WorldWideScience

Sample records for suspected counterfeit products

  1. Guidelines for identifying suspect/counterfeit material

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    These guidelines are intended to assist users of products in identifying: substandard, misrepresented, or fraudulently marked items. The guidelines provide information about such topics as: precautions, inspection and testing, dispositioning identified items, installed inspection and reporting suspect/counterfeit materials. These guidelines apply to users who are developing procurement documents, product acceptance/verification methods, company procedures, work instructions, etc. The intent of these SM guidelines in relation to the Quality Assurance Program Description (QAPD) and implementing company Management Control Procedures is not to substitute or replace existing requirements, as defined in either the QAPD or company implementing instructions (Management Control Procedures). Instead, the guidelines are intended to provide a consolidated source of information addressing the issue of Suspect/Counterfeit materials. These guidelines provide an extensive suspect component listing and suspect indications listing. Users can quickly check their suspect items against the list of manufacturers products (i.e., type, LD. number, and nameplate information) by consulting either of these listings.

  2. 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

  3. Validation of a quantitative NMR method for suspected counterfeit products exemplified on determination of benzethonium chloride in grapefruit seed extracts.

    Science.gov (United States)

    Bekiroglu, Somer; Myrberg, Olle; Ostman, Kristina; Ek, Marianne; Arvidsson, Torbjörn; Rundlöf, Torgny; Hakkarainen, Birgit

    2008-08-05

    A 1H-nuclear magnetic resonance (NMR) spectroscopy method for quantitative determination of benzethonium chloride (BTC) as a constituent of grapefruit seed extract was developed. The method was validated, assessing its specificity, linearity, range, and precision, as well as accuracy, limit of quantification and robustness. The method includes quantification using an internal reference standard, 1,3,5-trimethoxybenzene, and regarded as simple, rapid, and easy to implement. A commercial grapefruit seed extract was studied and the experiments were performed on spectrometers operating at two different fields, 300 and 600 MHz for proton frequencies, the former with a broad band (BB) probe and the latter equipped with both a BB probe and a CryoProbe. The concentration average for the product sample was 78.0, 77.8 and 78.4 mg/ml using the 300 BB probe, the 600MHz BB probe and CryoProbe, respectively. The standard deviation and relative standard deviation (R.S.D., in parenthesis) for the average concentrations was 0.2 (0.3%), 0.3 (0.4%) and 0.3mg/ml (0.4%), respectively.

  4. WGOE Discussion topic introduction: Counterfeit, Suspect, and Fraudulent parts

    International Nuclear Information System (INIS)

    Thorp, John

    2011-01-01

    This presentation (slides) provided an introduction to CSFI discussion. It presents: 1 - the many faces of counterfeiting (design and intellectual property, manufacturing and fabrication, product control, branding and document fraud), 2 - the key messages from the June 3, 2010 US-NRC Commission Briefing, 3 - the Regulator's role in ensuring nuclear plant safety, 4 - the CSFI survey status, 5 - the questions to be discussed during the meeting

  5. Counterfeit, Suspect, Fraudulent Items (CSFI): Today and Tomorrow

    International Nuclear Information System (INIS)

    Pasquale, Daniel

    2011-01-01

    This presentation (slides) addresses the U.S. NRC's current perception of the CSFI threat as it relates to existing licensed operating nuclear power plants as well as future units. The presentation addressed the following topics: 1) recent CSFI activity, 2) the role of Quality Assurance, 3) what the US NRC is doing, 4) US NRC outreach efforts, and 5) the need for a solid CSFI community. The presentation refers to the growing CSFI threat to other heavy industries as reported recently by the U.S. Department of Commerce, and describes how the existing US NRC guidance on this issue has proven to be the foundation for a strong anti-counterfeiting program. It also stresses the need for all stakeholders to adopt and maintain a proactive approach to counter the CSFI threat, including the need to share information, institute a zero tolerance policy, involve engineering in the procurement and product inspection processes, ensure that inspection processes (source, receipt, and testing) are effective, and to utilize engineering based programs in support of commercial grade dedication activities. Included with the presentation is a comprehensive list of generic communications issued by the U.S. NRC in response to counterfeit/fraudulent items over the years, and some of the various electronic repositories regarding the nuclear industry where related event information may be accessed

  6. Managing suspect and counterfeit items in the nuclear industry

    International Nuclear Information System (INIS)

    2000-08-01

    Some manufacturers and suppliers use inferior materials and processes to make substandard supplies whose properties can vary significantly from established standards and specifications. Other suppliers distribute items that they know do not meet the purchase requirements or provide documentation that misrepresent actual conformance to established specifications and standards. These substandard supplies, or suspect/counterfeit items (S/CIs), pose potential threats to the safety of workers, the public and the environment and may also have a detrimental effect on security and operations at nuclear facilities. Nuclear facilities often procure and use commercial-grade items and the quality assurance policies/procedures and procurement methods are not always properly applied to avoid the entry of S/Cls into those facilities. This publication offers practical guidance on how to apply existing quality assurance programmes to effectively prevent the procurement and use of S/Cls. In particular, it provides a practical method of applying the requirements and guidance contained in the IAEA Safety Series 50-C/SG-Q: Code and Safety Guides on Quality Assurance for Safety in Nuclear Power Plants and other Nuclear Installations (1996), to the S/CIs issue

  7. 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.

  8. THE ANALYSIS OF COUNTERFEITING FOOD PRODUCTS

    Directory of Open Access Journals (Sweden)

    Paula - Angela VIDRASCU

    2013-12-01

    Full Text Available The issue addressed in this paper makes a significant contribution to research on the effects that food tampering has at the expense of consumer health. Nowadays quality and food safety that consumers are entitled directly reflects the quality of life. In other words the present subject is of particular importance to the work of the bodies created for the purpose of protecting the health and quality of life of consumers. This study has an important role both in the short and long term through proper understanding of the terms of quality, adulteration and food safety. The essential aim of this article is played understanding and easy identification of counterfeit food. Thus the awareness of counterfeit food products consumers are becoming more aware and responsible on quality of life. Quality will always be one of the most important competitive factors of ensuring health and environmental protection.

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

    International Nuclear Information System (INIS)

    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

  10. 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.

  11. 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.

  12. The impact of counterfeit products on the market

    OpenAIRE

    Tkachov, Maksim

    2015-01-01

    The author proves that the level of counterfeit presentation of goods on the market directly affects the equilibrium of the market. The greater the number of counterfeit products, the greater the level of losses holders of intellectual property rights, the lower the level of consumer confidence to the market.

  13. 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

  14. 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.

  15. Development of anti-counterfeit consumer product authentication system

    Directory of Open Access Journals (Sweden)

    Olena V. Narimanova

    2015-06-01

    Full Text Available Aim of the research is to develop an anti-counterfeit consumer product authentication system. The main requirements for this system are formulated, the choice of method of consumer product authentication is substantiated. The scheme of anti-counterfeit consumer product authentication system is developed basing on previously proposed method of checking the QR-code integrity and authenticity. The proposed within the system consumer product authentication technology is simple, economical for implementation, does not require the external changes of product packaging, does not affect existing production process. The technology can be recommended for the use to private businesses and government institutions that are interested in the security of their products from counterfeiting, as well as tracking and removing from circulation the counterfeit consumer products.

  16. CONSPICUOUS CONSUMPTION, LUXURY PRODUCTS AND COUNTERFEIT MARKET IN THE UK

    OpenAIRE

    My Pham, TH; Nasir, M

    2016-01-01

    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 attitu...

  17. Counterfeit Electronic Cigarette Products with Mislabeled Nicotine Concentrations.

    Science.gov (United States)

    Omaiye, Esther E; Cordova, Iliana; Davis, Barbara; Talbot, Prue

    2017-07-01

    We compared nicotine concentrations in one brand of refill fluids that were purchased in 4 countries and labeled 0 mg of nicotine/mL. We then identified counterfeit e-cigarette products from these countries. Overall, 125 e-cigarette refill fluids were purchased in Nigeria, the United States (US), England, and China. Nicotine concentrations were measured using high performance liquid chromatography and compared to labeled concentrations. Refill fluids were examined to identify physical differences and grouped into authentic and counterfeit products. Whereas nicotine was in 51.7% (15/29) of the Nigerian, 3.7% (1/27) of the Chinese and 1.6% (1/61) of the American refill fluids (range = 0.4 - 20.4 mg/mL), 8 British products did not contain nicotine. Products from China, the US, and Nigeria with trace amounts of nicotine (0.4 to 0.6 mg/mL) were authentic; however, all products from Nigeria with more than 3.7 mg/mL were counterfeit. We introduce 2 novel issues in the e-cigarette industry, the production of counterfeit refill fluids under a brandjacked label and inclusion of nicotine in 81.3% of the counterfeit products labeled 0 mg/mL. This study emphasizes the need for better control and monitoring of nicotine containing products and sales outlets.

  18. 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

  19. Use of NDE Techniques for Compliance Verification of Suspect Counterfeit EEE Parts

    Data.gov (United States)

    National Aeronautics and Space Administration — Genuine microelectronics components are critical to NASA for Human Rating Requirement (HRR) for Manned Follow-On Vehicles and for planetary missions.  Counterfeited...

  20. Counterfeit Parts Prevention Strategy Guide Product Overview

    Science.gov (United States)

    2014-05-08

    avoidance • Develop a risk assessment methodology when using unauthorized or non- franchised suppliers • Identify methods to ensure and verify sub-tier...comments received – Obtain endorsement across team members for product and follow-on recommendations • Workshop Accomplishments – Obtained buy -in

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

    NARCIS (Netherlands)

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

    2017-01-01

    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

  2. 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.

  3. On the Counterfeiting Battlefield

    DEFF Research Database (Denmark)

    Beukel, Karin; Rullani, Francesco

    The protection of firms' identity is one of the main problems raised by the diffusion of counterfeit products. Firms protect their identity by fighting counterfeiters in their main and ancillary markets, as well as against diffusion of dangerous counterfeit products that can damage their brand...... and reputation. We describe the strategies of the firm and of the counterfeiters in these two contexts, and test our hypotheses using a unique dataset reporting 3333 battles taken by a high-tech firm against more than 2000 counterfeiters in 75 countries over a 6-year period. We find broad support for our...... hypotheses on the strategic behavior of the firm and of the counterfeiters, highlighting the difficulties firms find in protecting their main markets, and their advantages in limiting the diffusion of dangerous counterfeit products...

  4. 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....

  5. Anti-Counterfeiting

    Science.gov (United States)

    Tuyls, Pim; Guajardo, Jorge; Batina, Lejla; Kerins, Tim

    Counterfeiting of goods is becoming a very huge problem for our society. It not only has a global economic impact, but it also poses a serious threat to our global safety and health. Currently, global economic damage across all industries due to the counterfeiting of goods is estimated at over 600 billion annually [2]. In the United States, seizure of counterfeit goods has tripled in the last 5 years, and in Europe, over 100 million pirated and counterfeit goods were seized in 2004. Fake products cost businesses in the United Kingdom approximately 17 billion [2]. In India, 15% of fast-moving consumer goods and 38% of auto parts are counterfeit. Other industries in which many goods are being counterfeit are the toy industry, content and software, cosmetics, publishing, food and beverages, tobacco, apparel, sports goods, cards, and so forth.

  6. Implementation guide for use with suspect/counterfeit items: Requirements of DOE O 440.1, worker protection management; 10 CFR 830.120; and DOE 5700.6C, quality assurance

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-06-01

    Department of Energy (DOE) Order (O) 440.1, Worker Protection Management For DOE Federal and Contractors Employees, [7] sets forth requirements for DOE and its contractors to implement suspect and counterfeit items (S/CI) controls as part of the quality assurance (QA) programs required by 10 Code of Federal Regulations (CFR) 830.120 [8] or DOE 5700.6C, Quality Assurance [9]. DOE G-830.120, Implementation Guide for Use with 10 CFR Part 830.120, Quality Assurance, [10] provides additional guidance on establishing and implementing effective QA processes to control S/CIs. DOE O 232.1, Occurrence Reporting and Processing of Operations, [11] specifies requirements for reporting S/CIs under the DOE Occurrence Reporting and Processing System (ORPS). DOE promulgated the requirements and guidance to control or eliminate the hazards posed by S/CIs, which can lead to unexpected equipment failures and undue risks to the DOE mission, the environment, and personnel. This Guide is a compendium of information contained in the referenced DOE directives and other documents concerning S/CI controls. It incorporates, updates, and supersedes earlier guidance issued in Plan for the Suspect/Counterfeit Products Issue in the Department of Energy, dated October 1993, [4] and in memoranda issued by Defense Programs (DP) [12-16] and other DOE program offices. This guidance was developed to strengthen the procurement process, identify and eliminate S/CIs, and improve the reporting of S/CIs. The information in this Guide, when implemented by DOE and its contractors, will satisfy the S/CI requirements contained in the referenced DOE directives.

  7. Implementation guide for use with suspect/counterfeit items: Requirements of DOE O 440.1, worker protection management; 10 CFR 830.120; and DOE 5700.6C, quality assurance

    International Nuclear Information System (INIS)

    1997-06-01

    Department of Energy (DOE) Order (O) 440.1, Worker Protection Management For DOE Federal and Contractors Employees, [7] sets forth requirements for DOE and its contractors to implement suspect and counterfeit items (S/CI) controls as part of the quality assurance (QA) programs required by 10 Code of Federal Regulations (CFR) 830.120 [8] or DOE 5700.6C, Quality Assurance [9]. DOE G-830.120, Implementation Guide for Use with 10 CFR Part 830.120, Quality Assurance, [10] provides additional guidance on establishing and implementing effective QA processes to control S/CIs. DOE O 232.1, Occurrence Reporting and Processing of Operations, [11] specifies requirements for reporting S/CIs under the DOE Occurrence Reporting and Processing System (ORPS). DOE promulgated the requirements and guidance to control or eliminate the hazards posed by S/CIs, which can lead to unexpected equipment failures and undue risks to the DOE mission, the environment, and personnel. This Guide is a compendium of information contained in the referenced DOE directives and other documents concerning S/CI controls. It incorporates, updates, and supersedes earlier guidance issued in Plan for the Suspect/Counterfeit Products Issue in the Department of Energy, dated October 1993, [4] and in memoranda issued by Defense Programs (DP) [12-16] and other DOE program offices. This guidance was developed to strengthen the procurement process, identify and eliminate S/CIs, and improve the reporting of S/CIs. The information in this Guide, when implemented by DOE and its contractors, will satisfy the S/CI requirements contained in the referenced DOE directives

  8. Operating Experience Report: Counterfeit, Suspect and Fraudulent Items. Working Group on Operating Experience. Proceedings and Analysis on an Item of Generic Interest

    International Nuclear Information System (INIS)

    2011-01-01

    The NEA Committee on Nuclear Regulatory Activities (CNRA) believes that sharing operating experience from the national operating experience feedback programmes are a major element in the industry's and regulatory body's efforts to ensure the continued safe operation of nuclear facilities. Considering the importance of these issues, the Committee on the Safety of Nuclear Installations (CSNI) established a working group, PWG no.1 (Principle Working Group Number 1) to assess operating experience in the late 1970's, which was later renamed the Working Group on Operating Experience (WGOE). In 1978, the CSNI approved the establishment of a system to collect international operating experience data. The accident at Three Mile Island shortly after added impetus to this and led to the start of the Incident Reporting System (IRS). In 1983, the IRS database was moved to the International Agency for Atomic Energy (IAEA) to be operated as a joint database by IAEA and NEA for the benefit of all of the member countries of both organisations. In 2006, the WGOE was moved to be under the umbrella of the Committee on Nuclear Regulatory Activities (CNRA) in NEA. In 2009, the scope of the Incident Reporting System was expanded and re-named the International Reporting System for Operating Experience (although, the acronym remains the same). The purpose of WGOE is to facilitate the exchange of information, experience, and lessons learnt related to operating experience between member countries. The working group continues its mission to identify trending and issues that should be addressed in specialty areas of CNRA and CSNI working groups. The CSFI (Counterfeit, Suspect, and Fraudulent Items) issue was determined to be the Issue of Generic Interest at the April 2010 WGOE meeting. The Issue of Generic Interest is determined by the working group members for an in-depth discussion. They are often emerging issues in operating experience that a country or several countries would to the share

  9. Business strategies in the counterfeit market

    OpenAIRE

    Staake, Thorsten; Thiesse, Frederic; Fleisch, Elgar

    2012-01-01

    Counterfeit trade is amulti-billion dollar industry affecting anever-wider range of goods andmarkets. Despite the diversity of counterfeit products in terms of complexity, manufacturing techniques, investments in production facilities, potential dangers or value for the users, and degrees of conflict for the counterfeit producers with the local authorities, current academic literature still refers to counterfeit producers as one homogeneous group. Against this background, the present study in...

  10. 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

  11. 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...

  12. 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.

  13. Serial number coding and decoding by laser interference direct patterning on the original product surface for anti-counterfeiting.

    Science.gov (United States)

    Park, In-Yong; Ahn, Sanghoon; Kim, Youngduk; Bae, Han-Sung; Kang, Hee-Shin; Yoo, Jason; Noh, Jiwhan

    2017-06-26

    Here, we investigate a method to distinguish the counterfeits by patterning multiple reflective type grating directly on the surface of the original product and analyze the serial number from its rotation angles of diffracted fringes. The micro-sized gratings were fabricated on the surface of the material at high speeds by illuminating the interference fringe generated by passing a high-energy pulse laser through the Fresnel biprism. In addition, analysis of the grating's diffraction fringes was performed using a continuous wave laser.

  14. 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.

  15. Forensic intelligence for medicine anti-counterfeiting.

    Science.gov (United States)

    Dégardin, Klara; Roggo, Yves; Margot, Pierre

    2015-03-01

    Medicine counterfeiting is a crime that has increased in recent years and now involves the whole world. Health and economic repercussions have led pharmaceutical industries and agencies to develop many measures to protect genuine medicines and differentiate them from counterfeits. Detecting counterfeit is chemically relatively simple for the specialists, but much more information can be gained from the analyses in a forensic intelligence perspective. Analytical data can feed criminal investigation and law enforcement by detecting and understanding the criminal phenomenon. Profiling seizures using chemical and packaging data constitutes a strong way to detect organised production and industrialised forms of criminality, and is the focus of this paper. Thirty-three seizures of a commonly counterfeited type of capsule have been studied. The results of the packaging and chemical analyses were gathered within an organised database. Strong linkage was found between the seizures at the different production steps, indicating the presence of a main counterfeit network dominating the market. The interpretation of the links with circumstantial data provided information about the production and the distribution of counterfeits coming from this network. This forensic intelligence perspective has the potential to be generalised to other types of products. This may be the only reliable approach to help the understanding of the organised crime phenomenon behind counterfeiting and to enable efficient strategic and operational decision making in an attempt to dismantle counterfeit network. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. 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.

  17. 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...

  18. THE EMERGENCE OF THE EUROPEAN COUNTERFEIT MARKETS

    Directory of Open Access Journals (Sweden)

    Loredana Maftei

    2013-07-01

    Full Text Available The European market of counterfeit goods has become a subject of increasing concern for businesses, private firms and policymakers. With a growing demand in consumption for this kind of goods, each sector is damaged from the toy industries to the pharmaceuticals industry. This article is aimed to expose the dynamic of the European counterfeiting markets, to highlight the main factors of production, the main providers, the smuggling routes, the overall profit, the main counterfeit products and also to offer a general perspective on the affected European markets.

  19. 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.

  20. 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.

  1. 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.

  2. Recent Trends in Counterfeiting

    OpenAIRE

    Arianna Cowling

    2011-01-01

    Under the Reserve Bank Act 1959, the Reserve Bank has sole authority to issue banknotes in Australia. As such, a key responsibility of the Reserve Bank is to maintain public confidence in banknotes, so that they remain an effective payment mechanism and a secure store of wealth. This article examines how counterfeiting can impact on this confidence, and counterfeiting trends in Australia and overseas. The article also discusses the strategies the Reserve Bank employs to minimise the risks of ...

  3. The effects of luxury conceptualization on counterfeit purchase an empirical study

    OpenAIRE

    Simona Romani; Stefano Pace; Giacomo Gistri

    2011-01-01

    The extant literature on luxury counterfeiting examines a wide range of antecedents of counterfeit purchase (such as product attributes, socio-demographic factors, and various consumer attitudes). However, less attention has been devoted to the luxury conceptualization held by consumers. This study argues that luxury value perception can be a multidimensional antecedent of counterfeit purchase, and therefore investigates whether 1) consumers of counterfeits and originals differ in their perce...

  4. Dose-to-dose variations with single packages of counterfeit medicines and adulterated dietary supplements as a potential source of false negatives and inaccurate health risk assessments.

    Science.gov (United States)

    Venhuis, B J; Zwaagstra, M E; Keizers, P H J; de Kaste, D

    2014-02-01

    In this report, we show three examples of how the variability in dose units in single packages of counterfeit medicines and adulterated dietary supplements may contribute to a false negative screening result and inaccurate health risk assessments. We describe a counterfeit Viagra 100mg blister pack and a box of an instant coffee both containing dose units with and without an active pharmaceutical ingredient (API). We also describe a purportedly herbal slimming product with capsules that mutually differed in API and impurities. The adulterated dietary supplements contained sibutramine, benzyl-sibutramine, N-desmethyl-sibutramine (DMS), N,N-didesmethyl-sibutramine (DDMS) and several other related impurities. Counterfeit medicines and adulterated dietary supplements are a health risk because their quality is unreliable. Health risks are even greater when such unreliability extends to fundamental differences between dose units in one package. Because dose-to-dose variability for these products is unpredictable, the confidence interval of a sample size is unknown. Consequently, the analyses of a selection of dose units may not be representative for the package. In the worst case, counterfeit or unauthorised medicines are not recognised as such or a health risk is not identified. In order to reduce erroneous results particular care should be taken when analysing a composite of dose units, when finding no API in a dietary supplement and when finding conformity in a suspect counterfeit medicine. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. 'Counterfeit deviance' revisited.

    Science.gov (United States)

    Griffiths, Dorothy; Hingsburger, Dave; Hoath, Jordan; Ioannou, Stephanie

    2013-09-01

    The field has seen a renewed interest in exploring the theory of 'counterfeit deviance' for persons with intellectual disability who sexually offend. The term was first presented in 1991 by Hingsburger, Griffiths and Quinsey as a means to differentiate in clinical assessment a subgroup of persons with intellectual disability whose behaviours appeared like paraphilia but served a function that was not related to paraphilia sexual urges or fantasies. Case observations were put forward to provide differential diagnosis of paraphilia in persons with intellectual disabilities compared to those with counterfeit deviance. The brief paper was published in a journal that is no longer available and as such much of what is currently written on the topic is based on secondary sources. The current paper presents a theoretical piece to revisit the original counterfeit deviance theory to clarify the myths and misconceptions that have arisen and evaluate the theory based on additional research and clinical findings. The authors also propose areas where there may be a basis for expansion of the theory. The theory of counterfeit deviance still has relevance as a consideration for clinicians when assessing the nature of a sexual offence committed by a person with an intellectual disability. Clinical differentiation of paraphilia from counterfeit deviance provides a foundation for intervention that is designed to specifically treat the underlying factors that contributed to the offence for a given individual. Counterfeit deviance is a concept that continues to provide areas for consideration for clinicians regarding the assessment and treatment of an individual with an intellectual disability who has sexually offended. It is not and never was an explanation for all sexually offending behavior among persons with intellectual disabilities. © 2013 John Wiley & Sons Ltd.

  6. Counterfeit and Fraudulent Items - Mitigating the risk

    International Nuclear Information System (INIS)

    Tannenbaum, Marc

    2011-01-01

    This presentation (slides) provides an overview of the industry's challenges and activities. Firstly, it outlines the differences between counterfeit, fraudulent, suspect, and also substandard items. Notice is given that items could be found not to meet the standard, but the difference in the intent to deceive with counterfeit and fraudulent items is the critical element. Examples from other industries are used which also rely heavily on the assurance of quality for safety. It also informs that EPRI has just completed a report in October 2009 in coordination with other US government agencies and industry organizations; this report, entitled Counterfeit, Substandard and Fraudulent Items, number 1019163, is available for free on the EPRI web site. As a follow-up to this report, EPRI is developing a CFSI Database; any country interested in a collaborative agreement is invited to use and contribute to the database information. Finally, it stresses the importance of the oversight of contractors, training to raise the awareness of the employees and the inspectors, and having a response plan for identified items

  7. 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.

  8. Aging, Counterfeiting Configuration Control (AC3)

    Science.gov (United States)

    2010-01-31

    Systems Intergrated Into AC3 CABS - Common As-Built System PRISM - Process Re-inventing Integration Systems for Manufacturing PDM - Product Data...looks forward to deploying the completed tool at Raytheon in a true production environment, for as much as we like the challenge associated with...performance of DoD systems. DoD systems are particularly susceptible to intrusion of counterfeit parts, especially during surge and extended production

  9. Higgs friends and counterfeits at hadron colliders

    International Nuclear Information System (INIS)

    Fox, Patrick J.; Tucker-Smith, David; Weiner, Neal

    2011-01-01

    We consider the possibility of 'Higgs counterfeits' - scalars that can be produced with cross sections comparable to the SM Higgs, and which decay with identical relative observable branching ratios, but which are nonetheless not responsible for electroweak symmetry breaking. We also consider a related scenario involving 'Higgs friends,' fields similarly produced through gg fusion processes, which would be discovered through diboson channels WW,ZZ,γγ, or even γZ, potentially with larger cross sections times branching ratios than for the Higgs. The discovery of either a Higgs friend or a Higgs counterfeit, rather than directly pointing towards the origin of the weak scale, would indicate the presence of new colored fields necessary for the sizable production cross section (and possibly new colorless but electroweakly charged states as well, in the case of the diboson decays of a Higgs friend). These particles could easily be confused for an ordinary Higgs, perhaps with an additional generation to explain the different cross section, and we emphasize the importance of vector boson fusion as a channel to distinguish a Higgs counterfeit from a true Higgs. Such fields would naturally be expected in scenarios with 'effective Z's,' where heavy states charged under the SM produce effective charges for SM fields under a new gauge force. We discuss the prospects for discovery of Higgs counterfeits, Higgs friends, and associated charged fields at the LHC.

  10. “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.

  11. 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

  12. Consumption practices of counterfeit luxury goods in the Italian context

    OpenAIRE

    Giacomo Gistri; Simona Romani; Stefano Pace; Veronica Gabrielli; Silvia Grappi

    2009-01-01

    ABSTRACT Counterfeiting is an expanding and increasingly relevant phenomenon in contemporary markets that has a particular impact on luxury branded goods. Most academic literature to date has focused its attention on the determinants of purchase, underestimating the consumption phase. This paper aims to fi ll this gap by investigating how people consume counterfeit luxury products. Our results help us to better understand the phenomenon as a whole, with the objective of prov...

  13. Caveat oncologist: clinical findings and consequences of distributing counterfeit erythropoietin in the United States.

    Science.gov (United States)

    Qureshi, Zaina P; Norris, Leann; Sartor, Oliver; McKoy, June M; Armstrong, John; Raisch, Dennis W; Garg, Vishvas; Stafkey-Mailey, Dana; Bennett, Charles Lee

    2012-03-01

    Counterfeit pharmaceuticals pose risks domestically. Because of their cost, cancer pharmaceuticals are vulnerable. We review findings from a domestic counterfeiting episode involving erythropoietin and outline anticounterfeiting recommendations for policy makers, patients, and health care professionals. Information was obtained on patients who received counterfeit erythropoietin, its distribution, and criminal investigations into counterfeiting networks. Interview sources included a physician, an attorney, employees of the Florida Department of Health and Human Services and the US Food and Drug Administration's (FDA) Office of Criminal Investigation, manufacturers, and wholesalers. Other sources included the book "Dangerous Doses," LexisNexis (search terms "counterfeit" and "erythropoietin") and the FDA database. Counterfeit product consisted of 2,000 U vials with counterfeit labels denoting 40,000 U. The counterfeiters, in collaboration with a Miami pharmacy, purchased 110,000 erythropoietin 2,000 U vials and affixed counterfeit labels to each vial. Products were then sold via the pharmaceutical "gray market" to wholesalers, then pharmacy chains. Investigations by Florida government officials implicated 17 persons, all of whom were found guilty of trafficking in counterfeit pharmaceuticals. Despite the large size of the operation, the FDA received reports of only 12 patients who had received counterfeit erythropoietin and detailed information for only two individuals. A 17-year-old liver transplant recipient and a 61-year-old patient with breast cancer experienced loss of efficacy after receiving counterfeit erythropoietin. Wider use of FDA anticounterfeit initiatives, limiting pharmaceutical suppliers to reputable distributors, and educating providers and patients about signs of counterfeit drugs can improve the safety of cancer pharmaceuticals.

  14. PROACTIVE DEFENSE FOR EVOLVING SUPPLY CHAIN COUNTERFEITING

    Science.gov (United States)

    2015-12-01

    counterfeiters who reprocess the parts and sell them as original products .4 Information Communication Technology (ICT): refers to the information and...company that originally built a product .9 Supply Chain Risk: risks that arise from the confidentiality, integrity, or availability of information...four different graduate schools spread across 22 years of marriage. For the past few years, she has endured a life with an " absentee husband" who

  15. 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…

  16. 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/

  17. Comparison of cyclic fatigue resistance of original and counterfeit rotary instruments.

    Science.gov (United States)

    Ertas, Huseyin; Capar, Ismail Davut; Arslan, Hakan; Akan, Ender

    2014-05-31

    In recent years, with the advances in counterfeiting methods, counterfeit products have reached the dental market. The purpose of this study was to compare the cyclic fatigue resistance of original and counterfeit rotary root canal instruments. The cyclic fatigue of original and counterfeit ProTaper F2 endodontic instruments was tested (n = 20) in 3 mm radius steel canals with a 60° angle of curvature. The number of cycles to fracture (NCF) was calculated, and the data were subjected to the Student's t-test (α = 0.05). The original instruments showed better cyclic fatigue resistance than the counterfeit ones (p instruments was very low. As a result, clinicians should be careful not to purchase counterfeit products.

  18. Detection of counterfeit brand spirits using 1H NMR fingerprints in comparison to sensory analysis.

    Science.gov (United States)

    Kuballa, Thomas; Hausler, Thomas; Okaru, Alex O; Neufeld, Maria; Abuga, Kennedy O; Kibwage, Isaac O; Rehm, Jürgen; Luy, Burkhard; Walch, Stephan G; Lachenmeier, Dirk W

    2018-04-15

    Beverage fraud involving counterfeiting of brand spirits is an increasing problem not only due to deception of the consumer but also because it poses health risks e.g. from possible methanol admixture. Suspicious spirit samples from Russia and Kenya were analysed using 1 H nuclear magnetic resonance (NMR) spectroscopy in comparison to authentic products. Using linear regression analysis of spectral integral values, 4 counterfeited samples from Russia and 2 from Kenya were easily identifiable with R 2  counterfeited and authentic samples but the assessors were unable to correctly identify the counterfeited product in the majority of cases. An important conclusion is that consumers cannot assumed to be self-responsible when consuming counterfeit alcohol because there is no general ability to organoleptically detect counterfeit alcohol. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Through-container, extremely low concentration detection of multiple chemical markers of counterfeit alcohol using a handheld SORS device.

    Science.gov (United States)

    Ellis, David I; Eccles, Rebecca; Xu, Yun; Griffen, Julia; Muhamadali, Howbeer; Matousek, Pavel; Goodall, Ian; Goodacre, Royston

    2017-09-21

    Major food adulteration incidents occur with alarming frequency and are episodic, with the latest incident, involving the adulteration of meat from 21 producers in Brazil supplied to 60 other countries, reinforcing this view. Food fraud and counterfeiting involves all types of foods, feed, beverages, and packaging, with the potential for serious health, as well as significant economic and social impacts. In the spirit drinks sector, counterfeiters often 'recycle' used genuine packaging, or employ good quality simulants. To prove that suspect products are non-authentic ideally requires accurate, sensitive, analysis of the complex chemical composition while still in its packaging. This has yet to be achieved. Here, we have developed handheld spatially offset Raman spectroscopy (SORS) for the first time in a food or beverage product, and demonstrate the potential for rapid in situ through-container analysis; achieving unequivocal detection of multiple chemical markers known for their use in the adulteration and counterfeiting of Scotch whisky, and other spirit drinks. We demonstrate that it is possible to detect a total of 10 denaturants/additives in extremely low concentrations without any contact with the sample; discriminate between and within multiple well-known Scotch whisky brands, and detect methanol concentrations well below the maximum human tolerable level.

  20. 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.

  1. Caveat Oncologist: Clinical Findings and Consequences of Distributing Counterfeit Erythropoietin in the United States

    Science.gov (United States)

    Qureshi, Zaina P.; Norris, LeAnn; Sartor, Oliver; McKoy, June M.; Armstrong, John; Raisch, Dennis W.; Garg, Vishvas; Stafkey-Mailey, Dana; Bennett, Charles Lee

    2012-01-01

    Purpose: Counterfeit pharmaceuticals pose risks domestically. Because of their cost, cancer pharmaceuticals are vulnerable. We review findings from a domestic counterfeiting episode involving erythropoietin and outline anticounterfeiting recommendations for policy makers, patients, and health care professionals. Materials and Methods: Information was obtained on patients who received counterfeit erythropoietin, its distribution, and criminal investigations into counterfeiting networks. Interview sources included a physician, an attorney, employees of the Florida Department of Health and Human Services and the US Food and Drug Administration's (FDA) Office of Criminal Investigation, manufacturers, and wholesalers. Other sources included the book “Dangerous Doses,” LexisNexis (search terms “counterfeit” and “erythropoietin”) and the FDA database. Results: Counterfeit product consisted of 2,000 U vials with counterfeit labels denoting 40,000 U. The counterfeiters, in collaboration with a Miami pharmacy, purchased 110,000 erythropoietin 2,000 U vials and affixed counterfeit labels to each vial. Products were then sold via the pharmaceutical “gray market” to wholesalers, then pharmacy chains. Investigations by Florida government officials implicated 17 persons, all of whom were found guilty of trafficking in counterfeit pharmaceuticals. Despite the large size of the operation, the FDA received reports of only 12 patients who had received counterfeit erythropoietin and detailed information for only two individuals. A 17-year-old liver transplant recipient and a 61-year-old patient with breast cancer experienced loss of efficacy after receiving counterfeit erythropoietin. Conclusion: Wider use of FDA anticounterfeit initiatives, limiting pharmaceutical suppliers to reputable distributors, and educating providers and patients about signs of counterfeit drugs can improve the safety of cancer pharmaceuticals. PMID:23077434

  2. 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.

  3. [Anti-counterfeit activities of pharmaceutical companies in Japan: for patient safety].

    Science.gov (United States)

    Shofuda, Ken-ichi; Aragane, Katsumi; Igari, Yasutaka; Matsumoto, Kinya; Ito, Kazuya

    2014-01-01

    Global spread of counterfeit medicines is an imminent threat for the patients' safety. Although major targets of counterfeits are still erectile dysfunction (ED) drugs in the industrialized countries, including Japan, anti-cancer agents and some medicines for metabolic syndromes are also being counterfeited and circulated to the market mainly through the Internet. Due to the global expansion of the business, pharmaceutical companies based in Japan are suffering from the damage of counterfeits, illegal sales including diversion, and thefts, which have never been experienced in the conventional domestic market. We, pharmaceutical companies, must be responsible for the prevention of the prevalence because our mission is to deliver effective and safe medicine to patients. For this end, we are taking necessary actions including, 1. Forestalling counterfeit, falsification and illicit trade: Measures to prevent counterfeiting are taken by introducing anti-counterfeit technologies to the packaging and tablets on a risk basis. It is also important to establish supply chain security on a global scale. 2. Finding out counterfeits and cooperating crackdown: We are conducting market and internet surveillances when high risk products are sold in high risk markets. The outcome of the criminal investigation is reported to authorities and police if necessary. 3. Conducting educational campaign to medical staff or patients: For example, four companies which manufacture and sell ED drug in Japan are collaboratively continuing activities to raise the awareness of the danger of Internet purchase. To deliver effective and safe medicines stably and globally, pharmaceutical companies extend comprehensive measures against counterfeit and illicit trading.

  4. 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.

  5. 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…

  6. 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.

  7. Dynamics of counterfeit alcohol and tobacco goods in the Tatarstan Republic market

    Directory of Open Access Journals (Sweden)

    Oleg R. Karatayev

    2015-12-01

    Full Text Available Objective to identify and assess the share of counterfeit products in the total volume of alcohol and tobacco products in the consumer market of Tatarstan Republic which will allow the inspection bodies to deal more effectively to prevent the spreading of counterfeit products. Methods the research proposed in this paper used methods of probability theory and mathematical statistics and the method of sampling analysis of certificates for products in accordance with applicable laws and regulations of Rosstandart. Results basing on a sampling of certificates for products directly from retail outlets analysis of the state alcohol and tobacco consumer market of Tatarstan was carried out. Improper filling of the form of the certificate for products was identified violating all existing norms and laws which are strictly prescribed in technical regulations. On the basis of these violations the validity of certificates for products was assessed and the conclusion was made about the products quality. The share of counterfeit alcohol and tobacco products in the total sales in the consumer market was assessed. The shortcomings of the inspection authorities to detect counterfeit products were identified. Scientific novelty the consumer market was researched basing on the method of sampling using probability theory and mathematical statistics to estimate the share of counterfeit alcohol and tobacco products in the consumer market of Tatarstan. The error sampling for counterfeit products in the consumer market was defined. Practical significance the obtained results will allow the inspection authorities to better and more accurately identify counterfeit goods and to restrict the access of counterfeit alcohol and tobacco products to the consumer market of Tatarstan. It is necessary to strengthen the role of state regulation of commercial activities in the consumer market of Russia to stop the flow of counterfeit alcohol and tobacco products to the consumer

  8. Nanotag luminescent fingerprint anti-counterfeiting technology

    DEFF Research Database (Denmark)

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

    2012-01-01

    We describe a method to fabricate, transfer and validate via image processing nanofibre- based, unique security marks (“nanotags”) for anti-counterfeiting purposes. Epitaxial surface growth of oligophenylenes on a heated muscovite mica crystal results in a thin film of mutually aligned nanofibres....... 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....

  9. 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…

  10. Chromatographic determination of clopidogrel bisulfate; detection and quantification of counterfeit Plavix® tablets

    Directory of Open Access Journals (Sweden)

    Mona E. ElTantawy

    2014-06-01

    Full Text Available Counterfeiting of pharmaceutical products is a global problem. Upon using quality-ensuring methods of international pharmacopoeias, additional impurities and the low content of the active pharmaceutical ingredients were detected. In this paper, two chromatographic HPLC and TLC-densitometric methods were proposed as fast and reliable methods for detection and quantitation of counterfeit Plavix® tablets. These tablets were chemically counterfeited by aspirin, its degradate salicylic acid and metronidazole which were separated, besides the active ingredient clopidogrel bisulfate, by the proposed methods. Also, counterfeit was in packaging, strips and tablets’ color and these could be seen by visual inspection compared to original drug. The proposed methods can easily differentiate genuine from counterfeited tablets without need of prior separation. The proposed methods were validated according to ICH guidelines and applied to eleven batches, also were compared statistically with the reported one.

  11. 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.

  12. 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.

  13. Dynamics of counterfeit alcohol and tobacco goods in the Tatarstan Republic market

    OpenAIRE

    Oleg R. Karatayev

    2015-01-01

    Objective to identify and assess the share of counterfeit products in the total volume of alcohol and tobacco products in the consumer market of Tatarstan Republic which will allow the inspection bodies to deal more effectively to prevent the spreading of counterfeit products. Methods the research proposed in this paper used methods of probability theory and mathematical statistics and the method of sampling analysis of certificates for products in accordance with applicable laws and...

  14. 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.

  15. 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

  16. 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

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

    International Nuclear Information System (INIS)

    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. - Highlights: • Combined method to detect and categorize pesticide transformation products in soil. • Detection by QTOF-MS of new tebuconazole transformation products without standards. • Estimation by in silico molecular typology of their environmental parameters. • Method to rationally choose relevant transformation products to be studied. • The

  18. 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

  19. Counterfeiting in performance- and image-enhancing drugs.

    Science.gov (United States)

    Graham, Michael R; Ryan, Paul; Baker, Julien S; Davies, Bruce; Thomas, Non-Eleri; Cooper, Stephen-Mark; Evans, Peter; Easmon, Sue; Walker, Christopher J; Cowan, David; Kicman, Andrew T

    2009-03-01

    The current drastic escalation in obesity may be contributing to the exponential rise in drugs used for image enhancement. Drugs such as anabolic-androgenic steroids (AAS) are perceived as a viable method of achieving a perfect physique. They are also the most widely abused drugs in sport. The Internet has encouraged the abuse of expensive drugs, particularly human growth hormone (hGH), resulting in increased importation for personal use. The substantial increase in this market has opened up avenues for counterfeiting, estimated as a multi-million pound business. The acute adverse effects from contaminated vials may result in a variety of pathologies including communicable diseases. In 2007, in the UK, a series of intramuscular abscesses, requiring surgical treatment, led us to study samples obtained from the underground market. The analysis of 38 parenteral samples and 19 oral samples of tablets was performed by a World Anti-Doping Agency (WADA) accredited laboratory, in an attempt to establish the extent of available counterfeit products. Fifty-three per cent (20) of the injectable AAS esters and 21% (4) of the oral tablets were counterfeit. Culture and sensitivity revealed the presence of skin commensal organisms, which may have contributed to the development of the abscesses. Users of AAS and hGH for sport, including bodybuilding, are currently risking their health because of counterfeit and poorly controlled products. Copyright 2009 John Wiley & Sons, Ltd.

  20. Counterfeit Parts Prevention Strategies Guide

    Science.gov (United States)

    2014-06-24

    requirements of 252.211-7003, Item Unique Identification and Valuation .” This section establishes a recommended approach for requirements, polices, and...7003 Item Unique Identification and Valuation DoDI 4140.67 DoD Counterfeit Prevention Policy DoDI 5200.39 Critical Program Information (CPI...Deborah Valley deborah.valley@ll.mit.edu MIT Fred Van Milligen fvanmilligen@jdsu.com JDSU Marvin VanderWeg marvin.vanderwag@spacex.c om SpaceX Gerrit

  1. 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...

  2. Forensic classification of counterfeit banknote paper by X-ray fluorescence and multivariate statistical methods.

    Science.gov (United States)

    Guo, Hongling; Yin, Baohua; Zhang, Jie; Quan, Yangke; Shi, Gaojun

    2016-09-01

    Counterfeiting of banknotes is a crime and seriously harmful to economy. Examination of the paper, ink and toners used to make counterfeit banknotes can provide useful information to classify and link different cases in which the suspects use the same raw materials. In this paper, 21 paper samples of counterfeit banknotes seized from 13 cases were analyzed by wavelength dispersive X-ray fluorescence. After measuring the elemental composition in paper semi-quantitatively, the normalized weight percentage data of 10 elements were processed by multivariate statistical methods of cluster analysis and principle component analysis. All these paper samples were mainly classified into 3 groups. Nine separate cases were successfully linked. It is demonstrated that elemental composition measured by XRF is a useful way to compare and classify papers used in different cases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. 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.

  4. [The role of German official medicines control laboratories in combating counterfeit medicines].

    Science.gov (United States)

    Wiegard, Andrea; Heuermann, Matthias

    2017-11-01

    An official medicines control laboratory (OMCL) provides an important contribution to combat counterfeit and illegal medicines. The OMCL supports the competent authorities in controlling the quality of authorised medicinal products in the legal supply chain. For detecting counterfeit medicines in the legal supply chain, a risk-based approach in choice of products is conducted. Furthermore, the OMCL analyses suspicious medicines from the illegal supply chain for any other authority. The chemical analysis of a suspicious sample is needed to identify such a sample as a counterfeit medicine. The analytical results are fundamental for the evaluation of the legal status of the product and for the assessment of it's inherent hazard to public health. The global market of illegal medicines is rapidly changing. Therefore a good national and international working liaison and co-operation between laboratories and authorities is obligatory to protect public health. The OMCL provides important knowledge of new trends in counterfeit and illegal medicines. Hence, it is an essential part in surveillance of medicinal products. The efficient networking enables prompt official interventions. Thus, risks for the public health by substandard medicines were reduced. Beside the chemical analysis, the OMCL can help to raise public awareness about counterfeit and illegal medicines. In Germany, the risk of counterfeit medicines reaching patients through the legal supply chain is still low, but the possibility cannot be ignored.

  5. Attitude towards the purchase of counterfeits: Antecedents and effect on intention to purchase

    OpenAIRE

    Viot , Catherine; Le Roux , André; Kremer , Florence

    2014-01-01

    International audience; Counterfeiting is a major issue for companies, public institutions and consumers. Despite extensive literature on the subject in marketing, an instrument for measuring the wide variety of the determinants of attitude towards and intention to purchase counterfeit products is lacking. A second-order model comprising thirteen determinants, grouped into three latent constructs, is validated. This model includes a dimension related to the societal consequences of counterfei...

  6. Perceived Quality Of Counterfeit Perfume And Original Perfume

    OpenAIRE

    Saerang, David Paul Elia; Turk, Caleb Elijah

    2015-01-01

    Perfume is one type of product that often has prestigious prices tied with quality to attract consumers, which (as often is seen with high-priced products) arouses the interests of counterfeiters to copy the originals. Perfume comes in many fragrances which are offered to customers. Fragrances have their own characteristics in order to match with the various tastes, moods, and occasions they may want them for. Perfume also can reflect certain life-styles. Perfume creates different perceived v...

  7. Counterfeiting as corporate externality: intellectual property crime and global insecurity

    OpenAIRE

    2010-01-01

    Abstract Corporate negative externalities occur when corporations place some of the costs of their profit-seeking activity onto society. This paper suggests that the current global problem of intellectual property crime is such an externality, and that it has not been recognised as such because corporations present product counterfeiting and piracy as crimes which reduce their revenue, rather than as predictable side effects of corporate production and merchandising, including bran...

  8. 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.

  9. Overview of suspected adverse reactions to veterinary medicinal products reported in South Africa (March 2001 - February 2002 : report

    Directory of Open Access Journals (Sweden)

    V. Naidoo

    2002-07-01

    Full Text Available An overview of reports of suspected adverse drug reactions received by the Veterinary Pharmacovigilance and Medicines Information Centre during the period March 2001 to February 2002 is given. A total of 77 reports were received. The majority of reports involved suspected adverse reactions that occurred in dogs and cats. Most products implicated in the reports were Stock Remedies. The products were predominantly administered either by veterinarians or trained paraveterinary professionals. Although the majority of reports were received from veterinary pharmaceutical companies, the proportion of reports received directly from veterinarians increased compared with previous years.

  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. [The fight against counterfeit medicines in Africa: experience and role of pharmacists].

    Science.gov (United States)

    Chauvé, Martine

    2008-12-01

    The counterfeiting of medicines is a global scourge, which is particularly serious in the African continent. According to WHO estimations, whereas counterfeit medicines represent 1% of the market in developed countries, up to 30% of the medicines sold in African countries are counterfeit. Several factors may explain this high rate in Africa, from the weaknesses of legislation and controls, to the lack of affordability of medicines and the attitude of governments. A counterfeit medicine represents different levels of risk, depending if the active substance is present or not, if the dosage is the right one, if the product contains toxic substances, etc. In Africa, several examples sadly showed the terrible impact the use of counterfeit medicines may have (i.e. Nigeria, 1990, Niger, 1995). Pharmacists have a crucial role to play in fighting against the penetration of counterfeit medicines, both in securing the distribution chain, and in leading some actions towards patients. The FIP has produced some guidelines on this issue by adopting a statement (which was last updated in 2003) and by providing pharmacists with useful tools on its website. Several international organizations such as the CIOPF (International conference of French-speaking Orders) produced recommendations on this issue. However, the experience and expertise gained by national organizations from countries such as Côte d'Ivoire are also worth sharing and are presented here.

  12. Severe hypoglycaemia associated with ingesting counterfeit medication.

    Science.gov (United States)

    Chaubey, Santosh K; Sangla, Kunwarjit S; Suthaharan, Emershia N; Tan, Yong M

    2010-06-21

    Cross-border importation of traditional and prescription medications is common, and many of these drugs are not approved by the Australian Therapeutic Goods Administration. Furthermore, counterfeit versions of prescription medications are also available (eg, weight-loss medications, anabolic steroids, and medications to enhance sexual performance). We describe a 54-year-old man with the first Australian case of severe hypoglycaemia induced by imported, laboratory-confirmed counterfeit Cialis. This serves to remind medical practitioners that counterfeit medication may be the cause of severe hypoglycaemia (or other unexplained illness).

  13. Substandard and Counterfeit Antimicrobials: Recent Trends and ...

    African Journals Online (AJOL)

    ... trends in the availability of substandard and counterfeit antimicrobials in the global market ... Literature search using PubMed and Medline databases and Google search engine was conducted to identify related publications on the subject.

  14. Fake and Counterfeit Drug: A review

    African Journals Online (AJOL)

    intent to deceptively represent its origin authenticity or effectiveness. A counterfeit drug ... version of medication. The business of fake drugs is a lucrative crime that is .... management of target or most vulnerable groups of patients with high risk ...

  15. Legislations combating counterfeit drugs in Hong Kong.

    Science.gov (United States)

    Lai, C W; Chan, W K

    2013-08-01

    To understand legislation combating counterfeit drugs in Hong Kong. This study consisted of two parts. In part I, counterfeit drugs–related ordinances and court cases were reviewed. In part II, indepth interviews of the stakeholders were described. Hong Kong. All Hong Kong ordinances were screened manually to identify those combating counterfeit drugs. Court cases were searched for each of the identified cases. Then, the relevant judgement justifications were analysed to identify sentencing issues. Indepth interviews with the stakeholders were conducted to understand their perceptions about such legislation. Trade Marks Ordinance, Patents Ordinance, Trade Descriptions Ordinance, and Pharmacy and Poisons Ordinance were current legislative items combating counterfeit drugs. Sentencing criteria depended on: intention to deceive, quantity of seized drugs, presence of expected therapeutic effect or toxic ingredients, previous criminal records, cooperativeness with Customs officers, honest confessions, pleas of guilty, types of drugs, and precautionary measures to prevent sale of counterfeit drugs. Stakeholders’ perceptions were explored with respect to legislation regarding the scale and significance of the counterfeit drug problem, penalties and deterrents, drug-specific legislation and authority, and inspections and enforcement. To plug the loopholes, a specific law with heavy penalties should be adopted. This could be supplemented by non-legal measures like education of judges, lawyers, and the public; publishing the names of offending pharmacies; and emphasising the role of pharmacists to the public.

  16. [Are there counterfeit medicines in Croatia?].

    Science.gov (United States)

    Tomić, Sinisa; Milcić, Neven; Sokolić, Milenko; Sucić, Anita Filipović; Martinac, Adrijana Ilić

    2010-01-01

    Counterfeit medicines are a growing problem in the world, for their use may endanger patient's health and therefore they pose an enormous public health risk. The manufacture of counterfeit medicines usually involves organised crime groups which place the counterfeit medicines on the market for reasons of profit. Detection and prevention of trade in counterfeit medicines requires close cooperation between medicine regulatory authorities, police, customs, judiciary and pharmaceutical industry. To this day, there have been no recorded cases of counterfeit medicines in the legal supply chain in Croatia. However, medicines without marketing authorisation in Croatia, originating from different countries, could be found on the illegal market. Most frequently, this includes medicines for the treatment of erectile dysfunction such as: sildenafil, tadalafil, vardenafil. In this study, 26 medicines for the treatment of erectile dysfunction, seized in illegal supply chain, were tested. High performance liquid chromatography (HPLC) was used for identification and quantification of active substances in the tested samples. It was determined that 13 out of 26 samples did not comply with declared composition of medicine and quality specification. Furthermore, two samples did not contain declared active substance vardenafil and that may indicate that these medicines are counterfeit.

  17. Overview of suspected adverse reactions to veterinary medicinal products reported in South Africa (March 2004 - February 2006 : report

    Directory of Open Access Journals (Sweden)

    V. Naidoo

    2006-06-01

    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 2004 to February 2006 is presented. A total of 21 reports was received in the 2-year period, continuing the decline in the number of reports to a lower figure than in any previous year. This is surprising considering the legal obligation of the veterinary professionals to report all adverse drug reactions. Once again the majority of reports involved suspected adverse reactions that occurred in dogs and cats. Most of the products implicated were stock remedies. Veterinarians predominantly administered these products.

  18. Identifying a common origin of toner printed counterfeit banknotes by micro-Raman spectroscopy.

    Science.gov (United States)

    Skenderović Božičević, Martina; Gajović, Andreja; Zjakić, Igor

    2012-11-30

    This study explores the applicability of micro-Raman spectroscopy as a non-destructive technique for the analysis of color toner printed counterfeits. The main aim of the research paper was to find out whether Raman spectroscopy is a suitable method for establishing the connection between different specimens of counterfeits suspected to be printed with the same toner on the same machine. Specimens of different types of toners printed on different types of paper are analyzed by means of the micro-Raman spectroscopy system with the excitation line at 514.5 nm. For each specimen cyan, magenta and yellow toners are analyzed separately. The yellow toners displayed the most distinctive Raman spectra. The results show that micro-Raman spectroscopy can be successfully applied as a method for the analysis of color toner printed counterfeits, such as banknotes and documents, in order to establish links between more or less different specimens of counterfeits by measuring the properties of a color toner. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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.

  4. 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.)

  5. 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) (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.

  6. 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.

  7. Counterfeit Electronics Detection Using Image Processing and Machine Learning

    International Nuclear Information System (INIS)

    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. (paper)

  8. Rapid instrumental detection and quantification of counterfeit pharmaceutical tablet formulations

    OpenAIRE

    Ogwu, John; Lawson, Graham; Tanna, Sangeeta

    2015-01-01

    From therapeutic to lifestyle medicines, the counterfeiting of medicines has been on the rise in recent times. Estimates indicate that about 10% of medicines worldwide are counterfeits with much higher figures in developing countries. Currently, identifying counterfeit medicines at the point of care is a challenge leaving many patients at risk. This study considered the potential use of Attenuated Total Reflectance-Fourier Transform Infrared Spectroscopy (ATR-FTIR) in rapid quantitative analy...

  9. 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

  10. Economic analysis of use of counterfeit drugs: health impairment risk of counterfeit phosphodiesterase type 5 inhibitor taken as an example.

    Science.gov (United States)

    Sugita, Minoru; Miyakawa, Michiko

    2010-07-01

    The size of the market for counterfeit drugs throughout the world is considerable. Many cases of health impairment due to counterfeits have been reported. The market share of counterfeits in drug markets in developed countries is smaller than that in developing countries. However, the size of the market for counterfeits of phosphodiesterase type 5 inhibitors (PDE5Is) used as anti-erectile-dysfunction drugs is not small. The purpose of the present study was to analyze the health impairment risk of taking the counterfeit PDE5Is and the convenience of obtaining the counterfeits in Japan, using an economic methodology in order to work out countermeasures for reducing the health impairment risk. Information was obtained by interviewing employees of pharmaceutical and chemical corporations in Japan. The size of the market for counterfeit PDE5Is in Japan was recently estimated to be about 2.5 times larger than that of genuine PDE5Is. The price of the counterfeits in their market is reported to be nearly equal to that of the genuine PDE5Is. An outbreak of severe hypoglycemia among users of counterfeit PDE5Is containing an antidiabetic drug in Singapore was reported in 2008, and seven patients remained comatose as a result of prolonged neuroglycopenia. Four of them subsequently died, so the health impairment risk due to counterfeit PDE5Is should not be ignored. In order to obtain a genuine PDE5I in Japan, a patient must be examined and have a prescription written at a medical institution, and buy it at a dispensing pharmacy. Focusing on the health impairment risk due to counterfeit PDE5Is and the convenience of obtaining the counterfeits in Japan, we analyzed the effects on the prices and quantities of PDE5Is in the market from demand and supply curves, using an economic methodology. From the analysis, it was shown that the health impairment risk due to the counterfeits is underestimated in the market in Japan. Physicians should warn their patients not to buy counterfeit

  11. THE ANALYSIS OF COUNTERFEITING FOOD PRODUCTS

    OpenAIRE

    Paula - Angela VIDRASCU

    2013-01-01

    The issue addressed in this paper makes a significant contribution to research on the effects that food tampering has at the expense of consumer health. Nowadays quality and food safety that consumers are entitled directly reflects the quality of life. In other words the present subject is of particular importance to the work of the bodies created for the purpose of protecting the health and quality of life of consumers. This study has an important role both in the short and long term through...

  12. 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...

  13. Counterfeit detection for new and old currency designs

    Science.gov (United States)

    Hillstrom, Anne P.; Bernstein, Ira H.

    2002-04-01

    To test the effectiveness of counterfeit deterrence features recently introduced in US currency, observers were asked to discriminate genuine from counterfeit bills using a two-alternative forced-choice task. In Experiment 1, observers judged 100s with the new and old designs after receiving training in the deterrence features of each design. The counterfeits were representative of two common print processes: inkjet and offset printing. Judgments were made on whole bills, on individual features with the whole bill unmasked, and on individual features with only that feature visible. In Experiment 2, different observers judged 100s without any training. They then were trained and judged 50s and 20 bills. Taken together, the two experiments indicate that people are good at detecting counterfeits, that inkjet counterfeits are easier to detect than offset counterfeits, and that counterfeits of the newly designed bills are easier to detect than counterfeits of the older series. The design improvement was greatest with 100 bills and, to a lesser extent, 50 bills. Improvement was minimal with 20 bills, very likely because observers were very accurate for both series of 20s. Finally, some deterrence features were more useful than others in aiding discriminations.

  14. 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 ...

  15. 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 ...

  16. 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.

  17. Counterfeit analysis strategy illustrated by a case study.

    Science.gov (United States)

    Dégardin, Klara; Roggo, Yves

    2016-01-01

    Medicine counterfeiting is a current problem that the whole pharmaceutical field has to deal with. In 2014, counterfeits entered the legitimate supply chain in Europe. Quick and efficient action had to be taken. The aim of this paper is to explain which analytical strategy was chosen to deal with six of the cases concerned and which criteria have to be considered to provide quick and thorough information about the counterfeits. The evaluation of the packaging was performed in a first step, based on a comparison with genuine samples and evaluation of manipulation signs. Chemical methods were then used, consisting of near infrared and infrared spectroscopy, capillary zone electrophoresis and ultraviolet-visible spectrophotometry, in order to authenticate the samples and provide the chemical composition of the confirmed counterfeits. Among the 20 samples analyzed, 17 were confirmed as counterfeits. The counterfeits were the results of the manipulation of genuine samples, and one contained totally counterfeited parts. Several manipulation signs were asserted, like the addition of glue on the boxes and the vials. Genuine stolen goods had been diluted with water, while for an isolated case, a different active ingredient had been introduced in a vial. The analytical data generated were further investigated from a forensic intelligence perspective. Links could be revealed between the analyzed counterfeits, together with some interesting information about the modus operandi of the counterfeiters. The study was performed on a limited number of cases, and therefore encourages chemical and packaging profiling of counterfeits at a bigger scale. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  18. 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.

  19. 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.

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

    International Nuclear Information System (INIS)

    Storme-Paris, I.; Rebiere, H.; Matoga, M.; Civade, C.; Bonnet, P.-A.; Tissier, M.H.; Chaminade, P.

    2010-01-01

    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.

  1. Official control of plant protection products in Poland: detection of illegal products.

    Science.gov (United States)

    Miszczyk, Marek; Płonka, Marlena; Stobiecki, Tomasz; Kronenbach-Dylong, Dorota; Waleczek, Kazimierz; Weber, Roland

    2018-04-03

    Market presence of illegal and counterfeit pesticides is now a global problem. According to data published in 2012 by the European Crop Protection Association (ECPA), illegal products represent over 10% of the global market of plant protection products. Financial benefits are the main reason for the prevalence of this practice. Counterfeit and illegal pesticides may contain substances that may pose a threat to the environment, crops, animals, and humans, inconsistent with the label and registration dossier. In Poland, action against illegal and counterfeit plant protection products is undertaken by the Main Inspectorate of Plant Health and Seed Inspection (PIORiN), the police, the prosecution, and the pesticide producers. Results of chemical analyses carried out by the Institute of Plant Protection - National Research Institute Sośnicowice Branch, Pesticide Quality Testing Laboratory (PQTL IPP-NRI Sosnicowice Branch) indicate that a majority of illegal pesticides in Poland are detected in the group of herbicides. Products from parallel trade tend to have the most irregularities. This article describes the official quality control system of plant protection products in Poland and presents the analytical methods for testing pesticides suspected of adulteration and recent test results.

  2. 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. Keywords: Taxes, Smoking, Tobacco products, Government regulation, Government

  3. 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.

  4. 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

    2016-01-01

    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. PMID:27487978

  5. Analytical challenges in drug counterfeiting and falsification-The NMR approach.

    Science.gov (United States)

    Holzgrabe, Ulrike; Malet-Martino, Myriam

    2011-06-25

    Counterfeiting of products is a global problem. As long as clothes, clocks, leather wear, etc. are faked there is no danger, but when it comes to drugs, counterfeiting can be life-threatening. In the last years sub-standard active pharmaceutical ingredients (APIs) were found more often even though the use of the quality-ensuring methods of international pharmacopoeias should have detected additional impurities and the low content of the API. Methods orthogonal to the separating methods used in the pharmacopoeias are necessary to find counterfeits. Beside Raman and NIR spectroscopies as well as powder X-ray analysis, NMR spectroscopy being a primary ratio method of measurement is highly suitable to identify and quantify a drug and its related substances as well as to recognize a drug of sub-standard quality. DOSY experiments are suitable to identify the ingredients of formulations and therefore to identify wrong and/or additional ingredients. This review gives an overview of the application of quantitative NMR spectroscopy and DOSY NMR in anticounterfeiting. Copyright © 2010 Elsevier B.V. All rights reserved.

  6. Preventing Wine Counterfeiting by Individual Cork Stopper Recognition Using Image Processing Technologies

    Directory of Open Access Journals (Sweden)

    Valter Costa

    2018-03-01

    Full Text Available Wine counterfeiting is a major problem worldwide. Within this context, an approach to the problem of discerning original wine bottles from forged ones is the use of natural features present in the product, object and/or material (using it “as is”. The proposed application uses the cork stopper as a unique fingerprint, combined with state of the art image processing techniques to achieve individual object recognition and smartphones as the authentication equipment. The anti-counterfeiting scheme is divided into two phases: an enrollment phase, where every bottle is registered in a database using a photo of its cork stopper inside the bottle; and a verification phase, where an end-user/retailer captures a photo of the cork stopper using a regular smartphone, compares the photo with the previously-stored one and retrieves it if the wine bottle was previously registered. To evaluate the performance of the proposed application, two datasets of natural/agglomerate cork stoppers were built, totaling 1000 photos. The worst case results show a 100% precision ratio, an accuracy of 99.94% and a recall of 94.00%, using different smartphones. The perfect score in precision is a promising result, proving that this system can be applied to the prevention of wine counterfeiting and consumer/retailer security when purchasing a wine bottle.

  7. 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.

  8. Suspect online sellers and contraceptive access.

    Science.gov (United States)

    Liang, Bryan A; Mackey, Tim K; Lovett, Kimberly M

    2012-11-01

    Issues surrounding contraception access have been a national focus. During this debate, adolescent and adult women may seek these products online. Due to safety concerns, including potential counterfeit forms, we wished to assess whether online "no prescription" contraceptives were available. We assessed online availability of reversible, prescription contraceptive methods resulting in online pharmacy marketing is shifting from direct search engine access to social media (Facebook, Twitter, Slidehare, flickr). Online contraceptive sales represent patient safety risks and a parallel system of high-risk product access absent professional guidance. Providers should educate patients, while policy makers employ legal strategies to address these systemic risks. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Substandard and counterfeit medicines: a systematic review of the literature

    Science.gov (United States)

    Almuzaini, Tariq; Choonara, Imti; Sammons, Helen

    2013-01-01

    Objective To explore the evidence available of poor-quality (counterfeit and substandard) medicines in the literature. Design Systematic review. Data sources Databases used were EMBASE, MEDLINE, PubMed and the International Pharmaceutical Abstracts, including articles published till January 2013. Eligibility criteria Prevalence studies containing original data. WHO definitions (1992) used for counterfeit and substandard medicines. Study appraisal and synthesis Two reviewers independently scored study methodology against recommendations from the MEDQUARG Checklist. Studies were classified according to the World Bank classification of countries by income. Data extraction Data extracted: place of study; type of drugs sampled; sample size; percentage of substandard/counterfeit medicines; formulations included; origin of the drugs; chemical analysis and stated issues of counterfeit/substandard medicines. Results 44 prevalence studies were identified, 15 had good methodological quality. They were conducted in 25 different countries; the majority were in low-income countries (11) and/or lower middle-income countries (10). The median prevalence of substandard/counterfeit medicines was 28.5% (range 11–48%). Only two studies differentiated between substandard and counterfeit medicines. Prevalence data were limited to antimicrobial drugs (all 15 studies). 13 studies involved antimalarials, 6 antibiotics and 2 other medications. The majority of studies (93%) contained samples with inadequate amounts of active ingredients. The prevalence of substandard/counterfeit antimicrobials was significantly higher when purchased from unlicensed outlets (pcounterfeit medicines. Most studies assessed only a single therapeutic class of antimicrobials. Conclusions The prevalence of poor-quality antimicrobial medicines is widespread throughout Africa and Asia in lower income countries and lower middle-income countries . The main problem identified was inadequate amounts of the active

  10. Strategies and Systems-Level Interventions to Combat or Prevent Drug Counterfeiting: A Systematic Review of Evidence Beyond Effectiveness.

    Science.gov (United States)

    Fadlallah, Racha; El-Jardali, Fadi; Annan, Farah; Azzam, Hayat; Akl, Elie A

    2016-01-01

    A recent systematic review suggested that drug registrations and onsite quality inspections may be effective in reducing the prevalence of counterfeit and substandard drugs. However, simply replicating the most effective interventions is problematic, as it denotes implementing the intervention without further adaptation. The aim was to systematically review the evidence beyond effectiveness for systems-level interventions to combat or prevent drug counterfeiting. We conducted an extensive search, including an electronic search of 14 databases. We included studies examining the efficiency, feasibility, reliability, and economic outcomes of the interventions, as well as barriers and facilitators to their implementation. Two reviewers selected eligible studies and abstracted data in duplicate and independently. We synthesized the results narratively, stratified by type of intervention. Of 10,220 captured citations, 19 met our inclusion criteria. The findings suggest that the following may strengthen regulatory measures (e.g., registration): minimizing drug diversion, enhancing lines of communications, ensuring feedback on drug quality, and promoting strict licensing criteria. There is evidence that onsite quality surveillance and inspection systems may be efficient and cost-effective for preliminary testing of large samples of drugs. Laws and legislation need to be specific to counterfeit drugs, include firm penalties, address online purchasing of drugs, and be complemented by education of judges and lawyers. Public awareness and education should rely on multiple platforms and comprehensive and dedicated content. While product authentication technologies may be efficient and reliable in detecting counterfeit drugs in the supply chain, they require a strong information system infrastructure. As for pharmacovigilance systems, it is critical to tackle the issue of underreporting, to enhance their chances of success. Several factors are critical to the successful design

  11. The music of gold: can gold counterfeited coins be detected by ear?

    Science.gov (United States)

    Manas, Arnaud

    2015-07-01

    In this paper I investigate whether it is true and to what extent counterfeit coins can be detected by their sound frequency. I describe the different types of counterfeit coins encountered and their respective characteristics. I then use the Kirchoff thin plate theory to model a coin, and confirm the validity of the theory by listening to the tone of genuine and counterfeit coins.

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

    Science.gov (United States)

    2016-02-01

    agencies and contractors we met with stated that they have encountered counterfeit parts less frequently in the DOD supply chain , in part, because...the DOD supply chain as a method to prevent further counterfeiting.22 DOD and industry officials noted that timely reporting of...COUNTERFEIT PARTS DOD Needs to Improve Reporting and Oversight to Reduce Supply Chain Risk Report to Congressional Committees

  13. The temperature-sensitive luminescence of (Y,Gd)VO4:Bi3+,Eu3+ and its application for stealth anti-counterfeiting

    International Nuclear Information System (INIS)

    Chen, Lei; Zhang, Yao; Luo, Anqi; Liu, Fayong; Jiang, Yang; Hu, Qingzhuo; Chen, Shifu; Liu, Ru-Shi

    2012-01-01

    Anti-counterfeiting technologies are desired to protect products far away from the violation of dummy, fake and shoddy goods. The phosphor of (Y,Gd)VO 4 :Bi 3+ ,Eu 3+ was synthesized for the application of this purpose. Its photoluminescence was investigated by exciting with different wavelengths at variant temperatures. Wide emission color ranged from green through yellow to orange was tuned up by tailor-ing Bi 3+ and Eu 3+ concentrations. The temperature dependent luminescence and wavelength selective excitation of (Y,Gd)VO 4 :Bi 3+ ,Eu 3+ were observed, which provide different encryptions in anti-counterfeiting. To verify the feasibility in application, two anti-counterfeiting patterns were fabricated practically and excellent performance was obtained. Moreover, the physical mechanisms for the different phenomena of luminescence were elucidated from excitation spectra combining with the configuration coordinate model. (copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  14. 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.

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

    African Journals Online (AJOL)

    Findings of the research revealed that the naira notes are to be classified as counterfeit or genuine according to the model: Z = 440.3007X - 858.8366Y + 147.5228Z such that Z > Z0 where Z0 is the end point of classification. Hotelling's T2 and Mahalanobis quantity were also computed. The test result showed that ...

  16. Near-infrared imaging spectroscopy for counterfeit drug detection

    Science.gov (United States)

    Arnold, Thomas; De Biasio, Martin; Leitner, Raimund

    2011-06-01

    Pharmaceutical counterfeiting is a significant issue in the healthcare community as well as for the pharmaceutical industry worldwide. The use of counterfeit medicines can result in treatment failure or even death. A rapid screening technique such as near infrared (NIR) spectroscopy could aid in the search for and identification of counterfeit drugs. This work presents a comparison of two laboratory NIR imaging systems and the chemometric analysis of the acquired spectroscopic image data. The first imaging system utilizes a NIR liquid crystal tuneable filter and is designed for the investigation of stationary objects. The second imaging system utilizes a NIR imaging spectrograph and is designed for the fast analysis of moving objects on a conveyor belt. Several drugs in form of tablets and capsules were analyzed. Spectral unmixing techniques were applied to the mixed reflectance spectra to identify constituent parts of the investigated drugs. The results show that NIR spectroscopic imaging can be used for contact-less detection and identification of a variety of counterfeit drugs.

  17. 78 FR 35262 - Detection and Avoidance of Counterfeit Electronic Parts

    Science.gov (United States)

    2013-06-12

    ... experts and interested parties in Government and the private sector regarding the electronic parts... Avoidance of Counterfeit Electronic Parts AGENCY: Defense Acquisition Regulations System, Department of... interested parties in Government and the private sector about the requirements for detection and avoidance of...

  18. Combining overt and covert anti-counterfeiting technologies for securities

    Science.gov (United States)

    Uematsu, Tsuyoshi

    2006-02-01

    The National Printing Bureau of Japan has been developing new anti-counterfeiting technologies as a banknote printer. Some of our technologies have already been effectively introduced into Japan's new banknote series. Anti-counterfeiting technologies can be applied not only to banknotes but also to other security documents depending on desired features. In this presentation, I will introduce three of our newly developed overt and covert security techniques, which are intended for document security and brand protection, as well as banknotes. "Metallic View" is mainly for offset printing. "Copy Check" (micro-structural lines involving luminescence) is for plate making technology. "ImageSwitch" is for a new security solution which has unlimited printing applications. All three techniques create "latent images" (some of which may be better known as "carrier screen images") that are useful in preventing counterfeiting. While each of the techniques is effective by itself, all are more effective when applied together. Combining these techniques could make all security documents harder to copy using IT scanners, and provide cost-effective anti-counterfeiting solutions for all security users.

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

    International Nuclear Information System (INIS)

    Philp, R.P.; Allen, J.; Kuder, T.

    2002-01-01

    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

  20. Effectiveness of medicines authentication technology to detect counterfeit, recalled and expired medicines: a two-stage quantitative secondary care study

    Science.gov (United States)

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

    2016-01-01

    Objectives To identify the authentication and detection rate of serialised medicines using medicines authentication technology. Design and intervention 4192 serialised medicines were entered into a hospital dispensary over two separate 8-week stages in 2015. Medicines were authenticated using secure external database cross-checking, triggered by the scanning of a two-dimensional data matrix with a unit specific 12-digit serial code. 4% of medicines included were preprogrammed with a message to identify the product as either expired, pack recalled, product recalled or counterfeit. Setting A site within a large UK National Health Service teaching hospital trust. Participants Accredited checking staff, pharmacists and dispensers in a pharmacy department. Primary outcome measures Authentication and detection rate of counterfeit expired and recalled medicines. Results The operational detection rate of counterfeit, recalled and expired medicines scanned as a combined group was 81.4% (stage 1 (S1)) and 87% (stage 2 (S2)). The technology's technical detection rate (TDR) was 100%; however, not all medicines were scanned and of those that were scanned not all that generated a warning message were quarantined. Owing to an operational authentication rate (OAR) of 66.3% (over both stages), only 31.8% of counterfeit medicines, 58% of recalled drugs and 64% of expired medicines were detected as a proportion of those entered into the study. Response times (RTs) of 152 ms (S1) and 165 ms (S2) were recorded, meeting the falsified medicines directive-mandated 300 ms limit. Conclusions TDRs and RTs were not a limiting factor in this study. The suboptimal OAR poses significant quality and safety issues with this detection approach. Authentication at the checking stage, however, demonstrated higher OARs. There is a need for further qualitative research to establish the reasons for less than absolute authentication and detection rates in the hospital environment to improve this

  1. Determination of suspected allergens in cosmetic products by headspace-programmed temperature vaporization-fast gas chromatography-quadrupole mass spectrometry.

    Science.gov (United States)

    del Nogal Sánchez, Miguel; Pérez-Pavón, José Luis; Moreno Cordero, Bernardo

    2010-07-01

    results--highly suitable for the determination of suspected allergens in different cosmetic products.

  2. Trends in counterfeits amphetamine-type stimulants after its prohibition in Brazil.

    Science.gov (United States)

    Mariotti, Kristiane de Cássia; Ortiz, Rafael S; Souza, Daniele Z; Mileski, Thayse C; Fröehlich, Pedro E; Limberger, Renata P

    2013-06-10

    Brazil is one of the world's highest users of anorectic drugs, mainly diethylpropione, fenproporex and sibutramine. The present work focuses on physical and chemical characteristics of 17 counterfeited capsules containing amphetamine-type stimulants (ATS) from three seizures conducted by Brazilian Federal Police. The physical profile was useful in indicating forgery, bring complementary information, but the use of this data singly was not sufficient to distinguish between authentic and counterfeited medicines. The chemical analysis revealed that the seizures capsules labeled as Desobesi-M (fenproporex 25mg), actually contained the active pharmaceutical ingrediente (API) sibutramine. The amount of this API ranged from 1/3 to 2 times the amount of drug found in commercial product, may reach twice the recommended daily dose. Multivariate analysis with application of principal component analysis on data from spectroscopy attenuated total reflectance Fourier transform infrared classified the samples according to their similarities, indicating that two seizures had common origin. This study represents the first step in the elucidation of falsification of ATS in Brazil. Considering the forensic intelligence these information are valuable in order to develop and establish a database that enables correlate samples from different locations and/or suppliers and to map the profile and trends of trafficking. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. An NFC-Enabled Anti-Counterfeiting System for Wine Industry

    OpenAIRE

    Yiu, Neo C. K.

    2016-01-01

    Wine counterfeiting is not a new problem, however, the situation in China has been going worse even after Hong Kong manifested itself as a wine trading and distribution center with abolishing all taxes on wine in 2008. The most basic method, printing a fake label with a subtly misspelled brand name or a slightly different logo in hopes of fooling wine consumers, has been common to other luxury-goods markets prone to counterfeiting. More ambitious counterfeiters might remove an authentic label...

  4. The Determinants of Purchase Intention towards Counterfeit Mobile Phones in Pakistan

    OpenAIRE

    Muhammad Rizwan; Muhammad Nasir Jamal; Zain-Ul-Abidin; Khadeeja Gul Zareen; Arslan Khan; Barza Farhat; Rashid Khan

    2013-01-01

    The alarming emergence of global economic phenomenon of counterfeiting and the deficiency of research work in the context of consumer purchase intentions towards counterfeits makes the study more worthwhile than ever before. This study intends to examine the relationship of value consciousness, low price, past experience peer pressure and attitude on consumer purchase intentions in the context of counterfeit mobile phones in Pakistan. A sample of 329 students with the help of a questionnaire ...

  5. Addressing Counterfeit Parts in the DoD Supply Chain

    Science.gov (United States)

    2014-03-01

    property rights to that part. Franchised distributor Distributor with which OCM has a contractual agreement to buy , stock, repackage, sell, and...because the DoD is not the largest buyer of microelectronics, the private sector market must buy into DNA tagging in order for manufacturers to include...tacitly acknowledged that “it is impossible to eliminate all risk of counterfeit in every system that the DoD buys or supports” (p. 3). Thus, Metzger

  6. 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.

  7. 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.

  8. 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

  9. Full evaporation dynamic headspace in combination with selectable one-dimensional/two-dimensional gas chromatography-mass spectrometry for the determination of suspected fragrance allergens in cosmetic products.

    Science.gov (United States)

    Devos, Christophe; Ochiai, Nobuo; Sasamoto, Kikuo; Sandra, Pat; David, Frank

    2012-09-14

    Suspected fragrance allergens were determined in cosmetic products using a combination of full evaporation-dynamic headspace (FEDHS) with selectable one-dimensional/two-dimensional GC-MS. The full evaporation dynamic headspace approach allows the non-discriminating extraction and injection of both apolar and polar fragrance compounds, without contamination of the analytical system by high molecular weight non-volatile matrix compounds. The method can be applied to all classes of cosmetic samples, including water containing matrices such as shower gels or body creams. In combination with selectable (1)D/(2)D GC-MS, consisting of a dedicated heart-cutting GC-MS configuration using capillary flow technology (CFT) and low thermal mass GC (LTM-GC), a highly flexible and easy-to-use analytical solution is offered. Depending on the complexity of the perfume fraction, analyses can be performed in one-dimensional GC-MS mode or in heart-cutting two-dimensional GC-MS mode, without the need of hardware reconfiguration. The two-dimensional mode with independent temperature control of the first and second dimension column is especially useful to confirm the presence of detected allergen compounds when mass spectral deconvolution is not possible. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Adulterated and Counterfeit Male Enhancement Nutraceuticals and Dietary Supplements Pose a Real Threat to the Management of Erectile Dysfunction: A Global Perspective.

    Science.gov (United States)

    ElAmrawy, Fatema; ElAgouri, Ghada; Elnoweam, Ola; Aboelazayem, Samar; Farouk, ElMohanad; Nounou, Mohamed I

    2016-11-01

    Erectile dysfunction prevalence globally is noticeably high. This is accompanied by an increase in the use of nutraceuticals for male enhancement. However, the global market is invaded by counterfeit and adulterated nutraceuticals claimed to be of natural origin sold with a therapeutic claim. The objective of this article is to review male enhancement nutraceuticals worldwide with respect to claim, adulterants, and safety. The definition of such products is variable across countries. Thus, the registration procedures differ as well. This facilitates the manipulation of the process, which leads to widespread adulterated and counterfeit products without control. The tele-advertisement and Internet pharmacies aided the widespread sale of male enhancement nutraceuticals, unfortunately, the spurious ones. Finally, based on literature, most of these products were found to be adulterated with active pharmaceutical ingredients (API) and mislabeled as being natural. These products represent a major health hazard for consumers due to lack of clear regulations.

  11. Establishment of a Fast Chemical Identification System for screening of counterfeit drugs of macrolide antibiotics.

    Science.gov (United States)

    Hu, Chang-Qin; Zou, Wen-Buo; Hu, Wang-Sheng; Ma, Xiao-Kang; Yang, Min-Zhi; Zhou, Shi-Lin; Sheng, Jin-Fang; Li, Yuan; Cheng, Shuang-Hong; Xue, Jing

    2006-01-23

    A Fast Chemical Identification System (FCIS) consisting of two colour reactions based on functional groups in molecules of macrolide antibiotics and two TLC methods was developed for screening of fake macrolide drugs. The active ingredients could be extracted from their oral preparations by absolute alcohol. Sulfuric acid reaction as a common reaction of macrolides was first used to distinguish the macrolides from other types of drugs and then 16-membered macrolides and 14-membered ones were distinguished by potassium permanganate reactions depending on the time of loss of colour in the test solution; after which a TLC method carried out on a GF(254) plate (5 cm x 10 cm) was chosen to further identification of the macrolides. The mobile phase A consisting of ethyl acetate, hexane and ammonia (100:15:15, v/v) was used for the identification of 14-membered macrolides, and the mobile phase B consisting of trichloromethane, methanol and ammonia (100:5:1, v/v) was used for the identification of 16-membered ones. A suspected counterfeit macrolide preparation can be identified within 40 min. The system can be used under different conditions and has the virtues of robustness, simplicity and speed.

  12. 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

  13. 31 CFR 101.4 - Extraction of gold bullion from the counterfeit coins.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Extraction of gold bullion from the... MITIGATION OF FORFEITURE OF COUNTERFEIT GOLD COINS § 101.4 Extraction of gold bullion from the counterfeit... Bureau of the Mint where, if economically feasible, the gold bullion will be extracted from the...

  14. 75 FR 36062 - Notice of Enforcement Policy Symposium on Combating Counterfeiting in the 21st Century

    Science.gov (United States)

    2010-06-24

    ... second panel on criminal procedure will involve a discussion of enforcement policy involving the... Enforcement Policy Symposium on Combating Counterfeiting in the 21st Century AGENCY: United States Patent and... United States Government enforcement policy regarding counterfeit goods involving health and safety...

  15. PREFACE: Anti-counterfeit Image Analysis Methods (A Special Session of ICSXII)

    Science.gov (United States)

    Javidi, B.; Fournel, T.

    2007-06-01

    The International Congress for Stereology is dedicated to theoretical and applied aspects of stochastic tools, image analysis and mathematical morphology. A special emphasis on `anti-counterfeit image analysis methods' has been given this year for the XIIth edition (ICSXII). Facing the economic and social threat of counterfeiting, this devoted session presents recent advances and original solutions in the field. A first group of methods are related to marks located either on the product (physical marks) or on the data (hidden information) to be protected. These methods concern laser fs 3D encoding and source separation for machine-readable identification, moiré and `guilloche' engraving for visual verification and watermarking. Machine-readable travel documents are well-suited examples introducing the second group of methods which are related to cryptography. Used in passports for data authentication and identification (of people), cryptography provides some powerful tools. Opto-digital processing allows some efficient implementations described in the papers and promising applications. We would like to thank the reviewers who have contributed to a session of high quality, and the authors for their fine and hard work. We would like to address some special thanks to the invited lecturers, namely Professor Roger Hersch and Dr Isaac Amidror for their survey of moiré methods, Prof. Serge Vaudenay for his survey of existing protocols concerning machine-readable travel documents, and Dr Elisabet Pérez-Cabré for her presentation on optical encryption for multifactor authentication. We also thank Professor Dominique Jeulin, President of the International Society for Stereology, Professor Michel Jourlin, President of the organizing committee of ICSXII, for their help and advice, and Mr Graham Douglas, the Publisher of Journal of Physics: Conference Series at IOP Publishing, for his efficiency. We hope that this collection of papers will be useful as a tool to further

  16. 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. 

  17. 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

  18. Preparation and RGB upconversion optic properties of transparent anti-counterfeiting films.

    Science.gov (United States)

    Yao, Weijing; Tian, Qingyong; Liu, Jun; Xue, Qingwen; Li, Mengxiao; Liu, Li; Lu, Qiang; Wu, Wei

    2017-10-26

    Advanced anti-counterfeiting labels have aroused an intensive interest in packaging industry to avoid the serious issue of counterfeit. However, the preparation and cost of the existing labels associated with the drawbacks, including the complex and high-cost equipment, limit the protection of the authenticity of goods. Herein, we developed a series of anti-counterfeiting labels based on multicolor upconversion micro-particles (UCMPs) inks via straightforward and low-cost solutions, including spin-coating, stamping and screen printing. The UCMPs were synthesized through a facile hydrothermal process and displayed tunable red (R), green (G) and blue (B) color by doping different lanthanide ions, which are Er 3+ /Tm 3+ , Yb 3+ /Er 3+ and Yb 3+ /Tm 3+ in NaYF 4 hosts, respectively. The optimal UCMPs inks were deposited on a flexible polyethylene terephthalate (PET) substrate to obtain transparent anti-counterfeiting labels possessing higher transmittance, stronger upconversion fluorescence intensity and good photostability. Under ambient conditions, the patterns and films were transparent, but could exhibit multicolor light under 980 nm laser excitation. They can be used as anti-counterfeiting labels for die-cutting packages to further elevate the security of goods. The tunable and designable transparent anti-counterfeiting labels based on RGB UCMPs inks exhibit the merits of low-cost, easy-manufacture and versatility, underlying the practical application in the field of anti-counterfeiting.

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

    Science.gov (United States)

    Guan, Yajing; Wang, Jianchen; Tian, Yixin; Hu, Weimin; Zhu, Liwei; Zhu, Shuijin; Hu, Jin

    2013-01-01

    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.

  20. 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.

  1. Screen-printed nanoparticles as anti-counterfeiting tags

    Science.gov (United States)

    Campos-Cuerva, Carlos; Zieba, Maciej; Sebastian, Victor; Martínez, Gema; Sese, Javier; Irusta, Silvia; Contamina, Vicente; Arruebo, Manuel; Santamaria, Jesus

    2016-03-01

    Metallic nanoparticles with different physical properties have been screen printed as authentication tags on different types of paper. Gold and silver nanoparticles show unique optical signatures, including sharp emission bandwidths and long lifetimes of the printed label, even under accelerated weathering conditions. Magnetic nanoparticles show distinct physical signals that depend on the size of the nanoparticle itself. They were also screen printed on different substrates and their magnetic signals read out using a magnetic pattern recognition sensor and a vibrating sample magnetometer. The novelty of our work lies in the demonstration that the combination of nanomaterials with optical and magnetic properties on the same printed support is possible, and the resulting combined signals can be used to obtain a user-configurable label, providing a high degree of security in anti-counterfeiting applications using simple commercially-available sensors.

  2. 75 FR 79069 - Anti-Counterfeiting Trade Agreement: Request for Comments From the Public

    Science.gov (United States)

    2010-12-17

    ... proposed agreement to strengthen international cooperation, enforcement practices and legal frameworks for... international cooperation and to promote strong enforcement practices. Together these provisions will help to... OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE Anti-Counterfeiting Trade Agreement: Request for...

  3. Louis Vuitton in the bazaar: Negotiating the value of counterfeit goods in Shanghai's Xiangyang market

    OpenAIRE

    Hansen, Gard Hopsdal; Møller, Henrik Kloppenborg

    2017-01-01

    Abstract: Much work on counterfeiting takes the perspective of brand holders and focuses on strategies for restricting the infringement of their intellectual property rights (IPR). This article takes a different approach. Based on long-term ethnographic fieldwork in a market bazaar in Shanghai, the article examines the way in which market participants negotiate the value of counterfeit goods. Brand holders attempt to control the valuation of branded goods, which are usually traded in fixed-pr...

  4. Raman spectroscopy, a non-invasive mesurement technique for the detection of counterfeit medicines

    OpenAIRE

    Marta, Teresa Rita Pitorra

    2016-01-01

    Tese de mestrado, Engenharia Farmacêutica, Universidade de Lisboa, Faculdade de Farmácia, 2016 Perhaps no greater challenge exists for public health, patient safety, and shared global health security, than fake, falsified, fraudulent or poor quality unregulated medicines - also commonly known as “counterfeit medicines” - now endemic in the global drug supply chain (Tim K Mackey & Liang, 2013). Counterfeit medicines pose a serious risk to public health around the world. It is low- and mi...

  5. Positive Effects Of Counterfeiting On Luxury Goods: An Empirical Exploration With Consumers

    OpenAIRE

    Giacomo Gistri; Stefano Pace; Simona Romani

    2011-01-01

    In this study we explore the positive effects that counterfeiting might have on the original luxury brands. Through an experiment, we study whether the awareness of a counterfeited version of a fashion luxury brand can increase the purchase intention of the original brands and the price that subjects would like to pay to get the original brand. We account for the notoriety of the brand (whether well known or fictional). We control for the need for status and the expertise of the respondents. ...

  6. ATR-FTIR for rapid detection and quantification of counterfeit medicines

    OpenAIRE

    Ogwu, John; Lawson, Graham; Tanna, Sangeeta

    2015-01-01

    From therapeutic to lifestyle medicines, the counterfeiting of medicines has been on the rise in recent times [1]. Estimates indicate that about 10% of medicines worldwide are counterfeits with much higher figures in developing countries [2]. Currently, the rapid screening of medicines is a challenge leaving many patients at risk [1]. This study considered the potential use of Attenuated Total Reflectance-Fourier Transform Infrared Spectroscopy (ATR-FTIR) for rapid quantitative analysis of ta...

  7. The temperature-sensitive luminescence of (Y,Gd)VO{sub 4}:Bi{sup 3+},Eu{sup 3+} and its application for stealth anti-counterfeiting

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Lei; Zhang, Yao; Luo, Anqi; Liu, Fayong; Jiang, Yang; Hu, Qingzhuo [School of Materials Science and Engineering, Hefei University of Technology (China); Chen, Shifu [Department of Chemistry, Huaibei Normal University (China); Liu, Ru-Shi [Department of Chemistry, National Taiwan University, Taipei (China)

    2012-07-15

    Anti-counterfeiting technologies are desired to protect products far away from the violation of dummy, fake and shoddy goods. The phosphor of (Y,Gd)VO{sub 4}:Bi{sup 3+},Eu{sup 3+} was synthesized for the application of this purpose. Its photoluminescence was investigated by exciting with different wavelengths at variant temperatures. Wide emission color ranged from green through yellow to orange was tuned up by tailor-ing Bi{sup 3+} and Eu{sup 3+} concentrations. The temperature dependent luminescence and wavelength selective excitation of (Y,Gd)VO{sub 4}:Bi{sup 3+},Eu{sup 3+} were observed, which provide different encryptions in anti-counterfeiting. To verify the feasibility in application, two anti-counterfeiting patterns were fabricated practically and excellent performance was obtained. Moreover, the physical mechanisms for the different phenomena of luminescence were elucidated from excitation spectra combining with the configuration coordinate model. (copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  8. 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.

  9. 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.

  10. 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.

  11. ROLE OF THE INTERNATIONAL ORGANIZATIONS IN PREVENTING THE COUNTERFEIT MEDICINES ENTRY INTO THE WORLD MARKETS.

    Science.gov (United States)

    Stukina, Valeryia; Dohnal, Jiri; Saloun, Jan

    2016-09-01

    30 years have passed since Conference of Experts on the Rational Use of Drugs was held in Nairobi, Kenya, from 25 to 29 November 1985, where the problem of counterfeit medicines was mentioned as the international for the first time. The problem of counterfeit medicines is not only a major threat to public health and national and private economy, but also it is of great interest for key decision-making actors at the international level. The authors analyzed what has been done since that time by international organizations. Combating the counterfeiting of medicines cannot be successfully achieved by the health sector alone - World Health Organization (WHO), - so the efforts of the other United Nations (UN) organizations relevant to counterfeiting were in need and were studied in the article: World Intellectual Property Organization (WIPO), World Trade Organization (WTO), World Customs Organization (WCO), United Nations Office on Drugs and Crime (UNODC), etc. Today WHO is unable to coordinate all their activities, so the few existing proposals for establishing a new mechanism of international cooperation have been examined. Will the MEDICRIME Convention that will enter into force on January 1, 2016 be the start of the new era in the combating with the counterfeit medicines? - the authors offered their vision on the international developments.

  12. 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.

  13. Presence of Counterfeit Marlboro Gold Packs in Licensed Retail Stores in New York City: Evidence From Test Purchases.

    Science.gov (United States)

    Kurti, Marin; He, Yi; Silver, Diana; Giorgio, Margaret; von Lampe, Klaus; Macinko, James; Ye, Hua; Tan, Fidelis; Mei, Victoria

    2018-05-26

    There are no independent studies measuring the availability of premium brand counterfeit cigarettes in New York City from licensed retailers. We forensically analyzed the cigarette packaging of Marlboro Gold (n = 1021) purchased from licensed tobacco retailers in New York City, using ultraviolet irradiation and light microscopy to determine whether they were counterfeit. We find that while only 0.5% (n = 5) of our sample exhibits at least one characteristic synonymous with counterfeit packaging, none of our packs can be conclusively classified as counterfeit. We do not find any counterfeit Marlboro Gold packs purchased at full price from licensed cigarette retailers throughout New York City. Future research using test purchases should include other venues (eg, street and online) and specifically ask for discounts to ascertain the overall presence of counterfeit cigarettes. This is the first study to independently measure the availability of counterfeit cigarette packs purchased at full price from licensed retailers in New York City. We find that none of the Marlboro Gold packs purchased from licensed cigarette retailers are counterfeit.

  14. 76 FR 48905 - United States Government Inter-Agency Anti-Counterfeiting Working Group: Request for Public...

    Science.gov (United States)

    2011-08-09

    ... program managers to identify items at risk for counterfeiting or requiring authentication of legitimacy... program managers to identify items at risk for counterfeiting or requiring authentication of legitimacy... identification marking methods impose a substantial burden on manufacturers/suppliers? Identify the types of...

  15. 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.

  16. Spurious and counterfeit drugs: a growing industry in the developing world.

    Science.gov (United States)

    Gautam, C S; Utreja, A; Singal, G L

    2009-05-01

    Spread of spurious/counterfeit/substandard drugs is a modern day menace which has been recognised internationally, especially so in developing countries. The problem assumes added significance in view of rapid globalisation. The market of spurious and counterfeit drugs is a well-organised, white collar crime. Poverty, high cost of medicines, lack of an official supply chain, legislative lacunae, easy accessibility to computerised printing technology, ineffective law enforcement machinery, and light penalties provide the counterfeiters with an enormous economic incentive without much risk. The consequences of the use of such medicines may vary from therapeutic failure to the occurrence of serious adverse events and even death. Proper drug quality monitoring, enforcement of laws and legislation, an effective and efficient regulatory environment, and awareness and vigilance on part of all stakeholders can help tackle this problem.

  17. Laser photothermal diagnostics of genuine and counterfeit British and United States banknotes

    Science.gov (United States)

    Othonos, Andreas; Mandelis, Andreas; Nestoros, Marios; Christofides, Constantinos

    1997-02-01

    Laser-induced, frequency-scanned IR photothermal radiometry was used to investigate the thermophysical properties of the paper on which several genuine and counterfeit British (10 pounds) and U.S. ($DOL50, $DOL100) currency bills were printed. The radiometric photothermal amplitudes and phases were further compared with a theoretical model, which yielded simultaneous quantitative measurements of the thermal diffusivities and conductivities of the bills. Both statistical and single-specimen results demonstrated the excellent thermophysical resolution of the technique with prospects for its use in the nonintrusive, on-line identification of counterfeit banknotes.

  18. NFC based Equipment Qualification Management (NEQM) system preventing counterfeit and fraudulent item

    Energy Technology Data Exchange (ETDEWEB)

    Chang, C.K., E-mail: ckchang@kings.ac.kr [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of); Lee, K.J., E-mail: klee@khu.ac.kr [Kyung Hee Univ., Seoul (Korea, Republic of)

    2014-07-01

    Qualification of equipment essential to safety in nuclear power plants (NPPs) ensures its capability to perform designated safety functions on demand under postulated service conditions. However, a number of incidents identified by the NRC since 1980s catalysed the US nuclear industry to adopt standard precautions to guard against counterfeit items. The purpose of this paper is to suggest the NFC (Near Field Communication) based equipment qualification management system preventing counterfeit and fraudulent items. The NEQM (NFC based Equipment Qualification Management) system work with the support of legacy systems such as PMS (Procurement Management System) and FMS (Facility management System). (author)

  19. NFC based Equipment Qualification Management (NEQM) system preventing counterfeit and fraudulent item

    International Nuclear Information System (INIS)

    Chang, C.K.; Lee, K.J.

    2014-01-01

    Qualification of equipment essential to safety in nuclear power plants (NPPs) ensures its capability to perform designated safety functions on demand under postulated service conditions. However, a number of incidents identified by the NRC since 1980s catalysed the US nuclear industry to adopt standard precautions to guard against counterfeit items. The purpose of this paper is to suggest the NFC (Near Field Communication) based equipment qualification management system preventing counterfeit and fraudulent items. The NEQM (NFC based Equipment Qualification Management) system work with the support of legacy systems such as PMS (Procurement Management System) and FMS (Facility management System). (author)

  20. 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

  1. 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.

  2. NFC based Inspection and Qualification Management (NIQM) System Preventing Counterfeit and Fraudulent Item

    International Nuclear Information System (INIS)

    Chang, Choong Koo; Kim, Young Joo

    2013-01-01

    Design, manufacturing, fabrication, transportation and installation of the devices and equipment for nuclear power plants shall be conducted under the thorough quality assurance program for the nuclear safety. However, from late in the 1980s, NRC began to issue a number of communications alerting licenses to issues involving counterfeit and fraudulent items. A number of incidents identified by the NRC in the 1980s and 1990s catalyzed the US nuclear industry to adopt standard precautions to guard against counterfeit items. The purpose of this paper is to develop the NFC (Near Field Communication) based Inspection and Qualification Management(NIQM) system preventing counterfeit and fraudulent items. NFC is one of the latest wireless communication technologies. As a short-range wireless connectivity technology, NFC offers safe-yet simple and intuitive-communication between electronic devices. As described above, NFC technology can be applied to the inspection and qualification management system very effectively to prevent counterfeit and fraudulent items. In addition, NIQM system can use existing data and information through the interface with legacy system

  3. NFC based Inspection and Qualification Management (NIQM) System Preventing Counterfeit and Fraudulent Item

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Choong Koo; Kim, Young Joo [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2013-10-15

    Design, manufacturing, fabrication, transportation and installation of the devices and equipment for nuclear power plants shall be conducted under the thorough quality assurance program for the nuclear safety. However, from late in the 1980s, NRC began to issue a number of communications alerting licenses to issues involving counterfeit and fraudulent items. A number of incidents identified by the NRC in the 1980s and 1990s catalyzed the US nuclear industry to adopt standard precautions to guard against counterfeit items. The purpose of this paper is to develop the NFC (Near Field Communication) based Inspection and Qualification Management(NIQM) system preventing counterfeit and fraudulent items. NFC is one of the latest wireless communication technologies. As a short-range wireless connectivity technology, NFC offers safe-yet simple and intuitive-communication between electronic devices. As described above, NFC technology can be applied to the inspection and qualification management system very effectively to prevent counterfeit and fraudulent items. In addition, NIQM system can use existing data and information through the interface with legacy system.

  4. 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/.

  5. 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

  6. 31 CFR 100.18 - Counterfeit notes to be marked; “redemption” of notes wrongfully so marked.

    Science.gov (United States)

    2010-07-01

    ... moneys, and all officers of national banks, shall stamp or write in plain letters the word “counterfeit... money, which shall be presented at their places of business; and if such officers shall wrongfully stamp...

  7. High-throughput fabrication of anti-counterfeiting colloid-based photoluminescent microtags using electrical nanoimprint lithography

    International Nuclear Information System (INIS)

    Diaz, R; Palleau, E; Poirot, D; Sangeetha, N M; Ressier, L

    2014-01-01

    This work demonstrates the excellent capability of the recently developed electrical nanoimprint lithography (e-NIL) technique for quick, high-throughput production of well-defined colloid assemblies on surfaces. This is shown by fabricating micron-sized photoluminescent quick response (QR) codes based on the electrostatic directed trapping (so called nanoxerography process) of 28 nm colloidal lanthanide-doped upconverting NaYF 4 nanocrystals. Influencing experimental parameters have been optimized and the contribution of triboelectrification in e-NIL was evidenced. Under the chosen conditions, more than 300 000 nanocrystal-based QR codes were fabricated on a 4 inch silicon wafer, in less than 15 min. These microtags were then transferred to transparent flexible films, to be easily integrated onto desired products. Invisible to the naked eye, they can be decoded and authenticated using an optical microscopy image of their specific photoluminescence mapping. Beyond this very promising application for product tracking and the anti-counterfeiting strategies, e-NIL nanoxerography, potentially applicable to any types of charged and/or polarizable colloids and pattern geometries opens up tremendous opportunities for industrial scale production of various other kinds of colloid-based devices and sensors. (paper)

  8. Prime Suspect, Second Row Center

    Science.gov (United States)

    Laird, Ellen A.

    2011-01-01

    His father had been hacked to death in his own bed with an ax the previous November. His mother was similarly brutalized and left for dead with her husband but survived. On the last Monday of that August, after several months and many investigative twists, turns, and fumbles, there sat the son--the prime suspect--in Ellen Laird's literature class,…

  9. Through-container, extremely low concentration detection of multiple chemical markers of counterfeit alcohol using a handheld SORS device

    OpenAIRE

    Ellis, David; R, Eccles; Xu, Yun; J, Griffen; Muhamadali, H; P, Matousek; Goodall, I; Goodacre, Royston

    2017-01-01

    Major food adulteration incidents occur with alarming frequency and are episodic, with the latest incident, involving the adulteration of meat from 21 producers in Brazil supplied to 60 other countries, reinforcing this view. Food fraud and counterfeiting involves all types of foods, feed, beverages, and packaging, with the potential for serious health, as well as significant economic and social impacts. In the spirit drinks sector, counterfeiters often ‘recycle’ used genuine packaging, or em...

  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. Invisible marking system by extreme ultraviolet radiation: the new frontier for anti-counterfeiting tags

    International Nuclear Information System (INIS)

    Lazzaro, P. Di; Bollanti, S.; Flora, F.; Mezi, L.; Murra, D.; Torre, A.; Bonfigli, F.; Montereali, R.M.; Vincenti, M.A.

    2016-01-01

    We present a marking technology which uses extreme ultraviolet radiation to write invisible patterns on tags based on alkali fluoride thin films. The shape of the pattern is pre-determined by a mask (in the case of contact lithography) or by a suitable mirror (projection lithography). Tags marked using this method offer a much better protection against fakes than currently available anti-counterfeiting techniques. The complexity and cost of this technology can be tailored to the value of the good to be protected, leaving, on the other hand, the specific reading technique straightforward. So far, we have exploited our invisible marking to tag artworks, identity cards, electrical components, and containers of radioactive wastes. Advantages and limits of this technology are discussed in comparison with the anti-counterfeiting systems available in the market.

  12. 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

  13. A Script Analysis of the Distribution of Counterfeit Alcohol Across Two European Jurisdictions

    OpenAIRE

    Lord, Nicholas; Spencer, Jonathan; Bellotti, Elisa; Benson, Katie

    2017-01-01

    This article presents a script analysis of the distribution of counterfeit alcohols across two European jurisdictions. Based on an analysis of case file data from a European regulator and interviews with investigators, the article deconstructs the organisation of the distribution of the alcohol across jurisdictions into five scenes (collection, logistics, delivery, disposal, proceeds/finance) and analyses the actual (or likely permutations of) behaviours within each scene. The analysis also i...

  14. 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.

  15. 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

  16. 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

  17. 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

  18. Anti-Counterfeiting Quick Response Code with Emission Color of Invisible Metal-Organic Frameworks as Encoding Information.

    Science.gov (United States)

    Wang, Yong-Mei; Tian, Xue-Tao; Zhang, Hui; Yang, Zhong-Rui; Yin, Xue-Bo

    2018-06-08

    Counterfeiting is a global epidemic that is compelling the development of new anti-counterfeiting strategy. Herein, we report a novel multiple anti-counterfeiting encoding strategy of invisible fluorescent quick response (QR) codes with emission color as information storage unit. The strategy requires red, green, and blue (RGB) light-emitting materials for different emission colors as encrypting information, single excitation for all of the emission for practicability, and ultraviolet (UV) excitation for invisibility under slight. Therefore, RGB light-emitting nanoscale metal-organic frameworks (NMOFs) are designed as inks to construct the colorful light-emitting boxes for information encrypting, while three black vertex boxes were used for positioning. Full-color emissions are obtained by mixing the trichromatic NMOFs inks through inkjet printer. The encrypting information capacity is easily adjusted by the number of light-emitting boxes with the infinite emission colors. The information is decoded with specific excitation light at 275 nm, making the QR codes invisible under daylight. The composition of inks, invisibility, inkjet printing, and the abundant encrypting information all contribute to multiple anti-counterfeiting. The proposed QR codes pattern holds great potential for advanced anti-counterfeiting.

  19. 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

  20. Cooperation Agreement between the European Central Bank and Europol for Combating Euro Counterfeiting. Some Critical Opinions

    Directory of Open Access Journals (Sweden)

    Bogdan Birzu

    2016-08-01

    Full Text Available Within this paper there has been examined the Agreement between the European Police Office (Europol and the European Central Bank (ECB for preventing and combating euro counterfeiting, focusing on certain provisions which take into account the aim and the exchange of information between the two European institutions. The novelty of this paper relates to the achieved examination, where it is highlighted the importance of European legal instrument and the critical opinions and proposals for improving the agreement. The paper can be useful to academics and practitioners who conduct their activity within this area.

  1. 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.

  2. Magnetic-graphitic-nanocapsule templated diacetylene assembly and photopolymerization for sensing and multicoded anti-counterfeiting

    Science.gov (United States)

    Nie, Xiang-Kun; Xu, Yi-Ting; Song, Zhi-Ling; Ding, Ding; Gao, Feng; Liang, Hao; Chen, Long; Bian, Xia; Chen, Zhuo; Tan, Weihong

    2014-10-01

    Molecular self-assembly, a process to design molecular entities to aggregate into desired structures, represents a promising bottom-up route towards precise construction of functional systems. Here we report a multifunctional, self-assembled system based on magnetic-graphitic-nanocapsule (MGN) templated diacetylene assembly and photopolymerization. The as-prepared assembly system maintains the unique color and fluorescence change properties of the polydiacetylene (PDA) polymers, while also pursues the superior Raman, NIR, magnetic and superconducting properties from the MGN template. Based on both fluorescence and magnetic resonance imaging (MRI) T2 relaxivity, the MGN@PDA system could efficiently monitor the pH variations which could be used as a pH sensor. The MGN@PDA system further demonstrates potential as unique ink for anti-counterfeiting applications. Reversible color change, strong and unique Raman scattering and fluorescence emission, sensitive NIR thermal response, and distinctive magnetic properties afford this assembly system with multicoded anti-counterfeiting capabilities.Molecular self-assembly, a process to design molecular entities to aggregate into desired structures, represents a promising bottom-up route towards precise construction of functional systems. Here we report a multifunctional, self-assembled system based on magnetic-graphitic-nanocapsule (MGN) templated diacetylene assembly and photopolymerization. The as-prepared assembly system maintains the unique color and fluorescence change properties of the polydiacetylene (PDA) polymers, while also pursues the superior Raman, NIR, magnetic and superconducting properties from the MGN template. Based on both fluorescence and magnetic resonance imaging (MRI) T2 relaxivity, the MGN@PDA system could efficiently monitor the pH variations which could be used as a pH sensor. The MGN@PDA system further demonstrates potential as unique ink for anti-counterfeiting applications. Reversible color change

  3. Presentation of suspected pediatric uveitis.

    Science.gov (United States)

    Saeed, Muhammad Usman; Raza, Syed Hamid; Goyal, Sudeshna; Cleary, Gavin; Newman, William David; Chandna, Arvind

    2014-01-01

    Presentation of suspected pediatric uveitis: Pediatric uveitis is usually managed in specialized ophthalmic centers in the UK. Meaningful data acquisition in these clinics may be helpful in clinical governance, and healthcare planning in a specialty that is gradually changing due to changes in treatment choices. Retrospective analysis of prospectively acquired data in the Liverpool pediatric uveitis database was performed. Analysis of our data, based on 147 patients, with a mean age of 10 years, indicated a female to male ratio of 2:1. 99% of patients were Caucasian. Our data indicates 86% of all patients attending the uveitis clinic were diagnosed with juvenile idiopathic arthritis, followed by intermediate uveitis 5% and idiopathic uveitis 4%. 46% of patients required treatment. Systemic treatment included methotrexate (34%), prednisolone (14%), etanercept (6%), ciclosporin (6%), mycophenolate (3%), and infliximab (1%). Severe visual loss (defined by counting fingers or below vision) was seen in 10 eyes despite appropriately treated chronic uveitis. Our data shows uveitis-related ocular morbidity in a predominantly pediatric Caucasian population. Patients with severe and chronic uveitis may experience significant uveitis-related complications and subsequent visual loss despite aggressive treatment.

  4. Photoluminescence of patterned CdSe quantum dot for anti-counterfeiting label on paper

    International Nuclear Information System (INIS)

    Isnaeni,; Yulianto, Nursidik; Suliyanti, Maria Margaretha

    2016-01-01

    We successfully developed a method utilizing colloidal CdSe nanocrystalline quantum dot for anti-counterfeiting label on a piece of glossy paper. We deposited numbers and lines patterns of toluene soluble CdSe quantum dot using rubber stamper on a glossy paper. The width of line pattern was about 1-2 mm with 1-2 mm separation between lines. It required less than one minute for deposited CdSe quantum dot on glossy paper to dry and become invisible by naked eyes. However, patterned quantum dot become visible using long-pass filter glasses upon excitation of UV lamp or blue laser. We characterized photoluminescence of line patterns of quantum dot, and we found that emission boundaries of line patterns were clearly observed. The error of line size and shape were mainly due to defect of the original stamper. The emission peak wavelength of CdSe quantum dot was 629 nm. The emission spectrum of deposited quantum dot has full width at half maximum (FWHM) of 30-40 nm. The spectra similarity between deposited quantum dot and the original quantum dot in solution proved that our stamping method can be simply applied on glossy paper without changing basic optical property of the quantum dot. Further development of this technique is potential for anti-counterfeiting label on very important documents or objects.

  5. Photoluminescence of patterned CdSe quantum dot for anti-counterfeiting label on paper

    Energy Technology Data Exchange (ETDEWEB)

    Isnaeni,, E-mail: isnaeni@lipi.go.id; Yulianto, Nursidik; Suliyanti, Maria Margaretha [Research Center for Physics, Indonesian Institute of Sciences, Building 442, Kawasan Puspiptek, South Tangerang,Banten 15314 Indonesia (Indonesia)

    2016-03-11

    We successfully developed a method utilizing colloidal CdSe nanocrystalline quantum dot for anti-counterfeiting label on a piece of glossy paper. We deposited numbers and lines patterns of toluene soluble CdSe quantum dot using rubber stamper on a glossy paper. The width of line pattern was about 1-2 mm with 1-2 mm separation between lines. It required less than one minute for deposited CdSe quantum dot on glossy paper to dry and become invisible by naked eyes. However, patterned quantum dot become visible using long-pass filter glasses upon excitation of UV lamp or blue laser. We characterized photoluminescence of line patterns of quantum dot, and we found that emission boundaries of line patterns were clearly observed. The error of line size and shape were mainly due to defect of the original stamper. The emission peak wavelength of CdSe quantum dot was 629 nm. The emission spectrum of deposited quantum dot has full width at half maximum (FWHM) of 30-40 nm. The spectra similarity between deposited quantum dot and the original quantum dot in solution proved that our stamping method can be simply applied on glossy paper without changing basic optical property of the quantum dot. Further development of this technique is potential for anti-counterfeiting label on very important documents or objects.

  6. 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.

  7. 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

  8. Interventions for suspected placenta praevia.

    Science.gov (United States)

    Neilson, J P

    2003-01-01

    . Available data should, however, encourage further work to address the safety of more conservative policies of hospitalisation for women with suspected placenta praevia, and the possible value of insertion of a cervical suture.

  9. Aspect of the Characters from The Counterfeiters of André Gide

    Directory of Open Access Journals (Sweden)

    Hülya Kol

    2017-07-01

    Full Text Available As a pastry chef, the writer André Gide kneads his dough differently with the intention of putting an end to imitation in the world of the novel. He has the courage to treat the subject of the novel on the contrary to his contemporaries. He succeeds by introducing the reader into the novel. The reader finds fantastic stories and interesting characters in The Counterfeiters. Themes such as the hypocrisy and falsity of these characters are a reflection of the title that evokes them. Gide transmits this problematic period to the reader with surprising skill. The contrast in the words and behaviors of people are the evil traces of war.

  10. Fingerprint detection on counterfeit US dollar banknotes: the importance of preliminary paper examination.

    Science.gov (United States)

    Azoury, Myriam; Cohen, Drorit; Himberg, Kimmo; Qvintus-Leino, Pia; Saari, Terhi; Almog, Joseph

    2004-09-01

    Two seizures of counterfeit 100 US dollar bills related to the same indicative number were submitted for processing of latent fingerprints. On one group of notes, identifiable fingerprints could be detected by the routine application of amino acid reagents. In the second case, this technique gave no results, even on deliberately deposited prints. Fingerprints could be revealed, however, by cyanoacrylate fuming followed by magnetic powder. Comprehensive paper analysis showed that banknotes from both seizures differed remarkably by chemical composition as well as paper macroscopic properties. The difference in surface free energy (related to surface tension) of the banknotes in the two groups seemed to be the major factor responsible for the great variance in fingerprint detectability.

  11. 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.

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

    OpenAIRE

    Maria Neufeld; Dirk W. Lachenmeier; Stephan G. Walch; Jürgen Rehm

    2017-01-01

    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 t...

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

    OpenAIRE

    Maria Neufeld; Dirk W. Lachenmeier; Stephan G. Walch; Jürgen Rehm

    2017-01-01

    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 t...

  14. Handbook for Response to Suspect Radioactive Materials

    International Nuclear Information System (INIS)

    Cliff, William C.; Pappas, Richard A.; Arthur, Richard J.

    2005-01-01

    This document provides response actions to be performed following the initial port, airport, or border crossing discovery of material that is suspected of being radioactive. The purpose of this guide is to provide actions appropriate for handling radioactive material

  15. 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.

    2016-07-01

    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.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

  16. Is That a Nike? The Purchase of Counterfeit Sporting Goods through the Lens of the Theory of Planned Behavior

    OpenAIRE

    Weisheng Chiu; Ho Keat Leng

    2015-01-01

    The purpose of this study was to examine the consumer behavior related to the purchase of counterfeit sporting goods (CSGs) based on the theory of planned behavior. The results showed that consumers’ attitude, subjective norm, and brand consciousness were predictive of purchase intention, whereas perceived behavioral control had no influence on purchase intention. Moreover, both risk averseness and sport involvement negatively led to consumers’ attitude toward CSGs. The paper ends with a disc...

  17. The internet trade of counterfeit spirits in Russia – an emerging problem undermining alcohol, public health and youth protection policies?

    Science.gov (United States)

    Neufeld, Maria; Lachenmeier, Dirk W.; Walch, Stephan G.; Rehm, Jürgen

    2017-01-01

    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. PMID:28663784

  18. The internet trade of counterfeit spirits in Russia - an emerging problem undermining alcohol, public health and youth protection policies?

    Science.gov (United States)

    Neufeld, Maria; Lachenmeier, Dirk W; Walch, Stephan G; Rehm, Jürgen

    2017-01-01

    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.

  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 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

  1. 9 CFR 381.74 - Poultry suspected of having biological residues.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Poultry suspected of having biological... OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION POULTRY PRODUCTS INSPECTION REGULATIONS Ante Mortem...

  2. 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.

  3. Suspected Child Maltreatment: Recognize and Respond

    Science.gov (United States)

    Kemple, Kristen Mary; Kim, Hae Kyoung

    2011-01-01

    Early childhood educators spend extensive amounts of time with young children, so they are often the first adults to notice signs that a child may be abused or neglected. All educators are required by law to report suspected maltreatment, and can play an important role in preventing and responding to abuse and neglect of young children. What is…

  4. 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 ...

  5. Identification of Chinese Caterpillar Medicinal Mushroom, Ophiocordyceps sinensis (Ascomycetes) from Counterfeit Species.

    Science.gov (United States)

    Zhang, Wenjuan; Zhang, Xiaolong; Li, Minghua; Shi, Yan; Zhang, Ping; Cheng, Xian-Long; Wei, Feng; Ma, Shuangcheng

    2017-01-01

    Ophiocordyceps sinensis is a valuable traditional Chinese medicine with a high market price. In this study, a polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) method based on 2 enzymes was developed to distinguish O. sinensis from 6 common counterfeit species. To verify the applicability of this method, we experimentally tested O. sinensis organisms, tablet preparations made from O. sinensis, and cultured mycelia isolated from O. sinensis. To validate the results from this PCR-RFLP method, all real samples were identified by internal transcribed spacer sequencing. This is, to our knowledge, the first time the PCR-RFLP method has been applied to identify O. sinensis. The selection of 2 restrictive enzymes for identification dramatically improved the accuracy and efficiency of this method. It is the great advantage of this method that sampling from either of 2 parts of O. sinensis-the fruiting body or the caterpillar body-would not cause any difference in the final experimental results. Therefore, this method is not only feasible for testing crude drugs of O. sinensis but it is also useful when the crude drugs are broken down into powder or made into tablets, demonstrating the promising prospect of application in quality control.

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

    Science.gov (United States)

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

    2018-03-01

    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.

  7. 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.

  8. Detection of counterfeit antiviral drug Heptodin and classification of counterfeits using isotope amount ratio measurements by multicollector inductively coupled plasma mass spectrometry (MC-ICPMS) and isotope ratio mass spectrometry (IRMS).

    Science.gov (United States)

    Santamaria-Fernandez, Rebeca; Hearn, Ruth; Wolff, Jean-Claude

    2009-06-01

    Isotope ratio mass spectrometry (IRMS) and multicollector inductively coupled plasma mass spectrometry (MC-ICP-MS) are highly important techniques that can provide forensic evidence that otherwise would not be available. MC-ICP-MS has proved to be a very powerful tool for measuring high precision and accuracy isotope amount ratios. In this work, the potential of combining isotope amount ratio measurements performed by MC-ICP-MS and IRMS for the detection of counterfeit pharmaceutical tablets has been investigated. An extensive study for the antiviral drug Heptodin has been performed for several isotopic ratios combining MC-ICP-MS and an elemental analyser EA-IRMS for stable isotope amount ratio measurements. The study has been carried out for 139 batches of the antiviral drug and analyses have been performed for C, S, N and Mg isotope ratios. Authenticity ranges have been obtained for each isotopic system and combined to generate a unique multi-isotopic pattern only present in the genuine tablets. Counterfeit tablets have then been identified as those tablets with an isotopic fingerprint outside the genuine isotopic range. The combination of those two techniques has therefore great potential for pharmaceutical counterfeit detection. A much greater power of discrimination is obtained when at least three isotopic systems are combined. The data from these studies could be presented as evidence in court and therefore methods need to be validated to support their credibility. It is also crucial to be able to produce uncertainty values associated to the isotope amount ratio measurements so that significant differences can be identified and the genuineness of a sample can be assessed.

  9. 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.

  10. 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.

  11. Magnetic resonance angiography in suspected cerebral vasculitis

    International Nuclear Information System (INIS)

    Demaerel, Philippe; De Ruyter, Nele; Wilms, Guido; Maes, Frederik; Velghe, Beatrijs

    2004-01-01

    The purpose of this study was to determine the technical capacity and diagnostic accuracy of 3D time-of-flight magnetic resonance angiography (MRA) in suspected cerebral vasculitis in a retrospective analysis of MRA and digital subtraction angiography (DSA) in 14 young patients with clinical and/or radiological suspicion of cerebral vasculitis. A total of nine arteries were evaluated in each patient. Consensus review of DSA by three observers was the reference standard. The sensitivity for detecting a stenosis varied from 62 to 79% for MRA and from 76 to 94% for DSA, depending on the observer. The specificity for detecting a stenosis varied from 83 to 87% for MRA and from 83 to 97% for DSA. Using the criterion ''more than two stenoses in at least two separate vascular distributions'' to consider the examination as being true positive, the false-positive rates for MRA and DSA were comparable. MRA plays a role as the first angiographical examination in the diagnostic work-up of suspected cerebral vasculitis. When more than two stenoses in at least two separate vascular distributions are depicted on MRA, DSA is not expected to add a significant diagnostic contribution in a patient with suspected cerebral vasculitis. DSA remains necessary when MRA is normal or when less than three stenoses are seen. (orig.)

  12. Magnetic resonance angiography in suspected cerebral vasculitis

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, Philippe; De Ruyter, Nele; Wilms, Guido [Department of Radiology, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Maes, Frederik [Department of Medical Imaging Computing, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Velghe, Beatrijs [Department of Radiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk (Belgium)

    2004-06-01

    The purpose of this study was to determine the technical capacity and diagnostic accuracy of 3D time-of-flight magnetic resonance angiography (MRA) in suspected cerebral vasculitis in a retrospective analysis of MRA and digital subtraction angiography (DSA) in 14 young patients with clinical and/or radiological suspicion of cerebral vasculitis. A total of nine arteries were evaluated in each patient. Consensus review of DSA by three observers was the reference standard. The sensitivity for detecting a stenosis varied from 62 to 79% for MRA and from 76 to 94% for DSA, depending on the observer. The specificity for detecting a stenosis varied from 83 to 87% for MRA and from 83 to 97% for DSA. Using the criterion ''more than two stenoses in at least two separate vascular distributions'' to consider the examination as being true positive, the false-positive rates for MRA and DSA were comparable. MRA plays a role as the first angiographical examination in the diagnostic work-up of suspected cerebral vasculitis. When more than two stenoses in at least two separate vascular distributions are depicted on MRA, DSA is not expected to add a significant diagnostic contribution in a patient with suspected cerebral vasculitis. DSA remains necessary when MRA is normal or when less than three stenoses are seen. (orig.)

  13. Is That a Nike? The Purchase of Counterfeit Sporting Goods through the Lens of the Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Weisheng Chiu

    2015-04-01

    Full Text Available The purpose of this study was to examine the consumer behavior related to the purchase of counterfeit sporting goods (CSGs based on the theory of planned behavior. The results showed that consumers’ attitude, subjective norm, and brand consciousness were predictive of purchase intention, whereas perceived behavioral control had no influence on purchase intention. Moreover, both risk averseness and sport involvement negatively led to consumers’ attitude toward CSGs. The paper ends with a discussion on the theoretical and practical contributions of this study towards the purchase of CSGs.

  14. 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.

  15. Vascular factors in suspected normal pressure hydrocephalus

    Science.gov (United States)

    Agerskov, Simon; Rabiei, Katrin; Marlow, Thomas; Jensen, Christer; Guo, Xinxin; Kern, Silke; Wikkelsø, Carsten; Skoog, Ingmar

    2016-01-01

    Objective: We examined clinical and imaging findings of suspected idiopathic normal pressure hydrocephalus (iNPH) in relation to vascular risk factors and white matter lesions (WMLs), using a nested case-control design in a representative, population-based sample. Methods: From a population-based sample, 1,235 persons aged 70 years or older were examined with CT of the brain between 1986 and 2000. We identified 55 persons with hydrocephalic ventricular enlargement, i.e., radiologic findings consistent with iNPH. Among these, 26 had clinical signs that fulfilled international guideline criteria for probable iNPH. These cases were labeled suspected iNPH. Each case was matched to 5 controls from the same sample, based on age, sex, and study cohort. Data on risk factors were obtained from clinical examinations and the Swedish Hospital Discharge Register. History of hypertension, diabetes mellitus (DM), smoking, overweight, history of coronary artery disease, stroke/TIA, and WMLs on CT were examined. Risk factors associated with iNPH with a p value <0.1 in χ2 tests were included in conditional logistic regression models. Results: In the regression analyses, suspected iNPH was related to moderate to severe WMLs (odds ratio [OR] 5.2; 95% confidence interval [CI]: 1.5–17.6), while hydrocephalic ventricular enlargement was related to hypertension (OR 2.7; 95% CI: 1.1–6.8), moderate to severe WMLs (OR 6.5; 95% CI: 2.1–20.3), and DM (OR 4.3; 95% CI: 1.1–16.3). Conclusions: Hypertension, WMLs, and DM were related to clinical and imaging features of iNPH, suggesting that vascular mechanisms are involved in the pathophysiology. These findings might have implications for understanding disease mechanisms in iNPH and possibly prevention. PMID:26773072

  16. 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

  17. International Suspect Screening: NORMAN Suspect Exchange meets the US EPA CompTox Chemistry Dashboard (ICCE 2017 Oslo)

    Science.gov (United States)

    Members of the European NORMAN Network of Environmental Laboratories (www.norman-network.com) have many substance lists, including targets, suspects, surfactants, perfluorinated substances and regulated, partially confidential data sets of complex mixtures. The NORMAN Suspect Lis...

  18. CT coronary angiographic evaluation of suspected anginal chest pain.

    Science.gov (United States)

    Moss, Alastair J; Newby, David E

    2016-02-15

    Non-invasive imaging plays a critical role in the assessment of patients presenting with suspected angina chest pain. However, wide variations in practice across Europe and North America highlight the lack of consensus in selecting the appropriate first-line test for the investigation of coronary artery disease (CAD). CT coronary angiography (CTCA) has a high negative predictive value for excluding the presence of CAD. As such, it serves as a potential 'gatekeeper' to downstream testing by reducing the rate of inappropriate invasive coronary angiography. Two recent large multicentre randomised control trials have provided insights into whether CTCA can be incorporated into chest pain care pathways to improve risk stratification of CAD. They demonstrate that using CTCA enhances diagnostic certainty and improves the targeting of appropriate invasive investigations and therapeutic interventions. Importantly, reductions in cardiac death and non-fatal myocardial infarction appear to be attained through the more appropriate use of preventative therapy and coronary revascularisation when guided by CTCA. With this increasing portfolio of evidence, CTCA should be considered the non-invasive investigation of choice in the evaluation of patients with suspected angina pectoris due to coronary heart disease. NCT01149590, post-results. 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/

  19. 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.

  20. Believable Suspect Agents: Response and Interpersonal Style Selection for an Artificial Suspect

    NARCIS (Netherlands)

    Bruijnes, Merijn

    2016-01-01

    The social skills necessary to properly and successfully conduct a police interrogation can and need to be trained. In the thesis I will describe the steps I took towards a virtual character that can play the role of a suspect in a police interrogation training. Students of the police academy will

  1. Exome Sequencing in Suspected Monogenic Dyslipidemias

    Science.gov (United States)

    Stitziel, Nathan O.; Peloso, Gina M.; Abifadel, Marianne; Cefalu, Angelo B.; Fouchier, Sigrid; Motazacker, M. Mahdi; Tada, Hayato; Larach, Daniel B.; Awan, Zuhier; Haller, Jorge F.; Pullinger, Clive R.; Varret, Mathilde; Rabès, Jean-Pierre; Noto, Davide; Tarugi, Patrizia; Kawashiri, Masa-aki; Nohara, Atsushi; Yamagishi, Masakazu; Risman, Marjorie; Deo, Rahul; Ruel, Isabelle; Shendure, Jay; Nickerson, Deborah A.; Wilson, James G.; Rich, Stephen S.; Gupta, Namrata; Farlow, Deborah N.; Neale, Benjamin M.; Daly, Mark J.; Kane, John P.; Freeman, Mason W.; Genest, Jacques; Rader, Daniel J.; Mabuchi, Hiroshi; Kastelein, John J.P.; Hovingh, G. Kees; Averna, Maurizio R.; Gabriel, Stacey; Boileau, Catherine; Kathiresan, Sekar

    2015-01-01

    Background Exome sequencing is a promising tool for gene mapping in Mendelian disorders. We utilized this technique in an attempt to identify novel genes underlying monogenic dyslipidemias. Methods and Results We performed exome sequencing on 213 selected family members from 41 kindreds with suspected Mendelian inheritance of extreme levels of low-density lipoprotein (LDL) cholesterol (after candidate gene sequencing excluded known genetic causes for high LDL cholesterol families) or high-density lipoprotein (HDL) cholesterol. We used standard analytic approaches to identify candidate variants and also assigned a polygenic score to each individual in order to account for their burden of common genetic variants known to influence lipid levels. In nine families, we identified likely pathogenic variants in known lipid genes (ABCA1, APOB, APOE, LDLR, LIPA, and PCSK9); however, we were unable to identify obvious genetic etiologies in the remaining 32 families despite follow-up analyses. We identified three factors that limited novel gene discovery: (1) imperfect sequencing coverage across the exome hid potentially causal variants; (2) large numbers of shared rare alleles within families obfuscated causal variant identification; and (3) individuals from 15% of families carried a significant burden of common lipid-related alleles, suggesting complex inheritance can masquerade as monogenic disease. Conclusions We identified the genetic basis of disease in nine of 41 families; however, none of these represented novel gene discoveries. Our results highlight the promise and limitations of exome sequencing as a discovery technique in suspected monogenic dyslipidemias. Considering the confounders identified may inform the design of future exome sequencing studies. PMID:25632026

  2. Characterization of waste streams and suspect waste from largest Los Alamos National Laboratory generators

    International Nuclear Information System (INIS)

    Soukup, J.D.; Erpenbeck, G.J.

    1995-01-01

    A detailed waste stream characterization of 4 primary generators of low level waste at LANL was performed to aid in waste minimization efforts. Data was compiled for these four generators from 1988 to the present for analyses. Prior waste minimization efforts have focused on identifying waste stream processes and performing source materials substitutions or reductions where applicable. In this historical survey, the generators surveyed included an accelerator facility, the plutonium facility, a chemistry and metallurgy research facility, and a radiochemistry research facility. Of particular interest in waste minimization efforts was the composition of suspect low level waste in which no radioactivity is detected through initial survey. Ultimately, this waste is disposed of in the LANL low level permitted waste disposal pits (thus filling a scarce and expensive resource with sanitary waste). Detailed analyses of the waste streams from these 4 facilities, have revealed that suspect low level waste comprises approximately 50% of the low level waste by volume and 47% by weight. However, there are significant differences in suspect waste density when one considers the radioactive contamination. For the 2 facilities that deal primarily with beta emitting activation and spallation products (the radiochemistry and accelerator facilities), the suspect waste is much lower density than all low level waste coming from those facilities. For the 2 facilities that perform research on transuranics (the chemistry and metallurgy research and plutonium facilities), suspect waste is higher in density than all the low level waste from those facilities. It is theorized that the low density suspect waste is composed primarily of compactable lab trash, most of which is not contaminated but can be easily surveyed. The high density waste is theorized to be contaminated with alpha emitting radionuclides, and in this case, the suspect waste demonstrates fundamental limits in detection

  3. Study on the light-color mixing of rare earth luminescent materials for anti-counterfeiting application

    Science.gov (United States)

    Zhang, Jishu; Zhang, Yingzi; Tao, Jin; Zhu, Yanan

    2018-04-01

    In order to find out the light color mixing mechanism of rare earth luminescent materials used in anti-counterfeiting fibers, we prepared three kinds of rare earth luminescent materials according to RGB tri-primary color, and mixed it together to form different mixtures in certain proportion. The phase structures of the luminescent material monomers were measured by x-ray diffractometer. The photochromic properties of the luminescent materials were tested and analyzed by fluorescence spectrophotometer. The results show that the light color mixing was consistent with the blending principle of additive color, but not the same because of the photochromic properties of rare earth luminescent materials, and we explored the reasons in the light wavelength and intensity. It was found that the enhancement of the luminescence intensity of the mixture on account of the superimposing of luminescence.

  4. Lineup composition, suspect position, and the sequential lineup advantage.

    Science.gov (United States)

    Carlson, Curt A; Gronlund, Scott D; Clark, Steven E

    2008-06-01

    N. M. Steblay, J. Dysart, S. Fulero, and R. C. L. Lindsay (2001) argued that sequential lineups reduce the likelihood of mistaken eyewitness identification. Experiment 1 replicated the design of R. C. L. Lindsay and G. L. Wells (1985), the first study to show the sequential lineup advantage. However, the innocent suspect was chosen at a lower rate in the simultaneous lineup, and no sequential lineup advantage was found. This led the authors to hypothesize that protection from a sequential lineup might emerge only when an innocent suspect stands out from the other lineup members. In Experiment 2, participants viewed a simultaneous or sequential lineup with either the guilty suspect or 1 of 3 innocent suspects. Lineup fairness was varied to influence the degree to which a suspect stood out. A sequential lineup advantage was found only for the unfair lineups. Additional analyses of suspect position in the sequential lineups showed an increase in the diagnosticity of suspect identifications as the suspect was placed later in the sequential lineup. These results suggest that the sequential lineup advantage is dependent on lineup composition and suspect position. (c) 2008 APA, all rights reserved

  5. Identification of a particular cheese production by trace analysis with nuclear techniques

    Science.gov (United States)

    Salvini, A.; Stroppa, A.; Cagnazzo, M.; Pappalardo, P.; Borio, A.; Manera, S.

    2006-05-01

    The counterfeit of a product, in this case a type of cheese, is an economic damage for the trade-mark product. An identification of the product itself by quantification of trace elements could be done. Nuclear techniques are useful and give good results. Some elements are connected to the process so different productions could be identified. Thirty elements and 160 spectrums are analysed. The samples of the same kind of cheese come from different countries and different Italian producers (15 different productions).

  6. Identification of a particular cheese production by trace analysis with nuclear techniques

    International Nuclear Information System (INIS)

    Salvini, A; Stroppa, A; Cagnazzo, M; Pappalardo, P; Borio, A; Manera, S

    2006-01-01

    The counterfeit of a product, in this case a type of cheese, is an economic damage for the trade-mark product. An identification of the product itself by quantification of trace elements could be done. Nuclear techniques are useful and give good results. Some elements are connected to the process so different productions could be identified. Thirty elements and 160 spectrums are analysed. The samples of the same kind of cheese come from different countries and different Italian producers (15 different productions)

  7. 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

  8. 48 CFR 403.303 - Reporting suspected antitrust violations.

    Science.gov (United States)

    2010-10-01

    ... Antitrust Violations 403.303 Reporting suspected antitrust violations. Contracting officers shall report the circumstances of suspected violations of antitrust laws to the Office of Inspector General in accordance with... antitrust violations. 403.303 Section 403.303 Federal Acquisition Regulations System DEPARTMENT OF...

  9. 48 CFR 1403.303 - Reporting suspected antitrust violations.

    Science.gov (United States)

    2010-10-01

    ... Antitrust Violations 1403.303 Reporting suspected antitrust violations. (a) Reports on suspected violations of antitrust laws as required by FAR 3.303 shall be prepared by the CO, reviewed by the SOL, and... antitrust violations. 1403.303 Section 1403.303 Federal Acquisition Regulations System DEPARTMENT OF THE...

  10. 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 ...

  11. Selecting foils for identification lineups: matching suspects or descriptions?

    Science.gov (United States)

    Tunnicliff, J L; Clark, S E

    2000-04-01

    Two experiments directly compare two methods of selecting foils for identification lineups. The suspect-matched method selects foils based on their match to the suspect, whereas the description-matched method selects foils based on their match to the witness's description of the perpetrator. Theoretical analyses and previous results predict an advantage for description-matched lineups both in terms of correctly identifying the perpetrator and minimizing false identification of innocent suspects. The advantage for description-matched lineups should be particularly pronounced if the foils selected in suspect-matched lineups are too similar to the suspect. In Experiment 1, the lineups were created by trained police officers, and in Experiment 2, the lineups were constructed by undergraduate college students. The results of both experiments showed higher suspect-to-foil similarity for suspect-matched lineups than for description-matched lineups. However, neither experiment showed a difference in correct or false identification rates. Both experiments did, however, show that there may be an advantage for suspect-matched lineups in terms of no-pick and rejection responses. From these results, the endorsement of one method over the other seems premature.

  12. Arthroscintigraphy in suspected rotator cuff rupture

    International Nuclear Information System (INIS)

    Gratz, S.; Behr, T.; Becker, W.; Koester, G.; Vosshenrich, R.; Grabbe, E.

    1998-01-01

    Aim: In order to evaluate the diagnostic efficiency of arthroscintigraphy in suspected rotator cuff ruptures this new imaging procedure was performed 20 times in 17 patients with clinical signs of a rotator cuff lesion. The scintigraphic results were compared with sonography (n=20), contrast arthrography (n=20) and arthroscopy (n=10) of the shoulder joint. Methods: After performing a standard bone scintigraphy with intravenous application of 300 MBq 99m-Tc-methylene diphosphonate (MDP) for landmarking of the shoulder region arthroscintigraphy was performed after an intraarticular injection of 99m-Tc microcolloid (ALBU-RES 400 μCi/5 ml). The application was performed either in direct combination with contrast arthrography (n=10) or ultrasound conducted mixed with a local anesthetic (n=10). Findings at arthroscopical surgery (n=10) were used as the gold standard. Results: In case of complete rotator cuff rupture (n=5), arthroscintigraphy and radiographic arthrography were identical in 5/5. In one patient with advanced degenerative alterations of the shoulder joint radiographic arthrography incorrectly showed a complete rupture which was not seen by arthroscintigraphy and endoscopy. In 3 patients with incomplete rupture, 2/3 results were consistant. A difference was seen in one patient with a rotator cuff, that has been already revised in the past and that suffered of capsulitis and calcification. Conclusion: Arthroscinitgraphy is a sensitive technique for detection of rotator cuff ruptures. Because of the lower viscosity of the active compound, small ruptures can be easily detected, offering additional value over radiographic arthrography and ultrasound, especially for evaluation of incomplete cuff ruptures. (orig.) [de

  13. Suspected synthetic cannabinoid toxicosis in a dog.

    Science.gov (United States)

    Williams, Keysa; Wells, Raegan J; McLean, Mary Kay

    2015-01-01

    To describe the effects of suspected synthetic cannabinoid (SC) toxicosis and the response to intravenous lipid emulsion (ILE) therapy in a dog. A 2-year-8-month-old male Boxer dog was evaluated at an emergency hospital for progressive ataxia and inappropriate mentation. The initial physical examination identified marked hypothermia (32.7°C [90.9°F]), intermittent sinus bradycardia (60/min), stuporous mentation with intermittent aggression, and severe ataxia. Neurologic status deteriorated to comatose mentation within 2 hours of presentation. The initial diagnostic evaluation (eg, CBC, serum biochemistry profile, venous blood gas, and electrolyte determination) revealed a respiratory acidosis and thrombocytopenia. The owner reported that the dog was exposed to an SC containing Damiana leaf, Marshmallow leaf, and Athaea leaves. Initial treatment included IV fluids and supplemental oxygen. Mechanical ventilation was provided due to hypoventilation and periods of apnea. Intravenous lipid emulsion therapy was administered as a bolus (1.5 mL/kg) and continued as a continuous rate infusion (0.5 mL/kg/h) for a total of 6 hours. The dog became rousable and was weaned from mechanical ventilation approximately 15 hours following presentation. The dog was eating and walking with no ataxia, had a normal mentation at approximately 33 hours following presentation, and was discharged home at that time. Communication with the owners 5 days following discharge revealed that the dog was apparently normal. Based on this case and other reports in the literature regarding human exposures, SC ingestion may result in more severe clinical signs than marijuana ingestion in dogs. Significant clinical intervention may be necessary. Intravenous lipid emulsion treatment may be beneficial due to the lipophilicity of SC. © Veterinary Emergency and Critical Care Society 2015.

  14. 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...

  15. 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.

  16. COUNTERFEITING ROMAN COINS IN THE ROMAN EMPIRE I – III A.D. STUDY ON THE ROMAN PROVINCES OF DACIA AND PANNONIA

    Directory of Open Access Journals (Sweden)

    Razvan Bogdan Gaspar

    2015-12-01

    Full Text Available This paper is based on the study of Roman silver coins, from archaeological sites located in Roman Dacia and Pannonia. Initially centred on the record of hybrid silver coins, the paper expanded its analysis on counterfeit pieces as well in order to fully understand all problems of roman silver coinage from the 1stto the 3rd centuries AD.The new and larger area of research had more than one implications, coin distribution on the studied sites, influx of coin in the province, quantity of recorded counterfeited pieces being just some of them. Thus every situation was discussed in different chapters, first presenting the coins and the laws that protected them, the studied sites and the analyse of the silver coins on these sites, the general and compared situation between the provinces, interpretation of the counterfeited and hybrid pieces and finally, conclusions on the subject.All these tasks have been achieved one step at a time, each archaeological site providing precious data which piled up and was finally pressed in order to present the correct historical situation.

  17. 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.

  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. Design, fabrication and characterization of Computer Generated Holograms for anti-counterfeiting applications using OAM beams as light decoders.

    Science.gov (United States)

    Ruffato, Gianluca; Rossi, Roberto; Massari, Michele; Mafakheri, Erfan; Capaldo, Pietro; Romanato, Filippo

    2017-12-21

    In this paper, we present the design, fabrication and optical characterization of computer-generated holograms (CGH) encoding information for light beams carrying orbital angular momentum (OAM). Through the use of a numerical code, based on an iterative Fourier transform algorithm, a phase-only diffractive optical element (PO-DOE) specifically designed for OAM illumination has been computed, fabricated and tested. In order to shape the incident beam into a helicoidal phase profile and generate light carrying phase singularities, a method based on transmission through high-order spiral phase plates (SPPs) has been used. The phase pattern of the designed holographic DOEs has been fabricated using high-resolution Electron-Beam Lithography (EBL) over glass substrates coated with a positive photoresist layer (polymethylmethacrylate). To the best of our knowledge, the present study is the first attempt, in a comprehensive work, to design, fabricate and characterize computer-generated holograms encoding information for structured light carrying OAM and phase singularities. These optical devices appear promising as high-security optical elements for anti-counterfeiting applications.

  20. Using Internet Artifacts to Profile a Child Pornography Suspect

    OpenAIRE

    Marcus K. Rogers; Kathryn C. Seigfried-Spellar

    2014-01-01

    Digital evidence plays a crucial role in child pornography investigations. However, in the following case study, the authors argue that the behavioral analysis or “profiling” of digital evidence can also play a vital role in child pornography investigations. The following case study assessed the Internet Browsing History (Internet Explorer Bookmarks, Mozilla Bookmarks, and Mozilla History) from a suspected child pornography user’s computer. The suspect in this case claimed to be conducting an...

  1. Talking heads : interviewing suspects from a cultural perspective

    OpenAIRE

    Beune, K.

    2009-01-01

    Although the literature on the interviewing of suspects has increased over the past decade, research on the use and effectiveness of police strategies and their boundary conditions is very rare. The present dissertation aims to fill this void by identifying behaviors that appeal to and persuade suspects to talk (i.e., influencing behavior), focusing on the effects of such behaviors and their dependency on cultural context (low-context vs. high-context). In doing so, we depart from a theoretic...

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

    DEFF Research Database (Denmark)

    Okulova, Nastasia

    2016-01-01

    has been demonstrated. The focus of this study lies on the reproduction of the previous results for nano- or micro-structures and implementation of this technology for mass production of such patterned foils for the use in packaging. An interesting application is production of holograms with build...

  3. 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).

  4. 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.

  5. Organic Phase Change Nanoparticles for in-Product Labeling of Agrochemicals.

    Science.gov (United States)

    Wang, Miao; Duong, Binh; Su, Ming

    2015-10-28

    There is an urgent need to develop in-product covert barcodes for anti-counterfeiting of agrochemicals. This paper reports a new organic nanoparticle-based in-product barcode system, in which a panel of organic phase change nanoparticles is added as a barcode into in a variety of chemicals (herein agrochemicals). The barcode is readout by detecting melting peaks of organic nanoparticles using differential scanning calorimetry. This method has high labeling capacity due to small sizes of nanoparticles, sharp melting peaks, and large scan range of thermal analysis. The in-product barcode can be effectively used to protect agrochemical products from being counterfeited due to its large coding capacity, technical readiness, covertness, and robustness.

  6. Suspected adverse reactions to veterinary drugs reported in South Africa (January 1998 - February 2001 : special report

    Directory of Open Access Journals (Sweden)

    R. Gehring

    2001-07-01

    Full Text Available The Veterinary Pharmacovigilance Centre received 59 reports of suspected adverse drug reactions during the period January 1998 - February 2001. The number of reports received increased after the establishment of a formal procedure for recording and responding to reports. The number of reports received per species was: dogs 19, cats 15, cattle 7, sheep/ goats 6, chickens 4, pigs 3, horses 2 and giraffe 1. Many different types of adverse reactions were reported, including lack of efficacy, hypersensitivity, inappropriate use of products by non-veterinarians, known adverse effects and adverse effects encountered with extra-label use of products.

  7. 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...

  8. 78 FR 28780 - Defense Federal Acquisition Regulation Supplement: Detection and Avoidance of Counterfeit...

    Science.gov (United States)

    2013-05-16

    ... clause at FAR 52.244-2, Subcontracts. (1) Unallowability of costs of rework and corrective action. A new... cost of rework or corrective action that may be required to remedy the use or inclusion of such parts... such products and for any rework or corrective action that may be required to remedy the use or...

  9. 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.

  10. 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),

  11. 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.

  12. 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

  13. 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…

  14. 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 budesonide...

  15. Spatial epidemiology of suspected clinical leptospirosis in Sri Lanka.

    Science.gov (United States)

    Robertson, C; Nelson, T A; Stephen, C

    2012-04-01

    Leptospirosis is one of the most widespread zoonoses in the world. A large outbreak of suspected human leptospirosis began in Sri Lanka during 2008. This study investigated spatial variables associated with suspected leptospirosis risk during endemic and outbreak periods. Data were obtained for monthly numbers of reported cases of suspected clinical leptospirosis for 2005-2009 for all of Sri Lanka. Space-time scan statistics were combined with regression modelling to test associations during endemic and outbreak periods. The cross-correlation function was used to test association between rainfall and leptospirosis at four locations. During the endemic period (2005-2007), leptospirosis risk was positively associated with shorter average distance to rivers and with higher percentage of agriculture made up of farms <0·20 hectares. Temporal correlation analysis of suspected leptospirosis cases and rainfall revealed a 2-month lag in rainfall-case association during the baseline period. Outbreak locations in 2008 were characterized by shorter distance to rivers and higher population density. The analysis suggests the possibility of household transmission in densely populated semi-urban villages as a defining characteristic of the outbreak. The role of rainfall in the outbreak remains to be investigated, although analysis here suggests a more complex relationship than simple correlation.

  16. 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,

  17. 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…

  18. 48 CFR 3.303 - Reporting suspected antitrust violations.

    Science.gov (United States)

    2010-10-01

    ... suspect. Paragraph (c) below identifies behavior patterns that are often associated with antitrust... offers; (2) A sudden change from competitive bidding to identical bidding; (3) Simultaneous price... turn in sequence as low bidder, or so that certain competitors bid low only on some sizes of contracts...

  19. 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 ...

  20. A suspected case of Addison's disease in cattle.

    Science.gov (United States)

    Lambacher, Bianca; Wittek, Thomas

    2015-09-01

    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.

  1. 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

  2. 48 CFR 903.303 - Reporting suspected antitrust violations.

    Science.gov (United States)

    2010-10-01

    ... as described in FAR 3.301, and antitrust law violations as described in FAR 3.303, evidenced in bids... antitrust violations. 903.303 Section 903.303 Federal Acquisition Regulations System DEPARTMENT OF ENERGY GENERAL IMPROPER BUSINESS PRACTICES AND PERSONAL CONFLICTS OF INTEREST Reports of Suspected Antitrust...

  3. Suspected infection in afebrile patients : Are they septic?

    NARCIS (Netherlands)

    Martins, Fernanda de Souza; Guedes, Gisele Giuliane; Santos, Thiago Martins; de Carvalho-Filho, Marco A

    We prospectively evaluated afebrile patients admitted to an emergency department (ED), with suspected infection and only tachycardia or tachypnea.The white blood cell count (WBC) was obtained, and patients were considered septic if leukocyte count was >12,000 μL-1 or <4000 μL-1 or with >10% of band

  4. 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…

  5. Lineup Composition, Suspect Position, and the Sequential Lineup Advantage

    Science.gov (United States)

    Carlson, Curt A.; Gronlund, Scott D.; Clark, Steven E.

    2008-01-01

    N. M. Steblay, J. Dysart, S. Fulero, and R. C. L. Lindsay (2001) argued that sequential lineups reduce the likelihood of mistaken eyewitness identification. Experiment 1 replicated the design of R. C. L. Lindsay and G. L. Wells (1985), the first study to show the sequential lineup advantage. However, the innocent suspect was chosen at a lower rate…

  6. Pathologically confirmed autoimmune encephalitis in suspected Creutzfeldt-Jakob disease

    NARCIS (Netherlands)

    Maat, P.; de Beukelaar, J.W.; Jansen, C.; Schuur, M.; van Duijn, C.M.; van Coevorden, M.H.; de Graaff, E.; Titulaer, E.; Rozemuller, A.J.M.; Sillevis Smitt, P.

    2015-01-01

    Objective: To determine the clinical features and presence in CSF of antineuronal antibodies in patients with pathologically proven autoimmune encephalitis derived from a cohort of patients with suspected Creutzfeldt-Jakob disease (CJD). Methods: The Dutch Surveillance Centre for Prion Diseases

  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. Risk Factors and Bacterial Profile of Suspected Neonatal ...

    African Journals Online (AJOL)

    Neonatal septicaemia is a common cause of morbidity and mortality in developing countries and a major health concern. The aim of this study is to evaluate the bacterial profile, antibiotics susceptibility pattern and associated risk factors of suspected septicaemia in neonates in this locality. Five hundred and forty seven ...

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

    African Journals Online (AJOL)

    2012-01-03

    Jan 3, 2012 ... 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. Suspected pulmonary tuberculosis in rural South Africa - Sputum ...

    African Journals Online (AJOL)

    Three (125%) of the 24 patients with a discharge diagnosis other than TB (17 pneumonia, 3 old TB, 2 carcinoma of the lung, 1 bronchiectasis) turned out to have TB within the follow-up period; 2 of those had extrapulmonary TB Conclusion, SI produced a positive smear result in 29% of patients with suspected TB who had ...

  11. The development and appraisal of a tool designed to find patients harmed by falsely labelled, falsified (counterfeit) medicines.

    Science.gov (United States)

    Anđelković, Marija; Björnsson, Einar; De Bono, Virgilio; Dikić, Nenad; Devue, Katleen; Ferlin, Daniel; Hanževački, Miroslav; Jónsdóttir, Freyja; Shakaryan, Mkrtich; Walser, Sabine

    2017-06-20

    Falsely labelled, falsified (counterfeit) medicines (FFCm's) are produced or distributed illegally and can harm patients. Although the occurrence of FFCm's is increasing in Europe, harm is rarely reported. The European Directorate for the Quality of Medicines & Health-Care (EDQM) has therefore coordinated the development and validation of a screening tool. The tool consists of a questionnaire referring to a watch-list of FFCm's identified in Europe, including symptoms of their use and individual risk factors, and a scoring form. To refine the questionnaire and reference method, a pilot-study was performed in 105 self-reported users of watch-list medicines. Subsequently, the tool was validated under "real-life conditions" in 371 patients in 5 ambulatory and in-patient care sites ("sub-studies"). The physicians participating in the study scored the patients and classified their risk of harm as "unlikely" or "probable" (cut-off level: presence of ≥2 of 5 risk factors). They assessed all medical records retrospectively (independent reference method) to validate the risk classification and documented their perception of the tool's value. In 3 ambulatory care sites (180 patients), the tool correctly classified 5 patients as harmed by FFCm's. The positive and negative likelihood ratios (LR+/LR-) and the discrimination power were calculated for two cut-off levels: a) 1 site (50 patients): presence of two risk factors (at 10% estimated health care system contamination with FFCm's): LR + 4.9/LR-0, post-test probability: 35%; b) 2 sites (130 patients): presence of three risk factors (at 5% estimated prevalence of use of non-prescribed medicines (FFCm's) by certain risk groups): LR + 9.7/LR-0, post-test probability: 33%. In 2 in-patient care sites (191 patients), no patient was confirmed as harmed by FFCm's. The physicians perceived the tool as valuable for finding harm, and as an information source regarding risk factors. This "decision aid" is a systematic tool

  12. Multiscaled polarization effects in Suneve coronata (Lepidoptera) and other insects: application to anti-counterfeiting of banknotes

    Science.gov (United States)

    Berthier, S.; Boulenguez, J.; Bálint, Z.

    2007-01-01

    The scales of many Lepidoptera and the elytra of quite a number of Coleoptera possess specialized micro- and nano-structures that produce special polarization effects. They are constituted by concave multilayered cavities. This leads to two different effects: (1) interferential non-polarized coloration by reflection near normal incidence in the middle of the cavities and (2) polarized interferential colouration at lower wavelength after double reflection near the Brewster incidence at the periphery of the cavities. The macroscopic appearance resembles the “pointillist effect” with one of the component polarized while the other one is not. The first one can be extinguished with linear polarizer so that the colour is modified. In most insects, the structure is locally symmetric; hence, no macroscopic effects can be seen. In certain species, this symmetry is partly broken, and a slight effect can be observed. In the wing dorsal surface of the fascinating neotropical butterflies genus Suneve, perpendicular structures of two different kinds in size polarize the reflected light. The larger one is constituted by the convex cover scales whose apex falls perpendicularly on the bases of the following scales, creating long polarized valley (50 μm width) transversally running across the wing. The smaller one is constituted by the ridges of the scales (2 μm apart) that polarize light in the perpendicular direction. Adapted multilayered structures can be deposited onto banknotes to create anti-counterfeiting patterns as a further development of protection and security. Different effects can be produced by the use of such structures. (1) Changes of luminosity: A specific pattern will be constituted by two different areas: one with horizontal concave multilayered structures, and the other one with vertical structures. Under unpolarized light, the reflected spectra of these different areas are identical and no pattern appears. Under polarized light, i.e., through a linear

  13. Comparison of clinically suspected injuries with injuries detected at whole-body CT in suspected multi-trauma victims

    International Nuclear Information System (INIS)

    Shannon, L.; Peachey, T.; Skipper, N.; Adiotomre, E.; Chopra, A.; Marappan, B.; Kotnis, N.

    2015-01-01

    Aim: To assess the accuracy of the trauma team leader's clinical suspicion of injury in patients who have undergone whole-body computed tomography (WBCT) for suspected polytrauma, and to assess the frequency of unsuspected injuries and specific patterns of injury at WBCT. Materials and methods: Requests for patients who underwent WBCT for suspected polytrauma from April 2011 to March 2014 were reviewed and each body area that was clinically suspected to be injured was recorded. Body areas were divided into the following groups based on anatomical regions covered in each segment of the WBCT examination: head (including facial bones); neck (including cervical spine); chest (including thoracic spine); and abdomen/pelvis (including lumbar spine). The formal radiology report for each study was reviewed and injuries found at CT were grouped into the same body areas. For each patient, the number of clinically suspected injured areas was compared to the number of confirmed injured areas at WBCT. Results: Five hundred and eighty-eight patients were included in the study. Thirty-two percent (186/588) had a normal scan. Ninety-three percent (546/588) had fewer injured body areas at WBCT than suspected. Four percent (27/588) had the equivalent number of injured areas at WBCT as suspected. Three percent (15/588) had more injured areas at WBCT than suspected. Fifty percent (263/527) with clinically suspected chest injuries were confirmed to have chest injuries at WBCT. This was lower for other areas: abdomen/pelvis 31% (165/535); head 29% (155/533); neck 13% (66/513). Four percent of (24/588) patients had unsuspected injuries found at WBCT. Seventy-five percent (18/24) of unsuspected injuries were considered as serious, where failure to treat would have the potential for significant morbidity. Most of these patients had severe injuries to other body areas that were correctly suspected. Of the 165 with abdominal/pelvic region injuries, there were associated injuries in the

  14. Protective properties of wine products and the role of high performance liquid chromatography in the study of these properties

    International Nuclear Information System (INIS)

    Ulyanova, E V; Larionov, O G; Revina, A A; Andrievskaya, D V; Urusova, L M; Fenin, A A

    2013-01-01

    Data on the biologically active substances present in wines and wine products, the methods of their determination, and changes under chemical, radiation and other types of action are generalized. The role of high performance liquid chromatography in the studies of the protective properties of wines is demonstrated. Particular attention is devoted to problems of counterfeiting of wine products and the possibility to reveal it by using amperometric determination of the antioxidant activity. The bibliography includes 117 references

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

    OpenAIRE

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

    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: ...

  16. Methods for Characterisation of unknown Suspect Radioactive Samples

    International Nuclear Information System (INIS)

    Sahagia, M.; Grigorescu, E.L.; Luca, A.; Razdolescu, A.C.; Ivan, C.

    2001-01-01

    Full text: The paper presents various identification and measurement methods, used for the expertise of a wide variety of suspect radioactive materials, whose circulation was not legally stated. The main types of examined samples were: radioactive sources, illegally trafficked; suspect radioactive materials or radioactively contaminated devices; uranium tablets; fire detectors containing 241 Am sources; osmium samples containing radioactive 185 Os or enriched 187 Os. The types of analyses and determination methods were as follows: the chemical composition was determined by using identification reagents or by neutron activation analysis; the radionuclide composition was determined by using gamma-ray spectrometry; the activity and particle emission rates were determined by using calibrated radiometric equipment; the absorbed dose rate at the wall of all types of containers and samples was determined by using calibrated dose ratemeters. The radiation exposure risk for population, due to these radioactive materials, was evaluated for every case. (author)

  17. Cholescintigraphy and ultrasonography in patients suspected of having acute cholecystitis

    DEFF Research Database (Denmark)

    Lauritsen, K B; Sommer, W; Hahn, L

    1988-01-01

    The diagnostic power of combined cholescintigraphy and ultrasonography was tested in 67 patients suspected of having acute cholecystitis; of these, 42 (63%) had acute cholecystitis. The predictive value of a positive scintigraphy (PVpos) was 95% and that of a negative (PVneg) was 91% (n = 67......). The PVpos and PVneg of ultrasonography were 89% and 75%, respectively (n = 54), and these values did not achieve statistical significance when compared with those for scintigraphy. Inconclusive tests were 10% and 11%, respectively, but in no patient were both scintigraphy and ultrasonography inconclusive...... that in patients suspected of having acute cholecystitis cholescintigraphy should be the first diagnostic procedure performed. If the scintigraphy is positive, additional ultrasonographic detection of gallstones makes the diagnosis almost certain. If one diagnostic modality is inconclusive, the other makes a fair...

  18. 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.

  19. Incidence of clinically suspected venous thromboembolism in British Indian patients.

    Science.gov (United States)

    Siddiqui, B M; Patel, M S; Rudge, S; Best, A; Mangwani, J

    2018-05-01

    Introduction Venous thromboembolism (VTE) remains a major public health issue around the world. Ethnicity is known to alter the incidence of VTE. To our knowledge, there are no reports in the literature investigating the incidence of VTE in British Indians. The aim of this study was to investigate the rates of symptomatic VTE in British Indian patients in the UK. Methods Patients referred to our institution between January 2011 and August 2013 with clinically suspected VTE were eligible for inclusion in the study. Those not of British Indian or Caucasian ethnicity were excluded. A retrospective review of these two cohorts was conducted. Results Overall, 15,529 cases were referred to our institution for suspected VTE. This included 1,498 individuals of British Indian ethnicity. Of these, 182 (12%) had confirmed VTE episodes. A further 13,159 of the patients with suspected VTE were coded as Caucasian, including 2,412 (16%) who had confirmed VTE events. VTE rates were a third lower in British Indians with clinically suspected VTE than in the equivalent Caucasian group. The British Indian cohort presented with VTE at a much earlier age than Caucasians (mean 57.0 vs 68.0 years). Conclusions This study suggests that British Indian patients have a lower incidence of VTE and are more likely to present at an earlier age than Caucasians. There was no significant difference in VTE type (deep vein thrombosis vs pulmonary embolism) among the ethnic groups. Clinicians should be aware of variations within ethnicities but should continue to adhere to existing VTE prevention guidance.

  20. Spinal cord magnetic resonance imaging in suspected multiple sclerosis

    International Nuclear Information System (INIS)

    Lycklama a Nijeholt, G.J.; Bergers, E.; Castelijns, J.A.; Barkhof, F.; Uitdehaag, B.M.J.; Polman, C.H.

    2000-01-01

    We examined the value of spinal cord magnetic resonance imaging (MRI) in the diagnostic work-up of multiple sclerosis (MS). Forty patients suspected of having MS were examined within 24 months after the start of symptoms. Disability was assessed, and symptoms were categorized as either brain or spinal cord. Work-up further included cerebrospinal fluid analysis and standard proton-density, T2-, and T1-weighted gadolinium-enhanced brain and spinal cord MRI. Patients were categorized as either clinically definite MS (n = 13), laboratory-supported definite MS (n = 14), or clinically probable MS (n = 4); four patients had clinically probable MS, and in nine MS was suspected. Spinal cord abnormalities were found in 35 of 40 patients (87.5 %), consisting of focal lesions in 31, only diffuse abnormalities in two, and both in two. Asymptomatic spinal cord lesions occurred in six patients. All patients with diffuse spinal cord abnormality had clear spinal cord symptoms and a primary progressive disease course. In clinically definite MS, the inclusion of spinal imaging increased the sensitivity of MRI to 100 %. Seven patients without a definite diagnosis had clinically isolated syndromes involving the spinal cord. Brain MRI was inconclusive, while all had focal spinal cord lesions which explained symptoms and ruled out other causes. Two other patients had atypical brain abnormalities suggesting ischemic/vascular disease. No spinal cord abnormalities were found, and during follow-up MS was ruled out. Spinal cord abnormalities are common in suspected MS, and may occur asymptomatic. Although diagnostic classification is seldom changed, spinal cord imaging increases diagnostic sensitivity of MRI in patients with suspected MS. In addition, patients with primary progressive MS may possibly be earlier diagnosed. Finally, differentiation with atypical lesions may be improved. (orig.)

  1. 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...

  2. Creating fair lineups for suspects with distinctive features

    OpenAIRE

    Zarkadi, Theodora; Wade, Kimberley A.; Stewart, Neil

    2009-01-01

    In their descriptions, eyewitnesses often refer to a culprit's distinctive facial features. However, in a police lineup, selecting the only member with the described distinctive feature is unfair to the suspect and provides the police with little further information. For fair and informative lineups, the distinctive feature should be either replicated across foils or concealed on the target. In the present experiments, replication produced more correct identifications in target-present lineup...

  3. 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.)

  4. MRI for clinically suspected pediatric appendicitis: case interpretation

    International Nuclear Information System (INIS)

    Moore, Michael M.; Brian, James M.; Methratta, Sosamma T.; Hulse, Michael A.; Choudhary, Arabinda K.; Eggli, Kathleen D.; Boal, Danielle K.B.

    2014-01-01

    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.)

  5. 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.)

  6. 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.

  7. Does this adult patient with suspected bacteremia require blood cultures?

    Science.gov (United States)

    Coburn, Bryan; Morris, Andrew M; Tomlinson, George; Detsky, Allan S

    2012-08-01

    Clinicians order blood cultures liberally among patients in whom bacteremia is suspected, though a small proportion of blood cultures yield true-positive results. Ordering blood cultures inappropriately may be both wasteful and harmful. To review the accuracy of easily obtained clinical and laboratory findings to inform the decision to obtain blood cultures in suspected bacteremia. A MEDLINE and EMBASE search (inception to April 2012) yielded 35 studies that met inclusion criteria for evaluating the accuracy of clinical variables for bacteremia in adult immunocompetent patients, representing 4566 bacteremia and 25,946 negative blood culture episodes. Data were extracted to determine the prevalence and likelihood ratios (LRs) of findings for bacteremia. The pretest probability of bacteremia varies depending on the clinical context, from low (eg, cellulitis: 2%) to high (eg, septic shock: 69%). Elevated temperatures alone do not accurately predict bacteremia (for ≥38°C [>100.3°F], LR, 1.9 [95% CI, 1.4-2.4]; for ≥38.5°C [>101.2°F], LR, 1.4 [95% CI, 1.1-2.0]), nor does isolated leukocytosis (LR, cultures should not be ordered for adult patients with isolated fever or leukocytosis without considering the pretest probability. SIRS and the decision rule may be helpful in identifying patients who do not need blood cultures. These conclusions do not apply to immunocompromised patients or when endocarditis is suspected.

  8. Autism spectrum disorder symptoms in juvenile suspects of sex offenses.

    Science.gov (United States)

    't Hart-Kerkhoffs, Lisette A; Jansen, Lucres M; Doreleijers, Theo A; Vermeiren, Robert; Minderaa, Ruud B; Hartman, Catharina A

    2009-02-01

    To investigate autism spectrum disorder (ASD) symptoms in juvenile suspects of sex offenses. A group of 175 juvenile suspected sex offenders (all males, mean +/- SD age = 14.9 +/- 1.4 years) was compared with a matched healthy control group (N = 500, mean +/- SD age = 14.0 +/- 1.4 years) and a group of children with DSM-IV-diagnosed ASD (N = 114, mean +/- SD age = 14.2 +/- 1.9 years) with respect to autistic symptoms as measured by means of a standardized questionnaire, the Children's Social Behavior Questionnaire. Furthermore, specific subgroups of sexual offenders, i.e., child molesters, solo peer offenders, and group offenders, were compared with regard to levels of ASD symptoms. The study was conducted from May 2003 to December 2006. Significantly higher levels of ASD symptoms were found in juvenile sex offenders than in healthy controls, while levels were lower than in the ASD group (F = 148.259, p symptoms than group offenders (F = 5.127, p symptoms are higher in juvenile suspects of sex offenses as compared to the healthy population, which argues for considering specific diagnostic assessment in this population, especially in solo offenders and child molesters. Copyright 2009 Physicians Postgraduate Press, Inc.

  9. Police officers' perceptions and experiences with mentally disordered suspects.

    Science.gov (United States)

    Oxburgh, Laura; Gabbert, Fiona; Milne, Rebecca; Cherryman, Julie

    Despite mentally disordered suspects being over-represented within the criminal justice system, there is a dearth of published literature that examines police officers' perceptions when interviewing this vulnerable group. This is concerning given that police officers are increasingly the first point of contact with these individuals. Using a Grounded Theory approach, this study examined 35 police officers' perceptions and experiences when interviewing mentally disordered suspects. Current safeguards, such as Appropriate Adults, and their experiences of any training they received were also explored. A specially designed questionnaire was developed and distributed across six police forces in England and Wales. Nine conceptual categories emerged from the data that highlighted how police officers' level of experience impacted upon their perceptions when dealing with this cohort. As a consequence, a new model grounded within Schema Theory has emerged termed Police Experience Transitional Model. Implications include the treatment and outcome of mentally disordered suspects being heavily dependent on whom they encounter within the criminal justice system. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. [Suspected Alzheimer's disease. Selection of outpatients for neuropsychological assessment].

    Science.gov (United States)

    Wolf, S A; Henry, M; Deike, R; Ebert, A D; Wallesch, C-W

    2008-04-01

    Incipient Alzheimer's disease (AD) is frequently suspected by neurologists and psychiatrists, but diagnosis is difficult to establish. The aim of this report was to analyse to what extent suspicion is confirmed by a comprehensive neuropsychological examination intended to distinguish different types of dementia. Descriptive data analysis was used for investigating the differential diagnoses of 47 outpatients with suspected AD referred to a department of neuropsychology by physicians in private practice. Data analysis was based upon the NINCDS-ADRDA diagnostic criteria of AD. Only 38% of the outpatients examined with suspected AD met the NINCDS-ADRDA diagnostic criteria for AD or mixed dementia from a neuropsychological point of view, whereas 22% met criteria for other types of dementia. The remaining patients met criteria for distinct differential diagnoses (23%) or lacked pathological findings in neuropsychological functions (17%). Neuropsychology is an essential part in the differential diagnosis of mild to moderate dementias. It can aid in differential therapeutic considerations concerning the treatment of dementia, for example in selecting appropriate treatments or avoiding expensive but inappropriate ones.

  11. How useful is gastroesophageal reflux scintigraphy in suspected childhood aspiration

    Energy Technology Data Exchange (ETDEWEB)

    Fawcett, H.D.; Adams, J.C.; Hayden, C.K.; Swischuk, L.E.

    1988-05-01

    It has been suggested that gastroesophageal reflux scintigraphy might be useful in assisting one in determining therapy for patients suspected of aspirating or becoming apneic secondary to gastroesophageal reflux. This, however, has not been our experience and in reviewing 23 patients with recurrent pneumonia and/or apnea who had gastroesophageal reflux scintigraphy, we were able to detect aspiration in only one. This was especially significant since 13 (59%) of these patients had demonstrable reflux, and of these, eight were treated successfully for suspected aspiration even though none was demonstrated isotopically. To be sure, the demonstration of pulmonary aspiration with gastroesophageal reflux scintigraphy had little influence on patient selection and response to therapy. For this reason we feel there is little justification in depending on the GRS for the specific purpose of trying to document pulmonary aspiration in infants and children who are refluxing. One of the more serious complications of gastroesophageal (GE) reflux is aspiration leading to recurrent pulmonary infections and/or apnea. However, it always has been difficult to demonstrate actual aspiration into the lungs, and to be sure, barium studies of the upper GI tract seldom reveal this complication. Recently, however, considerable interest has been generated in gastroesophageal scintigraphy (GRS) as a possible means of documenting such aspiration. Rationale for this stems from the fact that suspected patients can be studied over a longer period of time and in addition, delayed and overnight images can be obtained. However, our experience does not support GRS as being an adequate method for demonstrating aspiration.

  12. Thoracic computed tomography in patients with suspected malignant pleural effusions

    International Nuclear Information System (INIS)

    Traill, Zoee C.; Davies, Robert J.O.; Gleeson, Fergus V.

    2001-01-01

    AIM: To assess the role of contrast-enhanced computed tomography (CT) prospectively in patients with suspected malignant pleural effusions. MATERIALS AND METHODS: Forty consecutive patients referred for the investigation of a suspected malignant pleural effusion had contrast-enhanced thoracic CT, thoracoscopy, thoraco-centesis and pleural biopsy, either percutaneously or at thoracoscopy. Final diagnoses were based on histopathological or cytological analysis (n = 30), autopsy findings (n = 3) or clinical follow-up (n = 7). The pleural surfaces were classified at contrast-enhanced CT as normal or abnormal and, if abnormal, as benign or malignant in appearance using previously established CT criteria for malignant pleural thickening by two observers unaware of the pathological diagnosis. RESULTS: Pleural effusions were malignant in 32 patients and benign in eight patients. Pleural surfaces assessed at CT showed features of malignancy in 27 out of 32 patients with a malignant effusion (sensitivity 84%, specificity 100%). Overall, CT appearances indicated the presence of malignancy in 28 of 32 (87%) patients. All eight patients with benign pleural disease were correctly diagnosed by CT. CONCLUSION: Contrast-enhanced CT is of value in patients with suspected malignant pleural effusions. The previously established criteria for malignant pleural thickening of nodularity, irregularity and pleural thickness >1 cm are reliable in the presence of a pleural effusion. Traill, Z.C. et al. (2001)

  13. Total quality management for addressing suspect parts at the Oak Ridge High Flux Isotope Reactor

    International Nuclear Information System (INIS)

    Hendrix, K.A.; Tulay, M.P.

    1993-01-01

    Martin Marietta Energy System (MMES) Research Reactors Division (RRD), operator of the High Flux Isotope Reactor (HFIR) recently embarked on an aggressive Program to address the issue of suspect Parts and to enhance their procurement process. Through the application of TQM process improvement, RRD has already achieved improved efficiency in specifying, procuring, and accepting replacement items for its largest research reactor. These process improvements have significantly decreased the risk of installing suspect parts in the HFIR safety systems. To date, a systematic plan has been implemented, which includes the following elements: Process assessment and procedure review; Procedural enhancements; On-site training and technology transfer; Enhanced receiving inspections; Performance supplier evaluations and source verifications integrated processes for utilizing commercial grade products in nuclear safety-related applications. This paper will describe the above elements, how a partnership between MMES and Gilbert/Commonwealth facilitated the execution of the plan, and how process enhancements were applied. We will also present measures for improved efficiency and productivity, that MMES intends to continually address with Quality Action Teams

  14. 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

  15. Heating/ethanol-response of poly methyl methacrylate (PMMA) with gradient pre-deformation and potential temperature sensor and anti-counterfeit applications

    International Nuclear Information System (INIS)

    Lu, Haibao; Huang, Wei Min; Ge, Yu Chun; Zhang, Fan; Zhao, Yong; Wu, Xue Lian; Geng, Junfeng

    2014-01-01

    In this paper, the heating/ethanol-response of a commercial poly methyl methacrylate (PMMA) is investigated. All PMMA samples are pre-deformed by means of impression (surface compression with a mold) to introduce a gradient pre-strain/stress field. Two types of molds are applied in impression. One is a Singaporean coin and the other is a particularly designed mold with a variable protrusive feature on top. Two potential applications—temperature sensors to monitor overheating temperatures and anti-counterfeit labels with a water-mark that appears only upon heating to a particular temperature—are demonstrated. Since the heating-responsive shape memory effect (SME) is an intrinsic feature of almost all polymers, other conventional polymers may be used in such applications as well. (technical note)

  16. A Novel Approach to Synthesise a Dual-Mode Luminescent Composite Pigment for Uncloneable High-Security Codes to Combat Counterfeiting.

    Science.gov (United States)

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

    2017-12-01

    A strategy is demonstrated to protect valuable items, such as currency, pharmaceuticals, important documents, etc. against counterfeiting, by marking them with luminescent security codes. These luminescent security codes were printed by employing luminescent ink formulated from a cost effective dual-mode luminescent composite pigment of Gd 1.7 Yb 0.2 Er 0.1 O 3 and Zn 0.98 Mn 0.02 S phosphors using commercially available PVC Gold medium. In the composite, Gd 1.7 Yb 0.2 Er 0.1 O 3 and Zn 0.98 Mn 0.02 S account for upconversion and downconversion processes, respectively. The synthesis procedure of the composite involves the admixing of Gd 1.7 Yb 0.2 Er 0.1 O 3 nanorods and Zn 0.98 Mn 0.02 S phosphor, synthesised by hydrothermal and facile solid-state reaction methods, respectively. The structural, morphological, microstructural, and photoluminescent features of Gd 1.7 Yb 0.2 Er 0.1 O 3 nanorods, Zn 0.98 Mn 0.02 S phosphor and composite were characterised by using XRD, SEM, TEM, and photoluminescence (PL) techniques, respectively. The distribution of PL intensity of the printed pattern was examined by using confocal PL mapping microscopy. The obtained results reveal that security codes printed using ink formulated from this bi-luminescent composite pigment provide dual-stage security against counterfeiting. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. 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

  18. 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

    2016-01-01

    Background & objectives: 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. Methods: 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 IS711 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. Results: 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. Interpretation & conclusions: 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. PMID:27488010

  19. Cohort profile: prevalence of valvular heart disease in community patients with suspected heart failure in UK.

    Science.gov (United States)

    Marciniak, Anna; Glover, Keli; Sharma, Rajan

    2017-01-27

    The aim of this study was to evaluate the proportion of suspected heart failure patients with significant valvular heart disease. Early diagnosis of valve disease is essential as delay can limit treatment and negatively affect prognosis for undiagnosed patients. The prevalence of unsuspected valve disease in the community is uncertain. We prospectively evaluated 79 043 patients, between 2001 and 2011, who were referred to a community open access echocardiography service for suspected heart failure. All patients underwent a standard transthoracic echocardiogram according to British Society of Echocardiography guidelines. Of the total number, 29 682 patients (37.5%) were diagnosed with mild valve disease, 8983 patients (11.3%) had moderate valve disease and 2134 (2.7%) had severe valve disease. Of the total number of patients scanned, the prevalence of aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation was 10%, 8.4%, 1%, and 12.5% respectively. 18% had tricuspid regurgitation. 5% had disease involving one or more valves. Of patients with suspected heart failure in the primary care setting, a significant proportion have important valvular heart disease. These patients are at high risk of future cardiac events and will require onward referral for further evaluation. We recommend that readily available community echocardiography services should be provided for general practitioners as this will result in early detection of valve disease. 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/.

  20. 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

  1. How useful is gastroesophageal reflux scintigraphy in suspected childhood aspiration?

    International Nuclear Information System (INIS)

    Fawcett, H.D.; Adams, J.C.; Hayden, C.K.; Swischuk, L.E.

    1988-01-01

    It has been suggested that gastroesophageal reflux scintigraphy might be useful in assisting one in determining therapy for patients suspected of aspirating or becoming apneic secondary to gastroesophageal reflux. This, however, has not been our experience and in reviewing 23 patients with recurrent pneumonia and/or apnea who had gastroesophageal reflux scintigraphy, we were able to detect aspiration in only one. This was especially significant since 13 (59%) of these patients had demonstrable reflux, and of these, eight were treated successfully for suspected aspiration even though none was demonstrated isotopically. To be sure, the demonstration of pulmonary aspiration with gastroesophageal reflux scintigraphy had little influence on patient selection and response to therapy. For this reason we feel there is little justification in depending on the GRS for the specific purpose of trying to document pulmonary aspiration in infants and children who are refluxing. One of the more serious complications of gastroesophageal (GE) reflux is aspiration leading to recurrent pulmonary infections and/or apnea. However, it always has been difficult to demonstrate actual aspiration into the lungs, and to be sure, barium studies of the upper GI tract seldom reveal this complication. Recently, however, considerable interest has been generated in gastroesophageal scintigraphy (GRS) as a possible means of documenting such aspiration. Rationale for this stems from the fact that suspected patients can be studied over a longer period of time and in addition, delayed and overnight images can be obtained. However, our experience does not support GRS as being an adequate method for demonstrating aspiration. (orig.)

  2. Use of biomarkers in triage of patients with suspected stroke.

    Science.gov (United States)

    Vanni, Simone; Polidori, Gianluca; Pepe, Giuseppe; Chiarlone, Melisenda; Albani, Alberto; Pagnanelli, Adolfo; Grifoni, Stefano

    2011-05-01

    The absence of a rapidly available and sensitive diagnostic test represents an important limitation in the triage of patients with suspected stroke. The aim of the present study was to investigate the triage accuracy of a novel test that measures blood-borne biomarkers (triage stroke panel, TSP) and to compare its accuracy with that of the Cincinnati Prehospital Stroke Scale (CPSS). Consecutive patients with suspected stroke presenting to the Emergency Departments of three Italian hospitals underwent triage by a trained nurse according to the CPSS and had blood drawn for TSP testing. The TSP simultaneously measures four markers (B-type natriuretic peptide, D-dimer, matrix metalloproteinase-9, and S100β) presenting a single composite result, the Multimarker Index (MMX). Stroke diagnosis was established by an expert committee blinded to MMX and CPSS results. There were 155 patients enrolled, 87 (56%) of whom had a final diagnosis of stroke. The area under the receiver operating characteristic (ROC) curve for CPSS was 0.77 (95% confidence interval [CI] 0.70-0.84) and that of MMX was 0.74 (95% CI 0.66-0.82) (p = 0.285). Thus, both tests, when used alone, failed to recognize approximately 25% of strokes. The area under the ROC curve of the combination of the two tests (0.86, 95% CI 0.79-0.91) was significantly greater than that of either single test (p = 0.01 vs. CPSS and p vs. TSP). In an emergency care setting, a panel test using multiple biochemical markers showed triage accuracy similar to that of CPSS. Further studies are needed before biomarkers can be introduced in the clinical work-up of patients with suspected stroke. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. 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.

  4. Investigation of suspected TRALI cases in 2006–2011

    Directory of Open Access Journals (Sweden)

    Marjeta Maček Kvanka

    2012-12-01

    Methods: In 2006–2011, eight suspected TRALI cases that met consensus clinical criteria and had chest radiograph were investigated in the Blood Transfusion Center of Slovenia. Patients and all donors of blood components transfused within 6 hours before the onset of acute respiratory distress were investigated for leukocyte antibodies against HLA class I and II antigens, and antibodies against neutrophil antigens HNA. All cases were investigated for patient, donor and blood component characteristics. In cooperation with clinicians, chest radiographs and alternative risk factors for acute lung injury (ALI were evaluated.

  5. Creating fair lineups for suspects with distinctive features.

    Science.gov (United States)

    Zarkadi, Theodora; Wade, Kimberley A; Stewart, Neil

    2009-12-01

    In their descriptions, eyewitnesses often refer to a culprit's distinctive facial features. However, in a police lineup, selecting the only member with the described distinctive feature is unfair to the suspect and provides the police with little further information. For fair and informative lineups, the distinctive feature should be either replicated across foils or concealed on the target. In the present experiments, replication produced more correct identifications in target-present lineups--without increasing the incorrect identification of foils in target-absent lineups--than did concealment. This pattern, and only this pattern, is predicted by the hybrid-similarity model of recognition.

  6. Cytogenetic dosimetry in suspected cases of ionizing radiation occupational exposure

    International Nuclear Information System (INIS)

    Ramalho, Adriana T.; Costa, Maria Lucia P.; Oliveira, Monica S.; Silva, Francisco Cesar A. da

    2001-01-01

    Cytogenetic dosimetry is very useful in routine as well as in serious accident situations in which exposed individuals do not wear physical dosimeters. Since 1984, the technique of cytogenetic dosimetry has been used as a routine in our laboratory at IRD/CNEN to complement the data of physical dosimetry. In the period from 1984 to 2000, 138 cases of occupational overexposure of individual dosimeters were investigated by us. In total, only in 36 of the 138 cases investigated the overexposure was confirmed by cytogenetic dosimetry. The data indicates a total confirmation index of just 26% of the suspected cases.(author)

  7. Glyphosate efficacy on sourgrass biotypes with suspected resistance collected in GR-crop fields

    Directory of Open Access Journals (Sweden)

    Hellen Martins da Silveira

    2017-11-01

    Full Text Available In Brazil, infestations of crop areas with glyphosate-resistant (GR sourgrass (Digitaria insularis (L. Fedde biotypes has risen significantly, increasing crop production costs. Glyphosate efficacy on three biotypes (GO, BA and MT of sourgrass with suspected resistance was evaluated. A susceptible biotype (MG was used as the control. The results confirmed that the MG and GO biotypes were susceptible to glyphosate (control > 90%. The MG biotype exhibited growth reduction and mortality by 50% (GR50 and LD50, respectively with mean glyphosate doses of 243.7 and 431.6 g ae ha-1. The resistance index of the biotypes with suspected resistance ranged from 2.8 to 6.1 in relation to GR50 and between 1.4 to 26.7 in relation to LD50. The glyphosate susceptibility ranking of the sourgrass biotypes was MG < GO < MT < BA. The MT and BA biotypes demonstrated high glyphosate resistance levels, and the GO biotype had a high potential to develop resistance. Farmers should avoid the application of glyphosate overdoses to minimize the selection pressure on weeds.

  8. A case of suspected 'Bickerstaff's encephalitis' and its CT findings

    International Nuclear Information System (INIS)

    Moto, Atsufumi; Endo, Shunro; Ohmori, Tomoaki; Oka, Nobuo; Takaku, Akira

    1985-01-01

    A case of suspected ''Bickerstaff's encephalitis'' was presented with special reference to the CT findings. A 4-year-old girl exhibited fever and nausea after the beginning of December, 1983, followed by unsteady gait on January 1, 1984. She was admitted to another hospital and diagnosed by means of a spinalfluid examination as having aseptic meningitis. Her symptoms subsided transiently, but then she began again to suffer recurrently from unsteady gait on January 27. After that she developed dysarthria and dysphagia, a disturbance of eye movement was observed, and she became lethargic and disoriented. On February 6, she was transferred to our hospital. Plain CT scan on admission revealed a low-density area on the left cerebellar peduncle and the inferior medial part of the left temporal lobe. Moreover, the low-density area was heterogenously enhanced with the contrast medium. Angiography showed no abnormal findings. Considering these CT findings, we suspected a pontine tumor. Four days after her admission, however, her symptoms and signs began rapidly to subside, and also the abnormal findings on the CT scan diminished gradually as the symptoms were relieved. On March 2, she was discharged without any neurological abnormality. (author)

  9. PMS2 involvement in patients suspected of Lynch syndrome.

    Science.gov (United States)

    Niessen, Renée 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

    2009-04-01

    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, PMS2, play a far more important role in Lynch syndrome than initially thought. To explore this further, we determined the prevalence of pathogenic germline PMS2 mutations in a series of Lynch syndrome-suspected patients. Ninety-seven patients who had early-onset microsatellite instable colorectal or endometrial cancer, or multiple Lynch syndrome-associated tumors and/or were from an Amsterdam Criteria II-positive family were selected for this study. These patients carried no pathogenic germline mutation in MLH1, MSH2, or MSH6. When available, tumors were investigated for immunohistochemical staining (IHC) for PMS2. PMS2 was screened in all patients by exon-by-exon sequencing. We identified four patients with a pathogenic PMS2 mutation (4%) among the 97 patients we selected. IHC of PMS2 was informative in one of the mutation carriers, and in this case, the tumor showed loss of PMS2 expression. In conclusion, our study confirms the finding of previous studies that PMS2 is more frequently involved in Lynch syndrome than originally expected.

  10. 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.

  11. The role of MRI in suspected inner ear malformations

    International Nuclear Information System (INIS)

    Koesling, S.; Juettemann, S.; Amaya, B.; Rasinski, C.; Bloching, M.; Koenig, E.

    2003-01-01

    Purpose: This is a prospective analysis of the value of MRI in suspected inner ear malformations. Materials and Methods: In 50 patients (43 children and young adults, 7 adults) with suspected inner ear malformation MRI (1.5 T) was performed. In addition, 42 of these patients underwent CT. For the analysis of the inner ear structures, the constructive interference in steady state (CISS) sequence with 0.7 mm slice thickness was used. Functional tests revealed a sensorineural hearing loss or deafness in 82 temporal bones (TB) and a combined hearing loss in 4 TB. The hearing loss was unilateral in 14 patients. MRI and CT findings were compared. Results: Imaging findings were normal in 58 TB. The pathological findings included inner ear malformations (35 TB), inflammatory changes (4 TB), partial obliteration of labyrinth (2 TB) and congenital aural atresia (1 TB). An isolated absence of the cochlear nerve (1 TB) could only be found by MRI. In the remaining cases, an inner ear malformation was diagnosed by MRI and CT with the same confidence but MRI was superior in displaying the fine details. Conclusions: MRI will become the method of choice in the diagnosis of inner ear malformations. (orig.) [de

  12. Early diagnosis of dengue virus infection in clinically suspected cases

    International Nuclear Information System (INIS)

    Afridi, N.K.; Ahmed, S.; Ali, N.; Khan, S.A.

    2016-01-01

    Objective: Comparison of real time reverse transcriptase polymerase chain reaction (RTPCR) and immunoglobulin M (IgM) capture enzyme linked immunosorbent assay (ELISA) for diagnosis of dengue virus infection in first week of illness in clinically suspected patients of dengue fever. Study Design: Cross sectional study. Place and Duration of Study: Department of haematology, Armed Forces Institute of Pathology (AFIP) Rawalpindi from Jan 2013 to Nov 2013. Material and Methods: A cross sectional study including 68 clinically suspected patients of dengue fever according to the World Health Organization (WHO) criteria. IgM capture ELISA and RT PCR for dengue virus ribonucleic acid (RNA) was performed on samples collected from patients having fever for 1 to 7 days. These were divided into two groups. Patients in group 1 presented with fever of 4 days or less, patients in group 2 had fever of 5 to 7 days duration. Results: In group 1, 72 percent of the patients were positive by RT PCR while 31 percent were positive by IgM capture ELISA. In group 2, 43 percent of the patients were positive by RT PCR while 97 percent were positive by ELISA. Conclusion: RT PCR can be used for early detection of dengue virus infection in the first few days of fever while IgM ELISA is diagnostic afterwards. (author)

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

    International Nuclear Information System (INIS)

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

    1999-01-01

    Objective. To demonstrate the utility of magnetic resonance (MR) imaging in the diagnosis of complete and partial ligamentous injuries in patients with suspected atlanto-occipital dissociation (AOD). Materials and methods. Five patients with suspected AOD had MR imaging performed within an average of 4 days after injury. MR scans were reviewed with specific analysis of craniocervical ligamentous structures. Charts were reviewed to obtain clinical information regarding presentation, treatment, hospital course, and outcome. Results. Two patients demonstrated MR evidence of complete AOD. One had disruption of all visualized major ligamentous structures at the craniocervical junction with anterolisthesis and evidence of cord damage. The second had injuries to the tectorial membrane, superior band of the cruciform ligament, apical ligament, and interspinous ligament at C 1-2. The remaining three patients sustained incomplete severance of the ligamentous structures at the craniocervical junction. All patients demonstrated subtle radiographic findings suggestive of AOD, including soft tissue swelling at the craniocervical junction without fracture. The two patients with complete AOD died. The three patients with partial AOD were treated with stabilization. On follow-up, these three children were asymptomatic following their craniocervical injury. Conclusion. MR imaging of acute AOD provides accurate identification of the craniocervical ligaments injured, classification of full versus partial ligamentous disruption, and analysis of accompanying spinal cord injury. This information is important for early appropriate neurosurgical management and preservation of neurologic function in survivors. (orig.)

  14. Value of noncontrast spiral CT for suspected acute appendicitis

    International Nuclear Information System (INIS)

    Choi, Pil Yeob; Lee, Sang Wook; Kwon, Jae Soo; Sung, Young Soon; Rho, Myoung Ho; Chang, Jeong A.

    1998-01-01

    To assess the diagnostic accuracy and clinical efficacy of noncontrast spiral CT in patients with suspected acute appendicitis. Over a six-month period, 100 patients with suspected acute appendicitis were prospectively evaluated with noncontrast spiral CT. All scans were obtained from the lower body of L3 to the symphysis pubis, with 5mm or 10mm collimation and pitch of 1 or 1.5, and without intravenous or oral contrast material. Diagnosis was established by means of surgical or clinical follow-up. Prospective diagnosis based on CT findings was compared with surgical results and clinical follow-up. Acute appendicitis was confirmed in 47 of 100 patients. On the basis of the Ct findings, SI patients were prospectively interpreted as positive for appendicitis, but in six the diagnosis was false-positive. Two of the 47 with acute appendicitis were prospectively interpreted as normal. The preoperative diagnosis of acute appendicitis was, thus, 45 true-positive, 47 true-negative, six false-positive and two false-negative yielding a sensitivity of 96%, a specificity of 89%, an accuracy of 92%, a positive predictive value of 88%, and a negative predictive value of 96%. Using CT, an alternative diagnosis was established in 14 patients. Noncontrast spiral CT is a useful technique for diagnosing acute appendicitis. =20

  15. Method for detection of a suspect viral deoxyribonucleic acid in an acellular biological fluid

    Energy Technology Data Exchange (ETDEWEB)

    Berninger, M S

    1982-10-06

    A method for evaluating an acellular biological fluid for the presence of a suspect viral DNA, such as DNA of the Hepatitis-B virus, is described. The acellular biological fluid is treated to immobilize in denatured form the DNAs including the suspect viral DNA on a solid substrate. This substrate is contacted with a solution including radioisotopically-labelled suspect viral denatured DNA to renature the immobilized suspect viral native DNA. The solid substrate is then evaluated for radioisotopically-labelled suspect viral renatured DNA.

  16. Method for detection of a suspect viral deoxyribonucleic acid in an acellular biological fluid

    International Nuclear Information System (INIS)

    Berninger, M.S.

    1982-01-01

    A method for evaluating an acellular biological fluid for the presence of a suspect viral DNA, such as DNA of the Hepatitis-B virus, is described. The acellular biological fluid is treated to immobilize in denatured form the DNAs including the suspect viral DNA on a solid substrate. This substrate is contacted with a solution including radioisotopically-labelled suspect viral denatured DNA to renature the immobilized suspect viral native DNA. The solid substrate is then evaluated for radioisotopically-labelled suspect viral renatured DNA. (author)

  17. Unfair Lineups Make Witnesses More Likely to Confuse Innocent and Guilty Suspects.

    Science.gov (United States)

    Colloff, Melissa F; Wade, Kimberley A; Strange, Deryn

    2016-09-01

    Eyewitness-identification studies have focused on the idea that unfair lineups (i.e., ones in which the police suspect stands out) make witnesses more willing to identify the police suspect. We examined whether unfair lineups also influence subjects' ability to distinguish between innocent and guilty suspects and their ability to judge the accuracy of their identification. In a single experiment (N = 8,925), we compared three fair-lineup techniques used by the police with unfair lineups in which we did nothing to prevent distinctive suspects from standing out. Compared with the fair lineups, doing nothing not only increased subjects' willingness to identify the suspect but also markedly impaired subjects' ability to distinguish between innocent and guilty suspects. Accuracy was also reduced at every level of confidence. These results advance theory on witnesses' identification performance and have important practical implications for how police should construct lineups when suspects have distinctive features. © The Author(s) 2016.

  18. 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

  19. PERAN PRODUCT CUES AND RISK AVERSION PADA PURCHASE INTENTION DAN POST PURCHASE FEELINGS

    Directory of Open Access Journals (Sweden)

    Sri Rejeki Ekasasi

    2015-11-01

    Full Text Available AbstractThe research aimed to investigate the influence of extrinsic cues and intrinsic cues and risk aversion towards purchase intention and post-purchase feeling of counterfeited computer software and music CD. This research study collected data from two populations which are students and employee. Approximately 128 respondents involved to give respond for the survey. The analysis using Structural Equation Model (SEM show that product cues and risk aversion give different significant impact towards purchase intention and post-purchase feeling of counterfeited computer software and music CD. The research concluded that risk aversion and extrinsic cues has a significant influence to purchase intention of counterfeited computer software while it does not appear similar result to music CD. Moreover, the study revealed that for both counterfeited computer software and music CD, the purchase intention is proven to have negative significant influence towards post-purchase feelings.Keywords: risk aversion, extrinsic cues, intrinsic cues, purchase intention, post-purchase feelingsAbstrakTujuan dari penelitian ini adalah untuk melihat pengaruh atribut ekstrinsik dan intrinsic produk serta aspek menolak resiko terhadap niat beli dan perasaan paska beli software computer dan CD music bajakan. Penelitian ini diharapkan akan memperoleh sebuah model dengan pendekatan cultural dan strategi bisnis untuk memblokir atau mengurangi produk bajakan yang dapat diakses konsumen di pasar. Data primer akan dikumpulkan dari dua populasi, kelompok mahasiswa dan kelompok pekerja, dari empat kota besar di Indonesia yaitu Jakarta, Semarang, Surabaya, dan Yogyakarta. Lebih kurang 128 responden terlibat dalam penelitian ini. Hasil penelitian menunjukkan bahwa aspek atribut produk yang bersifat ekstrinsik dan aspek menolak resiko terbukti memiliki hubungan signifikan mempengaruhi niat beli software computer, akan tetapi lain tidak demikian pada niat beli CD music bajakan

  20. Attitudes to coping with radiologically suspect or contaminated milk in the UK: a dairy industry viewpoint

    International Nuclear Information System (INIS)

    Komorowski, E.S.

    2005-01-01

    The attitudes of the UK milk processing industry to a nuclear incident which resulted in milk supplies being suspected of being contaminated, or actually being contaminated, with radioactivity is examined. The factors influencing these attitudes are discussed, together with their implications. In the event of a nuclear incident in which part of the United Kingdom's milk supply is possibly contaminated, the milk processing industry will want to ensure that consumers and retailers maintain complete confidence in dairy products. As a consequence the industry will require that solutions are not adopted merely to avoid wastage of milk, or awkward milk disposal problems. In the early history of the BSE crisis the government wrongly assured consumers that beef was completely safe to eat. It will be necessary to ensure that any assurances that milk is safe, following a nuclear incident, are well founded

  1. Distemper in raccoons and foxes suspected of having rabies

    Science.gov (United States)

    Habermann, R.T.; Herman, C.M.; Williams, F.P.

    1958-01-01

    1) Twenty-one raccoons and 3 red foxes were collected from areas where suspected rabies occurred. All were found to be nonrabid. 2) Distemper was diagnosed in 14 of the 21 raccoons by demonstrating intracytoplasmic and intranuclear inclusions in the brain and visceral tissues. Two of the 3 foxes were considered to have distemper; the clinical signs were typical and mouse inoculation tests were negative for rabies. 3) Deaths of the other 7 raccoons were attributed to: leishmaniasis 1, gastritis 1, bronchopneumonia 1, parasitism 2, car injury 1; 1 showed no significant lesions. The death of 1 fox was attributed to parasitism. 4) Distemper may be a frequent cause of death in raccoons and foxes, in epizootics which simulate rabies.

  2. Diagnosis of suspected venous thromboembolic disease in pregnancy

    International Nuclear Information System (INIS)

    Scarsbrook, A.F.; Evans, A.L.; Owen, A.R.; Gleeson, F.V.

    2006-01-01

    Venous thromboembolic disease is a leading cause of maternal mortality during pregnancy. Early and accurate radiological diagnosis is essential as anticoagulation is not without risk and clinical diagnosis is unreliable. Although the disorder is potentially treatable, unnecessary treatment should be avoided. Most of the diagnostic imaging techniques involve ionizing radiation which exposes both the mother and fetus to finite radiation risks. There is a relative lack of evidence in the literature to guide clinicians and radiologists on the most appropriate method of assessing this group of patients. This article will review the role of imaging of suspected venous thromboembolic disease in pregnant patients, highlight contentious issues such as radiation risk, intravenous contrast use in pregnancy and discuss the published guidelines, as well as suggesting an appropriate imaging algorithm based on the available evidence

  3. Strength training for a child with suspected developmental coordination disorder.

    Science.gov (United States)

    Menz, Stacy M; Hatten, Kristin; Grant-Beuttler, Marybeth

    2013-01-01

    Children with developmental coordination disorder (DCD) demonstrate difficulty with feedforward motor control and use varied compensatory strategies. To examine gross motor function changes following strength training in a child with motor control difficulties. A girl aged 6 years 11 months, with apraxia and hypotonia, and demonstrating motor delays consistent with DCD. Twenty-four strength training sessions were completed using a universal exercise unit. Postintervention scores significantly improved on the Bruininks-Oseretsky test of motor proficiency, second edition, and the Canadian occupational performance measure scores and raised the developmental coordination disorder questionnaire, revised 2007, scores above the range where DCD is suspected. Nonsignificant changes in strength were observed. Improved function and significant gains in manual coordination were observed following blocked practice of isolated, simple joint movements during strength training. Improved motor skills may be because of effective use of feedforward control and improved stabilization. Strength training does not rehearse skills using momentum, explaining nonsignificant changes in locomotor or locomotion areas.

  4. Management of suspected monogenic lung fibrosis in a specialised centre

    Directory of Open Access Journals (Sweden)

    Raphael Borie

    2017-04-01

    Full Text Available At least 10% of patients with interstitial lung disease present monogenic lung fibrosis suspected on familial aggregation of pulmonary fibrosis, specific syndromes or early age of diagnosis. Approximately 25% of families have an identified mutation in genes mostly involved in telomere homeostasis, and more rarely in surfactant homeostasis. Beyond pathophysiological knowledge, detection of these mutations has practical consequence for patients. For instance, mutations involved in telomere homeostasis are associated with haematological complications after lung transplantation and may require adapted immunosuppression. Moreover, relatives may benefit from a clinical and genetic evaluation that should be specifically managed. The field of genetics of pulmonary fibrosis has made great progress in the last 10 years, raising specific problems that should be addressed by a specialised team.

  5. Bile acid aspiration in suspected ventilator-associated pneumonia.

    Science.gov (United States)

    Wu, Yu-Chung; Hsu, Po-Kuei; Su, Kang-Cheng; Liu, Lung-Yu; Tsai, Cheng-Chien; Tsai, Shu-Ho; Hsu, Wen-Hu; Lee, Yu-Chin; Perng, Diahn-Warng

    2009-07-01

    The aims of this study were to measure the levels of bile acids in patients with suspected ventilator-associated pneumonia (VAP) and provide a possible pathway for neutrophilic inflammation to explain its proinflammatory effect on the airway. Bile acid levels were measured by spectrophotometric enzymatic assay, and liquid chromatography mass spectrometry was used to quantify the major bile acids. Alveolar cells were grown on modified air-liquid interface culture inserts, and bile acids were then employed to stimulate the cells. Reverse transcriptase polymerase chain reaction and Western blots were used to determine the involved gene expression and protein levels. The mean (+/- SE) concentration of total bile acids in tracheal aspirates was 6.2 +/- 2.1 and 1.1 +/- 0.4 mumol/L/g sputum, respectively, for patients with and without VAP (p VAP group (p aspiration may reduce the intensity of neutrophilic inflammation in intubated and mechanically ventilated patients in the ICU.

  6. [Diagnostic strategy in patients with clinically suspected deep vein thrombosis

    DEFF Research Database (Denmark)

    Mantoni, Margit Yvonne; Kristensen, M.; Brogaard, M.H.

    2008-01-01

    INTRODUCTION: The standard method for diagnosing deep vein thrombosis (DVT) involves determination of D-dimer and ultrasound scanning. In an attempt to reduce the number of ultrasound examinations we have supplemented this with a clinical probability estimate for DVT (DVT-score) over one year....... MATERIALS AND METHODS: A total of 508 consecutive patients presenting in the emergency room with suspected DVT had D-dimer and DVT-score performed. Patients with non-elevated D-dimer and a low or moderate DVT score received no treatment. The remainder had ultrasound scanning from the groin to the popliteal...... patients with normal D-dimer had high DVT-scores, none had DVT, so that the benefit from determining DVT-scores was modest. Ultrasound scanning revealed DVT in 85 out of 397 patients with elevated D-dimer. A repeat examination was performed in 91 patients with persisting symptoms, and disclosed DVT in two...

  7. Suspected seminal vesiculitis in an Asian elephant (Elephas maximus).

    Science.gov (United States)

    Kilburn, Jennifer J; Velguth, Karen E; Backues, Kay A

    2011-09-01

    A 32-year-old male Asian elephant (Elephas maximus) underwent routine transrectal stimulation for semen collection as part of an artificial insemination program. The procedure consisted of a preinsemination semen collection followed by two consecutive days of semen collections for artificial insemination. The second day's sample contained large numbers of inflammatory cells, intracellular bacteria, and phagocytized sperm. Semen was submitted for culture and sensitivity. Culture revealed Acinetobacter lwoffii, Staphylococcus intermedius, Kocuria roseus, and an unidentified gram-positive organism. Empirical antibiotic therapy with trimethoprim sulfa was initiated and then changed to enrofloxacin based on sensitivity panel results for a total of 28 days of treatment. Diagnostic semen collections were performed during treatment and 2 wk posttreatment to determine the success of therapy. Posttreatment collections revealed resolution of the inflammation. The origin of the infection was suspected to be the seminal vesicles.

  8. 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...

  9. Optical spectroscopy of known and suspected Herbig-Haro objects

    International Nuclear Information System (INIS)

    Cohen, M.; Fuller, G.A.; California Univ., Berkeley)

    1985-01-01

    Optical spectra of a number of suspected Herbig-Haro objects are presented. From these, the nature of these nebulosities are determined. Several of the nebulae are of very high density, perhaps due to their extreme youth. Extinctions measured toward DG Tau HH and the L1551 IRS 5 optical jet are in each case substantially less than the stellar values. It is suggested that this phenomenon reflects the existence of appreciably thick circumstellar dust disks around these, and two additional, exciting stars. Shock model diagnostics suggest that the emission lines in these Herbig-Haro nebulae arise in modest velocity shocks with sizable preshock densities in several cases. Radial velocities enable lower limits to be placed on the mass loss rates of those stars that have been detected in the radio continuum. 39 references

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

    International Nuclear Information System (INIS)

    McQueen, A.S.; Worthy, S.; Keir, M.J.

    2008-01-01

    Aims: To assess local clinical knowledge of the appropriate investigation of suspected acute pulmonary embolism (PE) and this compare with the 2003 British Thoracic Society (BTS) guidelines as a national reference standard. Methods: A clinical questionnaire was produced based on the BTS guidelines. One hundred and eight-six participants completed the questionnaires at educational sessions for clinicians of all grades, within a single NHS Trust. The level of experience amongst participants ranged from final year medical students to consultant physicians. Results: The clinicians were divided into four groups based on seniority: Pre-registration, Junior, Middle, and Senior. Forty-six point eight percent of all the clinicians correctly identified three major risk factors for PE and 25.8% recognized the definition of the recommended clinical probability score from two alternatives. Statements regarding the sensitivity of isotope lung imaging and computed tomography pulmonary angiography (CTPA) received correct responses from 41.4 and 43% of participants, respectively, whilst 81.2% recognized that an indeterminate ventilation-perfusion scintigraphy (V/Q) study requires further imaging. The majority of clinicians correctly answered three clinical scenario questions regarding use of D-dimers and imaging (78, 85, and 57.5%). There was no statistically significant difference between the four groups for any of the eight questions. Conclusions: The recommended clinical probability score was unfamiliar to all four groups of clinicians in the present study, and the majority of doctors did not agree that a negative CTPA or isotope lung scintigraphy reliably excluded PE. However, questions based on clinical scenarios received considerably higher rates of correct responses. The results indicate that various aspects of the national guidelines on suspected acute pulmonary embolism are unfamiliar to many UK hospital clinicians. Further research is needed to identify methods to improve

  11. The impact of ultrasound in suspected acute appendicitis

    International Nuclear Information System (INIS)

    Gracey, D.; McClure, M.J.

    2007-01-01

    Aims: To evaluate prospectively the impact of an appendix ultrasound (US) service on the clinical management of patients presenting with suspected acute appendicitis. Materials and methods: The referring clinician completed a proforma for patients presenting with suspected acute appendicitis. Two visual analogue scales assessed clinical suspicion before and after knowledge of laboratory results. The clinician also indicated if they intended to operate had US been unavailable. During a 3-year period, 327 patients were examined by graded-compression US and diagnosed 'positive' or 'negative' for acute appendicitis. Findings were correlated with histopathology results. The referring clinician completed a retrospective audit questionnaire to assess user satisfaction. Results: Clinical suspicion was altered by knowledge of laboratory results. The decision to operate if US had been unavailable, was 'yes' in 70 cases (group A), 'no' in 231 (group B), and incomplete in 26 (group C). In group A, 31 patients (44.3%) had a negative US and 25 avoided surgery. US identified 39 cases of appendicitis and 37 appendicectomies confirmed appendicitis in 34 cases. In group B, 72 (31.2%) patients had a positive US and 66 appendicectomies confirmed 51 cases of appendicitis. The sensitivity of US was 94.7% in group A, 93.3% in group B and 93.8% overall. Specificity was 90.6% in group A, 91.2% in group B and 91.3% overall. US findings were contrary to intended surgical management in 103 cases. Management was altered in 97 cases (32.2%), with a positive outcome in 85 (28.2%). The referrers found US of appendix very useful in planning appropriate management. Conclusion: US of the appendix increases diagnostic accuracy, alters management and is more sensitive and specific than clinical impression, either alone, or in conjunction with laboratory results

  12. Results of photorefractive keratectomy in keratoconus suspects at 4 years.

    Science.gov (United States)

    Bilgihan, K; Ozdek, S C; Konuk, O; Akata, F; Hasanreisoglu, B

    2000-01-01

    We studied the long-term results of photorefractive keratectomy (PRK) in keratoconus suspects detected by videokeratography (TMS). Bilateral inferior corneal steepening was detected in 6 candidates for PRK presenting with moderate myopia or astigmatism. Mean follow-up was 44.5 +/- 4.4 months (range, 38 to 54 mo). Mean spherical equivalent refraction was -5.18 +/- 1.60 D (mean sphere, -4.73 D; mean cyclinder, -0.92 D) which was stable for at least the preceding year. The quantitative measurement of inferior corneal steepening (I-S value) was greater than +1.60 (mean, 1.83 +/- 0.11) in all eyes. An Aesculap Meditec Mel 60 excimer laser was used for the PRK procedures and mean follow-up was 44.5 months. Postoperative pachymetric measurements were also performed in 6 eyes. Postoperative uncorrected visual acuity was 20/20 in 8 eyes (66.6%) and 20/32 or better in all eyes with a mean postoperative spherical equivalent refraction of -0.70 +/- 0.74 D (mean sphere, -0.63 D; mean cyclinder, -0.39 D). Five eyes (41.6%) were within +/- 0.50 D spherical equivalent refraction. Inferior steepening was associated with thinning of the inferior cornea which was statistically significantly thinner than the superior thickness (Student's t-test, P < .05). There were no wound healing problems or any sign that the excimer laser adversely affected the cornea during follow-up. Photorefractive keratectomy seems to be a safe procedure for reducing or eliminating myopia or astigmatism in keratoconus suspect eyes-most probably forme fruste keratoconus-with a stable refraction, but this may be different in eyes with early keratoconus, known to be a progressive disease.

  13. Evaluation of basophil activation test in suspected food hypersensitivity.

    Science.gov (United States)

    Pignatti, Patrizia; Yacoub, Mona-Rita; Testoni, Claudia; Pala, Gianni; Corsetti, Maura; Colombo, Giselda; Meriggi, Antonio; Moscato, Gianna

    2017-07-01

    Food hypersensitivity is characterized by a wide range of symptoms. The relationship between symptoms and food is more frequently suspected than objectively proven. Basophil activation test (BAT) is based on the evaluation of activation markers on blood basophils in vitro stimulated with drugs or allergens. The aim of the study was to evaluate the usefulness of BAT when introduced in the routine work-up of suspected food hypersensitivity. BAT was requested in subjects with food adverse reactions when a discrepancy existed among history and skin prick test (SPT) and/or specific IgE. Data from 150 subjects were analysed using CD63 as basophil activation marker. Thirty controls were evaluated for cut-offs. Immunoblots was performed with the sera of representative subjects positive for BAT and negative for SPT and sIgE. 1,024 BAT were carried out, the agreement (positive/positive and negative/negative) was 78.5% for BAT vs. SPT and 78.3% for BAT vs. IgE. Atopic patients, but not atopic controls, more frequently had a positive BAT than non-atopic patients (P tested food) and both negative sIgE and SPT. Immunoblots revealed the presence of sIgE for the tested foods in representative patients with positive BAT, negative SPT and sIgE. Introduction of BAT in routine of food hypersensitivity, limited to subjects with a discrepancy between history and traditional tests, might be useful particularly when total IgE are low. © 2015 International Clinical Cytometry Society. © 2015 International Clinical Cytometry Society.

  14. 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.

  15. 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.

  16. 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…

  17. Timing Errors in Two Children with Suspected Childhood Apraxia of Speech (sCAS) during Speech and Music-Related Tasks

    Science.gov (United States)

    Peter, Beate; Stoel-Gammon, Carol

    2005-01-01

    Impaired speech prosody has been identified as a critical feature of suspected childhood apraxia of speech (sCAS). Lexical stress productions of children with sCAS have been characterized as 'excessive/equal/misplaced'. This investigation examines two potential explanations of this particular deficit, articulatory difficulty and impaired intrinsic…

  18. 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....

  19. Uptake pathways of fluorescent indicators by pea seed and seedlings and their potential as anti-counterfeiting labeling for plant seeds

    International Nuclear Information System (INIS)

    Lin, C.; Guan, Y. J.; Fu, H.; Hu, J.; Tian, Y. X.

    2015-01-01

    The present study investigates the effects of seed soaking in varying concentration of rhodamine B (RB) or safranine T (ST) solutions on germination and seedling growth of pea seeds. The fluorescence in pea seedling at different developmental stages was observed. The results indicate that there were no adverse effects of seed soaking in RB (0.1mg/ml) and ST (0.5, 0.3, 0.1mg/ml) solutions on germination, seedling growth, antioxidant enzyme activities, malondialdehyde (MDA) and chlorophyll contents. The seeds treated with RB showed bright red and orange fluorescence under green (546 nm) and blue (495 nm) light excitation, respectively while no red or orange color was observed in the control seeds. In addition, the vascular bundles of stem, seedling roots and aerial parts of seedlings treated with RB all emitted brilliant fluorescence for a longer time as compared with that treated with ST. It can be concluded that pea seed labeled with RB by seed soaking at appropriate concentration could be used as a potential anti-counterfeiting technique in pea seeds. (author)

  20. Unfair lineups make witnesses more likely to confuse innocent and guilty suspects

    OpenAIRE

    Colloff, Melissa F.; Wade, Kimberley A.; Strange, D.

    2016-01-01

    Eyewitness-identification studies have focused on the idea that unfair lineups (i.e., ones in which the police suspect stands out) make witnesses more willing to identify the police suspect. We examined whether unfair lineups also influence subjects’ ability to distinguish between innocent and guilty suspects and their ability to judge the accuracy of their identification. In a single experiment (N = 8,925), we compared three fair-lineup techniques used by the police with unfair lineups in wh...

  1. Amnioinfusion for potential or suspected umbilical cord compression in labour.

    Science.gov (United States)

    Hofmeyr, G Justus; Lawrie, Theresa A

    2012-01-18

    Amnioinfusion aims to prevent or relieve umbilical cord compression during labour by infusing a solution into the uterine cavity. To assess the effects of amnioinfusion for potential or suspected umbilical cord compression on maternal and perinatal outcome . We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2011). Randomised trials of amnioinfusion compared with no amnioinfusion in women with babies at risk of umbilical cord compression in labour. The original review had one author only (Justus Hofmeyr (GJH)). For this update, two authors (GJH and T Lawrie) assessed 13 additional trial reports for eligibility and quality. We extracted data and checked for accuracy. We have included 19 studies, with all but two studies having fewer than 200 participants. Transcervical amnioinfusion for potential or suspected umbilical cord compression was associated with the following reductions: caesarean section overall (13 trials, 1493 participants; average risk ratio (RR) 0.62, 95% confidence interval (CI) 0.46 to 0.83); fetal heart rate (FHR) decelerations (seven trials, 1006 participants; average RR 0.53, 95% CI 0.38 to 0.74); Apgar score less than seven at five minutes (12 trials, 1804 participants; average RR 0.47, 95% CI 0.30 to 0.72); meconium below the vocal cords (three trials, 674 participants, RR 0.53, 95% CI 0.31 to 0.92); postpartum endometritis (six trials, 767 participants; RR 0.45, 95% CI 0.25 to 0.81) and maternal hospital stay greater than three days (four trials, 1051 participants; average RR 0.45, 95% CI 0.25 to 0.78). Transabdominal amnioinfusion showed similar trends, though numbers studied were small.Mean cord umbilical artery pH was higher in the amnioinfusion group (seven trials, 855 participants; average mean difference 0.03, 95% CI 0.00 to 0.06) and there was a trend toward fewer neonates with a low cord arterial pH (less than 7.2 or as defined by trial authors) in the amnioinfusion group (eight trials, 972

  2. 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

    2017-06-14

    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 searched CENTRAL (6 January 2017), MEDLINE (1966 to 6 January 2017), Embase (1980 to 6 January 2017), Web of Science (1985 to 6 January 2017), LILACS (1982 to 6 January 2017), and prospective trial registries to January 2017. We previously searched CAB Abstracts from 1985 to June 2015, but did not update this search in January 2017. 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 and so did not perform data synthesis. We assessed the overall quality of the evidence using the GRADE approach. We found no RCTs comparing pre-admission antibiotics versus no pre-admission antibiotics or placebo. We included one open-label, non-inferiority RCT with 510 participants, conducted during an epidemic in Niger, evaluating 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 1.21, 95% CI 0.57 to 2.56; N = 503; 308 confirmed meningococcal meningitis; 26 deaths; moderate-quality evidence), clinical failures (RR 0.83, 95% CI 0.32 to

  3. [Colorectal Carcinoma with Suspected Lynch Syndrome: A Multidisciplinary Algorithm].

    Science.gov (United States)

    Schneider, R; Schneider, C; Büttner, R; Reinacher-Schick, A; Tannapfel, A; Fürst, A; Rüschoff, J; Jakobeit, C; Royer-Pokora, B; Möslein, G

    2015-12-01

    Lynch syndrome is the most frequent hereditary cancer syndrome, accounting for approximately 3-5 % of all colorectal cancers. In addition, it is the most frequent predisposing hereditary cause of endometrial cancer and is also associated with gastric cancer, ovarian cancer, cancer of the urinary tract as well as several other cancers. In clinical practise Lynch syndrome is frequently not detected and many clinicians admit uncertainties regarding diagnostic procedures. Also, counselling of patients is considered difficult regarding therapeutic - especially prophylactic surgical and chemopreventive options and recommendations. Based on a review of available literature we discuss optimized strategies for improved detection of suspected Lynch syndrome patients. The aim of this review is to establish a clinical algorithm of how to proceed on a diagnostic level and to discuss surgical options at the time of a colorectal cancer. In order to identify patients with Lynch syndrome, family history should be ascertained and evaluated in regards to fulfilment of the Amsterdam-II- and/or the revised Bethesda criteria. Subsequently immunohistochemical staining for the mismatch-repair-genes, BRAF testing for MLH1 loss of expression, as well as testing for microsatellite instability in some, followed by genetic counselling and mutation analysis when indicated, is recommended. Pathological identification of suspected Lynch syndrome is readily feasible and straightforward. However, the need of performing these analyses in the tumor biopsy at the time of (gastroenterological) diagnosis of CRC neoplasia is essential, in order to offer patients the option of a prophylactically extended surgery and - as recommended in the German S3 guidelines - to discuss the option of a merely prophylactical hysterectomy and oophorectomy (if postmenopausal) in women. Close cooperation between gastroenterologists, pathologists and surgeons is warranted, so that patients may benefit from options of

  4. 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

  5. Not the usual suspects: addressing layers of vulnerability.

    Science.gov (United States)

    Luna, Florencia; Vanderpoel, Sheryl

    2013-07-01

    This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of 'usual suspects', focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different approaches to 'vulnerability' are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities. © 2013 John Wiley & Sons Ltd.

  6. 111indium-antimyosin immunoscintigraphy in suspected myocarditis

    International Nuclear Information System (INIS)

    Krause, T.; Schuemichen, C.; Joseph, A.; Moser, E.; Zeiher, A.

    1991-01-01

    111 Indium-monoclonal antimyosin scans were carried out in 21 patients with suspected myocarditis, confirmed by reduced ejection volume, pericardial effusion and clinical follow up in 12 patients. Coronary heart disease was excluded angiographically in all cases. Quantitative evaluation of myocardial 111 In-antimyosin accumulation 48 hours after injection showed a pathological uptake in 10/12 patients with increased heart/lung ratios (Q 48 >1,58). Ratios were also elevated in 2 patients with cardiomyopathy, 2 suffering from vasculitis and 1 with dermatomyositis. Four patients without proven cardiac disease had normal ratios (Q 48 ≤1,58). Examination after 24 hours was of limited value, depending on the residual blood pool activity. Visual analysis of the scans showed a high interobserver variation despite a positive correlation with quantitative analysis (48 h p.i.: r=0,72; p 111 In-antimyosin scan as a screening method prior to myocardial biopsy. However, scintigraphy cannot definitely elucidate the cause of myocardial damage. Therefore, myocardial biopsy is still recommended after positive antimyosin scans. (orig.) [de

  7. 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.

  8. Suspected invasive placenta: evaluation with magnetic resonance imaging

    International Nuclear Information System (INIS)

    Bour, Laurence; Place, Vinciane; Bendavid, Sandra; Fargeaudou, Yann; Portal, Jean-Jacques; Ricbourg, Aude; Sebbag, Delphine; Dohan, Anthony; Soyer, Philippe; Vicaut, Eric

    2014-01-01

    To determine the utility of magnetic resonance imaging (MRI) in diagnosing invasive placenta (IP). MRI findings in 32 women with suspected IP were evaluated independently by four readers. Interobserver agreement was calculated with kappa (κ) statistics. Associations between MRI findings and IP were assessed by univariate and multivariate analyses. Sensitivity, specificity and accuracy of MRI for the diagnosis of IP were estimated. Sixteen women (16/32; 50 %) had confirmed IP. Interobserver correlation for the diagnosis of IP was fair (κ = 0.40). Univariate analysis revealed that thinning or focal defect of the uteroplacental interface (P < 0.0001) was the most discriminating MRI variable in the differentiation between normal and IP. Overall sensitivity and specificity of MRI for the diagnosis of IP were 84 % [95 % CI: 75-94 %] and 80 % [95 % CI: 66-93 %], respectively. Thinning or focal defect of the uteroplacental interface was the most accurate finding (88 %) in the diagnosis of IP. Multivariate analysis revealed that thinning or focal defect of the uteroplacental interface was the single independent predictor of IP (P = 0.0006; OR = 64.99). MR imaging has 84 % sensitivity [95 % CI: 75-94 %] and 80 % specificity [95 % CI: 66-93 %] for the diagnosis of IP. Thinning or focal defect of the uteroplacental interface is the most discriminating independent MR variable in differentiating between normal placenta and IP. (orig.)

  9. [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.

  10. Three suspected cases of sugammadex-induced anaphylactic shock.

    Science.gov (United States)

    Takazawa, Tomonori; Tomita, Yukinari; Yoshida, Nagahide; Tomioka, Akihiro; Horiuchi, Tatsuo; Nagata, Chie; Orihara, Masaki; Yamada, Makiko Hardy; Saito, Shigeru

    2014-01-01

    Sugammadex has a unique mechanism of action and is widely used because of its safety and efficacy. A few recent reports have described allergic reactions to clinical doses of sugammadex. We hereby describe another series of cases of possible anaphylaxis to sugammadex. We present three suspected cases of sugammadex-induced anaphylactic shock, including a 13-year-old boy who underwent laparoscopic appendectomy, a 75-year-old woman who underwent left knee arthroplasty, and a 34-year-old man who underwent left pansinectomy for sinobronchitis. All three patients received general anesthesia with rocuronium and their tracheas were intubated. Shortly after injection of sugammadex for reversal of rocuronium, all of them experienced a decrease in blood pressure along with mucocutaneous erythema. In the most severe case, reintubation after extubation was required due to difficulty in manual ventilation. All patients recovered with anti-allergic therapy. On later investigation, all three patients had a positive skin reaction to sugammadex. Our results suggest that physicians using sugammadex should be aware of the possibility of sugammadex-induced anaphylaxis.

  11. Respiratory viral infections in infants with clinically suspected pertussis.

    Science.gov (United States)

    Ferronato, Angela E; Gilio, Alfredo E; Vieira, Sandra E

    2013-01-01

    to evaluate the frequency of respiratory viral infections in hospitalized infants with clinical suspicion of pertussis, and to analyze their characteristics at hospital admission and clinical outcomes. a historical cohort study was performed in a reference service for pertussis, in which the research of respiratory viruses was also a routine for infants hospitalized with respiratory problems. All infants reported as suspected cases of pertussis were included. Tests for Bordetella pertussis (BP) (polymerase chain reaction/culture) and for respiratory viruses (RVs) (immunofluorescence) were performed. Patients who received macrolides before hospitalization were excluded. Clinical data were obtained from medical records. Among the 67 patients studied, BP tests were positive in 44%, and 26% were positive for RV. There was no etiological identification in 35%, and RV combined with BP was identified in 5%. All patients had similar demographic characteristics. Cough followed by inspiratory stridor or cyanosis was a strong predictor of pertussis, as well as prominent leukocytosis and lymphocytosis. Rhinorrhea and dyspnea were more frequent in viral infections. Macrolides were discontinued in 40% of patients who tested positive for RV and negative for BP. the results suggest that viral infection can be present in hospitalized infants with clinical suspicion of pertussis, and etiological tests may enable a reduction in the use of macrolides in some cases. However, the etiological diagnosis of respiratory virus infection, by itself, does not exclude the possibility of infection with BP. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  12. Suspected zonisamide-related anticonvulsant hypersensitivity syndrome in a cat.

    Science.gov (United States)

    Collinet, Audrey; Sammut, Veronique

    2017-12-15

    CASE DESCRIPTION A 2-year-old neutered male domestic shorthair cat was evaluated for sudden onset of cluster seizures. CLINICAL FINDINGS At an emergency clinic, the cat had hyperimmunoglobulinemia and thrombocytopenia. On referral, treatment with levetiracetam, zonisamide, and phenobarbital initially provided good control of cluster seizure activity (attributable to epilepsy of unknow origin). Two weeks later, assessments revealed that serum phenobarbital concentration was within the ideal range but serum zonisamide concentration exceeded the recommended therapeutic range. The dosage of zonisamide was therefore decreased. Four days after dosage reduction, the cat developed generalized lymphadenopathy. Cytologic analysis of lymph node aspirate samples revealed a heterogeneous population of well-differentiated lymphocytes, interpreted as marked reactivity. Although neoplasia could not be ruled out, hypersensitivity to phenobarbital was suspected, and this treatment was discontinued. TREATMENT AND OUTCOME Despite cessation of phenobarbital administration, generalized peripheral lymphadenopathy progressed and hyperglobulinemia and cytopenias developed. These abnormalities resolved after discontinuation of zonisamide administration. The cat remained seizure free with no recurrence of the aforementioned concerns after reinstitution of phenobarbital treatment. CLINICAL RELEVANCE To the authors' knowledge, this is the first reported case of zonisamide-related lymphadenopathy, hyperglobulinemia, and cytopenias in a cat. Anticonvulsant hypersensitivity syndrome is well documented in human medicine, but little information has been published in the veterinary medical literature. Although the effects of anticonvulsant hypersensitivity syndrome in this cat were serious, these effects were reversible with treatment discontinuation.

  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. [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.

  16. Molecular detection of Orientia tsutsugamushi from suspected scrub typhus cases

    Directory of Open Access Journals (Sweden)

    Seethalakshmi Srinivasan

    2017-01-01

    Full Text Available Context: Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. The disease is under-diagnosed in India, because of low index of suspicion and also due to its nonspecific presentation, and lack of confirmatory diagnostic tests. Aims: This study was undertaken to diagnose scrub typhus in patients with undifferentiated fevers by serology and molecular methods. Materials and Methods: A total of 68 blood samples were collected from patients clinically suspected to have scrub typhus. After transportation to the laboratory, the serum was separated from the blood and subjected to rapid card test. The ethylenediaminetetraacetic acid blood samples were subjected to DNA extraction using QIAamp DNA Mini Kit followed by nested polymerase chain reaction (nPCR. Results: 24/68 (35.29% cases showed the presence of antibody against scrub typhus by serology. 6/68 (8.8% patients showed the presence of outer membrane protein antigen gene 56 kDa by nPCR. 5/24 serology positive cases showed the presence of 56 kDa outer membrane protein antigen gene by nPCR. A large number of cases positive by serology were negative by PCR which may indicate a low sensitivity of this test either due to low copy numbers or due to excess host DNA. Conclusion: Delay in treatment may increase disease severity and leads to higher mortality. Thus, molecular methods of diagnosis may aid in the early diagnosis of infection and enable prompt treatment. This is the first report on the diagnosis of scrub typhus in the suburbs of Chennai using molecular methods and reemphasizes the need for increased awareness of rickettsial infections in rural areas.

  17. Molecular detection of Orientia tsutsugamushi from suspected scrub typhus cases.

    Science.gov (United States)

    Srinivasan, Seethalakshmi; Menon, Thangam

    2017-01-01

    Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. The disease is under-diagnosed in India, because of low index of suspicion and also due to its nonspecific presentation, and lack of confirmatory diagnostic tests. This study was undertaken to diagnose scrub typhus in patients with undifferentiated fevers by serology and molecular methods. A total of 68 blood samples were collected from patients clinically suspected to have scrub typhus. After transportation to the laboratory, the serum was separated from the blood and subjected to rapid card test. The ethylenediaminetetraacetic acid blood samples were subjected to DNA extraction using QIAamp DNA Mini Kit followed by nested polymerase chain reaction (nPCR). 24/68 (35.29%) cases showed the presence of antibody against scrub typhus by serology. 6/68 (8.8%) patients showed the presence of outer membrane protein antigen gene 56 kDa by nPCR. 5/24 serology positive cases showed the presence of 56 kDa outer membrane protein antigen gene by nPCR. A large number of cases positive by serology were negative by PCR which may indicate a low sensitivity of this test either due to low copy numbers or due to excess host DNA. Delay in treatment may increase disease severity and leads to higher mortality. Thus, molecular methods of diagnosis may aid in the early diagnosis of infection and enable prompt treatment. This is the first report on the diagnosis of scrub typhus in the suburbs of Chennai using molecular methods and reemphasizes the need for increased awareness of rickettsial infections in rural areas.

  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. Deaths and Injuries by Counterfeit Alcohol and Oplosan – Potential Consequences of an Alcohol Prohibition in Indonesia

    OpenAIRE

    Rofi Uddarojat

    2016-01-01

    The Indonesian House of Representatives is deliberating a bill that aims to prohibit the production, sale, and consumption of alcoholic drinks containing between 1 and 55 per cent alcohol. However, there are no comprehensive studies on the adverse effects of alcohol in Indonesia. Alcohol consumption levels in Indonesia appear low when compared to other countries. Only about 500,000 Indonesians consume alcoholic beverages, mostly hard liquor. The Indonesian government already pursues a ran...

  20. Provider-initiated HIV testing and counselling for TB patients and suspects in Nairobi, Kenya.

    Science.gov (United States)

    Odhiambo, J; Kizito, W; Njoroge, A; Wambua, N; Nganga, L; Mburu, M; Mansoer, J; Marum, L; Phillips, E; Chakaya, J; De Cock, K M

    2008-03-01

    Integrated tuberculosis (TB) and human immunodeficiency virus (HIV) services in a resource-constrained setting. Pilot provider-initiated HIV testing and counselling (PITC) for TB patients and suspects. Through partnerships, resources were mobilised to establish and support services. After community sensitisation and staff training, PITC was introduced to TB patients and then to TB suspects from December 2003 to December 2005. Of 5457 TB suspects who received PITC, 89% underwent HIV testing. Although not statistically significant, TB suspects with TB disease had an HIV prevalence of 61% compared to 63% for those without. Of the 614 suspects who declined HIV testing, 402 (65%) had TB disease. Of 2283 patients referred for cotrimoxazole prophylaxis, 1951 (86%) were enrolled, and of 1727 patients assessed for antiretroviral treatment (ART), 1618 (94%) were eligible and 1441 (83%) started treatment. PITC represents a paradigm shift and is feasible and acceptable to TB patients and TB suspects. Clear directives are nevertheless required to change practice. When offered to TB suspects, PITC identifies large numbers of persons requiring HIV care. Community sensitisation, staff training, multitasking and access to HIV care contributed to a high acceptance of HIV testing. Kenya is using this experience to inform national response and advocate wide PITC implementation in settings faced with the TB-HIV epidemic.

  1. 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.

  2. 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.

  3. 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.

  4. Economic impact of an ultrasonographic contrast agent on the diagnosis and initial management of patients with suspected renal artery stenosis

    International Nuclear Information System (INIS)

    Levesque, J.; Lacourciere, Y.; Onrot, J.M.

    2002-01-01

    To determine resource use in the diagnosis and management of Canadian hypertensive patients with suspected renal artery stenosis and to estimate the impact of diagnosis with contrast-enhanced duplex Doppler ultrasonography (US) on resource use. Seventy-eight patients with suspected renal artery stenosis underwent usual diagnostic tests (captopril-enhanced renal scintigraphy or duplex Doppler US) and contrast-enhanced US. A management pathway ('planned') describing the medical resources required for further patient care was outlined on the basis of results from each test (separately), and a modified management pathway ('recommended'), which considered data from both diagnostic methods, was also outlined. Medical resources and productivity losses were assessed prospectively for a 3-month period after patients underwent both tests ('actual' management pathway). With usual diagnostic methods, 14 (18%) of the tests were inconclusive, whereas only 1 (1%) of the enhanced US examinations was inconclusive; the cost-efficacy ratio was $422 and $343 per successful diagnosis, respectively. Further management costs for patients with an inconclusive diagnosis were estimated at $6370 after the usual diagnostic tests, but only $1278 with enhanced US. Although the costs of the planned and recommended management pathways were similar ($227 and $294 per patient respectively), the proportion of patients requiring further resources was lower with enhanced US (56% v. 46%). Three-month actual management costs ranged from $121 to $1605 per patient (mean $360). Diagnostic tests and surgical procedures were the major cost drivers in all pathways, and costs wore highest for patients in whom stenosis was diagnosed. For patients with suspected renal artery stenosis, contrast-enhanced US had a higher diagnostic success rate than usual diagnostic methods and afforded savings through lower administrative costs and lower medical resource consumption for patients whose diagnosis was unclear after

  5. 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

  6. 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

  7. 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...

  8. Anesthetic management in patients suspected of Creutzfeldt-Jakob disease -A case report-.

    Science.gov (United States)

    In, Chi Bum; Choi, Young Sil; Park, Eun Young; Chang, Dong Jin; Lee, Soo Kyung; Choi, Hyun; Moon, Hyun Soo

    2011-09-01

    Creutzfeldt-Jakob disease (CJD) is a fatal neurodegenerative disorder in which accumulation of the pathogenic prion protein induces neuronal damage and results in distinct pathologic features. This abnormal prion is an infectious protein and resistant to methods of sterilization currently being used. Therefore, management of definite, or suspected CJD patients requires additional precautions. We report our experience of a patient who had undergone brain biopsy for suspected of CJD. The patient was confirmed to have sporadic CJD.

  9. The role of bone scintigraphy in the evaluation of the suspected abused child

    International Nuclear Information System (INIS)

    Sty, J.R.; Starshak, R.J.

    1983-01-01

    A comparison was made of the radiographic and scintigraphic skeletal surveys of 261 children who were suspected victims of abuse. Radiography was positive in 105 children and produced false-negative results in 32; scintigraphy was positive in 120 children and produced false-negative results in two. Although radiography has traditionally been used to assess the skeletal injuries of battered children, the authors conclude that scintigraphy should be the screening procedure of choice for children suspected of having been abused

  10. 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...

  11. [Characteristics of communication systems of suspected occupational disease in the Autonomous Communities, Spain].

    Science.gov (United States)

    García Gómez, Montserrat; Urbaneja Arrúe, Félix; García López, Vega; Estaban Buedo, Valentín; Rodríguez Suárez, Valentín; Miralles Martínez-Portillo, Lourdes; González García, Isabel; Egea Garcia, Josefa; Corraliza Infanzon, Emma; Ramírez Salvador, Laura; Briz Blázquez, Santiago; Armengol Rosell, Ricard; Cisnal Gredilla, José María; Correa Rodríguez, Juan Francisco; Coto Fernández, Juan Carlos; Díaz Peral, Mª Rosario; Elvira Espinosa, Mercedes; Fernández Fernández, Iñigo; García-Ramos Alonso, Eduardo; Martínez Arguisuelas, Nieves; Rivas Pérez, Ana Isabel

    2017-03-17

    There are several initiatives to develop systems for the notification of suspected occupational disease (OD) in different autonomous communities. The objective was to describe the status of development and characteristics of these systems implemented by the health authorities. A cross-sectional descriptive study was carried out on the existence of systems for the information and surveillance of suspected OD, their legal framework, responsible institution and availability of information. A specific meeting was held and a survey was designed and sent to all autonomous communities and autonomous cities (AACC). Information was collected on the existence of a regulatory standard, assigned human resources, notifiers, coverage and number of suspected OD received, processed and recognized. 18 of 19 AACC responded. 10 have developed a suspected OD notification system, 3 of them supported by specific autonomic law. The notifiers were physicians of the public health services, physicians of the occupational health services and, in 2 cases, medical inspectors. 7 AACC had specific software to support the system. The OD recognition rate of suspected cases was 53% in the Basque Country; 41% in Castilla-La Mancha; 36% in Murcia; 32.6% in the Valencian Community and 31% in La Rioja. The study has revealed an heterogeneous development of suspected OD reporting systems in Spain. Although the trend is positive, only 55% of the AACC have some type of development and 39% have specific software supporting it. Therefore unequal OD recognition rates have been obtained depending on the territory.

  12. Respiratory viral infections in infants with clinically suspected pertussis

    Directory of Open Access Journals (Sweden)

    Angela E. Ferronato

    2013-11-01

    Full Text Available Objective: to evaluate the frequency of respiratory viral infections in hospitalized infants with clinical suspicion of pertussis, and to analyze their characteristics at hospital admission and clinical outcomes. Methods: a historical cohort study was performed in a reference service for pertussis, in which the research of respiratory viruses was also a routine for infants hospitalized with respiratory problems. All infants reported as suspected cases of pertussis were included. Tests for Bordetella pertussis (BP (polymerase chain reaction/culture and for respiratory viruses (RVs (immunofluorescence were performed. Patients who received macrolides before hospitalization were excluded. Clinical data were obtained from medical records. Results: Among the 67 patients studied, BP tests were positive in 44%, and 26% were positive for RV. There was no etiological identification in 35%, and RV combined with BP was identified in 5%. All patients had similar demographic characteristics. Cough followed by inspiratory stridor or cyanosis was a strong predictor of pertussis, as well as prominent leukocytosis and lymphocytosis. Rhinorrhea and dyspnea were more frequent in viral infections. Macrolides were discontinued in 40% of patients who tested positive for RV and negative for BP. Conclusion: the results suggest that viral infection can be present in hospitalized infants with clinical suspicion of pertussis, and etiological tests may enable a reduction in the use of macrolides in some cases. However, the etiological diagnosis of respiratory virus infection, by itself, does not exclude the possibility of infection with BP. Resumo: Objetivo: avaliar a frequência das infecções por vírus respiratórios em lactentes hospitalizados com suspeita clínica de coqueluche e analisar suas características admissionais e evolutivas. Métodos: foi realizado um estudo de coorte histórica, em um serviço sentinela para coqueluche, no qual a pesquisa de v

  13. Analysis of spontaneous inquiries about suspected adverse drug reactions posted by the general public on the electronic Japanese bulletin board “Yahoo! Japan Chiebukuro”

    Directory of Open Access Journals (Sweden)

    Dobashi A

    2016-04-01

    Full Text Available Akira Dobashi,1 Kaori Kurata,1 Mitsuhiro Okazaki,2,3 Mari Nishizawa4 1Education and Research Institute of Information Science, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, 2Faculty of Health Sciences, Health Innovation and Technology Center, Hokkaido University, Hokkaido, 3Cross Care Field Co., Ltd., 4Yakuju Corporation, Tokyo, Japan Purpose: Spontaneous inquiries about the development of adverse drug reactions (ADRs to medicines can be extracted based on the questions posted by the general public on the electronic Japanese bulletin board “Yahoo! Japan Chiebukuro”. Our aim was to clarify the characteristics related to people’s descriptions of suspected ADRs and determine the reasons for submitting a spontaneous inquiry. Methods: Fifty brand names of medicines used for inquiry extraction were chosen by selecting 35 pharmaceutical products, based on the generic names that had the highest sales in Japan. Questions containing both the brand name of one of these medicines and the term “Fukusayō” (ADR in Japanese that were posted from July 2004 to June 2009 were extracted from the site. Results: Among 1,419 questions extracted, 614 questions had at least one identifiable brand name of a suspected medicine, an ADR description, and the extent to which the ADR appeared to be caused by the suspected medicine(s. Among these 614 questions, 589 described in detail the symptoms/signs that the inquirers themselves or their families had experienced as ADRs. The highest number of questions was found for Paxil (525. Posts asking whether the symptoms being experienced were due to an ADR accounted for the highest number of questions. In most cases, the inquirer suspected that a single medicine led to an ADR and was seeking advice from others taking the same medicine. Conclusion: Our examination of spontaneous inquiries showed that people have sufficient knowledge to adequately report potential ADRs in terms of their symptoms

  14. 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

  15. 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

    2015-10-01

    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. 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 association between levels of residual

  16. VEGF 936C > T Polymorphism and Association of BI-RADS Score in Women with Suspected Breast Cancer

    Directory of Open Access Journals (Sweden)

    M. Wehrschuetz

    2009-01-01

    Full Text Available Purpose Vascular endothelial growth factor (VEGF is a potent regulator of angiogenesis and thereby involved in the development and progression of solid tumors. A 936C> T polymorphism in the VEGF gene has been associated with reduced VEGF plasma levels. Purpose of the present study was to analyze the potential association between VEGF genotype and radiological appearance of breast lesions by mammography. Materials and Methods Fifty two women with 54 suspected breast lesions were analyzed by the use of mammography with the standard breast imaging reporting and data systems (BI-RADS. Germline VEGF genotype was determined in all subjects by allele-specific digestion of amplification products. An open biopsy was performed on all lesions. Results VEGF CC, CT and TT genotypes were found in 41 (79%, 9 (17% and 2 (4% patients. By mammography 26, 16 and 12 suspected breast lesions were classified as BI-RADS scores 3, 4 and 5, respectively. Both carriers of the TT genotype were classified as BI-RADS 5, whereas among CT or CC carriers, BI-RADS scores 3, 4 and 5 were found in 26, 16 and 10 subjects (P T polymorphism seems to be associated with a high BI-RADS score in women with suspicious breast lesions.

  17. Identification of novel micropollutants in wastewater by a combination of suspect and nontarget screening

    International Nuclear Information System (INIS)

    Hug, Christine; Ulrich, Nadin; Schulze, Tobias; Brack, Werner; Krauss, Martin

    2014-01-01

    To detect site-specific, suspected and formerly unknown contaminants in a wastewater treatment plant effluent, we established a screening procedure based on liquid chromatography–high resolution mass spectrometry (LC–HRMS) with stepwise identification schemes. Based on automated substructure searches a list of 2160 suspected site-specific and documented water contaminants was reduced to those amenable to LC–HRMS. After searching chromatograms for exact masses of suspects, presumably false positive detections were stepwise excluded by retention time prediction, the evaluation of isotope patterns, ionization behavior, and HRMS/MS spectra. In nontarget analysis, peaks for identification were selected based on distinctive isotope patterns and intensity. The stepwise identification of nontarget compounds was automated by a plausibility check of molecular formulas using the Seven Golden Rules, an exclusion of compounds with presumably low commercial importance and an automated HRMS/MS evaluation. Six suspected and five nontarget chemicals were identified, of which two have not been previously reported as environmental pollutants. -- Highlights: • A LC–HRMS-based suspect and nontarget screening was applied to wastewater. • Manual data processing to identify candidate structures was accelerated by automated software-based procedure. • Identification was supported by sophisticated analytical methods such as deuterium exchange. • Eleven site-specific and formerly unknown compounds were identified. • We provide a framework to extend analytical procedures from target to suspect and nontarget compounds. -- A screening procedure based on liquid chromatography–high resolution mass spectrometry (LC–HRMS) with a systematic data evaluation was established, which allowed detecting suspected and formerly unknown contaminants in wastewater

  18. A Risk Prediction Model for In-hospital Mortality in Patients with Suspected Myocarditis.

    Science.gov (United States)

    Xu, Duo; Zhao, Ruo-Chi; Gao, Wen-Hui; Cui, Han-Bin

    2017-04-05

    Myocarditis is an inflammatory disease of the myocardium that may lead to cardiac death in some patients. However, little is known about the predictors of in-hospital mortality in patients with suspected myocarditis. Thus, the aim of this study was to identify the independent risk factors for in-hospital mortality in patients with suspected myocarditis by establishing a risk prediction model. A retrospective study was performed to analyze the clinical medical records of 403 consecutive patients with suspected myocarditis who were admitted to Ningbo First Hospital between January 2003 and December 2013. A total of 238 males (59%) and 165 females (41%) were enrolled in this study. We divided the above patients into two subgroups (survival and nonsurvival), according to their clinical in-hospital outcomes. To maximize the effectiveness of the prediction model, we first identified the potential risk factors for in-hospital mortality among patients with suspected myocarditis, based on data pertaining to previously established risk factors and basic patient characteristics. We subsequently established a regression model for predicting in-hospital mortality using univariate and multivariate logistic regression analyses. Finally, we identified the independent risk factors for in-hospital mortality using our risk prediction model. The following prediction model for in-hospital mortality in patients with suspected myocarditis, including creatinine clearance rate (Ccr), age, ventricular tachycardia (VT), New York Heart Association (NYHA) classification, gender and cardiac troponin T (cTnT), was established in the study: P = ea/(1 + ea) (where e is the exponential function, P is the probability of in-hospital death, and a = -7.34 + 2.99 × [Ccr model demonstrated that a Ccr prediction model for in-hospital mortality in patients with suspected myocarditis. In addition, sufficient life support during the early stage of the disease might improve the prognoses of patients with

  19. Perception and reality in a case of suspected cervical fracture.

    Science.gov (United States)

    Ridolfi, Marcello; Antinolfi, Gabriele; Genova, Vincenzo; Scutellari, Pier Nuccio; Campioni, Paolo; Mannella, Paolo

    2005-01-01

    The case of a 36-year-old female, who following a road accident, had a cervical whiplash, is discussed. A radiographic examination of the affected region was performed at the Emergency Department. It showed a transverse radiolucent line at the basal odontoid process of the axis. A definitive interpretation was not possible and fracture of the odontoid process of the axis was suggested as differential diagnosis. On coronal CT reconstruction the presence of this fracture was ruled out. The line seen on the film was actually the product of a psychophysiologic visual illusion known as "Mach band". The use of conventional radiography correlated with digital CT images shows that the practical application of Mach band theory allows a better differentiation between normal and pathologic anatomy.

  20. 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.

  1. Suspect filler similarity in eyewitness lineups: a literature review and a novel methodology.

    Science.gov (United States)

    Fitzgerald, Ryan J; Oriet, Chris; Price, Heather L

    2015-02-01

    Eyewitness lineups typically contain a suspect (guilty or innocent) and fillers (known innocents). The degree to which fillers should resemble the suspect is a complex issue that has yet to be resolved. Previously, researchers have voiced concern that eyewitnesses would be unable to identify their target from a lineup containing highly similar fillers; however, our literature review suggests highly similar fillers have only rarely been shown to have this effect. To further examine the effect of highly similar fillers on lineup responses, we used morphing software to create fillers of moderately high and very high similarity to the suspect. When the culprit was in the lineup, a higher correct identification rate was observed in moderately high similarity lineups than in very high similarity lineups. When the culprit was absent, similarity did not yield a significant effect on innocent suspect misidentification rates. However, the correct rejection rate in the moderately high similarity lineup was 20% higher than in the very high similarity lineup. When choosing rates were controlled by calculating identification probabilities for only those who made a selection from the lineup, culprit identification rates as well as innocent suspect misidentification rates were significantly higher in the moderately high similarity lineup than in the very high similarity lineup. Thus, very high similarity fillers yielded costs and benefits. Although our research suggests that selecting the most similar fillers available may adversely affect correct identification rates, we recommend additional research using fillers obtained from police databases to corroborate our findings.

  2. 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...

  3. A case report of suspected malignant hyperthermia where patient survived the episode.

    Science.gov (United States)

    Iqbal, Asif; Badoo, Shoaib; Naqeeb, Ruqsana

    2017-01-01

    Malignant hyperthermia is rare inherited disorder in our part of the world; there are only few cases reported in literature in India who were suspected of having this condition. The overall incidence of malignant hyperthermia during general anesthesia is estimated to range from 1: 5000 to 1: 50,000-100,000 and mortality rate is estimated to be <5% in the presence of standard care. In India, there is no center where in vitro halothane caffeine contraction test is performed to confirm diagnosis in suspected cases. Second, dantrolene drug of choice for this condition is not freely available in market in India and is stored only in some hospitals in few major cities. Among the cases reported of suspected of malignant hyperthermia in India almost 50% have survived the condition despite nonavailability of dantrolene emphasizing role of early detection and aggressive management in these cases.

  4. A case report of suspected malignant hyperthermia where patient survived the episode

    Directory of Open Access Journals (Sweden)

    Asif Iqbal

    2017-01-01

    Full Text Available Malignant hyperthermia is rare inherited disorder in our part of the world; there are only few cases reported in literature in India who were suspected of having this condition. The overall incidence of malignant hyperthermia during general anesthesia is estimated to range from 1: 5000 to 1: 50,000–100,000 and mortality rate is estimated to be <5% in the presence of standard care. In India, there is no center where in vitro halothane caffeine contraction test is performed to confirm diagnosis in suspected cases. Second, dantrolene drug of choice for this condition is not freely available in market in India and is stored only in some hospitals in few major cities. Among the cases reported of suspected of malignant hyperthermia in India almost 50% have survived the condition despite nonavailability of dantrolene emphasizing role of early detection and aggressive management in these cases.

  5. Prevalence and Correlates of Suspected Nonalcoholic Fatty Liver Disease in Chinese Children

    Directory of Open Access Journals (Sweden)

    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. FDG-PET of patients with suspected renal failure. Standardized uptake values in normal tissues

    International Nuclear Information System (INIS)

    Minamimoto, Ryogo; Takahashi, Nobukazu; Inoue, Tomio

    2007-01-01

    This study aims to clarify the effect of renal function on 2-[ 18 F] fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) imaging and determine the clinical significance of renal function in this setting. We compared FDG distribution between normal volunteers and patients with suspected renal failure. Twenty healthy volunteers and 20 patients with suspected renal failure who underwent FDG-PET between November 2002 and May 2005 were selected for this study. We define ''patients with suspected renal failure'' as having a blood serum creatinine level in excess of 1.1 mg/dl. The serum creatinine level was examined once in 2 weeks of the FDG-PET study. Regions of interest were placed over 15 regions for semi-quantitative analysis: the white matter, cortex, both upper lung fields, both middle lung fields, both lower lung fields, mediastinum, myocardium of the left ventricle, the left atrium as a cardiac blood pool, central region of the right lobe of the liver, left kidney, and both femoris muscles. The mean standardized uptake values (SUVs) of brain cortex and white matter were higher in healthy volunteers than in renal patients. The mean SUVs of the mediastinum at the level of the aortic arch and left atrium as a cardiac blood pool were lower in healthy volunteers than in patients with suspected renal failure. These regions differed between healthy volunteers and patients with suspected renal failure (P<0.05). We found decreasing brain accumulation and increasing blood pool accumulation of FDG in patients with high plasma creatinine. Although the difference is small, this phenomenon will not have a huge effect on the assessment of FDG-PET imaging in patients with suspected renal failure. (author)

  7. Suspected placenta accreta and cesarean hysterectomy: observational cohort utilizing an intraoperative decision strategy.

    Science.gov (United States)

    Weiniger, Carolyn F; Kabiri, Doron; Ginosar, Yehuda; Ezra, Yossef; Shachar, BatZion; Lyell, Deirdre J

    2016-03-01

    Planned cesarean hysterectomy (CH) is recommended to minimize morbidity for suspected placenta accreta (PA), yet this ends fertility. We examined CH frequency and post-operative morbidities for suspected PA cases when an intra-operative decision strategy to perform CH was used. Suspected PA cases were pre-operatively identified in one tertiary care center. Women were assessed intra-operatively, prior to uterine incision, for immediate CH or for attempted placental separation. We compared outcomes among women with versus without PA (surgical and/or pathologic diagnosis), and examined outcomes following immediate CH versus attempted placental separation. Our cohort, from 2002 to 2012, comprised 99 women with suspected PA; 54 (54.5%) had PA diagnosed by surgery/pathology, and 45 (45.5%) did not. Among women diagnoses surgically or pathologically with PA, CH was performed for 46/54 (85%); 8 women with suspected PA had successful placental separation. 27 of the 46 CH were performed immediately following uterine wall examination and 19 were performed following attempted placental separation. We received histological confirmation of the clinical placenta accreta diagnosis for 24/46 (52.2%) cases, and in 22/46 (47.8%) cases the histology did not confirm the clinical diagnosis. Surgery duration, packed cell transfusion requirement and postoperative outcomes were similar among women with PA regardless of immediate CH versus attempted placental separation, except for a higher cystotomy rates following attempted placental separation. Emergency deliveries were performed at significantly earlier gestational ages. Among women with suspected PA, an intra-operative CH decision allows some women to avoid CH. Consideration of attempted placental separation did not increase blood transfusion or post-operative complications, but was associated with a higher rate of cystotomy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. A neonate with intestinal volvulus without malrotation exhibiting early jaundice with a suspected fetal onset.

    Science.gov (United States)

    Hara, Kaori; Kinoshita, Mari; Kin, Takane; Arimitsu, Takeshi; Matsuzaki, Yohei; Ikeda, Kazushige; Tomita, Hiroshi; Fujino, Akihiro; Kuroda, Tatsuo

    2015-01-01

    Intestinal volvulus without malrotation is a rare disease that causes volvulus of the small intestine despite normal intestinal rotation and fixation. We encountered a neonate with this disease who developed early jaundice and was suspected to have a fetal onset. This patient was characterized by early jaundice complicating intestinal volvulus without malrotation and is considered to have exhibited reduced fetal movement and early jaundice as a result of volvulus, necrosis, and hemorrhage of the small intestine in the fetal period. If abdominal distention accompanied by early jaundice is noted in a neonate, intestinal volvulus without malrotation and associated intraabdominal hemorrhage should be suspected and promptly treated.

  9. Anti-infective medicine quality: analysis of basic product quality by approval status and country of manufacture

    Directory of Open Access Journals (Sweden)

    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

  10. Producing 'internal suspect bodies': divisive effects of UK counter-terrorism measures on Muslim communities in Leeds and Bradford.

    Science.gov (United States)

    Abbas, Madeline-Sophie

    2018-04-06

    Research on UK government counter-terrorism measures has claimed that Muslims are treated as a 'suspect community'. However, there is limited research exploring the divisive effects that membership of a 'suspect community' has on relations within Muslim communities. Drawing from interviews with British Muslims living in Leeds or Bradford, I address this gap by explicating how co-option of Muslim community members to counter extremism fractures relations within Muslim communities. I reveal how community members internalize fears of state targeting which precipitates internal disciplinary measures. I contribute the category of 'internal suspect body' which is materialized through two intersecting conditions within preventative counter-terrorism: the suspected extremist for Muslims to look out for and suspected informer who might report fellow Muslims. I argue that the suspect community operates through a network of relations by which terrors of counter-terrorism are reproduced within Muslim communities with divisive effects. © London School of Economics and Political Science 2018.

  11. Clinical value of whole-blood interferon-gamma assay in patients with suspected pulmonary tuberculosis and AFB smear- and polymerase chain reaction-negative bronchial aspirates.

    Science.gov (United States)

    Lee, Jaehee; Lee, Shin Yup; Yoo, Seung Soo; Cha, Seung Ick; Won, Dong Il; Park, Jae Yong; Lee, Won-Kil; Kim, Chang Ho

    2012-07-01

    Combining a polymerase chain reaction (PCR) test with bronchoscopy is frequently performed to allow a rapid diagnosis of smear-negative pulmonary tuberculosis (PTB). However, limited data are available concerning clinical judgment in patients with suspected PTB and AFB smear- and PCR-negative bronchial aspirates (BA). The present study evaluated the usefulness of whole-blood QuantiFERON-TB Gold In-Tube (QFT) testing in these patients. Of 166 patients with suspected PTB who had undergone bronchoscopy because of smear-negative sputum or inadequate sputum production, 93 (56%) were diagnosed with culture-positive PTB. Seventy-four patients were either AFB smear- or PCR-positive. In the 75 patients whose BA AFB smear and PCR results were both negative, 19 were finally diagnosed with PTB by culture. The QFT test had a negative predictive value of 91% for PTB. The QFT test may be useful for excluding PTB in patients with suspected PTB whose BA AFB smear and PCR results are both negative. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. 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

  13. Severe Fever with Thrombocytopenia Syndrome in Patients Suspected of Having Scrub Typhus.

    Science.gov (United States)

    Wi, Yu Mi; Woo, Hye In; Park, Dahee; Lee, Keun Hwa; Kang, Cheol-In; Chung, Doo Ryeon; Peck, Kyong Ran; Song, Jae-Hoon

    2016-11-01

    To determine prevalence of severe fever with thrombocytopenia syndrome in South Korea, we examined serum samples from patients with fever and insect bite history in scrub typhus-endemic areas. During the 2013 scrub typhus season, prevalence of this syndrome among patients suspected of having scrub typhus was high (23.0%), suggesting possible co-infection.

  14. Comparison of CT and MRI for Diagnosis of Suspected Scaphoid Fractures

    NARCIS (Netherlands)

    Mallee, Wouter; Doornberg, Job N.; Ring, David; van Dijk, C. Niek; Maas, Mario; Goslings, J. Carel

    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

  15. 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

  16. 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

  17. Small-Bowel Capsule Endoscopy in Patients with Suspected Crohn's Disease—Diagnostic Value and Complications

    Directory of Open Access Journals (Sweden)

    Pedro Figueiredo

    2010-01-01

    Full Text Available 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.

  18. 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

    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%. 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.

  19. Suspected post-vaccinal acute polyradiculoneuritis in a puppy : short communication

    Directory of Open Access Journals (Sweden)

    R. Gehring

    2001-07-01

    Full Text Available A 4-month-old German shepherd puppy developed hindquarter weakness after vaccination with a multivalent vaccine. This is suggestive of post-vaccinal polyradiculoneuritis. To date, only 1 similar case has been reported, which may be due to the under-reporting of suspected adverse drug reactions.

  20. 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

  1. Optimisation of the MR protocol in pregnant women with suspected acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ilah; Chung, Yong Eun; An, Chansik; Kim, Honsoul; Lim, Joon Seok; Kim, Myeong-Jin [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Seoul (Korea, Republic of); Lee, Hye Sun [Yonsei University College of Medicine, Department of Research Affairs, Biostatistics Collaboration Unit, Seoul (Korea, Republic of)

    2018-02-15

    To investigate the optimal magnetic resonance (MR) imaging protocol in pregnant women suspected of having acute appendicitis. One hundred and forty-six pregnant women with suspected appendicitis were included. MR images were reviewed by two radiologists in three separate sessions. In session 1, only axial single-shot turbo spin echo (SSH-TSE) T2-weighted images (WI) were included with other routine sequences. In sessions 2 and 3, coronal and sagittal T2WI were sequentially added. The visibility of the appendix and diagnostic confidence of appendicitis were evaluated in each session using a 5-point grading scale. If diseases other than appendicitis were suspected, specific diagnosis with a 5-point confidence scale was recorded. Diagnostic performance for appendicitis and other diseases were evaluated. Twenty-five patients (17.1%) were diagnosed with appendicitis. Among the patients with normal appendix, 28 were diagnosed with other disease. Diagnostic performance including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve values for diagnosing appendicitis and other diseases showed no significant difference among sets for both reviewers (p>0.05). Diagnostic performance of MR in pregnant patients with suspected appendicitis can be preserved with omission of sagittal or both coronal and sagittal SSH-T2WI. (orig.)

  2. Reimbursement and Insurance Coverage in Cases of Suspected Sexual Abuse in the Emergency Department.

    Science.gov (United States)

    Kupfer, Gary M.; Giardino, Angelo P.

    1995-01-01

    Emergency department charts of 186 suspected preadolescent victims of sexual abuse (SSA) were compared with 623 patients evaluated for upper limb fracture. Hospital costs of SSA patients were more often and to a greater degree underwritten by the hospital itself because of lower reimbursement and a higher percentage of uninsured and publicly…

  3. 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…

  4. Ultrasonography, computed tomography, and cholescintigraphy in suspected obstructive jaundice--a prospective comparative study

    DEFF Research Database (Denmark)

    Matzen, P; Malchow-Møller, A; Brun, B

    1983-01-01

    In order to compare their capacity to visualize the bile ducts, ultrasonography, computed tomography, and cholescintigraphy were performed in 56 consecutive jaundiced patients in whom extrahepatic cholestasis was clinically suspected. The predictions as to the patency of the large bill ducts were...

  5. 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...

  6. 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...

  7. Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, Indonesia.

    Science.gov (United States)

    Ahmad, Riris Andono; Matthys, Francine; Dwihardiani, Bintari; Rintiswati, Ning; de Vlas, Sake J; Mahendradhata, Yodi; van der Stuyft, Patrick

    2012-02-15

    Early and accurate diagnosis of pulmonary tuberculosis (TB) is critical for successful TB control. To assist in the diagnosis of smear-negative pulmonary TB, the World Health Organisation (WHO) recommends the use of a diagnostic algorithm. Our study evaluated the implementation of the national tuberculosis programme's diagnostic algorithm in routine health care settings in Jogjakarta, Indonesia. The diagnostic algorithm is based on the WHO TB diagnostic algorithm, which had already been implemented in the health facilities. We prospectively documented the diagnostic work-up of all new tuberculosis suspects until a diagnosis was reached. We used clinical audit forms to record each step chronologically. Data on the patient's gender, age, symptoms, examinations (types, dates, and results), and final diagnosis were collected. Information was recorded for 754 TB suspects; 43.5% of whom were lost during the diagnostic work-up in health centres, 0% in lung clinics. Among the TB suspects who completed diagnostic work-ups, 51.1% and 100.0% were diagnosed without following the national TB diagnostic algorithm in health centres and lung clinics, respectively. However, the work-up in the health centres and lung clinics generally conformed to international standards for tuberculosis care (ISTC). Diagnostic delays were significantly longer in health centres compared to lung clinics. The high rate of patients lost in health centres needs to be addressed through the implementation of TB suspect tracing and better programme supervision. The national TB algorithm needs to be revised and differentiated according to the level of care.

  8. 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.

  9. RETRIEVING SUSPECT TRANSURANIC WASTE FROM THE HANFORD BURIAL GROUNDS PROGRESS PLANS AND CHALLENGES

    International Nuclear Information System (INIS)

    FRENCH, M.S.

    2006-01-01

    This paper describes the scope and status of the program for retrieval of suspect transuranic (TRU) waste stored in the Hanford Site low-level burial grounds. Beginning in 1970 and continuing until the late 1980's, waste suspected of containing significant quantities of transuranic isotopes was placed in ''retrievable'' storage in designated modules in the Hanford burial grounds, with the intent that the waste would be retrieved when a national repository for disposal of such waste became operational. Approximately 15,000 cubic meters of waste, suspected of being TRU, was placed in storage modules in four burial grounds. With the availability of the national repository (the Waste Isolation Pilot Plant), retrieval of the suspect TRU waste is now underway. Retrieval efforts, to date, have been conducted in storage modules that contain waste, which is in general, contact-handled, relatively new (1980's and later), is stacked in neat, engineered configurations, and has a relatively good record of waste characteristics. Even with these optimum conditions, retrieval personnel have had to deal with a large number of structurally degraded containers, radioactive contamination issues, and industrial hazards (including organic vapors). Future retrieval efforts in older, less engineered modules are expected to present additional hazards and difficult challenges

  10. CT for suspected appendicitis in children: an analysis of diagnostic errors

    International Nuclear Information System (INIS)

    Taylor, George A.; Callahan, Michael J.; Rodriguez, Diana; Smink, Douglas S.

    2006-01-01

    Mistakes have been made by the use of CT in diagnosing children with suspected appendicitis. Although others have reported the frequency of diagnostic errors, we were unable to find any studies that addressed the specific situations in which diagnostic errors occurred in children with suspected appendicitis. To investigate the frequency and type of diagnostic errors resulting from CT of children with suspected appendicitis when compared to surgical and pathological diagnosis. We reviewed imaging, clinical and pathological data on 1,207 consecutive pediatric patients who underwent CT examination for suspected appendicitis. Imaging findings were categorized as false-positive, false-negative, or indeterminate. Errors were classified as interpretative, technical or unavoidable. Concordance between surgical and pathological findings was also evaluated. The imaging findings of 34 patients (2.8%) were discrepant with the pathological examination or clinical follow-up. The errors in 23 cases were classified as interpretive (68%) and 11 as unavoidable (32%), and no errors were classified as technical. There were 23 false-positive errors (68%), 6 false-negative errors (18%), and 5 indeterminate imaging studies (15%). Isolated CT findings of an enlarged (greater than 6 mm) appendix, fat stranding, thickened bowel or non-visualization of the distal appendix were the most common false-positive CT findings. Of these 34 patients, 22 underwent appendectomy, with 10 (45%) having discordant surgical and pathological findings. (orig.)

  11. 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.)

  12. 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...

  13. 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 hospita...

  14. A method based on temporal concept analysis for detecting and profiling human trafficking suspects

    NARCIS (Netherlands)

    Poelmans, J.; Elzinga, P.; Viaene, S.; Dedene, G.; Hamza, M.H.

    2010-01-01

    Human trafficking and forced prostitution are a serious problem for the Amsterdam-Amstelland police (the Netherlands). In this paper, we present a method based on Temporal Concept Analysis for detecting and profiling human trafficking suspects. Using traditional Formal Concept Analysis, we first

  15. Frequency of suspected cases of neurocysticercosis detected by computed skull tomography in Santa Maria, RS, Brazil.

    Science.gov (United States)

    Silva, J E; Diefenthäler, A P; Palma, J K

    2000-01-01

    Due to the lack of studies about neurocysticercosis in the South of Brazil, an investigation was conducted to determine the percentage of suspected cases of neurocysticercosis in computed tomography diagnoses in Santa Maria, RS, from January 1997 to December 1998. Of 6300 computed tomographies (CT) of the skull performed at the private Hospital de Caridade Astrogildo de Azevedo, 80, i.e., 1.27% were suspected of neurocysticercosis. Fifty were women (62.5%) and 30 were men (37.5%). The most frequent radiological manifestation indicating neurocysticercosis was the presence of calcifications (isolated or associated), with a 95% rate (76 cases), while the presence of hypodense lesions reached a 5% rate (4 cases). After routine analysis, each CT was evaluated again and the suspected cases were confirmed. The percentage of suspected cases of neurocysticercosis detected by CT in the present study carried out in Santa Maria was considered low (1.27%). This can be explained by the fact that tomography is not accessible to the economically underprivileged population of Santa Maria. We hope that the present study can alert the population and the professionals to the fact that neurocysticercosis is a more frequent disease than indicated by the few diagnoses made.

  16. Genotype-phenotype correlation in patients suspected of having Sotos syndrome

    NARCIS (Netherlands)

    de Boer, Lonneke; Kant, Sarina G.; Karperien, Marcel; van Beers, Lotte; Tjon, Jennifer; Vink, Geraldine R.; van Tol, Dewy; Dauwerse, Hans; le Cessie, Saskia; Beemer, Frits A.; van der Burgt, Ineke; Hamel, Ben C. J.; Hennekam, Raoul C.; Kuhnle, Ursula; Mathijssen, Inge B.; Veenstra-Knol, Hermine E.; Stumpel, Connie T. Schrander; Breuning, Martijn H.; Wit, Jan M.

    2004-01-01

    Background: Deletions and mutations in the NSD1 gene are the major cause of Sotos syndrome. We wanted to evaluate the genotype-phenotype correlation in patients suspected of having Sotos syndrome and determine the best discriminating parameters for the presence of a NSD1 gene alteration. Methods:

  17. Genotype-phenotype correlation in patients suspected of having sotos syndrome.

    NARCIS (Netherlands)

    Boer, L. de; Kant, S.; Karperien, M.; Beers, L. van; Tjon, J.; Vink, G.R.; Tol, D. van; Dauwerse, H.G.; Cessie, S. le; Beemer, F.A.; Burgt, C.J.A.M. van der; Hamel, B.C.J.; Hennekam, R.C.M.; Kuhnle, U.; Mathijssen, I.B.; Veenstra-Knol, H.E.; Stumpel, C.T.; Breuning, M.H.; Wit, J.M.

    2004-01-01

    BACKGROUND: Deletions and mutations in the NSD1 gene are the major cause of Sotos syndrome. We wanted to evaluate the genotype-phenotype correlation in patients suspected of having Sotos syndrome and determine the best discriminating parameters for the presence of a NSD1 gene alteration. METHODS:

  18. A case report of suspected malignant hyperthermia where patient survived the episode

    OpenAIRE

    Iqbal, Asif; Badoo, Shoaib; Naqeeb, Ruqsana

    2017-01-01

    Malignant hyperthermia is rare inherited disorder in our part of the world; there are only few cases reported in literature in India who were suspected of having this condition. The overall incidence of malignant hyperthermia during general anesthesia is estimated to range from 1: 5000 to 1: 50,000–100,000 and mortality rate is estimated to be

  19. 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

  20. 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…

  1. 48 CFR 3003.203 - Reporting suspected violations of the Gratuities clause.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Reporting suspected violations of the Gratuities clause. 3003.203 Section 3003.203 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY, HOMELAND SECURITY ACQUISITION REGULATION (HSAR) GENERAL IMPROPER BUSINESS...

  2. Head Injury Secondary to Suspected Child Maltreatment: Results of a Prospective Canadian National Surveillance Program

    Science.gov (United States)

    Bennett, Susan; Ward, Michelle; Moreau, Katherine; Fortin, Gilles; King, Jim; MacKay, Morag; Plint, Amy

    2011-01-01

    Objective: We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries. Methods: From March 1, 2005 to February 28, 2008, an average of 2,545…

  3. 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 ...

  4. Which children could benefit from additional diagnostic tools in case of suspected appendicitis?

    NARCIS (Netherlands)

    van den Broek, W. T.; van der Ende, E. D.; Bijnen, A. B.; Breslau, P. J.; Gouma, D. J.

    2004-01-01

    Background: New diagnostic tools such as ultrasound scan, computed tomography (CT) scan, and diagnostic laparoscopy, have become available for children with suspected appendicitis but should be reserved for equivocal cases. The aim of this study was to develop a scoring system to identify this

  5. Optimisation of the MR protocol in pregnant women with suspected acute appendicitis

    International Nuclear Information System (INIS)

    Shin, Ilah; Chung, Yong Eun; An, Chansik; Kim, Honsoul; Lim, Joon Seok; Kim, Myeong-Jin; Lee, Hye Sun

    2018-01-01

    To investigate the optimal magnetic resonance (MR) imaging protocol in pregnant women suspected of having acute appendicitis. One hundred and forty-six pregnant women with suspected appendicitis were included. MR images were reviewed by two radiologists in three separate sessions. In session 1, only axial single-shot turbo spin echo (SSH-TSE) T2-weighted images (WI) were included with other routine sequences. In sessions 2 and 3, coronal and sagittal T2WI were sequentially added. The visibility of the appendix and diagnostic confidence of appendicitis were evaluated in each session using a 5-point grading scale. If diseases other than appendicitis were suspected, specific diagnosis with a 5-point confidence scale was recorded. Diagnostic performance for appendicitis and other diseases were evaluated. Twenty-five patients (17.1%) were diagnosed with appendicitis. Among the patients with normal appendix, 28 were diagnosed with other disease. Diagnostic performance including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve values for diagnosing appendicitis and other diseases showed no significant difference among sets for both reviewers (p>0.05). Diagnostic performance of MR in pregnant patients with suspected appendicitis can be preserved with omission of sagittal or both coronal and sagittal SSH-T2WI. (orig.)

  6. Analysis of suspected wildlife crimes submitted for forensic examinations in Scotland.

    Science.gov (United States)

    Millins, Caroline; Howie, Fiona; Everitt, Charles; Shand, Michael; Lamm, Catherine

    2014-09-01

    This study describes the occurrence of suspected wildlife crimes submitted for forensic examination in Scotland in 2010. The study aims were to determine which types of crimes were committed, which species were targeted, and the outcome of investigations, in order to assess the contribution of forensic examinations in the prosecution of wildlife crimes. Information on suspected wildlife crimes submitted between January 1 and December 31, 2010 to the SAC Consulting: Veterinary Services Disease Surveillance Centers, Science and Advice for Scottish Agriculture, and to the University of Glasgow, was used. The location of suspected crimes, the species targeted, cause of death, and types of the 188 submitted wildlife crimes were summarized. More information regarding cases involving birds were submitted than cases involving mammals, and included 114 raptors, 14 waterfowl, and 22 "other bird species." Mammal cases (n = 38) included 12 badgers, 8 foxes, 7 deer, 4 hares, and 7 "other mammals." The cause of death was determined in 124 suspected crimes; malicious or accidental trauma was the most likely cause of death in 72, and 33 were poisoned. Forensic evidence supporting criminal activity was found in 53 cases, and poisoning was the most frequent crime recorded. At least five individuals were successfully prosecuted, representing 2.7 % of submissions. It was challenging to track cases from submission through to prosecution and laboratories conducting forensic investigations were often not informed of the outcome of prosecutions or court decisions.

  7. 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

  8. 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

  9. Essential Medications for Patients With Suspected or Confirmed Ebola Virus Disease in Resource-Limited Environments.

    Science.gov (United States)

    Pierce, William F; Ready, Selena D; Chapman, John Tyson; Kulick, Corrinne; Shields, Anastasia; Wang, Jialynn; Andrews, Kimberly; Childs, Richard W; Bell, Carlos; Kosyak, Alexandr; Pham, Jade

    2017-09-01

    In 2014, the U.S. Public Health Service (USPHS) Commissioned Corps deployed to Monrovia, Liberia, to operate a 25-bed Ebola treatment unit (ETU) constructed by the U.S. Military. The ETU was named the Monrovia Medical Unit (MMU) and was constructed from an U.S. Air Force Expeditionary Medical Support (EMEDS) unit with modifications on the basis of consultation from Médecins Sans Frontières, the World Health Organization, and expert panels from the U.S. Department of Defense and Department of Health and Human Services. From November 12, 2014, to April 30, 2015, 42 patients (18 confirmed Ebola virus disease [EVD] and 24 suspected EVD) from nine countries were treated by USPHS providers at the MMU. The medications used in the MMU were primarily procured from the EMEDS 25-bed pharmacy cache. However, specific formulary additions were made for treatment of EVD. Using the MMU pharmacy dispensing data, we compared and contrasted the medications used in the MMU with recommendations in published EVD treatment guidelines for austere settings. After comparing and contrasting the MMU pharmacy dispensing data with publications with EVD medication recommendations applicable to resource-limited settings, 101 medications were included in the USPHS Essential Medications for the Management of EVD List (EML) for an austere, isolated clinical environment. Because Ebola outbreaks often occur in remote areas, proactive planning, improved preparedness, and optimal patient care for EVD are needed, especially in the context of austere environments with a scarcity of resources. We developed the EML to assist in the planning for future Ebola outbreaks in a remote clinical environment and to provide a list of medications that have been used in an ETU. The EML is a comprehensive medication list that builds on the existing publications with EVD treatment recommendations applicable to supply-constrained clinical environments. As well, it is a resource for the provision of medications when

  10. Exploring the Diagnostic Utility of Facial Composites: Beliefs of Guilt Can Bias Perceived Similarity between Composite and Suspect

    Science.gov (United States)

    Charman, Steve D.; Gregory, Amy Hyman; Carlucci, Marianna

    2009-01-01

    Facial composite research has generally focused on the investigative utility of composites--using composites to find suspects. However, almost no work has examined the diagnostic utility of facial composites--the extent to which composites can be used as evidence against a suspect. For example, detectives and jurors may use the perceived…

  11. [Analysis on the role of Sirius combined topography and tomography system in screening for suspect keratoconus].

    Science.gov (United States)

    Zhang, Y; Chen, Y G; Yang, H Y; Xia, Y J; Zhao, R

    2018-01-11

    Objective: To evaluate the role of Sirius combined topography and tomography system in screening for suspect keratoconus among the corneal refractive surgery candidates. Methods: Retrospective case series study. Eight hundred and sixteen consecutive ametropic patients (1 632 eyes) who underwent routine examinations before corneal refractive surgery at Peking University Third Hospital from January 2016 to September 2016 were reviewed. All the cases were analyzed with Sirius combined topography and tomography system. Fifty-nine eyes of 37 patients, aged (28.9±7.4) years, classified as suspect keratoconus by the system were enrolled in the suspect group, including 25 females (40 eyes) and 12 males (19 eyes). A random eye of the first 59 patients, aged (27.1±6.4)years, whose both eyes were classified as normal by Sirius system were enrolled in the control group, including 38 females and 21 males. The corneal anterior surface, posterior surface and minimum thickness data of the suspect group were analyzed and then compared with the control group. The classified results were further verified by Pentacam system. Independent-samples t test and Mann-Whitney U test were applied to analyze the normal distribution and non-normal distribution data respectively. Results: The medians of anterior surface and posterior surface symmetry index and Baiocchi Calossi Versaci index of anterior surface and posterior surface of the suspect group were 0.84, 0.22, 0.58 and 0.51 D, and that of the control group were 0.05, 0.04, 0.09 and 0.06 D, and the differences were of statistical significance ( Z=- 18.764, -8.351, -12.248, -10.709, Ptopography and tomography and its integral automatic classification system is capable to screen out the suspect keratoconus simply and effectively. These indices maybe arranged in descending order in terms of the sensitivity as corneal posterior surface, followed by corneal anterior surface and then corneal thinnest point thickness. (Chin J Ophthalmol, 2018

  12. Factors associated to referral of tuberculosis suspects by private practitioners to community health centres in Bali Province, Indonesia.

    Science.gov (United States)

    Artawan Eka Putra, I Wayan Gede; Utami, Ni Wayan Arya; Suarjana, I Ketut; Duana, I Made Kerta; Astiti, Cok Istri Darma; Putra, I W; Probandari, Ari; Tiemersma, Edine W; Wahyuni, Chatarina Umbul

    2013-10-28

    The contrast between the low proportion of tuberculosis (TB) suspects referred from private practitioners in Bali province and the high volume of TB suspects seeking care at private practices suggests problems with TB suspect referral from private practitioners to the public health sector. We aimed to identify key factors associated with the referral of TB suspects by private practitioners. We conducted a case-control study conducted in Bali province, Indonesia. The cases were private practitioners who had referred at least one TB suspect to a community health centre between 1 January 2007 and the start of data collection, while the controls were private practitioners who had not referred a single TB suspect in the same time. The following factors were independently associated with referral of TB suspects by private practitioners: having received information about the directly observed treatment short-course (DOTS) strategy (OR 2.0; 95% CI 1.1-3.8), ever having been visited by a district TB program officer (OR 2.1; 95% CI 1.0-4.5), availability of TB suspect referral forms in the practice (OR 2.8; 95% CI 1.5-5.2), and less than 5 km distance between the private practice and the laboratory for smear examination (OR 2.2; 95% CI 1.2-4.0). Education and exposure of private practitioners to the TB program improves referral of TB suspects from private practitioners to the national TB program. We recommend that the TB program provides all private practitioners with information about the DOTS strategy and TB suspect referral forms, and organizes regular visits to private practitioners.

  13. Food-stimulated cholescintigraphy as a supplement to ERC in patients with suspected bile flow obstruction

    International Nuclear Information System (INIS)

    Hansen, H.H.; Toftgaard, C.; Rokkjor, M.J.; Kruse, A.; Funch-Jensen, P.; Thommesen, P.; Municipal Hospital, Aarhus

    1990-01-01

    Cholescintigraphy after food stimulation was carried out in 40 patients (13 patients with biliary enteric bypass, 14 patients with bile duct stenosis, demonstrated by ERC, 5 patients with endoprothesis and 8 patients with clinically suspected post-cholecystectomy syndrome). Biliary-bowel transit time of one hour or less was considered to be normal. It is concluded that in patients with biliary enteric bypass (hepatico-jejunostomia) or biliary strictures a biliary-bowel transit time of one hour will be discriminatory between normal and abnormal conditions. This is in contrast to patients with endoprothesis and suspected sphincter of Oddi dysmotility, where a transit time of one hour only will have limited predictive value. (orig.) [de

  14. SUSPECTED HYPERVITAMINOSIS D IN RED-RUMPED AGOUTI ( DASYPROCTA LEPORINA) RECEIVING A COMMERCIAL RODENT DIET.

    Science.gov (United States)

    Anderson, Kadie M; Lewandowski, Albert; Dennis, Patricia M

    2018-03-01

    An 8 yr, intact male red-rumped agouti ( Dasyprocta leporina) was evaluated for weight loss. Examination revealed poor body condition, hypercalcemia, elevated serum 25-hydroxyvitamin D, metastatic calcification of soft tissues, and hyperechoic kidneys. The diet, formulated for laboratory rodents, contained elevated levels of vitamin D 3 . Histopathology from a female conspecific that died 5 mo prior identified dystrophic mineralization and nephrosclerosis, suggestive of a vitamin D 3 toxicity. The male agouti responded well to a dietary reduction in vitamin D 3 and calcium. Six months into therapy, progressive renal failure was identified and was further managed with enalapril, phosphorus binders, and dietary manipulation. Suspected vitamin D 3 toxicity has been reported in pacas ( Cuniculus paca) and agouti and has been linked to exposure to New World primate diets. In this brief communication, an agouti developed suspected hypervitaminosis D after receiving a commercial rodent diet commonly fed to this species in captivity.

  15. A case of hypopharyngeal fistula suspected of late complication due to irradiation

    International Nuclear Information System (INIS)

    Fuchigami, Teruhiko; Karaho, Takehiro; Hyodo, Yoshihiro; Tanabe, Tetsuya; Kitahara, Satoshi

    2003-01-01

    We report a case of hypopharyngeal fistula which was suspected of being a late complication due to radiotherapy. The patient was 54-year-old female who had undergone total thyroidectomy for thyroid carcinoma in 1967, receiving a total of 75 Gy postoperative irradiation. In 2001 she came to our hospital complaining of neck pain and difficulty in swallowing. On pharyngoesophagogram we found a hypopharyngeal fistula. The fistula was located under the posterior wall of the hypopharynx between C4 and C7. It was undetectable with flexible fiberscope but was detected with rigid endoscope under the general anesthesia. We suspected it was a late complication of the irradiation. We performed endoscopic laser surgery (KTP), resected the tissue between the upper and lower openings of the fistula, and vertically exposed the fistula in the hypopharyngeal space. Her dysphagia improved. We discuss the mechanism of fistula formation in this case. (author)

  16. A case of hypopharyngeal fistula suspected of late complication due to irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Fuchigami, Teruhiko; Karaho, Takehiro; Hyodo, Yoshihiro; Tanabe, Tetsuya; Kitahara, Satoshi [National Defense Medical Coll., Tokorozawa, Saitama (Japan)

    2003-05-01

    We report a case of hypopharyngeal fistula which was suspected of being a late complication due to radiotherapy. The patient was 54-year-old female who had undergone total thyroidectomy for thyroid carcinoma in 1967, receiving a total of 75 Gy postoperative irradiation. In 2001 she came to our hospital complaining of neck pain and difficulty in swallowing. On pharyngoesophagogram we found a hypopharyngeal fistula. The fistula was located under the posterior wall of the hypopharynx between C4 and C7. It was undetectable with flexible fiberscope but was detected with rigid endoscope under the general anesthesia. We suspected it was a late complication of the irradiation. We performed endoscopic laser surgery (KTP), resected the tissue between the upper and lower openings of the fistula, and vertically exposed the fistula in the hypopharyngeal space. Her dysphagia improved. We discuss the mechanism of fistula formation in this case. (author)

  17. Optimisation of the digital radiographic imaging of suspected non-accidental injury

    Science.gov (United States)

    Offiah, Amaka

    Aim: To optimise the digital (radiographic) imaging of children presenting with suspected non-accidental injury (NAI). Objectives: (i) To evaluate existing radiographic quality criteria, and to develop a more suitable system if these are found to be inapplicable to skeletal surveys obtained in suspected NAI. (ii) To document differences in image quality between conventional film-screen and the recently installed Fuji5000R computed radiography (CR) system at Great Ormond Street Hospital for Children, (iii) To document the extent of variability in the standard of skeletal surveys obtained in the UK for suspected NAI. (iv) To determine those radiographic parameters which yield the highest diagnostic accuracy, while still maintaining acceptable radiation dose to the child, (v) To determine how varying degrees of edge-enhancement affect diagnostic accuracy. (vi) To establish the accuracy of soft compared to hard copy interpretation of images in suspected NAI. Materials and Methods: (i) and (ii) Retrospective analysis of 286 paediatric lateral spine radiographs by two observers based on the Commission of European Communities (CEC) quality criteria, (iii) Review of the skeletal surveys of 50 consecutive infants referred from hospitals throughout the United Kingdom (UK) with suspected NAI. (iv) Phantom studies. Leeds TO. 10 and TO. 16 test objects were used to compare the relationship between film density, exposure parameters and visualisation of object details, (iv) Clinical study. Anteroposterior and lateral post mortem skull radiographs of six consecutive infants were obtained at various exposures. Six observers independently scored the images based on visualisation of five criteria, (v) and (vi) A study of diagnostic accuracy in which six observers independently interpreted 50 radiographs from printed copies (with varying degrees of edge-enhancement) and from a monitor. Results: The CEC criteria are useful for optimisation of imaging parameters and allow the detection

  18. 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.

  19. In-111 labeled leukocyte scintigraphy in patients with suspected inflammation after failed antibiotic therapy

    International Nuclear Information System (INIS)

    Nasu, Reiko; Akagi, Kiyoshi; Murata, Takashi; Uokawa, Kyousuke; Isoda, Hiroyoshi; Tanaka, Yoshimasa; Itagaki, Yasushi

    1998-01-01

    In-111 labeled leukocyte scintigrapy (In-111 WBC scan) was performed in 16 patients with inflammation suspected on the basis of laboratory findings, symptoms, and diagnostic imaging, but who had failed antibiotic therapy. In-111 WBC scans revealed an abnormal focus of radiotracer activity (positive scans) in five of 16 patients. No correlation was found between the peripheral WBC count and accumulation of In-111 WBC. Inflammatory disease suspected on the basis of the CRP level should be considered when In-111 WBC scanning results in negative findings. Our results indicated that In-111 WBC scanning has low sensitivity after antibiotic therapy. Selection of patients on the basis of persistent elevation of CRP may be valuable. (author)

  20. Conversion disorder as psychogenic nonepileptic seizures in suspected cancer: a case report.

    Science.gov (United States)

    Jimenez, Xavier F; Sharma, Jennifer S; Dar, Syma A

    2014-01-01

    Psychogenic nonepileptic seizures (PNES), a form of conversion disorder, are paroxysmal episodes resembling epilepsy while lacking electrographic correlation. The phenomenon has rarely been reported in elderly patients and has not been associated with a new-onset medical diagnosis. We present the case of an 81-year-old female with no past psychiatric or traumatic history who developed PNES within the context of a new, suspected cancer. To our knowledge, this is the first such reported case of a suspected cancer (or otherwise medical) diagnosis contributing directly and temporally to the development of PNES. Discussion of involved psychosocial variables follows the vignette, and a brief review of relevant literature is offered. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. 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.
.

  2. 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

  3. 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.

  4. Improving the diagnostic performance of lung scintigraphy in suspected pulmonary embolic disease

    International Nuclear Information System (INIS)

    Gleeson, F.V.; Turner, S.; Scarsbrook, A.F.

    2006-01-01

    Aim: to determine the effectiveness of a new imaging algorithm in the investigation of suspected pulmonary embolism (PE). Materials and methods: A new imaging algorithm for suspected PE was introduced following the installation of a multisection computed tomography (CT) machine at our institution. Before its installation, patients with suspected PE were evaluated with ventilation/perfusion (V/Q) scintigraphy. Subsequently, patients were triaged according to chest radiography (CR) and respiratory history to either lung scintigraphy or CT pulmonary angiography (CTPA). Patients with a normal CR and no history of lung disease were evaluated using perfusion (Q) scintigraphy [ventilation (V) scintigraphy was no longer performed]. Patients with an abnormal CR, asthma or chronic lung disease were evaluated using CTPA. All V/Q images in a continuous 3-year period before the introduction of the new imaging algorithm and all Q images performed in a 3-year period after its introduction were retrospectively reviewed. Imaging reports were categorized into normal, non-diagnostic (low or intermediate probability) or high probability for PE. Patients in the later group who subsequently underwent CTPA, were also reviewed. Results: After the policy change the percentage of normal scintigrams significantly increased (39 to 60%; p < 0.001). There was a non-significant increase in the percentage of high probability scintigrams (15 to 18%; p = 0.716). Overall the diagnostic yield of lung scintigraphy improved significantly (54 to 78%; p < 0.001). Conclusion: the diagnostic performance of lung scintigraphy can be improved by careful triage of patients to either Q scintigraphy or CTPA based on clinical history and CR findings. Q scintigraphy remains a valuable diagnostic test in the investigation of suspected PE in carefully selected patients

  5. 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.

  6. Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome

    OpenAIRE

    Biso, Sylvia Marie; Lu, Marvin; De Venecia, Toni Anne; Wongrakpanich, Supakanya; Rodriguez-Ziccardi, Mary; Yadlapati, Sujani; Kishlyansky, Marina; Rammohan, Harish Seetha; Figueredo, Vincent M.

    2017-01-01

    Background Acute coronary syndrome (ACS) can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-...

  7. Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Ahmad Riris

    2012-02-01

    Full Text Available Abstract Background Early and accurate diagnosis of pulmonary tuberculosis (TB is critical for successful TB control. To assist in the diagnosis of smear-negative pulmonary TB, the World Health Organisation (WHO recommends the use of a diagnostic algorithm. Our study evaluated the implementation of the national tuberculosis programme's diagnostic algorithm in routine health care settings in Jogjakarta, Indonesia. The diagnostic algorithm is based on the WHO TB diagnostic algorithm, which had already been implemented in the health facilities. Methods We prospectively documented the diagnostic work-up of all new tuberculosis suspects until a diagnosis was reached. We used clinical audit forms to record each step chronologically. Data on the patient's gender, age, symptoms, examinations (types, dates, and results, and final diagnosis were collected. Results Information was recorded for 754 TB suspects; 43.5% of whom were lost during the diagnostic work-up in health centres, 0% in lung clinics. Among the TB suspects who completed diagnostic work-ups, 51.1% and 100.0% were diagnosed without following the national TB diagnostic algorithm in health centres and lung clinics, respectively. However, the work-up in the health centres and lung clinics generally conformed to international standards for tuberculosis care (ISTC. Diagnostic delays were significantly longer in health centres compared to lung clinics. Conclusions The high rate of patients lost in health centres needs to be addressed through the implementation of TB suspect tracing and better programme supervision. The national TB algorithm needs to be revised and differentiated according to the level of care.

  8. Police reports of mock suspect interrogations: A test of accuracy and perception.

    Science.gov (United States)

    Kassin, Saul M; Kukucka, Jeff; Lawson, Victoria Z; DeCarlo, John

    2017-06-01

    A 2-phased experiment assessed the accuracy and completeness of police reports on mock interrogations and their effects on people's perceptions. In Phase 1, 16 experienced officers investigated a mock crime scene, interrogated 2 innocent suspects-1 described by the experimenter as more suspicious than the other-and filed an incident report. All 32 sessions were covertly recorded; the recordings were later used to assess the reports. In Phase 2, 96 lay participants were presented with a brief summary of the case and then either read 1 police report, read 1 verbatim interrogation transcript, or listened to an audiotape of a session. Results showed that (a) Police and suspects diverged in their perceptions of the interrogations; (b) Police committed frequent errors of omission in their reports, understating their use of confrontation, maximization, leniency, and false evidence; and (c) Phase 2 participants who read a police report, compared to those who read a verbatim transcript, perceived the process as less pressure-filled and were more likely to misjudge suspects as guilty. These findings are limited by the brevity and low-stakes nature of the task and by the fact that no significant effects were obtained for our suspicion manipulation, suggesting a need for more research. Limitations notwithstanding, this study adds to a growing empirical literature indicating the need for a requirement that all suspect interrogations be electronically recorded. To provide a more objective and accurate account of what transpired, this study also suggests the benefit of producing verbatim transcripts. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Optical Coherence Tomography Angiography Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes

    Science.gov (United States)

    Yarmohammadi, Adeleh; Zangwill, Linda M.; Diniz-Filho, Alberto; Suh, Min Hee; Manalastas, Patricia Isabel; Fatehee, Naeem; Yousefi, Siamak; Belghith, Akram; Saunders, Luke J.; Medeiros, Felipe A.; Huang, David; Weinreb, Robert N.

    2016-01-01

    Purpose The purpose of this study was to compare retinal nerve fiber layer (RNFL) thickness and optical coherence tomography angiography (OCT-A) retinal vasculature measurements in healthy, glaucoma suspect, and glaucoma patients. Methods Two hundred sixty-one eyes of 164 healthy, glaucoma suspect, and open-angle glaucoma (OAG) participants from the Diagnostic Innovations in Glaucoma Study with good quality OCT-A images were included. Retinal vasculature information was summarized as a vessel density map and as vessel density (%), which is the proportion of flowing vessel area over the total area evaluated. Two vessel density measurements extracted from the RNFL were analyzed: (1) circumpapillary vessel density (cpVD) measured in a 750-μm-wide elliptical annulus around the disc and (2) whole image vessel density (wiVD) measured over the entire image. Areas under the receiver operating characteristic curves (AUROC) were used to evaluate diagnostic accuracy. Results Age-adjusted mean vessel density was significantly lower in OAG eyes compared with glaucoma suspects and healthy eyes. (cpVD: 55.1 ± 7%, 60.3 ± 5%, and 64.2 ± 3%, respectively; P glaucoma and healthy eyes, the age-adjusted AUROC was highest for wiVD (0.94), followed by RNFL thickness (0.92) and cpVD (0.83). The AUROCs for differentiating between healthy and glaucoma suspect eyes were highest for wiVD (0.70), followed by cpVD (0.65) and RNFL thickness (0.65). Conclusions Optical coherence tomography angiography vessel density had similar diagnostic accuracy to RNFL thickness measurements for differentiating between healthy and glaucoma eyes. These results suggest that OCT-A measurements reflect damage to tissues relevant to the pathophysiology of OAG. PMID:27409505

  10. Determination of neuronal antibodies in suspected and definite Creutzfeldt-Jakob disease

    OpenAIRE

    Grau-Rivera, O.; Sánchez del Valle Díaz, Raquel; Saiz Hinajeros, Albert; Molinuevo, José L.; Bernabé, Reyes; Munteis, Elvira; Pujadas, Francesc; Salvador, Antoni; Saura, Júlia; Ugarte, Antonio; Titulaer, Maarten; Dalmau Obrador, Josep; Graus Ribas, Francesc

    2014-01-01

    IMPORTANCE Creutzfeldt-Jakob disease (CJD) and autoimmune encephalitis with antibodies against neuronal surface antigens (NSA-abs) may present with similar clinical features. Establishing the correct diagnosis has practical implications in the management of care for these patients. OBJECTIVE To determine the frequency of NSA-abs in the cerebrospinal fluid of patients with suspected CJD and in patients with pathologically confirmed (ie, definite) CJD. DESIGN, SETTING, AND PARTICIPANTS A mixed ...

  11. Prevalence of vulvovaginitis and relation to physical findings in girls assessed for suspected child sexual abuse.

    Science.gov (United States)

    Rahman, Gisel; Ocampo, Dolores; Rubinstein, Anahí; Risso, Paula

    2015-10-01

    The presence of sexually transmitted infections (STIs) in patients with suspected sexual abuse is uncommon in the field of pediatrics. To establish the prevalence of anogenital findings and their relation to the presence of STIs in girls referred for suspected child sexual abuse. Retrospective study conducted between January 1st, 2003 and December 31st, 2013. Physical findings and detection of STIs in girls with suspected child sexual abuse were analyzed. One thousand thirty-four patients were included. Their median age was 7.9 years old. Anogenital findings were classified as class I (normal):38.4%, class II (nonspecific):38.1%, class III (specific):19.9% and class IV (definitive):3.6%. STIs were observed in 42 patients (4.1%). A relation was established between STIs and the classification of physical findings: 10 (class II: 9; class III: 1) Neisseria gonorrhoeae, 17 (class I: 2; class II: 8; class III: 7) Chlamydia trachomatis, 15 (class I: 2; class II: 10; class III: 3) Trichomonas vaginalis. Statistically significant differences for Trichomonas vaginalis (p= 0.01) and Neisseria gonorrhoeae (p < 0.0001) were observed, with predominance of nonspecific clinical signs. Both nonspecific and specific findings were similarly observed for Chlamydia trachomatis (p= 0.03). Most cases of girls with suspected child sexual abuse had normal or nonspecific anogenital findings. The prevalence of STIs in these girls is low. Trichomonas vaginalis and Neisseria gonorrhoeae were related to nonspecific findings, while both nonspecific and specific findings were observed for Chlamydia trachomatis.

  12. The role of bone scintigraphy in the evaluation of the suspected abused child

    International Nuclear Information System (INIS)

    Sty, J.R.; Starshak, R.J.

    1983-01-01

    A comparison was made of the radiographic and scintigraphic skeletal surveys of 261 children and produced false-negative results in 32; scintigraphy was positive in 120 children and produced false-negative results in two. Although radiography has traditionally been used to assess the skeletal injuries of battered children, the authors conclude that scintigraphy should be the screening procedure of choice for children suspected of having been abused

  13. The yield of high-detail radiographic skeletal surveys in suspected infant abuse

    International Nuclear Information System (INIS)

    Barber, Ignasi; Perez-Rossello, Jeannette M.; Kleinman, Paul K.; Wilson, Celeste R.

    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. (orig.)

  14. Suspected primary immune deficiency in a Donge de Bordeaux dog : short communication

    Directory of Open Access Journals (Sweden)

    R.G. Lobetti

    2002-07-01

    Full Text Available A young Donge de Bordeaux dog was presented with chronic intermittent antibiotic responsive gastrointestinal and respiratory disease. Further evaluation showed bacterial lymphadenitis, bacterial tracheitis, normal white cell and differential cell counts, hypogammaglobulinaemia, and the absence of B-lymphocytes but the presence of T-lymphocytes in the lymphoid tissue stained with lymphocyte markers. As the dog came from a narrow genetic base, with related dogs showing similar clinical signs, possible B-cell congenital immune deficiency was suspected.

  15. 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.)

  16. 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.)

  17. The role of the follow-up chest radiograph in suspected non-accidental injury

    Energy Technology Data Exchange (ETDEWEB)

    Anilkumar, Adikesavalu; Fender, Laura J; Broderick, Nigel J; Somers, John M; Halliday, Katharine E [Nottingham University Hospital NHS Trust, Department of Radiology, Queen' s Medical Centre, Nottingham (United Kingdom)

    2006-03-15

    Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection. To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury. The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend. Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted. The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children. (orig.)

  18. The role of the follow-up chest radiograph in suspected non-accidental injury

    International Nuclear Information System (INIS)

    Anilkumar, Adikesavalu; Fender, Laura J.; Broderick, Nigel J.; Somers, John M.; Halliday, Katharine E.

    2006-01-01

    Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection. To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury. The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend. Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted. The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children. (orig.)

  19. The 24- hour pattern of intraocular pressure in suspected glaucoma patients

    Directory of Open Access Journals (Sweden)

    Shan-Shan Li

    2018-05-01

    Full Text Available AIM: To analyze the value of 24-hour intraocular pressure(IOPmonitoring in suspected glaucoma patients.METHODS: Totally 48 suspected glaucoma(96 eyeswere selected for 24-hour IOP monitoring by using Accupen tonometer(24-3000and non-contact tonometer(NCT, CT-80Afrom 9:30 to 7:30 next day(once in 2h. During 07:30 to 21:30, patients were measured in sitting position, while during 23:30 to 05:30 in both sitting and supine position.RESULTS: A morning peak of IOP was shown at 7:30 in traditional position by using two measures with 22.05±3.608mmHg of NCT and 19.79±4.147mmHg of Accupen tonometer. The peak IOP in habitual position appeared in 5:30 with 21.64±4.814mmHg. The lowest IOP occurred in both position at 21:30 with 15.73±3.649mmHg. Both positions showed IOP trend of going up at night and then declining in the morning. CONCLUSION: The peak IOP in suspected glaucoma occurs mostly at early morning. Supine IOP of sleeping time is higher than that of sitting position.

  20. Overcoming Innocents' Naiveté: Pre-interrogation Decision-making Among Innocent Suspects.

    Science.gov (United States)

    Scherr, Kyle C; Alberts, Kimberly M; Franks, Andrew S; Hawkins, Ian

    2016-07-01

    Suspects, especially innocent ones, are highly susceptible to waiving their interrogation rights. This research tested the ability of two strategies to overcome innocent suspects' willingness to waive their rights. One strategy was based on the social influence of scarcity (i.e., not constraining the pre-interrogation time limit). The other strategy focused on disrupting individuals' cognitive fluency during the decision-making process (i.e., violating their induced expectation of offering a waiver). Disrupting innocent individuals' cognitive fluency increased their willingness to invoke their rights and, notably, was not qualified by interactions with any other factors. However, scarcity did not influence individuals' pre-interrogation decision-making. Results also further established the association between innocent individuals' naïve mindset and their willingness to waive their rights - specifically, innocents' willingness to waive their rights increased with the strength of their just world beliefs. The theoretical and applied implications of these findings are discussed. The importance and benefit of reforming pre-interrogation protocols using fair and feasible strategies that would disrupt suspects' cognitive fluency are emphasized. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Evaluation of suspected physical abuse in children: a 500-case study

    Directory of Open Access Journals (Sweden)

    Marcos Picini

    Full Text Available ABSTRACT OBJECTIVE: This study evaluated the epidemiological profile of patients with suspected physical abuse, especially regarding the occurrence of fractures, treated in a referral hospital. METHODS: The authors reviewed all reports of suspected abuse against children and adolescents (AACA in this hospital from January 2005 to December 2015. They were assessed and separated by month and year. The characteristics of the victims of physical abuse with occurrence of fractures were studied. The features of the fractures were evaluated in those patients with available radiographs. RESULTS: Of the 3125 notifications, 500 were classified as physical injuries; of these, 63 had fractures. An annual progressive increase in notifications was observed. As for age group, 50 patients (80.6% were up to three years old and 36 (58% up to one year. Most were male (60% and the likely aggressors were mother alone and both parents (27.5% each. In 30 patients with available images, fractures of long bones (femur, tibia, and humerus predominated (71%, as well as a single fracture line (74%, diaphyseal location (73%, and a transverse line (57%. There were two deaths in fracture cases (3%. CONCLUSION: All orthopedists should be alert to suspected AACA in children with trauma below the age of three, even without classic signs of abuse.

  2. Usefulness of unenhanced helical CT in patients with suspected ureteral colic

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bong Soo; Nam Kung, Sook; Kim, Heung Cheol; Hwang, Woo Chul; Lee, In Sun; Hwang, Im Kyung; Kim, Ho Chul; Bae, Sang Hoon; Lee, Sang Kon; Lee, Seong Ho [College of Medicine, Hallym Univ., Chunchon (Korea, Republic of)

    2002-07-01

    To determine the usefulness of unenhanced helical CT in patients with suspected renal colic. One hundred and fourteen patients with suspected ureteral colic, referred by physicians, underwent unenhanced helical CT. Two radiologists prospectively interpreted the results, determining the presence or absence of ureter stone and other diseases the arise outside the urinary tract. In cases of ureteral stone, we retrospectively sought secondary signs of hydronephrosis, perinephric fat stranding, thickening of renal fascia, renal enlargement, and the tissue rim sign. Among the 114 patients, 57 were confirmed as having ureter stones. Unenhanced helical CT depicted 57 of 58 stones in 57 patients, producing one false-negative and one false-positive result. Overall, the results showed 98% sensitivity, 95% specificity, 98% positive predictive value, 95% negative predictive value, and 97% accuracy. The frequencies of secondary signs were as follows: hydronephrosis, 95%(54/57); perinephric fat stranding, 81% (46/57); thickening of renal fascia, 77% (44/57); renal enlargement , 65%(37/57); and the tissure rim sign 72%(21/29). In 20 patients, the diagnoses were not related to stone disease and included one false-negative diagnosis of pyonephrosis. Unenhanced helical CT provides information which is valuable in the accurate diagnosis of ureteral stone as well as other diseases that arise outside the urinary tract in patients with suspected renal colic.

  3. Suspect/foil identification in actual crimes and in the laboratory: a reality monitoring analysis.

    Science.gov (United States)

    Behrman, Bruce W; Richards, Regina E

    2005-06-01

    Four reality monitoring variables were used to discriminate suspect from foil identifications in 183 actual criminal cases. Four hundred sixty-one identification attempts based on five and six-person lineups were analyzed. These identification attempts resulted in 238 suspect identifications and 68 foil identifications. Confidence, automatic processing, eliminative processing and feature use comprised the set of reality monitoring variables. Thirty-five verbal confidence phrases taken from police reports were assigned numerical values on a 10-point confidence scale. Automatic processing identifications were those that occurred "immediately" or "without hesitation." Eliminative processing identifications occurred when witnesses compared or eliminated persons in the lineups. Confidence, automatic processing and eliminative processing were significant predictors, but feature use was not. Confidence was the most effective discriminator. In cases that involved substantial evidence extrinsic to the identification 43% of the suspect identifications were made with high confidence, whereas only 10% of the foil identifications were made with high confidence. The results of a laboratory study using the same predictors generally paralleled the archival results. Forensic implications are discussed.

  4. Usefulness of the Negative Multidetector CT Angiography in Patients with Suspected Pulmonary Embolism

    International Nuclear Information System (INIS)

    Holguin Holguin, Alfonso Jose; Lombana, Milton; Collazos, Giovanny; Bravo, Hector; Abella Calle, Jose

    2012-01-01

    Objective: The aim of the study is to evaluate alternative findings in pulmonary CT angiography using MDCT reported as negative in patients with suspected pulmonary embolism. Material and method: Cross sectional study with 178 patients. We recognized other findings reported in pulmonary CT angiography using MDCT whose result was negative. Subsequently these findings were classified into six different categories of clinical relevance and their association with clinical scenario was analyzed. Results: from November 2004 to June 2007 we requested 231 pulmonary CT angiography using MDCT in patients with suspected pulmonary embolism. 217 patients were included in the final analysis. Of these, 39 (185) were positive for pulmonary embolism. The 178 remaining negative studies, 8.43% were normal, 53.37% were classified as category A, 20.79% category B, 14.04% category C; category D 1.12% and 2.25% were not interpretable. The most frequent diagnoses were pneumonia, interstitial lung disease and cardiogenic pulmonary edema. It was less likely to find a normal report whether the study was requested in the hospital department in emergency patients (OR = 0.38 95% 0.16 to 0.88, p = 0.0007). No differences were found in other categories or between patients younger or older than 65 years (p = 0.436). Conclusion: Pulmonary CT angiography as first line imaging tool in patients with suspected pulmonary embolism is useful, offering alternative diagnoses in hospitalized and emergency room patients, regardless of their age and clinical findings.

  5. 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.

  6. 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

    2018-01-01

    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.

  7. Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Gaemperli, Oliver; Valenta, Ines; Schepis, Tiziano [University Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); Husmann, Lars; Scheffel, Hans; Desbiolles, Lotus; Leschka, Sebastian; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Zurich Center for Integrative Human Physiology (ZIHP), Zurich (Switzerland)

    2008-06-15

    The aim of this study was to assess the prognostic value of 64-slice CT angiography (CTA) in patients with known or suspected coronary artery disease (CAD). Sixty-four-slice coronary CTA was performed in 220 patients [mean age 63 {+-} 11 years, 77 (35%) female] with known or suspected CAD. CTA images were analyzed with regard to the presence and number of coronary lesions. Patients were followed-up for the occurrence of the following clinical endpoints: death, nonfatal myocardial infarction, unstable angina, and coronary revascularization. During a mean follow-up of 14 {+-} 4 months, 59 patients (27%) reached at least one of the predefined clinical endpoints. Patients with abnormal coronary arteries on CTA (i.e., presence of coronary plaques) had a 1st-year event rate of 34%, whereas in patients with normal coronary arteries no events occurred (event rate, 0%, p < 0.001). Similarly, obstructive lesions ({>=}50% luminal narrowing) on CTA were associated with a high first-year event rate (59%) compared to patients without stenoses (3%, p < 0.001). The presence of obstructive lesions was a significant independent predictor of an adverse cardiac outcome. Sixty-four-slice CTA predicts cardiac events in patients with known or suspected CAD. Conversely, patients with normal coronary arteries on CTA have an excellent mid-term prognosis. (orig.)

  8. 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.)

  9. 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.

  10. 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 dengue home care card. The intervention group received the fluid 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

  11. Determination of neuronal antibodies in suspected and definite Creutzfeldt-Jakob disease.

    Science.gov (United States)

    Grau-Rivera, Oriol; Sánchez-Valle, Raquel; Saiz, Albert; Molinuevo, José Luis; Bernabé, Reyes; Munteis, Elvira; Pujadas, Francesc; Salvador, Antoni; Saura, Júlia; Ugarte, Antonio; Titulaer, Maarten; Dalmau, Josep; Graus, Francesc

    2014-01-01

    Creutzfeldt-Jakob disease (CJD) and autoimmune encephalitis with antibodies against neuronal surface antigens (NSA-abs) may present with similar clinical features. Establishing the correct diagnosis has practical implications in the management of care for these patients. To determine the frequency of NSA-abs in the cerebrospinal fluid of patients with suspected CJD and in patients with pathologically confirmed (ie, definite) CJD. A mixed prospective (suspected) and retrospective (definite) CJD cohort study was conducted in a reference center for detection of NSA-abs. The population included 346 patients with suspected CJD and 49 patients with definite CJD. Analysis of NSA-abs in cerebrospinal fluid with brain immunohistochemistry optimized for cell-surface antigens was performed. Positive cases in the suspected CJD group were further studied for antigen specificity using cell-based assays. All definite CJD cases were comprehensively tested for NSA-abs, with cell-based assays used for leucine-rich glioma-inactivated 1 (LGI1), contactin-associated protein-like 2 (CASPR2), N-methyl-d-aspartate (NMDA), and glycine (GlY) receptors. Neuronal surface antigens were detected in 6 of 346 patients (1.7%) with rapid neurologic deterioration suggestive of CJD. None of these 6 patients fulfilled the diagnostic criteria for probable or possible CJD. The target antigens included CASPR2, LGI1, NMDAR, aquaporin 4, Tr (DNER [δ/notch-like epidermal growth factor-related receptor]), and an unknown protein. Four of the patients developed rapidly progressive dementia, and the other 2 patients had cerebellar ataxia or seizures that were initially considered to be myoclonus without cognitive decline. The patient with Tr-abs had a positive 14-3-3 test result. Small cell lung carcinoma was diagnosed in the patient with antibodies against an unknown antigen. All patients improved or stabilized after appropriate treatment. None of the 49 patients with definite CJD had NSA-abs. A low, but

  12. Dentists' intention to report suspected violence: a cross-sectional study in eight Arab countries.

    Science.gov (United States)

    El Tantawi, Maha; Gaffar, Balgis; Arheiam, Arheiam; AbdelAziz, Wafaa; Al-Batayneh, Ola B; Alhoti, Mansur F; Al-Maweri, Sadeq; Dama, Mai A; Zaghez, Mounir; Hassan, Khalid Saddiq; Al-Sane, Mona; AbdelSalam, Maha; Sabbah, Wael; Owais, Arwa I; Abdelgawad, Fatma; Aldhelai, Thiyezen Abdullah; El Meligy, Omar Abd El Sadek; AlHumaid, Jehan; Al-Harbi, Fahad

    2018-03-30

    This study assessed dentists' intention in eight Arab countries to report suspected exposure to violence among patients and factors associated with this intention based on the theory of planned behaviour. A cross-sectional study was conducted in 2016 including a convenience sample of dentists practising in public, private and academic sectors in Algeria, Egypt, Jordan, Kuwait, Libya, Palestine, Saudi Arabia and Yemen. Respondents answered a self-administered questionnaire collecting information about personal and professional background and perceived ability to identify victims of violence. The questionnaire assessed (on a scale from 1 to 10 using six negative statements) dentists' perception of healthcare system mandated reporting of suspected violence. Six statements were used to assess professional attitude towards reporting suspected violence. Logistic regression was used to assess the association between intention to report suspected violence and perceived ability, perception and attitude adjusting for confounders. The response rate was 65.2% (n=2936/4506) from general practitioners (70.9%) of mean age=31 years with 56.7% women. Of those, 68.8% intended to report and 52.2% considered themselves able to identify violence victims. The mean (SD) negative perception score=5.3/10 (2.1) and the mean (SD) professional attitude score=7.5/10 (1.9). In multivariate regression, intention to report was associated with professional attitude (OR 1.08, 95% CI 1.03 to 1.14), ability to identify violence victims (OR 1.76, 95% CI 1.45 to 2.12) and negative perception that reporting is not mandated (OR 0.89, 95% CI 0.85 to 0.94). Significant differences existed among countries in intention to report. Most dentists intended to report suspected violence and their intention could be explained by the theory of planned behaviour which offers a framework for professional development to support violence victims. Sharing of training resources, policies and guidelines is needed to ensure

  13. Dentists’ intention to report suspected violence: a cross-sectional study in eight Arab countries

    Science.gov (United States)

    Gaffar, Balgis; Arheiam, Arheiam; AbdelAziz, Wafaa; Al-Batayneh, Ola B; Alhoti, Mansur F; Al-Maweri, Sadeq; Dama, Mai A; Zaghez, Mounir; Hassan, Khalid Saddiq; Al-Sane, Mona; AbdelSalam, Maha; Sabbah, Wael; Owais, Arwa I; Abdelgawad, Fatma; Aldhelai, Thiyezen Abdullah; El Meligy, Omar Abd El Sadek; AlHumaid, Jehan; Al-Harbi, Fahad

    2018-01-01

    Objectives This study assessed dentists’ intention in eight Arab countries to report suspected exposure to violence among patients and factors associated with this intention based on the theory of planned behaviour. Methods A cross-sectional study was conducted in 2016 including a convenience sample of dentists practising in public, private and academic sectors in Algeria, Egypt, Jordan, Kuwait, Libya, Palestine, Saudi Arabia and Yemen. Respondents answered a self-administered questionnaire collecting information about personal and professional background and perceived ability to identify victims of violence. The questionnaire assessed (on a scale from 1 to 10 using six negative statements) dentists’ perception of healthcare system mandated reporting of suspected violence. Six statements were used to assess professional attitude towards reporting suspected violence. Logistic regression was used to assess the association between intention to report suspected violence and perceived ability, perception and attitude adjusting for confounders. Results The response rate was 65.2% (n=2936/4506) from general practitioners (70.9%) of mean age=31 years with 56.7% women. Of those, 68.8% intended to report and 52.2% considered themselves able to identify violence victims. The mean (SD) negative perception score=5.3/10 (2.1) and the mean (SD) professional attitude score=7.5/10 (1.9). In multivariate regression, intention to report was associated with professional attitude (OR 1.08, 95% CI 1.03 to 1.14), ability to identify violence victims (OR 1.76, 95% CI 1.45 to 2.12) and negative perception that reporting is not mandated (OR 0.89, 95% CI 0.85 to 0.94). Significant differences existed among countries in intention to report. Conclusion Most dentists intended to report suspected violence and their intention could be explained by the theory of planned behaviour which offers a framework for professional development to support violence victims. Sharing of training resources

  14. Molecular Identification of Mycobacterium Tuberculosis and Analysis of Its Resistance to Rifampin in Sputa from Tuberculosis Suspected Patients

    International Nuclear Information System (INIS)

    Syaifudin, M.

    2010-01-01

    An accurate identification of different species of Mycobacterium provides to allow appropriate treatment for Mycobacterium tuberculosis infection. Beside that, drug resistance of M. tuberculosis strains to rifampin is not clearly understood in contributing to the spread of tuberculosis in Indonesia. To assess the molecular mechanism of rifampin resistance, a number of clinical specimens of M. tuberculosis were analyzed their molecular nature of a part of the rpoB gene using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) methods. DNA's extracted from sputum samples were amplified and 32 P-labeled by PCR with the specific primers and the product was analyzed their mutation conferring resistance by MDE gel electrophoresis. Of the 70 specimens tested, 57 specimens were positive for M. tuberculosis organism only, three specimens contained a mixture of M. tuberculosis and non tuberculosis mycobacteria (NTM), and 10 specimens were negative approved by Duplex PCR. Of these sixty DNA positive samples (thus the sensitivity of PCR was 85.71%), 5 (8.3%) of them suspected to contain mutations in rpoB which were associated with rifampin resistance. Even though the frequency of mutation was low, the results from our study clearly indicate that the molecular mechanism of rifampin resistance in M. tuberculosis isolates from Indonesia involves alterations in the rpoB gene. Molecular diagnosis by PCR which is fast and easy to perform is useful for early and rapid detection of TB in sputum specimen. (author)

  15. Muscle-fiber conduction velocity and electromyography as diagnostic tools in patients with suspected inflammatory myopathy: a prospective study.

    NARCIS (Netherlands)

    Blijham, P.J.; Hengstman, G.J.D.; Laak, H.J. ter; Engelen, B.G.M. van; Zwarts, M.J.

    2004-01-01

    Combinations of different techniques can increase the diagnostic yield from neurophysiological examination of muscle. In 25 patients with suspected inflammatory myopathy, we prospectively performed needle electromyography (EMG) and measured muscle-fiber conduction velocity (MFCV) in a single muscle,

  16. Utility of urine cytology in evaluating hematuria with sonographically suspected bladder lesion in patients older than 50 years

    Directory of Open Access Journals (Sweden)

    Hussam Eldin Helmy Mady

    2014-01-01

    Conclusion: Hematuria in patients older than 50 years with sonographically suspected bladder lesion mandates cystoscopy and biopsy. UC does not add more significant information in this group of patients.

  17. Endosonography for suspected obstructive jaundice with no definite pathology on ultrasonography.

    Science.gov (United States)

    Chen, Chien-Hua; Yang, Chi-Chieh; Yeh, Yung-Hsiang; Yang, Tsang; Chung, Tieh-Chi

    2015-09-01

    Ultrasonography (US) cannot demonstrate all the etiologies of biliary tract dilatation in patients with jaundice. Thus, we evaluated the etiologic yield of endosonography (EUS) for suspected obstructive jaundice when no definite pathology was found on US. Additionally, we sought to identify the predictors of the most common etiologies. We performed a retrospective review of 123 consecutive patients who had undergone EUS for suspected obstructive jaundice when no definite pathology was identified on US. The most common diagnoses included no pathological obstruction (n = 43), pancreatobiliary malignancy (n = 41), and choledocholithiasis (n = 28). Pancreatobiliary malignancy was associated with common bile duct (CBD) dilatation, and fever and elevated alanine aminotransferase were predictors of choledocholithiasis (p jaundice, 100% (40/40) for no pathological finding, 100% (23/23) for ampullary cancer, 100% (13/13) for pancreatic cancer, 75% (3/4) for CBD cancer, and 92.9% (26/28) for choledocholithiasis, respectively. Besides the two patients with focal chronic pancreatitis misdiagnosed as with pancreatic cancer, EUS missed the lesions in one CBD cancer patient and two patients with choledocholithiasis. The overall accuracy of EUS in ascertaining pancreatobiliary malignancy and choledocholithiasis was comparable (97.6%, 40/41 vs. 92.9%, 26/28; p > 0.05). Marked CBD dilatation (≥12 mm) should remind us of the high risk of malignancy, and the presence of CBD dilatation and fever is suggestive of choledocholithiasis. Negative EUS findings cannot assure any pathological obstruction in patients with clinically suspected obstructive jaundice. Copyright © 2013. Published by Elsevier B.V.

  18. Preoperative local MRI-staging of patients with a suspected pancreatic mass

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, U.; Vosshenrich, R.; Salamat, B.; Baum, F.; Grabbe, E. [Department of Radiology, Georg August University, Goettingen (Germany); Horstmann, O.; Becker, H. [Department of Surgery, Georg August University, Goettingen (Germany)

    2002-02-01

    The aim of this study was to define the value of MRI of the pancreas for preoperative local staging of patients with a suspected pancreatic mass. Ninety-four patients (41 women, 53 men; age range 32-87 years) with a suspected pancreatic tumor underwent preoperative staging with MRI on a 1.5-T system. The MRI protocol included breath-hold MR cholangiopancreatography in turbo spin-echo technique, biphasic contrast-enhanced 3D MR angiography, and MRI of the upper abdomen with breath-hold T2-weighted half-Fourier acquired single-shot turbo spin-echo and T1-weighted fast-low-angle-shot (pre- and postcontrast) sequences. Data were collected prospectively and analyzed by two radiologists in agreement modality. Evaluation criteria were vascular involvement, resectability, and a characterization benign vs malignant. Results were compared to histopathology in 78 patients. Sixteen patients were followed-up. In 74 of 94 patients a solid tumor or an inflammation of the pancreas (n=62) or the papilla (n=12) was detected. In this group, MRI had a sensitivity of 98%, a specificity of 92%, and an accuracy of 96% in the characterization of malignant tumors. Regarding only the solid tumors, the positive predictive value of MRI was 87% with respect to resectability. Other pathologic findings included adenoma or inflammation of the duodenum (n=5), carcinoma or benign stenosis of the choledochus duct (n=7) and carcinoma of the gall bladder (n=2). In 6 patients MRI did not depict any pathologic findings, and follow-up confirmed this interpretation. Magnetic resonance imaging allows a local preoperative staging in patients with suspected pancreatic tumor. Limitations, however, concern to the diagnostics of peritoneal and/or liver metastases. (orig.)

  19. Intravenous contrast enhanced computed tomography colonoscopy in children with suspected colonic polyps

    International Nuclear Information System (INIS)

    Bhatia, Anmol; Saxena, Akshay K.; Kalra, Naveen; Sodhi, Kushaljit S.; Thapa, Babu R.; Rao, Katragadda L.N.; Khandelwal, Niranjan

    2013-01-01

    Objective: The purpose of this study was to evaluate the diagnostic performance of intravenous contrast enhanced computed tomographic colonoscopy (IVCTC) in the diagnosis of clinically suspected colorectal polyps in children, using conventional colonoscopy (CC) as the gold standard. Methods: This was a prospective study conducted between July 2008 and June 2010. 30 pediatric patients with history of rectal bleeding and clinically suspected to have colorectal polyps were enrolled. All of the patients underwent IVCTC followed by CC. 30 IVCTC and 31 CC were performed in 30 patients. The findings of IVCTC were compared with those of CC. Statistical analysis was performed to obtain diagnostic performance values of IVCTC on per polyp (sensitivity and positive predictive value) and per patient (sensitivity, specificity, positive predictive value and negative predictive value) basis. Results: By IVCTC, 63 polyps were detected in 28 patients of which 53 polyps were eligible for inclusion in the statistical analysis. 60 polyps were detected by CC in 28 patients of which 50 polyps were eligible for inclusion in the statistical analysis. The per polyp sensitivity and positive predictive values were 94% and 88.6% respectively. The per patient sensitivity, specificity, positive predictive value, and negative predictive values were 96.4, 50, 96.4, and 50% respectively. Twenty polyps, in 10 patients, were visualized only after intravenous contrast administration of which 5 polyps, in 5 patients, were likely to have been missed in the absence of the intravenous contrast injection as these polyps were submerged in fluid. Four patients would have had a false negative CTC examination if the intravenous contrast had not been injected; while in another patient, the number of polyps would have been underestimated. Conclusion: CTC is capable of serving as a safe and efficient non-invasive tool for evaluating children with clinically suspected colorectal polyps. Administration of

  20. 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