool maintenance, improved air quality, education and certification for all operators of public and semipublic pools, and education about healthy swimming practices.

  8. Multicenter study of preservative sensitivity in patients with suspected cosmetic contact dermatitis in Korea.

    Science.gov (United States)

    Lee, Sang S; Hong, Dong K; Jeong, Nam J; Lee, Jeung H; Choi, Yun-Seok; Lee, Ai-Young; Lee, Cheol-Heon; Kim, Kea J; Park, Hae Y; Yang, Jun-Mo; Lee, Ga-Young; Lee, Joon; Eun, Hee C; Moon, Kee-Chan; Seo, Seong J; Hong, Chang K; Lee, Sang W; Choi, Hae Y; Lee, Jun Y

    2012-08-01

    As many new cosmetic products are introduced into the market, attention must be given to contact dermatitis, which is commonly caused by cosmetics. We investigate the prevalence of preservative allergy in 584 patients with suspected cosmetic contact dermatitis at 11 different hospitals. From January 2010 to March 2011, 584 patients at 11 hospital dermatology departments presented with cosmetic contact dermatitis symptoms. These patients were patch-tested for preservative allergens. An irritancy patch test performed on 30 control subjects using allergens of various concentrations showed high irritancy rates. Preservative hypersensitivity was detected in 41.1% of patients. Allergens with the highest positive test rates were benzalkonium chloride (12.1%), thimerosal (9.9%) and methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) (5.5%). Benzalkonium chloride and chlorphenesin had the highest irritancy rate based on an irritancy patch test performed using various concentrations. Seven of 30 normal subjects had a positive irritant patch reading with 0.1% benzalkonium chloride and eight of 30 normal subjects had a positive irritant patch reading at 4 days with 0.5% chlorphenesin in petrolatum. Although benzalkonium chloride was highly positive for skin reactions in our study, most reactions were probably irritation. MCI/MI and thimerosal showed highly positive allergy reactions in our study. The optimum concentration of chlorphenesin to avoid skin reactions is less than 0.5%. © 2012 Japanese Dermatological Association.

  9. Herbal Traditional Chinese Medicine and suspected liver injury: A prospective study.

    Science.gov (United States)

    Melchart, Dieter; Hager, Stefan; Albrecht, Sabine; Dai, Jingzhang; Weidenhammer, Wolfgang; Teschke, Rolf

    2017-10-18

    To analyze liver tests before and following treatment with herbal Traditional Chinese Medicine (TCM) in order to evaluate the frequency of newly detected liver injury. Patients with normal values of alanine aminotransferase (ALT) as a diagnostic marker for ruling out pre-existing liver disease were enrolled in a prospective study of a safety program carried out at the First German Hospital of TCM from 1994 to 2015. All patients received herbal products, and their ALT values were reassessed 1-3 d prior to discharge. To verify or exclude causality for suspected TCM herbs, the Roussel Uclaf Causality Assessment Method (RUCAM) was used. This report presents for the first time liver injury data derived from a prospective, hospital-based and large-scale study of 21470 patients who had no liver disease prior to treatment with herbal TCM. Among these, ALT ranged from 1 × to liver adaptive abnormalities. However, 26 patients (0.12%) experienced higher ALT values of ≥ 5 × ULN (300.0 ± 172.9 U/L, mean ± SD). Causality for TCM herbs was RUCAM-based probable in 8/26 patients, possible in 16/26, and excluded in 2/26 cases. Bupleuri radix and Scutellariae radix were the two TCM herbs most commonly implicated. In 26 (0.12%) of 21470 patients treated with herbal TCM, liver injury with ALT values of ≥ 5 × ULN was found, which normalized shortly following treatment cessation, also substantiating causality.

  10. A profile of suspected child abuse as a subgroup of major trauma patients.

    Science.gov (United States)

    Davies, Ffion C; Coats, Timothy J; Fisher, Ross; Lawrence, Thomas; Lecky, Fiona E

    2015-12-01

    Non-accidental injury (NAI) in children is an important cause of major injury. The Trauma Audit Research Network (TARN) recently analysed data on the demographics of paediatric trauma and highlighted NAI as a major cause of death and severe injury in children. This paper examined TARN data to characterise accidental versus abusive cases of major injury. The national trauma registry of England and Wales (TARN) database was interrogated for the classification of mechanism of injury in children by intent, from January 2004 to December 2013. Contributing hospitals' submissions were classified into accidental injury (AI), suspected child abuse (SCA) or alleged assault (AA) to enable demographic and injury comparisons. In the study population of 14 845 children, 13 708 (92.3%, CI 91.9% to 92.8%) were classified as accidental injury, 368 as alleged assault (2.5%, CI 2.2% to 2.7%) and 769 as SCA (5.2%, CI 4.8% to 5.5%). Nearly all cases of severely injured children suffering trauma because of SCA occurred in the age group of 0-5 years (751 of 769, 97.7%), with 76.3% occurring in infants under the age of 1 year. Compared with accidental injury, suspected victims of abuse have higher overall injury severity scores, have a higher proportion of head injury and a threefold higher mortality rate of 7.6% (CI 5.51% to 9.68%) vs 2.6% (CI 2.3% to 2.9%). This study highlights that major injury occurring as a result of SCA has a typical demographic pattern. These children tend to be under 12 months of age, with more severe injury. Understanding these demographics could help receiving hospitals identify children with major injuries resulting from abuse and ensure swift transfer to specialist care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Suspected systemic calcinosis and calciphylaxis in 5 horses

    Science.gov (United States)

    Tan, Jean-Yin; Valberg, Stephanie J.; Sebastian, Manu M.; Davis, Gordon D.; Kelly, Jenny R.; Goehring, Lutz S.; Harland, Malte M.; Kuebelbeck, K. Leann; Waldridge, Bryan M.; Newton, Joseph C.; Reimer, Johanna M.

    2010-01-01

    Five horses were presented with signs of myopathy along with systemic malaise, hyperfibrinogenemia, hyperphosphatemia, and an elevated calcium phosphorus product (Ca*P). Postmortem findings were consistent with systemic calcinosis, a syndrome of calcium deposition in the tissue of organs including lungs, kidneys, muscle, and heart that has not been previously described in horses. PMID:21119866

  12. Towards Rational Use of Antibiotics for Suspected Secondary Infections in Buruli Ulcer Patients

    NARCIS (Netherlands)

    Barogui, Yves T.; Klis, Sandor; Bankole, Honore Sourou; Sopoh, Ghislain E.; Mamo, Solomon; Baba-Moussa, Lamine; Manson, Willem L.; Johnson, Roch Christian; van der Werf, Tjip S.; Stienstra, Ymkje

    2013-01-01

    Background: The emerging disease Buruli ulcer is treated with streptomycin and rifampicin and surgery if necessary. Frequently other antibiotics are used during treatment. Methods/Principal Findings: Information on prescribing behavior of antibiotics for suspected secondary infections and for

  13. High Resolution Imagery of Nikunau Island Coral Reef Systems Prior to and During Suspected Bleaching Events

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset is a collection of imagery of Nikunau Island coral reef systems. They are pairs of imagery where one image was acquired during a suspected bleaching...

  14. High Resolution Imagery of Keppel Island Coral Reef Systems Prior to and During Suspected Bleaching Events

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset is a collection of imagery of Keppel Island coral reef systems. They are pairs of imagery where one image was acquired during a suspected bleaching...

  15. Metagenomic analysis reveals Hepatitis A virus in suspected yellow fever cases in Brazil.

    Science.gov (United States)

    Conteville, Liliane C; Filippis, Ana Maria B de; Nogueira, Rita Maria R; Mendonça, Marcos César L de; Vicente, Ana Carolina P

    2018-01-01

    Using a metagenomic approach, we identified hepatitis A virus among cases of acute febrile illnesses that occurred in 2008-2012 in Brazil suspected as yellow fever. These findings reinforce the challenge facing routine clinical diagnosis in complex epidemiological scenarios.

  16. High Resolution Imagery of Howland Island Coral Reef Systems Prior to and During Suspected Bleaching Events

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset is a collection of imagery of Howland Island coral reef systems. They are pairs of imagery where one image was acquired during a suspected bleaching...

  17. Frequency of rapid growing mycobacteria among tuberculosis suspected patients in Basra-Iraq

    National Research Council Canada - National Science Library

    Sulami, Amin A. Al; Taee, Asaad Al; Hasan, Zainab A

    2016-01-01

    Objective: The purpose of this study was to estimate the frequency of rapid growing mycobacteria among tuberculosis suspected patients in Basra governorate and study their resistance to drugs. Methods...

  18. Confirmation test of suspected Mycobacterium avium subspecies paratuberculosis (MAP isolated using PCR F57

    Directory of Open Access Journals (Sweden)

    Widagdo Sri Nugroho

    2008-06-01

    Full Text Available Seropositive and isolate suspected as Mycobacterium avium subspecies paratuberculosis (MAP was detected at dairy cows in West Java. This bacteria causes Johne’s disease (JD and potentially becomes a new emerging disease for Indonesian dairy cows. The aim of this study was to confirm the suspected local isolate as a MAP distinctively by PCR. Reculture of MAP reference isolate, suspected local isolate done by resuspending bacteria in PBS 0.5% and inoculating it in Herrold’s egg yolk medium with mycobactin J (HEYM and than inoculating it in 37oC for 16 weeks. The cultures grew in various time, Mycobacterium avium subspecies avium was detected in 3rd week, MAP reference was detected in 7th week, and local isolate was detected in 14th week. The confirmation test was carried out by PCR with primer F57. The PCR F57 result showed that MAP suspected isolate was not a Mycobacterium avium subspecies paratuberculosis.

  19. Ileoscopy reduces the need for small bowel imaging in suspected Crohn's disease

    DEFF Research Database (Denmark)

    Jensen, Michael Dam; Nathan, Torben; Rafaelsen, Søren Rafael

    2012-01-01

    In suspected Crohn's disease (CD), current diagnostic guidelines recommend additional small bowel imaging irrespective of the findings at ileocolonoscopy. Magnetic resonance imaging enterography (MRE) and computed tomography enterography (CTE) are regarded first line imaging techniques and should...

  20. Suboptimal performance on neuropsychological tests in patients with suspected chronic toxic encephalopathy

    NARCIS (Netherlands)

    van Hout, MSE; Schmand, B; Wekking, EM; Hageman, G; Deelman, BG

    Suboptimal performance during neuropsychological testing can seriously complicate assessment in behavioral neurotoxicology. We present data on the prevalence of suboptimal performance in a group of Dutch patients with suspected chronic toxic encephalopathy (CTE) after long-term occupational exposure

  1. Suboptimal performance on neuropsychological tests in patients with suspected chronic toxic encephalopathy

    NARCIS (Netherlands)

    van Hout, Moniek S. E.; Schmand, Ben; Wekking, Ellie M.; Hageman, Gerard; Deelman, Betto G.

    2003-01-01

    Suboptimal performance during neuropsychological testing can seriously complicate assessment in behavioral neurotoxicology. We present data on the prevalence of suboptimal performance in a group of Dutch patients with suspected chronic toxic encephalopathy (CTE) after long-term occupational exposure

  2. 9 CFR 381.78 - Condemnation of carcasses and parts: separation of poultry suspected of containing biological...

    Science.gov (United States)

    2010-01-01

    ...: separation of poultry suspected of containing biological residues. 381.78 Section 381.78 Animals and Animal... carcasses and parts: separation of poultry suspected of containing biological residues. (a) At the time of... to be not adulterated. (b) When a lot of poultry suspected of containing biological residues is...

  3. Randomized clinical trial of preoperative dexamethasone on postoperative nausea and vomiting after laparoscopy for suspected appendicitis

    DEFF Research Database (Denmark)

    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...

  4. [A case of paragonimiasis miyazakii suspected after pathologic examination and subsequently confirmed].

    Science.gov (United States)

    Ota, Kyoko; Matsuyama, Masashi; Kokuho, Nariaki; Masuko, Hironori; Hayashi, Hiroki; Iizuka, Takashi; Hayashibara, Kenji; Saito, Takefumi; Kawabata, Yoshinori; Tomichi, Nobukazu

    2009-03-01

    A 58-year-old man presented with right backache and bloody sputum. Chest X-ray revealed a nodular opacity in the right lung. Since could not obtain a diagnosis by bronchoscopy, we performed a lower lobectomy. Histopathologically, there were irregularly shaped necrotizing granulomas and an area of acute hemorrhagic, eosinophilic abscess. We suspected paragonimiasis. The diagnosis of paragonimiasis miyazakii was confirmed by ELISA. This is a valuable case of suspected paragonimiasis confirmed pathologically.

  5. [Association between time spent on physical exercise, sleep, homework and suspected myopia among students].

    Science.gov (United States)

    Xu, S J; Wan, Y H; Xu, Z H; Zhang, H; Xu, L; Wang, B; Tao, F B

    2016-02-01

    To investigate the prevalence of suspected myopia among students and to examine the relationship between time spent on physical exercise, sleep, homework and suspected myopia. A total of 8 030 primary and secondary school students from 4(th) to 12(th) grades were selected from the National Student Constitution and Health Survey (NSCHS) in Anhui province in 2014. Time spent on exercise, sleep and homework per day were collected using a self-administrated questionnaire. Visual acuity was examined using the Standard Logarithmic Visual Acuity Chart. The overall prevalence of suspected myopia was 69.03%. Prevalence rates of suspected myopia appeared higher in girls, in urban students, with the highest in the 16 to 18 year-old groups. RESULTS from the multiple logistic regression analysis showed that the amount of time spent on physical exercise, sleep and homework per day were all significantly associated with suspected myopia. Suspected myopia was associated with longer time on physical exercise among students aged 8 to 12 years (OR=0.80, 95%CI: 0.64-0.99), and longer sleep time among students in the age groups of 13 to 15 years and 16 to 18 years (OR=0.73, 95% CI: 0.56-0.94;OR=0.38, 95% CI: 0.21-0.68, respectively). Longer time spent on homework significantly increased the risk of suspected myopia among students in the age groups of 8 to 12 years and 13 to 15 years (OR=1.41, 95%CI: 1.11-1.79; OR=1.74, 95% CI: 1.36-2.23, respectively). Suspected myopia appeared common among students. Comprehensive intervention programs focusing on sufficient physical exercise and sleep but less homework might help to prevent myopia among students at different ages.

  6. The changing rate of suspected rabies bites after begin to act animal shelter in erzurum city.

    Science.gov (United States)

    Vancelik, Serhat; Set, Turan; Akturk, Zekeriya; Calikoglu, Oksan; Kosan, Zahide

    2014-10-01

    We aimed to evaluate the relationship between establishing an animal shelter in Erzurum and the number of suspected rabies bites between the years 2005 and 2012. A retrospective, repeated cross-sectional study was planned in Erzurum in the year 2013. Records between the years 2005 and 2012 were obtained from the Communicable Diseases Department of the Erzurum Health Directorate. Data for 5789 cases exposed to suspected rabies bites were analyzed. 5789 suspected rabies bites were encountered in Erzurum between the years 2005 and 2012. After establishing the animal shelter in 2009, 4239 dogs were collected from the streets within four years and 426 of them were released after immunization. Additionally, the following services were given in the animal shelter between 2009 and 2012: immunization of 2935 dogs, sterilization of 1735 dogs, and release of 2082 dogs back to the street. 4-years before the establishment of the animal shelter, the number of dog-bites had decreased from 3403 cases to 2386 cases; 4-years after the establishment of the shelter, it declined by 29.8%. While there were 1096 suspected rabies cases during the year 2008, this ratio decreased by 40.9% after the establishment of the animal shelter in the year 2009. During the year 2010, where we had the highest number of homeless dog collection to the animal shelter, the decrease in suspected rabies bites reached the maximum decrease, namely 51.0%. Spearman correlation analysis showed a strong negative correlation between the number of collected animals and suspected rabies bites (r = -0,862; p=0.006). Suspected rabies cases are common in Turkey and some cases of rabies are encountered. The number of suspected rabies bites in Erzurum has decreased significantly after establishing the animal shelter. It is an evident that establishing rehabilitation centers for homeless animals in all cities will have an important role in controlling zoonotic diseases including rabies.

  7. Sudden Suspected Death in Emergency Department: Autopsy Results

    Directory of Open Access Journals (Sweden)

    Mehtap GURGER

    2014-09-01

    Full Text Available SUMMARY: Objectives: Sudden deaths occur within 24 hours after symptoms' onset and are caused by cardiac, neurological and pulmonary diseases. Autopsy is the gold standard in determining cause of death. In this study, death's etiology was evaluated in cases applied to our department that underwent autopsy with sudden death indication. Methods: This study included cases aged 18 or older with sudden, suspected, non-traumatic death applying to our department between 2008 and 2012. Patients' age, sex, death time, co-morbid diseases, initial signs, cardiac rhythm, and autopsy findings were recorded after reviewing patient charts. Results: The study included 46 patients. Mean age was 45.73±19.6. Of the cases, 84.78% applied to emergency with cardiopulmonary arrest. Thirty-two cases (69.6% were male. The most frequent cause of death was cardiovascular diseases (52.2%, followed by central nervous system disorders (21.7%, intoxications (15.2%, and respiratory diseases (10.9%. The most common diseases were myocardial infarction (45.7%, subarachnoid hemorrhage (8.7%, and chronic obstructive pulmonary disease. There were three drug ingestions, three carbon monoxide intoxications, and one corrosive material ingestion among the intoxication cases. Conclusions: Sudden deaths are rarely encountered. Emergency clinicians should consider cause in differential diagnosis and provide appropriate approaches at first evaluation. ÖZET: Amaç: Ani ölümler semptomlar başladıktan sonra 24 saat içerisinde oluşur. En yaygın nedenleri kardiyak, nörolojik ve pulmoner hastalıkları içerir. Otopsi bu ölümlerin nedenini tespit etmede altın standarttır. Bu çalışmada acil servisimize başvuran ani ölüm olgularının otopsi bulgularına göre ölüm nedenlerini değerlendirdik. Gereç ve Yöntem: Bu retrospektif çalışmaya 2008–2012 yılları arasında acil servisimize başvuran, yaşları 18 ve üzeri olan, nontravmatik, ani, şüpheli ölüm vakaları al

  8. Resuscitation characteristics and outcomes in suspected drug overdose-related out-of-hospital cardiac arrest.

    Science.gov (United States)

    Koller, Allison C; Salcido, David D; Callaway, Clifton W; Menegazzi, James J

    2014-10-01

    We sought to compare characteristics of emergency medical services-treated out-of-hospital cardiac arrests resulting from suspected drug overdose with non-overdose cases and test the relationship between suspected overdose and survival to hospital discharge. Data from emergency medical services-treated, non-traumatic out-of-hospital cardiac arrests from 2006 to 2008 and late 2009 to 2011 were obtained from four EMS agencies in the Pittsburgh, Pennsylvania metropolitan area. Case definition for suspected drug overdose was naloxone administration, indication on the patient care report and/or indication by a review of hospital records. Resuscitation parameters included chest compression fraction, rate, and depth and the administration of resuscitation drugs. Demographic and outcome variables compared by suspected overdose status included age, sex, and survival to hospital discharge. From 2342 treated out-of-hospital cardiac arrests, 180 were suspected overdose cases (7.7%) and were compared to 2162 non-overdose cases. Suspected overdose cases were significantly younger (45 vs. 65, pcardiac arrest were younger, received different resuscitative care, and survived more often than non-overdose cases. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Water Supply Interruptions and Suspected Cholera Incidence: A Time-Series Regression in the Democratic Republic of the Congo

    Science.gov (United States)

    Jeandron, Aurélie; Saidi, Jaime Mufitini; Kapama, Alois; Burhole, Manu; Birembano, Freddy; Vandevelde, Thierry; Gasparrini, Antonio; Armstrong, Ben; Cairncross, Sandy; Ensink, Jeroen H. J.

    2015-01-01

    Background The eastern provinces of the Democratic Republic of the Congo have been identified as endemic areas for cholera transmission, and despite continuous control efforts, they continue to experience regular cholera outbreaks that occasionally spread to the rest of the country. In a region where access to improved water sources is particularly poor, the question of which improvements in water access should be prioritized to address cholera transmission remains unresolved. This study aimed at investigating the temporal association between water supply interruptions and Cholera Treatment Centre (CTC) admissions in a medium-sized town. Methods and Findings Time-series patterns of daily incidence of suspected cholera cases admitted to the Cholera Treatment Centre in Uvira in South Kivu Province between 2009 and 2014 were examined in relation to the daily variations in volume of water supplied by the town water treatment plant. Quasi-poisson regression and distributed lag nonlinear models up to 12 d were used, adjusting for daily precipitation rates, day of the week, and seasonal variations. A total of 5,745 patients over 5 y of age with acute watery diarrhoea symptoms were admitted to the CTC over the study period of 1,946 d. Following a day without tap water supply, the suspected cholera incidence rate increased on average by 155% over the next 12 d, corresponding to a rate ratio of 2.55 (95% CI: 1.54–4.24), compared to the incidence experienced after a day with optimal production (defined as the 95th percentile—4,794 m3). Suspected cholera cases attributable to a suboptimal tap water supply reached 23.2% of total admissions (95% CI 11.4%–33.2%). Although generally reporting less admissions to the CTC, neighbourhoods with a higher consumption of tap water were more affected by water supply interruptions, with a rate ratio of 3.71 (95% CI: 1.91–7.20) and an attributable fraction of cases of 31.4% (95% CI: 17.3%–42.5%). The analysis did not suggest any

  10. Extended-Spectrum β-Lactamase- and Carbapenemase-Producing Enterobacteriaceae Isolated from Egyptian Patients with Suspected Blood Stream Infection.

    Directory of Open Access Journals (Sweden)

    H M Abdallah

    Full Text Available The aim of the study was to investigate the prevalence of extended-spectrum β-lactamase and carbapenemase production among Enterobacteriaceae isolated from Egyptian patients with suspected blood stream infection.Ninety-four Enterobacteriaceae blood culture isolates from Egyptian patients with suspected blood stream infection were collected, one isolate per patient. Identification of bacterial isolates was performed with MALDI-TOF (MS-based Vitek MS system, bioMerieux. Screening for ESBLs and carbapenemases production was done with the Vitek 2 system (bioMérieux. ESBL production was confirmed using the combined disk diffusion method for cefotaxime, ceftazidime, and cefepime, all with and without clavulanic acid (Rosco. Real-time PCR and sequencing were used to characterize the resistance genes. The phylogenetic groups of E. coli were identified by a PCR-based method.Of the 94 Enterobacteriaceae isolates 46 (48.93% showed an ESBL phenotype. One Enterobacter spp isolate was ESBL-producer and meropenem-resistant. The genetic analysis showed that CTX-M was present in 89.13% (41/46 of the ESBL-producing Enterobacteriaceae, whereas TEM and SHV were detected in 56.52% (26/46 and 21.74% (10/46 respectively (47.83% of the ESBL-producing isolates were multidrug resistant (MDR. Eleven out of 30 ESBL-producing E-coli isolates were assigned to phylogroup B2, followed by groups B1 (8 isolates, A (6 isolates and D (5 isolates.The high ESBL-E rates (48.93% found in this study together with the identification of one carbapenem-resistant Enterobacter spp isolate is worrisome. Our results indicate that systems for monitoring and detection of ESBL-producing bacteria in Egyptian hospitals have to be established. Also strict hospital infection control policies with the restriction of the consumption of extended-spectrum cephalosporins are necessary.

  11. Prevalence of suspected nonalcoholic fatty liver disease in Hispanic/Latino individuals differs by heritage.

    Science.gov (United States)

    Kallwitz, Eric R; Daviglus, Martha L; Allison, Matthew A; Emory, Kristen T; Zhao, Lihui; Kuniholm, Mark H; Chen, Jinsong; Gouskova, Natalia; Pirzada, Amber; Talavera, Gregory A; Youngblood, Marston E; Cotler, Scott J

    2015-03-01

    Nonalcoholic fatty liver disease (NAFLD) was shown to disproportionally affect Hispanic persons. We examined the prevalence of suspected NAFLD in Hispanic/Latino persons with diverse backgrounds. We studied the prevalence of suspected NAFLD among 12,133 persons included in the Hispanic Community Health Study/Study of Latinos. We collected data on levels of aminotransferase, metabolic syndrome (defined by National Cholesterol Education Program-Adult Treatment Panel III guidelines), demographics, and health behaviors. Suspected NAFLD was defined on the basis of increased level of aminotransferase in the absence of serologic evidence for common causes of liver disease or excessive alcohol consumption. In multivariate analyses, data were adjusted for metabolic syndrome, age, acculturation, diet, physical activity, sleep, and levels of education and income. In multivariate analysis, compared with persons of Mexican heritage, persons of Cuban (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.57-0.85), Puerto Rican (OR, 0.67; 95% CI, 0.52-0.87), and Dominican backgrounds (OR, 0.71; 95% CI, 0.54-0.93) had lower rates of suspected NAFLD. Persons of Central American and South American heritage had a similar prevalence of suspected NAFLD compared with persons of Mexican heritage. NAFLD was less common in women than in men (OR, 0.49; 95% CI, 0.40-0.60). Suspected NAFLD associated with metabolic syndrome and all 5 of its components. On the basis of an analysis of a large database of health in Latino populations, we found the prevalence of suspected NAFLD among Hispanic/Latino individuals to vary by region of heritage. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  12. Two cases of methemoglobinaemia caused by suspected sodium nitrite poisoning

    Directory of Open Access Journals (Sweden)

    Osvaldo Matteucci

    2008-06-01

    Full Text Available Among the causes of acute methemo-globinaemia are the ingestion and inhalation of over 40 oxidising substances, including nitrite, nitrate, carbon monoxide, some medicines, chlorine. The authors describe a case of acute methemoglobinaemia in two people that most probably suffered from food poisoning resulting from the consumption of a preparation of a dish called turkey alla canzanese that contained significant amounts of sodium nitrite. Both subjects who were treated promptly with methylene blue and hyperbaric oxygen therapy room recovered fully. Epidemiological investigations performed to clarify the dynamics of the episode suggested that among the causes of contamination were the swapping of products at the time of sale and the non-compliance to rules for the preparation of foods for human consumption.

  13. LEGAL ASPECTS OF THE AUTHENTICITY OF DAIRY PRODUCTS AS EXEMPLIFIED BY BUTTER AND CHEESE

    Directory of Open Access Journals (Sweden)

    Krystyna Ziółkowska

    2016-12-01

    Full Text Available The authenticity of food products is one of the criteria settling the consumers’ decision on the purchase of given goods. Herebythis article the authors focus on authenticity issues of butter and cheese. Matters of counterfeiting and methods of detecting such falsifications are brought up. The subject of additional substances permitted in the production of butter and cheese has been broadly discussed. The authors pay special attention to the issues of modern methods for the production of butter, having been in use for years in western European countries, which has run into resistance from supervising units. The problem of authenticity of butter and cheese has also been discussed in the context of products marked as Protected Designation of Origin (PDO, Protected Geographical Indication (PGI and Traditional Speciality Guaranted (TSG. The authors present possible offences against products subject to protection and legal regulations in the scope of the protection of traditional and regional products.

  14. Counterfeit Parts Prevention Strategies Guide

    Science.gov (United States)

    2014-06-24

    Documentation check, which checks for spelling, grammatical , or other errors in the part or packaging labels and paperwork. 2. Bar code check, which...in writing . 3.1.3 Supplier Assessment The approved unauthorized supplier should have a documented process for assessing all new or previously...in writing (e-mail is acceptable) if either of the following conditions is a necessary requirement to fulfill the sale: a. The order of preference

  15. COIN: Is Current Doctrine Counterfeit?

    Science.gov (United States)

    2012-05-17

    incorporate lessons from the British in Malaya .74 From the British example in Malaysia , doctrine absorbed lessons on civil-military coordination and...to Eat Soup with a Knife: Counterinsurgency Lessons from Malaya and Vietnam. Chicago: University of Chicago Press, 2005. Napoleoni, Loretta...insurgencies. Choosing mainly the French-Algerian insurgency, the Philippines, Northern Ireland, Malaya , and Vietnam as their primary examples of insurgency

  16. From Law to Urban Legend, and Vice Versa: Creative Food Counterfeiting in Early Modern Spain / De la ley a la leyenda urbana y viceversa: falsificaciones de la cocina creativa en la España del Siglo de Oro

    Directory of Open Access Journals (Sweden)

    Elena del Río Parra

    2012-04-01

    Full Text Available ABSTRACT. This text takes on common urban legends related to food forgery in order to find ground in legal texts. While literature is keen on food counterfeiting and perpetuates common to- pics, there seems to be more than a taste for lite- rary expression: town cries and ordinances are eloquent in pointing out elaborate methods to manipulate certain foods, some of which coincide to what were believed to be cultural myths. RESUMEN. Este texto se aproxima a conocidas leyendas urbanas relacionadas con la falsificación de alimentos para encontrar su base en textos legales. Si bien en la literatura son frecuentes las menciones a comida manipulada, estas parecen ser más que una repetición de lugares comunes: pregones y ordenanzas abundan en métodos muy elaborados de alteración de ciertos alimentos, algunos de los cuales coinciden con lo que hasta ahora entendíamos como mitos culturales.

  17. Lactobacillus rhamnosus GG suspected infection in a newborn with intrauterine growth restriction.

    Science.gov (United States)

    Sadowska-Krawczenko, I; Paprzycka, M; Korbal, P; Wiatrzyk, A; Krysztopa-Grzybowska, K; Polak, M; Czajka, U; Lutyńska, A

    2014-12-01

    A disseminated Lactobacillus rhamnosus GG ATCC 53103 infection was suspected in a 6 day-old newborn with intrauterine growth restriction (IUGR) symptoms, treated empirically with antibiotics and given L. rhamnosus GG with the aim of preventing antibiotic-associated gastrointestinal complications. The level of C-reactive protein on day 5 compared with day 2 was increased in spite of negative urine and cerebrospinal fluid cultures. The blood sampled on day 6 was found to be positive for lactobacilli, and the isolate was pre-identified as L. rhamnosus or Lactobacillus casei on day 11. The strain identity was then verified as L. rhamnosus GG through PCR and 16S rRNA sequencing. Genotyping with the rep-PCR and AFLP methods confirmed the 100% genetic similarity for both the strain isolated from patient blood and the probiotic product. The newborn became touch-sensitive, cried a lot, had worsening laboratory test results, and increased inflammation parameters, but no fever was observed. After a further 9 days of antibiotic therapy, blood cultures became negative, and laboratory tests improved on day 25. The patient was discharged from the hospital after 27 days. IUGR with a possible link to L. rhamnosus GG bacteraemia might be a new potential risk group, beside patients with organ failure, immunocompromised status and dysfunctional gut barrier mechanisms, for which safe use of probiotics needs careful attention. Universally accepted or improved guidelines for the safer administration of probiotics in risk groups are urgently needed. This report should not discourage the use of probiotics, but should highlight the need for their careful use in IUGR patients.

  18. An outbreak of Shigella dysenteriae in Sweden, May-June 2009, with sugar snaps as the suspected source.

    Science.gov (United States)

    Löfdahl, M; Ivarsson, S; Andersson, S; Långmark, J; Plym-Forshell, L

    2009-07-16

    We report an outbreak of Shigella dysenteriae type 2 infections during May-June 2009 in Sweden, involving 47 suspected cases of whom 35 were laboratory-confirmed. The epidemiological investigation based on interviews with the patients pointed at sugar snaps from Kenya as the source. Shigella was not detected in samples of sugar snaps. However, Escherichia coli was confirmed in three of four samples indicating contamination by faecal material. During April to May 2009 outbreaks with Shigella connected to sugar snaps from Kenya were reported from Norway and Denmark. In the three countries trace back of the indicated sugar snaps revealed a complex system with several involved import companies and distributers. In Sweden one wholesale company was identified and connections were seen to the Danish trace back. These three outbreaks question whether the existing international certification and quality standards that are in place to prevent products from contamination by faecal pathogens are strict enough.

  19. Pattern Electroretinography in Glaucoma Suspects and Early Primary Open Angle Glaucoma

    Directory of Open Access Journals (Sweden)

    Ebrahim Jafarzadehpour

    2013-01-01

    Full Text Available Purpose: To explore retinal ganglion cell (RGC dysfunction in glaucoma suspects and patients with early primary open angle glaucoma (POAG using pattern electroretinography (PERG. Methods: Twenty glaucoma suspects (glaucomatous optic disc appearance, 15 early POAG (based on abnormal discs and abnormal visual fields and 16 normal controls were enrolled. Transient PERG was recorded in response to 0.8΀ and 16΀ black and white checkerboard stimuli. Amplitude and peak time (latency of the P50 and N95 components of the PERG response, and the ratio of N95 amplitude in response to 0.8΀ and 16΀ checks were measured. Results: N95 peak time (latency was significantly increased in both early manifest POAG and glaucoma suspects as compared to normal controls (P<0.001. In early POAG, N95 amplitude in response to small (0.8΀ checks and the small/large check ratio were reduced in comparison to normal eyes (P<0.05. However, in glaucoma suspects no significant N95 amplitude reduction was observed. No significant difference was observed among the study groups in terms of P50 amplitude or peak time. Conclusion: The N95 PERG response demonstrated uncoupled peak time and amplitude alterations in glaucoma. N95 peak time was significantly increased both in glaucoma suspects and early POAG; N95 amplitude reduction was present only in early POAG. PERG may detect RGC dysfunction (increased latency before cell death (decreased amplitude occurs.

  20. Facing suspected child abuse--what keeps Swedish general practitioners from reporting to child protective services?

    Science.gov (United States)

    Talsma, Marijke; Bengtsson Boström, Kristina; Östberg, Anna-Lena

    2015-03-01

    The aim of this study was to examine the reporting of suspected child abuse among Swedish general practitioners (GPs), and to investigate factors influencing them in their decision whether or not to report to child protective services (CPS). A cross-sectional questionnaire study. Primary health care centres in western Sweden. 177 GPs and GP trainees. Demographic and educational background, education on child abuse, attitudes to reporting and CPS, previous experience of reporting suspected child abuse, and need of support. Despite mandatory reporting, 20% of all physicians had at some point suspected but not reported child abuse. Main reasons for non-reporting were uncertainty about the suspicion and use of alternative strategies; for instance, referral to other health care providers or follow-up of the family by the treating physician. Only 30% of all physicians trusted CPS's methods of investigating and acting in cases of suspected child abuse, and 44% of all physicians would have wanted access to expert consultation. There were no differences in the failure to report suspected child abuse that could be attributed to GP characteristics. However, GPs educated abroad reported less frequently to CPS than GPs educated in Sweden. This study showed that GPs see a need for support from experts and that the communication and cooperation between GPs and CPS needs to be improved. The low frequency of reporting indicates a need for continued education of GPs and for updated guidelines including practical advice on how to manage child abuse.

  1. Patch Test Results with Standard and Cosmetic Series in Patients with Suspected Cosmetic-Induced Contact Dermatitis

    Directory of Open Access Journals (Sweden)

    Şenay Hacıoğlu

    2010-12-01

    Full Text Available Background and Design: Our aim was to evaluate the hypersensitivity to cosmetic chemicals in patients with clinically suspected cosmetic-induced contact dermatitis in Bursa and the South Marmara Region (Turkey by patch testing with standard and cosmetic series.Material and Method: Seventy-three patients with clinically suspected contact dermatitis due to cosmetics were patch tested by the European standard series and cosmetic series. The patch test results were analyzed as percentages. x2 test was used to demonstrate the relationship between cosmetic products and cosmetic allergens.Results: 90.4% of patients in our study group were female and 9.6% were male; the median age was 37.5 (range 16-71 years. The most commonly involved parts of the body were the face (49.3%, hands (16.4%, periocular region (6.8%, lips (6.8%, and the neck (5.5%. The most common offending cosmetic products causing allergic contact dermatitis were soaps and cleansing lotions (32.8%, moisturizer creams (21.9%, make-up (15.0%, and hair dyes (9.6%. 41.0% of patients showed positive reaction to at least one cosmetic allergen included in either standard or cosmetic series. The cosmetic allergens in the standard series and the rates of positivity were as follows: fragrance mix (6.8%, lanolin alcohols (5.5%, paraphenylenedaimine (2.7%, colophony (1.4%, paraben mix (1.4%, formaldehyde (1.4%, and methylchloroisothiazolinone (Kathon CG in descending order. The most common offending cosmetic allergen groups were preservatives (21.9%, antioxidants (8.2% and fragrances (6.8%. Conclusion: Allergic or irritant contact dermatitis due to cosmetics should be considered in cases of eczema involving face, neck, eyelids, lips, scalp or hands. Patch testing with cosmetic series beside standard series would be more helpful in detecting the responsible allergen(s.

  2. Anti-infective medicine quality: analysis of basic product quality by approval status and country of manufacture

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    Bate R

    2012-07-01

    Full Text Available Roger Bate,1 Lorraine Mooney,2 Kimberly Hess,3 Julissa Milligan,1 Amir Attaran41American Enterprise Institute, Washington DC, USA; 2Africa Fighting Malaria, London, UK; 3Africa Fighting Malaria, Washington DC, USA; 4Faculty of Law and Medicine, University of Ottawa, Ottawa, CanadaBackground: Some medicines for sale in developing countries are approved by a stringent regulatory authority (SRA or the World Health Organization (WHO prequalification program; many of these are global brands. This study ascertains whether medicines approved by SRAs or the WHO perform better in simple quality tests than those that have not been approved by either.Methods: Over the past 4 years, 2652 essential drugs (products to treat malaria, tuberculosis, and bacterial infections were procured by covert shoppers from eleven African cities and eight cities in a variety of mid-income nations. All samples were assessed using the Global Pharma Health Fund eV Minilab® protocol to identify whether they were substandard, degraded, or counterfeit.Results: The failure rate among SRA-approved products was 1.01%, among WHO-approved products was 6.80%, and 13.01% among products that were not approved by either. African cities had a greater proportion of SRA- or WHO-approved products (31.50% than Indian cities (26.57%, but they also experienced a higher failure rate (14.21% than Indian cities (7.83%. The remainder of cities tested had both the highest proportion of approved products at 34.46% and the lowest failure rate at 2.70%. Products made in Africa had the highest failure rate at 25.77%, followed by Chinese products at 15.74%, Indian products at 3.70%, and European/US products, which failed least often, at 1.70%. Most worrying is that 17.65% of Chinese products approved by the WHO failed.Conclusion: The results strongly indicate that approval by either an SRA or the WHO is correlated with higher medicine quality at a statistically significant level. The comparatively high

  3. Outcome of splanchnic blood flow determination in patients with suspected chronic intestinal ischaemia. A retrospective survey

    DEFF Research Database (Denmark)

    Møller, Søren; Madsen, Jan Lysgård

    2002-01-01

    BACKGROUND: Different diagnostic examinations have been applied in the management of patients with suspected intestinal ischaemia. In some centres, invasive determination of a meal-induced increase in splanchnic blood flow is used in the diagnostic process and in the selection of patients for sur...... underwent angioplasty. Future studies are needed to validate the determination of splanchnic blood flow in relation to splanchnic angiography and other imaging modalities in patients with chronic intestinal ischaemia.......BACKGROUND: Different diagnostic examinations have been applied in the management of patients with suspected intestinal ischaemia. In some centres, invasive determination of a meal-induced increase in splanchnic blood flow is used in the diagnostic process and in the selection of patients...... for surgery. However, no studies have evaluated the impact of splanchnic blood flow determination on therapy in such patients. OBJECTIVE: The aim of the present study was therefore to analyse the outcome of splanchnic blood flow determination in patients with suspected chronic intestinal ischaemia. METHODS...

  4. 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...

  5. Prevalence and Correlates of Suspected Nonalcoholic Fatty Liver Disease in Chinese Children

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    Peige Song

    2017-04-01

    Full Text Available Nonalcoholic fatty liver disease (NAFLD has become a serious public health problem worldwide; however, the availability of information on the prevalence of NAFLD in the general pediatric population is still limited. The primary aim of this study was to reveal the prevalence and correlates of suspected NAFLD in Chinese children at the national level. Data from the China Health and Nutrition Surveys (CHNS was used. Weight, height, waist circumference (WC, blood pressure (BP were measured for children aged 7–18 years. Blood samples were collected and analyzed. Children were classified as having suspected NAFLD if common causes of liver disease were excluded, and serum alanine aminotransferase (ALT values were above the established thresholds (>22.1 IU/L for girls and >25.8 IU/L for boys. A percentage of 9.03% (75 out of 831 of Chinese children was found to have suspected NAFLD. Overweight and obesity according to BMI percentiles, abdominal obesity, hyperuricemia (uric acid (UA > 327 μmol/L, and elevated total cholesterol (TC were all detected as the correlates of childhood suspected NAFLD when adjusting for other factors. Our study revealed the prevalence of suspected NAFLD in general Chinese children at the national level for the first time. Our findings indicate that suspected NAFLD in children is associated with increasing childhood morbidities, further studies are needed to better understand the prevalence of childhood NAFLD and its correlates, and large-scale programs should be launched to screen NAFLD in the pediatric population in China.

  6. Prevalence of Clostridium perfringens toxin genotypes in enterotoxemia suspected sheep flocks of Andhra Pradesh

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    N. Vinod Kumar

    2014-12-01

    Full Text Available Aim: To identify the Clostridium perfringens toxin genotypes prevailing in enterotoxemia suspected sheep flocks in Andhra Pradesh by using multiplex PCR. Materials and Methods: Intestinal scrapings were collected from lambs below three months of age from flocks with similar management from different Districts of Andhra Pradesh, in India. A total of 208 samples were collected with 140 from enterotoxemia suspected flocks and 68 from healthy flocks. Following processing and culture of the samples, colonies were identified by morphological and biochemical tests. All the clostridial isolates were analyzed by multiplex PCR. Results: C. pefringens were isolated from 97 out of 140 enterotoxemia suspected flocks (69.29% and 27 out of 68 healthy flocks (39.71 %. Genotyping of the 97 iolates by multiplex PCR from enterotoxemia suspected flocks indicated C. perfringens type A, C and D 67.01% (65 out of 97; 11.34% (11 out of 97 and 21.65% (21 out of 97 respectively. Isolates from healthy flocks indicated the presence of type A and D 92.59% (25 out of 27 and 7.40% (2 out of 27 respectively. Number of isolates from enterotoxaemia suspected flocks were significantly high (P<0.001 than healthy flocks. Type A is found to be predominant in both enterotoxemia suspected and healthy flocks (67.01% and 92.59%. Conclusions: Prevalence of C. perfringens type C was reported for the first time in India. Clostridium perfringens type D and type C were found to be the major causative types for enterotoxemia.

  7. Cost-benefit analysis of Xpert MTB/RIF for tuberculosis suspects in German hospitals.

    Science.gov (United States)

    Diel, Roland; Nienhaus, Albert; Hillemann, Doris; Richter, Elvira

    2016-02-01

    Our objective was to assess the cost-benefit of enhancing or replacing the conventional sputum smear with the real-time PCR Xpert MTB/RIF method in the inpatient diagnostic schema for tuberculosis (TB).Recent data from published per-case cost studies for TB/multidrug-resistant (MDR)-TB and from comparative analyses of sputum microscopy, mycobacterial culture, Xpert MTB/RIF and drug susceptibility testing, performed at the German National Reference Center for Mycobacteria, were used. Potential cost savings of Xpert MTB/RIF, based on test accuracy and multiple cost drivers, were calculated for diagnosing TB/MDR-TB suspects from the hospital perspective.Implementing Xpert MTB/RIF as an add-on in smear-positive and smear-negative TB suspects saves on average €48.72 and €503, respectively, per admitted patient as compared with the conventional approach. In smear-positive and smear-negative MDR-TB suspects, cost savings amount to €189.56 and €515.25 per person, respectively. Full replacement of microscopy by Xpert MTB/RIF saves €449.98. In probabilistic Monte-Carlo simulation, adding Xpert MTB/RIF is less costly in 46.4% and 76.2% of smear-positive TB and MDR-TB suspects, respectively, but 100% less expensive in all smear-negative suspects. Full replacement by Xpert MTB/RIF is also consistently cost-saving.Using Xpert MTB/RIF as an add-on to and even as a replacement for sputum smear examination may significantly reduce expenditures in TB suspects. Copyright ©ERS 2016.

  8. Successful conservative management of suspected Fournier’s gangrene in cats: three cases

    Directory of Open Access Journals (Sweden)

    Heather H Vaske

    2015-06-01

    Full Text Available Case series summary Three cats with suspected Fournier’s gangrene had an acute onset of clinical signs and bloodwork changes consistent with sepsis. All cases had similar progression of wounds that were managed without aggressive surgical debridement, which is the currently accepted treatment of choice. All cats survived and have maintained an excellent long-term quality of life. Relevance and novel information Fournier’s gangrene is a potentially fatal disease, with few cases reported in the veterinary literature. This retrospective case series describes the only known reports of survival from suspected Fournier’s gangrene cats, none of which required aggressive surgical debridement.

  9. The Lawyer in the Dutch Interrogation Room: Influence on Police and Suspect

    OpenAIRE

    Verhoeven, Willem-Jan; Stevens, Lonneke

    2012-01-01

    textabstractIn many European countries, providing a suspect in custody with legal aid before the first police interrogation is a heavily debated issue. In this paper, we report on an exploratory study on the use of coercion by the police and the use of the right to silence by suspects in 70 Dutch homicide cases and their relation to prior consultation and presence of a lawyer. Analysis of the data indicates that there is a relation between the presence of a lawyer in the interrogation room an...

  10. Suspected-target pesticide screening using gas chromatography-quadrupole time-of-flight mass spectrometry with high resolution deconvolution and retention index/mass spectrum library.

    Science.gov (United States)

    Zhang, Fang; Wang, Haoyang; Zhang, Li; Zhang, Jing; Fan, Ruojing; Yu, Chongtian; Wang, Wenwen; Guo, Yinlong

    2014-10-01

    A strategy for suspected-target screening of pesticide residues in complicated matrices was exploited using gas chromatography in combination with hybrid quadrupole time-of-flight mass spectrometry (GC-QTOF MS). The screening workflow followed three key steps of, initial detection, preliminary identification, and final confirmation. The initial detection of components in a matrix was done by a high resolution mass spectrum deconvolution; the preliminary identification of suspected pesticides was based on a special retention index/mass spectrum (RI/MS) library that contained both the first-stage mass spectra (MS(1) spectra) and retention indices; and the final confirmation was accomplished by accurate mass measurements of representative ions with their response ratios from the MS(1) spectra or representative product ions from the second-stage mass spectra (MS(2) spectra). To evaluate the applicability of the workflow in real samples, three matrices of apple, spinach, and scallion, each spiked with 165 test pesticides in a set of concentrations, were selected as the models. The results showed that the use of high-resolution TOF enabled effective extractions of spectra from noisy chromatograms, which was based on a narrow mass window (5 mDa) and suspected-target compounds identified by the similarity match of deconvoluted full mass spectra and filtering of linear RIs. On average, over 74% of pesticides at 50 ng/mL could be identified using deconvolution and the RI/MS library. Over 80% of pesticides at 5 ng/mL or lower concentrations could be confirmed in each matrix using at least two representative ions with their response ratios from the MS(1) spectra. In addition, the application of product ion spectra was capable of confirming suspected pesticides with specificity for some pesticides in complicated matrices. In conclusion, GC-QTOF MS combined with the RI/MS library seems to be one of the most efficient tools for the analysis of suspected-target pesticide residues

  11. A novel sonographic scoring system for antenatal risk assessment of obstetric complications in suspected morbidly adherent placenta.

    Science.gov (United States)

    Gilboa, Yinon; Spira, Maya; Mazaki-Tovi, Shali; Schiff, Eyal; Sivan, Eyal; Achiron, Reuven

    2015-04-01

    The purpose of this study was to evaluate a novel sonographic scoring system for risk assessment of complications in patients suspected of having morbidly adherent placenta. This retrospective study evaluated the association between maternal complications and a grayscale sonographic scoring system for adherent placenta before surgery. Criteria for adherent placenta included uteroplacental and uterobladder demarcation lines and the presence of lacunae. Placentas were classified into 4 stages: stage 0, normal placentation; stage 1, low probability of adherence; stage 2, moderate possibility of adherence; and stage 3, high suspicion of adherence. Placental adherence as assessed by a surgical team, estimated blood loss, and postoperative hospitalization days were determined for each group, as well as the rates of the need for packed blood cells, cryoprecipitate units, and hysterectomy. One hundred nine women were included in the study. Twenty-six (23.8%) women were given a score of stage 0, 22 (20.2%) stage 1, 28 (25.7%) stage 2, and 33 (30.3%) stage 3. Linear regression analysis demonstrated that the sonographic staging was the only variable significantly associated with the number of packed cells or cryoprecipitate units transfused (P< .001) and a clinical diagnosis of adherent placenta (P< .001). In addition, both sonographic staging and a history of cesarean delivery were significantly associated with hysterectomy (P = .01; P = .03, respectively), treatment with any blood products (P< .001; P= .01), and the duration of postoperative hospitalization (P< .001; P = .006). A scoring system based on simple grayscale parameters may be effective for antenatal risk assessment of maternal complications in cases of suspected morbidly adherent placenta. © 2015 by the American Institute of Ultrasound in Medicine.

  12. Evaluation of suspected cosmetic induced facial dermatoses with the use of Indian standard series and cosmetic series patch test.

    Science.gov (United States)

    Rastogi, Madhur Kant; Gupta, Astha; Soodan, Puneet Singh; Mishra, Nitin; Gahalaut, Pratik

    2015-03-01

    Awareness about skin beauty or cosmetic elegance has received worldwide attention in the present day youth oriented society. Along with careful detailed history and thorough examination patch test is considered cornerstone in diagnosis of allergic contact dermatitis. Fifty patients suspected clinical diagnosis of contact facial dermatitis due to attended the Department of Dermatology, were included in a hospital based study. The patch test was applied on the upper back of using 32 allergens present in Indian cosmetic series and 20 known allergens in Indian standard battery series procured from Systopic Pharmaceutical Ltd, after applying the patch test, the patient was asked to come after 48h and 72h for reading the results of the patch test. Out of 50 patients there were 32 (64%) females (housewives 36%) patients and 18 (36%) male (farmers 12%). Itching was the most common presenting symptom in 39 patients (78%) least was hypopigmentation and pain in 2%. Forehead was the most common site of involvement in 25 patients (50%) least were cheeks in 15 patients (30%). Erythema was the commonest morphological presentation seen in 36 patients (72%). Hair dye was suspected in maximum number of patients that is 13 (26%). Most common antigen showing patch test positivity was paraphenylenediamine in nine patients (18%). There are significantly more chances of developing positive test reaction with Indian standard series compared to cosmetic series. (p=.0053 using Fischer Exact test). In India there is no legislation regarding labeling ingredients on cosmetics as in the western countries, so labelling of the contents of cosmetic products should be the main challenge in cosmetic dermatitis is to identify.

  13. MR enterography versus capsule endoscopy in paediatric patients with suspected Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Casciani, Emanuele; Masselli, Gabriele; Polettini, Elisabetta; Bertini, Luca; Gualdi, Gianfranco [University, Radiology DEA, Azienda Policlinico Umberto I, Rome (Italy); Di Nardo, Giovanni; Oliva, Salvatore; Cucchiara, Salvatore [University, Pediatric Gastroenterology, Rome (Italy); Floriani, Irene [Istituto di Ricerche Farmacologiche ' ' Mario Negri' ' , Milan (Italy)

    2011-04-15

    The aim of this prospective study was to compare the diagnostic yield of MR enterography (MRE) with small-bowel capsule endoscopy (SBCE) in paediatric patients with suspected Crohn's disease (CD). Paediatric patients with suspected CD were considered eligible to be enrolled in the study. All patients underwent diagnostic work-up including 1.5-T MRE, ileo-colonoscopy and oesophagogastroduodenoscopy. SBCE was not performed if MRE showed SB stricture or extra-intestinal findings consistent with symptoms. Sixty consecutive paediatric patients (36 male; average age 14) were enrolled into the study. A positive diagnosis for CD was made in 19 patients, 29 had a negative result and 12 were affected by other gastro-intestinal conditions. SBCE was performed in 37 patients (61.7%); 23 patients were excluded (strictures in five, extra-intestinal findings in 11 and parents' refusal in seven cases). The accuracy, sensitivity, and specificity of MRE and SBCE were 98.3%, 100%, 97.6%, and 91.9%, 90.9%, 92.3%, respectively. Both MRE and SBCE are accurate methods for patients with suspected CD. MRE can be used as a primary imaging technique in suspected CD, in that it allows access to the ileal stricture, which forms a contra-indication for SBCE and provides extra-intestinal information. (orig.)

  14. Factors Affecting Special Education Services for English Language Learners with Suspected Language Learning Disabilities

    Science.gov (United States)

    Langdon, Henriette W.

    2002-01-01

    This article focuses on factors that impact identification of and services for English-language learners (ELLs) with suspected language-learning disabilities. These factors include (a) home and school environments, (b) the school's philosophy, (c) instructional strategies, and (d) other contextual variables that affect language use. In addition,…

  15. Study of topical corticosteroid response in glaucoma suspects and family members of established glaucoma patients

    Directory of Open Access Journals (Sweden)

    Jilani F

    1987-01-01

    Full Text Available The present study was conducted to study the topical steroid response in glaucoma suspects and family members of established glaucoma patients and its hereditary pattern The cases understudy were divided into three groups, namely normal (25 cases, suspected open angle glaucoma cases (20 and family members of established open angle glaucoma cases (33. After preliminary examination each patient was advised to put dexamethasone drop 1 % in one eye and a placebo in other eye. The IOP was noted after three weeks It was found that 80% of all eyes under study showed a rise in IOP after use of topical dexamethasone. The highest mean IOP was found in primary open angle glaucoma suspects, and the highest mean post-corticosteroid rise in IOP of 8.91 mm Hg was found among family members of established open angle glaucoma patients. The lOP response to topical corticosteroids was found to be of three phenotypical types viz., poor responders (nn, moderate responders (ng and high responders (gg. Normal subjects were generally poor responders. Suspected open angle glaucoma cases were generally high responders. However, family members of established open angle glaucoma cases showed the highest percentage of presence of responder gene.

  16. Teachers' Reporting of Suspected Child Abuse and Neglect: Behaviour and Determinants

    Science.gov (United States)

    Goebbels, A. F. G.; Nicholson, J. M.; Walsh, K.; De Vries, H.

    2008-01-01

    By reporting suspected child abuse and neglect, teachers can make an important contribution to the early detection and prevention of abuse. However, teachers are sometimes reluctant to report their suspicions. This study investigated the determinants of teachers' reporting behaviour using concepts from the Integrated Change Model. Self-report data…

  17. Correlation of serum apelin level with coronary calcium score in patients with suspected coronary artery disease

    Directory of Open Access Journals (Sweden)

    Mohammed Hassan Zeitoun

    2014-03-01

    Conclusion: To the best of our knowledge, this is the first report of an independent association between apelin and CCS in patients with suspected CAD. Apelin emerges as a possible novel biomarker for CAD, but this result remains to be proved prospectively.

  18. Retributive reactions to suspected offenders: The importance of social categorizations and guilt probability

    NARCIS (Netherlands)

    van Prooijen, J.W.

    2006-01-01

    In the current research, the author investigates the influence of social categorizations on retributive emotions (e.g., anger) and punishment intentions when people evaluate suspected offenders as independent observers. It is argued that information that guilt is certain or uncertain (i.e., guilt

  19. Metrical Analysis of the Speech of Children with Suspected Developmental Apraxia of Speech.

    Science.gov (United States)

    Velleman, Shelley L.; Shriberg, Lawrence D.

    1999-01-01

    This study attempted to identify diagnostic markers for suspected developmental apraxia of speech (SD-DAS) in 30 children with either SD-DAS or speech delay using analytic procedures from metrical phonology. Findings indicated that, although lexical metrical patterns did not differentiate the groups, syllable omissions persisted until much later…

  20. Neurohormonal activation and diagnostic value of cardiac peptides in patients with suspected mild heart failure

    DEFF Research Database (Denmark)

    Mikkelsen, Kirsten V.; Bie, Peter; Møller, Jacob E.

    2006-01-01

    accuracy of cardiac peptides to detect any left ventricular dysfunction (LVD) in patients referred from primary care with suspected HF before institution of medical therapy. METHODS: Of 166 referred patients 150 were consecutively included (14 were excluded and two refused consent). Echocardiography...

  1. Cortical capillary dysfunction in patients suspected of Alzheimer’s disease

    DEFF Research Database (Denmark)

    Eskildsen, Simon Fristed; Gyldensted, Louise; Nagenthiraja, Kartheeban

    Vascular risk factors are suspected to play a role in the etiology of Alzheimer’s disease. Recently, a model that relates capillary dysfunction to the development of AD was proposed[1]. The model predicts that capillary dysfunction in form of increased capillary transit time heterogeneity (CTH...

  2. 32 CFR 644.530 - Conditions in conveying land suspected of contamination.

    Science.gov (United States)

    2010-07-01

    ... contamination. 644.530 Section 644.530 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... Contamination from Proposed Excess Land and Improvements § 644.530 Conditions in conveying land suspected of contamination. The following conditions, appropriately modified to conform to local law, will be included in...

  3. Dynamics of Forensic Interviews with Suspected Abuse Victims Who Do Not Disclose Abuse

    Science.gov (United States)

    Hershkowitz, Irit; Orbach, Yael; Lamb, Michael E.; Sternberg, Kathleen J.; Horowitz, Dvora

    2006-01-01

    Objectives: The present study was designed to explore structural differences between forensic interviews in which children made allegations and those in which children did not make allegations. Methodology: Fifty forensic interviews of 4- to 13-year-old suspected victims of abuse who did not disclose abuse during the interview were compared with…

  4. Hypocholesterolemia and nonregenerative, suspected immune-mediated, anemia: Report of 3 canine cases.

    Science.gov (United States)

    Robbins, Rachel; Viviano, Katrina R

    2017-10-01

    This report describes hypocholesterolemia in 3 dogs with nonregenerative, suspected immune-mediated anemias. Common causes of hypocholesterolemia were ruled out, raising suspicion for a mechanistic link between anemia and hypocholesterolemia in dogs. As observed in humans with concurrent anemia and hypocholesterolemia, cholesterol concentrations increased to within the reference interval once the dogs' anemia resolved.

  5. Diagnostic efficacy of impedance plethysmography for clinically suspected deep-vein thrombosis. A randomized trial

    NARCIS (Netherlands)

    Hull, R. D.; Hirsh, J.; Carter, C. J.; Jay, R. M.; Ockelford, P. A.; Buller, H. R.; Turpie, A. G.; Powers, P.; Kinch, D.; Dodd, P. E.

    1985-01-01

    Impedance plethysmography is an accurate noninvasive method to test for proximal vein thrombosis, but it is insensitive to calf-vein thrombi. We randomly assigned patients on referral with clinically suspected deep-vein thrombosis and normal impedance plethysmographic findings to either serial

  6. 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

    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...

  7. Experiences of School Counselors during and after Making Suspected Child Abuse Reports

    Science.gov (United States)

    Sikes, April; Remley, Theodore P., Jr.; Hays, Danica G.

    2010-01-01

    The purpose of this study was to explore the experiences of school counselors during and after making suspected child abuse and neglect reports. A total of 847 school counselors who were members of the American School Counselor Association (ASCA) participated in this study. Results showed that professional school counselors encountered some…

  8. STATUS GIZI DAN STATUS IODIUM PADA BALITA DENGAN SUSPECT DOWN SYNDROME

    Directory of Open Access Journals (Sweden)

    Hastin Dyah K.

    2012-10-01

    Full Text Available Background: Nutritional status is one of the factor that determines the human resources and quality of life. Toddlers are one of vulnerable groups for nutritional problems. One of the nutrition problem in Indonesia is Iodine deficiency disorder. Clinical manifestations are not only endemic goiter and cretins, but also abortion, stillbirth, and congenital abnormalities. Congenital abnormalities are commonly found in areas ofendemic iodine deficiency disorder such as Down Syndrome. Objectives: This study aims to determine the iodine nutrition status of children under jive with Down Syndrome Suspect in endemic areas ofiodine deficiency disorder. Method: This research is descriptive study with cross sectional design. The study was conducted in Magelang district, which is endemic iodine deficiency disorder. Total sample of30 under jive years old with Down Syndrome Suspect. Result: The result showed that the nutritional status of respondents based on the weight/age index was 50% had good nutritional status. According to height/age index as much as 70% are short and very short. Based on weight/height index was 73,3% with normal nutritional status. At least 33% of children with Down Syndrome Suspect accompanied hypothyroidism.  Keywords: Suspect Down Syndrome, Nutritional Status, Iodine Status

  9. Small-Bowel Capsule Endoscopy in Patients with Suspected Crohn's Disease—Diagnostic Value and Complications

    Science.gov (United States)

    Figueiredo, Pedro; Almeida, Nuno; Lopes, Sandra; Duque, Gabriela; Freire, Paulo; Lérias, Clotilde; Gouveia, Hermano; Sofia, Carlos

    2010-01-01

    Background. The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Conclusions. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy. PMID:20811612

  10. Mitochondrial DNA haplogroup background affects LHON, but not suspected LHON, in Chinese patients.

    Science.gov (United States)

    Zhang, A-Mei; Jia, Xiaoyun; Bi, Rui; Salas, Antonio; Li, Shiqiang; Xiao, Xueshan; Wang, Panfeng; Guo, Xiangming; Kong, Qing-Peng; Zhang, Qingjiong; Yao, Yong-Gang

    2011-01-01

    Recent studies have shown that mtDNA background could affect the clinical expression of Leber hereditary optic neuropathy (LHON). We analyzed the mitochondrial DNA (mtDNA) variation of 304 Chinese patients with m.11778G>A (sample #1) and of 843 suspected LHON patients who lack the three primary mutations (sample #2) to discern mtDNA haplogroup effect on disease onset. Haplogroup frequencies in the patient group was compared to frequencies in the general Han Chinese population (n = 1,689; sample #3). The overall matrilineal composition of the suspected LHON population resembles that of the general Han Chinese population, suggesting no association with mtDNA haplogroup. In contrast, analysis of these LHON patients confirms mtDNA haplogroup effect on LHON. Specifically, the LHON sample significantly differs from the general Han Chinese and suspected LHON populations by harboring an extremely lower frequency of haplogroup R9, in particular of its main sub-haplogroup F (#1 vs. #3, P-value = 1.46×10(-17), OR = 0.051, 95% CI: 0.016-0.162; #1 vs. #2, P-value = 4.44×10(-17), OR = 0.049, 95% CI: 0.015-0.154; in both cases, adjusted P-value LHON in Chinese patients with m.11778G>A but not suspected LHON. Haplogroup F has a protective effect against LHON, while M7b is a risk factor.

  11. A simple diagnostic strategy in hospitalized patients with clinically suspected pulmonary embolism

    NARCIS (Netherlands)

    Kruip, M. J. H. A.; Söhne, M.; Nijkeuter, M.; Kwakkel-van Erp, H. M.; Tick, L. W.; Halkes, S. J. M.; Prins, M. H.; Kramer, M. H. H.; Huisman, M. V.; Büller, H. R.; Leebeek, F. W. G.

    2006-01-01

    OBJECTIVES: Diagnostic strategies in patients with suspected pulmonary embolism have been extensively studied in outpatients; their value in hospitalized patients has not been well established. Our aim was to determine the safety and clinical utility of a simple diagnostic strategy in hospitalized

  12. Endoscopic pH Monitoring for Patients with Suspected or Refractory Gastroesophageal Reflux Disease

    Directory of Open Access Journals (Sweden)

    Brian G Turner

    2007-01-01

    Full Text Available BACKGROUND: Wireless pH studies can offer prolonged pH monitoring, which may potentially facilitate the diagnosis and management of patients with gastroesophageal reflux disease (GERD. The aim of the present study was to evaluate the detection rate of abnormal esophageal acid exposure using prolonged pH monitoring in patients with suspected or refractory GERD symptoms.

  13. Temporal artery biopsy is not required in all cases of suspected giant cell arteritis.

    LENUS (Irish Health Repository)

    Quinn, Edel Marie

    2012-07-01

    Temporal artery biopsy (TAB) is performed during the diagnostic workup for giant cell arteritis (GCA), a vasculitis with the potential to cause irreversible blindness or stroke. However, treatment is often started on clinical grounds, and TAB result frequently does not influence patient management. The aim of this study was to assess the need for TAB in cases of suspected GCA.

  14. 45 CFR 681.5 - What happens if program fraud is suspected?

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false What happens if program fraud is suspected? 681.5 Section 681.5 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Procedures Leading to Issuance of A Complaint § 681.5...

  15. Unexpected MRI findings in clinically suspected Legg-Calve-Perthes disease

    Energy Technology Data Exchange (ETDEWEB)

    Lobert, Philip F.; Dillman, Jonathan R.; Strouse, Peter J.; Hernandez, Ramiro J. [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, C.S. Mott Children' s Hospital/F3503, Ann Arbor, MI (United States)

    2011-03-15

    In the setting of clinically suspected Legg-Calve-Perthes (LCP) disease and negative/equivocal radiographs, contrast-enhanced MRI can be performed to confirm the diagnosis. To determine the frequency of unexpected causes of hip pain as identified by MRI in children with clinically suspected LCP disease and negative/equivocal radiographs. All pediatric contrast-enhanced MRI examinations of the pelvis and hips performed between January 2000 and February 2009 to evaluate for possible LCP disease in the setting of negative/equivocal radiographs were identified. MRI examinations performed to evaluate for secondary avascular necrosis were excluded. Imaging reports were retrospectively reviewed for unexpected clinically important causes of hip pain. Thirty-six pediatric patients underwent contrast-enhanced MRI examinations for clinically suspected LCP disease in the setting of negative/equivocal radiographs. Twenty-two (61%) imaging studies were normal, while four (11%) imaging studies demonstrated findings consistent with LCP disease. Ten (28%) imaging studies revealed unexpected clinically important causes of hip pain, including nonspecific unilateral joint effusion and synovitis (n = 7, juvenile chronic arthritis was eventually diagnosed in 3 patients), sacral fracture (n = 1), apophyseal injury (n = 1), and femoral head subluxation (n = 1). MRI frequently reveals unexpected clinically important causes of hip pain in children with suspected LCP disease and negative/equivocal radiographs. (orig.)

  16. MR imaging of neuropathic feet in leprosy patients with suspected osteomyelitis

    NARCIS (Netherlands)

    Maas, Mario; Slim, Erik J.; Heoksma, Agnes F.; van der Kleij, Ad J.; Akkerman, Erik M.; den Heeten, Gerard J.; Faber, William R.

    2002-01-01

    This study was undertaken to analyze MRI findings in leprosy patients with neuropathic feet, which are suspected of having osteomyelitis. As far as we know, there is no literature concerning osteomyelitis and MRI in neuropathic leprosy feet at present. Therefore, we have included MRI examination of

  17. Diagnostic Performance Tests for Suspected Scaphoid Fractures Differ with Conventional and Latent Class Analysis

    NARCIS (Netherlands)

    Buijze, Geert A.; Mallee, Wouter H.; Beeres, Frank J. P.; Hanson, Timothy E.; Johnson, Wesley O.; Ring, David

    2011-01-01

    Evaluation of the diagnostic performance characteristics of radiographic tests for diagnosing a true fracture among suspected scaphoid fractures is hindered by the lack of a consensus reference standard. Latent class analysis is a statistical method that takes advantage of unobserved, or latent,

  18. Arm and Hand Movement in Children Suspected of Having Autism Spectrum Disorder

    Science.gov (United States)

    Braddock, Barbara A.; Hilton, Jane C.

    2016-01-01

    The aim of this study was to describe arm and hand movement in children suspected of having autism spectrum disorder (ASD; age range 29-43 months). A videotaped retrospective review of five children with symptoms of ASD during "Communication Temptation Tasks" was completed at two time points (pre-testing and 6 weeks later). Categories of…

  19. Evaluation of quantitative IFN-gamma response for risk stratification of active tuberculosis suspects.

    Science.gov (United States)

    Metcalfe, John Z; Cattamanchi, Adithya; Vittinghoff, Eric; Ho, Christine; Grinsdale, Jennifer; Hopewell, Philip C; Kawamura, L Masae; Nahid, Payam

    2010-01-01

    The contribution of interferon-gamma release assays (IGRAs) to appropriate risk stratification of active tuberculosis suspects has not been studied. To determine whether the addition of quantitative IGRA results to a prediction model incorporating clinical criteria improves risk stratification of smear-negative-tuberculosis suspects. Clinical data from tuberculosis suspects evaluated by the San Francisco Department of Public Health Tuberculosis Control Clinic from March 2005 to February 2008 were reviewed. We excluded tuberculosis suspects who were acid fast-bacilli smear-positive, HIV-infected, or under 10 years of age. We developed a clinical prediction model for culture-positive disease and examined the benefit of adding quantitative interferon (IFN)-gamma results measured by QuantiFERON-TB Gold (Cellestis, Carnegie, Australia). Of 660 patients meeting eligibility criteria, 65 (10%) had culture-proven tuberculosis. The odds of active tuberculosis increased by 7% (95% confidence interval [CI], 3-11%) for each doubling of IFN-gamma level. The addition of quantitative IFN-gamma results to objective clinical data significantly improved model performance (c-statistic 0.71 vs. 0.78; P added clinical value to a prediction model incorporating conventional risk factors. Although this benefit may be attenuated within highly experienced centers, the predictive accuracy of quantitative IFN-gamma levels should be evaluated in other settings.

  20. Diagnostic value of a psychological test in cases of suspected child abuse.

    Science.gov (United States)

    Geddis, D C; Turner, I F; Eardley, J

    1977-01-01

    The use of the Bene-Anthony Family Relations Test is described and illustrated by three examples of child abuse. This test should be considered in the investigation of definite or suspected cases of abuse and as part of the preparation of court evidence. PMID:921320

  1. Expected Consequences of Disclosure Revealed in Investigative Interviews with Suspected Victims of Child Sexual Abuse

    Science.gov (United States)

    Malloy, Lindsay C.; Brubacher, Sonja P.; Lamb, Michael E.

    2011-01-01

    The current study explored the expected consequences of disclosure discussed by 204 5- to 13-year-old suspected victims of child sexual abuse during the course of investigative interviews conducted using the NICHD Investigative Interview Protocol. Expected consequences were mentioned in nearly half of all interviews, with older children and those…

  2. Mitochondrial DNA haplogroup background affects LHON, but not suspected LHON, in Chinese patients.

    Directory of Open Access Journals (Sweden)

    A-Mei Zhang

    Full Text Available Recent studies have shown that mtDNA background could affect the clinical expression of Leber hereditary optic neuropathy (LHON. We analyzed the mitochondrial DNA (mtDNA variation of 304 Chinese patients with m.11778G>A (sample #1 and of 843 suspected LHON patients who lack the three primary mutations (sample #2 to discern mtDNA haplogroup effect on disease onset. Haplogroup frequencies in the patient group was compared to frequencies in the general Han Chinese population (n = 1,689; sample #3. The overall matrilineal composition of the suspected LHON population resembles that of the general Han Chinese population, suggesting no association with mtDNA haplogroup. In contrast, analysis of these LHON patients confirms mtDNA haplogroup effect on LHON. Specifically, the LHON sample significantly differs from the general Han Chinese and suspected LHON populations by harboring an extremely lower frequency of haplogroup R9, in particular of its main sub-haplogroup F (#1 vs. #3, P-value = 1.46×10(-17, OR = 0.051, 95% CI: 0.016-0.162; #1 vs. #2, P-value = 4.44×10(-17, OR = 0.049, 95% CI: 0.015-0.154; in both cases, adjusted P-value A but not suspected LHON. Haplogroup F has a protective effect against LHON, while M7b is a risk factor.

  3. Mild cognitive impairment with suspected nonamyloid pathology (SNAP) Prediction of progression

    NARCIS (Netherlands)

    Caroli, A.; Prestia, A.; Galluzzi, S.; Ferrari, C.; van der Flier, W.M.; Ossenkoppele, R.; van Berckel, B.; Barkhof, F.; Teunissen, C.; Wall, A.E.; Carter, S.F.; Scholl, M.; Choo, I.H.; Grimmer, T.; Redolfi, A.; Nordberg, A.; Scheltens, P.; Drzezga, A.; Frisoni, G. B.

    2015-01-01

    Objectives: The aim of this study was to investigate predictors of progressive cognitive deterioration in patients with suspected non-Alzheimer disease pathology (SNAP) and mild cognitive impairment (MCI). Methods: We measured markers of amyloid pathology (CSF b-amyloid 42) and neurodegeneration

  4. Video Game Effects--Confirmed, Suspected, and Speculative: A Review of the Evidence

    Science.gov (United States)

    Barlett, Christopher P.; Anderson, Craig A.; Swing, Edward L.

    2009-01-01

    This literature review focuses on the confirmed, suspected, and speculative effects of violent and non-violent video game exposure on negative and positive outcomes. Negative outcomes include aggressive feelings, aggressive thoughts, aggressive behavior, physiological arousal, and desensitization, whereas positive outcomes include various types of…

  5. Comparison of CT and MRI for Diagnosis of Suspected Scaphoid Fractures

    NARCIS (Netherlands)

    Mallee, W.; Doornberg, J.N.; Ring, D.; van Dijk, C.N.; Maas, M.; Goslings, J.C.

    2011-01-01

    Background: There is no consensus on the optimum imaging method to use to confirm the diagnosis of true scaphoid fractures among patients with suspected scaphoid fractures. This study tested the null hypothesis that computed tomography (CT) and magnetic resonance imaging (MRI) have the same

  6. Nurse Reporting of Known and Suspected Child Abuse and Neglect Cases in Taiwan

    Directory of Open Access Journals (Sweden)

    Pei-Yu Lee

    2007-03-01

    Full Text Available Despite the frontline role of taking care of children, nurses in Taiwan have been reluctant to report known and suspected cases of child abuse and neglect (CAN. This problem threatens the success of legislation aimed at reducing CAN cases in Taiwan. The purpose of this study was to examine the influence of nurses' perceptions, attitudes, and knowledge on suspecting and reporting CAN cases in health care settings in Taiwan. Two hundred and thirty-eight nurses were surveyed using structured questionnaires with a return rate of 79.3%. Health care settings surveyed in this study included emergency units, pediatric units, and community centers from eight hospitals in southern Taiwan. Almost 3/4 (70% of the sample of nurses thought they needed more training courses on CAN. Correlation analysis showed a significant relationship between suspecting and reporting CAN with perception, attitude, and knowledge. Stepwise multiple regression analysis revealed that perception (β= 0.475, knowledge (β= 0.265, and attitude (β= 0.246 accounted for 60% of the variance in suspecting and reporting CAN. The focus and scope of training programs for nurses in Taiwan should take these findings into consideration.

  7. The incidence of suspected myocardial infarction in Dutch general practice in the period 1978-1994.

    NARCIS (Netherlands)

    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

  8. The prevalence of suspected and challenge-verified penicillin allergy in a university hospital population

    DEFF Research Database (Denmark)

    Borch, Jacob Eli; Andersen, Klaus Ejner; Bindslev-Jensen, Carsten

    2006-01-01

    -allergic. The prevalence of suspected penicillin allergy was lower than reported elsewhere. A substantial number of patients failed to recall basic information about their alleged allergy. Patients reporting penicillin allergy upon admission and labels stating penicillin allergy on medical files are ignored in almost...

  9. Anterior segment changes after pharmacologic mydriasis using Pentacam and optical coherence tomography in angle closure suspects

    Directory of Open Access Journals (Sweden)

    Jing-Min Guo

    2015-10-01

    Full Text Available AIM:To compare the dynamic changes of anterior segment parameters especially iris morphology induced by pharmacologic mydriasis between angle closure suspects and normal controls.METHODS:The study group comprised 19 eyes of 19 angle closure suspects and 19 eyes of 19 age- and sex-matched normal open-angle eyes. Pentacam and optical coherence tomography measurements before and 30min after instillation of compound tropicamide eye drop were performed and compared. Biometric evaluations of iris tomography and anterior chamber angle were estimated by a customized image-processing software.RESULTS:Baseline axial length, iris cross sectional area and volume did not differ significantly between angle closure suspects and normal controls. Angle closure suspects had smaller pupil size, narrower anterior segment dimension and axial length, thinner iris with greater curve in comparison with normal controls. Pharmacologic mydriasis led to significant increments in iris thickness at 750 μm, anterior chamber depth and volume, whereas significant decrements in iris curve, cross sectional area and volume in both groups. Angle opening distance at 500 μm was increased significantly in normal controls (from 0.465±0.115 mm to 0.539±0.167 mm, P=0.009, but not in angle closure suspects (from 0.125±0.100 mm to 0.145±0.131 mm, P=0.326. Iris volume change per millimeter of pupil dilation (△IV/△PD decreased significantly less in angle closure suspects than normal controls (-2.47±1.33 mm2 vs -3.63±1.58 mm2, P=0.019. Linear regression analysis showed that the change of angle opening distance at 500 μm was associated most with the change of central anterior chamber depth (β=0.841, P=0.002 and △IV/△PD (β=0.028, P=0.002, followed by gender (β=0.062, P=0.032.CONCLUSION:Smaller iris volume decrement per millimeter of pupil dilation is related significantly with the less anterior angle opening in angle closure suspects after pharmacologic mydriasis. Dynamic

  10. Optimizing imaging in suspected appendicitis (OPTIMAP-study: A multicenter diagnostic accuracy study of MRI in patients with suspected acute appendicitis. Study Protocol

    Directory of Open Access Journals (Sweden)

    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

  11. CT pulmonary angiography: an over-utilized imaging modality in hospitalized patients with suspected pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Erin Smith

    2013-04-01

    Full Text Available Aims: To determine if computed tomographic pulmonary angiography (CTPA was overemployed in the evaluation of hospitalized patients with suspected acute pulmonary embolism (PE. Methods: Data were gathered retrospectively on hospitalized patients (n=185 who had CTPA for suspected PE between June and August 2009 at our institution. Results: CTPA was done in 185 hospitalized patients to diagnose acute PE based on clinical suspicion. Of these, 30 (16.2% patients were tested positive for acute PE on CTPA. The Well's pretest probability for PE was low, moderate, and high in 77 (41.6%, 83 (44.9%, and 25 (13.5% patients, respectively. Out of the 30 PE-positive patients, pretest probability was low in 2 (6.6%, moderate in 20 (66.7%, and high in 8 (26.6% (p=0.003. Modified Well's criteria applied to all patients in our study revealed 113 (61% with low and 72 (39% with high clinical pretest probability. When modified Well's criteria was applied to 30 PE-positive patients, 10 (33.3% and 20 (66.6% were found to have low and high pretest probability, respectively (p=0.006. D-dimer assay was done in 30 (16.2% of the inpatients with suspected PE and all of them were found to have elevated levels. A lower extremity duplex ultrasound confirmed deep venous thrombosis in 17 (9.1% of the patients with suspected PE, at least 1 week prior to having CTPA. Conclusion: Understanding the recommended guidelines, evidence-based literature, and current concepts in evaluation of patients with suspected acute PE will reduce unnecessary CTPA examinations.

  12. Diagnostic Value of Bronchoalveolar Lavage for Diagnosis of Suspected Peripheral Lung Cancer.

    Science.gov (United States)

    Bezel, Pascal; Tischler, Verena; Robinson, Cecile; Baumueller, Stephan; Bode-Lesniewska, Beata; Kohler, Malcolm; Freitag, Lutz; Franzen, Daniel

    2016-09-01

    There is a paucity of data concerning the benefit of bronchoalveolar lavage (BAL) for the diagnosis of suspected peripheral lung cancer (PLC). The aim of this study was to investigate the diagnostic value of BAL for the diagnosis of suspected PLC. All flexible bronchoscopies that included BAL among other modalities (brush, forceps, washing) for the diagnosis of a suspected PLC performed between 2009 and 2013 were analyzed in this retrospective study. A total of 260 patients were included. Malignancy was present in 61%. BAL's sensitivity for the diagnosis of malignancy was 29%, and overall diagnostic yield of BAL was 46%. However, only 1% of cancer diagnoses would have been missed in the absence of BAL. In the multivariable analysis, the size of lesion (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.02-1.33; P = .023), the presence of bronchus sign (OR, 4.73; 95% CI, 1.06-21.08; P = .042), and the presence of mediastinal/hilar lymphadenopathy (OR, 3.37; 95% CI, 1.53-7.41; P = .002) were associated with improved BAL true-positive ratio relating to diagnosis of malignancy. However, the effect of lesion size on sensitivity was small (area under the curve, 0.31; 95% CI, 0.23-0.40; P diagnosis of malignancy or pulmonary infection was 37. Conventional BAL has a low diagnostic value for the diagnosis of suspected PLC, and the low number needed to test does not qualify BAL as a recommended routine investigation for the diagnosis of suspected PLC for either solid or ground-glass lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Relationship between hemoglobin levels and risk for suspected non-alcoholic fatty liver in Taiwanese adults.

    Science.gov (United States)

    Bai, Chyi-Huey; Wu, Ming-Shun; Owaga, Eddy; Cheng, Shu-Yu; Pan, Wen-Harn; Chang, Jung-Su

    2014-10-31

    Body iron levels have recently been shown to be a strong predictor for non-alcoholic fatty liver disease (NAFLD). The aims of this study were to investigate the prevalence of NAFLD in a general adult population, and to investigate the relationship between body iron levels, NAFLD and the metabolic syndrome (MetS). 2186 adults participated in the third National Nutrition and Health Survey in Taiwan (NAHSIT, 2005-2008). The participants underwent anthropometry measurements and phlebotomy after an overnight fast, and those with excessive alcohol intake, iron overload of serum ferritin > 600 ng/ml, hepatitis viral infection and hepatocellular carcinoma were excluded. Suspected NAFLD was diagnosed by three alanine transaminase (ALT) cut-points: cut-point 1: serum ALT > 40 U/l; cut-point 2: ALT ≥ 25 U/l for male and ALT ≥ 17 U/l for female; and cut-point 3: ALT ≥ 35 U/l for male and ALT ≥ 26 U/l for female. The prevalence proportion of suspected NAFLD among Taiwanese adults was 6.6% (cut-point 1), 36% (cut-point 2); and 14.3% (cut-point 3). Body iron levels were significantly higher in individuals with suspected NAFLD compared with those without. Distribution of hemoglobin levels, but not serum ferritin levels, by decade of age showed strong correlation with the prevalence of suspected NAFLD in individuals with MetS. Multivariate adjusted odds ratio (OR) showed that the best predictors for suspected NAFLD with the MetS were hemoglobin [OR 1.43 (1.21-1.68); P hemoglobin [OR 1.25 (1.12-1.41); P hemoglobin levels (14.4 μg/dl for male and 13.2 μg/dl for female) are at the greatest risk for developing abnormal liver function. Hemoglobin test should be considered as a part of clinical evaluation for patients with NAFLD.

  14. Facing suspected child abuse – what keeps Swedish general practitioners from reporting to child protective services?

    Science.gov (United States)

    Bengtsson Boström, Kristina; Östberg, Anna-Lena

    2015-01-01

    Abstract Objective. The aim of this study was to examine the reporting of suspected child abuse among Swedish general practitioners (GPs), and to investigate factors influencing them in their decision whether or not to report to child protective services (CPS). Design. A cross-sectional questionnaire study. Setting. Primary health care centres in western Sweden. Subjects. 177 GPs and GP trainees. Main outcome measures. Demographic and educational background, education on child abuse, attitudes to reporting and CPS, previous experience of reporting suspected child abuse, and need of support. Results. Despite mandatory reporting, 20% of all physicians had at some point suspected but not reported child abuse. Main reasons for non-reporting were uncertainty about the suspicion and use of alternative strategies; for instance, referral to other health care providers or follow-up of the family by the treating physician. Only 30% of all physicians trusted CPS's methods of investigating and acting in cases of suspected child abuse, and 44% of all physicians would have wanted access to expert consultation. There were no differences in the failure to report suspected child abuse that could be attributed to GP characteristics. However, GPs educated abroad reported less frequently to CPS than GPs educated in Sweden. Conclusions. This study showed that GPs see a need for support from experts and that the communication and cooperation between GPs and CPS needs to be improved. The low frequency of reporting indicates a need for continued education of GPs and for updated guidelines including practical advice on how to manage child abuse. PMID:25676563

  15. ANALYTICAL JUSTIFICATION OF INCLUDING THE ANTIVIRAL DRUG INTO TREATMENT SCHEME FOR PATIENTS WITH SUSPECTED VIRAL DISEASE

    Directory of Open Access Journals (Sweden)

    Soloviov S. O

    2016-12-01

    Full Text Available Background: Viruses play a leading role in human pathology development, causing a large number of infectious diseases in acute, persistent or chronic forms. Although the number of deaths caused by viral infections have decreased significantly today, they continue to be a significant factor in reducing of the population overall productivity. Viral diseases cause additional losses in community related to the duration of the course or disease or its chronization, increased use of health care, loss of working hours, premature death etc. Introduction of the new antiviral drugs into medical practice is accompanied by the emergence of questions to assess its effectiveness and including into existing clinical protocols. So the aim of this work is the development of methodology of choosing and justification of optimal treatment strategy for viral diseases that could be included into certain clinical protocols for managing patients with certain viral diseases. Methodology justification: The methodology based on the method of pharmacoeconomic analysis "cost of illness", takes into account the economic burden of viral diseases: direct costs for treating of disease, indirect costs related to the disease and intangible costs. Algorithm of treatment scheme choice depends on the cost of treatment for the patient without viral disease also as for patient with viral disease. It was proposed to use lower limit priori probability (critical prevalence of viral disease as decision rule in the choice of treatment scheme. Results: Examples of the proposed methodology use show that the choice of the optimal therapeutic scheme for patients with suspected viral disease depends on the current prevalence of this disease among patients with similar clinical symptoms of the disease and its cost, depending on the chosen strategy of therapy. The proposed methodology determines the critical level of viral infection prevalence, which comparing to the current prevalence level is

  16. 31 CFR 585.215 - Conveyances and cargo suspected of being in violation of United Nations sanctions; detention...

    Science.gov (United States)

    2010-07-01

    ... being in violation of United Nations sanctions; detention; blocking. 585.215 Section 585.215 Money and... and cargo suspected of being in violation of United Nations sanctions; detention; blocking. (a) Except... § 585.201, but which are suspected of a violation of United Nations Security Council Resolutions No. 713...

  17. Magnetic resonance venography in consecutive patients with suspected deep vein thrombosis of the upper extremity: Initial experience

    NARCIS (Netherlands)

    Baarslag, H. J.; van Beek, E. J. R.; Reekers, J. A.

    2004-01-01

    Purpose: To assess the feasibility and accuracy of two magnetic resonance (MR) venography methods in a consecutive series of patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Material and Methods: Consecutive in- and outpatients who were referred for imaging of suspected

  18. Controlled Hypotension in Patients Suspected of a Ruptured Abdominal Aortic Aneurysm: Feasibility during Transport by Ambulance Services and Possible Harm

    NARCIS (Netherlands)

    Reimerink, J. J.; Hoornweg, L. L.; Vahl, A. C.; Wisselink, W.; Balm, R.

    2010-01-01

    Objective: To evaluate a controlled hypotension protocol for patients suspected of a ruptured aneurysm of the abdominal aorta (RAAA) and to identify possible harm to patients with a final diagnosis other than RAAA. Design: Retrospective analysis of patients suspected of RAAA and transported by

  19. Disparities in the Medical Examination of Children in the Home of a Child with Suspected Physical Abuse

    Science.gov (United States)

    Campbell, Kristine A.; Squires, Janet; Cook, Lawrence J.; Berger, Rachel P.

    2009-01-01

    Objective: To identify factors predicting the medical examination of children living in a home with a child referred to child protection services (CPS) for suspected physical abuse. Methods: Medical providers at Children's Hospital of Pittsburgh referred 189 children for suspected physical abuse to CPS between November 1, 2004 and May 1, 2006…

  20. Comparison of planar bone scintigraphy and single photon emission computed tomography in patients suspected of having unilateral condylar hyperactivity

    NARCIS (Netherlands)

    Saridin, C.P.; Raijmakers, P.G.H.M.; Tuinzing, D.B.; Becking, A.G.

    2008-01-01

    Objective A comparison is made of single photon emission computed tomography (SPECT) and planar bone scintigraphy in the diagnosis of patients with suspected unilateral condylar hyperactivity (UCH). Study design The subjects comprised 56 patients with suspected UCH who underwent SPECT and regular

  1. Comparison of planar bone scintigraphy and single photon emission computed tomography in patients suspected of having unilateral condylar hyperactivity

    NARCIS (Netherlands)

    Saridin, Carrol P.; Raijmakers, Pieter G. H. M.; Tuinzing, Dirk B.; Becking, Alfred G.

    2008-01-01

    A comparison is made of single photon emission computed tomography (SPECT) and planar bone scintigraphy in the diagnosis of patients with suspected unilateral condylar hyperactivity (UCH). The subjects comprised 56 patients with suspected UCH who underwent SPECT and regular planar bone scans.

  2. Global perspectives on ensuring the safety of pharmaceutical products in the distribution process
.

    Science.gov (United States)

    Jeong, Sohyun; Ji, Eunhee

    2018-01-01

    The distribution of counterfeit or falsified drugs is increasing worldwide. This can contribute to the high burden of disease and cost to society and is of global concern with the worldwide circulation of pharmaceuticals. The preparation and implementation of good distribution practice should be one of the most important aspects of ensuring safe drug circulation and administration. This research aimed to compare and analyze good distribution practice guidelines from advanced countries and international organizations, and to evaluate the status of the current good distribution practice guidelines in the world. Advanced pharmaceutical countries and international organizations, such as the World Health Organization, European Union, Pharmaceutical Inspection Co-operation Scheme, United States of America, Canada, and Australia, which have stable good distribution practice guidelines and public confidence, were included in the analysis. The World Health Organization and European Union guidelines are models for standardized good distribution practice for nations worldwide. The United States of America has a combination of four different series of distribution practices which have a unique structure and detailed content compared to those of other countries. The Canadian guidelines focus on temperature control during storage and transportation. The Australian guidelines apply to both classes of medicinal products and medical devices and need separate standardization. Transparent information about the Internet chain, international cooperation regarding counterfeiting, a high-standard qualification of sellers and customers, and technology to track and trace the whole life cycle of drugs should be the main focus of future good distribution practice guidelines worldwide.
.

  3. QUALITY CONTROL OF SOME TRADITIONAL MEAT PRODUCTS

    Directory of Open Access Journals (Sweden)

    S. DOBRINAS

    2014-03-01

    Full Text Available In this paper, we present the characterization of six traditional meat products: smoked file, smoked bacon, pork sausages, sausage prepared from swine’s entrails, pork pastrami, sheep sausages. Organoleptic tests (the aspect and shape, the aspect of freshly cut in the section, smell, taste and consistency, physico-chemical and microbiological determinations (NTG, Salmonella, Listeria monocytogenes and Escherichia coli were performed. These analyzes are a part of quality control that must be done in order to obtain a certificate from the Ministry of Agriculture for a traditional product. After identification of H2S and starch and according to fat oxidation degree it was concluded that analyzed samples didn’t contain counterfeiters and all parameters analyzed are within the maximum limits allowed by law. Considering all the procedures for manufacturing, characteristics of raw and auxiliary materials, organoleptic properties of final products analyzed in this study, it can be concluded that analyzed meat specialties meet the requirements of Ministry Order no. 690/28.09.2004 for the traditional products certification.

  4. [Viral load test conducive to excluding negative subjects from suspects in HIV antibody detections].

    Science.gov (United States)

    Hei, Fa-Xin; Zhang, Qi-Yun; Sun, Wei-Dong; Zhang, Qin; Ye, Jing-Rong; Liu, Hai-Lin; Lu, Hong-Yan

    2008-01-01

    To study whether plasma viral load testing is helpful to exclude ones free from Human immunodeficiency virus (HIV) infections from suspects in HIV antibody detections. 19 Specimens, which showed disconcordant results of the two HIV EIA testing (S/CO test, were selected. Viral load of the specimens were detected. A six-month follow up survey in detecting HIV antibody was conducted in these subjects. None of these 19 cases was observed to be positive HIV viral loads and there was no any progress in WB bands development during the follow-up period. The possibility of HIV infection could be excluded. When the specimens react with very low intensity in both EIA and WB, negative viral load result is conducive to exclude negative subjects from suspects in HIV antibody detections.

  5. Treatment with Epinephrine (Adrenaline) in Suspected Anaphylaxis during Anesthesia in Denmark

    DEFF Research Database (Denmark)

    Garvey, Lene H; Belhage, Bo; Krøigaard, Mogens

    2011-01-01

    BACKGROUND:: Literature on the use of epinephrine in the treatment of anaphylaxis during anesthesia is very limited. The objective of this study was to investigate how often epinephrine is used in the treatment of suspected anaphylaxis during anesthesia in Denmark and whether timing of treatment...... is important. METHODS:: A retrospective study of 270 patients investigated at the Danish Anaesthesia Allergy Centre after referral due to suspected anaphylaxis during anesthesia was performed. Reactions had been graded by severity: C1, mild reactions; C2, moderate reactions; C3, anaphylactic shock......, infusion was needed in 12 of 60 patients (20%) treated early versus 12 of 35 patients (34%) treated late (odds ratio, 2.09) (95% confidence interval, 0.81-5.35). CONCLUSION:: Anaphylaxis may be difficult to diagnose during anesthesia, and treatment with epinephrine can be delayed as a consequence...

  6. Magnetic resonance angiography evidence of vasospasm in children with suspected acute hemiplegic migraine.

    Science.gov (United States)

    Safier, Robert; Cleves-Bayon, Catalina; Vaisleib, Inna; Siddiqui, Ali; Zuccoli, Giulio

    2014-06-01

    Hemiplegic migraine is a rare subtype of migraine that is differentiated by motor weakness in the aura phase. The purpose of this case series was to examine the magnetic resonance angiogram findings of patients suffering from suspected acute hemiplegic migraine. This was a retrospective institutional board review protocol study of 8 patients. All patients received full brain magnetic resonance imaging under a 1.5-T magnet. The scans were subsequently evaluated by a neuroradiologist and 2 neurologists who were blinded to the study. The magnetic resonance angiogram findings of this study showed the presence of vasospasm within the intracranial vasculature during suspected acute hemiplegic migraine. This case series suggests that routine use of magnetic resonance angiography might be beneficial in both managing patients with acute hemiplegic migraine and helping to further understand the pathophysiology of this complicated disease process. © The Author(s) 2013.

  7. Comparison of cortisol and thyroid hormones between tuberculosis-suspect and healthy elephants of Nepal.

    Science.gov (United States)

    Paudel, Sarad; Brown, Janine L; Thapaliya, Sharada; Dhakal, Ishwari P; Mikota, Susan K; Gairhe, Kamal P; Shimozuru, Michito; Tsubota, Toshio

    2016-12-01

    We compared cortisol and thyroid hormone (T3 and T4) concentrations between tuberculosis (TB)-suspected (n=10) and healthy (n=10) elephants of Nepal. Whole blood was collected from captive elephants throughout Nepal, and TB testing was performed using the ElephantTB STAT-PAK® and DPP VetTB® serological assays that detect antibodies against Mycobacterium tuberculosis and M. bovis in elephant serum. Cortisol, T3 and T4 were quantified by competitive enzyme immunoassays, and the results showed no significant differences in hormone concentrations between TB-suspect and healthy elephants. These preliminary data suggest neither adrenal nor thyroid function is altered by TB disease status. However, more elephants, including those positively diagnosed for TB by trunk wash cultures, need to be evaluated over time to confirm results.

  8. The assessment of children with suspected laryngopharyngeal reflux: An Otorhinolaringological perspective.

    Science.gov (United States)

    Galluzzi, Francesca; Schindler, Antonio; Gaini, Renato Maria; Garavello, Werner

    2015-10-01

    The assessment of pediatric laryngopharyngeal reflux (LPR) is controversial. Otorhinolaryngologists may play a role in the evaluation of children with suspected LPR detecting typical airway endoscopic findings and/or associated diseases and may help in the selection of children to be subjected to further instrumental tests. In this perspective the present review aims at examining the available evidence in the literature regarding the assessment of LPR in children. After careful literature search there are no current validated symptoms assessment questionnaires for LPR evaluation in children; flexible fiberoptic nasopharyngolaryngoscopy remains controversial as a diagnostic tool in suspect LPR cases; even though the multichannel intraluminal impedance with pH monitoring has been proposed as the instrumental gold standard, further evidence need to be found for validation in children with typical features of LPR. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Neurological signs in 23 dogs with suspected rostral cerebellar ischaemic stroke

    DEFF Research Database (Denmark)

    Thomsen, Barbara Blicher; Garosi, Laurent; Skerritt, Geoff

    2016-01-01

    Background: In dogs with ischaemic stroke, a very common site of infarction is the cerebellum. The aim of this study was to characterise neurological signs in relation to infarct topography in dogs with suspected cerebellar ischaemic stroke and to report short-term outcome confined...... to the hospitalisation period. A retrospective multicentre study of dogs with suspected cerebellar ischaemic stroke examined from 2010–2015 at five veterinary referral hospitals was performed. Findings from clinical, neurological, and paraclinical investigations including magnetic resonance imaging were assessed....... Results: Twenty-three dogs, 13 females and 10 males with a median age of 8 years and 8 months, were included in the study. The Cavalier King Charles Spaniel (n = 9) was a commonly represented breed. All ischaemic strokes were located to the vascular territory of the rostral cerebellar artery including...

  10. The paramilitary speech Alias '39': suspects, offenders and redeemed in La Mesa, Cesar

    Directory of Open Access Journals (Sweden)

    José Gregorio Pérez V.

    2016-08-01

    Full Text Available The paper aims to characterize the paramilitary speech in the village of La Mesa, Cesar, whose practices of power-knowledge are not registered only in the coercive field, but extend to forms of communication, where the control and subjugation of the population, legitimation and de-legitimation of the main enemy (FARC and ELN, and suspects and the problematic resident (offenders, acquire a particular form of registration in the individualities and the social body, and extends to the soccer field, the school, the streets, the workplaces, the artifacts (stone and soccer arches present in the territory. In addition to suspects and offenders, the paramilitary leader, David Hernández Rojas, alias ‘39’, led to another subject registered in the speech, the redeemed/collaborators.

  11. Aparasitemic serological suspects in Trypanosoma brucei gambiense human African trypanosomiasis : a potential human reservoir of parasites ?

    OpenAIRE

    Koffi, Mathurin; Solano, Philippe; Denizot, M.; Courtin, D.; Garcia, André; Lejon, V.; Buscher, P.; Cuny, Gérard; Jamonneau, Vincent

    2006-01-01

    The serological and parasitological tests used for Trypanosoma brucei gambiense human African trypanosomiasis (HAT) diagnosis have low specificity and sensitivity, respectively, and in the field, control program teams are faced with subjects with positive serology but negative parasitology who remain untreated. The aim of this work was to explore, using PCR tool, the significance of these aparasitemic serological suspects. Since discordant PCR results have been observed earlier with different...

  12. An approach to the patient with a suspected tachycardia in the ...

    African Journals Online (AJOL)

    SVT with a right or left BBB or an intra- ventricular conduction abnormality. This. An approach to the patient with a suspected tachycardia in the emergency department. A Chin,1 MB ChB, MPhil, FHRS; B Vezi,2 MB ChB, FCP (SA), Cert Cardiology (SA); M Namane,3 MB ChB, MPhil;. H Weich,4 MB ChB, MRCP (UK), MMed ...

  13. Performance characteristics of the suspected blood indicator feature in capsule endoscopy according to indication for study.

    Science.gov (United States)

    Buscaglia, Jonathan M; Giday, Samuel A; Kantsevoy, Sergey V; Clarke, John O; Magno, Priscilla; Yong, Elaine; Mullin, Gerard E

    2008-03-01

    The suspected blood indicator (SBI) feature of wireless capsule endoscopy (WCE) was developed for rapid screening of intestinal lesions with bleeding potential. Our aim was to assess the accuracy and performance characteristics of the SBI according to the indications for study in a large cohort of patients. We reviewed collected data on all WCE studies performed at Johns Hopkins Hospital from January 2006 to June 2007. Study indications were as follows: anemia of unknown origin (n = 53), obscure gastrointestinal bleeding (n = 112), suspected Crohn's disease (n = 122), and other (n = 4). Concordant and discordant findings between gastroenterologists' readings and SBI were recorded for each patient. A total of 221 lesions with bleeding potential was detected. The overall sensitivity, specificity, positive predictive value, and negative predictive value for the SBI were 56.4%, 33.5%, 24.0%, and 67.3%, respectively. For actively bleeding lesions, the SBI sensitivity and positive predictive value were only 58.3% and 70%, respectively. The sensitivity was highest (64%) in patients undergoing WCE for suspected Crohn's disease, with a negative predictive value of 80.4%. The sensitivity was only 58.3% and 41.3%, respectively, in studies performed for obscure gastrointestinal bleeding and anemia. Performance characteristics of the currently available SBI feature in WCE are suboptimal and insufficient to screen for lesions with bleeding potential. Even in patients with active intestinal bleeding, the sensitivity of SBI was less than 60%, which is lower than previously reported. However, in patients with suspected Crohn's disease, the high sensitivity and negative predictive value of SBI may make it a useful tool for the detection of large areas of abnormal mucosa.

  14. Extra-appendiceal findings in pediatric abdominal CT for suspected appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Halverson, Mark; Delgado, Jorge; Mahboubi, Soroosh [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2014-07-15

    Much has been written regarding the incidence, types, importance and management of abdominal CT incidental findings in adults, but there is a paucity of literature on incidental findings in children. We sought to determine the prevalence and characteristics of extra-appendiceal and incidental findings in pediatric abdominal CT performed for suspected appendicitis. A retrospective review was performed of abdominal CT for suspected appendicitis in a pediatric emergency department from July 2010 to June 2012. Extra-appendiceal findings were recorded. Any subsequent imaging was noted. Extra-appendiceal findings were divided into incidental findings of doubtful clinical significance, alternative diagnostic findings potentially providing a diagnosis other than appendicitis explaining the symptoms, and incidental findings that were abnormalities requiring clinical correlation and sometimes requiring further evaluation but not likely related to the patient symptoms. One hundred sixty-five children had abdominal CT for suspected appendicitis. Seventy-seven extra-appendiceal findings were found in 57 (34.5%) patients. Most findings (64 of 77) were discovered in children who did not have appendicitis. Forty-one of these findings (53%) could potentially help explain the patient's symptoms, while 30 of the findings (39%) were abnormalities that were unlikely to be related to the symptoms but required clinical correlation and sometimes further work-up. Six of the findings (8%) had doubtful or no clinical significance. Extra-appendiceal findings are common in children who undergo abdominal CT in the setting of suspected appendicitis. A significant percentage of these patients have findings that help explain their symptoms. Knowledge of the types and prevalence of these findings may help radiologists in the planning and interpretation of CT examinations in this patient population. (orig.)

  15. Suspected Pulmonary Infection with Trichoderma longibrachiatum after Allogeneic Stem Cell Transplantation

    OpenAIRE

    Akagi, Tomoaki; Kawamura, Chizuko; Terasawa, Norio; Yamaguchi, Kohei; Kubo, Kohmei

    2017-01-01

    Aspergillus and Candida species are the main causative agents of invasive fungal infections in immunocompromised human hosts. However, saprophytic fungi are now increasingly being recognized as serious pathogens. Trichoderma longibrachiatum has recently been described as an emerging pathogen in immunocompromised patients. We herein report a case of isolated suspected invasive pulmonary infection with T. longibrachiatum in a 29-year-old man with severe aplastic anemia who underwent allogeneic ...

  16. The yield of high-detail radiographic skeletal surveys in suspected infant abuse.

    Science.gov (United States)

    Barber, Ignasi; Perez-Rossello, Jeannette M; Wilson, Celeste R; Kleinman, Paul K

    2015-01-01

    Skeletal surveys are routinely performed in cases of suspected child abuse, but there are limited data regarding the yield of high-detail skeletal surveys in infants. To determine the diagnostic yield of high-detail radiographic skeletal surveys in suspected infant abuse. We reviewed the high-detail American College of Radiology standardized skeletal surveys performed for suspected abuse in 567 infants (median: 4.4 months, SD 3.47; range: 4 days-12 months) at a large urban children's hospital between 2005 and 2013. Skeletal survey images, radiology reports and medical records were reviewed. A skeletal survey was considered positive when it showed at least one unsuspected fracture. In 313 of 567 infants (55%), 1,029 definite fractures were found. Twenty-one percent (119/567) of the patients had a positive skeletal survey with a total of 789 (77%) unsuspected fractures. Long-bone fractures were the most common injuries, present in 145 children (26%). The skull was the site of fracture in 138 infants (24%); rib cage in 77 (14%), clavicle in 24 (4.2%) and uncommon fractures (including spine, scapula, hands and feet and pelvis) were noted in 26 infants (4.6%). Of the 425 infants with neuroimaging, 154 (36%) had intracranial injury. No significant correlation between positive skeletal survey and associated intracranial injury was found. Scapular fractures and complex skull fractures showed a statistically significant correlation with intracranial injury (P = 0.029, P = 0.007, respectively). Previously unsuspected fractures are noted on skeletal surveys in 20% of cases of suspected infant abuse. These data may be helpful in the design and optimization of global skeletal imaging in this vulnerable population.

  17. A Case of Suspected Breast Cancer Metastasis to Brachial Plexus Detected by Magnetic Resonance Neurography

    Directory of Open Access Journals (Sweden)

    Atsushi Mizuma

    2016-07-01

    Full Text Available Metastasis of breast cancer is often detected through a long-term course and difficult to diagnose. We report a case of brachial plexopathy suspected to be the initial lesion of breast cancer metastasis, which was only detected by magnetic resonance (MR neurography. A 61-year-old woman was admitted to our hospital within 2 years after operation for breast cancer because of progressive dysesthesia and motor weakness initially in the upper limb on the affected side and subsequently on the contralateral side. Enhanced computed tomography, axillary lymph node echo, gallium scintigraphy, and short tau inversion recovery MR images showed no abnormalities. MR neurography revealed a swollen region in the left brachial plexus. We suspected neuralgic amyotrophy and initiated treatment with intravenous immunoglobulin therapy and steroid therapy. However, there was no improvement, and the progression of motor weakness in the bilateral lower limbs appeared over 4 years. Concomitant elevation of carbohydrate antigen 15-3 level (58.9 U/ml led us to suspect breast cancer metastasis, which was associated with the worsening of neurological findings, although gallium scintigraphy and bone scintigraphy showed no inflammatory and metastatic lesions. Swelling of the cauda equina in enhanced lumbar MR imaging and abnormal accumulation at the brachial plexus and cervical spinal cord in positron-emission tomography were newly detected contrary to the normal findings on the gallium scintigraphy, which suggested cerebrospinal fluid seeding. We suspected breast cancer metastasis about the initial brachial plexopathy based on the clinical course. MR neurography may be a helpful tool to detect metastatic lesion, especially in nerve roots.

  18. Economic evaluation of a clinical protocol for diagnosing emergency patients with suspected pulmonary embolism

    Directory of Open Access Journals (Sweden)

    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.

  19. The yield of high-detail radiographic skeletal surveys in suspected infant abuse

    Energy Technology Data Exchange (ETDEWEB)

    Barber, Ignasi [Hospital Vall d' Hebron, Universitat Autonoma de Barcelona, Pediatric Radiology Department, Barcelona (Spain); Perez-Rossello, Jeannette M.; Kleinman, Paul K. [Boston Children' s Hospital, Radiology Department, Boston, MA (United States); Wilson, Celeste R. [Boston Children' s Hospital, Division of General Pediatrics, Boston, MA (United States)

    2014-07-06

    Skeletal surveys are routinely performed in cases of suspected child abuse, but there are limited data regarding the yield of high-detail skeletal surveys in infants. To determine the diagnostic yield of high-detail radiographic skeletal surveys in suspected infant abuse. We reviewed the high-detail American College of Radiology standardized skeletal surveys performed for suspected abuse in 567 infants (median: 4.4 months, SD 3.47; range: 4 days-12 months) at a large urban children's hospital between 2005 and 2013. Skeletal survey images, radiology reports and medical records were reviewed. A skeletal survey was considered positive when it showed at least one unsuspected fracture. In 313 of 567 infants (55%), 1,029 definite fractures were found. Twenty-one percent (119/567) of the patients had a positive skeletal survey with a total of 789 (77%) unsuspected fractures. Long-bone fractures were the most common injuries, present in 145 children (26%). The skull was the site of fracture in 138 infants (24%); rib cage in 77 (14%), clavicle in 24 (4.2%) and uncommon fractures (including spine, scapula, hands and feet and pelvis) were noted in 26 infants (4.6%). Of the 425 infants with neuroimaging, 154 (36%) had intracranial injury. No significant correlation between positive skeletal survey and associated intracranial injury was found. Scapular fractures and complex skull fractures showed a statistically significant correlation with intracranial injury (P = 0.029, P = 0.007, respectively). Previously unsuspected fractures are noted on skeletal surveys in 20% of cases of suspected infant abuse. These data may be helpful in the design and optimization of global skeletal imaging in this vulnerable population. (orig.)

  20. Understanding Gut Fermentation Syndrome in the Psychiatric Evaluation of Patients with Suspected Alcohol Use Disorder

    Science.gov (United States)

    2017-10-18

    Fermentation Syndrome in the Psychiatric Evaluation of Patients with Suspected Alcohol Use Disorder Sb. GRANT NUMBER Sc. PROGRAM ELEMENT NUMBER 6...by ANSI Std. Z39.18 Adobe Professional 7. 0 Introduction Gut Fermentation Syndrome, also known as auto- brewery syndrome, is a phenomenon not well...patient stated abstinence from alcohol use and that Gut Fermentation Syndrome was the cause of continually elevated blood alcohol levels. We will

  1. Terrorism, governmentality and the simulated city: the Boston Marathon bombing and the search for suspect two

    OpenAIRE

    Topinka, Robert

    2016-01-01

    This article examines the online circulation of a photograph of the immediate aftermath of the 2013 Boston Marathon bombings taken by David Green, a Boston Marathon runner. The photograph fortuitously captured an image of Dzhokhar Tsarnaev, the younger Tsarnaev brother, running from the scene. Initially, Tsarnaev went unnoticed by online message board users and FBI investigators – he was just another face in the urban crowd. However, after he was identified as suspect two, he emerged in the p...

  2. [A case of Reye's-like syndrome due to suspected Bordetella pertussis infection in an adult].

    Science.gov (United States)

    Ikeda, Kenichi; Sonoda, Ken

    2009-11-01

    We report a rare case of Reye's-like syndrome associated with suspected pertussis infection. A 26-year-old woman admitted comatose and found in laboratory studies to have acute liver dysfunction, severe hypoglycemia and prolonged prothrombin time, was diagnosed with clinical Reye's-like syndrome due to aspirin use. Her child was probably infected with pertussis, which she contracted and which, in turn, triggered Reye's-like syndrome.

  3. When the Child is Suspected to Have Autism Spectrum Disorder: Recommendation for Parents

    OpenAIRE

    Borodina L.G.; Soldatenkova E.N.

    2015-01-01

    Experts in the area of treatment and intervention for autism spectrum disorders provide parents with recommenda¬tions for situations when their children are suspected to have autism or have been diagnosed. These recommenda¬tions are universal and are appropriate for raising a child with any spectrum disorder. Following these recommenda¬tions will allow parents to comprehend the situation with the child’s development, access approaches, that are used by professionals, and will help them to not...

  4. Diagnostic significance of ascites adenosine deaminase levels in suspected tuberculous peritonitis in adults

    Directory of Open Access Journals (Sweden)

    Anil Chander

    2013-09-01

    Full Text Available Objective: There are contradictory reports about the use of adenosine deaminase (ADA as a diagnostic marker intuberculous peritonitis patients. Reports evaluating significance of ADA activity in the diagnosis of tuberculous peritonitisin adults are lacking in Nepal. We thus set out to investigate the ascitic fluid ADA levels in suspected tuberculousperitonitis patients and to determine the diagnostic significance of the test statistically.Methods: This study population comprised of two different adult patients groups. Group I - 35 suspected cases oftuberculous peritonitis and Group II - 35 cases of transudative ascites - the control group (patients with biochemicallyproved transudates or hypoproteinaemia and peritoneal tap was done. ADA estimation was carried out by spectrophotometry.Results: ADA levels (Mean ± SD in suspected tuberculous peritonitis and transudative ascites cases were 48.5±17.9U/L and 19.8±7.7 U/L respectively (P<0.001. In the receiver operating characteristic (ROC curve for ascites, ADA cut-offlevel of 41.5 U/L was found to yield the best results of differential diagnosis; sensitivity, specificity, positive predictivevalue, negative predictive value and accuracy of the test in tuberculous peritonitis cases were 80.0%, 97.2 %, 96.6%,82.9%, 88.6% respectively.Conclusion: ADA levels are elevated in suspected tuberculous peritonitis cases and it is a simple, rapid, inexpensiveand the least invasive test. It is thus a useful biochemical marker for the early diagnosis of tuberculous peritonitis whilewaiting for the results of mycobacterial cultures or biopsies. J Microbiol Infect Dis 2013; 3(3: 104-108Key words: adenosine deaminase, sensitivity, specificity, diagnostic significance, tuberculous peritonitis

  5. Audit of the practice of sputum smear examination for patients with suspected pulmonary tuberculosis in Fiji.

    Science.gov (United States)

    Gounder, Shakti; Tayler-Smith, Katherine; Khogali, Mohammed; Raikabula, Maopa; Harries, Anthony D

    2013-07-01

    In Fiji, patients with suspected pulmonary tuberculosis (PTB) currently submit three sputum specimens for smear microscopy for acid-fast bacilli, but there is little information about how well this practice is carried out. A cross-sectional retrospective review was carried out in all four TB diagnostic laboratories in Fiji to determine among new patients presenting with suspected PTB in 2011: the quality of submitted sputum; the number of sputum samples submitted; the relationship between quality and number of submitted samples to smear-positivity; and positive yield from first, second and third samples. Of 1940 patients with suspected PTB, 3522 sputum samples were submitted: 997 (51.4%) patients submitted one sample, 304 (15.7%) patients submitted two samples and 639 (32.9%) submitted three samples. Sputum quality was recorded in 2528 (71.8%) of samples, of which 1046 (41.4%) were of poor quality. Poor quality sputum was more frequent in females, inpatients and children (0-14 years). Good quality sputum and a higher number of submitted samples positively correlated with smear-positivity for acid-fast bacilli. There were 122 (6.3%) patients with suspected PTB who were sputum smear positive. Of those, 89 had submitted three sputum samples: 79 (89%) were diagnosed based on the first sputum sample, 6 (7%) on the second sample and 4 (4%) on the third sample. This study shows that there are deficiencies in the practice of sputum smear examination in Fiji with respect to sputum quality and recommended number of submitted samples, although the results support the continued use of three sputum samples for TB diagnosis. Ways to improve sputum quality and adherence to recommended guidelines are needed.

  6. Case Report: Clinical Features of a Case of Suspected Borrelia miyamotoi Disease in Hokkaido, Japan.

    Science.gov (United States)

    Yamano, Kimiaki; Ito, Takuya; Kiyanagi, Kaori; Yamazaki, Hirotaka; Sugawara, Mutsubu; Saito, Takashige; Ohashi, Norio; Zamoto-Niikura, Aya; Sato, Kozue; Kawabata, Hiroki

    2017-07-01

    We herein report a case of suspected Borrelia miyamotoi disease in Hokkaido, Japan. The patient complained of lassitude, arthralgia, and high fever after a tick bite. Furthermore, at the time of consultation, the patient exhibited momentary loss of consciousness and low blood pressure. Laboratory tests revealed elevation of liver enzymes, thrombocytopenia, and increased C-reactive protein. Seroconversion to B. miyamotoi glycerophosphoryl diester phosphodiesterase antigen suggested the patient was infected with a relapsing fever group Borrelia species.

  7. Assessment and management of a child with suspected acute neck injury.

    Science.gov (United States)

    Jones, Chris

    2012-04-01

    Any child presenting at an emergency department after trauma, such as road traffic accidents, falls, sports and head injuries, should be assessed for risk of injury to the cervical spine. The aim of this article is to provide an overview of the assessment and nursing management of a child with a suspected cervical spine injury. Basic anatomy is covered along with neck injury assessment, how to measure a cervical collar correctly, safe immobilisation, and communication.

  8. Clinical and laboratorial investigation in patients with suspected drug allergy in a tertiary hospital

    OpenAIRE

    Luciana Mabel Ferreira Vasconcelos

    2012-01-01

    Allergic drug reactions account for 6.5% of hospital admissions, prolonged hospitalization 15.1% of patients and are severe in 6.7% of patients. There are difficulties in understanding the immune mechanisms, diagnosis and treatment of patients. Therefore, such reactions are considered a Public Health problem. The objective of this study was to describe the cases of patients with suspected allergic hypersensitivity to drugs and to evaluate the response of individuals to skin tests. A total of ...

  9. Shortening Isolation of Patients With Suspected Tuberculosis by Using Polymerase Chain Reaction Analysis

    DEFF Research Database (Denmark)

    Fløe, Andreas; Hilberg, Ole; Thomsen, Vibeke Østergaard

    2015-01-01

    Background. Isolation of patients suspected for pulmonary tuberculosis is guided by serial sputum smears. This can result in isolation for days for patients with noncontagious tuberculosis. To determine whether a single sample negative for Mycobacterium tuberculosis complex at polymerase chain re......-positive/PCR-negative cases underlines the importance of increasing the quantity and quality of samples. Moreover, it is important that samples analyzed with PCR are cultured, owing to higher-sensitivity drug susceptibility testing, differential diagnosis, and surveillance....

  10. [Air embolism during lumbar discal hernia repair. Retroperioneal vessels lesions have to be suspected].

    Science.gov (United States)

    Lieutaud, T; Terrier, A; Linne, M; Farhat, F; Tahon, F

    2006-03-01

    Occurrence of deep PETCO(2) drop during surgical lumbar disk repair is rare but dramatic. This case report leads to the diagnosis of retroperitoneal vessels lesions. We review the different diagnosis related to the drop of the PETCO(2) during surgery in the genupectoral position. We recommend that the diagnosis of retroperitoneal vessels lesion have to be suspected early if air embolism occurs during lumbar disk surgery.

  11. Low rate of positive bronchoscopy for suspected foreign body aspiration in infants.

    Science.gov (United States)

    Sheehan, Cameron C; Lopez, Joseph; Elmaraghy, Charles A

    2018-01-01

    To describe our institution's low rate of positive bronchoscopy in infants suspected of inhaling a foreign body. Retrospective chart review. A retrospective review was performed of patients at a tertiary children's hospital with suspected inhalation of a foreign body. Charts were reviewed for demographic information, radiologic findings, operative reports, and respiratory viral panels were reviewed. Sixteen pediatric patients under 12 months of age were identified from 2008 to 2016 with a diagnosis of possible airway foreign body inhalation who underwent emergent bronchoscopy. Of these patients, only one was positive for a foreign body present in the airway. The remaining 15 children were found to have a negative direct laryngoscopy and bronchoscopy evaluation for a foreign body. Of these fifteen patients, 14 were found to have structural airway abnormalities and 7 tested positive for a respiratory viral infection. Our institution has a low rate of positive bronchoscopy for highly suspected foreign body inhalation in a group of patients less than 12 months of age. Patients presenting with respiratory distress, stridor, or other airway symptoms were often found to have an underlying airway abnormality or viral infection, which coupled with an unclear history, would increase the suspicion for an airway foreign body and subsequent decision to perform bronchoscopy. In stable patients, diagnostic evaluation for an underlying respiratory infection should be performed in these cases. Case Series. Copyright © 2017. Published by Elsevier B.V.

  12. Towards rational use of antibiotics for suspected secondary infections in Buruli ulcer patients.

    Science.gov (United States)

    Barogui, Yves T; Klis, Sandor; Bankolé, Honoré Sourou; Sopoh, Ghislain E; Mamo, Solomon; Baba-Moussa, Lamine; Manson, Willem L; Johnson, Roch Christian; van der Werf, Tjip S; Stienstra, Ymkje

    2013-01-01

    The emerging disease Buruli ulcer is treated with streptomycin and rifampicin and surgery if necessary. Frequently other antibiotics are used during treatment. Information on prescribing behavior of antibiotics for suspected secondary infections and for prophylactic use was collected retrospectively. Of 185 patients that started treatment for Buruli ulcer in different centers in Ghana and Bénin 51 were admitted. Forty of these 51 admitted patients (78%) received at least one course of antibiotics other than streptomycin and rifampicin during their hospital stay. The median number (IQR) of antibiotic courses for admitted patients was 2 (1, 5). Only twelve patients received antibiotics for a suspected secondary infection, all other courses were prescribed as prophylaxis of secondary infections extended till 10 days on average after excision, debridement or skin grafting. Antibiotic regimens varied considerably per indication. In another group of BU patients in two centers in Bénin, superficial wound cultures were performed. These cultures from superficial swabs represented bacteria to be expected from a chronic wound, but 13 of the 34 (38%) S. aureus were MRSA. A guide for rational antibiotic treatment for suspected secondary infections or prophylaxis is needed. Adherence to the guideline proposed in this article may reduce and tailor antibiotic use other than streptomycin and rifampicin in Buruli ulcer patients. It may save costs, reduce toxicity and limit development of further antimicrobial resistance. This topic should be included in general protocols on the management of Buruli ulcer.

  13. Assessment Of Suspected Skin Lesion Depth By Multispectral Digital Dermatoscopy: In-Vivo Tests

    Science.gov (United States)

    Scalise, L.; Munaretto, R.; Serresi, S.; Tomasini, E. P.

    2010-05-01

    The aim of the present study is to demonstrate the possibility to assess the depth of suspected skin lesion in-vivo, using multispectral digital dermatoscopy (MDD); being malignant lesion depth an important factor related to survival rate. The system realised in this work is based on a special multi-wavelength LED illuminator (700 nm, 940 nm and 950 nm) and an high quality CCD camera which allows to acquire a detailed image of the suspected skin lesion. A statistically significant correlation between contrast of the area of the lesion at single wavelength and the depth of the lesions in vivo (as determined by histopathology survey) has been found using 39 samples. Interesting results, have been especially obtained using illuminating wavelength at 940 nm and 950 nm. Using a linear fitting of our data the maximum depth of melanoma has been overestimation of 0.43 ± 0.26 mm. The present study shows a possible use of our MDD system as in the assessment of maximum depth of suspected skin lesions.

  14. Systolically gated 3D phase contrast MRA of mesenteric arteries in suspected mesenteric ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Wasser, M.N.; Schultze Kool, L.J.; Roos, A. de [Leiden Univ. Hospital (Netherlands)] [and others

    1996-03-01

    Our goal was to assess the value of MRA for detecting stenoses in the celiac (CA) and superior mesenteric (SMA) arteries in patients suspected of having chronic mesenteric ischemia, using an optimized systolically gated 3D phase contrast technique. In an initial study in 24 patients who underwent conventional angiography of the abdominal vessels for different clinical indications, a 3D phase contrast MRA technique (3D-PCA) was evaluated and optimized to image the CAs and SMAs. Subsequently, a prospective study was performed to assess the value of systolically gated 3D-PCA in evaluation of the mesenteric arteries in 10 patients with signs and symptoms of chronic mesenteric ischemia. Intraarterial digital subtraction angiography and surgical findings were used as the reference standard. In the initial study, systolic gating appeared to be essential in imaging the SMA on 3D-PCA. In 10 patients suspected of mesenteric ischemia, systolically gated 3D-PCA identified significant proximal disease in the two mesenteric vessels in 4 patients. These patients underwent successful reconstruction of their stenotic vessels. Cardiac-gated MRA may become a useful tool in selection of patients suspected of having mesenteric ischemia who may benefit from surgery. 16 refs., 6 figs., 4 tabs.

  15. Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review.

    Science.gov (United States)

    Zafrir, Yaron; Trattner, Akiva; Hodak, Emmillia; Eldar, Oren; Lapidoth, Moshe; Ben Amitai, Dan

    2017-11-16

    Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature. The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files. Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively). Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background. © 2017 Wiley Periodicals, Inc.

  16. Uncertainty and anxiety during the diagnostic period for women with suspected breast cancer.

    Science.gov (United States)

    Liao, Mei-Nan; Chen, Miin-Fu; Chen, Shin-Cheh; Chen, Ping-Ling

    2008-01-01

    A possible diagnosis of breast cancer imposes a huge psychological impact on most women, but few studies have addressed uncertainty and anxiety changes at different diagnostic stages in women with suspected breast cancer. Thus, this longitudinal study examined uncertainty and anxiety and predictive factors for uncertainty in women with suspected breast cancer. Data were collected on uncertainty (Uncertainty in Illness Scale) and anxiety (State Anxiety Inventory) from 127 women at 3 times: upon notice of a breast biopsy, before biopsy, and after diagnosis. The results showed that uncertainty and anxiety levels were significantly higher before than after diagnosis. At the 3 data collection times, uncertainty and anxiety were significantly lower for participants diagnosed with benign tumors than for those with malignant diagnoses. Uncertainty and anxiety were positively, moderately correlated. Uncertainty was predicted by age, marital status, education level, religious status, family history of benign breast tumor, regular breast self-examination, self-perceived probability of receiving a breast cancer diagnosis, and biopsy result. Therefore, nursing professionals should be aware of the uncertainty and anxiety changes and impact of personal attributes on women with suspected breast cancer during the diagnostic period and provide care programs to alleviate their psychological distress.

  17. Routine deferred computed tomography for patients with suspected urolithiasis is low-value healthcare.

    Science.gov (United States)

    Rosenlund, Ingvild M; Førde, Olav H; Revhaug, Arthur

    2017-02-01

    The aim of this study was to investigate the benefits of deferred routine computed tomography of the kidneys, ureters and bladder (CT KUB) for patients with a self-limiting episode of suspected urolithiasis. The study comprised a case series of consecutive patients examined with deferred routine CT KUB for control of suspected urolithiasis. Patients examined with CT KUB at the University Hospital of North Norway, between 1 January 2010 and 31 December 2013, were included. The final analysis included 189 CT KUBs (response rate 48%). All data were extracted from the patient case files. The primary endpoint was the proportion of asymptomatic patients with a confirmed diagnosis of urolithiasis on CT KUB that led to surgical intervention within 1 year from the initial CT scan. At the time of CT KUB, 171 patients (90%) were asymptomatic, of whom three (1.8%) were treated. Urolithiasis was confirmed on CT KUB in 23% of asymptomatic patients. Deferred CT KUB did not alter the clinical outcome for the great majority of asymptomatic patients. The majority of patients who received adequate pain relief in primary care remained asymptomatic, and did not need specialized healthcare. Refraining from CT KUB involves little risk. Deferred CT KUB for patients with suspected urolithiasis is a low-value healthcare service.

  18. Diagnostic accuracy and patient acceptance of MRI in children with suspected appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Thieme, Mai E.; Valdehueza, Zaldy D.; Wiarda, Bart M. [Medical Centre Alkmaar, Department of Radiology, Alkmaar (Netherlands); Leeuwenburgh, Marjolein M.N. [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands); Academic Medical Centre Amsterdam, Department of Surgery, Amsterdam (Netherlands); Bouman, Donald E. [Medical Spectrum Twente, Department of Radiology, Enschede (Netherlands); Bruin, Ivar G.J.M. de; Schreurs, W.H.; Houdijk, Alexander P.J. [Medical Centre Alkmaar, Department of Surgery, Alkmaar (Netherlands); Stoker, Jaap [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands)

    2014-03-15

    To compare magnetic resonance imaging (MRI) and ultrasound in children with suspected appendicitis. In a single-centre diagnostic accuracy study, children with suspected appendicitis were prospectively identified at the emergency department. All underwent abdominal ultrasound and MRI within 2 h, with the reader blinded to other imaging findings. An expert panel established the final diagnosis after 3 months. We evaluated the diagnostic accuracy of three imaging strategies: ultrasound only, conditional MRI after negative or inconclusive ultrasound, and MRI only. Significance between sensitivity and specificity was calculated using McNemar's test statistic. Between April and December 2009 we included 104 consecutive children (47 male, mean age 12). According to the expert panel, 58 patients had appendicitis. The sensitivity of MRI only and conditional MRI was 100 % (95 % confidence interval 92-100), that of ultrasound was significantly lower (76 %; 63-85, P < 0.001). Specificity was comparable among the three investigated strategies; ultrasound only 89 % (77-95), conditional MRI 80 % (67-89), MRI only 89 % (77-95) (P values 0.13, 0.13 and 1.00). In children with suspected appendicitis, strategies with MRI (MRI only, conditional MRI) had a higher sensitivity for appendicitis compared with a strategy with ultrasound only, while specificity was comparable. (orig.)

  19. Positron emission tomography myocardial perfusion imaging in children with suspected coronary abnormalities.

    Science.gov (United States)

    Singh, T P; Muzik, O; Forbes, T F; Di Carli, M F

    2003-01-01

    Positron emission tomography (PET) myocardial perfusion imaging has higher spatial resolution than conventional single photon emission computed tomography (SPECT) imaging and allows accurate and reproducible quantification of myocardial blood flow (MBF). In this article, we describe the role of PET myocardial perfusion imaging in clinical decision making in children with suspected coronary abnormalities. We performed a PET myocardial perfusion study using N-13 ammonia in 10 children (median age, 14 years; range, 1-17 years). The indications included exercise-induced chest pain and ST segment changes during exercise testing, coronary artery ectasia, hypertrophic cardiomyopathy with myocardial bridging of the left anterior descending coronary artery, and suspected left coronary stenosis in an infant with William's syndrome. MBF was assessed at baseline and during adenosine hyperemia in all 10 patients and postexercise in 8 patients. Myocardial perfusion was homogeneous at baseline in all 10 patients, during adenosine perfusion in 9 of 10 patients, and postexercise in all 8 patients. Three patients with homogeneous rest and stress perfusion had impaired myocardial flow reserve. The infant with William's syndrome developed a large, reversible perfusion defect in the left coronary territory during adenosine stress and underwent surgical repair. Myocardial flow reserve findings were valuable for clinical decision making in individual patients. We conclude that MBF quantification with N-13 ammonia and PET provides supplemental perfusion information and is helpful in clinical decision making in children with suspected coronary abnormalities.

  20. Incidental findings at MRI-enterography in patients with suspected or known Crohn's disease

    DEFF Research Database (Denmark)

    Jensen, Michael Dam; Nathan, Torben; Kjeldsen, Jens

    2010-01-01

    AIM: To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging (MRI)-enterography in patients with suspected or known Crohn's disease (CD). METHODS: Incidental findings were defined as unexpected lesions outside the small intestine, not previou......AIM: To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging (MRI)-enterography in patients with suspected or known Crohn's disease (CD). METHODS: Incidental findings were defined as unexpected lesions outside the small intestine......, not previously known or suspected at the time of referral, and not related to inflammatory bowel disease. Through a systematic review of medical charts we analyzed the clinical impact of incidental findings, and compared the MRI findings with subsequent diagnostic procedures. RESULTS: A total of 283 patients...... were included in the analysis, and MRI detected active CD in 31%, fistula in 1.4% and abscess in 0.7%. Extra-intestinal findings not related to CD were recorded in 72 patients (25%), of which 58 patients (20%) had 74 previously unknown lesions. Important or incompletely characterized findings were...

  1. Use of /sup 131/I-MIBG scintigraphy in the evaluation of suspected pheochromocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Swensen, S.J.; Brown, M.L.; Sheps, S.G.; Sizemore, G.W.; Gharib, H.; Grant, C.S.; van Heerden, J.A.

    1985-05-01

    Studies at the University of Michigan have shown that /sup 131/I-metaiodobenzylguanidine (/sup 131/I-MIBG) is an effective agent for the diagnosis and localization of pheochromocytomas and paragangliomas. The authors conducted a study that confirmed and expanded that finding. From January 1983 to March 1984, 48 patients at our institution had 51 /sup 131/I-MIBG scans during the workup of suspected sporadic or metastatic pheochromocytoma. Scintigrams were obtained after 500 microCI of /sup 131/I-MIBG had been administered intravenously. The final diagnosis (true-positive, false-negative, or false-positive result) was made at operation and pathologic examination. A true-negative diagnosis was confirmed by normal plasma and fractionated urinary levels of catecholamines and metabolites and, in most patients, computed tomography (CT). The overall sensitivity of /sup 131/I-MIBG scanning was 77%, specificity was 96%, and accuracy was 86%. This test is fairly sensitive in the workup of patients with known or suspected recurrent or metastatic pheochromocytoma. It may also be helpful in the evaluation of suspected sporadic pheochromocytoma when CT findings are normal.

  2. Detection of herpes viruses in the cerebrospinal fluid of adults with suspected viral meningitis in Malawi.

    Science.gov (United States)

    Benjamin, L A; Kelly, M; Cohen, D; Neuhann, F; Galbraith, S; Mallewa, M; Hopkins, M; Hart, I J; Guiver, M; Lalloo, D G; Heyderman, R S; Solomon, T

    2013-02-01

    We looked for herpes simplex virus types 1 and 2 (HSV-1 and HSV-2, respectively), varicella zoster virus (VZV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV) DNA in Malawian adults with clinically suspected meningitis. We collected cerebrospinal fluid (CSF) from consecutive adults admitted with clinically suspected meningitis to Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi, for a period of 3 months. Those with proven bacterial or fungal meningitis were excluded. Real-time polymerase chain reaction (PCR) was performed on the CSF for HSV-1 and HSV-2, VZV, EBV and CMV DNA. A total of 183 patients presented with clinically suspected meningitis. Of these, 59 (32 %) had proven meningitis (bacterial, tuberculous or cryptococcal), 39 (21 %) had normal CSF and 14 (8 %) had aseptic meningitis. For the latter group, a herpes virus was detected in 9 (64 %): 7 (50 %) had EBV and 2 (14 %) had CMV, all were human immunodeficiency virus (HIV)-positive. HSV-2 and VZV were not detected. Amongst those with a normal CSF, 8 (21 %) had a detectable herpes virus, of which 7 (88 %) were HIV-positive. The spectrum of causes of herpes viral meningitis in this African population is different to that in Western industrialised settings, with EBV being frequently detected in the CSF. The significance of this needs further investigation.

  3. Patient selection for later delivery timing with suspected previa-accreta.

    Science.gov (United States)

    Perlman, Nicola C; Little, Sarah E; Thomas, Ann; Cantonwine, David E; Carusi, Daniela A

    2017-08-01

    We identified patients with previa and suspected accreta who are at lowest risk of unscheduled delivery or major morbidity with planned delivery beyond 34 weeks' gestation. This was a retrospective cohort study of patients who had reached 34.0 weeks' gestational age with a suspected previa-accreta. We evaluated rates of unscheduled and emergent delivery based on known risk factors for premature birth. In a second analysis, we stratified patients based on level of preoperative morbidity concern and evaluated rates of major transfusion and Intensive Care Unit admission by delivery week (34 weeks, 35 weeks or 36 weeks and beyond). Of 84 available patients, we classified 31 patients as low risk for unscheduled delivery and 52 as high risk. The low risk group was scheduled later (36.6 vs. 36.0 weeks; p delivery prior to 36 weeks (3% vs. 19%, p = 0.05). Of the patients with no prior cesarean section, only one (7%) experienced massive blood loss even though 36% had unscheduled deliveries. We observed no significant increase in major transfusion or massive blood loss with advancing gestational age, likely due to selection of the most concerning patients for early, scheduled delivery. Patients with suspected previa-accreta and no risk factors for preterm birth are at low risk for an unscheduled delivery prior to 36 weeks. Those with no concern for percreta or increta or no prior cesarean section may also be candidates for later delivery. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  4. Emergency unenhanced multi-slice computed tomography in suspected urinary calculi—with dose reduction method (care dose 4D

    Directory of Open Access Journals (Sweden)

    Syed Nabir

    2012-09-01

    Full Text Available Objectives: To assess urinary calculi and the secondary signs of obstruction, in patients referred from the accident and emergency department, by unenhanced computed tomography examination and to review the radiation dose the patients received with the use of automatic dose modulation technique, care dose 4D. Material and methods: Medical records of unenhanced multi-slice computed tomography (MSCT examinations for 114 patients referred to the emergency department for analysis of suspected urinary calculi were reviewed retrospectively. Their treatment involved automatic tube current modulation, a dose reduction method (care dose 4D, in Hamad General Hospital. The cases were analyzed for the presence of stones, size, site, density and the secondary signs of obstruction, namely hydronephrosis, hydroureter, perinephric fat stranding, peri-ureteric fat stranding and renal enlargement. A search for alternate diagnosis was made if no stone was found. The final diagnosis was noted from the discharge summary in medical records. The radiation dose, Computed Tomographic Dose Index volume (CTDI and Dose Length Product (DLP in each patient was recorded from patient protocol. Results: Of 114 patients referred to CT scan for suspected urinary calculi, between March and June 2008, urinary calculi were noted in 75.4 %. An alternate diagnosis was offered to 5.3 % and a diagnosis of normal was given to 19.3 %. The size of stones detected varied from 2mm-35mm. Density of stones varied from 110-1250 hounsfield units (HU. Solitary stones were seen in 54.4 % of cases observed and multiple stones in 22 %. Renal stones were observed in 6.1 % of cases, urteric stones in 26.3%, vesico-uretric junction stones in 18.4%, multiple sites in 23.7%. Hydronephrosis was seen in 68% of cases, hydroureter in 63%, perinephric fat stranding in 51%, periureteral fat stranding in 34%, ureteric rim sign in 28% and renomegaly in 24%. Time interval between onset of symptoms to imaging

  5. Effectiveness of a fluid chart in outpatient management of suspected dengue fever: A pilot study.

    Science.gov (United States)

    Nasir, Nazrila Hairin; Mohamad, Mohazmi; Lum, Lucy Chai See; Ng, Chirk Jenn

    2017-01-01

    Dengue infection is the fastest spreading mosquito-borne viral disease in the world. One of the complications of dengue is dehydration which, if not carefully monitored and treated, may lead to shock, particularly in those with dengue haemorrhagic fever. WHO has recommended oral fluid intake of five glasses or more for adults who are suspected to have dengue fever. However, there have been no published studies looking at self-care intervention measures to improve oral fluid intake among patients suspected of dengue fever. To assess the feasibility and effectiveness of using a fluid chart to improve oral fluid intake in patients with suspected dengue fever in a primary care setting. This feasibility study used a randomized controlled study design. The data was collected over two months at a primary care clinic in a teaching hospital. The inclusion criteria were: age > 12 years, patients who were suspected to have dengue fever based on the assessment by the primary healthcare clinician, fever for > three days, and thrombocytopenia (platelets chart and a cup (200ml). Baseline clinical and laboratory data, 24-hour fluid recall (control group), and fluid chart were collected. The main outcomes were: hospitalization rates, intravenous fluid requirement and total oral fluid intake. Among the 138 participants who were included in the final analysis, there were fewer hospital admissions in the intervention group (n = 7, 10.0%) than the control group (n = 12, 17.6%) (p = 0.192). Similarly, fewer patients (n = 9, 12.9%) in the intervention group required intravenous fluid compared to the control group (n = 15, 22.1%), (p = 0.154). There was an increase in the amount of daily oral fluid intake in the intervention group (about 3,000 ml) compared to the control group (about 2,500 ml, p = 0.521). However, these differences did not reach statistical significance. This is a feasible and acceptable study to perform in a primary care setting. The fluid chart is a simple, inexpensive

  6. 19 CFR 12.45 - Transportation and marketing of prison-labor products.

    Science.gov (United States)

    2010-04-01

    ... SECURITY; DEPARTMENT OF THE TREASURY SPECIAL CLASSES OF MERCHANDISE Merchandise Produced by Convict, Forced... from the United States attorney or the court. Counterfeit Coins, Obligations, and Other Securities...

  7. The Relationship between caffeine and coffee consumption and exfoliation glaucoma or glaucoma suspect: a prospective study in two cohorts.

    Science.gov (United States)

    Pasquale, Louis R; Wiggs, Janey L; Willett, Walter C; Kang, Jae H

    2012-09-21

    We examined the association between caffeine and caffeinated beverage consumption in relation to the risk of exfoliation glaucoma or exfoliation glaucoma suspect (EG/EGS). We followed 78,977 women from the Nurses' Health Study (NHS) and 41,202 men from the Health Professionals Follow-up Study (HPFS) who were at least 40 years of age, did not have glaucoma, and reported undergoing eye examinations from 1980 (NHS) or 1986 (HPFS) to 2008. Information on consumption of caffeine-containing beverages and potential confounders were repeatedly ascertained in validated follow-up questionnaires. Confirmation with medical record review revealed 360 incident EG/EGS cases. Multivariate rate ratios (RRs) for EG/EGS were calculated in each cohort and then pooled using meta-analytic techniques. Compared with participants whose cumulatively updated total caffeine consumption was caffeinated coffee daily were at increased risk of EG/EGS (RR = 1.66; 95% CI, 1.09-2.54; P trend = 0.02). These results were not materially altered after adjustment for total fluid intake. Associations were stronger among women with a family history of glaucoma (P interaction = 0.06 for coffee; P interaction = 0.03 for caffeine). We did not find associations with consumption of other caffeinated products (caffeinated soda, caffeinated tea, decaffeinated coffee or chocolate) and risk of EG/EGS (P trend ≥ 0.31). We observed a positive association between heavier coffee consumption with risk of EG/EGS in this large prospective study.

  8. LEGAL INSTRUMENT FOR PROTECTION OF GEOGRAPHICAL INDICATION PRODUCT IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Almusawir Nansa

    2013-07-01

    Full Text Available As an archipelago country, Indonesia comprises of a large territory where every region is capable of producing distinctive and characterized products due to its geographical, social, and cultural factors, in addition to its higher quality compared to imported products. In the market, goods with distinct characterization as a result of various geographical locations of production regions is known as Geographical Indication Products. Geographical Indication defines as a characterization that indicates the origin of a product, which includes several influencing factors such as geographical factor, natural factor, human factor or the combination of both factors which eventually contribute to establish a certain distinction and quality upon a product. Several geographical indicated products in Indonesia are widely known to have excellent reputation on the market, namely Delinese tobacco, Temanggung tobacco, Ciancur rice, Muntok white pepper, Lampung black pepper, Kerinci cinnamon, Cilembu cassava, Bandanese nutmeg, Proboliggo sweet mango, Balinese Kintamani coffee, Kalosi coffee, Papuan matoa, etc. Those are several richness of goods from certain regions in Indonesia widely known for their characterization. Characterization of goods are resulted by variation of geographic locations of producing regions in Indonesia. These goods possess high quality and high economic value. Consequently, certain instruments are required to provide protection upon the regions producing those goods against the act of counterfeiting.

  9. Added value of fetal MRI in fetuses with suspected brain abnormalities on neurosonography : a systematic review and meta-analysis

    NARCIS (Netherlands)

    van Doorn, Martine; Oude Rengerink, K|info:eu-repo/dai/nl/375367292; Newsum, Esther A; Reneman, Liesbeth; Majoie, Charles B; Pajkrt, Eva

    PURPOSE: To evaluate the additional diagnostic value of fetal Magnetic Resonance Imaging (MRI) in fetuses with suspected brain abnormalities identified with advanced neurosonography (NS). METHODS: A systematic literature search was performed for studies reporting on a comparison between diagnosis

  10. Study of sonography sensitivity and specificity to the diagnosis of acute appendicitis in suspected patients referred to Khorramabad Ashayer hospital

    Directory of Open Access Journals (Sweden)

    mojtaba Ahmai Nejad

    2012-03-01

    Conclusion: As the study suggests, sonography before sugery can help and leads to definite diagnosis in suspected patients to appendicitis and it can prevent unnecessary surgeries, as well as it can prevent delay in treatment and related complications .

  11. EuroClonality/BIOMED-2 guidelines for interpretation and reporting of Ig/TCR clonality testing in suspected lymphoproliferations

    National Research Council Canada - National Science Library

    Langerak, A.W; Groenen, P.J.T.A; Bruggemann, M; Beldjord, K; Bellan, C; Bonello, L; Boone, E; Carter, G.I; Catherwood, M; Davi, F; Delfau-Larue, M.H; Diss, T; Evans, P.A; Gameiro, P; Garcia Sanz, R; Gonzalez, D; Grand, D; Hakansson, A; Hummel, M; Liu, H; Lombardia, L; Macintyre, E.A; Milner, B.J; Montes-Moreno, S; Schuuring, E; Spaargaren, M; Hodges, E; Dongen, J.J. van

    2012-01-01

    PCR-based immunoglobulin (Ig)/T-cell receptor (TCR) clonality testing in suspected lymphoproliferations has largely been standardized and has consequently become technically feasible in a routine diagnostic setting...

  12. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography

    NARCIS (Netherlands)

    van Belle, Arne; Büller, Harry R.; Huisman, Menno V.; Huisman, Peter M.; Kaasjager, Karin; Kamphuisen, Pieter W.; Kramer, Mark H. H.; Kruip, Marieke J. H. A.; Kwakkel-van Erp, Johanna M.; Leebeek, Frank W. G.; Nijkeuter, Mathilde; Prins, Martin H.; Sohne, Maaike; Tick, Lidwine W.

    2006-01-01

    CONTEXT: Previous studies have evaluated the safety of relatively complex combinations of clinical decision rules and diagnostic tests in patients with suspected pulmonary embolism. OBJECTIVE: To assess the clinical effectiveness of a simplified algorithm using a dichotomized clinical decision rule,

  13. The results of 15 years of consistent strategy in treating antenatally suspected pelvi-ureteric junction obstruction

    DEFF Research Database (Denmark)

    Thorup, J; Jokela, R; Cortes, D

    2003-01-01

    OBJECTIVE: To determine how to select patients for surgery among those with antenatally detected pelvi-ureteric junction (PUJ) obstruction. PATIENTS AND METHODS: The study comprised 100 consecutive children with antenatally detected suspected unilateral PUJ obstruction and a normal contralateral...

  14. Scheduling delay in suspected cases of oral cancer Atraso de agendamento em casos suspeitos de câncer bucal

    National Research Council Canada - National Science Library

    Luciana Meneses Souza; Edgard Michel-Crosato; Maria Gabriela Haye Biazevic; José Leopoldo Ferreira Antunes

    2011-01-01

    ... of São Paulo of patients suspected of having oral cancer. A cross-sectional study was performed in which telephone conversations simulated clinical situations that represented two types of patients...

  15. Retrospective histopathological classification of 1,108 skin biopsies from patients clinically suspected of having leprosy from Bahia, Northeast Brazil

    Directory of Open Access Journals (Sweden)

    Barbosa Júnior Aryon de Almeida

    1998-01-01

    Full Text Available We report a retrospective histopathological classification carried out under laboratory conditions by the method of Ridley & Jopling of 1,108 skin biopsies from patients clinically suspected of having leprosy from Bahia, Northeast Brazil.

  16. Viral etiology of mumps-like illnesses in suspected mumps cases reported in Catalonia, Spain.

    Science.gov (United States)

    Barrabeig, Irene; Costa, Josep; Rovira, Ariadna; Marcos, M Angeles; Isanta, Ricard; López-Adalid, Rubén; Cervilla, Ana; Torner, Nuria; Domínguez, Angela

    2015-01-01

    We investigated the etiology of reported sporadic suspected mumps cases with a negative RT-PCR result for the mumps virus in the Barcelona-South region in 2007-2011. Samples from mumps virus-negative patients presenting unilateral or bilateral parotitis or other salivary gland swelling were tested for Epstein-Barr virus (EBV) by real-time PCR and for respiratory viruses by two multiplex-PCR-based assays to detect parainfluenza virus (PIV) 1-4, influenza virus (InV) A, B and C, respiratory syncytial virus (RSV), enterovirus, coronavirus 229E, coronavirus OC43, and rhinovirus. 101 samples were analyzed in persons aged 8 months to 50 years. Oral samples were collected on the first day of glandular swelling in 53 patients (52.5%), and on the first two days in 74 patients (73.3%). Viruses were detected in 52 (51.5%) of samples: one virus (25 EBV, 8 PIV3, 4 adenovirus, 4 PIV2, 1 PIV1, 1 InVA, and 1 enterovirus) was detected in 44 patients (84.6%), two viruses in 7 patients, and three viruses in one patient. In 58 patients (57.5%) whose sample was collected in the first 2 days after onset of parotitis and had received two doses of MMR vaccine and in 15 patients (14.8%) whose sample was collected on the first day, it is very likely that the cause was not the mumps virus. This would mean that 72.3% (73/101) of the reported sporadic suspected mumps cases were not mumps cases. The timing of oral-sample collection is crucial to correctly interpret the negative results for mumps virus RNA, especially when suspected cases occur in vaccinated persons.

  17. Multivariable prediction model for suspected giant cell arteritis: development and validation

    Science.gov (United States)

    Ing, Edsel B; Lahaie Luna, Gabriela; Toren, Andrew; Ing, Royce; Chen, John J; Arora, Nitika; Torun, Nurhan; Jakpor, Otana A; Fraser, J Alexander; Tyndel, Felix J; Sundaram, Arun NE; Liu, Xinyang; Lam, Cindy TY; Patel, Vivek; Weis, Ezekiel; Jordan, David; Gilberg, Steven; Pagnoux, Christian; ten Hove, Martin

    2017-01-01

    Purpose To develop and validate a diagnostic prediction model for patients with suspected giant cell arteritis (GCA). Methods A retrospective review of records of consecutive adult patients undergoing temporal artery biopsy (TABx) for suspected GCA was conducted at seven university centers. The pathologic diagnosis was considered the final diagnosis. The predictor variables were age, gender, new onset headache, clinical temporal artery abnormality, jaw claudication, ischemic vision loss (VL), diplopia, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and platelet level. Multiple imputation was performed for missing data. Logistic regression was used to compare our models with the non-histologic American College of Rheumatology (ACR) GCA classification criteria. Internal validation was performed with 10-fold cross validation and bootstrap techniques. External validation was performed by geographic site. Results There were 530 complete TABx records: 397 were negative and 133 positive for GCA. Age, jaw claudication, VL, platelets, and log CRP were statistically significant predictors of positive TABx, whereas ESR, gender, headache, and temporal artery abnormality were not. The parsimonious model had a cross-validated bootstrap area under the receiver operating characteristic curve (AUROC) of 0.810 (95% CI =0.766–0.854), geographic external validation AUROC’s in the range of 0.75–0.85, calibration pH–L of 0.812, sensitivity of 43.6%, and specificity of 95.2%, which outperformed the ACR criteria. Conclusion Our prediction rule with calculator and nomogram aids in the triage of patients with suspected GCA and may decrease the need for TABx in select low-score at-risk subjects. However, misclassification remains a concern. PMID:29200816

  18. Imaging Algorithms for Evaluating Suspected Rotator Cuff Disease: Society of Radiologists in Ultrasound Consensus Conference Statement

    Science.gov (United States)

    Jacobson, Jon A.; Benson, Carol B.; Bancroft, Laura W.; Bedi, Asheesh; McShane, John M.; Miller, Theodore T.; Parker, Laurence; Smith, Jay; Steinbach, Lynne S.; Teefey, Sharlene A.; Thiele, Ralf G.; Tuite, Michael J.; Wise, James N.; Yamaguchi, Ken

    2013-01-01

    The Society of Radiologists in Ultrasound convened a panel of specialists from a variety of medical disciplines to reach a consensus about the recommended imaging evaluation of painful shoulders with clinically suspected rotator cuff disease. The panel met in Chicago, Ill, on October 18 and 19, 2011, and created this consensus statement regarding the roles of radiography, ultrasonography (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography. The consensus panel consisted of two co-moderators, a facilitator, a statistician and health care economist, and 10 physicians who have specialty expertise in shoulder pain evaluation and/or treatment. Of the 13 physicians on the panel, nine were radiologists who were chosen to represent a broad range of skill sets in diagnostic imaging, different practice types (private and academic), and different geographical regions of the United States. Five of the radiologists routinely performed musculoskeletal US as part of their practice and four did not. There was also one representative from each of the following clinical specialties: rheumatology, physical medicine and rehabilitation, orthopedic surgery, and nonoperative sports medicine. The goal of this conference was to construct several algorithms with which to guide the imaging evaluation of suspected rotator cuff disease in patients with a native rotator cuff, patients with a repaired rotator cuff, and patients who have undergone shoulder replacement. The panel hopes that these recommendations will lead to greater uniformity in rotator cuff imaging and more cost-effective care for patients suspected of having rotator cuff abnormality. © RSNA, 2013 PMID:23401583

  19. Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Francisco Flávio Costa Filho

    2015-11-01

    Full Text Available AbstractBackground:Guidelines recommend that in suspected stable coronary artery disease (CAD, a clinical (non-invasive evaluation should be performed before coronary angiography.Objective:We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD.Methods:We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests.Results:A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77, age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26, diabetes (OR, 2.01; CI 95%, 1.40 - 2.90, dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07, typical angina (OR, 2.92; CI 95%, 1.77 - 4.83 and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27.Conclusions:In this study, less than a quarter of the patients referred for coronary angiography with suspected CAD had the diagnosis confirmed. A better clinical and non-invasive assessment is necessary, to improve the efficacy of patient selection for coronary angiography.

  20. Peripapillary retinal splitting visualized on OCT in glaucoma and glaucoma suspect patients.

    Directory of Open Access Journals (Sweden)

    Dilraj S Grewal

    Full Text Available To identify the risk factors for development of peripapillary retinal splitting (schisis in patients with glaucoma or suspicion of glaucoma.Glaucoma Clinic, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL.In this institutional cross-sectional study, 495 patients (990 eyes who had undergone spectral-domain optical coherence tomography (OCT Spectralis HRA-OCT, Heidelberg Engineering optic nerve head (ONH imaging and did not have identifiable optic nerve pits, pseudopits or coloboma were included. OCT scans were reviewed by two observers.Presence of peripapillary retinal splitting identified on OCT raster scans.Eleven of 990 glaucoma and glaucoma suspect eyes (1.1% of 7 patients (2 females, 5 males, mean age 64.5 ± 9.2 years had peripapillary retinal splitting. Two of these 11 eyes had extension of the splitting into the macula but none to the fovea. Of these 11 patients, 2 (28.6% were glaucoma suspects, 3 (42.9% had primary open-angle glaucoma, 1 (14.3% had chronic angle-closure glaucoma and 1 (14.3% had pigmentary glaucoma. 7/11 (63.6% eyes had vitreous traction to the disc visualized on OCT and 6/11 eyes (54.5% had beta-zone peripapillary atrophy.We observed peripapillary retinal splitting in 1.1% of a series of 990 glaucoma and glaucoma-suspect eyes. Evidence of adherent vitreous with traction and peripapillary atrophy was found in a majority of the involved eyes. A comparison to an age and axial length matched cohort is required to determine if this is a condition that is associated with glaucoma.