WorldWideScience

Sample records for suspected herbig-haro objects

  1. The formation of Herbig Haro objects

    Science.gov (United States)

    Tenorio-Tagle, G.; Rozyczka, M.

    The basic observational facts that have to be accounted for by theories of Herbig-Haro objects are reviewed. A critical discussion of various hypotheses concerning the origin of Herbig-Haro phenomena is then given. It is pointed out that none of these hypotheses can definitely be accepted or rejected at the present moment, although some of them are undoubtedly more successful than others. The most promising one seems to be a scenario originally proposed by Canto (1980), in which the wind from a pre-main sequence star is very efficiently focused. Originally isotropic winds develop into narrow, dense streams of high-velocity gas, whose working surfaces (i.e. areas where they interact with the ambient medium) can be identified with Herbig-Haro objects. Finally, prospects for future research in the field of Herbig-Haro objects are briefly outlined.

  2. X-ray Emission Mechanisms in Herbig - Haro objects .

    Science.gov (United States)

    Bonito, R.; Orlando, S.; Peres, G.; Favata, F.; Rosner, R.

    X-ray emission in Herbig - Haro objects is a quite recent and uncommon finding still waiting full explanation. With the scope of explaining this X-ray emission, our project is devoted to model the interaction between a supersonic jet originating from a young stellar object and the ambient medium. We have performed a wide exploration of the parameter space to infer the configuration(s) which can give rise to X-ray emission very similar to what recently observed.

  3. Chemistry of dense clumps near moving Herbig-Haro objects

    Science.gov (United States)

    Christie, H.; Viti, S.; Williams, D. A.; Girart, J. M.; Morata, O.

    2011-09-01

    Localized regions of enhanced emission from HCO+, NH3 and other species near Herbig-Haro objects (HHOs) have been interpreted as arising in a photochemistry stimulated by the HHO radiation on high-density quiescent clumps in molecular clouds. Static models of this process have been successful in accounting for the variety of molecular species arising ahead of the jet; however, recent observations show that the enhanced molecular emission is widespread along the jet as well as ahead. Hence, a realistic model must take into account the movement of the radiation field past the clump. It was previously unclear as to whether the short interaction time between the clump and the HHO in a moving source model would allow molecules such as HCO+ to reach high enough levels, and to survive for long enough to be observed. In this work we model a moving radiation source that approaches and passes a clump. The chemical picture is qualitatively unchanged by the addition of the moving source, strengthening the idea that enhancements are due to evaporation of molecules from dust grains. In addition, in the case of several molecules, the enhanced emission regions are longer lived. Some photochemically induced species, including methanol, are expected to maintain high abundances for ˜104 yr.

  4. Optical manifestations of mass outflows from young stars - At atlas of CCD images of Herbig-Haro objects

    Science.gov (United States)

    Strom, K. M.; Strom, S. E.; Wenz, M.; Wolff, S. C.; Morgan, J.

    1986-01-01

    An attempt is made to provide deep CCD images suitable for tracing the shock-excited and scattered-light components characterizing extended Herbig-Haro complexes. Tabular data include astrometric positions for all stars, shock-excited emission knots, prominent scattered-light patches, as well as an identification for all H-alpha emission objects within the CCD images. It is concluded that: (1) optical outflows are not always accompanied by molecular flows, (2) optical outflows show a higher degree of collimation than their molecular counterparts, and (3) the Herbig-Haro phenomenon is not restricted to low-mass young stellar objects.

  5. Improved bow shock models for Herbig-Haro objects - Application to HH 2A-prime

    Science.gov (United States)

    Raymond, John C.; Hartmann, Lee; Hartigan, Patrick

    1988-01-01

    An improved version of the bow shock theory previously applied to Herbig-Haro objects is presented. The modifications provide a more accurate calculation of the ionization state of material entering the bow shock. The revised preionization does not drastically affect the emission-line predictions for a 200 km/s bow shock model, though the effects will be more severe for slower shock velocities. The line profiles of the new models resemble the observed profiles somewhat more closely, and the relative emission-line intensities typically differ by 30 percent from those predicted by the older models. The models agree well with new IUE spectra and existing optical data for HH 2A-prime.

  6. Herbig-Haro Objects and Mid-infrared Outflows in the Vela C Molecular Cloud

    Science.gov (United States)

    Zhang, Miaomiao; Wang, Hongchi; Henning, Thomas

    2014-08-01

    We have performed a deep [S II] λλ6717/6731 wide field Herbig-Haro (HH) object survey toward the Vela C molecular cloud with a sky coverage of about 2 deg2. In total, 18 new HH objects, HH 1090-1107, are discovered and the two previously known HH objects, HH 73-74, are also detected in our [S II] images. We also present an investigation of mid-infrared outflows in the Vela C molecular cloud using the Wide-field Infrared Survey Explorer images taken from AllWISE data release. Using the method suggested by Zhang & Wang, 11 extended green objects (EGOs) are identified to be the mid-infrared outflows, including 6 new mid-infrared outflows that have not been detected previously at other wavelengths and 5 mid-infrared counterparts of the HH objects detected in this work. Using the AllWISE Source Catalog and the source classification scheme suggested by Koenig et al., we have identified 56 young stellar object (YSO) candidates in the Vela C molecular cloud. The possible driving sources of the HH objects and EGOs are discussed based on the morphology of HH objects and EGOs and the locations of HH objects, EGOs and YSO candidates. Finally we associate 12 HH objects and 5 EGOs with 10 YSOs and YSO candidates. The median length of the outflows in Vela C is 0.35 pc and the outflows seem to be oriented randomly.

  7. Outflows from Young Stellar Objects: Bringing Numerical Simulations Closer to Observations of Herbig-Haro Objects

    Science.gov (United States)

    Hansen, Edward C.

    High resolution observations of Young Stellar Object (YSO) jets show them to be composed of many small-scale knots or clumps. 2-D and 3-D numerical simulations were conducted with the code AstroBEAR to study how such clumps interact and create morphologies and kinematic patterns seen in emission line observations. Two main classes of simulations were used in this study: outflows of spherical, over-dense clumps, and pulsed jets in which the pulsations create clumps within the jet. Such flows lead to the formation of bow shocks which then interact with each other as faster material overtakes slower material. We show that much of the spatial structure apparent in emission line images of jets arises from the dynamics and interactions of these bow shocks. The simulations show a variety of time-dependent features, including bright knots associated with Mach stems where the shocks intersect, a "frothy" emission structure that arises from the presence of the Non-linear Thin Shell Instability (NTSI) along the surfaces of the bow shocks, and the merging and fragmentation of clumps. Simulations with magnetic fields show how the field affects the dynamics of YSO jets and the emission they produce. This work contributes to the ultimate goal of one day being able to observationally estimate the strength of the magnetic field within these jets. The simulations use a new non-equilibrium cooling method to produce synthetic emission maps in H? and [S II]. These are directly compared with multi-epoch Hubble Space Telescope (HST) observations of Herbig-Haro (HH) jets. There is excellent agreement between features seen in the simulations and the observations in terms of both proper motion and morphologies. Thus, YSO jets may be dominated by heterogeneous structures, and interactions between these structures and the shocks they produce can account for many details of YSO jet evolution.

  8. Herbig-Haro objects in the receding lobe of the L 1551 outflow

    Science.gov (United States)

    Graham, J. A.; Rubin, Vera C.

    1992-01-01

    A spectrum has been obtained of two Herbig-Haro objects which are seen against the receding lobe of the bipolar outflow within the dark cloud Lynds 1551. Positive heliocentric velocities up to 90 km/s have been measured from the H-alpha line which point to an association of these emission knots with the embedded infrared source L 1551-IRS 5 rather than with other young stellar objects in this part of the sky. There is a velocity range of 50-100 km/s within each object. (S II) lambda 6716 is also detected at a strength of about 50 pct of H-alpha. Along the entire length of the slit there is broad H-alpha emission with strength about four times that normally seen in emission from the night sky. This feature partially resolves into two components, one of which we suggest is from the general Galactic field, and the other from extended bow-shock emission.

  9. The ultraviolet continuous and emission-line spectra of the Herbig-Haro objects HH 2 and HH 1

    Science.gov (United States)

    Boehm-Vitense, E.; Cardelli, J. A.; Nemec, J. M.; Boehm, K. H.

    1982-01-01

    Recent studies of the continuous spectrum of Herbig-Haro (HH) objects at optical and near-infrared wavelengths and the observation of continuous radiation in the ultraviolet have shown an unexpectedly steep increase of the flux toward shorter wavelengths. The present investigation provides the results of ultraviolet observations of HH 2. The obtained data are compared with the HH 1 data. It is found that HH 2 has an ultraviolet continuous and emission-line spectrum which is similar to that of HH 1. The UV line spectrum of HH 2H indicates an even somewhat larger ionization than does the HH 1 spectrum. As in HH1, the UV emission-line spectrum shows a much higher degree of ionization than that derived from the optical spectrum. Consequently, the same difficulty arises as in the case of HH 1. The complete UV plus optical spectrum cannot be explained by a single plane-parallel shock-wave model.

  10. Luminous Herbig-Haro objects from a massive protostar: The unique case of HH 80/81

    Science.gov (United States)

    Reipurth, Bo

    2017-08-01

    Herbig-Haro (HH) objects are the optical manifestations of shock waves excited by outflows from young stars. They represent one of the few classes of spatially extended astronomical objects where both structural changes and proper motions can be measured on time scales of years to decades. HH 80/81 is a pair of HH objects in Sagittarius which are the intrinsically most luminous HH objects known. The driving source of HH 80/81 is the embedded star IRAS 18162-2048, which has a luminosity of 20,000 Lsun and excites a compact HII region, suggesting that it is a newborn massive star. HH objects associated with massive young stars are very rare, only a handful of cases are known, but what makes the HH 80/81 source unique among massive protostars is that it produces a finely collimated bipolar radio jet with extremely high velocity and pointing straight to HH 80/81. We propose to observe the HH 80/81 complex with WFC3 and the following four filters: Halpha 6563, Hbeta 4861, [SII] 6717/31, and [OIII] 5007. First epoch HST images were obtained 22 years ago, which now allows a very precise determination of proper motions. Groundbased optical and radio proper motions are not only uncertain, but actually contradict each other, a controversy that will be resolved by HST. The fine resolution of WFC3 allows a study of both fine structural details and structural changes of the shocks. Finally we will use a sophisticated adaptive grid code to interpret the (de-reddened) line ratios across the shocks.

  11. The spatial distribution of ultraviolet line and continuum emission in Herbig-Haro objects

    Science.gov (United States)

    Lee, M. G.; Boehm, K. H.; Temple, S. D.; Raga, A. C.; Mateo, M. L.

    1988-01-01

    Archival IUE data and monochromatic CCD images in the optical range are used to compare the spatial distribution of UV and optical emission in HH 1, HH 2, HH 24, HH 32, HH 43, and HH 47. For all six objects, the observed UV radiation is shown to originate in the objects themselves. The results indicate that the C IV and semiforbidden emission-line regions are small. Although the continuum in the IUE short-wavelength range displays a distribution that is broader than that of any measured line emission in the UV or optical range, the continuum distribution in the IUE long-wavelength range is quite narrow.

  12. Spectropolarimetry of Herbig-Haro objects and the exciting star of HH 30

    Science.gov (United States)

    Cohen, M.; Schmidt, G. D.

    1981-01-01

    Spectrophotometric and spectropolarimetric observations are presented of three HH objects: HH 11, 30, and 43. Although null polarization results are obtained for HH 11 and 43, the unusually strong continuum of HH 30 is linearly polarized by 3%. The emission lines in this nebula are unpolarized. The electric vector position angle appropriate to the continuum polarization, and the presence of Fe II emission lines apparently from the photosphere of a T Tauri-like star, indicate HL Tau as the exciting/illuminating star for HH 30. Evidence is adduced for a highly anisotropic distribution of circumstellar obscuration around this star.

  13. Ionized Outflows in 3-D Insights from Herbig-Haro Objects and Applications to Nearby AGN

    Science.gov (United States)

    Cecil, Gerald

    1999-01-01

    HST shows that the gas distributions of these objects are complex and clump at the limit of resolution. HST spectra have lumpy emission-line profiles, indicating unresolved sub-structure. The advantages of 3D over slits on gas so distributed are: robust flux estimates of various dynamical systems projected along lines of sight, sensitivity to fainter spectral lines that are physical diagnostics (reddening-gas density, T, excitation mechanisms, abundances), and improved prospects for recovery of unobserved dimensions of phase-space. These advantages al- low more confident modeling for more profound inquiry into underlying dynamics. The main complication is the effort required to link multi- frequency datasets that optimally track the energy flow through various phases of the ISM. This tedium has limited the number of objects that have been thoroughly analyzed to the a priori most spectacular systems. For HHO'S, proper-motions constrain the ambient B-field, shock velocity, gas abundances, mass-loss rates, source duty-cycle, and tie-ins with molecular flows. If the shock speed, hence ionization fraction, is indeed small then the ionized gas is a significant part of the flow energetics. For AGN'S, nuclear beaming is a source of ionization ambiguity. Establishing the energetics of the outflow is critical to determining how the accretion disk loses its energy. CXO will provide new constraints (especially spectral) on AGN outflows, and STIS UV-spectroscopy is also constraining cloud properties (although limited by extinction). HHO's show some of the things that we will find around AGN'S. I illustrate these points with results from ground-based and HST programs being pursued with collaborators.

  14. Ultraviolet spectra of Herbig-Haro objects and of the environment of the Cohen-Schwartz star

    Science.gov (United States)

    Boehm, K. H.; Boehm-Vitense, E.; Cardelli, J. A.

    1982-01-01

    Observations in both spectral regions were used in order to determine the continuous energy distribution and the emission line fluxes for H-H 2. The continuous spectrum is similar to that in H-H 1 and F lambda increases rapidly towards shorter wavelengths. This statement is found to be qualitatively correct for all obvious choices of the ultraviolet extinction curve if we use the E(B-V) value determined by the use of the S II method. The origin of the continuum remains enigmatic. The emission line spectrum of H-H 2 shows an even somewhat higher degree of ionization than the spectrum of H-H 1, indicating an even larger discrepancy between ionization information from optical data and that contained in the UV spectra. The immediate environment of the Cohen-Schwartz star emits a continuous spectrum similar to that of a H-H-object but increasing even more steeply towards shorter wavelengths.

  15. First Large-scale Herbig-Haro Jet Driven by a Proto-brown Dwarf

    Science.gov (United States)

    Riaz, B.; Briceño, C.; Whelan, E. T.; Heathcote, S.

    2017-07-01

    We report the discovery of a new Herbig-Haro jet, HH 1165, in SOAR narrow-band imaging of the vicinity of the σ Orionis cluster. HH 1165 shows a spectacular extended and collimated spatial structure, with a projected length of 0.26 pc, a bent C-shaped morphology, multiple knots, and fragmented bow shocks at the apparent ends of the flow. The Hα image shows a bright halo with a clumpy distribution of material seen around the driving source, and curved reflection nebulosity tracing the outflow cavities. The driving source of HH 1165 is a Class I proto-brown dwarf, Mayrit 1701117 (M1701117), with a total (dust+gas) mass of ˜36 M Jup and a bolometric luminosity of ˜0.1 L ⊙. High-resolution VLT/UVES spectra of M1701117 show a wealth of emission lines indicative of strong outflow and accretion activity. SOAR/Goodman low-resolution spectra along the jet axis show an asymmetrical morphology for HH 1165. We find a puzzling picture wherein the northwest part exhibits a classical HH jet running into a pre-dominantly neutral medium, while the southern part resembles an externally irradiated jet. The C-shaped bending in HH 1165 may be produced by the combined effects from the massive stars in the ionization front to the east, the σ Orionis core to the west, and the close proximity to the B2-type star HR 1950. HH 1165 shows all of the signatures to be considered as a scaled-down version of parsec-length HH jets, and can be termed as the first sub-stellar analog of a protostellar HH jet system.

  16. Discovery of X-rays from the protostellar outflow object HH2.

    Science.gov (United States)

    Pravdo, S H; Feigelson, E D; Garmire, G; Maeda, Y; Tsuboi, Y; Bally, J

    2001-10-18

    Herbig-Haro (HH) objects have been known for 50 years to be luminous condensations of gas in star-forming regions, but their underlying physical nature is still being elucidated. Previously suggested models encompass newborn stars, stellar winds clashing with nebular material, dense pockets of interstellar gas excited by shocks from outflows, and interstellar 'bullets' (ref. 6). Recent progress has been made with the jet-induced shock model, in which material streams out of young stellar objects and collides with the surrounding interstellar medium. A clear prediction of this model is that the most energetic Herbig-Haro objects will emit X-rays, although they have not hitherto been detected. Here we report the discovery of X-ray emission from one of the brightest and closest Herbig-Haro objects, HH2, at a level consistent with the model predictions. We conclude that this Herbig-Haro object contains shock-heated material located at or near its leading edge with a temperature of about 106 K.

  17. The outflow history of two Herbig-Haro jets in RCW 36: HH 1042 and HH 1043

    Science.gov (United States)

    Ellerbroek, L. E.; Podio, L.; Kaper, L.; Sana, H.; Huppenkothen, D.; de Koter, A.; Monaco, L.

    2013-03-01

    Jets around low- and intermediate-mass young stellar objects (YSOs) contain a fossil record of the recent accretion and outflow activity of their parent star-forming systems. We aim to understand whether the accretion/ejection process is similar across the entire stellar mass range of the parent YSOs. To this end we have obtained optical to near-infrared spectra of HH 1042 and HH 1043, two newly discovered jets in the massive star-forming region RCW 36, using X-shooter on the ESO Very Large Telescope. HH 1042 is associated with the intermediate-mass YSO 08576nr292. Over 90 emission lines are detected in the spectra of both targets. High-velocity (up to 220 km s-1) blue- and redshifted emission from a bipolar flow is observed in typical shock tracers. Low-velocity emission from the background cloud is detected in nebular tracers, including lines from high ionization species. We applied combined optical and infrared spectral diagnostic tools in order to derive the physical conditions (density, temperature, and ionization) in the jets. The measured mass outflow rates are Ṁjet ~ 10-7M⊙ yr-1. It is not possible to determine a reliable estimate for the accretion rate of the driving source of HH 1043 using optical tracers. We measure a high accretion rate for the driving source of HH 1042 (Ṁacc ~ 10-6M⊙ yr-1). For this system the ratio Ṁjet/Ṁacc ~ 0.1, which is comparable to low-mass sources and consistent with models for magneto-centrifugal jet launching. The knotted structure and velocity spread in both jets are interpreted as fossil signatures of a variable outflow rate. While the mean velocities in both lobes of the jets are comparable, the variations in mass outflow rate and velocity in the two lobes are not symmetric. This asymmetry suggests that the launching mechanism on either side of the accretion disk is not synchronized. For the HH 1042 jet, we have constructed an interpretative physical model with a stochastic or periodic outflow rate and a

  18. Infrared observations of low-mass star formation in Orion - HH objects

    Science.gov (United States)

    Harvey, P. M.; Wilking, B. A.; Cohen, M.

    1982-01-01

    The results of a preliminary analysis of IR data on Herbig-Haro objects in the Orion nebula are reported. The observations were made with the high angular resolution IR photometry equipment on the NASA Kuiper Airborne Observatory and the NASA facility on Mauna Kea, HI. Data were taken in the 1-200 microns region with 40, 6, and 8 arcsec resolution. Attention was focused on NGC 1999 (HH1-3) and M78 (HH24-25) and the determination of absolute luminosities of the exciting stars. Measurements were also made of the IR energy distribution in the thermally emitting dust clouds and the point sources. Herbig-Haro objects featured compact and far IR sizes and large visual extinction, in addition to a steeply rising energy distribution up to 50-100 microns, where the luminosity emitted was concentrated.

  19. Optical and Near Infrared Study of the Cepheus E outflow, a very low excitation object

    OpenAIRE

    Ayala, S.; Noriega-Crespo, A.; Garnavich, P.M.; Curiel, S.; A. C. Raga; Bohm, K. H.; Raymond, J.

    2000-01-01

    We present images and spectra of the Cepheus E (Cep E) region at both optical and infrared wavelengths. Only the brightest region of the southern lobe of the Cep E outflow reveals optical emission, suggesting that the extinction close to the outflow source plays an important r\\^ole in the observed difference between the optical and IR morphologies. Cep E is a unique object since it provides a link between the spectroscopic properties of the optical Herbig-Haro (HH) objects and those of deeply...

  20. Featured Image: Revealing Hidden Objects with Color

    Science.gov (United States)

    Kohler, Susanna

    2018-02-01

    Stunning color astronomical images can often be the motivation for astronomers to continue slogging through countless data files, calculations, and simulations as we seek to understand the mysteries of the universe. But sometimes the stunning images can, themselves, be the source of scientific discovery. This is the case with the below image of Lynds Dark Nebula 673, located in the Aquila constellation, that was captured with the Mayall 4-meter telescope at Kitt Peak National Observatory by a team of scientists led by Travis Rector (University of Alaska Anchorage). After creating the image with a novel color-composite imaging method that reveals faint H emission (visible in red in both images here), Rector and collaborators identified the presence of a dozen new Herbig-Haro objects small cloud patches that are caused when material is energetically flung out from newly born stars. The image adapted above shows three of the new objects, HH 118789, aligned with two previously known objects, HH 32 and 332 suggesting they are driven by the same source. For more beautiful images and insight into the authors discoveries, check out the article linked below!Full view of Lynds Dark Nebula 673. Click for the larger view this beautiful composite image deserves! [T.A. Rector (University of Alaska Anchorage) and H. Schweiker (WIYN and NOAO/AURA/NSF)]CitationT. A. Rector et al 2018 ApJ 852 13. doi:10.3847/1538-4357/aa9ce1

  1. IRAS observations near young objects with bipolar outflows L1551 and HH 46-47

    Science.gov (United States)

    Emerson, J. P.; Harris, S.; Jennings, R. E.; Beichman, C. A.; Baud, B.; Beintema, D. A.; Wesselius, P. R.; Marsden, P. L.

    1984-01-01

    A 6-solar luminosity dust-embedded precursor of a low-mass (about 1 solar mass) pre-main-sequence star has been discovered with IRAS near the northeast lobe of the bipolar outflow region in the dust cloud L1551 and designated L1551 NE. Star formation is proceeding in at least two locations in L1551, reminiscent of the situation in regions of more massive star formation. If the position of NE in the flow from IRS 5 is indicative of the flow having initiated star formation in NE, then the object can be only about 24,000 years old. Alternatively, NE could appear by chance to lie in the flow from IRS 5. In the globule ES 0210-6A, a 12 solar luminosity dust-embedded precursor of a low-mass (about 1 solar mass) pre-main-sequence star is found which drives the bipolar flow responsible for the string of Herbig-Haro objects HH 46-47 A-D. In this globule, there is only one region of active star formation.

  2. Jets and Outflows from Young Stellar Objects in the Carina Nebula Observed in [Fe II] 1.64 um

    Science.gov (United States)

    Shinn, Jong-Ho; Pyo, Tae-Soo; Lee, Jae-Joon; Lee, Ho-Gyu; Kim, Hyun-Jeong; Koo, Bon-Chul; Sung, Hwankyung; Chun, Moo Young; Lyo, A.-Ran; Moon, Dae-Sik; Kyeong, Jaemann; Park, Byeong-Gon; Hur, Hyeonoh; Lee, Yong-Hyun

    2013-07-01

    We present [Fe II] 1.64 um imaging observations for jets and outflows from young stellar objects (YSOs) over the northern part (~24'x45') of the Carina Nebula, a massive star forming region. The observations were performed with IRIS2 of Anglo-Autralian Telescope and the seeing was ~1.5". Several jets and outflows features are detected at eight different regions, and named as forbidden emission line regions (FELRs). One new candidate for Herbig-Haro Object is identified comparing our [Fe II] images to H_alpha images of Hubble Space Telescope. FELRs have knotty or longish shapes, and distribute around the triangular area formed by three star clusters Tr 14, Tr 15, and Tr 16, which contain many massive stars. The detection rate of FELRs against previously identified YSOs is 1.4 %. We estimate the outflow rate from the [Fe II] flux based on some assumptions. The jet-driving objects are identified for three FELRs (FELR-2, -4, and -7), for which we study the relations between the outflow rate and the YSO physical parameters from the radiative transfer model fitting. The ratios of the outflow rate over the disk accretion rate are consistent for FELR-4 and -7 with the previously reported values, while it is higher for FELR-2. The masses of jet-driving objects are low or intermediate, and they are not likely to become massive stars (> 8 Ms). Other YSO physical parameters, such as luminosity and age, show reasonable relations or trends.

  3. The outflow history of two Herbig-Haro jets in RCW 36: HH 1042 and HH 1043

    National Research Council Canada - National Science Library

    Ellerbroek, L. E; Podio, L; Kaper, L; Sana, H; Huppenkothen, D; de Koter, A; Monaco, L

    2013-01-01

    .... To this end we have obtained optical to near-infrared spectra of HH 1042 and HH 1043, two newly discovered jets in the massive star-forming region RCW 36, using X-shooter on the ESO Very Large Telescope...

  4. [Fe II] 1.64 μm Features of Jets and Outflows from Young Stellar Objects in the Carina Nebula

    Science.gov (United States)

    Shinn, Jong-Ho; Pyo, Tae-Soo; Lee, Jae-Joon; Lee, Ho-Gyu; Kim, Hyun-Jeong; Koo, Bon-Chul; Sung, Hwankyung; Chun, Moo-Young; Lyo, A.-Ran; Moon, Dae-Sik; Kyeong, Jaemann; Park, Byeong-Gon; Hur, Hyeonoh; Lee, Yong-Hyun

    2013-11-01

    We present [Fe II] 1.64 μm imaging observations for jets and outflows from young stellar objects (YSOs) over the northern part (~24' × 45') of the Carina Nebula, a massive star-forming region. The observations were performed with IRIS2 of the Anglo-Australian Telescope and the seeing was ~1.''5 ± 0.''5. Eleven jet and outflow features are detected at eight different regions and are termed ionized Fe objects (IFOs). One Herbig-Haro candidate that was missed in Hubble Space Telescope Hα observations is newly identified as HHc-16, referring to our [Fe II] images. IFOs have knotty or longish shapes, and the detection rate of IFOs against previously identified YSOs is 1.4%, which should be treated as a lower limit. Four IFOs show anti-correlated peak intensities in [Fe II] and Hα, where the ratio I([Fe II])/I(Hα) is higher for longish IFOs than for knotty IFOs. We estimate the outflow mass loss rate from the [Fe II] flux using two different methods. The jet-driving objects are identified for three IFOs (IFO-2, -4, and -7) for which we study the relations between the outflow mass loss rate and the YSO physical parameters from the radiative transfer model fitting. The ratios of the outflow mass loss rate over the disk accretion rate for IFO-4 and -7 are consistent with the previously reported values (10-2-10+1), while the ratio is higher for IFO-2. This excess may result from underestimating the disk accretion rate. The jet-driving objects are likely to be low- or intermediate-mass stars. Other YSO physical parameters, such as luminosity and age, show reasonable relations or trends.

  5. Objective CT criteria to determine the presence of abnormal basal enhancement in children with suspected tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Przybojewski, Stefan; Andronikou, Savvas [Stellenbosch University Medical School, Department of Radiology, P.O. Box 19063, Tygerberg (South Africa); Wilmshurst, Jo [Red Cross Children' s Hospital and School of Child and Adolescent Health, Department of Paediatric Neurology, Cape Town (South Africa)

    2006-07-15

    There are no widely accepted objective criteria to determine the presence of basal enhancement on CT in children with suspected tuberculous meningitis (TBM). To test nine recently described objective CT criteria for the presence of abnormal basal enhancement in children with suspected TBM against the definite diagnosis as determined by cerebrospinal fluid (CSF) culture. CT scans of patients with a clinical suspicion of TBM who had undergone lumbar puncture for CSF culture spanning a period of 4 years were reviewed for the presence of nine recently described criteria for the presence of abnormal basal enhancement. The radiologists were blinded to the final diagnosis based on CSF culture against which the criteria were tested. The criteria have been named: the 'Y-sign', 'linear enhancement', 'double lines', 'infundibular recess of the third', 'ill-defined edge', 'nodular enhancement', 'join the dots', 'contrast filling the cisterns', and 'asymmetry'. A total of 65 patients were included in the study, 34 with culture-proven TBM and 31 with other diagnoses. Four individual criteria had a specificity of 100%, but the sensitivities of these criteria ranged from 15% to 53% only. Three other criteria had specificities of 97% and sensitivities ranging from 62% to 82%. The presence of more than one criterion in the same patient showed a specificity of 97% and sensitivity of 91%. Very high specificity was demonstrated for all nine criteria, including 100% specificity for four individual criteria. Sensitivity was at best 82%, but improved to 91% when more than one criterion was present. These criteria need to be tested for inter- and intraobserver variability to prove their clinical usefulness. (orig.)

  6. FAST Maser Surveys J. S. Zhang

    Indian Academy of Sciences (India)

    are found to be closely associated with ultra-compact HII regions, embedded IR sources, hot molecular cores, Herbig-Haro objects, and outflows etc., which can be used to probe .... Baan, W. A., Wood, P. A. D., Haschick, A. D. 1982, Astrophys. J., 260, 49. Baan, W. A., Rhoads, J., Fisher, K. et al. 1992, Astrophys. J., 396, 99.

  7. 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.)

  8. Ammonia downstream from HH 80 North

    Science.gov (United States)

    Girart, Jose M.; Rodriguez, Luis F.; Anglada, Guillem; Estalella, Robert; Torrelles, Jose, M.; Marti, Josep; Pena, Miriam; Ayala, Sandra; Curiel, Salvador; Noriega-Crespo, Alberto

    1994-01-01

    HH 80-81 are two optically visible Herbig-Haro (HH) objects located about 5 minutes south of their exciting source IRAS 18162-2048. Displaced symmetrically to the north of this luminous IRAS source, a possible HH counterpart was recently detected as a radio continuum source with the very large array (VLA). This radio source, HH 80 North, has been proposed to be a member of the Herbig-Haro class since its centimeter flux density, angular size, spectral index, and morphology are all similar to those of HH 80. However, no object has been detected at optical wavelengths at the position of HH 80 North, possibly because of high extinction, and the confirmation of the radio continuum source as an HH object has not been possible. In the prototypical Herbig-Haro objects HH 1 and 2, ammonia emission has been detected downstream of the flow in both objects. This detection has been intepreted as a result of an enhancement in the ammonia emission produced by the radiation field of the shock associated with the HH object. In this Letter we report the detection of the (1,1) and (2,2) inversion transitions of ammonia downstream HH 80 North. This detection gives strong suppport to the interpretation of HH 80 North as a heavily obscured HH object. In addition, we suggest that ammonia emission may be a tracer of embedded Herbig-Haro objects in other regions of star formation. A 60 micrometer IRAS source could be associated with HH 80 North and with the ammonia condensation. A tentative explanation for the far-infrared emission as arising in dust heated by their optical and UV radiation of the HH object is presented.

  9. HH 588: A giant bipolar outflow in the dark cloud BRC 37

    Science.gov (United States)

    Movsessian, T. A.; Magakian, T. Yu.; Sargsyan, D. M.; Ogura, K.

    2012-12-01

    Results of 2D spectroscopy of the complex of Herbig-Haro objects HH 588 in the dark globule BRC 37 are presented. The multipupil spectrograph VAGR has been used to obtain spectra of four parts of this complex, including the objects NE2, NE1, center, and SW2. The kinematic characteristics of these components of the complex confirm the existence of a giant bipolar outflow from the central infrared source IRAS 21388+5622. Spectral studies also show that the central object has the very low excitation and strong [OI] and [SII] emission characteristic of jets emerging from young stellar objects. In terms of their physical parameters, the other objects are typical Herbig-Haro objects. On the other hand, it is found that the entire HH 588 complex is an irradiated Herbig-Haro flow. This is indicated by the comparatively high excitation of the object NE2, and by the fact that the entire HH 588 flow is an arc with its convex side facing the center of the HII region IC 1396.

  10. 182nd Symposium of the International Astronomical Union

    CERN Document Server

    Bertout, Claude

    1997-01-01

    Herbig-Haro objects were discovered 50 years ago, and during this half century they have developed from being mysterious small nebulae to be­ coming an important phenomenon in star formation. Indeed, HH flows are now recognized not only as fascinating astrophysical laboratories involving shock physics and chemistry, hydrodynamics and radiation processes, but it has gradually been realized that HH flows hold essential clues to the birth and early evolution of low mass stars. IAU Symposium No. 182 on Herbig-Haro Flows and the Birth of Low Mass Stars were held from January 20 to 24, 1997 in Chamonix in the french alps. A total of 178 researchers from 26 countries met to discuss our present level of understanding of Herbig-Haro flows and their relation to disk accretion events and T Tauri winds and other outflow phenomena like molecular outflows, embedded molecular hydrogen flows and radio jets. The present book contains the manuscripts from the oral contributions of the symposium. The poster papers were printed...

  11. Observations of feedback between protostars and their natal clouds

    Science.gov (United States)

    Green, Joel D.

    2008-06-01

    In this thesis we explore the relationship between the formation of protostars, and the influence of protostellar outflows on their environment using Infrared Spectrograph onboard the Spitzer Space Telescope. First we introduce the modern understanding of protostellar development advanced by the IRS_Disks guaranteed time program. Next we explore the FU Orionis phenomenon, an IRS_Disks dataset of flaring stars undergoing a burst accretion event. Finally we present a suite of data on Herbig Haro flows in Cepheus A to determine whether protostellar outflows can dissociate a wide angle cavity in their natal cloud. We present 5-35 mm spectra, taken with the Infrared Spectrograph (IRS) on the Spitzer Space Telescope, of five FU Orionis objects: FU Ori, V1515 Cyg, V1057 Cyg, BBW 76, and V346 Nor. All but V346 Nor reveal amorphous silicate grains in emission at 10 mm and 20 mm, and show water-vapor absorption bands at 5.8 and 6.8 mm and SiO or possibly methane absorption at 8 mm. These absorption features closely match these bands in model stellar photospheres--signs of the gaseous photospheres of the inner regions of these objects' accretion disks. The continuum emission at 5-8 mm is also consistent with such disks, and, for FU Orionis and BBW 76, longer-wavelength emission may be fit by a model which includes moderate disk flaring. V1057 Cyg and V1515 Cyg have much more emission at longer wavelengths than the others, perhaps evidence of substantial remnant of their natal, infalling envelopes. This indicates that FU Orionis events can briefly raise outflow rates sufficiently high to dispel their surrounding envelopes and open swaths of the ambient medium via compression waves. Herbig Haro objects are small emission nebulae that signify the interaction between both broad and collimated outflows from young stellar objects and the ambient molecular cloud material. GGD37 is suspected to be an amalgamation of at least two superposed flows (including HH 168) traveling in

  12. Objectivity

    CERN Document Server

    Daston, Lorraine

    2010-01-01

    Objectivity has a history, and it is full of surprises. In Objectivity, Lorraine Daston and Peter Galison chart the emergence of objectivity in the mid-nineteenth-century sciences--and show how the concept differs from its alternatives, truth-to-nature and trained judgment. This is a story of lofty epistemic ideals fused with workaday practices in the making of scientific images. From the eighteenth through the early twenty-first centuries, the images that reveal the deepest commitments of the empirical sciences--from anatomy to crystallography--are those featured in scientific atlases, the compendia that teach practitioners what is worth looking at and how to look at it. Galison and Daston use atlas images to uncover a hidden history of scientific objectivity and its rivals. Whether an atlas maker idealizes an image to capture the essentials in the name of truth-to-nature or refuses to erase even the most incidental detail in the name of objectivity or highlights patterns in the name of trained judgment is a...

  13. Objective sound wave amplitude measurement generated by a tuning fork. An analysis of its use as a diagnostic tool in suspected femoral neck fractures.

    Science.gov (United States)

    Jawad, Z; Odumala, A; Jones, M

    2012-06-01

    Hip injuries are becoming a more common problem as the elderly population increases and their management represents a significant proportion of health care costs. Diagnosis of a fracture based on clinical assessment and plain films is not always conclusive and further investigations for such occult fractures, such as magnetic resonance imaging (MRI), are sometimes required which are expensive and may be difficult to access. Disruption to the conduction of a sound wave travelling through a fractured bone is a concept that has been used to diagnose fractures. In our study we used a tuning fork with frequency of 128 Hz to objectively measure the reduction in sound amplitude in fractured and non-fractured hips. We looked at the feasibility of using this test as a diagnostic tool for neck of femur fractures. A total of 20 patients was included in the study, using MRI scan as the standard for comparison of diagnostic findings. Informed consent was obtained from the patients. There was a significant difference in the amplitude reduction of the sound waves when comparing normal to fractured hips. This was 0.9 in normal hips, compared to 0.31 and 0.18 in intra-capsular and extra-capsular fractures, respectively. Our test was 80% accurate at diagnosing neck of femur fractures. In conclusion this test may be used as a diagnostic test or screening tool in the assessment of occult hip fractures. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Observations of jets from low-luminosity stars. II - SVS 12, HH 30, near HL Tauri, and HH 34

    Science.gov (United States)

    Cohen, Martin; Jones, B. F.

    1987-01-01

    Spatially resolved spectral scans were obtained for four Herbig-Haro jets emanating from low-luminosity premain-sequence stars. There appears to be a general tendency for the excitation and electron density to diminish along these jets. For three jets, the electron density dependence is close to 1/r. HH 30's scattered stellar continuum showed much weaker Fe II lines in 1985 than in 1979, indicative of variable stellar activity. The most distant knot in HH 34's jet has the lowest excitation of any known HH object, with S II-line/H-alpha = 12.

  15. Outflows, Dusty Cores, and a Burst of Star Formation in the North America and Pelican Nebulae

    Science.gov (United States)

    Bally, John; Ginsburg, Adam; Probst, Ron; Reipurth, Bo; Shirley, Yancy L.; Stringfellow, Guy S.

    2014-12-01

    We present observations of near-infrared 2.12 μm molecular hydrogen outflows emerging from 1.1 mm dust continuum clumps in the North America and Pelican Nebula (NAP) complex selected from the Bolocam Galactic Plane Survey (BGPS). Hundreds of individual shocks powered by over 50 outflows from young stars are identified, indicating that the dusty molecular clumps surrounding the NGC 7000/IC 5070/W80 H II region are among the most active sites of ongoing star formation in the solar vicinity. A spectacular X-shaped outflow, MHO 3400, emerges from a young star system embedded in a dense clump more than a parsec from the ionization front associated with the Pelican Nebula (IC 5070). Suspected to be a binary, the source drives a pair of outflows with orientations differing by 80°. Each flow exhibits S-shaped symmetry and multiple shocks indicating a pulsed and precessing jet. The "Gulf of Mexico," located south of the North America Nebula (NGC 7000), contains a dense cluster of molecular hydrogen objects (MHOs), Herbig-Haro (HH) objects, and over 300 young stellar objects (YSOs), indicating a recent burst of star formation. The largest outflow detected thus far in the North America and Pelican Nebula complex, the 1.6 parsec long MHO 3417 flow, emerges from a 500 M ⊙ BGPS clump and may be powered by a forming massive star. Several prominent outflows such as MHO 3427 appear to be powered by highly embedded YSOs only visible at λ > 70 μm. An "activity index" formed by dividing the number of shocks by the mass of the cloud containing their source stars is used to estimate the relative evolutionary states of Bolocam clumps. Outflows can be used as indicators of the evolutionary state of clumps detected in millimeter and submillimeter dust continuum surveys.

  16. Outflows, dusty cores, and a burst of star formation in the North America and Pelican nebulae

    Energy Technology Data Exchange (ETDEWEB)

    Bally, John [Department of Astrophysical and Planetary Sciences, University of Colorado, UCB 389, Boulder, CO 80309 (United States); Ginsburg, Adam [European Southern Observatory, Karl-Schwarzschild-Str. 2, D-85748 Garching bei Munchen (Germany); Probst, Ron [National Optical Astronomy Observatory, 950 North Cherry Avenue, Tucson, AZ 85719 (United States); Reipurth, Bo [Institute for Astronomy and NASA Astrobiology Institute, University of Hawaii at Manoa, 640 North A' ohoku Place, Hilo, HI 96720 (United States); Shirley, Yancy L. [Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, AZ 85721 (United States); Stringfellow, Guy S., E-mail: John.Bally@colorado.edu, E-mail: aginsburg@eso.org, E-mail: probst@noao.edu, E-mail: reipurth@ifa.hawaii.edu, E-mail: yshirley@as.arizona.edu, E-mail: Guy.Stringfellow@colorado.edu [Center for Astrophysics and Space Astronomy, University of Colorado, UCB 389, Boulder, CO 80309 (United States)

    2014-12-01

    We present observations of near-infrared 2.12 μm molecular hydrogen outflows emerging from 1.1 mm dust continuum clumps in the North America and Pelican Nebula (NAP) complex selected from the Bolocam Galactic Plane Survey (BGPS). Hundreds of individual shocks powered by over 50 outflows from young stars are identified, indicating that the dusty molecular clumps surrounding the NGC 7000/IC 5070/W80 H II region are among the most active sites of ongoing star formation in the solar vicinity. A spectacular X-shaped outflow, MHO 3400, emerges from a young star system embedded in a dense clump more than a parsec from the ionization front associated with the Pelican Nebula (IC 5070). Suspected to be a binary, the source drives a pair of outflows with orientations differing by 80°. Each flow exhibits S-shaped symmetry and multiple shocks indicating a pulsed and precessing jet. The 'Gulf of Mexico', located south of the North America Nebula (NGC 7000), contains a dense cluster of molecular hydrogen objects (MHOs), Herbig-Haro (HH) objects, and over 300 young stellar objects (YSOs), indicating a recent burst of star formation. The largest outflow detected thus far in the North America and Pelican Nebula complex, the 1.6 parsec long MHO 3417 flow, emerges from a 500 M {sub ☉} BGPS clump and may be powered by a forming massive star. Several prominent outflows such as MHO 3427 appear to be powered by highly embedded YSOs only visible at λ > 70 μm. An 'activity index' formed by dividing the number of shocks by the mass of the cloud containing their source stars is used to estimate the relative evolutionary states of Bolocam clumps. Outflows can be used as indicators of the evolutionary state of clumps detected in millimeter and submillimeter dust continuum surveys.

  17. Pediatric glaucoma suspects

    Directory of Open Access Journals (Sweden)

    Kooner K

    2014-06-01

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

  18. Sandqvist 187 - A dense molecular cloud in Norma

    Science.gov (United States)

    Alvarez, H.; Bronfman, L.; Cohen, R.; Garay, G.; Graham, J.; Thaddeus, P.

    1986-01-01

    Observations of Sandqvist 187, an elongated dust cloud in the southern constellation Norma are presented and discussed. The cloud contains two Herbig-Haro objects, HH 56 and HH 57. HH 57 currently displays on its NE edge a 17th mag variable star of the FU Ori type. Using the Columbia University 1.2 m millimeter-wave telescope at Cerro Tololo, the region is mapped and an extended CO cloud which envelops and is elongated along the optical dust cloud is found. The position of maximum CO emission coincides with HH 56 and HH 57. Assuming a distance of 0.7 kpc, the total mass of the cloud is found to be close to 500 solar masses. The CO spectra show evidence of a molecular flow. Photographs and CCD images obtained mostly with the CTIO 4 m telescope show the detailed optical structure of the dark cloud's core region. The Herbig-Haro object HH 56 appears to be related to an emission-line star embedded in the small nebula Reipurth 13, not to the FU Ori star in HH 57.

  19. The Launch Region of the SVS13 Outflow

    Science.gov (United States)

    Hodapp, Klaus

    2013-07-01

    We present the results of Keck Telescope laser adaptive optics integral field spectroscopy with OSIRIS of the innermost regions of the NGC1333 SVS13 jet that drives the system of Herbig-Haro objects 7-11. We find a 0.4" long micro-jet traced by the emission of shock-excited [FeII]. Beyond the extent of this jet, we find a series of near-spherical bubbles traced in the lower excitation H 2 1-0 S(1) line. While this most recent outflow activity is directed almost precisely (PA 170°) to the south of SVS13, the older bubbles show a different direction of motion and orientation more towards the south-east, connecting the recent outflow activity to the well-known, poorly collimated HH 7-11 system of Herbig-Haro objects. We postulate that the creation of a series of bubbles and the changes in outflow direction are indicative of a precessing disk. Our velocity-resolved observations of the microjet in the [FeII] emission line at 1.644μm, as well as the HI12-4 and 13-4 (Brackett series) emission lines originating from the accretion disk or jet launch region clearly show the kinematic signature of disk and jet rotation.

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

    African Journals Online (AJOL)

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

  1. MRI for clinically suspected appendicitis during pregnancy.

    NARCIS (Netherlands)

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

    2004-01-01

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

  2. The Nature and Frequency of Outflows from Stars in the Central Orion Nebula Cluster

    Science.gov (United States)

    O'Dell, C. R.; Ferland, G. J.; Henney, W. J.; Peimbert, M.; García-Díaz, Ma. T.; Rubin, Robert H.

    2015-10-01

    Recent Hubble Space Telescope images have allowed the determination with unprecedented accuracy of motions and changes of shocks within the inner Orion Nebula. These originate from collimated outflows from very young stars, some within the ionized portion of the nebula and others within the host molecular cloud. We have doubled the number of Herbig-Haro objects known within the inner Orion Nebula. We find that the best-known Herbig-Haro shocks originate from relatively few stars, with the optically visible X-ray source COUP 666 driving many of them. While some isolated shocks are driven by single collimated outflows, many groups of shocks are the result of a single stellar source having jets oriented in multiple directions at similar times. This explains the feature that shocks aligned in opposite directions in the plane of the sky are usually blueshifted because the redshifted outflows pass into the optically thick photon-dominated region behind the nebula. There are two regions from which optical outflows originate for which there are no candidate sources in the SIMBAD database. Based on observations at the San Pedro Martir Observatory operated by the Universidad Nacional Autónoma de México.

  3. 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 ...

  4. 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

  5. Technology and the Glaucoma Suspect

    National Research Council Canada - National Science Library

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

    2016-01-01

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

  6. 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...

  7. Tocolytics for suspected intrapartum fetal distress.

    Science.gov (United States)

    Kulier, R; Hofmeyr, G J

    2000-01-01

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

  8. Proper Motions of Young Stellar Outflows in the Mid-infrared with Spitzer (IRAC). I. The NGC 1333 Region

    Science.gov (United States)

    Raga, A. C.; Noriega-Crespo, A.; Carey, S. J.; Arce, H. G.

    2013-02-01

    We use two 4.5 μm Spitzer (IRAC) maps of the NGC 1333 region taken over a ~7 yr interval to determine proper motions of its associated outflows. This is a first successful attempt at obtaining proper motions of stellars' outflow from Spitzer observations. For the outflow formed by the Herbig-Haro objects HH7, 8, and 10, we find proper motions of ~9-13 km s-1, which are consistent with previously determined optical proper motions of these objects. We determine proper motions for a total of eight outflows, ranging from ~10 to 100 km s-1. The derived proper motions show that out of these eight outflows, three have tangential velocities <=20 km s-1. This result shows that a large fraction of the observed outflows have low intrinsic velocities and that the low proper motions are not merely a projection effect.

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

    Directory of Open Access Journals (Sweden)

    Vivian Milani

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

  10. Faecal Calprotectin in Suspected Paediatric Inflammatory Bowel Disease

    NARCIS (Netherlands)

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

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

  11. 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…

  12. 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 ...

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

    African Journals Online (AJOL)

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

  14. Star Formation in IC 348

    Science.gov (United States)

    Herbst, W.

    2008-12-01

    A review of work on the small, compact, nearby young cluster IC 348 is given. This region is particularly important because it is well surveyed at a variety of wavelengths and intermediate in nature between dense clusters and loose associations. Its earliest type star is B5 and it contains a few hundred stellar members as well as some brown dwarfs, protostars, Herbig-Haro objects and starless sub-mm cores. The total mass of its components is ˜90 M_⊙, most of which is in the form of pre-main sequence stars. Perhaps the biggest challenge to work on the cluster is the relatively high and variable extinction (A_v=3D1-7 mag). Studies to date have provided particularly valuable insights into the initial mass function, disk lifetimes, stellar rotation properties, X-ray properties, outflows and substructure of the cluster. Results on the stellar component include the following: 1) the initial mass function matches that for field stars in the stellar and brown dwarf regimes, 2) the fraction of stars with disks is probably normal for the cluster's age, 3) the rotation properties match those of the Orion Nebula Cluster and are significantly different, in the sense of slower rotation, than NGC 2264, 4) the X-ray properties of the stars appear normal for T Tauri stars. There is a ridge of high extinction that lies ˜10 arcmin (0.9 pc in projection) to the southwest of IC 348 and contains about a dozen Class 0 and I protostars as well as some Herbig Haro objects and sub-mm cores. This region, which also contains the "Flying Ghost Nebula" and the well-studied object HH 211, clearly signals that star formation in this part of the Perseus dark clouds is not yet finished. An extensive kinematical study involving both proper motions and radial velocities for the 400 members of the cluster would be most desirable.

  15. X-rays from protostellar jets: emission from continuous flows

    Science.gov (United States)

    Bonito, R.; Orlando, S.; Peres, G.; Favata, F.; Rosner, R.

    2007-02-01

    Context: Recently X-ray emission from protostellar jets has been detected with both XMM-Newton and Chandra satellites, but the physical mechanism which can give rise to this emission is still unclear. Aims: We performed an extensive exploration of the parameter space for the main parameters influencing the jet/ambient medium interaction. Aims include: 1) to constrain the jet/ambient medium interaction regimes leading to the X-ray emission observed in Herbig-Haro objects in terms of the emission by a shock forming at the interaction front between a continuous supersonic jet and the surrounding medium; 2) to derive detailed predictions to be compared with optical and X-ray observations of protostellar jets; 3) to get insight into the protostellar jet's physical conditions. Methods: We performed a set of two-dimensional hydrodynamic numerical simulations, in cylindrical coordinates, modeling supersonic jets ramming into a uniform ambient medium. The model takes into account the most relevant physical effects, namely thermal conduction and radiative losses. Results: Our model explains the observed X-ray emission from protostellar jets in a natural way. In particular, we find that a protostellar jet that is less dense than the ambient medium well reproduces the observations of the nearest Herbig-Haro object, HH 154, and allows us to make detailed predictions of a possible X-ray source proper motion (v_sh ≈500 km s-1) detectable with Chandra. Furthermore, our results suggest that the simulated protostellar jets which best reproduce the X-rays observations cannot drive molecular outflows.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2005-01-01

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

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  19. Suspected levamisole intoxication in calves.

    Science.gov (United States)

    Müller, K R; Dwyer, C

    2016-07-01

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

  20. Predictors of leadership: The usual suspects and the suspect traits

    OpenAIRE

    Antonakis, J.

    2011-01-01

    In this chapter, I review literature on traits (i.e., individual differences) and their links to leader outcomes. I present an integrated model, the ascription-actuality trait theory, to explain two routes to leader outcomes that stem from traits: the route that objectively matters and the route that appears to matter but objectively may not. I discuss the history of trait research and provide criteria by which we should judge the validity of trait models. Finally, I review trait models that ...

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

    National Research Council Canada - National Science Library

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-08-22

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

  3. A case of suspect “cyanosis”

    OpenAIRE

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

    2013-01-01

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

  4. 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.

  5. 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.

  6. The phenomenology of specialization of criminal suspects.

    Directory of Open Access Journals (Sweden)

    Michele Tumminello

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

  7. Controlled Hypotension in Patients Suspected of a Ruptured Abdominal Aortic Aneurysm: Feasibility during Transport by Ambulance Services and Possible Harm

    NARCIS (Netherlands)

    Reimerink, J. J.; Hoornweg, L. L.; Vahl, A. C.; Wisselink, W.; Balm, R.

    2010-01-01

    Objective: To evaluate a controlled hypotension protocol for patients suspected of a ruptured aneurysm of the abdominal aorta (RAAA) and to identify possible harm to patients with a final diagnosis other than RAAA. Design: Retrospective analysis of patients suspected of RAAA and transported by

  8. Disparities in the Medical Examination of Children in the Home of a Child with Suspected Physical Abuse

    Science.gov (United States)

    Campbell, Kristine A.; Squires, Janet; Cook, Lawrence J.; Berger, Rachel P.

    2009-01-01

    Objective: To identify factors predicting the medical examination of children living in a home with a child referred to child protection services (CPS) for suspected physical abuse. Methods: Medical providers at Children's Hospital of Pittsburgh referred 189 children for suspected physical abuse to CPS between November 1, 2004 and May 1, 2006…

  9. Comparison of planar bone scintigraphy and single photon emission computed tomography in patients suspected of having unilateral condylar hyperactivity

    NARCIS (Netherlands)

    Saridin, C.P.; Raijmakers, P.G.H.M.; Tuinzing, D.B.; Becking, A.G.

    2008-01-01

    Objective A comparison is made of single photon emission computed tomography (SPECT) and planar bone scintigraphy in the diagnosis of patients with suspected unilateral condylar hyperactivity (UCH). Study design The subjects comprised 56 patients with suspected UCH who underwent SPECT and regular

  10. A case of suspect “cyanosis”

    Directory of Open Access Journals (Sweden)

    Elisabetta Antonucci

    2013-05-01

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

  11. Patch Testing in Suspected Allergic Contact Dermatitis to Cosmetics

    OpenAIRE

    Pramod Kumar; Rekha Paulose

    2014-01-01

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

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

    African Journals Online (AJOL)

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

  13. Biomechanical properties of keratoconus suspect eyes.

    Science.gov (United States)

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

    2010-06-01

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

  14. Characterization of suspected illegal skin whitening cosmetics.

    Science.gov (United States)

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

    2014-03-01

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

  15. 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 ...

  16. Suspected poisoning of domestic animals by pesticides.

    Science.gov (United States)

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

    2016-01-01

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

  17. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography

    NARCIS (Netherlands)

    van Belle, Arne; Büller, Harry R.; Huisman, Menno V.; Huisman, Peter M.; Kaasjager, Karin; Kamphuisen, Pieter W.; Kramer, Mark H. H.; Kruip, Marieke J. H. A.; Kwakkel-van Erp, Johanna M.; Leebeek, Frank W. G.; Nijkeuter, Mathilde; Prins, Martin H.; Sohne, Maaike; Tick, Lidwine W.

    2006-01-01

    CONTEXT: Previous studies have evaluated the safety of relatively complex combinations of clinical decision rules and diagnostic tests in patients with suspected pulmonary embolism. OBJECTIVE: To assess the clinical effectiveness of a simplified algorithm using a dichotomized clinical decision rule,

  18. The results of 15 years of consistent strategy in treating antenatally suspected pelvi-ureteric junction obstruction

    DEFF Research Database (Denmark)

    Thorup, J; Jokela, R; Cortes, D

    2003-01-01

    OBJECTIVE: To determine how to select patients for surgery among those with antenatally detected pelvi-ureteric junction (PUJ) obstruction. PATIENTS AND METHODS: The study comprised 100 consecutive children with antenatally detected suspected unilateral PUJ obstruction and a normal contralateral...

  19. Object and Objective Lost?

    DEFF Research Database (Denmark)

    Lopdrup-Hjorth, Thomas

    2015-01-01

    This paper explores the erosion and problematization of ‘the organization’ as a demarcated entity. Utilizing Foucault's reflections on ‘state-phobia’ as a source of inspiration, I show how an organization-phobia has gained a hold within Organization Theory (OT). By attending to the history...... of this organization-phobia, the paper argues that OT has become increasingly incapable of speaking about its core object. I show how organizations went from being conceptualized as entities of major importance to becoming theoretically deconstructed and associated with all kinds of ills. Through this history......, organizations as distinct entities have been rendered so problematic that they have gradually come to be removed from the center of OT. The costs of this have been rather significant. Besides undermining the grounds that gave OT intellectual credibility and legitimacy to begin with, the organization-phobia...

  20. The evaluation of suspected child physical abuse.

    Science.gov (United States)

    Christian, Cindy W

    2015-05-01

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

  1. 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.

  2. Glaucoma suspect & Humphrey Field Analyzer a correlation

    Directory of Open Access Journals (Sweden)

    P Dahal

    2012-09-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-04-01

    Objective. To demonstrate the utility of magnetic resonance (MR) imaging in the diagnosis of complete and partial ligamentous injuries in patients with suspected atlanto-occipital dissociation (AOD). Materials and methods. Five patients with suspected AOD had MR imaging performed within an average of 4 days after injury. MR scans were reviewed with specific analysis of craniocervical ligamentous structures. Charts were reviewed to obtain clinical information regarding presentation, treatment, hospital course, and outcome. Results. Two patients demonstrated MR evidence of complete AOD. One had disruption of all visualized major ligamentous structures at the craniocervical junction with anterolisthesis and evidence of cord damage. The second had injuries to the tectorial membrane, superior band of the cruciform ligament, apical ligament, and interspinous ligament at C 1-2. The remaining three patients sustained incomplete severance of the ligamentous structures at the craniocervical junction. All patients demonstrated subtle radiographic findings suggestive of AOD, including soft tissue swelling at the craniocervical junction without fracture. The two patients with complete AOD died. The three patients with partial AOD were treated with stabilization. On follow-up, these three children were asymptomatic following their craniocervical injury. Conclusion. MR imaging of acute AOD provides accurate identification of the craniocervical ligaments injured, classification of full versus partial ligamentous disruption, and analysis of accompanying spinal cord injury. This information is important for early appropriate neurosurgical management and preservation of neurologic function in survivors. (orig.) With 7 figs., 1 tab., 14 refs.

  5. Patch Testing in Suspected Allergic Contact Dermatitis to Cosmetics

    Science.gov (United States)

    Paulose, Rekha

    2014-01-01

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

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

    African Journals Online (AJOL)

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

  7. Nuclear Pedigree Criteria of Suspected HNPCC

    Directory of Open Access Journals (Sweden)

    Kładny Józef

    2003-01-01

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

  8. Dynamics of Forensic Interviews with Suspected Abuse Victims Who Do Not Disclose Abuse

    Science.gov (United States)

    Hershkowitz, Irit; Orbach, Yael; Lamb, Michael E.; Sternberg, Kathleen J.; Horowitz, Dvora

    2006-01-01

    Objectives: The present study was designed to explore structural differences between forensic interviews in which children made allegations and those in which children did not make allegations. Methodology: Fifty forensic interviews of 4- to 13-year-old suspected victims of abuse who did not disclose abuse during the interview were compared with…

  9. A simple diagnostic strategy in hospitalized patients with clinically suspected pulmonary embolism

    NARCIS (Netherlands)

    Kruip, M. J. H. A.; Söhne, M.; Nijkeuter, M.; Kwakkel-van Erp, H. M.; Tick, L. W.; Halkes, S. J. M.; Prins, M. H.; Kramer, M. H. H.; Huisman, M. V.; Büller, H. R.; Leebeek, F. W. G.

    2006-01-01

    OBJECTIVES: Diagnostic strategies in patients with suspected pulmonary embolism have been extensively studied in outpatients; their value in hospitalized patients has not been well established. Our aim was to determine the safety and clinical utility of a simple diagnostic strategy in hospitalized

  10. Mild cognitive impairment with suspected nonamyloid pathology (SNAP) Prediction of progression

    NARCIS (Netherlands)

    Caroli, A.; Prestia, A.; Galluzzi, S.; Ferrari, C.; van der Flier, W.M.; Ossenkoppele, R.; van Berckel, B.; Barkhof, F.; Teunissen, C.; Wall, A.E.; Carter, S.F.; Scholl, M.; Choo, I.H.; Grimmer, T.; Redolfi, A.; Nordberg, A.; Scheltens, P.; Drzezga, A.; Frisoni, G. B.

    2015-01-01

    Objectives: The aim of this study was to investigate predictors of progressive cognitive deterioration in patients with suspected non-Alzheimer disease pathology (SNAP) and mild cognitive impairment (MCI). Methods: We measured markers of amyloid pathology (CSF b-amyloid 42) and neurodegeneration

  11. CT diagnosis of suspected acute appendicitis in adult patients

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-06-01

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

  12. Outcome of splanchnic blood flow determination in patients with suspected chronic intestinal ischaemia. A retrospective survey

    DEFF Research Database (Denmark)

    Møller, Søren; Madsen, Jan Lysgård

    2002-01-01

    BACKGROUND: Different diagnostic examinations have been applied in the management of patients with suspected intestinal ischaemia. In some centres, invasive determination of a meal-induced increase in splanchnic blood flow is used in the diagnostic process and in the selection of patients for sur...... underwent angioplasty. Future studies are needed to validate the determination of splanchnic blood flow in relation to splanchnic angiography and other imaging modalities in patients with chronic intestinal ischaemia.......BACKGROUND: Different diagnostic examinations have been applied in the management of patients with suspected intestinal ischaemia. In some centres, invasive determination of a meal-induced increase in splanchnic blood flow is used in the diagnostic process and in the selection of patients...... for surgery. However, no studies have evaluated the impact of splanchnic blood flow determination on therapy in such patients. OBJECTIVE: The aim of the present study was therefore to analyse the outcome of splanchnic blood flow determination in patients with suspected chronic intestinal ischaemia. METHODS...

  13. 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...

  14. Magnetic resonance imaging of suspected atrial tumors.

    Science.gov (United States)

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

    1992-05-01

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

  15. Cost-benefit analysis of Xpert MTB/RIF for tuberculosis suspects in German hospitals.

    Science.gov (United States)

    Diel, Roland; Nienhaus, Albert; Hillemann, Doris; Richter, Elvira

    2016-02-01

    Our objective was to assess the cost-benefit of enhancing or replacing the conventional sputum smear with the real-time PCR Xpert MTB/RIF method in the inpatient diagnostic schema for tuberculosis (TB).Recent data from published per-case cost studies for TB/multidrug-resistant (MDR)-TB and from comparative analyses of sputum microscopy, mycobacterial culture, Xpert MTB/RIF and drug susceptibility testing, performed at the German National Reference Center for Mycobacteria, were used. Potential cost savings of Xpert MTB/RIF, based on test accuracy and multiple cost drivers, were calculated for diagnosing TB/MDR-TB suspects from the hospital perspective.Implementing Xpert MTB/RIF as an add-on in smear-positive and smear-negative TB suspects saves on average €48.72 and €503, respectively, per admitted patient as compared with the conventional approach. In smear-positive and smear-negative MDR-TB suspects, cost savings amount to €189.56 and €515.25 per person, respectively. Full replacement of microscopy by Xpert MTB/RIF saves €449.98. In probabilistic Monte-Carlo simulation, adding Xpert MTB/RIF is less costly in 46.4% and 76.2% of smear-positive TB and MDR-TB suspects, respectively, but 100% less expensive in all smear-negative suspects. Full replacement by Xpert MTB/RIF is also consistently cost-saving.Using Xpert MTB/RIF as an add-on to and even as a replacement for sputum smear examination may significantly reduce expenditures in TB suspects. Copyright ©ERS 2016.

  16. MULTIPLE OBJECTS

    Directory of Open Access Journals (Sweden)

    A. A. Bosov

    2015-04-01

    Full Text Available Purpose. The development of complicated techniques of production and management processes, information systems, computer science, applied objects of systems theory and others requires improvement of mathematical methods, new approaches for researches of application systems. And the variety and diversity of subject systems makes necessary the development of a model that generalizes the classical sets and their development – sets of sets. Multiple objects unlike sets are constructed by multiple structures and represented by the structure and content. The aim of the work is the analysis of multiple structures, generating multiple objects, the further development of operations on these objects in application systems. Methodology. To achieve the objectives of the researches, the structure of multiple objects represents as constructive trio, consisting of media, signatures and axiomatic. Multiple object is determined by the structure and content, as well as represented by hybrid superposition, composed of sets, multi-sets, ordered sets (lists and heterogeneous sets (sequences, corteges. Findings. In this paper we study the properties and characteristics of the components of hybrid multiple objects of complex systems, proposed assessments of their complexity, shown the rules of internal and external operations on objects of implementation. We introduce the relation of arbitrary order over multiple objects, we define the description of functions and display on objects of multiple structures. Originality.In this paper we consider the development of multiple structures, generating multiple objects.Practical value. The transition from the abstract to the subject of multiple structures requires the transformation of the system and multiple objects. Transformation involves three successive stages: specification (binding to the domain, interpretation (multiple sites and particularization (goals. The proposed describe systems approach based on hybrid sets

  17. 48 CFR 803.806 - Processing suspected violations.

    Science.gov (United States)

    2010-10-01

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

  18. Clinical and laboratorial investigation in patients with suspected drug allergy in a tertiary hospital

    OpenAIRE

    Luciana Mabel Ferreira Vasconcelos

    2012-01-01

    Allergic drug reactions account for 6.5% of hospital admissions, prolonged hospitalization 15.1% of patients and are severe in 6.7% of patients. There are difficulties in understanding the immune mechanisms, diagnosis and treatment of patients. Therefore, such reactions are considered a Public Health problem. The objective of this study was to describe the cases of patients with suspected allergic hypersensitivity to drugs and to evaluate the response of individuals to skin tests. A total of ...

  19. 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

  20. Evaluation of quantitative IFN-gamma response for risk stratification of active tuberculosis suspects.

    Science.gov (United States)

    Metcalfe, John Z; Cattamanchi, Adithya; Vittinghoff, Eric; Ho, Christine; Grinsdale, Jennifer; Hopewell, Philip C; Kawamura, L Masae; Nahid, Payam

    2010-01-01

    The contribution of interferon-gamma release assays (IGRAs) to appropriate risk stratification of active tuberculosis suspects has not been studied. To determine whether the addition of quantitative IGRA results to a prediction model incorporating clinical criteria improves risk stratification of smear-negative-tuberculosis suspects. Clinical data from tuberculosis suspects evaluated by the San Francisco Department of Public Health Tuberculosis Control Clinic from March 2005 to February 2008 were reviewed. We excluded tuberculosis suspects who were acid fast-bacilli smear-positive, HIV-infected, or under 10 years of age. We developed a clinical prediction model for culture-positive disease and examined the benefit of adding quantitative interferon (IFN)-gamma results measured by QuantiFERON-TB Gold (Cellestis, Carnegie, Australia). Of 660 patients meeting eligibility criteria, 65 (10%) had culture-proven tuberculosis. The odds of active tuberculosis increased by 7% (95% confidence interval [CI], 3-11%) for each doubling of IFN-gamma level. The addition of quantitative IFN-gamma results to objective clinical data significantly improved model performance (c-statistic 0.71 vs. 0.78; P added clinical value to a prediction model incorporating conventional risk factors. Although this benefit may be attenuated within highly experienced centers, the predictive accuracy of quantitative IFN-gamma levels should be evaluated in other settings.

  1. Pragmatic Objectivity

    OpenAIRE

    Michele Marsonet

    2014-01-01

    Nicholas Rescher writes that “objectivity is not something we infer from the data; it is something we must presuppose. It is something that we postulate or presume from the very outset of our dealings with people’s claims about the world’s facts”. Such definition is just the opposite of objectivity conceived of in classical terms, but it cannot be equated with an idealistic viewpoint according to which objectivity is something that our mind simply creates in the process of reflection. It is, ...

  2. Trusted Objects

    Energy Technology Data Exchange (ETDEWEB)

    CAMPBELL,PHILIP L.; PIERSON,LYNDON G.; WITZKE,EDWARD L.

    1999-10-27

    In the world of computers a trusted object is a collection of possibly-sensitive data and programs that can be allowed to reside and execute on a computer, even on an adversary's machine. Beyond the scope of one computer we believe that network-based agents in high-consequence and highly reliable applications will depend on this approach, and that the basis for such objects is what we call ''faithful execution.''

  3. Awareness of Memory Abilities in Community-Dwelling Older Adults with Suspected Dementia and Mild Cognitive Impairment

    Science.gov (United States)

    Lin, Feng; Wharton, Whitney; Dowling, N. Maritza; Ries, Michele L.; Johnson, Sterling C.; Carlsson, Cynthia M.; Asthana, Sanjay; Gleason, Carey E.

    2010-01-01

    Aims To examine awareness of memory abilities by groups (healthy control, suspected dementia/mild cognitive impairment, MCI, and diagnosed dementia/MCI), and to describe group differences in the relationship between awareness and cognitive performance in a community sample. Methods In a cross-sectional design, 183 subjects were evaluated in a community setting and categorized into 3 groups based on their cognitive performance and reported medical history. Awareness of memory abilities was quantified using a published anosognosia ratio (AR) comparing the estimated to the objective memory performance by subjects. Each group was further categorized into ‘overestimators’, ‘accurate estimators’, and ‘underestimators’ based on their AR scores. Results The suspected and diagnosed dementia/MCI groups had significantly higher AR scores than the controls. The suspected group also had a significantly larger proportion (96.2%) of overestimators than the diagnosed (73.3%) and control groups (26.1%). Impaired awareness in overestimators of the suspected and diagnosed groups was correlated with deficits in executive function, language or global cognition. Conclusion Impaired awareness of memory abilities was prevalent in community-dwelling older adults with suspected and diagnosed dementia or MCI. Those with suspected dementia or MCI were more likely to overestimate their memory abilities than their diagnosed counterparts, suggesting that limited awareness of deficits may hinder utilization of dementia diagnostic services. PMID:20714155

  4. Prediction of Suspect Location Based on Spatiotemporal Semantics

    Directory of Open Access Journals (Sweden)

    Lian Duan

    2017-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Mertz, D.W.

    1996-01-12

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

  6. Fashion Objects

    DEFF Research Database (Denmark)

    Andersen, Bjørn Schiermer

    2009-01-01

    This article attempts to create a framework for understanding modern fashion phenomena on the basis of Durkheim's sociology of religion. It focuses on Durkheim's conception of the relation between the cult and the sacred object, on his notion of 'exteriorisation', and on his theory of the social...... symbol in an attempt to describe the peculiar attraction of the fashion object and its social constitution. However, Durkheim's notions of cult and ritual must undergo profound changes if they are to be used in an analysis of fashion. The article tries to expand the Durkheimian cult, radically enlarging...... it without totally dispersing it; depicting it as held together exclusively by the sheer 'force' of the sacred object. Firstly, the article introduces the themes and problems surrounding Durkheim's conception of the sacred. Next, it briefly sketches an outline of fashion phenomena in Durkheimian categories...

  7. Facing suspected child abuse – what keeps Swedish general practitioners from reporting to child protective services?

    Science.gov (United States)

    Bengtsson Boström, Kristina; Östberg, Anna-Lena

    2015-01-01

    Abstract Objective. The aim of this study was to examine the reporting of suspected child abuse among Swedish general practitioners (GPs), and to investigate factors influencing them in their decision whether or not to report to child protective services (CPS). Design. A cross-sectional questionnaire study. Setting. Primary health care centres in western Sweden. Subjects. 177 GPs and GP trainees. Main outcome measures. Demographic and educational background, education on child abuse, attitudes to reporting and CPS, previous experience of reporting suspected child abuse, and need of support. Results. Despite mandatory reporting, 20% of all physicians had at some point suspected but not reported child abuse. Main reasons for non-reporting were uncertainty about the suspicion and use of alternative strategies; for instance, referral to other health care providers or follow-up of the family by the treating physician. Only 30% of all physicians trusted CPS's methods of investigating and acting in cases of suspected child abuse, and 44% of all physicians would have wanted access to expert consultation. There were no differences in the failure to report suspected child abuse that could be attributed to GP characteristics. However, GPs educated abroad reported less frequently to CPS than GPs educated in Sweden. Conclusions. This study showed that GPs see a need for support from experts and that the communication and cooperation between GPs and CPS needs to be improved. The low frequency of reporting indicates a need for continued education of GPs and for updated guidelines including practical advice on how to manage child abuse. PMID:25676563

  8. Stopping and Questioning Suspected Shoplifters Without Creating Civil Liability

    Science.gov (United States)

    Reed, Jack R., Jr.

    1977-01-01

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

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

    Directory of Open Access Journals (Sweden)

    S. R. Gilarevsky

    2013-01-01

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

  10. Suspect confession of child sexual abuse to investigators.

    Science.gov (United States)

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

    2010-05-01

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

  11. The magnetic field geometry in the vicinity of HH 7-11/HH 12 and HH 33/HH 40

    Science.gov (United States)

    Heyer, Mark H.; Strom, Stephen E.; Strom, Karen M.

    1987-01-01

    The small-scale structure of the interstellar magnetic field in the vicinity of the Herbig-Haro objects HH 7-11/HH 12 and HH 33/40 is derived from CCD imaging polarimetry of stars nearby to these young stellar object driven outflows. The outflow associated with SVS 13/HH 7-11 lies approximately parallel to the local field direction. The outflow mapped by HH 33/HH 40 is also well aligned with the local magnetic field. However, the orientation of the outflow associated with HH 12 located 2 arcmin to the north of HH 7-11 is offset from the inferred magnetic field direction by 60 deg. These results taken together with those of previous studies suggest: (1) magnetic fields are directly or indirectly responsible for the observed orientation of outflows associated with newborn stars in the majority of cases; and (2) in some cases, the flow properties may depend upon other characteristics of the parent cloud core.

  12. THE EVOLUTION OF HETERGENEOUS 'CLUMPY JETS': A PARAMETER STUDY

    Energy Technology Data Exchange (ETDEWEB)

    Yirak, Kristopher; Schroeder, Ed; Frank, Adam [Department of Physics and Astronomy, University of Rochester, Rochester, NY 14620 (United States); Cunningham, Andrew J., E-mail: yirak@pas.rochester.edu [Lawrence Livermore National Laboratory, Livermore, CA 94551 (United States)

    2012-02-20

    We investigate the role discrete clumps embedded in an astrophysical jet play on the jet's morphology and line emission characteristics. By varying clumps' size, density, position, and velocity, we cover a range of parameter space motivated by observations of objects such as the Herbig-Haro object HH 34. We here extend the results presented in Yirak et al., including how analysis of individual observations may lead to spurious sinusoidal variation whose parameters vary widely over time, owing chiefly to interactions between clumps. The goodness of fits, while poor in all simulations, are best when clump-clump collisions are minimal. Our results indicate that a large velocity dispersion leads to a clump-clump collision-dominated flow which disrupts the jet beam. Finally, we present synthetic emission images of H{alpha} and [S II] and note an excess of [S II] emission along the jet length as compared to observations. This suggests that observed beams undergo earlier processing, if they are present at all.

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

    Science.gov (United States)

    Woodhams, Jessica; Cooke, Claire

    2013-11-01

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

  14. 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).

  15. Treatment with Epinephrine (Adrenaline) in Suspected Anaphylaxis during Anesthesia in Denmark

    DEFF Research Database (Denmark)

    Garvey, Lene H; Belhage, Bo; Krøigaard, Mogens

    2011-01-01

    BACKGROUND:: Literature on the use of epinephrine in the treatment of anaphylaxis during anesthesia is very limited. The objective of this study was to investigate how often epinephrine is used in the treatment of suspected anaphylaxis during anesthesia in Denmark and whether timing of treatment...... is important. METHODS:: A retrospective study of 270 patients investigated at the Danish Anaesthesia Allergy Centre after referral due to suspected anaphylaxis during anesthesia was performed. Reactions had been graded by severity: C1, mild reactions; C2, moderate reactions; C3, anaphylactic shock......, infusion was needed in 12 of 60 patients (20%) treated early versus 12 of 35 patients (34%) treated late (odds ratio, 2.09) (95% confidence interval, 0.81-5.35). CONCLUSION:: Anaphylaxis may be difficult to diagnose during anesthesia, and treatment with epinephrine can be delayed as a consequence...

  16. Pressure ulcer development in trauma patients with suspected spinal injury; the influence of risk factors present in the Emergency Department

    NARCIS (Netherlands)

    Ham, H. W (Wietske); Schoonhoven, Lisette; Schuurmans, M. (Marieke) J; Leenen, L. (Luke) P H

    2017-01-01

    Objectives To explore the influence of risk factors present at Emergency Department admission on pressure ulcer development in trauma patients with suspected spinal injury, admitted to the hospital for evaluation and treatment of acute traumatic injuries. Design Prospective cohort study setting

  17. Maternal allopurinol administration during suspected fetal hypoxia : a novel neuroprotective intervention? A multicentre randomised placebo controlled trial

    NARCIS (Netherlands)

    Kaandorp, Joepe J.; Benders, Manon J. N. L.; Schuit, Ewoud; Rademaker, Carin M. A.; Oudijk, Martijn A.; Porath, Martina M.; Oetomo, Sidarto Bambang; Wouters, Maurice G. A. J.; van Elburg, Ruurd M.; Franssen, Maureen T. M.; Bos, Arie F.; de Haan, Timo R.; Boon, Janine; de Boer, Inge P.; Rijnders, Robbert J. P.; Jacobs, Corrie J. W. F. M.; Scheepers, Liesbeth H. C. J.; Gavilanes, Danilo A. W.; Bloemenkamp, Kitty W. M.; Rijken, Monique; van Meir, Claudia A.; von Lindern, Jeannette S.; Huisjes, Anjoke J. M.; Bakker, Saskia C. M. J. E. R.; Mo, Ben W. J.; Visser, Gerard H. A.; Van Bel, Frank; Derks, Jan B.

    Objective To determine whether maternal allopurinol treatment during suspected fetal hypoxia would reduce the release of biomarkers associated with neonatal brain damage. Design A randomised double-blind placebo controlled multicentre trial. Patients We studied women in labour at term with clinical

  18. Impact of delay in clinical presentation on the diagnostic management and prognosis of patients with suspected pulmonary embolism

    NARCIS (Netherlands)

    Den Exter, Paul L.; Van Es, Josien; Erkens, Petra M.G.; Van Roosmalen, Mark J.G.; Van Den Hoven, Pim; Hovens, Marcel M.C.; Kamphuisen, Pieter W.; Klok, Frederikus A.; Huisman, Menno V.

    2013-01-01

    Rationale: The nonspecific clinical presentation of pulmonary embolism (PE) frequently leads to delay in its diagnosis. Objectives: This study aimed to assess the impact of delay in presentation on the diagnostic management and clinical outcome of patients with suspected PE. Methods: In 4,044

  19. Implementation of a pre-hospital decision rule in general practice. Triage of patients with suspected myocardial infarction

    NARCIS (Netherlands)

    E.W.M. Grijseels (Els); J.W. Deckers (Jaap); A.W. Hoes (Arno); H. Boersma (Eric); J.A.M. Hartman; E. van der Does (Emiel); M.L. Simoons (Maarten)

    1996-01-01

    textabstractOBJECTIVE: To improve pre-hospital triage of patients with suspected acute cardiac disease. DESIGN: Prospective study. SUBJECTS. Patients with symptoms suggestive of acute cardiac pathology, who were seen by a general practitioner, for whom acute admission into hospital was requested,

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

    Science.gov (United States)

    McMonnies, Charles W

    2014-11-01

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

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

    Science.gov (United States)

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

    2017-08-10

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

  2. Suspected dog bite associated HIV horizontal transmission in Swaziland

    Directory of Open Access Journals (Sweden)

    Ganizani Mlawanda

    2013-01-01

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

  3. 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

  4. Hyperspectral imaging of the Eagle Nebula with the Fourier Transform Spectrograph SITELLE at CFHT

    Science.gov (United States)

    Flagey, Nicolas; McLeod, Anna Faye; Aguilar, Laura; SITELLE instrument team, CHFT science operations team

    2018-01-01

    We present the very first large field of view, optical, spectral mapping of one of the most famous star-forming regions in the Galaxy: the Eagle Nebula (M 16). The observations have been obtained with the new imaging Fourier transform spectrograph at CFHT: SITELLE. Three spectral cubes are presented, with a spectral range of 30-40 nm around the [OII] 7327, H-alpha and H-beta lines, with a resolving power of 10000, 1500 and 600, respectively. The spectral cubes cover the same region: a field of view of 11’ by 11 centered on the Pillars of Creation.We discuss the performance, calibration and data reduction of SITELLE data by comparing it to MUSE integral field data of the same region, and (within errors) obtain remarkably comparable values for fluxes, velocities, and various diagnostics for star-forming regions.With the spatial and spectral coverage of SITELLE, it was furthermore possible to confirm the bipolar structure of the Herbig-Haro object 216 present in the field. Together with narrow-band H2 and Br-gamma near-infrared data obtained with Wircam at CFHT, we further analyze the spatial correlation of the ionized and molecular emission.

  5. The Spectral Energy Distribution of HH 100 IRS

    Science.gov (United States)

    Siebenmorgen, Ralf

    1996-01-01

    Recent progress in the modeling of the radiative transfer in star forming regions has lead to improved dusty envelope models. Such models can now explain in great detail the observed infrared spectrum. The success of such models suggests that input parameters correspond to the true physical situation of the environment of the young stellar object. However, so far only minor attention has been given to models which include the spectroscopic signature of ice bands. Such models are applied to the Herbig-Haro energy source HH100 IRS. Calculations have been performed to interpret the spectral energy distribution as a function of dust parameters such as the grain size, the ice volume fraction, and the 'fluffiness' of the particles. The infrared spectrum together with the strength of the water ice band of HH 100 IRS is successfully reproduced if an upper limit of the grain size below 1 micron is used. Comet-like grains, with sizes above 1 micron, result in a poor fit of the observations.

  6. The dusty silhouette jet HH 1019 in the Carina Nebula

    Science.gov (United States)

    Reiter, Megan; Kiminki, Megan M.; Smith, Nathan; Bally, John

    2017-06-01

    We report the discovery in Hubble Space Telescope (HST) images of the new Herbig-Haro jet, HH 1019, located near the Tr 14 cluster in the Carina Nebula. Like other HH jets in the region, this bipolar collimated flow emerges from the head of a dark dust pillar. However, HH 1019 is unique because - unlike all other HH jets known to date - it is identified by a linear chain of dark, dusty knots that are seen primarily in silhouette against the background screen of the H II region. Proper motions confirm that these dark condensations move along the jet axis at high speed. [S ii] emission traces a highly collimated jet that is spatially coincident with these dust knots. The high extinction in the body of the jet suggests that this outflow has lifted a large amount of dust directly from the disc, although it is possible that it has entrained dust from its surrounding protostellar envelope before exiting the dust pillar. If dust in HH 1019 originates from the circumstellar disc, this provides further evidence for a jet launched from a range of radii in the disc, including those outside the dust sublimation radius. HH 1019 may be the prototype for a new subclass of dusty HH objects seen primarily in extinction against the background screen of a bright H II region. Such jets may be common, but difficult to observe because they require the special condition of a very bright background in order to be seen in silhouette.

  7. Molecular hydrogen and excitation in the HH 1-2 system

    Science.gov (United States)

    Noriega-Crespo, A.; Garnavich, P. M.

    1994-01-01

    We present a series of molecular hydrogen images of the Herbig-Haro 1-2 system in the 1-0 S(1) transition at 2.121 microns, with a spatial resolution of approximately 2 sec. The distribution of H2 is then compared with that of the excitation, given by the (S II) 6717+6731 to H-alpha line ratio. We find that most optical condensations in the HH 1-2 system, including the VLA 1 jet, have H2 counterparts. H2 emission is detected in most low excitation knots, as expected for low velocity shocks (50 km/s less than), but also in high excitation regions, like in HH 1F and HH 2A min. For these latter objects, the H2 emission could be due to the interaction of the preionizing flux, produced by 150-200 km/s shocks, with the surrounding interstellar matter, i.e., fluorescence. The lack fluorescent lines in the ultraviolet (UV), however, suggest a different mechanism. H2 is detected at the tip of the VLA 1 jet, where the knot morphology suggests the presence of a second bow shock. H2 is detected also SE of HH 2E and SW of HH 1F, in regions with known NH3 emission.

  8. The Integral Field View of the Orion Nebula

    Directory of Open Access Journals (Sweden)

    Adal Mesa-Delgado

    2014-01-01

    Full Text Available This paper reviews the major advances achieved in the Orion Nebula through the use of integral field spectroscopy (IFS. Since the early work of Vasconcelos and collaborators in 2005, this technique has facilitated the investigation of global properties of the nebula and its morphology, providing new clues to better constrain its 3D structure. IFS has led to the discovery of shock-heated zones at the leading working surfaces of prominent Herbig-Haro objects as well as the first attempt to determine the chemical composition of Orion protoplanetary disks, also known as proplyds. The analysis of these morphologies using IFS has given us new insights into the abundance discrepancy problem, a long-standing and unresolved issue that casts doubt on the reliability of current methods used for the determination of metallicities in the universe from the analysis of H II regions. Results imply that high-density clumps and high-velocity flows may play an active role in the production of such discrepancies. Future investigations based on the large-scale IFS mosaic of Orion will be very valuable for exploring how the integrated effect of small-scale structures may have impact at larger scales in the framework of star-forming regions.

  9. Objective thermomechanics

    CERN Document Server

    Fülöp, Tamás

    2015-01-01

    An irreversible thermodynamical theory of solids is presented where the kinematic quantities are defined in an automatically objective way. Namely, auxiliary elements like reference frame, reference time and reference configuration are avoided by formulating the motion of the continuum on spacetime directly, utilizing the Weyl-Matolcsi description of spacetime. This restricts the range of definable kinematic quantities heavily. Solids are distinguished from fluids by possessing not only an instantaneous metric tensor but a relaxed metric, too, that represents the natural geometric structure of the solid. The comparison of the instantaneous metric to the relaxed one is the basis of the definition of the elastic state variable, the elastic deformedness tensor. Thermal expansion is conceived as the temperature dependence of the relaxed metric. As opposed to this reversible type of change, plasticity means an irreversible change in the relaxed metric, and is describable via a plastic change rate tensor. The relat...

  10. Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review.

    Science.gov (United States)

    Zafrir, Yaron; Trattner, Akiva; Hodak, Emmillia; Eldar, Oren; Lapidoth, Moshe; Ben Amitai, Dan

    2017-11-16

    Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature. The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files. Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively). Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background. © 2017 Wiley Periodicals, Inc.

  11. 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.

  12. Diagnostic significance of ascites adenosine deaminase levels in suspected tuberculous peritonitis in adults

    Directory of Open Access Journals (Sweden)

    Anil Chander

    2013-09-01

    Full Text Available Objective: There are contradictory reports about the use of adenosine deaminase (ADA as a diagnostic marker intuberculous peritonitis patients. Reports evaluating significance of ADA activity in the diagnosis of tuberculous peritonitisin adults are lacking in Nepal. We thus set out to investigate the ascitic fluid ADA levels in suspected tuberculousperitonitis patients and to determine the diagnostic significance of the test statistically.Methods: This study population comprised of two different adult patients groups. Group I - 35 suspected cases oftuberculous peritonitis and Group II - 35 cases of transudative ascites - the control group (patients with biochemicallyproved transudates or hypoproteinaemia and peritoneal tap was done. ADA estimation was carried out by spectrophotometry.Results: ADA levels (Mean ± SD in suspected tuberculous peritonitis and transudative ascites cases were 48.5±17.9U/L and 19.8±7.7 U/L respectively (P<0.001. In the receiver operating characteristic (ROC curve for ascites, ADA cut-offlevel of 41.5 U/L was found to yield the best results of differential diagnosis; sensitivity, specificity, positive predictivevalue, negative predictive value and accuracy of the test in tuberculous peritonitis cases were 80.0%, 97.2 %, 96.6%,82.9%, 88.6% respectively.Conclusion: ADA levels are elevated in suspected tuberculous peritonitis cases and it is a simple, rapid, inexpensiveand the least invasive test. It is thus a useful biochemical marker for the early diagnosis of tuberculous peritonitis whilewaiting for the results of mycobacterial cultures or biopsies. J Microbiol Infect Dis 2013; 3(3: 104-108Key words: adenosine deaminase, sensitivity, specificity, diagnostic significance, tuberculous peritonitis

  13. 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.

  14. 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

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

    Science.gov (United States)

    Ng, Kevin; Fiani, Nadine; Peralta, Santiago

    2017-12-01

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

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

    DEFF Research Database (Denmark)

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

    1988-01-01

    The diagnostic power of combined cholescintigraphy and ultrasonography was tested in 67 patients suspected of having acute cholecystitis; of these, 42 (63%) had acute cholecystitis. The predictive value of a positive scintigraphy (PVpos) was 95% and that of a negative (PVneg) was 91% (n = 67...... that in patients suspected of having acute cholecystitis cholescintigraphy should be the first diagnostic procedure performed. If the scintigraphy is positive, additional ultrasonographic detection of gallstones makes the diagnosis almost certain. If one diagnostic modality is inconclusive, the other makes a fair...

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  18. Raman Spectroscopic Characterization of Melanoma and Benign Melanocytic Lesions Suspected of Melanoma Using High-Wavenumber Raman Spectroscopy.

    Science.gov (United States)

    Santos, Inês P; Caspers, Peter J; Bakker Schut, Tom C; van Doorn, Remco; Noordhoek Hegt, Vincent; Koljenović, Senada; Puppels, Gerwin J

    2016-08-02

    Melanoma is a pigmented type of skin cancer, which has the highest mortality of all skin cancers. Because of the low clinical diagnostic accuracy for melanoma, an objective tool is needed to assist clinical assessment of skin lesions that are suspected of (early) melanoma. The aim of this study was to identify spectral differences in the CH region of HWVN (high-wavenumber) Raman spectra between melanoma and benign melanocytic lesions clinically suspected of melanoma. We used these spectral differences to explore preliminary classification models to distinguish melanoma from benign melanocytic lesions. Data from 82 freshly excised melanocytic lesions clinically suspected of melanoma were measured using an in-house built Raman spectrometer, which has been optimized for measurements on pigmented skin lesions (excitation wavelength 976 nm and a wavelength range of the Raman signal 1340-1540 nm). Clear spectral differences were observed between melanoma and benign melanocytic lesions. These differences can be assigned mainly to the symmetric CH2 stretching vibrations of lipids. Our results show that the Raman bands between 2840 and 2930 cm(-1) have increased intensity for melanoma when compared to benign melanocytic lesions, suggesting an increase in lipid content in melanoma. These results demonstrate that spectroscopic information in the CH-stretching region of HWVN Raman spectra can discriminate melanoma from benign melanocytic lesions that are often clinically misdiagnosed as melanoma and that Raman spectroscopy has the potential to provide an objective clinical tool to improve the clinical diagnostic accuracy of skin lesions suspected of melanoma.

  19. Are novel non-invasive imaging techniques needed in patients with suspected prosthetic heart valve endocarditis? A systematic review and meta-analysis

    NARCIS (Netherlands)

    J. Habets; W. Tanis (Wilco); J.B. Reitsma (Johannes B.); R.B.A. van den Brink (Renee); W.P. Mali (Willem); S.A.J. Chamuleau (Steven); R.P.J. Budde (Ricardo)

    2015-01-01

    textabstractObjectives: Multimodal non-invasive imaging plays a key role in establishing a diagnosis of PHV endocarditis. The objective of this study was to provide a systematic review of the literature and meta-analysis of the diagnostic accuracy of TTE, TEE, and MDCT in patients with (suspected)

  20. 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,

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

    African Journals Online (AJOL)

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

  2. 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

  3. Nonreferral of Nursing Home Patients With Suspected Breast Cancer

    NARCIS (Netherlands)

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

    2012-01-01

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

  4. 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.

  5. 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…

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

    OpenAIRE

    Lambacher, Bianca; Wittek, Thomas

    2015-01-01

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

  7. 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…

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

    Science.gov (United States)

    Adams, Joyce A.

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Bisgaard, H; Pedersen, S; Nikander, K

    1994-01-01

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

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

    African Journals Online (AJOL)

    Ramakantb

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

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

    African Journals Online (AJOL)

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

  12. Ajmaline challenge in young individuals with suspected Brugada syndrome

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2017-01-01

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

  16. A 3-mode, Variable Velocity Jet Model for HH 34

    Science.gov (United States)

    Raga, A.; Noriega-Crespo, A.

    1998-01-01

    Variable ejection velocity jet models can qualitatively explain the appearance of successive working surfaces in Herbig-Haro (HH) jets. This paper presents an attempt to explore which features of the HH 34 jet can indeed be reproduced by such a model.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-08-01

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

  18. Predictors of increasing injury severity across suspected recurrent episodes of non-accidental trauma: a retrospective cohort study.

    Science.gov (United States)

    Thackeray, Jonathan; Minneci, Peter C; Cooper, Jennifer N; Groner, Jonathan I; Deans, Katherine J

    2016-01-16

    Little is known about how the severity of injury changes with recurrent events of suspected non-accidental trauma (NAT). Our objective was to determine risk factors for escalating severity of injury in children with multiple events of suspected NAT. This retrospective longitudinal cohort study included children from a pediatric Medicaid accountable care organization with ≥ 1 non-birth related episode containing an International Classification of Diseases, Ninth Revision, Clinical Modification or Current Procedural Terminology code for NAT or a skeletal survey between 2007 and 2011. Subsequent potential NAT events were defined as independent episodes with codes for either NAT, a skeletal survey, or injuries suspicious for abuse. Severity of injury was calculated using the New Injury Severity Score (NISS). Multivariable Cox proportional hazards regression modeling was used with results expressed as hazard ratios and 95 % confidence intervals. Of the 914 children with at least one suspected NAT event, 39 % had at least one suspected recurrent NAT event; 12 % had 2 events and 5 % had ≥ 3 events during follow-up. Factors associated with an increased risk for a recurrent episode of suspected NAT with higher NISS were living in a rural area (1.69, 1.02-2.78, p = 0.04) and having an open wound (2.12, 1.24-3.62, p = 0.006), or superficial injury (2.28, 1.31-3.98, p = 0.004). In contrast, a greater number of injuries was associated with a decreased risk for a recurrent episode of suspected NAT with higher NISS (p injuries are either not reported to child protective services or not removed from the unsafe environment with either situation leading to subsequent events. The medical and child welfare systems need to better identify these potential victims of recurrent events..

  19. Rivaroxaban for treatment of suspected or confirmed heparin-induced thrombocytopenia study.

    Science.gov (United States)

    Linkins, L A; Warkentin, T E; Pai, M; Shivakumar, S; Manji, R A; Wells, P S; Wu, C; Nazi, I; Crowther, M A

    2016-06-01

    Essentials Heparin-induced thrombocytopenia (HIT) is a thrombogenic condition that is difficult to treat. We evaluated rivaroxaban as a treatment option in patients with suspected or confirmed HIT. One patient had recurrent thrombosis and 9/10 patients with thrombocytopenia had platelet recovery. Rivaroxaban may be an effective and safe treatment option for HIT. Background Rivaroxaban is a direct oral anti-Xa inhibitor that has the potential to greatly simplify treatment of heparin-induced thrombocytopenia (HIT). Objectives To evaluate the efficacy and safety of rivaroxaban in this patient population, we conducted a multicenter, single-arm, prospective cohort study of patients with suspected or confirmed HIT. Patients/Methods Twenty-two consecutive adults with suspected or confirmed HIT received rivaroxaban 15 mg bid until a local HIT assay result was available. Participants with a positive local assay result continued rivaroxaban 15 mg bid until platelet recovery (or until day 21 if they had acute thrombosis at study entry), then stepped down to rivaroxaban 20 mg daily until day 30. Results and Conclusions The primary outcome measure, incidence of new symptomatic, objectively-confirmed venous and arterial thromboembolism at 30 days, occurred in one HIT-positive participant (4.5%; 95% confidence interval [CI], 0-23.5%) and one HIT-positive participant required limb amputation despite platelet recovery. Platelet recovery was achieved in nine out of 10 HIT-positive patients with thrombocytopenia. Rivaroxaban appears to be effective for treating patients with confirmed HIT, although the small number of patients enrolled limits precision. © 2016 International Society on Thrombosis and Haemostasis.

  20. A rational clinical approach to suspected insulin allergy

    DEFF Research Database (Denmark)

    Bødtger, Uffe; Wittrup, M

    2005-01-01

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

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

    Science.gov (United States)

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

    2015-04-01

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

  2. Suspected side effects to the quadrivalent human papilloma vaccine

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Biello, D.R.

    1987-06-19

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

  4. Discovery of a patient with strongly suspected bullous pemphigoid in a ward by oral health care providers

    OpenAIRE

    Kanda, N; SOGA, Y; Meguro, M.; Tanabe, A; Yagi, Y; Himuro, Y; Fujiwara, Y.; Takashiba, S; Kobayashi, N.

    2011-01-01

    Objectives: Oral health care providers may discover systemic diseases incidentally from signs observed in the oral cavity. Here, we report a case in which oral health care providers in a hospital discovered a patient with strongly suspected bullous pemphigoid (BP), which is a relatively rare but important disease, in a ward. Methods: The patient was a 78-year-old Japanese woman admitted to our hospital because of severe Alzheimer's disease. We discovered recurrent ulcers in the oral mucosa an...

  5. Radiotherapy in three suspect cases of feline thymoma.

    Science.gov (United States)

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

    2001-01-01

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

  6. 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...

  7. 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.)

  8. 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.)

  9. Epidemiology of suspected wrist joint infection versus inflammation.

    Science.gov (United States)

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

    2011-03-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Steven Henderson

    2013-11-01

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

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

    Science.gov (United States)

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

    2012-08-01

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

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

    Science.gov (United States)

    Tepsumethanon, V; Wilde, H; Sitprija, V

    2008-01-01

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

  14. MR delayed enhancement imaging findings in suspected acute myocarditis

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-01-15

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

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

    Science.gov (United States)

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

    2001-11-01

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

  16. 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.

  17. Limitation of personal freedom by detention of suspect

    Directory of Open Access Journals (Sweden)

    Knežević Saša

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-01-01

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

  19. 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

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

    Science.gov (United States)

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

    2012-11-01

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

  1. Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease

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    Francisco Flávio Costa Filho

    2015-11-01

    Full Text Available AbstractBackground:Guidelines recommend that in suspected stable coronary artery disease (CAD, a clinical (non-invasive evaluation should be performed before coronary angiography.Objective:We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD.Methods:We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests.Results:A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77, age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26, diabetes (OR, 2.01; CI 95%, 1.40 - 2.90, dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07, typical angina (OR, 2.92; CI 95%, 1.77 - 4.83 and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27.Conclusions:In this study, less than a quarter of the patients referred for coronary angiography with suspected CAD had the diagnosis confirmed. A better clinical and non-invasive assessment is necessary, to improve the efficacy of patient selection for coronary angiography.

  2. Suspectable Risk Factors of Congenital Anomaly in Dr. Hasan Sadikin General Hospital Bandung, Indonesia

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    Pradistya Syifa Yudiasari

    2017-06-01

    Full Text Available Background: Congenital anomaly is a disease of structural or functional alteration since birth. The cause of congenital anomaly is genetic, environtment, and unknown. The cause of congenital anomaly is unknown, made congenital anomaly is difficult to detect. Therefore, the objective of this study was to identify the suspectable risk factors of congenital anomaly. Methods: This was a descriptive study. About 78 samples were taken by purposive sampling from medical records of patients with congenital anomaly in pediatric surgery ambulatory unit at Dr. Hasan Sadikin General Hospital (RSHS, Bandung from September to November 2014. From the selected medical records, an interview was carried out to the parents’ patient to identify some suspectable risk factors. The collected data were analyzed and presented in tables. Results: From 78 medical records,  hirschprung disease was the highest among all type of congenital anomaly (29%. The characteristic of congenital anomaly was mothers in the age of 20–35 years (65%, fathers’ age was  more than 20 years old, family history of congenital anomaly was 1%, there was no history of previous congenital anomaly in previous pregnancy, infection history was 3%, history of medication was 11.5%, mother’s BMI was in normal term (18.5─24.9 as much as 65%, no history of radiation, there was no history of chronic alcohol. History of smoking/passive smoking was high (65%. Conclusions: Hirschprung disease is the highest rate disease in congenital anomaly and smoking is a highest suspectable risk factor contribute to congenital anomaly.   DOI: 10.15850/amj.v4n2.1095

  3. Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Eleci Vaz; Gazzana, Marcelo Basso; Seligman, Renato; Knorst, Marli Maria, E-mail: mknorst@gmail.com [Hospital de Clinicas de Porto Alegre, Porto Alegre, RS (Brazil); Guerra, Vinicius Andre [Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS (Brazil). Faculdade de Medicina. Programa de Pos-Graduacao em Ciencias Pneumologicas; Sarmento, Muriel Bossle; Guazzelli, Pedro Arends; Hoffmeister, Mariana Costa [Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre (Brazil). Faculdade de Medicina

    2016-01-15

    Objective: To determine the prevalence of alternative diagnoses based on chest CT angiography (CTA) in patients with suspected pulmonary thromboembolism (PTE) who tested negative for PTE, as well as whether those alternative diagnoses had been considered prior to the CTA. Methods: This was a cross-sectional, retrospective study involving 191 adult patients undergoing CTA for suspected PTE between September of 2009 and May of 2012. Chest X-rays and CTAs were reviewed to determine whether the findings suggested an alternative diagnosis in the cases not diagnosed as PTE. Data on symptoms, risk factors, comorbidities, length of hospital stay, and mortality were collected. Results: On the basis of the CTA findings, PTE was diagnosed in 47 cases (24.6%). Among the 144 patients not diagnosed with PTE via CTA, the findings were abnormal in 120 (83.3%). Such findings were consistent with an alternative diagnosis that explained the symptoms in 75 patients (39.3%). Among those 75 cases, there were only 39 (20.4%) in which the same alterations had not been previously detected on chest X-rays. The most common alternative diagnosis, made solely on the basis of the CTA findings, was pneumonia (identified in 20 cases). Symptoms, risk factors, comorbidities, and the in-hospital mortality rate did not differ significantly between the patients with and without PTE. However, the median hospital stay was significantly longer in the patients with PTE than in those without (18.0 and 9.5 days, respectively; p = 0.001). Conclusions: Our results indicate that chest CTA is useful in cases of suspected PTE, because it can confirm the diagnosis and reveal findings consistent with an alternative diagnosis in a significant number of patients. (author)

  4. Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism

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    Eleci Vaz Ferreira

    2016-02-01

    Full Text Available Objective : To determine the prevalence of alternative diagnoses based on chest CT angiography (CTA in patients with suspected pulmonary thromboembolism (PTE who tested negative for PTE, as well as whether those alternative diagnoses had been considered prior to the CTA. Methods : This was a cross-sectional, retrospective study involving 191 adult patients undergoing CTA for suspected PTE between September of 2009 and May of 2012. Chest X-rays and CTAs were reviewed to determine whether the findings suggested an alternative diagnosis in the cases not diagnosed as PTE. Data on symptoms, risk factors, comorbidities, length of hospital stay, and mortality were collected. Results : On the basis of the CTA findings, PTE was diagnosed in 47 cases (24.6%. Among the 144 patients not diagnosed with PTE via CTA, the findings were abnormal in 120 (83.3%. Such findings were consistent with an alternative diagnosis that explained the symptoms in 75 patients (39.3%. Among those 75 cases, there were only 39 (20.4% in which the same alterations had not been previously detected on chest X-rays. The most common alternative diagnosis, made solely on the basis of the CTA findings, was pneumonia (identified in 20 cases. Symptoms, risk factors, comorbidities, and the in-hospital mortality rate did not differ significantly between the patients with and without PTE. However, the median hospital stay was significantly longer in the patients with PTE than in those without (18.0 and 9.5 days, respectively; p = 0.001. Conclusions : Our results indicate that chest CTA is useful in cases of suspected PTE, because it can confirm the diagnosis and reveal findings consistent with an alternative diagnosis in a significant number of patients.

  5. Ultrasonography for suspected deep vein thrombosis: how useful is single-point augmentation?

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

    2009-02-15

    Aims: To assess the role of single-point augmentation of spectral Doppler flow in the diagnosis of acute deep vein thrombosis (DVT). Secondary objectives included identifying the augmentation response in non-DVT diagnoses. Methods: Patients attending the ultrasound departments of two hospitals for investigation of suspected acute DVT during an 8-month period were recruited to the study group. Spectral Doppler assessment of the superficial femoral vein was recorded during Valsalva and calf compression manoeuvres in the asymptomatic and symptomatic legs. The Doppler waveforms from the symptomatic limb were characterized as 'normal' or 'abnormal' by the operator. Standard compression ultrasonography of the symptomatic leg was then performed with the presence of DVT or an alternative diagnosis documented. Results: One hundred and sixty-seven patients underwent ultrasound examinations using the study methodology. Nine patients were subsequently excluded due to bilateral DVT or inability to tolerate calf compression. The mean age of the remaining 158 patients was 65.4 years with 28 DVTs identified (18% of patients). Calf compression elicited a normal response in 118/130 of non-DVT examinations (specificity 91%) and an abnormal response in 18/28 DVT examinations (sensitivity 64%). Diminished or absent augmentation was identified in alternative diagnoses that included haematoma and Baker's cyst. Conclusions: This study demonstrates that single-point augmentation has a low sensitivity in suspected lower-limb DVT, and that the majority of undetected DVTs are isolated to the calf veins. An abnormal augmentation response is a poor predictor of lower-limb DVT as alternative diagnoses can produce diminished or reduced augmentation. Therefore, single-point augmentation does not add to the standard compression ultrasound examination for suspected DVT and should not be routinely performed.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  7. Factors associated with late presentation of suspected tuberculosis cases to tuberculosis management facilities: The case in Dagoretti district, Nairobi, Kenya

    Science.gov (United States)

    Njau, Irene Wambui; Karanja, Simon Muturi; Wanzala, Peter; Omolo, Jared Odhiambo

    2012-01-01

    Background Tuberculosis is a highly contagious disease accounting for a high number of deaths in the developing countries; its control can be effectively achieved if individuals with the disease receive adequate and timely treatment. The objective of this study was to determine the factors associated with late presentation of suspects to tuberculosis management facilities in Dagoretti district in Nairobi, Kenya. Method A cross sectional study was conducted on patients aged 18 years and above attending TB clinics in Dagoretti District, Nairobi Kenya. A total of 426 TB suspects were interviewed. The study covered 8 clinics in Dagoretti district. Analysis was done using SPSS version 16.0 and Epi info version 6, this included Chi Square for Bivariate analysis and Binary Logistic Regression for Multivariate Analysis. Results Out of the 426 tuberculosis suspects, 248 (58.2%) suspects had delayed in seeking medical care. In Bivariate analysis male gender (P = 0.039, O.R = 1.51; 95% Confidence Interval; 1.00- 2.27), level of education (Primary class 5-8) (P = 0.001, O.R= 2.06; 95% C.I 1.34-3.19) and place of first medical care (drug store) (P= 0.013, O.R = 1.63; 95% C.I 1.09-2.46) were all significantly associated with late presentation. After multivariate logistic regression, gender (P = 0,019, OR = 1.6), level of education (p = 0.029, OR = 1.26) and place of first medical care (P= 0.01 OR = 1.27), were found to be significantly associated with late presentation. Conclusion This study shows that age, level of education and place of first medical care are the factors associated with late presentation of suspects to tuberculosis management facilities. PMID:23077714

  8. Abdominal CT Does Not Improve Outcome for Children with Suspected Acute Appendicitis

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    Danielle I. Miano

    2015-12-01

    Full Text Available Introduction: Acute appendicitis in children is a clinical diagnosis, which often requires preoperative confirmation with either ultrasound (US or computed tomography (CT studies. CTs expose children to radiation, which may increase the lifetime risk of developing malignancy. US in the pediatric population with appropriate clinical follow up and serial exam may be an effective diagnostic modality for many children without incurring the risk of radiation. The objective of the study was to compare the rate of appendiceal rupture and negative appendectomies between children with and without abdominal CTs; and to evaluate the same outcomes for children with and without USs to determine if there were any associations between imaging modalities and outcomes. Methods: We conducted a retrospective chart review including emergency department (ED and inpatient records from 1/1/2009–2/31/2010 and included patients with suspected acute appendicitis. Results: 1,493 children, aged less than one year to 20 years, were identified in the ED with suspected appendicitis. These patients presented with abdominal pain who had either a surgical consult or an abdominal imaging study to evaluate for appendicitis, or were transferred from an outside hospital or primary care physician office with the stated suspicion of acute appendicitis. Of these patients, 739 were sent home following evaluation in the ED and did not return within the subsequent two weeks and were therefore presumed not to have appendicitis. A total of 754 were admitted and form the study population, of which 20% received a CT, 53% US, and 8% received both. Of these 57%, 95% CI [53.5,60.5] had pathology-proven appendicitis. Appendicitis rates were similar for children with a CT (57%, 95% CI [49.6,64.4] compared to those without (57%, 95% CI [52.9,61.0]. Children with perforation were similar between those with a CT (18%, 95% CI [12.3,23.7] and those without (13%, 95% CI [10.3,15.7]. The proportion of

  9. Follow-up of Mothers with Suspected Postpartum Depression from Pediatrics Clinics

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    Nerissa S. Bauer

    2017-10-01

    Full Text Available PurposePediatric providers are increasingly screening for postpartum depression (PD, yet, it is unknown how often mothers comply with recommendations to seek treatment. The objectives were to describe the rate at which mothers with suspected PD seek treatment and explore factors that predict help-seeking behavior.Design and methodsMothers were recruited from four pediatric clinics after identification using the Child Health Improvement through Computer Automation (CHICA system. Mothers with a positive screen were invited to participate in a telephone interview between January 2012 and December 2014. Mothers reported if they sought treatment or called a community resource.Results73 of 133 eligible mothers participated (55% response rate. Fifty women recalled a recommendation to seek help. Only 43.8% (32/73 made a follow-up appointment with an adult provider and even fewer kept the appointment.ConclusionA majority of mothers suspected of having PD recalled a referral for further intervention; yet, less than half took action. Further investigation of barriers of help-seeking behavior is warranted.

  10. INVESTIGATION OF SUSPECTED PERIPHERAL NEUROPATHY OUTBREAK IN DECHENTSEMO CENTRAL SCHOOL, THINLEYGANG, PUNAKHA

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    Tsheten

    2016-09-01

    Full Text Available Background: A suspected peripheral neuropathy outbreak was reported from Dechentsemo Central School, Thinleygang, Punakha, following which the investigation team was immediately dispatched in the field. Objective: The aim of investigation was to ascertain the cause and risk factor for the outbreak in order to implement control measures. Methods: A case control study was devised for the investigation to study about the past exposure or deficiencies in order to find out the suspected cause and risk factors. A semi-quantitative food frequency questionnaire was administered to both cases and controls to collect information on the type of food they have consumed. The information garnered was analyzed using Chi-Square or Fischer Exact test for categorical variables and Man-Whitney U-test for quantitative variables. Results: All 17 cases were females with mean age of 13 years (SD 2.7 years. The average daily amount of thiamine intake was 0.6 mg/day for case and 0.8 mg/day for controls against the recommended daily allowance (RDA of 1.2 mg/day. Case and control patients differed significantly with respect to fat intake (p-value = 0.02, more strongly with folate and iron intake (p-value < 0.01. Conclusion: The outbreak of peripheral neuropathy in Dechentsemo Central School appears to be linked to reduced dietary intake rich in vitamin B1 coupled with low intake of folate and iron in their diet.

  11. No visible dental staining in children treated with doxycycline for suspected Rocky Mountain Spotted Fever.

    Science.gov (United States)

    Todd, Suzanne R; Dahlgren, F Scott; Traeger, Marc S; Beltrán-Aguilar, Eugenio D; Marianos, Donald W; Hamilton, Charlene; McQuiston, Jennifer H; Regan, Joanna J

    2015-05-01

    To evaluate whether cosmetically relevant dental effects occurred among children who had received doxycycline for treatment of suspected Rocky Mountain spotted fever (RMSF). Children who lived on an American Indian reservation with high incidence of RMSF were classified as exposed or unexposed to doxycycline, based on medical and pharmacy record abstraction. Licensed, trained dentists examined each child's teeth and evaluated visible staining patterns and enamel hypoplasia. Objective tooth color was evaluated with a spectrophotometer. Fifty-eight children who received an average of 1.8 courses of doxycycline before 8 years of age and who now had exposed permanent teeth erupted were compared with 213 children who had never received doxycycline. No tetracycline-like staining was observed in any of the exposed children's teeth (0/58, 95% CI 0%-5%), and no significant difference in tooth shade (P=.20) or hypoplasia (P=1.0) was found between the 2 groups. This study failed to demonstrate dental staining, enamel hypoplasia, or tooth color differences among children who received short-term courses of doxycycline at <8 years of age. Healthcare provider confidence in use of doxycycline for suspected RMSF in children may be improved by modifying the drug's label. Published by Elsevier Inc.

  12. Feasibility of abdominal plain film images in evaluation suspected drug smuggler

    Energy Technology Data Exchange (ETDEWEB)

    Sormaala, Markus J., E-mail: markus.sormaala@welho.com [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Salonen, Hanna-Mari, E-mail: hanna-mari.salonen@hus.fi [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Mattila, Ville M., E-mail: ville.mattila@uta.fi [Department of Orthopedic Surgery and Trauma, Tampere University Hospital, Tampere (Finland); Kivisaari, Arto, E-mail: arto.kivisaari@hus.fi [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Autti, Taina, E-mail: taina.autti@hus.fi [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland)

    2012-09-15

    Objective: Drug smuggling in the gastrointestinal tract has soared within the last 20 years. Though illegal substances in the gastrointestinal tract can be visualized with ultrasound, MRI and CT, the abdominal radiograph has by far remained the most frequently used way of detecting smuggled drugs. The purpose of the study was to evaluate the inter-radiologist interpretation error and the reliability of the abdominal radiograph in detecting smuggled drugs. Materials and methods: A total of 279 abdominal radiographs of suspected smugglers were classified by three radiologists as clearly positive or negative for drug smuggling. All available information about the cases was collected from the customs officers and police. Results: Out of these cases 203 (73%) were interpreted as negative and 35 (13%) as positive by all three radiologists. In 86% of the cases there was, therefore, an inter-radiological agreement in interpreting the images. In 41 (14%) cases, however, there was an inter-radiologist disagreement. Kappa-value for inter-observer variability was 0.70. Conclusions: In up to a seventh of the abdominal radiographs the interpretation can be challenging even for an experienced radiologist. False positive interpretation can lead to innocent passengers being detained in vain. As negatively interpreted images usually result in releasing of the suspect, there is no way of knowing how many false negative occur. This makes the abdominal radiograph a suboptimal examination, and low dose CT should be considered as the screening modality for gastrointestinal drug smugglers.

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

    Science.gov (United States)

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

    2011-04-01

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

  14. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  16. 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.

  17. Abstracting of suspected illegal land use in urban areas using case-based classification of remote sensing images

    Science.gov (United States)

    Chen, Fulong; Wang, Chao; Yang, Chengyun; Zhang, Hong; Wu, Fan; Lin, Wenjuan; Zhang, Bo

    2008-11-01

    This paper proposed a method that uses a case-based classification of remote sensing images and applied this method to abstract the information of suspected illegal land use in urban areas. Because of the discrete cases for imagery classification, the proposed method dealt with the oscillation of spectrum or backscatter within the same land use category, and it not only overcame the deficiency of maximum likelihood classification (the prior probability of land use could not be obtained) but also inherited the advantages of the knowledge-based classification system, such as artificial intelligence and automatic characteristics. Consequently, the proposed method could do the classifying better. Then the researchers used the object-oriented technique for shadow removal in highly dense city zones. With multi-temporal SPOT 5 images whose resolution was 2.5×2.5 meters, the researchers found that the method can abstract suspected illegal land use information in urban areas using post-classification comparison technique.

  18. 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.

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

    Science.gov (United States)

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

    1999-04-01

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

  20. CT Pulmonary Angiography and Suspected Acute Pulmonary Embolism

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-05-01

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

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

    Science.gov (United States)

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

    2012-07-01

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

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

    Science.gov (United States)

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

    2015-04-01

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

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

    Science.gov (United States)

    Grave, Tobias W; Boag, Amanda K

    2010-11-01

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

  4. Sound objects – Auditory objects – Musical objects

    DEFF Research Database (Denmark)

    Hjortkjær, Jens

    2015-01-01

    ’. In this paper, I review recent neurocognitive research suggesting that the auditory system is sensitive to structural information about real-world objects. Instead of focusing solely on perceptual sound features as determinants of auditory objects, I propose that real-world object properties are inherent......The auditory system transforms patterns of sound energy into perceptual objects but the precise definition of an ‘auditory object’ is much debated. In the context of music listening, Pierre Schaeffer argued that ‘sound objects’ are the fundamental perceptual units in ‘musical objects...

  5. Sound objects – Auditory objects – Musical objects

    DEFF Research Database (Denmark)

    Hjortkjær, Jens

    2016-01-01

    ’. In this paper, I review recent neurocognitive research suggesting that the auditory system is sensitive to structural information about real-world objects. Instead of focusing solely on perceptual sound features as determinants of auditory objects, I propose that real-world object properties are inherent......The auditory system transforms patterns of sound energy into perceptual objects but the precise definition of an ‘auditory object’ is much debated. In the context of music listening, Pierre Schaeffer argued that ‘sound objects’ are the fundamental perceptual units in ‘musical objects...

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

    Directory of Open Access Journals (Sweden)

    Rafael Chacon

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

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

    Science.gov (United States)

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

    2015-01-01

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

  8. Utility of testing for monoclonal bands in serum of patients with suspected osteoporosis

    DEFF Research Database (Denmark)

    Abrahamsen, B.; Andersen, Ivan; Christensen, Susanne S.

    2005-01-01

    , Denmark. PARTICIPANTS: 799 people (685 women) aged 19 to 94 years newly referred with suspected osteoporosis. MAIN OUTCOME MEASURES: Proportion of patients fulfilling the Nordic Myeloma Study Group definition for target condition and proportion of patients with other important haematological conditions......OBJECTIVE: To determine whether measuring monoclonal bands (M component) in serum should be part of the investigation of patients referred to osteoporosis clinics. DESIGN: Retrospective, cross sectional, observational study. SETTING: Referral centre for osteoporosis in a university hospital....... RESULTS: 4.9% (18 of 366) of patients with osteoporosis and 2.2% (9 of 408) of patients without osteoporosis had M component in serum (chi2 = 3.66, P = 0.04). Multiple myeloma was diagnosed in three patients with osteoporosis (absolute risk 0.8%, 95% confidence interval 0.11% to 1.7%). The relative risk...

  9. Emergency physician performed tricuspid annular plane systolic excursion in the evaluation of suspected pulmonary embolism.

    Science.gov (United States)

    Daley, James; Grotberg, John; Pare, Joseph; Medoro, Amanda; Liu, Rachel; Hall, Michael Kennedy; Taylor, Andrew; Moore, Christopher L

    2017-01-01

    The primary objectives were to describe the diagnostic characteristics tricuspid annular plane systolic excursion (TAPSE) for pulmonary embolism (PE) and to optimize the measurement cutoff of TAPSE for the diagnosis of PE. Secondary objectives included assessment of interrater reliability and the quantitative visual estimation of TAPSE. This is a prospective observational cohort study involving a convenience sample of patients at an urban academic emergency department. Patients underwent focused right heart echocardiogram (FOCUS) before computed tomographic angiography (CTA) for suspected PE. A total of 150 patients were enrolled, 32 of whom (21.3%) were diagnosed as having a PE. A receiver operating characteristic curve analysis yielded 2.0 cm as the optimal cutoff for TAPSE in the diagnosis of PE, with a sensitivity of 72% (95% confidence interval [CI], 53-86), a specificity of 66% (95% CI, 57-75), and an area under the curve of 0.73 (95% CI, 0.65-0.83). In patients with tachycardia or hypotension, post hoc analysis demonstrated that FOCUS is 100% (95% CI, 80-100) sensitive for PE, whereas TAPSE is 94% (95% CI, 71-99) sensitive for PE. The intraclass correlation coefficient was 0.87 (95% CI, 0.79-0.93). Emergency physicians with training in echocardiography accurately visually estimated TAPSE, with a κ statistic of 0.94 (95% CI, 0.87-0.98). Emergency physicians with training in echocardiography can reliably measure TAPSE and are able to accurately visually estimate TAPSE as either normal or abnormal. When using an abnormal cutoff of less than 2.0 cm, TAPSE has moderate diagnostic value in patients with suspected PE. On post hoc analysis, TAPSE and FOCUS appear to be highly sensitive for PE in patients with tachycardia or hypotension. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Sudden Suspected Death in Emergency Department: Autopsy Results

    Directory of Open Access Journals (Sweden)

    Mehtap GURGER

    2014-09-01

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

  11. Quasi-objects, Cult Objects and Fashion Objects

    DEFF Research Database (Denmark)

    Andersen, Bjørn Schiermer

    2011-01-01

    This article attempts to rehabilitate the concept of fetishism and to contribute to the debate on the social role of objects as well as to fashion theory. Extrapolating from Michel Serres’ theory of the quasi-objects, I distinguish two phenomenologies possessing almost opposite characteristics....... These two phenomenologies are, so I argue, essential to quasi-object theory, yet largely ignored by Serres’ sociological interpreters. They correspond with the two different theories of fetishism found in Marx and Durkheim, respectively. In the second half of the article, I introduce the fashion object...... as a unique opportunity for studying the interchange between these two forms of fetishism and their respective phenomenologies. Finally, returning to Serres, I briefly consider the theoretical consequences of introducing the fashion object as a quasi-object....

  12. 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

  13. Teicoplanin versus vancomycin for proven or suspected infection.

    Science.gov (United States)

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

    2010-06-16

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

  14. Validation of two age dependent D-dimer cut-off values for exclusion of deep vein thrombosis in suspected elderly patients in primary care: retrospective, cross sectional, diagnostic analysis

    OpenAIRE

    Schouten, Henrike J; Koek, H L; Oudega, Ruud; Geersing, Geert-Jan; Janssen, Kristel J M; Johannes J M van Delden; Moons, Karel G.M.

    2012-01-01

    Objective To determine whether the use of age adapted D-dimer cut-off values can be translated to primary care patients who are suspected of deep vein thrombosis. Design Retrospective, cross sectional diagnostic study. Setting 110 primary care doctors affiliated with three hospitals in the Netherlands. Participants 1374 consecutive patients (936 (68.1%) aged >50 years) with clinically suspected deep vein thrombosis. Main outcome measures Proportion of patients with D-dimer values below two pr...

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

    Science.gov (United States)

    Brown, Joel D; Kwee, Sandi

    2010-11-01

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

  16. Seroprevalance of brucellosis among suspected cases in Malaysia.

    Science.gov (United States)

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

    2011-06-01

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

  17. 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...

  18. 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.

  19. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-06-15

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

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

    Science.gov (United States)

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

    2013-01-01

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

  2. The evaluation of the patients who admitted to a regional hospital emergency service with suspect of rabies

    Directory of Open Access Journals (Sweden)

    Nurettin Tunç

    2012-09-01

    Full Text Available Objectives: Rabies is one of the highest mortality ratesinfectious disease. The aim was the evaluation of the patientswho admitted to The Batman Regional State HospitalEmergency Service with suspect of rabies in the datesbetween June 2011 and November 2011.Materials and methods: Totally, 166 cases who admittedto our center was recorded according to the followingdata: place of residence (rural/urban, contact type andwound information, time after the contact, whether vaccineor immunoglobulin is applied or not and also the species,breed and being owned of suspected animal.Results: Our study population consisted of a total of 166cases including 38 women (23%, 128 men (77% withthe mean age of 22.01 ± 17.90 years. Of all subjects, 105(63% lived in urban and 61 (37% lived in rural areas.Eighty-five percent of suspicious animals (51% had anowner, while 81 animals were unattended.Conclusions: Our results showed that all admitted patientswere vaccinated and the ones contacted with petsor had a surface wound were vaccinated with 3 doses.Moreover, since the 49% of our cases were contactedwith animals which cannot be follow-up, our study obviouslyreveals that in our country deficiencies in the controlof waifs still is a public health problem and increases thecost of vaccination. J Clin Exp Invest 2012; 3 (3: 383-386Key words: Rabies, suspected bite, rabies prophylaxis

  3. Direct access exercise electrocardiography: a new service that improves the management of suspected ischaemic heart disease in the community.

    Science.gov (United States)

    McClements, B. M.; Campbell, N. P.; Cochrane, D.; Stockman, S.

    1994-01-01

    OBJECTIVE--To assess the safety and value of an exercise electrocardiography service for the diagnosis of suspected ischaemic heart disease to which general practitioners have direct access. DESIGN--Direct access to a hospital exercise electrocardiography service was offered on a trial basis to 122 general practitioners in a defined urban area. Maximal exercise tests were performed according to the modified Bruce protocol and the results were dispatched promptly to the referring doctors who were responsible for the subsequent management of their patients. SETTING--All general practices in north and west Belfast (combined list size about 180,000) and the regional medical cardiology centre. PATIENTS--212 request forms were received in a two year period and 192 eligible patients attended for exercise testing. All patients were suspected to have pain due to myocardial ischaemia, were aged electrocardiography for patients with suspected ischaemic heart disease is safe, feasible, and helpful to general practitioners. This service seems to reduce the number of patients referred to cardiology outpatient clinics and to facilitate the management of these patients in the community. PMID:8043332

  4. Prevalence of IgG autoantibody against F-actin in patients suspected of having autoimmune or acute viral hepatitis.

    Science.gov (United States)

    Jaskowski, Troy D; Konnick, Eric Q; Ashwood, Edward R; Litwin, Christine M; Hill, Harry R

    2007-01-01

    Our objectives in this study were to compare results obtained by an enzyme immunoassay (EIA) for F-actin antibody (FAA) immunoglobulin G (IgG) to those determined by an indirect fluorescent antibody (IFA) assay for smooth muscle antibody (SMA) IgG, and to determine the prevalence of FAA in patient sera having serologic evidence of acute viral hepatitis. Sera from 415 patients suspected of having autoimmune hepatitis (AIH), 208 patients suspected of having acute viral hepatitis A, B, or C, and 100 healthy blood donors (HBD) were included in the study. Only one of 100 HBD showed low levels (20-30 Units) of F-actin IgG. In patients suspected of having AIH, the prevalence of FAA increased as SMA titers increased and all sera with SMA titers of >or=1:160 were FAA-positive. In contrast, there were many sera with negative (30 Units) of FAA; many exceeding 80 Units. Moreover, 51.4% of these sera were also positive for anti-nuclear antibody (ANA), which is also utilized in diagnosing type 1 AIH. FAA was detected in 25% of viral hepatitis antibody-positive sera, with the majority (59.3%) containing low levels, and all were ANA-negative. Copyright (c) 2007 Wiley-Liss, Inc.

  5. Prevalence of Intestinal Parasites and Associated Factors among Pulmonary Tuberculosis Suspected Patients Attending University of Gondar Hospital, Gondar, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Yalewayker Tegegne

    2018-01-01

    Full Text Available Introduction. Intestinal parasitic infections are among the major public health problems in developing countries. Hence, it is significant to explore coinfection with intestinal parasites and pulmonary tuberculosis because coinfection increases the complexity of control and prevention of pulmonary tuberculosis and parasitic diseases. Objective. To assess the prevalence of intestinal parasites among pulmonary tuberculosis suspected patients. Method. Institutional based cross-sectional study was conducted at University of Gondar Hospital from March to May, 2017. Stool samples were taken from each participant and examined by direct microscopy and concentration technique. Descriptive statistics was performed and chi-square test was used to show the association between variables. P values of <0.05 were considered statistically significant. Results. Intestinal parasites were detected in 50 (19.6% among a total of 256 pulmonary tuberculosis suspected patients who were included in the study, whereas the prevalence of pulmonary tuberculosis was 16.8% (43/256. Pulmonary tuberculosis and intestinal parasite coinfection was detected in 5 (2.0% of the participants. The most prevalent intestinal parasites infection in this study was Ascaris lumbricoides, 15 (5.85%, followed by Entamoeba histolytica/dispar, 14 (5.46%, and Hookworm, 13 (5.1%. Conclusion. The prevalence of intestinal parasites and their coinfection rate with pulmonary tuberculosis among pulmonary tuberculosis suspected patients were considerable.

  6. Characteristics of fetuses evaluated due to suspected anencephaly: a population-based cohort study in southern Brazil

    Directory of Open Access Journals (Sweden)

    Emanuele Pelizzari

    Full Text Available CONTEXT AND OBJECTIVE: Anencephaly is considered to be the most common type of neural tube defect. Our aim was to assess the clinical and gestational features of a cohort of fetuses with suspected anencephaly. DESIGN AND SETTING: Population-based retrospective cohort study in a referral hospital in southern Brazil. METHODS: The sample consisted of fetuses referred due to suspected anencephaly, to the Fetal Medicine Service of Hospital Materno Infantil Presidente Vargas, between January 2005 and September 2013. Clinical, radiological, pathological and survival data were gathered. RESULTS: Our sample was composed of 29 fetuses. The diagnosis of suspected anencephaly was made on average at 21.3 weeks of gestation. Seven fetuses had malformations that affected other organs, and these included oral clefts (n = 4 and congenital heart defects (n = 2. In 16 cases, there was termination of pregnancy (n = 12 or intrauterine death (n = 4. Regarding those who were born alive (n = 13, all of them died in the first week of life. After postnatal evaluation, the diagnosis of anencephaly was confirmed in 22 cases (75.9%. Other conditions included amniotic band disruption complex (6.9%, microhydranencephaly (6.9%, merocrania (3.4% and holoprosencephaly (3.4%. CONCLUSIONS: Different conditions involving the cranial vault may be confused with anencephaly, as seen in our sample. However, these conditions also seem to have a poor prognosis. It seems that folic acid supplementation is not being properly performed.

  7. [Genetic analysis of TPO, DUOX2 and DUOXA2 genes in children with permanent congenital hypothyroidism suspected dyshormonogenesis].

    Science.gov (United States)

    Huang, Y L; Tan, M Y; Jiang, X; Li, B; Chen, Q Y; Jia, X F; Tang, C F; Liu, J L; Liu, L

    2017-03-02

    Objective: To explore the TPO, DUOX2 and DUOXA2 genotypes and phenotypes of children with permanent congenital hypothyroidism(PCH) suspected dyshormonogenesis in Guangzhou, identified and treated at Guangzhou Newborn Screening Center. Six of them were born between 2011 and 2012. Method: Retrospectively analyzed the clinical data of 9 children with PCH suspected dyshormonogenesis. Genetic analysis of TPO, DUOX2 and DUOXA2 genes were performed with Sanger sequencing. Result: Of the 9 patients, four were identified variants in TPO gene including three cases with biallelic variants and one case with monoallelic variant. Novel c. 1784G>C( p. R595T) variant in TPO was predicted to be damaging by SIFT and PolyPhen-2. Four patients harbored monoallelic known variants in DUOX2 gene and the other one harbored heterozygous known mutation c. 738C>G(p.Y246X) in DUOXA2 gene.Two adolescent patients with biallelic variants in TPO gene showed classical PCH phenotypes with thyroid goiter or nodules. The six patients with monoallelic variant in TPO, DUOX2 or DUOXA2 presented variable phenotypes. Among the 433 578 newborns in the 2011-2012 cohort, there were 156 cases of CH. Six of these cases were PCH suspected dyshormonogenesis, among which 1 case was confirmed TPO biallelic variants and 5 cases were monoallelic variants of TPO, DUOX2, or DUOXA2 genes. Conclusion: TPO and DUOX2 variants are the common molecular pathogenesis in children with PCH suspected dyshormonogenesis. Monoallelic variants in TPO, DUOX2 or DUOXA2 are associated with PCH and showed wide variability in their phenotypes. The novel variant p. R595T in TPO is probably a pathologic variant. The prevalence of PCH caused by TPO gene defects is rare in Guangzhou.

  8. Stethoscope vs. ultrasound probe - which is more reliable in children with suspected pneumonia?

    Directory of Open Access Journals (Sweden)

    Jovan Lovrenski

    2016-05-01

    Full Text Available Objective. To compare lung ultrasound (LUS with auscultation findings in children with clinical suspicion of pneumonia. Patients and methods. A prospective study including 95 patients (age: from 2 months to 17.5 years; mean age: 5.1 y, SD 4.5 y with referral diagnosis of suspected pneumonia. In all patients LUS and auscultatory examinations were performed within an hour. These findings were compared separately in each hemithorax. The radiologist performing LUS was blinded to the patient’s clinical information. Positive auscultatory findings included: crackles and/or abnormal breath sounds (decreased, asymmetric, absent, or bronchial. For LUS examinations a combined transthoracic – transabdominal approach was used. A pneumonia-positive LUS finding included subpleural consolidation with air-bronchogram, or an adjacent area of interstitial edema. For each subpleural consolidation the cranio-caudal (CC diameter was measured, and 95% confidence intervals (CI of the sizes of subpleural consolidations for positive and negative auscultatory findings were compared. The p-value between LUS and auscultation was calculated using McNemar’s test. Results. LUS and auscultation showed pneumonia-positive findings in 98 and 64 hemithoraces, i.e. in 67 and 45 patients respectively. In positive auscultatory findings the CI for CC diameters of subpleural consolidations ranged from 32.46 to 54.14 mm, and in negative auscultatory findings the CI was between 16.52 and 29.83 mm, which showed a statistically significant difference. McNemar’s test showed a statistically significant difference between LUS and auscultation. Conclusions. LUS showed positive findings in more hemithoraces than auscultation in children with suspected pneumonia. A cranio-caudal size of subpleural consolidation of less than 30 mm significantly reduces the possibility of auscultatory detection.

  9. Emergency Department Management of Suspected Calf-Vein Deep Venous Thrombosis: A Diagnostic Algorithm

    Directory of Open Access Journals (Sweden)

    Levi Kitchen

    2016-06-01

    Full Text Available Introduction: Unilateral leg swelling with suspicion of deep venous thrombosis (DVT is a common emergency department (ED presentation. Proximal DVT (thrombus in the popliteal or femoral veins can usually be diagnosed and treated at the initial ED encounter. When proximal DVT has been ruled out, isolated calf-vein deep venous thrombosis (IC-DVT often remains a consideration. The current standard for the diagnosis of IC-DVT is whole-leg vascular duplex ultrasonography (WLUS, a test that is unavailable in many hospitals outside normal business hours. When WLUS is not available from the ED, recommendations for managing suspected IC-DVT vary. The objectives of the study is to use current evidence and recommendations to (1 propose a diagnostic algorithm for IC-DVT when definitive testing (WLUS is unavailable; and (2 summarize the controversy surrounding IC-DVT treatment. Discussion: The Figure combines D-dimer testing with serial CUS or a single deferred FLUS for the diagnosis of IC-DVT. Such an algorithm has the potential to safely direct the management of suspected IC-DVT when definitive testing is unavailable. Whether or not to treat diagnosed IC-DVT remains widely debated and awaiting further evidence. Conclusion: When IC-DVT is not ruled out in the ED, the suggested algorithm, although not prospectively validated by a controlled study, offers an approach to diagnosis that is consistent with current data and recommendations. When IC-DVT is diagnosed, current references suggest that a decision between anticoagulation and continued follow-up outpatient testing can be based on shared decision-making. The risks of proximal progression and life-threatening embolization should be balanced against the generally more benign natural history of such thrombi, and an individual patient’s risk factors for both thrombus propagation and complications of anticoagulation. [West J Emerg Med. 2016;17(4384-390.

  10. Cochrane meta-analysis: teicoplanin versus vancomycin for proven or suspected infection

    Directory of Open Access Journals (Sweden)

    Diogo Diniz Gomes Bugano

    2011-09-01

    Full Text Available Objective: To compare efficacy and safety of vancomycin versusteicoplanin in patients with proven or suspected infection.Methods: Data Sources: Cochrane Renal Group’s SpecializedRegister, CENTRAL, MEDLINE, EMBASE, nephrology textbooksand review articles. Inclusion criteria: Randomized controlled trialsin any language comparing teicoplanin to vancomycin for patientswith proven or suspected infection. Data extraction: Two authorsindependently evaluated methodological quality and extracted data.Study investigators were contacted for unpublished information. Arandom effect model was used to estimate the pooled risk ratio (RRwith 95% confidence interval (CI. Results: A total of 24 studies (2,610patients were included. The drugs had similar rates of clinical cure(RR: 1.03; 95%CI: 0.98-1.08, microbiological cure (RR: 0.98; 95%CI:0.93-1.03 and mortality (RR: 1.02; 95%CI: 0.79-1.30. Teicoplaninhad lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92, red mansyndrome (RR: 0.21; 95%CI: 0.08-0.59 and total adverse events (RR:0.73; 95%CI: 0.53-1.00. Teicoplanin reduced the risk of nephrotoxicity(RR: 0.66; 95%CI: 0.48-0.90. This effect was consistent for patientsreceiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88 or havingvancomycin doses corrected by serum levels (RR: 0.22; 95%CI:0.10-0.52. There were no cases of acute kidney injury needingdialysis. Limitations: Studies lacked a standardized definition fornephrotoxicity. Conclusions: Teicoplanin and vancomycin are equallyeffective; however the incidence of nephrotoxicity and other adverseevents was lower with teicoplanin. It may be reasonable to considerteicoplanin for patients at higher risk for acute kidney injury.

  11. Treatment with epinephrine (adrenaline) in suspected anaphylaxis during anesthesia in Denmark.

    Science.gov (United States)

    Garvey, Lene H; Belhage, Bo; Krøigaard, Mogens; Husum, Bent; Malling, Hans-Jørgen; Mosbech, Holger

    2011-07-01

    Literature on the use of epinephrine in the treatment of anaphylaxis during anesthesia is very limited. The objective of this study was to investigate how often epinephrine is used in the treatment of suspected anaphylaxis during anesthesia in Denmark and whether timing of treatment is important. A retrospective study of 270 patients investigated at the Danish Anaesthesia Allergy Centre after referral due to suspected anaphylaxis during anesthesia was performed. Reactions had been graded by severity: C1, mild reactions; C2, moderate reactions; C3, anaphylactic shock with circulatory instability; C4, cardiac arrest. Use of epinephrine, dosage, route of administration, and time between onset of circulatory instability and epinephrine administration were noted. A total of 122 (45.2%) of referred patients had C3 or C4 reactions; of those, 101 (82.8%) received epinephrine. Route of administration was intravenous in 95 (94%) patients. Median time from onset of reported hypotension to treatment with epinephrine was 10 min (range, 1-70 min). Defining epinephrine treatment less than or equal to 10 min after onset of hypotension as early, and more than 10 min as late, infusion was needed in 12 of 60 patients (20%) treated early versus 12 of 35 patients (34%) treated late (odds ratio, 2.09) (95% confidence interval, 0.81-5.35). Anaphylaxis may be difficult to diagnose during anesthesia, and treatment with epinephrine can be delayed as a consequence. Anaphylaxis should be considered and treated in patients with circulatory instability during anesthesia of no apparent cause who do not respond to the usual treatments.

  12. Added diagnostic value of magnetoencephalography (MEG) in patients suspected for epilepsy, where previous, extensive EEG workup was unrevealing

    DEFF Research Database (Denmark)

    Duez, Lene; Beniczky, Sándor; Tankisi, Hatice

    2016-01-01

    normal EEGs, including sleep-EEG, were prospectively analyzed. The reference standard was inferred from the diagnosis obtained from the medical charts, after at least one-year follow-up. MEG (306-channel, whole-head) and simultaneous EEG (MEG-EEG) was recorded for one hour. The added sensitivity of MEG......OBJECTIVE: To elucidate the possible additional diagnostic yield of MEG in the workup of patients with suspected epilepsy, where repeated EEGs, including sleep-recordings failed to identify abnormalities. METHODS: Fifty-two consecutive patients with clinical suspicion of epilepsy and at least three...

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

    Science.gov (United States)

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

    2013-08-02

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

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

    Science.gov (United States)

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

    2016-05-01

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

  15. 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

  16. [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.

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

    Science.gov (United States)

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

    1988-01-01

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

  18. 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.

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

    Science.gov (United States)

    Bustos B, Raúl; Padilla P, Oslando

    2015-01-01

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

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

    Science.gov (United States)

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

    2011-10-01

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

  1. 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.

  2. Per Object statistical analysis

    DEFF Research Database (Denmark)

    2008-01-01

    This RS code is to do Object-by-Object analysis of each Object's sub-objects, e.g. statistical analysis of an object's individual image data pixels. Statistics, such as percentiles (so-called "quartiles") are derived by the process, but the return of that can only be a Scene Variable, not an Object...... an analysis of the values of the object's pixels in MS-Excel. The shell of the proceedure could also be used for purposes other than just the derivation of Object - Sub-object statistics, e.g. rule-based assigment processes....... Variable. This procedure was developed in order to be able to export objects as ESRI shape data with the 90-percentile of the Hue of each object's pixels as an item in the shape attribute table. This procedure uses a sub-level single pixel chessboard segmentation, loops for each of the objects...

  3. Natural Language Object Retrieval

    OpenAIRE

    Hu, Ronghang; Xu, Huazhe; Rohrbach, Marcus; Feng, Jiashi; Saenko, Kate; Darrell, Trevor

    2015-01-01

    In this paper, we address the task of natural language object retrieval, to localize a target object within a given image based on a natural language query of the object. Natural language object retrieval differs from text-based image retrieval task as it involves spatial information about objects within the scene and global scene context. To address this issue, we propose a novel Spatial Context Recurrent ConvNet (SCRC) model as scoring function on candidate boxes for object retrieval, integ...

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  5. 9 CFR 354.123 - Segregation of suspects on ante-mortem inspection.

    Science.gov (United States)

    2010-01-01

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

  6. 9 CFR 381.72 - Segregation of suspects on ante mortem inspection.

    Science.gov (United States)

    2010-01-01

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

  7. 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

  8. 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.

  9. [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.

  10. 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.

  11. The Drama of Starbirth - new-born stars wreak havoc in their nursery

    Science.gov (United States)

    2011-03-01

    A new image from ESO's Very Large Telescope gives a close-up view of the dramatic effects new-born stars have on the gas and dust from which they formed. Although the stars themselves are not visible, material they have ejected is colliding with the surrounding gas and dust clouds and creating a surreal landscape of glowing arcs, blobs and streaks. The star-forming region NGC 6729 is part of one of the closest stellar nurseries to the Earth and hence one of the best studied. This new image from ESO's Very Large Telescope gives a close-up view of a section of this strange and fascinating region (a wide-field view is available here: eso1027). The data were selected from the ESO archive by Sergey Stepanenko as part of the Hidden Treasures competition [1]. Sergey's picture of NGC 6729 was ranked third in the competition. Stars form deep within molecular clouds and the earliest stages of their development cannot be seen in visible-light telescopes because of obscuration by dust. In this image there are very young stars at the upper left of the picture. Although they cannot be seen directly, the havoc that they have wreaked on their surroundings dominates the picture. High-speed jets of material that travel away from the baby stars at velocities as high as one million kilometres per hour are slamming into the surrounding gas and creating shock waves. These shocks cause the gas to shine and create the strangely coloured glowing arcs and blobs known as Herbig-Haro objects [2]. In this view the Herbig-Haro objects form two lines marking out the probable directions of ejected material. One stretches from the upper left to the lower centre, ending in the bright, circular group of glowing blobs and arcs at the lower centre. The other starts near the left upper edge of the picture and extends towards the centre right. The peculiar scimitar-shaped bright feature at the upper left is probably mostly due to starlight being reflected from dust and is not a Herbig-Haro object. This

  12. Gemini-IFU Spectroscopy of HH 111

    Science.gov (United States)

    Cerqueira, A. H.; Vasconcelos, M. J.; Raga, A. C.; Feitosa, J.; Plana, H.

    2015-03-01

    We present new optical observations of the Herbig-Haro (HH) 111 jet using the Gemini Multi Object Spectrograph in its Integral Field Unit mode. Eight fields of 5\\prime\\prime × 3\\buildrel{\\prime\\prime}\\over{.} 5 have been positioned along and across the HH 111 jet, covering the spatial region from knot E to L in HH 111 (namely, knots E, F, G, H, J, K, and L). We present images and velocity channel maps for the [O i] 6300+6360, Hα, [N ii] 6548+6583, and [S ii] 6716+6730 lines, as well as for the [S ii] 6716/6730 line ratio. We find that the HH 111 jet has an inner region with lower excitation and higher radial velocity, surrounded by a broader region of higher excitation and lower radial velocity. Also, we find higher electron densities at lower radial velocities. These results imply that the HH 111 jet has a fast, axial region with lower velocity shocks surrounded by a lower velocity sheath with higher velocity shocks. Based on observations obtained at the Gemini Observatory, which is operated by the Association of Universities for Research in Astronomy, Inc., under a cooperative agreement with the NSF on behalf of the Gemini partnership: the National Science Foundation (United States), the Science and Technology Facilities Council (United Kingdom), the National Research Council (Canada), CONICYT (Chile), the Australian Research Council (Australia), Ministério da Ciência, Tecnologia e Inovação (Brazil), and Ministerio de Ciencia, Tecnología e Innovación Productiva (Argentina).

  13. A PROPER MOTION STUDY OF THE HARO 6-10 OUTFLOW: EVIDENCE FOR A SUBARCSECOND BINARY

    Energy Technology Data Exchange (ETDEWEB)

    Wilking, Bruce A.; Gerling, Bradley M.; Gibb, Erika [Department of Physics and Astronomy, University of Missouri-St. Louis, 1 University Boulevard, St. Louis, MO 63121 (United States); Marvel, Kevin B. [American Astronomical Society, 2000 Florida Avenue, NW, Suite 400, Washington, DC 20009 (United States); Claussen, Mark J. [National Radio Astronomy Observatory (NRAO), Array Operations Center, P.O. Box 0, 1003 Lopezville Road, Socorro, NM 87801 (United States); Wootten, Alwyn, E-mail: bwilking@umsl.edu, E-mail: bmg5333@truman.edu, E-mail: gibbe@umsl.edu, E-mail: marvel@aas.org, E-mail: mclausse@nrao.edu, E-mail: awootten@nrao.edu [NRAO, 520 Edgemont Road, Charlottesville, VA 22903-2475 (United States)

    2012-07-10

    We present single-dish and very long baseline interferometry observations of an outburst of water maser emission from the young binary system Haro 6-10. Haro 6-10 lies in the Taurus molecular cloud and contains a visible T Tauri star with an infrared companion 1.''3 north. Using the Very Long Baseline Array, we obtained five observations spanning three months and derived absolute positions for 20 distinct maser spots. Three of the masers can be traced over three or more epochs, enabling us to extract absolute proper motions and tangential velocities. We deduce that the masers represent one side of a bipolar outflow that lies nearly in the plane of the sky with an opening angle of {approx}45 Degree-Sign . They are located within 50 mas of the southern component of the binary, the visible T Tauri star Haro 6-10S. The mean position angle on the sky of the maser proper motions ({approx}220 Degree-Sign ) suggests they are related to the previously observed giant Herbig-Haro (HH) flow which includes HH 410, HH 411, HH 412, and HH 184A-E. A previously observed HH jet and extended radio continuum emission (mean position angle of {approx}190 Degree-Sign ) must also originate in the vicinity of Haro 6-10S and represent a second, distinct outflow in this region. We propose that a yet unobserved companion within 150 mas of Haro 6-10S is responsible for the giant HH/maser outflow while the visible star is associated with the HH jet. Despite the presence of H{sub 2} emission in the spectrum of the northern component of the binary, Haro 6-10N, none of outflows/jets can be tied directly to this young stellar object.

  14. HADES code for numerical simulations of high-mach number astrophysical radiative flows

    Science.gov (United States)

    Michaut, C.; Di Menza, L.; Nguyen, H. C.; Bouquet, S. E.; Mancini, M.

    2017-03-01

    The understanding of astrophysical phenomena requires to deal with robust numerical tools in order to handle realistic scales in terms of energy, characteristic lengths and Mach number that cannot be easily reproduced by means of laboratory experiments. In this paper, we present the 2D numerical code HADES for the simulation of realistic astrophysical phenomena in various contexts, first taking into account radiative losses. The version of HADES including a multigroup modeling of radiative transfer will be presented in a forthcoming study. Validation of HADES is performed using several benchmark tests and some realistic applications are discussed. Optically thin radiative loss is modeled by a cooling function in the conservation law of energy. Numerical methods involve the MUSCL-Hancock finite volume scheme as well as HLLC and HLLE Riemann solvers, coupled with a second-order ODE solver by means of Strang splitting algorithm that handles source terms arising from geometrical or radiative contributions, for cartesian or axisymmetric configurations. A good agreement has been observed for all benchmark tests, either in hydrodynamic cases or in radiative cases. Furthermore, an overview of the main astrophysical studies driven with this code is proposed. First, simulations of radiative shocks in accretion columns and supernova remnant dynamics at large timescales including Vishniac instability have improved the understanding of these phenomena. Finally, astrophysical jets are investigated and the influence of the cooling effect on the jet morphology is numerically demonstrated. It is also found that periodic source enables to recover pulsating jets that mimic the structure of Herbig-Haro objects. HADES code has revealed its robustness, especially for the wall-shock test and for the so-called implosion test which turns out to be a severe one since the hydrodynamic variables are self-similar and become infinite at finite time. The simulations have proved the efficiency of

  15. To study the pattern of suspected adverse drug reactions in patients coming to the department of dermatology in Gauhati Medical College and Hospital, Guwahati, Assam, India

    OpenAIRE

    Ajoy Borah; Mangala Lahkar; Binita Singha; Lihite, Ratan J.; Debeeka Hazarika

    2016-01-01

    Background: Cutaneous adverse drug reactions (ADRs) are the commonest ADRs (30-45%) and are responsible for about 2% of hospital admissions. This study was conducted to study the pattern of ADRs coming to the department of dermatology in a Tertiary Health Care Hospital. The objectives of the study were to assess the causality, severity, preventability, age distribution, sex distribution and the reactions occurring. Methods: Cross-sectional study. The suspected adverse drug reactions (ADRs)...

  16. Suggested Cut-Off Values for Vitamin D as a Risk Marker for Total and Cardiac Death in Patients with Suspected Acute Coronary Syndrome

    OpenAIRE

    Naesgaard, Patrycja A.; Ricardo A. León de la Fuente; Nilsen, Stein Tore; Pönitz, Volker; Brügger-Andersen, Trygve; Grundt, Heidi; Staines, Harry; Nilsen, Dennis W.T.

    2016-01-01

    Background Several studies have demonstrated an association between low vitamin D levels and cardiovascular risk. Vitamin D cut-off levels are still under debate. Objectives To assess two cut-off levels, 40 and 70 nmol/L, respectively, for vitamin D measured as 25-hydroxyvitamin D in chest pain patients with suspected acute coronary syndrome. Methods We investigated 1853 patients from coastal-Norway and inland Northern-Argentina. A similar database was used for pooling of d...

  17. SEVA TB ELISA - Multi antigen and antibody assays for serodiagnosis of suspected cases of pulmonary and extra pulmonary tuberculosis in tertiary care hospital -A retrospective study

    Directory of Open Access Journals (Sweden)

    Pranita J Waghmare

    2012-10-01

    Full Text Available Objective: To assess the usefulness of in-house developed multiantigen and antibody assays, in diagnosis of both pulmonary and extra-pulmonary tuberculosis. Method: Clinically suspected cases of 31 pulmonary and 171 extra-pulmonary tuberculosis (TB were screened by ELISA using cocktail (ES-31 + EST-6 antigen and their specific antibodies (anti ES-31 + anti EST-6 IgG for detection of antibody and and antigen (circulating antigen and immune complexed antigen respectively and correlated with antituberculosis therapy in retrospective study. Results: Out of 31 cases of pulmonary TB screened, 15 patients showed ELISA positivity out of which five cases were given antituberculosis therapy. Out of 171 cases of EPTB screened, 76 cases showed ELISA positivity out of which 18 were given antituberculosis therapy. Further 4 EPTB cases which showed AFB negativity were given ATT. The data was further analyzed based on PTB & EPTB, adults and children, OPD and IPD patients to understand false positivity in clinically suspected PTB and EPTB cases. There was significant correlation (108/202 cases with ELISA negativity and no ATT advised in clinically suspected PTB and EPTB patients. Conclusions: In house developed multi antigen and antibody assays have been observed to be quite useful as adjunct test in serodiagnosis of suspected cases of tuberculosis in particular extrapulmonary tuberculosis.

  18. Nasal Methicillin-Resistant Staphylococcus aureus (MRSA) PCR Testing Reduces the Duration of MRSA-Targeted Therapy in Patients with Suspected MRSA Pneumonia.

    Science.gov (United States)

    Baby, Nidhu; Faust, Andrew C; Smith, Terri; Sheperd, Lyndsay A; Knoll, Laura; Goodman, Edward L

    2017-04-01

    The objective of this study was to evaluate the impact of pharmacist-ordered methicillin-resistant Staphylococcus aureus (MRSA) PCR testing on the duration of empirical MRSA-targeted antibiotic therapy in patients with suspected pneumonia. This is a retrospective analysis of patients who received vancomycin or linezolid for suspected pneumonia before and after the implementation of a pharmacist-driven protocol for nasal MRSA PCR testing. Patients were included if they were adults of >18 years of age and initiated on vancomycin or linezolid for suspected MRSA pneumonia. The primary endpoint was the duration of vancomycin or linezolid therapy. After screening 368 patients, 57 patients met inclusion criteria (27 pre-PCR and 30 post-PCR). Baseline characteristics were similar between the two groups, with the majority of patients classified as having health care-associated pneumonia (68.4%). The use of the nasal MRSA PCR test reduced the mean duration of MRSA-targeted therapy by 46.6 h (74.0 ± 48.9 h versus 27.4 ± 18.7 h; 95% confidence interval [CI], 27.3 to 65.8 h; P MRSA PCR testing in patients with suspected MRSA pneumonia reduced the duration of empirical MRSA-targeted therapy by approximately 2 days without increasing adverse clinical outcomes. Copyright © 2017 American Society for Microbiology.

  19. Object reading: text recognition for object recognition

    NARCIS (Netherlands)

    Karaoglu, S.; van Gemert, J.C.; Gevers, T.

    2012-01-01

    We propose to use text recognition to aid in visual object class recognition. To this end we first propose a new algorithm for text detection in natural images. The proposed text detection is based on saliency cues and a context fusion step. The algorithm does not need any parameter tuning and can

  20. Seeing Objects as Faces Enhances Object Detection

    Directory of Open Access Journals (Sweden)

    Kohske Takahashi

    2015-09-01

    Full Text Available The face is a special visual stimulus. Both bottom-up processes for low-level facial features and top-down modulation by face expectations contribute to the advantages of face perception. However, it is hard to dissociate the top-down factors from the bottom-up processes, since facial stimuli mandatorily lead to face awareness. In the present study, using the face pareidolia phenomenon, we demonstrated that face awareness, namely seeing an object as a face, enhances object detection performance. In face pareidolia, some people see a visual stimulus, for example, three dots arranged in V shape, as a face, while others do not. This phenomenon allows us to investigate the effect of face awareness leaving the stimulus per se unchanged. Participants were asked to detect a face target or a triangle target. While target per se was identical between the two tasks, the detection sensitivity was higher when the participants recognized the target as a face. This was the case irrespective of the stimulus eccentricity or the vertical orientation of the stimulus. These results demonstrate that seeing an object as a face facilitates object detection via top-down modulation. The advantages of face perception are, therefore, at least partly, due to face awareness.

  1. A suspected case of autoinduction of voriconazole metabolism in a patient with cerebral aspergillosis

    Directory of Open Access Journals (Sweden)

    Ferguson MJ

    2017-09-01

    Full Text Available Martin J Ferguson,1 Maria L Randles,2 Declan G de Freitas3 1Pharmacy Department, Beaumont Hospital, Beaumont, Dublin, 2Pharmacy Department, Wexford General Hospital, Wexford, 3Department of Transplantation, Urology and Nephrology, Beaumont Hospital Kidney Centre, Dublin, Ireland Objective: This study aims to report a case of accelerated metabolism of voriconazole in a patient with cerebral aspergillosis.Case summary: A 36-year-old woman developed cerebral aspergillosis after immunosuppressive treatment for suspected atypical hemolytic uremic syndrome/thrombotic thrombocytopenic purpura. She was treated with voriconazole using therapeutic drug monitoring to guide dosing. After an initial high level, her dose was reduced, but over the following weeks, she required several dose increases in order to achieve a voriconazole level within the target range. The patient’s dose requirements eventually stabilized at 700 mg twice daily. Cimetidine and omeprazole were added in an effort to inhibit the metabolism of voriconazole.Discussion: The metabolism of voriconazole is known to be highly variable among different patients depending on pharmacogenetic factors; however, an increasing rate of voriconazole metabolism in a single patient over time is not well recognized. Therapeutic drug monitoring of voriconazole in this case facilitated the use of large doses while controlling for toxicity.Conclusion: This case is further evidence of autoinduction in voriconazole metabolism. Therapeutic drug monitoring of voriconazole is useful in detecting variation in a patient’s metabolism of voriconazole over time. Keywords: voriconazole, therapeutic drug monitoring, metabolism, enzyme inhibition, autoinduction 

  2. Reduced-dose abdominopelvic CT using hybrid iterative reconstruction in suspected left-sided colonic diverticulitis

    Energy Technology Data Exchange (ETDEWEB)

    Laqmani, Azien; Dulz, Simon; Behzadi, Cyrus; Schmidt-Holtz, Jakob; Wassenberg, Felicia; Adam, Gerhard; Regier, Marc [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Veldhoen, Simon [University Medical Center Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Derlin, Thorsten [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Sehner, Susanne [University Medical Center Hamburg-Eppendorf, Department of Medical Biometry and Epidemiology, Hamburg (Germany); Nagel, Hans-Dieter [Scientific and Application-oriented Studies and Consulting in Radiology (SASCRAD), Buchholz (Germany)

    2016-01-15

    To assess the effect of hybrid iterative reconstruction (HIR) and filtered back projection (FBP) on abdominopelvic CT with reduced-dose (RD-APCT) in the evaluation of acute left-sided colonic diverticulitis (ALCD). Twenty-five consecutive patients with suspected ALCD who underwent RD-APCT (mean CTDIvol 11.2 ± 4.2 mGy) were enrolled in this study. Raw data were reconstructed using FBP and two increasing HIR levels, L4 and L6. Two radiologists assessed image quality, image noise and reviewer confidence in interpreting findings of ALCD, including wall thickening, pericolic fat inflammation, pericolic abscess, and contained or free extraluminal air. Objective image noise (OIN) was measured. OIN was reduced up to 54 % with HIR compared to FBP. Subjective image quality of HIR images was superior to FBP; subjective image noise was reduced. The detection rate of extraluminal air was higher with HIR L6. Reviewer confidence in interpreting CT findings of ALCD significantly improved with application of HIR. RD-APCT with HIR offers superior image quality and lower image noise compared to FBP, allowing a high level of reviewer confidence in interpreting CT findings in ALCD. HIR facilitates detection of ALCD findings that may be missed with the FBP algorithm. (orig.)

  3. Study of the frequency of allergens in cosmetics components in patients with suspected allergic contact dermatitis.

    Science.gov (United States)

    Silva, Eliane Aparecida; Bosco, Marcia Regina Miras; Mozer, Erika

    2012-01-01

    Contact dermatitis to cosmetics is a common dermatosis, especially in adults and professionals who handle them. The objective of this study was to evaluate the frequency of sensitization to cosmetics' components in patients with suspected allergic contact dermatitis and to identify the main sensitizers related to occupational contact dermatitis. During the period of January 2008 to June 2010, all the patients with a presumptive diagnosis of allergic contact dermatitis to cosmetics were selected. The patients were submitted to the patch tests of cosmetics series, composed by ten substances. Among the 147 patients studied sensitization to cosmetics components occurred in 31,29% of the cases, 14 of those (19,18%) equally corresponding to BHT and triethanolamine substances, 13 (17,81%) to ammonium thioglycolate, 09 to sorbic acid (12,33%), 08 to tosilamida (10,95%), 06 to germall (8,22%). The other elements tested showed indices of 5% or less. A higher frequency of contact dermatitis to cosmetics was observed in women and the age most affected was concordant with the age range of greatest professional activity of the population. Allergic contact dermatitis was more frequently associated with Triethanolamine, BHT and ammonium thioglycolate, and the relation with occupational contact dermatitis was discreet.

  4. Individual serological follow-up of patients with suspected or confirmed abdominal angiostrongyliasis

    Directory of Open Access Journals (Sweden)

    Penélope E Palominos

    2008-02-01

    Full Text Available Abdominal angiostrongyliasis (AA is a zoonotic nematode infection caused by Angiostrongylus costaricensis, with widespread occurrence in the Americas. Although the human infection may be highly prevalent, morbidity is low in Southern Brazil. Confirmed diagnosis is based on finding parasitic structures in pathological examination of biopsies or surgical resections. Serology stands as an important diagnostic tool in the less severe courses of the infection. Our objective is to describe the follow up of humoral reactivity every 2-4 weeks up to one year, in six individuals with confirmed (C and ten suspected (S AA. Antibody (IgG detection was performed by ELISA and resulted in gradually declining curves of reactivity in nine subjects (56% (4C + 5S, that were consistently negative in only three of them (2C + 1S after 221, 121 and 298 days. Three individuals (2C + 1S presented with low persistent reacitivity, other two (1C + 1S were serologically negative from the beginning, but also presenting a declining tendency. The study shows indications that abdominal angiostrongyliasis is usually not a persistent infection: although serological negativation may take many months, IgG reactivity is usually declining along time and serum samples pairing may add valuable information to the diagnostic workout.

  5. Initial diagnostic errors in children suspected of having heart disease: prevalence and long-term consequences

    Directory of Open Access Journals (Sweden)

    Fernando Amaral

    2003-08-01

    Full Text Available OBJECTIVE: To access the incidence of diagnostic errors in the initial evaluation of children with cardiac murmurs. METHODS: We evaluated our 7-years of experience in a public pediatric cardiology outpatient clinic. Of 3692 patients who were sent to the hospital, 2603 presented with a heart murmur and were investigated. Patients for whom a disagreement existed between the initial and final diagnoses were divided into the following 2 groups: G1 (n=17 with an initial diagnosis of an innocent murmur and a final diagnosis of cardiopathy, and G2 (n=161 with an initial diagnosis of cardiopathy and a final diagnosis of a normal heart. RESULTS: In G1, the great majority of patients had cardiac defects with mild hemodynamic repercussions, such as small ventricular septal defect and mild pulmonary stenosis. In G2, the great majority of structural defects were interventricular communication, atrial septal defect and pulmonary valve stenosis. CONCLUSION: A global analysis demonstrated that diagnostic error in the initial evaluation of children with cardiac murmurs is real, reaching approximately 6% of cases. The majority of these misdiagnoses were in patients with an initial diagnosis of cardiopathy, which was not confirmed through later complementary examinations. Clinical cardiovascular examination is an excellent resource in the evaluation of children suspected of having cardiopathy. Immediate outpatient discharge of children with an initial diagnosis of an innocent heart murmur seems to be a suitable approach.

  6. STT Doubles with Large Delta_M - Objects Nearby

    Science.gov (United States)

    Nanson, John; Knapp, Wilfried

    2017-07-01

    Following our series of reports on STT doubles with large delta_M, we are submitting measurements of WDS objects which were by chance found nearby in the images taken of the STT doubles. In these cases we did not suspect any issues with the current WDS catalog data, but wanted to make use of existing image material as any double star visited is worth a current measurement.

  7. Choosing for learning objects

    NARCIS (Netherlands)

    Schoonenboom, Judith; Emans, Bruno; Meijer, Joost

    2006-01-01

    Choosing for learning objects discusses eight educational ambitions and the possible roles of learning objects in realising these ambitions. The eight educational ambitions are: (1) Creating independent learning pathways, for example for lifelong learners; (2) Making education more flexible; (3)

  8. Enhancing communication about paediatric medicines: lessons from a qualitative study of parents' experiences of their child's suspected adverse drug reaction.

    Directory of Open Access Journals (Sweden)

    Janine Arnott

    Full Text Available BACKGROUND: There is little research on parents' experiences of suspected adverse drug reactions in their children and hence little evidence to guide clinicians when communicating with families about problems associated with medicines. OBJECTIVE: To identify any unmet information and communication needs described by parents whose child had a suspected adverse drug reaction. METHODS: Semi-structured qualitative interviews with parents of 44 children who had a suspected adverse drug reaction identified on hospital admission, during in-patient treatment or reported by parents using the Yellow Card Scheme (the UK system for collecting spontaneous reports of adverse drug reactions. Interviews were conducted face-to-face or by telephone; most interviews were audiorecorded and transcribed. Analysis was informed by the principles of the constant comparative method. RESULTS: Many parents described being dissatisfied with how clinicians communicated about adverse drug reactions and unclear about the implications for their child's future use of medicines. A few parents felt that clinicians had abandoned their child and reported refusing the use of further medicines because they feared a repeated adverse drug reaction. The accounts of parents of children with cancer were different. They emphasised their confidence in clinicians' management of adverse drug reactions and described how clinicians prospectively explained the risks associated with medicines. Parents linked symptoms to medicines in ways that resembled the established reasoning that clinicians use to evaluate the possibility that a medicine has caused an adverse drug reaction. CONCLUSION: Clinicians' communication about adverse drug reactions was poor from the perspective of parents, indicating that improvements are needed. The accounts of parents of children with cancer indicate that prospective explanation about adverse drug reactions at the time of prescription can be effective. Convergence

  9. Accuracy and interobserver agreement between MR-non-expert radiologists and MR-experts in reading MRI for suspected appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Leeuwenburgh, Marjolein M.N., E-mail: m.m.leeuwenburgh@amc.uva.nl [Department of Surgery, Academic Medical Center, University of Amsterdam (Netherlands); Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands); Wiarda, Bart M. [Department of Radiology, Alkmaar Medical Center, Alkmaar (Netherlands); Jensch, Sebastiaan [Department of Radiology, Sint Lucas Andreas Hospital, Amsterdam (Netherlands); Wouter van Es, H. [Department of Radiology, Sint Antonius Hospital, Nieuwegein (Netherlands); Stockmann, Hein B.A.C. [Department of Surgery, Kennemer Gasthuis, Haarlem (Netherlands); Gratama, Jan Willem C. [Department of Radiology, Gelre Hospitals, Apeldoorn (Netherlands); Cobben, Lodewijk P.J. [Department of Radiology, Haaglanden Medical Center, Leidschendam (Netherlands); Bossuyt, Patrick M.M. [Department of Clinical Epidemiology, Academic Medical Center, University of Amsterdam (Netherlands); Boermeester, Marja A. [Department of Surgery, Academic Medical Center, University of Amsterdam (Netherlands); Stoker, Jaap [Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands)

    2014-01-15

    Objective: To compare accuracy and interobserver agreement between radiologists with limited experience in the evaluation of abdominal MRI (non-experts), and radiologists with longer MR reading experience (experts), in reading MRI in patients with suspected appendicitis. Methods: MR imaging was performed in 223 adult patients with suspected appendicitis and read independently by two members of a team of eight MR-inexperienced radiologists, who were trained with 100 MR examinations previous to this study (non-expert reading). Expert reading was performed by two radiologists with a larger abdominal MR experience (>500 examinations) in consensus. A final diagnosis was assigned after three months based on all available information, except MRI findings. We estimated MRI sensitivity and specificity for appendicitis and for all urgent diagnoses separately. Interobserver agreement was evaluated using kappa statistics. Results: Urgent diagnoses were assigned to 147 of 223 patients; 117 had appendicitis. Sensitivity for appendicitis was 0.89 by MR-non-expert radiologists and 0.97 in MR-expert reading (p = 0.01). Specificity was 0.83 for MR-non-experts versus 0.93 for MR-expert reading (p = 0.002). MR-experts and MR-non-experts agreed on appendicitis in 89% of cases (kappa 0.78). Accuracy in detecting urgent diagnoses was significantly lower in MR-non-experts compared to MR-expert reading: sensitivity 0.84 versus 0.95 (p < 0.001) and specificity 0.71 versus 0.82 (p = 0.03), respectively. Agreement on urgent diagnoses was 83% (kappa 0.63). Conclusion: MR-non-experts have sufficient sensitivity in reading MRI in patients with suspected appendicitis, with good agreement with MR-expert reading, but accuracy of MR-expert reading was higher.

  10. Behavioral Objectives for English

    Science.gov (United States)

    Zoellner, Robert

    1972-01-01

    A review-critique of On Writing Behavioral Objectives for English, by John Maxwell and Anthony Lovat, in which behavioral objectives theory is dominated by a stimulus-response rather than a stimulus-response-reinforcement psychology. The reviewer questions whether behavioral objectives can be applied accurately and without distortion of meanings,…

  11. Objects in Motion

    Science.gov (United States)

    Damonte, Kathleen

    2004-01-01

    One thing scientists study is how objects move. A famous scientist named Sir Isaac Newton (1642-1727) spent a lot of time observing objects in motion and came up with three laws that describe how things move. This explanation only deals with the first of his three laws of motion. Newton's First Law of Motion says that moving objects will continue…

  12. Survivability via Control Objectives

    Energy Technology Data Exchange (ETDEWEB)

    CAMPBELL,PHILIP L.

    2000-08-11

    Control objectives open an additional front in the survivability battle. A given set of control objectives is valuable if it represents good practices, it is complete (it covers all the necessary areas), and it is auditable. CobiT and BS 7799 are two examples of control objective sets.

  13. On the Crime Object

    Science.gov (United States)

    Akutaev, Rasul M.; Magomedov, Guseyn B.

    2016-01-01

    The relevance of the research of this problem is caused by the theoretical and practical needs of a specific concept of the crime object as one of the corpus delicti signs essentially the determining and defining its object and objective side, thereby--the nature of socially dangerous act. Besides, being a facultative sign of corpus delicti, the…

  14. Differential diagnosis of suspected multiple sclerosis: a consensus approach

    NARCIS (Netherlands)

    Miller, D. H.; Weinshenker, B.G.; Filippi, M.; Banwell, B.L.; Cohen, J.A.; Freedman, M.S.; Galetta, S.L.; Hutchinson, M.; Johnson, R.T.; Kappos, L.; Kira, J.; Lublin, F.D.; McFarland, H.F.; Montalban, X.; Panitch, H.; Richert, J.R.; Reingold, S.C.; Polman, C.H.

    2008-01-01

    Background and objectives: Diagnosis of multiple sclerosis (MS) requires exclusion of diseases that could better explain the clinical and paraclinical findings. A systematic process for exclusion of alternative diagnoses has not been defined. An International Panel of MS experts developed consensus

  15. High rate of benign histology in radiologically suspect renal lesions

    DEFF Research Database (Denmark)

    Lindkvist Pedersen, Christina; Winck-Flyvholm, Lili; Dahl, Claus

    2014-01-01

    INTRODUCTION: The objective of this study was to determine the incidence of benign renal lesions for clinically localised renal masses and the need for new diagnostic procedures to assess these lesions. MATERIAL AND METHODS: This retrospective study included patients who underwent partial or radi...

  16. Colorectal cancer in South Africa: A heritable cause suspected in ...

    African Journals Online (AJOL)

    Background. Colorectal carcinoma (CRC) has a low incidence among the black African population. Largely unrecognised in the scientific literature is the fact that a disproportionately large number of young black patients (<50 years old) present with CRC. Objectives. To analyse those tumours, which we propose may link ...

  17. EMS runs for suspected opioid overdose: implications for surveillance and prevention.

    Science.gov (United States)

    Knowlton, Amy; Weir, Brian W; Hazzard, Frank; Olsen, Yngvild; McWilliams, Junette; Fields, Julie; Gaasch, Wade

    2013-01-01

    Opioid (including prescription opiate) abuse and overdose rates in the United States have surged in the past decade. The dearth and limitations of opioid abuse and overdose surveillance systems impede the development of interventions to address this epidemic. Objective. We explored evidence to support the validity of emergency medical services (EMS) data on naloxone administration as a possible proxy for estimating incidence of opioid overdose. We reviewed data from Baltimore City Fire Department EMS patient records matched with dispatch records over a 13-month time period (2008-2009) based on 2008 Census data. We calculated incidence rates and patient demographic and temporal patterns of naloxone administration, and examined patient evaluation data associated with naloxone administration. Results were compared with the demographic distributions of the EMS patient and city populations and with prior study findings. Of 116,910 EMS incidents during the study period for patients aged 15 years and older, EMS providers administered naloxone 1,297 times (1.1% of incidents), an average of 100 administrations per month. The overall incidence was 1.87 administrations per 1,000 residents per year. Findings indicated that naloxone administration peaked in the summer months (31% of administrations), on weekends (32%), and in the late afternoon (4:00-5:00 pm [8%]); and there was a trend toward peaking in the first week of the month. The incidence of suspected opioid overdose was highest among male patients, white patients, and those in the 45-54-year age group. Findings on temporal patterns were comparable with findings from prior studies. Demographic patterns of suspected opioid overdose were similar to medical examiner reports of demographic patterns of fatal drug- or alcohol-related overdoses in Baltimore in 2008-2009 (88% of which involved opioids). The findings on patient evaluation data suggest some inconsistencies with previously recommended clinical indications of

  18. 'Chest pain typicality' in suspected acute coronary syndromes and the impact of clinical experience.

    Science.gov (United States)

    Carlton, Edward W; Than, Martin; Cullen, Louise; Khattab, Ahmed; Greaves, Kim

    2015-10-01

    Physicians rely upon chest pain history to make management decisions in patients with suspected acute coronary syndromes, particularly where the diagnosis is not immediately apparent through electrocardiography and troponin testing. The objective of this study was to establish the discriminatory value of "typicality of chest pain" and the effect of clinician experience, for the prediction of acute myocardial infarction and presence of significant coronary artery disease. This prospective single-center observational study was undertaken in a UK General Hospital emergency department. We recruited consecutive adults with chest pain and a nondiagnostic electrocardiogram, for whom the treating physician determined that delayed troponin testing was necessary. Using their own clinical judgment, physicians recorded whether the chest pain described was typical or atypical for acute coronary syndrome. Physicians were defined as "experienced" or "novice" according to postgraduate experience. Acute myocardial infarction was adjudicated using a high-sensitivity troponin (hs-cTn) assay, whereas coronary artery disease was adjudicated angiographically. Overall, 912 patients had typicality of chest pain assessed, of whom 114/912 (12.5%) had an acute myocardial infarction and 157/912 (17.2%) underwent angiography. In patients undergoing angiography, 90/157 (57.3%) had hs-cTn elevation, of whom 60 (66.7%) had significant coronary artery disease. Sixty-seven of 157 (42.7%) patients had angiography without hs-cTn elevation; of these, 31 (46.2%) had significant coronary artery disease. For the diagnosis of acute myocardial infarction, chest pain typicality had an area under the curve (AUC) of 0.54 (95% confidence interval [CI], 0.49-0.60). For the prediction of significant coronary artery disease with hs-cTn elevation AUC: 0.54 (95% CI, 0.40-0.67), and without hs-cTn elevation AUC: 0.45 (95% CI, 0.31-0.59). When assessed by experienced physicians, specificity for the diagnosis of acute

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

    Directory of Open Access Journals (Sweden)

    Kotru Mrinalini

    2007-01-01

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

  20. Suspected alcohol and addictive narcotic use were more at risk to severe head injury

    Directory of Open Access Journals (Sweden)

    Woro Riyadina

    2012-07-01

    Full Text Available Latar belakang: Cedera kepala menyebabkan dampak seperti gangguan kognitif, perilaku dan keterbatasan fisik. Tujuan studi ini untuk menentukan faktor utama yang berkontribusi terhadap keparahan cedera kepala pada pasien yang dirawat inap di rumah sakit. Metode: Studi ini merupakan bagian dari penelitian “Pengembangan Database Registri Trauma sebagai Penunjang Sistem Surveilans Cedera”. Data dikumpulkan dengan cara abstraksi dari rekam medis oleh petugas terlatih dengan formulir registri pada pasien cedera yang dirawat inap di 3 rumah sakit dari bulan Januari – Agustus 2010. Keparahan cedera diklasifikasikan berdasarkan Glasgow Coma Scale (GCS dengan batasan nilai 3-9 mengalami cedera kepala berat, 10-12 cedera kepala sedang dan 13-15 cedera kepala ringan. Hasil: Dari 450 pasien cedera rawat inap terdapat 36 pasien (8% yang mengalami cedera kepala berat. Pasien dengan indikasi mengkonsumsi alkohol/narkotik mempunyai risiko hampir 5 kali mengalami cedera kepala berat [rasio odds suaian (ORa = 4,77; 95% interval kepercayaan (CI=1,04–21,75] dibanding tanpa indikasi. Pasien yang tidak dirujuk mempunyai risiko 5,5 kali  mengalami cedera kepala berat (ORa=5,50; 95% CI=2,28–13,27 dibanding pasien yang dirujuk. Pasien cedera karena kecelakaaan lalu lintas dibanding bukan kecelakaan lalu lintas mempunyai risiko 3 kali mengalami cedera kepala berat (ORa=3,43; 95% CI=1,14–10,32. Kesimpulan: Indikasi mengkonsumsi alkohol/narkotik berkontribusi paling besar terhadap keparahan cedera kepala. Kampanye anti alkohol/narkotik dan perlu dilakukan untuk mencegah cedera kepala berat. (Health Science Indones 2011;2:34-40   Abstract Background: The impact of head injuries were cognitive disorder, behavioral disorder and physical limitation. The objective of this study was to identify a major factor that contributes to head injury severity in hospitalized patients. Methods: This study was part of research "Development of Trauma Registry Databases as a

  1. Objects, materiality and meaning

    DEFF Research Database (Denmark)

    Lenau, Torben Anker; Lindegaard, Hanne

    2008-01-01

    of the object, and the designers aim is therefore to tune both in order to achieve a desired goal. To do so the designer basically has 2 options: Alteration of the physical shape of the object and the selection of materials. Through the manipulation of shape and materials can symbolic and sensory information......The present research work investigates the relation between physical objects, their materiality, understood as the physical substances they are made from, and the communication from the objects. In product design of physical objects the communicative aspects are just as important as the function...... be written into the object. The materials are therefore carriers of communication, even though this is dependent of the cultural context and the environment which the object will be part of. However the designer has only minor influence on those....

  2. Abstract Objects of Verbs

    DEFF Research Database (Denmark)

    2014-01-01

    Verbs do often take arguments of quite different types. In an orthodox type-theoretic framework this results in an extreme polysemy of many verbs. In this article, it is shown that this unwanted consequence can be avoided when a theory of "abstract objects" is adopted according to which...... these objects represent non-objectual entities in contexts from which they are excluded by type restrictions. Thus these objects are "abstract'' in a functional rather than in an ontological sense: they function as representatives of other entities but they are otherwise quite normal objects. Three examples...... of such a representation are considered: the denotations of that-phrases are objects representing propositions, generic noun phrases denote objects standing for sorts, and infinitivals are viewed as denoting objects representing attributes, i.e., the "ordinary'' meanings of verb phrases....

  3. Frequency and Clinical Manifestations of Scabies in Suspected Patients Referred to Health Centers of Kashan, Central Iran (2010 - 2014

    Directory of Open Access Journals (Sweden)

    Sima Rasti

    2017-02-01

    Full Text Available Background Scabies is one of the most common itching contagious skin disorder in the world. The agent of disease is Sarcoptes scabiei. Objectives This study was conducted to determine the frequency and clinical manifestations of S. scabies in suspected patients referred to health centers of Kashan during 2010 - 2014. Methods This cross-sectional study was performed on 129 patients suspected to Sarcoptes scabiei. The demographic and clinical symptoms for each of patients were recorded in questionnaire by interview. A deep skin scrap was prepared and wet smear were prepared using 10% KOH. By observation of each form of Sarcoptes was identified as positive sample. The data were recorded in Spss. ver 16.5 and analyzed by X2 and fisher exact tests. Results The results of this study showed that 28 (21.7 % were Sarcoptes positive. The frequency of sarcoptes was higher in males (23% than females (20.6%. The difference was not statistically significant. The most cases were isolated in spring and winter. Sarcoptes infestation was the most in elderly and patients undergone dialysis. There is significant difference between disease and age group and underlying disease (P = 0.03, P = 0.014; respectively. Erosion or pustule was the most clinical signs in positive cases. Conclusions The results of study showed that the rate of scabies infestation in Kashan is relatively high, and the most cases were in elderly patients. Health education to increase awareness of the families for prevention of scabies was recommended.

  4. Early object relations into new objects.

    Science.gov (United States)

    Downey, T W

    2001-01-01

    Two strands of change are suggested by this review, one maturational, the other therapeutic or developmental (Hartmann and Kris, 1945). By "maturational" I mean to suggest energies that infuse the individual from earliest life in a manner that includes object relations, but for the healthy exercise of which object relations per se need not be of central and crucial importance. Within wide limits such energies may be delayed until growth conditions prevail without significant distortion of certain of the organism's ego functions. Therapeutic change is analogous to developmental change in that both involve the crucial presence of another to release energies. In therapeutic change these are energies that have been repressed beyond the reach of developmental dynamics. In everyday development crisis and synthesis alternate in conjunction with new and emerging objects to add to the psychological structures brought to the fore by maturation. In many instances, as we see with John, over time and in a less focussed manner, developmental changes can approximate therapeutic change and visa versa. Freud-Dann in their "experiment" pursued one line, in which the equipmental delay brought on by extremely adverse living circumstances was redressed by providing an interpersonally enriching, loving, developmentally facilitating milieu. The sketches of individual children and John's subsequent story provide a perspective into what becomes the stuff of growth and what remains the stuff of neurosis. The developmental reserves and ego resilience of these children were impressive but probably not extraordinary. Usual growth ensued as soon as they were provided with the rich soil of Bulldogs Bank instead of the desert sand of the Tereszin concentration camp. However, no one can escape such adverse circumstances without having taken in the stuff of neurosis. Affects and percepts that were not assimilatable or even available to consciousness at the time remain buried in the unconscious

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Data.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Widagdo Sri Nugroho

    2008-06-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  12. 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

  13. 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

  14. Cultivating objects in interaction

    DEFF Research Database (Denmark)

    Hazel, Spencer

    2014-01-01

    the interactional resources which mundane everyday objects provide interactants in the multimodal design of their turns-at-talk. Although the objects which feature in the data – for example notepads, tables, computer monitors – have practical functions within the social ecology of these institutional settings......This paper demonstrates how an initial indexing of objects through gesture and talk provides a residual basis for later indexical development across a stretch of discourse. I show how participants are able to perform an initial mobilization of affordances (Hutchby, 2001) of objects in the immediate...... surround through a combination of vocal, visual and tactile means; once indexed one way, these objects are subsequently recycled in later multimodal turn design. By tracking recurrent participant orientations to particular objects made relevant in the surround, we are able to explore further...

  15. Confinement for Active Objects

    OpenAIRE

    Florian Kammuller

    2014-01-01

    In this paper, we provide a formal framework for the security of distributed active objects. Active objects com-municate asynchronously implementing method calls via futures. We base the formal framework on a security model that uses a semi-lattice to enable multi-lateral security crucial for distributed architectures. We further provide a security type system for the programming model ASPfun of functional active objects. Type safety and a confinement property are presented. ASPfun thus reali...

  16. 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...

  17. Objective-C

    CERN Document Server

    DeVoe, Jiva

    2011-01-01

    A soup-to-nuts guide on the Objective-C programming language. Objective-C is the language behind Cocoa and Cocoa Touch, which is the Framework of applications written for the Macintosh, iPod touch, iPhone, and iPad platforms. Part of the Developer Reference series covering the hottest Apple topics, this book covers everything from the basics of the C language to advanced aspects of Apple development. You'll examine Objective-C and high-level subjects of frameworks, threading, networking, and much more.: Covers the basics of the C language and then quickly moves onto Objective-C and more advanc

  18. Abstract Objects of Verbs

    DEFF Research Database (Denmark)

    Robering, Klaus

    2014-01-01

    Verbs do often take arguments of quite different types. In an orthodox type-theoretic framework this results in an extreme polysemy of many verbs. In this article, it is shown that this unwanted consequence can be avoided when a theory of "abstract objects" is adopted according to which...... of such a representation are considered: the denotations of that-phrases are objects representing propositions, generic noun phrases denote objects standing for sorts, and infinitivals are viewed as denoting objects representing attributes, i.e., the "ordinary'' meanings of verb phrases....

  19. Predictive value of routine point-of-care cardiac troponin T measurement for prehospital diagnosis and risk-stratification in patients with suspected acute myocardial infarction

    DEFF Research Database (Denmark)

    Rasmussen, Martin B; Stengaard, Carsten; Sørensen, Jacob T

    2017-01-01

    OBJECTIVE: The purpose of this study was to determine the predictive value of routine prehospital point-of-care cardiac troponin T measurement for diagnosis and risk stratification of patients with suspected acute myocardial infarction. METHODS AND RESULTS: All prehospital emergency medical servi...... irrespective of the final diagnosis. Routine troponin measurement in the prehospital setting has a high predictive value and can be used to identify high-risk patients even before hospital arrival so that they may be re-routed directly for advanced care at an invasive centre.......OBJECTIVE: The purpose of this study was to determine the predictive value of routine prehospital point-of-care cardiac troponin T measurement for diagnosis and risk stratification of patients with suspected acute myocardial infarction. METHODS AND RESULTS: All prehospital emergency medical service...... vehicles in the Central Denmark Region were equipped with a point-of-care cardiac troponin T device (Roche Cobas h232) for routine use in all patients with a suspected acute myocardial infarction. During the study period, 1 June 2012-30 November 2015, prehospital point-of-care cardiac troponin T...

  20. 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...

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

    Science.gov (United States)

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

    2009-03-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

  5. What are Objects?

    Indian Academy of Sciences (India)

    Obj ect oriented development of software systems is becom- ing de-facto standard in large software projects. This article explains the motivation behind object orientation and how it promotes the use of software components. Objects as Reusable Subsystems. Can you imagine, designing afresh and fabricating every unit.

  6. Cultivating objects in interaction

    DEFF Research Database (Denmark)

    Hazel, Spencer

    2014-01-01

    is chapter explores patterns of repeated orientations to physical objects in interactants’ visuo-spatial and haptic surround. A number of examples are presented from advice-giving activities in various institutional settings, where participants-in-interaction initially draw on material objects at...

  7. Haptic object individuation

    NARCIS (Netherlands)

    Plaisier, M.A.; Bergmann Tiest, W.M.; Kappers, A.M.L.

    2010-01-01

    Item individuation, i.e., how we decide which parts belong to one object and which to another, is an important aspect of haptic perception and may be important for design of interfaces in which different buttons have to be distinguished. We daily hold several objects in our hand. Somehow, we decide

  8. Conscience and Conscientious Objections

    NARCIS (Netherlands)

    Schinkel, Anders

    2007-01-01

    In Western countries conscientious objection is usually accommodated in various ways, at least in certain areas (military conscription, medicine) and to some extent. It appears to be regarded as fundamentally different from other kinds of objection. But why? This study argues that conscientious

  9. Modelling Digital Media Objects

    DEFF Research Database (Denmark)

    Troelsgaard, Rasmus

    The goal of this thesis is to investigate two relevant issues regarding computational representation and classification of digital multi-media objects. With a special focus on music, a model for representation of objects comprising multiple heterogeneous data types is investigated. Necessary...

  10. On object-orientation

    NARCIS (Netherlands)

    Diertens, B.

    2010-01-01

    Although object-orientation has been around for several decades, its key concept abstraction has not been exploited for proper application of object-orientation in other phases of software development than the implementation phase. We mention some issues that lead to a lot of confusion and obscurity

  11. Simultanagnosia and object individuation.

    Science.gov (United States)

    Mazza, Veronica

    2017-06-06

    Simultanagnosic patients have difficulty in perceiving multiple objects when presented simultaneously. In this review article, I discuss how neuropsychological research on simultanagnosia has been inspirational for two interconnected lines of research related to the core mechanisms by which the visual system processes cluttered scenes. First, I review previous studies on enumeration tasks indicating that, despite their inability to identify multiple objects, simultanagnosic patients can enumerate up to 2-3 elements as efficiently as healthy individuals (the so-called "subitizing" phenomenon). This intriguing observation is one of the first results to support the existence of an "object individuation" mechanism that can spatially tag a limited set of objects simultaneously, and resonates with recent research on the brain dynamics of enumeration in healthy individuals. Second, I further develop the implications of the dissociation between object identification and object enumeration in simultanagnosia specifically for the distinction between object identification and individuation. The latter distinction has been the subject of recent neuroimaging research that has provided fine-grained information on the spatial as well as temporal aspects of object individuation and recognition. The lessons learned from neuropsychological research on exact enumeration in simultanagnosia can be generalized to the normal functioning of the human mind, and have provided insightful clues for cognitive neuroscience.

  12. Near Earth Objects

    DEFF Research Database (Denmark)

    Wolff, Stefan

    2006-01-01

    , Near Earth Objects: Asteroids and comets following paths that bring them near the Earth. NEOs have collided with the Earth since its formation, some causing local devastation, some causing global climate changes, yet the threat from a collision with a near Earth object has only recently been recognised...

  13. Programs as Data Objects

    DEFF Research Database (Denmark)

    This book constitutes the refereed proceedings of the Second Symposium on Programs as Data Objects, PADO 2001, held in Aarhus, Denmark, in May 2001. The 14 revised full papers presented were carefully reviewed and selected from 30 submissions. Various aspects of looking at programs as data objects...... are covered from the point of view of program analysis, program transformation, computational complexity, etc....

  14. Gamifying Video Object Segmentation.

    Science.gov (United States)

    Spampinato, Concetto; Palazzo, Simone; Giordano, Daniela

    2017-10-01

    Video object segmentation can be considered as one of the most challenging computer vision problems. Indeed, so far, no existing solution is able to effectively deal with the peculiarities of real-world videos, especially in cases of articulated motion and object occlusions; limitations that appear more evident when we compare the performance of automated methods with the human one. However, manually segmenting objects in videos is largely impractical as it requires a lot of time and concentration. To address this problem, in this paper we propose an interactive video object segmentation method, which exploits, on one hand, the capability of humans to identify correctly objects in visual scenes, and on the other hand, the collective human brainpower to solve challenging and large-scale tasks. In particular, our method relies on a game with a purpose to collect human inputs on object locations, followed by an accurate segmentation phase achieved by optimizing an energy function encoding spatial and temporal constraints between object regions as well as human-provided location priors. Performance analysis carried out on complex video benchmarks, and exploiting data provided by over 60 users, demonstrated that our method shows a better trade-off between annotation times and segmentation accuracy than interactive video annotation and automated video object segmentation approaches.

  15. Beginning Objective-C

    CERN Document Server

    Dovey, James

    2012-01-01

    Objective-C is today's fastest growing programming language, at least in part due to the popularity of Apple's Mac, iPhone and iPad. Beginning Objective-C is for you if you have some programming experience, but you're new to the Objective-C programming language and you want a modern-and fast-way forwards to your own coding projects. Beginning Objective-C offers you a modern programmer's perspective on Objective-C courtesy of two of the best iOS and Mac developers in the field today, and gets you programming to the best of your ability in this important language.  It gets you rolling fast into

  16. Space Object Query Tool

    Science.gov (United States)

    Phillips, Veronica J.

    2017-01-01

    STI is for a fact sheet on the Space Object Query Tool being created by the MDC. When planning launches, NASA must first factor in the tens of thousands of objects already in orbit around the Earth. The number of human-made objects, including nonfunctional spacecraft, abandoned launch vehicle stages, mission-related debris and fragmentation debris orbiting Earth has grown steadily since Sputnik 1 was launched in 1957. Currently, the U.S. Department of Defenses Joint Space Operations Center, or JSpOC, tracks over 15,000 distinct objects and provides data for more than 40,000 objects via its Space-Track program, found at space-track.org.

  17. Guidelines for skeletal surveys in Suspected Child Abuse

    DEFF Research Database (Denmark)

    Mussmann, Bo

    Purpose/Objective Child abuse imaging differs from general musculoskeletal imaging in the demands for low noise. The consequences of misdiagnosis are serious. The images are directly involved in legal processes and the child and the family faces major consequences if the images are not adequate....... If head trauma or fractures are overlooked, or if the radiological diagnosis is uncertain, abused children may be sent home with violent parents or caregivers. If no abuse has taken place, and the certainty of the diagnosis is questionable, it may result in prolonged hospitalization of an innocent family....... In many cases supplement images or a complete reexamination of the child were needed in order to state a second opinion, resulting in unnecessary excess radiation dose. Materials and methods A literature review was performed and the results were discussed at an initial meeting at Odense University...

  18. Diagnosing Sporadic Creutzfeldt-Jakob Disease in a Patient with a Suspected Status Epilepticus in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Harm J. van der Horn

    2013-01-01

    Full Text Available Objective. Several tests are available in the diagnostics of sporadic Creutzfeldt-Jakob disease (sCJD; however, none of these is conclusive. We review the values of these tests, from an intensive care unit (ICU perspective. Methods. Case report and review of the literature. Results. A 53-year-old woman initially presenting with psychiatric symptoms developed myoclonus and was admitted 1 month later to the ICU with a suspected nonconvulsive status epilepticus and respiratory insufficiency, probably due to extensive antiepileptic drug therapy. Typical MRI and EEG findings and a positive 14-3-3 protein led to the diagnosis of sCJD. All treatments were terminated, and autopsy confirmed sCJD. Conclusions. Clinical signs combined with MRI, EEG, and 14-3-3 and/or tau protein determination might be sufficient to diagnose or exclude sCJD and may therefore prevent the application of unnecessary diagnostic tests.

  19. Population pharmacokinetic characteristics of amikacin in suspected cases of neonatal sepsis in a low-resource African setting

    DEFF Research Database (Denmark)

    Amponsah, Seth K; Adjei, George O; Enweronu-Laryea, Christabel C

    2017-01-01

    BACKGROUND: Amikacin exhibits marked pharmacokinetic (PK) variability and is commonly used in combination with other drugs in the treatment of neonatal sepsis. There is a paucity of amikacin PK information in neonates from low-resource settings. OBJECTIVES: To determine the PK parameters...... of amikacin, and explore the influence of selected covariates, including coadministration with aminophylline, on amikacin disposition in neonates of African origin. METHODS: Neonates with suspected sepsis admitted to an intensive care unit in Accra, Ghana, and treated with amikacin (15 mg/kg loading followed...... by 7.5 mg/kg every 12 hours), were recruited. Serum amikacin concentration was measured at specified times after treatment initiation and analyzed using a population PK modeling approach. RESULTS: A total of 419 serum concentrations were available for 247 neonates. Mean (SD) trough amikacin...

  20. Unifying Subjectivity and Objectivity

    Directory of Open Access Journals (Sweden)

    Murugesan Chandrasekaran

    2016-10-01

    Full Text Available The contribution of modern science to the progress of civilization is immeasurable. Even its tendency toward exclusive concentration on the objective world has had salutary effects of great value. Modern science has wiped away much that was merely superstitious or speculative. Its rejection of unfounded opinions and prejudices has helped the thinking mind question conventional beliefs, shed preferences and prejudices, and challenge established authority. But modern systems thinking inherited from natural science is the suppression of the subjective dimension of reality. Many complex systems are an attempt to define and represent all subjective experience in physical terms. The modern man has a bias towards objectivity. The powerful influence of sense impressions on his mind and thinking makes him ignore the subjective experience and consider only objective facts as a valid, legitimate and representation of reality. Observing objective factors that are physical is easier than observing subjective factors that are subtle. The mechanistic view of reality has led to the rejection of the role of the individual in social development as insignificant. The individuals determine the development of society. Their social power has its roots both in subjective factors and objective factors. Economy, politics, society, and culture are inseparable dimensions of a single integrated reality. Subject and object constitute an integrated whole. The mind sees them as separate and independent. Or it views one as completely subordinate to the other. Unbiased approach to the study of all human experiences may prove that subject and object are interdependent dimensions or elements of reality.

  1. On Coordinating Collaborative Objects

    Directory of Open Access Journals (Sweden)

    Abdessamad Imine

    2010-07-01

    Full Text Available A collaborative object represents a data type (such as a text document designed to be shared by a group of dispersed users. The Operational Transformation (OT is a coordination approach used for supporting optimistic replication for these objects. It allows the users to concurrently update the shared data and exchange their updates in any order since the convergence of all replicas, i.e. the fact that all users view the same data, is ensured in all cases. However, designing algorithms for achieving convergence with the OT approach is a critical and challenging issue. In this paper, we propose a formal compositional method for specifying complex collaborative objects. The most important feature of our method is that designing an OT algorithm for the composed collaborative object can be done by reusing the OT algorithms of component collaborative objects. By using our method, we can start from correct small collaborative objects which are relatively easy to handle and incrementally combine them to build more complex collaborative objects.

  2. Comparison of Magnetic Resonance Imaging and Cardiac Catheterization in Patients with Suspected Severe Aortic Stenosis

    Directory of Open Access Journals (Sweden)

    Miroslav Solař

    2008-01-01

    Full Text Available Objective. Magnetic resonance imaging (MRI is a novel technique used in the assessment of aortic stenosis. The aim of the study was to compare MRI and cardiac catheterization (CAT that is still considered to be a “golden standard” in this indication. Methods. Thirty-four patients referred to CAT for the evaluation of aortic stenosis were enrolled into the study. CAT was performed according to the standardized protocol. Cardiac output was measured by thermodilution and mean aortic gradient was determined using simultaneous blood pressure measurement in aorta and left ventricle. MRI was performed within the period of 3 weeks after CAT. True FISP sequence with retrospective ECG gating was used for the imaging of the aortic valve orifice. Planimetry of the aortic valve area (AVA was performed at the time of maximal opening of the valve during systole. Results. MRI enabled the measurement of AVA in all patients enrolled. Mean AVA defined by CAT and MRI were 0,97 (±0,41 cm2 and 1,38 (±0,55 cm2, respectively. The correlation between the evaluated methods was statistically significant (p=0,003, but not very strong (r=0,43. The comparison of both methods in the identification of the severe aortic stenosis was characterized by kappa value of 0,331. Conclusion. Our study shows low agreement between cardiac catheterization and magnetic resonance imaging in the assessment of aortic stenosis. However, MRI might have a role in the diagnostic algorithm in patients with suspected severe aortic stenosis and moderate mean aortic gradient or concomitant valvular insufficiency.

  3. Suspected blood indicator in capsule endoscopy: a valuable tool for gastrointestinal bleeding diagnosis

    Directory of Open Access Journals (Sweden)

    Pedro BOAL CARVALHO

    Full Text Available ABSTRACT BACKGROUND Small bowel bleeding is a leading indication for small bowel capsule endoscopy. The Suspected Blood Indicator (SBI is a software feature directed to automatically detect bleeding lesions during small bowel capsule endoscopy. OBJECTIVE We aimed to assess SBI diagnostic accuracy for small bowel haemorrhage or potentially bleeding lesions during small bowel capsule endoscopy for small bowel bleeding. Methods - Single-centre retrospective study including 281 consecutive small bowel capsule endoscopy performed for small bowel bleeding during 6 years. The investigators marked lesions with high bleeding potential (P2, such as angioectasias, ulcers and tumours, as well as active bleeding during regular small bowel capsule endoscopy viewing with PillCam SB2(r. All small bowel capsule endoscopy were independently reviewed by another central reader using SBI. RESULTS Among the 281 patients, 29 (10.3% presented with active haemorrhage while 81 (28.9% presented with a P2 lesion. The most frequently observed P2 lesions were angioectasias (52, ulcers (15, polyps (7 and ulcerated neoplasias (7. SBI showed a 96.6% (28/29 sensitivity for active small bowel bleeding, with a 97.7% negative predictive value. Regarding P2 lesions, the SBI displayed an overall sensitivity of 39.5%, being highest for ulcerated neoplasias (100%, but significantly lower for angioectasias (38.5% or ulcers (20.0%. CONCLUSION Although SBI sensitivity for the automatic detection of potentially bleeding lesions was low, it effectively detected active small bowel bleeding with very high sensitivity and negative predictive value.

  4. Management approaches for suspected and established Lyme disease used at the Lyme disease diagnostic center.

    Science.gov (United States)

    Wormser, Gary P; McKenna, Donna; Nowakowski, John

    2016-01-14

    2015 marks the 27th year that the Lyme Disease Diagnostic Center, located in New York State in the United States, has provided care for patients with suspected or established deer tick-transmitted infections. There are five deer tick-transmitted infectious in this geographic area of which Lyme disease is the most common.For patients with erythema migrans, we do not obtain any laboratory testing. However, if the patient is febrile at the time of the visit or reports rigors and high-grade fevers, we consider the possibility of a co-infection and order pertinent laboratory tests.Our preferred management for Lyme disease-related facial palsy and/or radiculopathy is a 2-week course of doxycycline. Patients who are hospitalized for Lyme meningitis are usually treated at least initially with ceftriaxone. We have not seen convincing cases of encephalitis or myelitis solely due to Borrelia burgdorferi infection in the absence of laboratory evidence of concomitant deer tick virus infection (Powassan virus). We have also never seen Lyme encephalopathy or a diffuse axonal peripheral neuropathy and suggest that these entities are either very rare or nonexistent.We have found that Lyme disease rarely presents with fever without other objective clinical manifestations. Prior cases attributed to Lyme disease may have overlooked an asymptomatic erythema migrans skin lesion or the diagnosis may have been based on nonspecific IgM seroreactivity. More research is needed on the appropriate management and significance of IgG seropositivity in asymptomatic patients who have no history of Lyme disease.

  5. Frequency-doubling technology perimetry and multifocal visual evoked potential in glaucoma, suspected glaucoma, and control patients

    Directory of Open Access Journals (Sweden)

    Kanadani FN

    2014-07-01

    Full Text Available Fabio N Kanadani,1 Paulo AA Mello,1 Syril K Dorairaj,2 Tereza CM Kanadani31Federal University of Sao Paulo, Sao Paulo, Brazil; 2Mayo Clinic, Department of Ophthalmology, Jacksonville, Florida, USA; 3Sao Jose University Hospital, Belo Horizonte, BrazilIntroduction: The gold standard in functional glaucoma evaluation is standard automated perimetry (SAP. However, SAP depends on the reliability of the patients’ responses and other external factors; therefore, other technologies have been developed for earlier detection of visual field changes in glaucoma patients. The frequency-doubling perimetry (FDT is believed to detect glaucoma earlier than SAP. The multifocal visual evoked potential (mfVEP is an objective test for functional evaluation.Objective: To evaluate the sensitivity and specificity of FDT and mfVEP tests in normal, suspect, and glaucomatous eyes and compare the monocular and interocuar mf VEP.Methods: Ninety-five eyes from 95 individuals (23 controls, 33 glaucoma suspects, 39 glaucomatous were enrolled. All participants underwent a full ophthalmic examination, followed by SAP, FDT, and mfVEP tests. Results: The area under the curve for mean deviation and pattern standard deviation were 0.756 and 0.761, respectively, for FDT, 0.564 and 0.512 for signal and alpha for interocular mfVEP, and 0.568 and 0.538 for signal and alpha for monocular mfVEP. This difference between monocular and interocular mfVEP was not significant. Conclusion: The FDT matrix was superior to mfVEP in glaucoma detection. The difference between monocular and interocular mfVEP in the diagnosis of glaucoma was not significant. Keywords: standard automated perimetry, electrophysiology, glaucomatous eyes

  6. Functional Object Analysis

    DEFF Research Database (Denmark)

    Raket, Lars Lau

    We propose a direction it the field of statistics which we will call functional object analysis. This subfields considers the analysis of functional objects defined on continuous domains. In this setting we will focus on model-based statistics, with a particularly emphasis on mixed......-effect formulations, where the observed functional signal is assumed to consist of both fixed and random functional effects. This thesis takes the initial steps toward the development of likelihood-based methodology for functional objects. We first consider analysis of functional data defined on high...

  7. [Achievement of therapeutic objectives].

    Science.gov (United States)

    Mantilla, Teresa

    2014-07-01

    Therapeutic objectives for patients with atherogenic dyslipidemia are achieved by improving patient compliance and adherence. Clinical practice guidelines address the importance of treatment compliance for achieving objectives. The combination of a fixed dose of pravastatin and fenofibrate increases the adherence by simplifying the drug regimen and reducing the number of daily doses. The good tolerance, the cost of the combination and the possibility of adjusting the administration to the patient's lifestyle helps achieve the objectives for these patients with high cardiovascular risk. Copyright © 2014 Sociedad Española de Arteriosclerosis y Elsevier España, S.L. All rights reserved.

  8. Prevalence of suspected nonalcoholic fatty liver disease in Hispanic/Latino individuals differs by heritage.

    Science.gov (United States)

    Kallwitz, Eric R; Daviglus, Martha L; Allison, Matthew A; Emory, Kristen T; Zhao, Lihui; Kuniholm, Mark H; Chen, Jinsong; Gouskova, Natalia; Pirzada, Amber; Talavera, Gregory A; Youngblood, Marston E; Cotler, Scott J

    2015-03-01

    Nonalcoholic fatty liver disease (NAFLD) was shown to disproportionally affect Hispanic persons. We examined the prevalence of suspected NAFLD in Hispanic/Latino persons with diverse backgrounds. We studied the prevalence of suspected NAFLD among 12,133 persons included in the Hispanic Community Health Study/Study of Latinos. We collected data on levels of aminotransferase, metabolic syndrome (defined by National Cholesterol Education Program-Adult Treatment Panel III guidelines), demographics, and health behaviors. Suspected NAFLD was defined on the basis of increased level of aminotransferase in the absence of serologic evidence for common causes of liver disease or excessive alcohol consumption. In multivariate analyses, data were adjusted for metabolic syndrome, age, acculturation, diet, physical activity, sleep, and levels of education and income. In multivariate analysis, compared with persons of Mexican heritage, persons of Cuban (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.57-0.85), Puerto Rican (OR, 0.67; 95% CI, 0.52-0.87), and Dominican backgrounds (OR, 0.71; 95% CI, 0.54-0.93) had lower rates of suspected NAFLD. Persons of Central American and South American heritage had a similar prevalence of suspected NAFLD compared with persons of Mexican heritage. NAFLD was less common in women than in men (OR, 0.49; 95% CI, 0.40-0.60). Suspected NAFLD associated with metabolic syndrome and all 5 of its components. On the basis of an analysis of a large database of health in Latino populations, we found the prevalence of suspected NAFLD among Hispanic/Latino individuals to vary by region of heritage. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  9. Piles of objects

    KAUST Repository

    Hsu, Shu-Wei

    2010-01-01

    We present a method for directly modeling piles of objects in multi-body simulations. Piles of objects represent some of the more interesting, but also most time-consuming portion of simulation. We propose a method for reducing computation in many of these situations by explicitly modeling the piles that the objects may form into. By modeling pile behavior rather than the behavior of all individual objects, we can achieve realistic results in less time, and without directly modeling the frictional component that leads to desired pile shapes. Our method is simple to implement and can be easily integrated with existing rigid body simulations. We observe notable speedups in several rigid body examples, and generate a wider variety of piled structures than possible with strict impulse-based simulation. © 2010 ACM.

  10. Safety objectives for 2014

    CERN Multimedia

    HSE Unit

    2014-01-01

    This is the third year in which the CERN Management has presented annual safety objectives for the Organization, the “HSE Objectives”.   The HSE objectives for 2014, which were announced by the Director-General at his traditional New Year’s address to the staff and were presented at the first Enlarged Directorate meeting of the year, have been drawn up and agreed in close collaboration between the DSOs, the HSE Unit and the DG himself. From safety in the workplace to radiation and environmental protection, the document emphasises that “Safety is a priority for CERN” and that safety policy is a key element in how the Organization is run. And, like all policies, it generates objectives that “serve as a general framework for action”. The HSE objectives are broken down into the following fields: occupational health and safety on sites and in the workplace, radiation protection, radiation safety, environmental protection, emerge...

  11. Pinocchio: Geppetto's transitional object

    National Research Council Canada - National Science Library

    Gabriele Zeloni

    2015-01-01

    .... From this perspective, the author puts forward the following hypothesis: Pinocchio is a puppet who comes to life and is therefore, from a child's perception, a transitional object according to Winnicott...

  12. Birth of the Object: Detection of Objectness and Extraction of Object Shape through Object Action Complexes

    DEFF Research Database (Denmark)

    Kraft, Dirk; Pugeault, Nicolas; Baseski, Emre

    2008-01-01

    by the robot. This also leads to the concept of an "object" as a set of features that change predictably over different frames. The system is equipped with a certain degree of generic prior knowledge about the world in terms of a sophisticated visual feature extraction process in an early cognitive vision...... system, knowledge about its own embodiment as well as knowledge about geometric relationships such as rigid body motion. This prior knowledge allows the extraction of representations that are semantically richer compared to many other approaches.......We describe a process in which the segmentation of objects as well as the extraction of the object shape becomes realized through active exploration of a robot vision system. In the exploration process, two behavioral modules that link robot actions to the visual and haptic perception of objects...

  13. Measuring Object Salience

    Directory of Open Access Journals (Sweden)

    A.D.F Clarke

    2014-08-01

    Full Text Available Over the past 15 years work on visual salience has been restricted to models of low-level, bottom-up salience that give an estimate of the salience for every pixel in an image. This study concerns the question of how to measure the salience of objects: given an image and a list of areas of interest (AOIs, can we assign salience scores to the AOIs that reflect their visual prominence? There is increasing evidence that fixations locations are best explained at an object level and an object-level notion of visual salience can easily be incorporated with other object features task relevance and concepts such as scene context. However, extracting scores for AOIs from the saliency maps output by existing models is a non-trivial task. Using simple psychophysical (1/f-noise stimuli, we demonstrate that simple methods for assigning salience score to AOIs (such as taking the maximum, mean, or sum of the relevant pixels in the salience map produce unintuitive results, such as predicting that larger objects are less salient. We also evaluate object salience models over a range of tasks and compare to empirical data. Beyond predicting the number of fixations to different objects in a scene, we also estimate the difficulty of visual search trials; and incorporate visual salience into language production tasks. We present a simple object-based salience model (based on comparing the likelihood of an AOI given the rest of the image to the likelihood of a typical patch of the same area] that gives intuitive results for the 1/f-noise stimuli and performs as well as existing methods on empirical datasets.

  14. Object Based Systems Engineering

    Science.gov (United States)

    2011-10-17

    Based Systems Engineering ( MBSE ) has shifted the emphasis of the Systems Engineering community away from documents towards view-based artifacts. These...Engineering lies primarily in these objects, not the containers that deliver them. FIGURE 1: Evolution of Systems Engineering Practice MBSE ...capture minority viewpoints and discussion threads associated with each object of interest. If the majority view doesn’t lead to success, this data may

  15. Conscientious Objection to Vaccination

    OpenAIRE

    Clarke, Steve; Giubilini, Alberto; Walker, Mary Jean

    2016-01-01

    ABSTRACT Vaccine refusal occurs for a variety of reasons. In this article we examine vaccine refusals that are made on conscientious grounds; that is, for religious, moral, or philosophical reasons. We focus on two questions: first, whether people should be entitled to conscientiously object to vaccination against contagious diseases (either for themselves or for their children); second, if so, to what constraints or requirements should conscientious objection (CO) to vaccination be subject. ...

  16. Protected Objects in Java

    DEFF Research Database (Denmark)

    Løvengreen, Hans Henrik; Schwarzer, Jens Christian

    1998-01-01

    We present an implementation of Ada 95's notion of protected objects in Java. The implementation comprises a class library supporting entry queues and a (pre-) compiler translating slightly decorated Java classes to pure Java classes utilizing the library.......We present an implementation of Ada 95's notion of protected objects in Java. The implementation comprises a class library supporting entry queues and a (pre-) compiler translating slightly decorated Java classes to pure Java classes utilizing the library....

  17. Clinical and diagnostic characteristics of patients with suspected polyneuropathy

    Directory of Open Access Journals (Sweden)

    Mikhailova Е.V.

    2013-09-01

    Full Text Available Objective: to study the causes and clinical manifestations of disease in children referred for hospitalization in children infectious diseases hospital in Saratov with a diagnosis of «acute flaccid paralysis». Material and methods: 157 children with the diagnosis on admission of the guide «acute flaccid paralysis». Conducted clinical examination and laboratory tests included a general analysis of cerebrospinal fluid, urine, virological examination of nasal swabs and faeces, with the definition of a serological ELISA method and RPHA immunoglobulins to influenza, rubella, and enterovirus, immunological study of blood, cerebrospinal fluid PCR, electromyography of the affected limbs. Results. 77 patients (49% with the disease associated with the violation of the musculoskeletal system were registered. In the other cases revealed polyneuropathy was not of poliovirus etiology. Etiological nature of the disease could be explained by 54% of patients. In 37 (46% patients the diagnosis was formulated in accordance with the severity of paralysis. One child was diagnosed with a vaccine-associated poliomyelitis. Conclusion. The diagnosis of «acute flaccid paralysis» used as administered requires a detailed interpretation in a hospital.

  18. Pin Worms Presenting as Suspected Crohn’s Disease

    Science.gov (United States)

    Al-Saffar, Farah; Najjar, Nimeh; Ibrahim, Saif; Clark, Matthew

    2015-01-01

    Patient: Female, 24 Final Diagnosis: Pinworms infection Symptoms: Abdominal pain • bloating Medication: — Clinical Procedure: Colonoscopy and biopsy Specialty: Gastroenterology and Hepatology Objective: Rare disease Background: Inflammatory bowel disease (IBD) is well recognized in developed countries and is generally among the differential diagnoses of young patients presenting with refractory diarrhea once other more common etiologies have been excluded. Pinworm infections, on the other hand, are not as common among adults in the United States. Case Report: Based on computed tomography features, a 24-year-old female patient with a history of multiple autoimmune disorders presented with abdominal pain and was diagnosed recently with Crohn’s disease. Colonoscopy was significant for pinworms seen throughout the colon. Colonic biopsy was negative for inflammatory bowel disease (IBD)-related changes. Conclusions: The diagnosis of IBD is a serious label that requires biopsy confirmation before committing to possibly lifelong treatment and possible adverse effects. Even in the most typical patient and when the presentation and imaging are classical, uncommon conditions (like Enterobius infection in this case) may preclude appropriate diagnosis and management. PMID:26471462

  19. Left ventricular dysfunction in patients with suspected pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    Francisca Gavilanes

    2014-12-01

    Full Text Available OBJECTIVE: To evaluate the role of right heart catheterization in the diagnosis of pulmonary arterial hypertension (PAH. METHODS: We evaluated clinical, functional, and hemodynamic data from all patients who underwent right heart catheterization because of diagnostic suspicion of PAH-in the absence of severe left ventricular dysfunction (LVD, significant changes in pulmonary function tests, and ventilation/perfusion lung scintigraphy findings consistent with chronic pulmonary thromboembolism-between 2008 and 2013 at our facility. RESULTS: During the study period, 384 patients underwent diagnostic cardiac catheterization at our facility. Pulmonary hypertension (PH was confirmed in 302 patients (78.6%. The mean age of those patients was 48.7 years. The patients without PH showed better hemodynamic profiles and lower levels of B-type natriuretic peptide. Nevertheless, 13.8% of the patients without PH were categorized as New York Heart Association functional class III or IV. Of the 218 patients who met the inclusion criteria, 40 (18.3% and 178 (81.7% were diagnosed with PH associated with LVD (PH-LVD and with PAH, respectively. The patients in the HP-LVD group were significantly older than were those in the PAH group (p < 0.0001. CONCLUSIONS: The proportional difference between the PAH and PH-LVD groups was quite significant, considering the absence of echocardiographic signs suggestive of severe LVD during the pre-catheterization investigation. Our results highlight the fundamental role of cardiac catheterization in the diagnosis of PAH, especially in older patients, in whom the prevalence of LVD that has gone undiagnosed by non-invasive tests is particularly relevant.

  20. Objects of consciousness

    Directory of Open Access Journals (Sweden)

    Donald David Hoffman

    2014-06-01

    Full Text Available Current models of visual perception typically assume that human vision estimates true properties of physical objects, properties that exist even if unperceived. However, recent studies of perceptual evolution, using evolutionary games and genetic algorithms, reveal that natural selection often drives true perceptions to extinction when they compete with perceptions tuned to fitness rather than truth: Perception guides adaptive behavior; it does not estimate a preexisting physical truth. Moreover, shifting from evolutionary biology to quantum physics, there is reason to disbelieve in preexist-ing physical truths: Certain interpretations of quantum theory deny that dynamical properties of physical objects have defi-nite values when unobserved. In some of these interpretations the observer is fundamental, and wave functions are com-pendia of subjective probabilities, not preexisting elements of physical reality. These two considerations, from evolutionary biology and quantum physics, suggest that current models of object perception require fundamental reformulation. Here we begin such a reformulation, starting with a formal model of consciousness that we call a conscious agent. We develop the dynamics of interacting conscious agents, and study how the perception of objects and space-time can emerge from such dynamics. We show that one particular object, the quantum free particle, has a wave function that is identical in form to the harmonic functions that characterize the asymptotic dynamics of conscious agents; particles are vibrations not of strings but of interacting conscious agents. This allows us to reinterpret physical properties such as position, momentum, and energy as properties of interacting conscious agents, rather than as preexisting physical truths. We sketch how this approach might extend to the perception of relativistic quantum objects, and to classical objects of macroscopic scale.

  1. Objects of consciousness.

    Science.gov (United States)

    Hoffman, Donald D; Prakash, Chetan

    2014-01-01

    Current models of visual perception typically assume that human vision estimates true properties of physical objects, properties that exist even if unperceived. However, recent studies of perceptual evolution, using evolutionary games and genetic algorithms, reveal that natural selection often drives true perceptions to extinction when they compete with perceptions tuned to fitness rather than truth: Perception guides adaptive behavior; it does not estimate a preexisting physical truth. Moreover, shifting from evolutionary biology to quantum physics, there is reason to disbelieve in preexisting physical truths: Certain interpretations of quantum theory deny that dynamical properties of physical objects have definite values when unobserved. In some of these interpretations the observer is fundamental, and wave functions are compendia of subjective probabilities, not preexisting elements of physical reality. These two considerations, from evolutionary biology and quantum physics, suggest that current models of object perception require fundamental reformulation. Here we begin such a reformulation, starting with a formal model of consciousness that we call a "conscious agent." We develop the dynamics of interacting conscious agents, and study how the perception of objects and space-time can emerge from such dynamics. We show that one particular object, the quantum free particle, has a wave function that is identical in form to the harmonic functions that characterize the asymptotic dynamics of conscious agents; particles are vibrations not of strings but of interacting conscious agents. This allows us to reinterpret physical properties such as position, momentum, and energy as properties of interacting conscious agents, rather than as preexisting physical truths. We sketch how this approach might extend to the perception of relativistic quantum objects, and to classical objects of macroscopic scale.

  2. Objects of consciousness

    Science.gov (United States)

    Hoffman, Donald D.; Prakash, Chetan

    2014-01-01

    Current models of visual perception typically assume that human vision estimates true properties of physical objects, properties that exist even if unperceived. However, recent studies of perceptual evolution, using evolutionary games and genetic algorithms, reveal that natural selection often drives true perceptions to extinction when they compete with perceptions tuned to fitness rather than truth: Perception guides adaptive behavior; it does not estimate a preexisting physical truth. Moreover, shifting from evolutionary biology to quantum physics, there is reason to disbelieve in preexisting physical truths: Certain interpretations of quantum theory deny that dynamical properties of physical objects have definite values when unobserved. In some of these interpretations the observer is fundamental, and wave functions are compendia of subjective probabilities, not preexisting elements of physical reality. These two considerations, from evolutionary biology and quantum physics, suggest that current models of object perception require fundamental reformulation. Here we begin such a reformulation, starting with a formal model of consciousness that we call a “conscious agent.” We develop the dynamics of interacting conscious agents, and study how the perception of objects and space-time can emerge from such dynamics. We show that one particular object, the quantum free particle, has a wave function that is identical in form to the harmonic functions that characterize the asymptotic dynamics of conscious agents; particles are vibrations not of strings but of interacting conscious agents. This allows us to reinterpret physical properties such as position, momentum, and energy as properties of interacting conscious agents, rather than as preexisting physical truths. We sketch how this approach might extend to the perception of relativistic quantum objects, and to classical objects of macroscopic scale. PMID:24987382

  3. Pattern Electroretinography in Glaucoma Suspects and Early Primary Open Angle Glaucoma

    Directory of Open Access Journals (Sweden)

    Ebrahim Jafarzadehpour

    2013-01-01

    Full Text Available Purpose: To explore retinal ganglion cell (RGC dysfunction in glaucoma suspects and patients with early primary open angle glaucoma (POAG using pattern electroretinography (PERG. Methods: Twenty glaucoma suspects (glaucomatous optic disc appearance, 15 early POAG (based on abnormal discs and abnormal visual fields and 16 normal controls were enrolled. Transient PERG was recorded in response to 0.8΀ and 16΀ black and white checkerboard stimuli. Amplitude and peak time (latency of the P50 and N95 components of the PERG response, and the ratio of N95 amplitude in response to 0.8΀ and 16΀ checks were measured. Results: N95 peak time (latency was significantly increased in both early manifest POAG and glaucoma suspects as compared to normal controls (P<0.001. In early POAG, N95 amplitude in response to small (0.8΀ checks and the small/large check ratio were reduced in comparison to normal eyes (P<0.05. However, in glaucoma suspects no significant N95 amplitude reduction was observed. No significant difference was observed among the study groups in terms of P50 amplitude or peak time. Conclusion: The N95 PERG response demonstrated uncoupled peak time and amplitude alterations in glaucoma. N95 peak time was significantly increased both in glaucoma suspects and early POAG; N95 amplitude reduction was present only in early POAG. PERG may detect RGC dysfunction (increased latency before cell death (decreased amplitude occurs.

  4. Facing suspected child abuse--what keeps Swedish general practitioners from reporting to child protective services?

    Science.gov (United States)

    Talsma, Marijke; Bengtsson Boström, Kristina; Östberg, Anna-Lena

    2015-03-01

    The aim of this study was to examine the reporting of suspected child abuse among Swedish general practitioners (GPs), and to investigate factors influencing them in their decision whether or not to report to child protective services (CPS). A cross-sectional questionnaire study. Primary health care centres in western Sweden. 177 GPs and GP trainees. Demographic and educational background, education on child abuse, attitudes to reporting and CPS, previous experience of reporting suspected child abuse, and need of support. Despite mandatory reporting, 20% of all physicians had at some point suspected but not reported child abuse. Main reasons for non-reporting were uncertainty about the suspicion and use of alternative strategies; for instance, referral to other health care providers or follow-up of the family by the treating physician. Only 30% of all physicians trusted CPS's methods of investigating and acting in cases of suspected child abuse, and 44% of all physicians would have wanted access to expert consultation. There were no differences in the failure to report suspected child abuse that could be attributed to GP characteristics. However, GPs educated abroad reported less frequently to CPS than GPs educated in Sweden. This study showed that GPs see a need for support from experts and that the communication and cooperation between GPs and CPS needs to be improved. The low frequency of reporting indicates a need for continued education of GPs and for updated guidelines including practical advice on how to manage child abuse.

  5. [Medicine and conscientious objection].

    Science.gov (United States)

    Martínez, K

    2007-01-01

    Conscientious objection to democratically accepted laws in democratic societies is a fact, both among citizens and among professionals. Due respect for laws is a prima facie duty in these societies. But democratic justice must at the same time respect peoples' conscience for it constitutes the ethical identity of individuals. And both law and ethics are necessary - although neither of them is sufficient - for its realization. The problem of conscientious objection among healthcare professionals is analysed from this standpoint and the conclusion is that objection is not an absolute right to exemption from several duties, but that the responsibility of the professional and of the institutions towards the citizenry must always be taken into account. Some solutions are suggested that try to protect both the professionals and the citizens in a bi-directional way.

  6. Pinocchio: Geppetto's transitional object

    Directory of Open Access Journals (Sweden)

    Gabriele Zeloni

    2015-01-01

    Full Text Available The literature has been considered by Freud and others after him, a form of unaware exploration of mind that can leads to discoveries similar to psychoanalysis’s discoveries. From this perspective, the author puts forward the following hypothesis: Pinocchio is a puppet who comes to life and is therefore, from a child's perception, a transitional object according to Winnicott. Consequently Geppetto is nothing more than the involuntary representation of any child interacting with the transitional object. The author explains the results of the analysis of the text in support of the hypothesis and reflects on the impact of The adventure of Pinocchio on the reader.

  7. Learning Objects Web

    DEFF Research Database (Denmark)

    Blåbjerg, Niels Jørgen

    2005-01-01

    Learning Objects Web er et DEFF projekt som Aalborg Universitetsbibliotek har initieret. Projektet tager afsæt i de resultater og erfaringer som er opnået med vores tidligere projekt Streaming Webbased Information Modules (SWIM). Vi har et internationalt netværk af interessenter som giver os...... sparring og feedback i forhold til udviklingskoncept både omkring de teoretiske rammer og i forhold til praktisk anvendelse af vores undervisningskoncept. Med disse rygstød og input har vi forfulgt ønsket om at videreudvikle SWIM i det nye projekt Learning Objects Web. Udgivelsesdato: juni...

  8. The Language of Objects

    DEFF Research Database (Denmark)

    Eskildsen, Kasper Risbjerg

    2012-01-01

    . The arrangement of artifacts not only helped him formulate his theories, but also allowed him to present his arguments in a language of objects. At the same time, Thomsen's definition of archaeology as a museum science placed his branch of archaeology in a closer relationship with other museum sciences...... themselves to histories of texts and therefore abandoned the earliest human history. Instead, he proposed a new history of objects, which included the entire history of humankind. Thomsen's work as director of the Royal Museum of Nordic Antiquities in Copenhagen was especially important for this renewal...

  9. 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.

  10. Prevalence of Clostridium perfringens toxin genotypes in enterotoxemia suspected sheep flocks of Andhra Pradesh

    Directory of Open Access Journals (Sweden)

    N. Vinod Kumar

    2014-12-01

    Full Text Available Aim: To identify the Clostridium perfringens toxin genotypes prevailing in enterotoxemia suspected sheep flocks in Andhra Pradesh by using multiplex PCR. Materials and Methods: Intestinal scrapings were collected from lambs below three months of age from flocks with similar management from different Districts of Andhra Pradesh, in India. A total of 208 samples were collected with 140 from enterotoxemia suspected flocks and 68 from healthy flocks. Following processing and culture of the samples, colonies were identified by morphological and biochemical tests. All the clostridial isolates were analyzed by multiplex PCR. Results: C. pefringens were isolated from 97 out of 140 enterotoxemia suspected flocks (69.29% and 27 out of 68 healthy flocks (39.71 %. Genotyping of the 97 iolates by multiplex PCR from enterotoxemia suspected flocks indicated C. perfringens type A, C and D 67.01% (65 out of 97; 11.34% (11 out of 97 and 21.65% (21 out of 97 respectively. Isolates from healthy flocks indicated the presence of type A and D 92.59% (25 out of 27 and 7.40% (2 out of 27 respectively. Number of isolates from enterotoxaemia suspected flocks were significantly high (P<0.001 than healthy flocks. Type A is found to be predominant in both enterotoxemia suspected and healthy flocks (67.01% and 92.59%. Conclusions: Prevalence of C. perfringens type C was reported for the first time in India. Clostridium perfringens type D and type C were found to be the major causative types for enterotoxemia.

  11. Turning subjective into objective

    DEFF Research Database (Denmark)

    Cardoso, Maria João; Cardoso, Jaime; Amaral, Natália

    2007-01-01

    Twelve expert observers from nine different countries convened in a workshop to evaluate the validity of the Breast Cancer Conservative Treatment. Cosmetic results (BCCT.core) software, an objective method for the aesthetic evaluation of breast cancer conservative treatment. Experts were initiall...

  12. Gender Object Identification Test.

    Science.gov (United States)

    Sigmon, Scott B.

    This test was designed primarily for the purpose of assisting social psychologists in researching sex roles and/or sex differences when a nonverbal instrument is desired. The hypothesis was that some objects would be easier for members of one gender to name. The subjects were 30 female and 20 male undergraduate students. Pictures of 65 commercial…

  13. Robust video object cosegmentation.

    Science.gov (United States)

    Wang, Wenguan; Shen, Jianbing; Li, Xuelong; Porikli, Fatih

    2015-10-01

    With ever-increasing volumes of video data, automatic extraction of salient object regions became even more significant for visual analytic solutions. This surge has also opened up opportunities for taking advantage of collective cues encapsulated in multiple videos in a cooperative manner. However, it also brings up major challenges, such as handling of drastic appearance, motion pattern, and pose variations, of foreground objects as well as indiscriminate backgrounds. Here, we present a cosegmentation framework to discover and segment out common object regions across multiple frames and multiple videos in a joint fashion. We incorporate three types of cues, i.e., intraframe saliency, interframe consistency, and across-video similarity into an energy optimization framework that does not make restrictive assumptions on foreground appearance and motion model, and does not require objects to be visible in all frames. We also introduce a spatio-temporal scale-invariant feature transform (SIFT) flow descriptor to integrate across-video correspondence from the conventional SIFT-flow into interframe motion flow from optical flow. This novel spatio-temporal SIFT flow generates reliable estimations of common foregrounds over the entire video data set. Experimental results show that our method outperforms the state-of-the-art on a new extensive data set (ViCoSeg).

  14. The Object of Research

    DEFF Research Database (Denmark)

    Bean, Jonathan; Figueiredo, Bernardo; Pico Larsen, Hanne

    2017-01-01

    explicates the role of objects in supporting this patterning. We explain how an in-situ diary tool (dscout, in our case) can be useful to support this approach. We demonstrate our methodological approach in the context of the Red Rooster Harlem, a cosmopolitan restaurant in New York, owned by the celebrity...

  15. The Road to Objects

    Directory of Open Access Journals (Sweden)

    Graham Harman

    2011-09-01

    Full Text Available Harman presents an outline of how object-oriented ontology (OOO differentiates itself from other branches of speculative realism. Can OOO steer philosophy from an epistemological project that tends to reduce the discipline to "a series of small-time drug busts"?

  16. Testing object Interactions

    NARCIS (Netherlands)

    Grüner, Andreas

    2010-01-01

    In this thesis we provide a unit testing approach for multi-purposes object-oriented programming languages in the style of Java and C#. Our approach includes the definition of a test specification language which results from extending the programming language with new designated specification

  17. Big Java late objects

    CERN Document Server

    Horstmann, Cay S

    2012-01-01

    Big Java: Late Objects is a comprehensive introduction to Java and computer programming, which focuses on the principles of programming, software engineering, and effective learning. It is designed for a two-semester first course in programming for computer science students.

  18. Forecasters' Objectives and Strategies

    DEFF Research Database (Denmark)

    Marinovic, Iván; Ottaviani, Marco; Sørensen, Peter Norman

    2013-01-01

    This chapter develops a unified modeling framework for analyzing the strategic behavior of forecasters. The theoretical model encompasses reputational objectives, competition for the best accuracy, and bias. Also drawing from the extensive lit- erature on analysts, we review the empirical evidenc...

  19. Yield of computed tomography pulmonary angiogram in the emergency department in cancer patients suspected to have pulmonary embolism.

    Science.gov (United States)

    Tannous, Pierre; Mukadam, Zubin; Kammari, Chetan; Banavasi, Harsha; Soubani, Ayman O

    2016-12-01

    The use of computed tomography pulmonary angiography (CTPA) in the emergency department (ED) for patients suspected to have pulmonary embolism (PE) has been steadily rising in the last 2decades. However, there are limited studies that specifically address the use of CTPA in the ED for cancer patients suspected to have PE. The objective of this study is to assess the rate of positive PE by CTPA in the ED in cancer patients and the variables that are associated with positive results. A retrospective review of electronic medical records for 208 consecutive patients with cancer who presented to the ED and received a CTPA for suspected PE over a 12-month period. The review included demographics, type and status of cancer, presenting symptoms, CTPA results, calculation of Wells Score, management based on CT findings, and outcome of patients. Among the 208 patients who met the inclusion criteria during our study period (mean age 57±13.37years, 73% women, 59% African American, and 32% Caucasians), 5.7% were diagnosed with PE. One hundred and eighty-two (83.7%) had a Wells Score ⩽4, of which 2.2% were found to have to have PE, 22 (16.3%) patients had a Wells Score >4, of which 36.4% were found to have PE (p4 was 66.7% and 92.9%, respectively, with an odds ratio of 27 (95% CI 6.6-113.6). Receiver operator characteristics area under the curve for Wells Score was 0.868. Age, race, sex, malignancy type, stage, status, clinical presentation, D-dimer, and a previous history of venous thromboembolism were not found to have statistically significant predictive values. The yield of CTPA to rule out PE in patients with cancer presenting in the ED is low. Following a validated decision-making protocol such as Wells Criteria may significantly decrease the number of CTPA used in the ED. Copyright © 2016 King Faisal Specialist Hospital & Research Centre. Published by Elsevier Ltd. All rights reserved.

  20. d-dimer testing as an adjunct to ultrasonography in patients with clinically suspected deep vein thrombosis: prospective cohort study

    Science.gov (United States)

    Bernardi, Enrico; Prandoni, Paolo; Lensing, Anthonie W A; Agnelli, Giancarlo; Guazzaloca, Giuliana; Scannapieco, Gianluigi; Piovella, Franco; Verlato, Fabio; Tomasi, Cristina; Moia, Marco; Scarano, Luigi; Girolami, Antonio

    1998-01-01

    Objective To investigate the efficacy of using a rapid plasma d-dimer test as an adjunct to compression ultrasound for diagnosing clinically suspected deep vein thrombosis. Design d-dimer concentrations were determined in all patients with a normal ultrasonogram at presentation. Repeat ultrasonography was performed 1 week later only in patients with abnormal d-dimer test results. Main outcome measure Patients with normal ultrasonograms were not treated with anticoagulants and were followed for 3 months for thromboembolic complications. Setting University research and affiliated centres. Subjects 946 patients with clinically suspected deep vein thrombosis. Results Ultrasonograms were abnormal at presentation in 260 (27.5%) patients. Of the remaining 686 patients tested for d-dimer, 88 (12.8%) had abnormal concentrations. During follow up venous thromboembolic complications occurred in one of the 598 patients who were not treated with anticoagulants and who had an initial normal ultrasonogram and d-dimer concentration, whereas thromboembolic complications occurred in two of the 83 untreated patients who had abnormal d-dimer concentrations but a normal repeat ultrasonogram. The cumulative incidence of venous thromboembolic complications during follow up was 0.4% (95% confidence interval 0% to 0.9%). The rapid plasma d-dimer test used as an adjunct to compression ultrasonography resulted in a reduction in the mean number of repeat ultrasound examinations and additional hospital visits from 0.7 to 0.1 per patient. Conclusions Testing for d-dimer as an adjunct to a normal baseline ultrasound examination decreased the number of subsequent ultrasound examinations considerably without any increased risk of venous thromboembolic complications in patients not receiving anticoagulants. The use of ultrasound and testing for d-dimer enabled treatment decisions to be made at the time of presentation in most patients. Key messagesPatients with clinically suspected deep vein

  1. Successful conservative management of suspected Fournier’s gangrene in cats: three cases

    Directory of Open Access Journals (Sweden)

    Heather H Vaske

    2015-06-01

    Full Text Available Case series summary Three cats with suspected Fournier’s gangrene had an acute onset of clinical signs and bloodwork changes consistent with sepsis. All cases had similar progression of wounds that were managed without aggressive surgical debridement, which is the currently accepted treatment of choice. All cats survived and have maintained an excellent long-term quality of life. Relevance and novel information Fournier’s gangrene is a potentially fatal disease, with few cases reported in the veterinary literature. This retrospective case series describes the only known reports of survival from suspected Fournier’s gangrene cats, none of which required aggressive surgical debridement.

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

    OpenAIRE

    Verhoeven, Willem-Jan; Stevens, Lonneke

    2012-01-01

    textabstractIn many European countries, providing a suspect in custody with legal aid before the first police interrogation is a heavily debated issue. In this paper, we report on an exploratory study on the use of coercion by the police and the use of the right to silence by suspects in 70 Dutch homicide cases and their relation to prior consultation and presence of a lawyer. Analysis of the data indicates that there is a relation between the presence of a lawyer in the interrogation room an...

  3. Part Objects and Their Location

    DEFF Research Database (Denmark)

    Madsen, Ole Lehrmann; Møller-Pedersen, Birger

    1992-01-01

    The notion of location of part objects is introduced, yielding a reference to the containing object. Combined with locally defined objects and classes (block structure), singularly defined part objects, and references to part objects, it is a powerful language mechanism for defining objects...... with different aspects or roles. The use of part objects for inheritance of code is also explored....

  4. Objectives and Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Segalman, D.J.

    1998-11-30

    I have recently become involved in the ABET certification process under the new system - ABET 2000. This system relies heavily on concepts of Total Quality Management (TQM). It encourages each institution to define its objectives in terms of its own mission and then create a coherent program based on it. The prescribed steps in setting up the new system at an engineering institution are: o identification of constituencies G definition of mission. It is expected that the department's mission will be consistent with that of the overall institution, but containing some higher resolution language appropriate to that particular discipline of the engineering profession. o statement of objectives consistent with the mission 3G~~\\vED " enumeration of desired, and preferably measurable, outcomes of the process that would ~ `=. verify satisfaction of the objectives. ~~~ 07 !398 o establish performance standards for each outcome. o creation of appropriate feedback loops to assure that the objectives are still consistent with Q$YT1 the mission, that the outcomes remain consistent with the objectives, and that the curriculum and the teaching result in those outcomes. It is my assertion that once the institution verbalizes a mission, enumerated objectives naturally flow from that mission. (We shall try to demonstrate by example.) Further, if the mission uses the word "engineer", one would expect that word also to appear in at least one of the objectives. The objective of producing engineers of any sort must -by decree - involve the presence of the ABET criteria in the outcomes list. In other words, successful satisfaction of the ABET items a-k are a necessary subset of the measure of success in producing engineers. o We shall produce bachelor level engineers whose training in the core topics of chemical (or electrical, or mechanical) engineering is recognized to be among the best in the nation. o We shall provide an opportunity for our students to gain

  5. Clinical criteria replenish high-sensitive troponin and inflammatory markers in the stratification of patients with suspected acute coronary syndrome.

    Directory of Open Access Journals (Sweden)

    Barbara Elisabeth Stähli

    Full Text Available OBJECTIVES: In patients with suspected acute coronary syndrome (ACS, rapid triage is essential. The aim of this study was to establish a tool for risk prediction of 30-day cardiac events (CE on admission. 30-day cardiac events (CE were defined as early coronary revascularization, subsequent myocardial infarction, or cardiovascular death within 30 days. METHODS AND RESULTS: This single-centre, prospective cohort study included 377 consecutive patients presenting to the emergency department with suspected ACS and for whom troponin T measurements were requested on clinical grounds. Fifteen biomarkers were analyzed in the admission sample, and clinical parameters were assessed by the TIMI risk score for unstable angina/Non-ST myocardial infarction and the GRACE risk score. Sixty-nine (18% patients presented with and 308 (82% without ST-elevations, respectively. Coronary angiography was performed in 165 (44% patients with subsequent percutaneous coronary intervention--accounting for the majority of CE--in 123 (33% patients, respectively. Eleven out of 15 biomarkers were elevated in patients with CE compared to those without. High-sensitive troponin T (hs-cTnT was the best univariate biomarker to predict CE in Non-ST-elevation patients (AUC 0.80, but did not yield incremental information above clinical TIMI risk score (AUC 0.80 vs 0.82, p = 0.69. Equivalence testing of AUCs of risk models and non-inferiority testing demonstrated that the clinical TIMI risk score alone was non-inferior to its combination with hs-cTnT in predicting CE. CONCLUSIONS: In patients presenting without ST-elevations, identification of those prone to CE is best based on clinical assessment based on TIMI risk score criteria and hs-cTnT.

  6. Clinical Criteria Replenish High-Sensitive Troponin and Inflammatory Markers in the Stratification of Patients with Suspected Acute Coronary Syndrome

    Science.gov (United States)

    Stähli, Barbara Elisabeth; Yonekawa, Keiko; Altwegg, Lukas Andreas; Wyss, Christophe; Hof, Danielle; Fischbacher, Philipp; Brauchlin, Andreas; Schulthess, Georg; Krayenbühl, Pierre-Alexandre; von Eckardstein, Arnold; Hersberger, Martin; Neidhart, Michel; Gay, Steffen; Novopashenny, Igor; Wolters, Regine; Frank, Michelle; Wischnewsky, Manfred Bernd; Lüscher, Thomas Felix; Maier, Willibald

    2014-01-01

    Objectives In patients with suspected acute coronary syndrome (ACS), rapid triage is essential. The aim of this study was to establish a tool for risk prediction of 30-day cardiac events (CE) on admission. 30-day cardiac events (CE) were defined as early coronary revascularization, subsequent myocardial infarction, or cardiovascular death within 30 days. Methods and Results This single-centre, prospective cohort study included 377 consecutive patients presenting to the emergency department with suspected ACS and for whom troponin T measurements were requested on clinical grounds. Fifteen biomarkers were analyzed in the admission sample, and clinical parameters were assessed by the TIMI risk score for unstable angina/Non-ST myocardial infarction and the GRACE risk score. Sixty-nine (18%) patients presented with and 308 (82%) without ST-elevations, respectively. Coronary angiography was performed in 165 (44%) patients with subsequent percutaneous coronary intervention – accounting for the majority of CE – in 123 (33%) patients, respectively. Eleven out of 15 biomarkers were elevated in patients with CE compared to those without. High-sensitive troponin T (hs-cTnT) was the best univariate biomarker to predict CE in Non-ST-elevation patients (AUC 0.80), but did not yield incremental information above clinical TIMI risk score (AUC 0.80 vs 0.82, p = 0.69). Equivalence testing of AUCs of risk models and non-inferiority testing demonstrated that the clinical TIMI risk score alone was non-inferior to its combination with hs-cTnT in predicting CE. Conclusions In patients presenting without ST-elevations, identification of those prone to CE is best based on clinical assessment based on TIMI risk score criteria and hs-cTnT. PMID:24892556

  7. Isolation, biochemical and molecular identification of Nocardia species among TB suspects in northeastern, Tanzania; a forgotten or neglected threat?

    Science.gov (United States)

    Hoza, Abubakar S; Mfinanga, Sayoki G S; Moser, Irmgard; König, Brigitte

    2017-06-08

    Pulmonary nocardiosis mimic pulmonary tuberculosis in most clinical and radiological manifestations. In Tanzania, where tuberculosis is one of the major public health threat clinical impact of nocardiosis as the cause of the human disease remains unknown. The objective of the present study was to isolate and identify Nocardia isolates recovered from TB suspects in Northeastern, Tanzania by using biochemical and molecular methods. The study involved 744 sputum samples collected from 372 TB suspects from four periphery diagnostic centers in Northeastern, Tanzania. Twenty patients were diagnosed as having presumptively Nocardia infections based on microscopic, cultural characteristics and biomèrieux ID 32C Yeast Identification system and confirmed using 16S rRNA and hsp65 gene specific primers for Nocardia species and sequencing. Biochemically, the majority of the isolates were N. asteroides (n = 8/20, 40%), N. brasiliensis (n = 4/20, 20%), N. farcinica (n = 3/20, 15%), N. nova (n = 1/20, 5%). Other aerobic actinomycetales included Streptomyces cyanescens (n = 2/20, 10%), Streptomyces griseus, Actinomadura madurae each (n = 1/20, 5%). Results of 16S rRNA and hsp65 sequencing were concordant in 15/17 (88. 2%) isolates and discordant in 2/17 (11.8%) isolates. Majority of the isolates belonged to N. cyriacigeorgica and N. farcinica, four (23.5%) each. Our findings suggest that Nocardia species may be an important cause of pulmonary nocardiosis that is underdiagnosed or ignored. This underscores needs to consider pulmonary nocardiosis as a differential diagnosis when there is a failure of anti-TB therapy and as a possible cause of human infections.

  8. Risks associated with suspected dysphagia in infants admitted to a neonatal intensive care unit in a South African public hospital

    Directory of Open Access Journals (Sweden)

    Jacoline Schoeman

    2017-07-01

    Full Text Available Background. The prevalence of neonatal dysphagia is increasing, as medical advances contribute to the survival of critically ill and preterm infants. Additional factors such as low birth weight (LBW, gastro-oesoephageal reflux disorder, failure-to-thrive (FTT, and HIV may increase the complexity of dysphagia symptoms. Knowledge of context-specific risk factors for dysphagia may lead to an effective pathway of diagnosis and management in vulnerable neonates. Objective. To describe the feeding characteristics and categories of underlying medical conditions in infants of gestational age 24 - 42 weeks. Methods. The study was a retrospective review of 231 purposively selected medical and speech-language therapy records. Participants had a mean stay of 28.5 days in a neonatal intensive care unit in a peri-urban public hospital and were referred for a swallowing and feeding assessment. An existing seven-category framework for the classification of suspected dysphagia was used. Results. Most participants (90.0% presented with multiple medical conditions. Underlying neurological conditions (48.5% and feeding difficulties secondary to systemic illness (65.8% contributed mostly to suspected dysphagia in the sample. It was found that 71.0% of infants presented with feeding difficulties secondary to other conditions such as LBW and prematurity, highlighting the need for an expanded dysphagia classification framework. Conclusion. The results concur with the outcomes of previous studies and confirm the need for a unique classification framework in South Africa. Dysphagia is a complex condition and frequently cannot be attributed to a single risk factor.

  9. Misdiagnosis of resistant hypertension: Real frequency of true resistant hypertension in patients with suspected resistance to treatment.

    Science.gov (United States)

    Doménech, Mónica; Sastre, Enric; Camafort, Miguel; Sierra, Cristina; Coca, Antonio

    2017-08-01

    Resistant hypertension(RH) has been defined as failure to control office blood pressure (BP) despite the use of≥3 different antihypertensive agents at optimal doses, including, ideally, a diuretic. Apparent RH, defines patients with an incorrect diagnosis of RH due to different causes. The objective was to determine whether most patients with RH in fact have apparent but not true RH. Observational study involving 93 patients with suspected RH, being 60 patients finally included. Screening for secondary causes of hypertension was perfomed. True RH was defined as office BP>140/90mmHg despite full doses of 3 antihypertensive drugs including a diuretic. Mean age 63.7±9.8years, 68.3%were male. Office BP 154.3±14.4/84.4±13.7mmHg. Of the 60 patients, 23.3% had white coat effect, 3.3% didn't have a diuretic and 8.3% were non-adherent-to-treatment. Accordingly, 58.3% were classified as true RH. Spironolactone was added in 62.5% of patients of whom 78.4% achieved ambulatory BP control. Almost half of the patients with suspected RH were not really true RH. We provide more evidence of excess of fluid retention as an underlying cause of lack of BP control in patients with RH, reinforce the relevant paper of spironolactone for the management in those patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  10. Suspected acute toxoplasmosis in pregnant women Suspeita de toxoplasmose aguda em gestantes

    Directory of Open Access Journals (Sweden)

    Marcela Peres Castilho-Pelloso

    2007-02-01

    Full Text Available OBJECTIVE: To determine the prevalence of reagent serology for suspected acute toxoplasmosis in pregnant women and to describe clinical, laboratory and therapeutic profiles of mothers and their children. METHODS: A retrospective study was conducted with IgM-anti-Toxoplasma gondii-reagent pregnant women and their children who attended the public health system in the state of Paraná, Southern Brazil, from January 2001 to December 2003. Information were obtained from clinical, laboratory (ELISA IgM/IgG and ultrasonographic data and from interviews with the mothers. To test the homogeneity of the IgM indices in relation to the treatment used, the Pearson's Chi-square test was applied. Comparisons were considered significant at a 5% level. RESULTS: Two hundred and ninety (1.0% cases of suspected IgM-reagent infection were documented, with a prevalence of 10.7 IgM-reagent women per 1,000 births. Prenatal care started within the first 12 weeks for 214/290; 146/204 were asymptomatic. Frequent complaints included headaches, visual disturbance and myalgia. Ultrasonography revealed abnormalities in 13 of 204 pregnancies. Chemoprophylaxis was administered to 112/227; a single ELISA test supported most decisions to begin treatment. Pregnant women with IgM indices =2.000 tended to be treated more often. Among exposed children, 44/208 were serologically followed up and all were IgG-reagent, and three IgM-reagent cases showed clinical symptoms. CONCLUSIONS: The existence of pregnant women with laboratorially suspected acute toxoplasmosis who were not properly followed up, and of fetuses that were not adequately monitored, shows that basic aspects of the prenatal care are not being systematically observed. There is need of implementing a surveillance system of pregnant women and their children exposed to T. gondii.OBJETIVO: Determinar a prevalência de gestantes com sorologia reagente suspeita de toxoplasmose aguda e descrever as variáveis maternas e do

  11. Antibiotic treatment interruption of suspected lower respiratory tract infections based on a single procalcitonin measurement at hospital admission--a randomized trial

    DEFF Research Database (Denmark)

    Kristoffersen, K B; Søgaard, O S; Wejse, C

    2009-01-01

    on antibiotic use in suspected lower respiratory tract infections (LRTIs) in a Danish hospital setting. In a randomized, controlled intervention study, 223 adult patients admitted to the hospital because of suspicion of LRTI were included with 210 patients available for analysis. Patients were randomized......Recent studies have suggested that procalcitonin (PCT) is a safe marker for the discrimination between bacterial and viral infection, and that PCT-guided treatment may lead to substantial reductions in antibiotic use. The present objective was to evaluate the effect of a single PCT measurement...

  12. Object-Oriented Education

    DEFF Research Database (Denmark)

    Pasgaard, Niels Jakob

    Education is traditionally seen as a teleological discipline. Teaching is always done with a purpose in mind. Thus, teaching can be said to be an intentional practice. With a popular Danish expression, one may say that teaching is to want something with someone (Nepper Larsen 2016). In recent years...... tradition, where predefined learning-objectives form the basis for the selection of content and methods of teaching. However, the idea of letting such learning-objectives form the basis for teaching, now also permeates the educational policies of the European Union (European Commision 2011). The spread......, Bogost 2012, Bryant 2014), the article presents a critique of this development. The criticism is based on a questioning of the idea that education should be understood as wanting something with someone. Instead, it is argued that education is the art of introducing Something for someone. The article aims...

  13. Conscientious objection in Italy.

    Science.gov (United States)

    Minerva, Francesca

    2015-02-01

    The law regulating abortion in Italy gives healthcare practitioners the option to make a conscientious objection to activities that are specific and necessary to an abortive intervention. Conscientious objectors among Italian gynaecologists amount to about 70%. This means that only a few doctors are available to perform abortions, and therefore access to abortion is subject to constraints. In 2012 the International Planned Parenthood Federation European Network (IPPF EN) lodged a complaint against Italy to the European Committee of Social Rights, claiming that the inadequate protection of the right to access abortion implies a violation of the right to health. In this paper I will discuss the Italian situation with respect to conscientious objection to abortion and I will suggest possible solutions to the problem. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. DOLIB: Distributed Object Library

    Energy Technology Data Exchange (ETDEWEB)

    D' Azevedo, E.F.

    1994-01-01

    This report describes the use and implementation of DOLIB (Distributed Object Library), a library of routines that emulates global or virtual shared memory on Intel multiprocessor systems. Access to a distributed global array is through explicit calls to gather and scatter. Advantages of using DOLIB include: dynamic allocation and freeing of huge (gigabyte) distributed arrays, both C and FORTRAN callable interfaces, and the ability to mix shared-memory and message-passing programming models for ease of use and optimal performance. DOLIB is independent of language and compiler extensions and requires no special operating system support. DOLIB also supports automatic caching of read-only data for high performance. The virtual shared memory support provided in DOLIB is well suited for implementing Lagrangian particle tracking techniques. We have also used DOLIB to create DONIO (Distributed Object Network I/O Library), which obtains over a 10-fold improvement in disk I/O performance on the Intel Paragon.

  15. DOLIB: Distributed Object Library

    Energy Technology Data Exchange (ETDEWEB)

    D`Azevedo, E.F.; Romine, C.H.

    1994-10-01

    This report describes the use and implementation of DOLIB (Distributed Object Library), a library of routines that emulates global or virtual shared memory on Intel multiprocessor systems. Access to a distributed global array is through explicit calls to gather and scatter. Advantages of using DOLIB include: dynamic allocation and freeing of huge (gigabyte) distributed arrays, both C and FORTRAN callable interfaces, and the ability to mix shared-memory and message-passing programming models for ease of use and optimal performance. DOLIB is independent of language and compiler extensions and requires no special operating system support. DOLIB also supports automatic caching of read-only data for high performance. The virtual shared memory support provided in DOLIB is well suited for implementing Lagrangian particle tracking techniques. We have also used DOLIB to create DONIO (Distributed Object Network I/O Library), which obtains over a 10-fold improvement in disk I/O performance on the Intel Paragon.

  16. Object relational mapping frameworks

    OpenAIRE

    Patrný, Vojtěch

    2008-01-01

    This paper is about Java object relational frameworks and related processes. The goal of this work consists of showing design patterns for ORM, introducing Java ORM standards along with the main implementations, finding criteria for comparison of ORM frameworks and showing working ORM example in a case study. This paper has the following structure: The first part of this paper discusses main ORM design patters, approaches to ORM and performance related features of Java ORM frameworks. Next pa...

  17. Dropped object protection analyses

    OpenAIRE

    Nilsen, Ingve

    2014-01-01

    Master's thesis in Offshore structural engineering Impact from dropped object is a typical accident action (NOKSOK N-004, 2013). Hence, the DOP structure is to be analyzed in an accidental limit state (ALS) design practice, which means that a non-linear finite element analysis can be applied. The DOP structure will be based on a typical DOP structure. Several FEM analyses are performed for the DOP structure. Different shapes size and weights and various impact positions are used for si...

  18. Suggestive Objects at Work

    DEFF Research Database (Denmark)

    Ratner, Helene Gad

    2009-01-01

    In Western secular societies, spiritual life is no longer limited to classical religious institutions but can also be found at workplace organizations. While spirituality is conventionally understood as a subjective and internal process, this paper proposes the concept of ‘suggestive objects’, co...... scaffolding. This has deep implications for our understanding of the sacred, including a better appreciation of the way that suggestive objects make the sacred durable, the way they organize it....

  19. Diagnostic prediction models for suspected pulmonary embolism: systematic review and independent external validation in primary care

    Science.gov (United States)

    Geersing, Geert-Jan; Lucassen, Wim A M; Erkens, Petra M G; Stoffers, Henri E J H; van Weert, Henk C P M; Büller, Harry R; Hoes, Arno W; Moons, Karel G M

    2015-01-01

    Objective To validate all diagnostic prediction models for ruling out pulmonary embolism that are easily applicable in primary care. Design Systematic review followed by independent external validation study to assess transportability of retrieved models to primary care medicine. Setting 300 general practices in the Netherlands. Participants Individual patient dataset of 598 patients with suspected acute pulmonary embolism in primary care. Main outcome measures Discriminative ability of all models retrieved by systematic literature search, assessed by calculation and comparison of C statistics. After stratification into groups with high and low probability of pulmonary embolism according to pre-specified model cut-offs combined with qualitative D-dimer test, sensitivity, specificity, efficiency (overall proportion of patients with low probability of pulmonary embolism), and failure rate (proportion of pulmonary embolism cases in group of patients with low probability) were calculated for all models. Results Ten published prediction models for the diagnosis of pulmonary embolism were found. Five of these models could be validated in the primary care dataset: the original Wells, modified Wells, simplified Wells, revised Geneva, and simplified revised Geneva models. Discriminative ability was comparable for all models (range of C statistic 0.75-0.80). Sensitivity ranged from 88% (simplified revised Geneva) to 96% (simplified Wells) and specificity from 48% (revised Geneva) to 53% (simplified revised Geneva). Efficiency of all models was between 43% and 48%. Differences were observed between failure rates, especially between the simplified Wells and the simplified revised Geneva models (failure rates 1.2% (95% confidence interval 0.2% to 3.3%) and 3.1% (1.4% to 5.9%), respectively; absolute difference −1.98% (−3.33% to −0.74%)). Irrespective of the diagnostic prediction model used, three patients were incorrectly classified as having low probability of pulmonary

  20. MR enterography versus capsule endoscopy in paediatric patients with suspected Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Casciani, Emanuele; Masselli, Gabriele; Polettini, Elisabetta; Bertini, Luca; Gualdi, Gianfranco [University, Radiology DEA, Azienda Policlinico Umberto I, Rome (Italy); Di Nardo, Giovanni; Oliva, Salvatore; Cucchiara, Salvatore [University, Pediatric Gastroenterology, Rome (Italy); Floriani, Irene [Istituto di Ricerche Farmacologiche ' ' Mario Negri' ' , Milan (Italy)

    2011-04-15

    The aim of this prospective study was to compare the diagnostic yield of MR enterography (MRE) with small-bowel capsule endoscopy (SBCE) in paediatric patients with suspected Crohn's disease (CD). Paediatric patients with suspected CD were considered eligible to be enrolled in the study. All patients underwent diagnostic work-up including 1.5-T MRE, ileo-colonoscopy and oesophagogastroduodenoscopy. SBCE was not performed if MRE showed SB stricture or extra-intestinal findings consistent with symptoms. Sixty consecutive paediatric patients (36 male; average age 14) were enrolled into the study. A positive diagnosis for CD was made in 19 patients, 29 had a negative result and 12 were affected by other gastro-intestinal conditions. SBCE was performed in 37 patients (61.7%); 23 patients were excluded (strictures in five, extra-intestinal findings in 11 and parents' refusal in seven cases). The accuracy, sensitivity, and specificity of MRE and SBCE were 98.3%, 100%, 97.6%, and 91.9%, 90.9%, 92.3%, respectively. Both MRE and SBCE are accurate methods for patients with suspected CD. MRE can be used as a primary imaging technique in suspected CD, in that it allows access to the ileal stricture, which forms a contra-indication for SBCE and provides extra-intestinal information. (orig.)

  1. Factors Affecting Special Education Services for English Language Learners with Suspected Language Learning Disabilities

    Science.gov (United States)

    Langdon, Henriette W.

    2002-01-01

    This article focuses on factors that impact identification of and services for English-language learners (ELLs) with suspected language-learning disabilities. These factors include (a) home and school environments, (b) the school's philosophy, (c) instructional strategies, and (d) other contextual variables that affect language use. In addition,…

  2. Study of topical corticosteroid response in glaucoma suspects and family members of established glaucoma patients

    Directory of Open Access Journals (Sweden)

    Jilani F

    1987-01-01

    Full Text Available The present study was conducted to study the topical steroid response in glaucoma suspects and family members of established glaucoma patients and its hereditary pattern The cases understudy were divided into three groups, namely normal (25 cases, suspected open angle glaucoma cases (20 and family members of established open angle glaucoma cases (33. After preliminary examination each patient was advised to put dexamethasone drop 1 % in one eye and a placebo in other eye. The IOP was noted after three weeks It was found that 80% of all eyes under study showed a rise in IOP after use of topical dexamethasone. The highest mean IOP was found in primary open angle glaucoma suspects, and the highest mean post-corticosteroid rise in IOP of 8.91 mm Hg was found among family members of established open angle glaucoma patients. The lOP response to topical corticosteroids was found to be of three phenotypical types viz., poor responders (nn, moderate responders (ng and high responders (gg. Normal subjects were generally poor responders. Suspected open angle glaucoma cases were generally high responders. However, family members of established open angle glaucoma cases showed the highest percentage of presence of responder gene.

  3. Teachers' Reporting of Suspected Child Abuse and Neglect: Behaviour and Determinants

    Science.gov (United States)

    Goebbels, A. F. G.; Nicholson, J. M.; Walsh, K.; De Vries, H.

    2008-01-01

    By reporting suspected child abuse and neglect, teachers can make an important contribution to the early detection and prevention of abuse. However, teachers are sometimes reluctant to report their suspicions. This study investigated the determinants of teachers' reporting behaviour using concepts from the Integrated Change Model. Self-report data…

  4. Correlation of serum apelin level with coronary calcium score in patients with suspected coronary artery disease

    Directory of Open Access Journals (Sweden)

    Mohammed Hassan Zeitoun

    2014-03-01

    Conclusion: To the best of our knowledge, this is the first report of an independent association between apelin and CCS in patients with suspected CAD. Apelin emerges as a possible novel biomarker for CAD, but this result remains to be proved prospectively.

  5. 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

  6. Metrical Analysis of the Speech of Children with Suspected Developmental Apraxia of Speech.

    Science.gov (United States)

    Velleman, Shelley L.; Shriberg, Lawrence D.

    1999-01-01

    This study attempted to identify diagnostic markers for suspected developmental apraxia of speech (SD-DAS) in 30 children with either SD-DAS or speech delay using analytic procedures from metrical phonology. Findings indicated that, although lexical metrical patterns did not differentiate the groups, syllable omissions persisted until much later…

  7. 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...

  8. 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...

  9. 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...

  10. Hypocholesterolemia and nonregenerative, suspected immune-mediated, anemia: Report of 3 canine cases.

    Science.gov (United States)

    Robbins, Rachel; Viviano, Katrina R

    2017-10-01

    This report describes hypocholesterolemia in 3 dogs with nonregenerative, suspected immune-mediated anemias. Common causes of hypocholesterolemia were ruled out, raising suspicion for a mechanistic link between anemia and hypocholesterolemia in dogs. As observed in humans with concurrent anemia and hypocholesterolemia, cholesterol concentrations increased to within the reference interval once the dogs' anemia resolved.

  11. Diagnostic efficacy of impedance plethysmography for clinically suspected deep-vein thrombosis. A randomized trial

    NARCIS (Netherlands)

    Hull, R. D.; Hirsh, J.; Carter, C. J.; Jay, R. M.; Ockelford, P. A.; Buller, H. R.; Turpie, A. G.; Powers, P.; Kinch, D.; Dodd, P. E.

    1985-01-01

    Impedance plethysmography is an accurate noninvasive method to test for proximal vein thrombosis, but it is insensitive to calf-vein thrombi. We randomly assigned patients on referral with clinically suspected deep-vein thrombosis and normal impedance plethysmographic findings to either serial

  12. Parents with Schizophrenia – Insights from notifications of suspected child abuse and neglect

    DEFF Research Database (Denmark)

    Wulf-Andersen, Trine Østergaard; Ranning, Anne

    2016-01-01

    with schizophrenia. In this study, notifications of suspected child abuse and neglect was used to elicit difficulties in parental role functioning in schizophrenia patients. Qualitative text analysis was used to elicit common themes in 49 written documents from social workers at mental health centres expressing...

  13. 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…

  14. 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

  15. Mitochondrial DNA haplogroup background affects LHON, but not suspected LHON, in Chinese patients.

    Science.gov (United States)

    Zhang, A-Mei; Jia, Xiaoyun; Bi, Rui; Salas, Antonio; Li, Shiqiang; Xiao, Xueshan; Wang, Panfeng; Guo, Xiangming; Kong, Qing-Peng; Zhang, Qingjiong; Yao, Yong-Gang

    2011-01-01

    Recent studies have shown that mtDNA background could affect the clinical expression of Leber hereditary optic neuropathy (LHON). We analyzed the mitochondrial DNA (mtDNA) variation of 304 Chinese patients with m.11778G>A (sample #1) and of 843 suspected LHON patients who lack the three primary mutations (sample #2) to discern mtDNA haplogroup effect on disease onset. Haplogroup frequencies in the patient group was compared to frequencies in the general Han Chinese population (n = 1,689; sample #3). The overall matrilineal composition of the suspected LHON population resembles that of the general Han Chinese population, suggesting no association with mtDNA haplogroup. In contrast, analysis of these LHON patients confirms mtDNA haplogroup effect on LHON. Specifically, the LHON sample significantly differs from the general Han Chinese and suspected LHON populations by harboring an extremely lower frequency of haplogroup R9, in particular of its main sub-haplogroup F (#1 vs. #3, P-value = 1.46×10(-17), OR = 0.051, 95% CI: 0.016-0.162; #1 vs. #2, P-value = 4.44×10(-17), OR = 0.049, 95% CI: 0.015-0.154; in both cases, adjusted P-value LHON in Chinese patients with m.11778G>A but not suspected LHON. Haplogroup F has a protective effect against LHON, while M7b is a risk factor.

  16. Endoscopic pH Monitoring for Patients with Suspected or Refractory Gastroesophageal Reflux Disease

    Directory of Open Access Journals (Sweden)

    Brian G Turner

    2007-01-01

    Full Text Available BACKGROUND: Wireless pH studies can offer prolonged pH monitoring, which may potentially facilitate the diagnosis and management of patients with gastroesophageal reflux disease (GERD. The aim of the present study was to evaluate the detection rate of abnormal esophageal acid exposure using prolonged pH monitoring in patients with suspected or refractory GERD symptoms.

  17. 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.

  18. 45 CFR 681.5 - What happens if program fraud is suspected?

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false What happens if program fraud is suspected? 681.5 Section 681.5 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Procedures Leading to Issuance of A Complaint § 681.5...

  19. 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.)

  20. MR imaging of neuropathic feet in leprosy patients with suspected osteomyelitis

    NARCIS (Netherlands)

    Maas, Mario; Slim, Erik J.; Heoksma, Agnes F.; van der Kleij, Ad J.; Akkerman, Erik M.; den Heeten, Gerard J.; Faber, William R.

    2002-01-01

    This study was undertaken to analyze MRI findings in leprosy patients with neuropathic feet, which are suspected of having osteomyelitis. As far as we know, there is no literature concerning osteomyelitis and MRI in neuropathic leprosy feet at present. Therefore, we have included MRI examination of

  1. Diagnostic Performance Tests for Suspected Scaphoid Fractures Differ with Conventional and Latent Class Analysis

    NARCIS (Netherlands)

    Buijze, Geert A.; Mallee, Wouter H.; Beeres, Frank J. P.; Hanson, Timothy E.; Johnson, Wesley O.; Ring, David

    2011-01-01

    Evaluation of the diagnostic performance characteristics of radiographic tests for diagnosing a true fracture among suspected scaphoid fractures is hindered by the lack of a consensus reference standard. Latent class analysis is a statistical method that takes advantage of unobserved, or latent,

  2. Arm and Hand Movement in Children Suspected of Having Autism Spectrum Disorder

    Science.gov (United States)

    Braddock, Barbara A.; Hilton, Jane C.

    2016-01-01

    The aim of this study was to describe arm and hand movement in children suspected of having autism spectrum disorder (ASD; age range 29-43 months). A videotaped retrospective review of five children with symptoms of ASD during "Communication Temptation Tasks" was completed at two time points (pre-testing and 6 weeks later). Categories of…

  3. Diagnostic value of a psychological test in cases of suspected child abuse.

    Science.gov (United States)

    Geddis, D C; Turner, I F; Eardley, J

    1977-01-01

    The use of the Bene-Anthony Family Relations Test is described and illustrated by three examples of child abuse. This test should be considered in the investigation of definite or suspected cases of abuse and as part of the preparation of court evidence. PMID:921320

  4. Expected Consequences of Disclosure Revealed in Investigative Interviews with Suspected Victims of Child Sexual Abuse

    Science.gov (United States)

    Malloy, Lindsay C.; Brubacher, Sonja P.; Lamb, Michael E.

    2011-01-01

    The current study explored the expected consequences of disclosure discussed by 204 5- to 13-year-old suspected victims of child sexual abuse during the course of investigative interviews conducted using the NICHD Investigative Interview Protocol. Expected consequences were mentioned in nearly half of all interviews, with older children and those…

  5. Mitochondrial DNA haplogroup background affects LHON, but not suspected LHON, in Chinese patients.

    Directory of Open Access Journals (Sweden)

    A-Mei Zhang

    Full Text Available Recent studies have shown that mtDNA background could affect the clinical expression of Leber hereditary optic neuropathy (LHON. We analyzed the mitochondrial DNA (mtDNA variation of 304 Chinese patients with m.11778G>A (sample #1 and of 843 suspected LHON patients who lack the three primary mutations (sample #2 to discern mtDNA haplogroup effect on disease onset. Haplogroup frequencies in the patient group was compared to frequencies in the general Han Chinese population (n = 1,689; sample #3. The overall matrilineal composition of the suspected LHON population resembles that of the general Han Chinese population, suggesting no association with mtDNA haplogroup. In contrast, analysis of these LHON patients confirms mtDNA haplogroup effect on LHON. Specifically, the LHON sample significantly differs from the general Han Chinese and suspected LHON populations by harboring an extremely lower frequency of haplogroup R9, in particular of its main sub-haplogroup F (#1 vs. #3, P-value = 1.46×10(-17, OR = 0.051, 95% CI: 0.016-0.162; #1 vs. #2, P-value = 4.44×10(-17, OR = 0.049, 95% CI: 0.015-0.154; in both cases, adjusted P-value A but not suspected LHON. Haplogroup F has a protective effect against LHON, while M7b is a risk factor.

  6. 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…

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

    NARCIS (Netherlands)

    Mallee, W.; Doornberg, J.N.; Ring, D.; van Dijk, C.N.; Maas, M.; Goslings, J.C.

    2011-01-01

    Background: There is no consensus on the optimum imaging method to use to confirm the diagnosis of true scaphoid fractures among patients with suspected scaphoid fractures. This study tested the null hypothesis that computed tomography (CT) and magnetic resonance imaging (MRI) have the same

  8. Nurse Reporting of Known and Suspected Child Abuse and Neglect Cases in Taiwan

    Directory of Open Access Journals (Sweden)

    Pei-Yu Lee

    2007-03-01

    Full Text Available Despite the frontline role of taking care of children, nurses in Taiwan have been reluctant to report known and suspected cases of child abuse and neglect (CAN. This problem threatens the success of legislation aimed at reducing CAN cases in Taiwan. The purpose of this study was to examine the influence of nurses' perceptions, attitudes, and knowledge on suspecting and reporting CAN cases in health care settings in Taiwan. Two hundred and thirty-eight nurses were surveyed using structured questionnaires with a return rate of 79.3%. Health care settings surveyed in this study included emergency units, pediatric units, and community centers from eight hospitals in southern Taiwan. Almost 3/4 (70% of the sample of nurses thought they needed more training courses on CAN. Correlation analysis showed a significant relationship between suspecting and reporting CAN with perception, attitude, and knowledge. Stepwise multiple regression analysis revealed that perception (β= 0.475, knowledge (β= 0.265, and attitude (β= 0.246 accounted for 60% of the variance in suspecting and reporting CAN. The focus and scope of training programs for nurses in Taiwan should take these findings into consideration.

  9. 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

  10. The prevalence of suspected and challenge-verified penicillin allergy in a university hospital population

    DEFF Research Database (Denmark)

    Borch, Jacob Eli; Andersen, Klaus Ejner; Bindslev-Jensen, Carsten

    2006-01-01

    -allergic. The prevalence of suspected penicillin allergy was lower than reported elsewhere. A substantial number of patients failed to recall basic information about their alleged allergy. Patients reporting penicillin allergy upon admission and labels stating penicillin allergy on medical files are ignored in almost...

  11. Music-based Autism Diagnostics (MUSAD) - A newly developed diagnostic measure for adults with intellectual developmental disabilities suspected of autism.

    Science.gov (United States)

    Bergmann, Thomas; Sappok, Tanja; Diefenbacher, Albert; Dames, Sibylle; Heinrich, Manuel; Ziegler, Matthias; Dziobek, Isabel

    2015-01-01

    The MUSAD was developed as a diagnostic observational instrument in an interactional music framework. It is based on the ICD-10/DSM-5 criteria for autism spectrum disorder (ASD) and was designed to assess adults on a lower level of functioning, including individuals with severe language impairments. This study aimed to evaluate the psychometric properties of the newly developed instrument. Calculations were based on a consecutive clinical sample of N=76 adults with intellectual and developmental disabilities (IDD) suspected of ASD. Objectivity, test-retest reliability, and construct validity were calculated and a confirmatory factor analysis was applied to verify a reduced and optimized test version. The structural model showed a good fit, while internal consistency of the subscales was excellent (ω>.92). Item difficulties ranged between .04≤pi≤.82 and item-total correlation from .21 to .85. Objectivity was assessed by comparing the scorings of two external raters based on a subsample of n=12; interrater agreement was .71 (ICC 2, 1). Reliability was calculated for four test repetitions: the average ICC (3, 1) was .69. Convergent ASD measures correlated significantly with the MUSAD, while the discriminant Modified Overt Aggression Scale (MOAS) showed no significant overlap. Confirmation of factorial structure and acceptable psychometric properties suggest that the MUSAD is a promising new instrument for diagnosing ASD in adults with IDD. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. 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

  13. 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

  14. War Journalism and 'Objectivity'

    Directory of Open Access Journals (Sweden)

    Annabel McGoldrick

    2006-10-01

    Full Text Available This article opens by considering an apparent paradox. Many professional journalists, working on many media in many countries, consider themselves 'objective'. They do not, at least, set out to skew their coverage of important issues in favour of one side or the other. And yet much of their coverage of conflicts shows a discernible dominant pattern of War Journalism - biased in favour of war. This is not because of a lack of objectivity, the article suggests, but a surfeit. The set of conventions many editors and reporters regard as defining 'objective' journalism arose in response to economic and political conditions which rewarded news that could commend itself as unobjectionable to the maximum number of potential customers. Three of the most important conventions privilege official sources; a dualistic construction of stories and event, over process. Each of these, when applied to the representation of conflicts, leads readers and audiences - or leaves them - to over-value violent, reactive responses and under-value non-violent, developmental responses. Industry conventions sit uneasily alongside equally time-honoured expectations of journalism. These are encoded in rules and regulations governing the content of broadcast news, in many jurisdictions which have a public service concept for radio and television. In some respects, War Journalism can be shown to make it more difficult for broadcast news services to fulfil their public service obligations. Awareness is now growing, of the tension between these two pressures on journalism and its influence on the way pressing public debates are shaped and mediated. More Peace Journalism would help to bring public service news back into line with legitimate public expectations.

  15. Numerical Analysis Objects

    Science.gov (United States)

    Henderson, Michael

    1997-08-01

    The Numerical Analysis Objects project (NAO) is a project in the Mathematics Department of IBM's TJ Watson Research Center. While there are plenty of numerical tools available today, it is not an easy task to combine them into a custom application. NAO is directed at the dual problems of building applications from a set of tools, and creating those tools. There are several "reuse" projects, which focus on the problems of identifying and cataloging tools. NAO is directed at the specific context of scientific computing. Because the type of tools is restricted, problems such as tools with incompatible data structures for input and output, and dissimilar interfaces to tools which solve similar problems can be addressed. The approach we've taken is to define interfaces to those objects used in numerical analysis, such as geometries, functions and operators, and to start collecting (and building) a set of tools which use these interfaces. We have written a class library (a set of abstract classes and implementations) in C++ which demonstrates the approach. Besides the classes, the class library includes "stub" routines which allow the library to be used from C or Fortran, and an interface to a Visual Programming Language. The library has been used to build a simulator for petroleum reservoirs, using a set of tools for discretizing nonlinear differential equations that we have written, and includes "wrapped" versions of packages from the Netlib repository. Documentation can be found on the Web at "http://www.research.ibm.com/nao". I will describe the objects and their interfaces, and give examples ranging from mesh generation to solving differential equations.

  16. Propelling soft objects

    Science.gov (United States)

    Boukellal, Hakim; Plastino, Julie; Noireaux, Vincent; Sykes, Cécile

    2003-03-01

    Cells move by the action of specific proteins or small molecules that assemble and interact, constituting a dynamic network called the cytoskeleton. Actin, one of the major components of eucaryotic cells, exists as filaments (semi-flexible polymers) or as monomers. Local assembly of the actin network leads to cell movement as well as to the propulsion of objects like bacteria or liposomes within cells. In order to understand the force generated for this propulsion, we use biomimetic experimental systems that allow for the control of physical parameters. We show evidence for the role of elasticity in the propulsion mechanism. To cite this article: H. Boukellal et al., C. R. Physique 4 (2003).

  17. Kuiper Belt Objects

    Science.gov (United States)

    Jewitt, David

    The region of the solar system immediately beyond Neptune's orbit is densely populated with small bodies. This region, known as the Kuiper Belt, consists of objects that may predate Neptune, the orbits of which provide a fossil record of processes operative in the young solar system. The Kuiper Belt contains some of the Solar System's most primitive, least thermally processed matter. It is probably the source of the short-period comets and Centaurs, and may also supply collisionally generated interplanetary dust. I discuss the properties of the Kuiper Belt and provide an overview of the outstanding scientific issues.

  18. Managing Permanent Objects

    Science.gov (United States)

    1984-11-01

    pe,ttlca ItI Mamaging Faaaet Objects 1 commen main memory. Note that in the case of shared man memory, the thing that enabled sharing to be...u.ussed. 3.8.1 Non-e.•"t.ndz We have already diwxmd pairs. One additionrl item about pais is that they are often chained togtther by their edr to form a...that the garbage collector can be invoked 7 Unfortunfately Aegis does not supply the m*casary functicnality wo do this, but It would not be difcult so

  19. CT pulmonary angiography: an over-utilized imaging modality in hospitalized patients with suspected pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Erin Smith

    2013-04-01

    Full Text Available Aims: To determine if computed tomographic pulmonary angiography (CTPA was overemployed in the evaluation of hospitalized patients with suspected acute pulmonary embolism (PE. Methods: Data were gathered retrospectively on hospitalized patients (n=185 who had CTPA for suspected PE between June and August 2009 at our institution. Results: CTPA was done in 185 hospitalized patients to diagnose acute PE based on clinical suspicion. Of these, 30 (16.2% patients were tested positive for acute PE on CTPA. The Well's pretest probability for PE was low, moderate, and high in 77 (41.6%, 83 (44.9%, and 25 (13.5% patients, respectively. Out of the 30 PE-positive patients, pretest probability was low in 2 (6.6%, moderate in 20 (66.7%, and high in 8 (26.6% (p=0.003. Modified Well's criteria applied to all patients in our study revealed 113 (61% with low and 72 (39% with high clinical pretest probability. When modified Well's criteria was applied to 30 PE-positive patients, 10 (33.3% and 20 (66.6% were found to have low and high pretest probability, respectively (p=0.006. D-dimer assay was done in 30 (16.2% of the inpatients with suspected PE and all of them were found to have elevated levels. A lower extremity duplex ultrasound confirmed deep venous thrombosis in 17 (9.1% of the patients with suspected PE, at least 1 week prior to having CTPA. Conclusion: Understanding the recommended guidelines, evidence-based literature, and current concepts in evaluation of patients with suspected acute PE will reduce unnecessary CTPA examinations.

  20. Diagnostic Value of Bronchoalveolar Lavage for Diagnosis of Suspected Peripheral Lung Cancer.

    Science.gov (United States)

    Bezel, Pascal; Tischler, Verena; Robinson, Cecile; Baumueller, Stephan; Bode-Lesniewska, Beata; Kohler, Malcolm; Freitag, Lutz; Franzen, Daniel

    2016-09-01

    There is a paucity of data concerning the benefit of bronchoalveolar lavage (BAL) for the diagnosis of suspected peripheral lung cancer (PLC). The aim of this study was to investigate the diagnostic value of BAL for the diagnosis of suspected PLC. All flexible bronchoscopies that included BAL among other modalities (brush, forceps, washing) for the diagnosis of a suspected PLC performed between 2009 and 2013 were analyzed in this retrospective study. A total of 260 patients were included. Malignancy was present in 61%. BAL's sensitivity for the diagnosis of malignancy was 29%, and overall diagnostic yield of BAL was 46%. However, only 1% of cancer diagnoses would have been missed in the absence of BAL. In the multivariable analysis, the size of lesion (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.02-1.33; P = .023), the presence of bronchus sign (OR, 4.73; 95% CI, 1.06-21.08; P = .042), and the presence of mediastinal/hilar lymphadenopathy (OR, 3.37; 95% CI, 1.53-7.41; P = .002) were associated with improved BAL true-positive ratio relating to diagnosis of malignancy. However, the effect of lesion size on sensitivity was small (area under the curve, 0.31; 95% CI, 0.23-0.40; P diagnosis of malignancy or pulmonary infection was 37. Conventional BAL has a low diagnostic value for the diagnosis of suspected PLC, and the low number needed to test does not qualify BAL as a recommended routine investigation for the diagnosis of suspected PLC for either solid or ground-glass lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Relationship between hemoglobin levels and risk for suspected non-alcoholic fatty liver in Taiwanese adults.

    Science.gov (United States)

    Bai, Chyi-Huey; Wu, Ming-Shun; Owaga, Eddy; Cheng, Shu-Yu; Pan, Wen-Harn; Chang, Jung-Su

    2014-10-31

    Body iron levels have recently been shown to be a strong predictor for non-alcoholic fatty liver disease (NAFLD). The aims of this study were to investigate the prevalence of NAFLD in a general adult population, and to investigate the relationship between body iron levels, NAFLD and the metabolic syndrome (MetS). 2186 adults participated in the third National Nutrition and Health Survey in Taiwan (NAHSIT, 2005-2008). The participants underwent anthropometry measurements and phlebotomy after an overnight fast, and those with excessive alcohol intake, iron overload of serum ferritin > 600 ng/ml, hepatitis viral infection and hepatocellular carcinoma were excluded. Suspected NAFLD was diagnosed by three alanine transaminase (ALT) cut-points: cut-point 1: serum ALT > 40 U/l; cut-point 2: ALT ≥ 25 U/l for male and ALT ≥ 17 U/l for female; and cut-point 3: ALT ≥ 35 U/l for male and ALT ≥ 26 U/l for female. The prevalence proportion of suspected NAFLD among Taiwanese adults was 6.6% (cut-point 1), 36% (cut-point 2); and 14.3% (cut-point 3). Body iron levels were significantly higher in individuals with suspected NAFLD compared with those without. Distribution of hemoglobin levels, but not serum ferritin levels, by decade of age showed strong correlation with the prevalence of suspected NAFLD in individuals with MetS. Multivariate adjusted odds ratio (OR) showed that the best predictors for suspected NAFLD with the MetS were hemoglobin [OR 1.43 (1.21-1.68); P hemoglobin [OR 1.25 (1.12-1.41); P hemoglobin levels (14.4 μg/dl for male and 13.2 μg/dl for female) are at the greatest risk for developing abnormal liver function. Hemoglobin test should be considered as a part of clinical evaluation for patients with NAFLD.

  2. Conscientious Objection to Vaccination

    Science.gov (United States)

    Clarke, Steve; Giubilini, Alberto

    2016-01-01

    ABSTRACT Vaccine refusal occurs for a variety of reasons. In this article we examine vaccine refusals that are made on conscientious grounds; that is, for religious, moral, or philosophical reasons. We focus on two questions: first, whether people should be entitled to conscientiously object to vaccination against contagious diseases (either for themselves or for their children); second, if so, to what constraints or requirements should conscientious objection (CO) to vaccination be subject. To address these questions, we consider an analogy between CO to vaccination and CO to military service. We argue that conscientious objectors to vaccination should make an appropriate contribution to society in lieu of being vaccinated. The contribution to be made will depend on the severity of the relevant disease(s), its morbidity, and also the likelihood that vaccine refusal will lead to harm. In particular, the contribution required will depend on whether the rate of CO in a given population threatens herd immunity to the disease in question: for severe or highly contagious diseases, if the population rate of CO becomes high enough to threaten herd immunity, the requirements for CO could become so onerous that CO, though in principle permissible, would be de facto impermissible. PMID:28008636

  3. Conscientious Objection to Vaccination.

    Science.gov (United States)

    Clarke, Steve; Giubilini, Alberto; Walker, Mary Jean

    2017-03-01

    Vaccine refusal occurs for a variety of reasons. In this article we examine vaccine refusals that are made on conscientious grounds; that is, for religious, moral, or philosophical reasons. We focus on two questions: first, whether people should be entitled to conscientiously object to vaccination against contagious diseases (either for themselves or for their children); second, if so, to what constraints or requirements should conscientious objection (CO) to vaccination be subject. To address these questions, we consider an analogy between CO to vaccination and CO to military service. We argue that conscientious objectors to vaccination should make an appropriate contribution to society in lieu of being vaccinated. The contribution to be made will depend on the severity of the relevant disease(s), its morbidity, and also the likelihood that vaccine refusal will lead to harm. In particular, the contribution required will depend on whether the rate of CO in a given population threatens herd immunity to the disease in question: for severe or highly contagious diseases, if the population rate of CO becomes high enough to threaten herd immunity, the requirements for CO could become so onerous that CO, though in principle permissible, would be de facto impermissible. © 2016 The Authors Bioethics Published by John Wiley & Sons Ltd.

  4. Cost object in accounting

    Directory of Open Access Journals (Sweden)

    Gertruda Świderska

    2016-07-01

    Full Text Available In Polish literature in the field of accounting there are many synonymous terms such as the object of cost calculation, cost unit, or cost driver. Their definitions are often very similar, and their use in certain cir-cumstances unclear. This article aims to answer the question whether the term costs object meaning „something whose cost is of interest to accounting information users”, can replace previously used terms. The analysis applies to literature in Polish, in which different schools have developed their own terms, which is connected with the tradition of schools of accounting in Poland and the evolution of the con-cepts. The analysis aims to verify the hypothesis that for many synonymous terms used in publications in the field of accounting a universal solution can be proposed, taking into account the technological pro-gress and changing user needs. The research methods used include a systematic review of literature in Polish from the period 1966 to 2016 and an analysis of the terms.

  5. Hardware Objects for Java

    DEFF Research Database (Denmark)

    Schoeberl, Martin; Thalinger, Christian; Korsholm, Stephan

    2008-01-01

    Java, as a safe and platform independent language, avoids access to low-level I/O devices or direct memory access. In standard Java, low-level I/O it not a concern; it is handled by the operating system. However, in the embedded domain resources are scarce and a Java virtual machine (JVM) without...... in three quite different JVMs: in the Java processor JOP, the JIT compiler CACAO, and in the interpreting embedded JVM SimpleRTJ.......Java, as a safe and platform independent language, avoids access to low-level I/O devices or direct memory access. In standard Java, low-level I/O it not a concern; it is handled by the operating system. However, in the embedded domain resources are scarce and a Java virtual machine (JVM) without...... an underlying middleware is an attractive architecture. When running the JVM on bare metal, we need access to I/O devices from Java; therefore we investigate a safe and efficient mechanism to represent I/O devices as first class Java objects, where device registers are represented by object fields. Access...

  6. Fundamentals of Object Databases Object-Oriented and Object-Relational Design

    CERN Document Server

    Dietrich, Suzanne

    2010-01-01

    Object-oriented databases were originally developed as an alternative to relational database technology for the representation, storage, and access of non-traditional data forms that were increasingly found in advanced applications of database technology. After much debate regarding object-oriented versus relational database technology, object-oriented extensions were eventually incorporated into relational technology to create object-relational databases. Both object-oriented databases and object-relational databases, collectively known as object databases, provide inherent support for object

  7. ARTEMIS Science Objectives

    Science.gov (United States)

    Sibeck, D. G.; Angelopoulos, V.; Brain, D. A.; Delory, G. T.; Eastwood, J. P.; Farrell, W. M.; Grimm, R. E.; Halekas, J. S.; Hasegawa, H.; Hellinger, P.; hide

    2011-01-01

    NASA's two spacecraft ARTEMIS mission will address both heliospheric and planetary research questions, first while in orbit about the Earth with the Moon and subsequently while in orbit about the Moon. Heliospheric topics include the structure of the Earth's magnetotail; reconnection, particle acceleration, and turbulence in the Earth's magnetosphere, at the bow shock, and in the solar wind; and the formation and structure of the lunar wake. Planetary topics include the lunar exosphere and its relationship to the composition of the lunar surface, the effects of electric fields on dust in the exosphere, internal structure of the Moon, and the lunar crustal magnetic field. This paper describes the expected contributions of ARTEMIS to these baseline scientific objectives.

  8. Breaking Object Correspondence Across Saccadic Eye Movements Deteriorates Object Recognition.

    Science.gov (United States)

    Poth, Christian H; Herwig, Arvid; Schneider, Werner X

    2015-01-01

    Visual perception is based on information processing during periods of eye fixations that are interrupted by fast saccadic eye movements. The ability to sample and relate information on task-relevant objects across fixations implies that correspondence between presaccadic and postsaccadic objects is established. Postsaccadic object information usually updates and overwrites information on the corresponding presaccadic object. The presaccadic object representation is then lost. In contrast, the presaccadic object is conserved when object correspondence is broken. This helps transsaccadic memory but it may impose attentional costs on object recognition. Therefore, we investigated how breaking object correspondence across the saccade affects postsaccadic object recognition. In Experiment 1, object correspondence was broken by a brief postsaccadic blank screen. Observers made a saccade to a peripheral object which was displaced during the saccade. This object reappeared either immediately after the saccade or after the blank screen. Within the postsaccadic object, a letter was briefly presented (terminated by a mask). Observers reported displacement direction and letter identity in different blocks. Breaking object correspondence by blanking improved displacement identification but deteriorated postsaccadic letter recognition. In Experiment 2, object correspondence was broken by changing the object's contrast-polarity. There were no object displacements and observers only reported letter identity. Again, breaking object correspondence deteriorated postsaccadic letter recognition. These findings identify transsaccadic object correspondence as a key determinant of object recognition across the saccade. This is in line with the recent hypothesis that breaking object correspondence results in separate representations of presaccadic and postsaccadic objects which then compete for limited attentional processing resources (Schneider, 2013). Postsaccadic object recognition is

  9. 31 CFR 585.215 - Conveyances and cargo suspected of being in violation of United Nations sanctions; detention...

    Science.gov (United States)

    2010-07-01

    ... being in violation of United Nations sanctions; detention; blocking. 585.215 Section 585.215 Money and... and cargo suspected of being in violation of United Nations sanctions; detention; blocking. (a) Except... § 585.201, but which are suspected of a violation of United Nations Security Council Resolutions No. 713...

  10. Magnetic resonance venography in consecutive patients with suspected deep vein thrombosis of the upper extremity: Initial experience

    NARCIS (Netherlands)

    Baarslag, H. J.; van Beek, E. J. R.; Reekers, J. A.

    2004-01-01

    Purpose: To assess the feasibility and accuracy of two magnetic resonance (MR) venography methods in a consecutive series of patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Material and Methods: Consecutive in- and outpatients who were referred for imaging of suspected

  11. Comparison of planar bone scintigraphy and single photon emission computed tomography in patients suspected of having unilateral condylar hyperactivity

    NARCIS (Netherlands)

    Saridin, Carrol P.; Raijmakers, Pieter G. H. M.; Tuinzing, Dirk B.; Becking, Alfred G.

    2008-01-01

    A comparison is made of single photon emission computed tomography (SPECT) and planar bone scintigraphy in the diagnosis of patients with suspected unilateral condylar hyperactivity (UCH). The subjects comprised 56 patients with suspected UCH who underwent SPECT and regular planar bone scans.

  12. Breaking object correspondence across saccadic eye movements deteriorates object recognition

    Directory of Open Access Journals (Sweden)

    Christian H. Poth

    2015-12-01

    Full Text Available Visual perception is based on information processing during periods of eye fixations that are interrupted by fast saccadic eye movements. The ability to sample and relate information on task-relevant objects across fixations implies that correspondence between presaccadic and postsaccadic objects is established. Postsaccadic object information usually updates and overwrites information on the corresponding presaccadic object. The presaccadic object representation is then lost. In contrast, the presaccadic object is conserved when object correspondence is broken. This helps transsaccadic memory but it may impose attentional costs on object recognition. Therefore, we investigated how breaking object correspondence across the saccade affects postsaccadic object recognition. In Experiment 1, object correspondence was broken by a brief postsaccadic blank screen. Observers made a saccade to a peripheral object which was displaced during the saccade. This object reappeared either immediately after the saccade or after the blank screen. Within the postsaccadic object, a letter was briefly presented (terminated by a mask. Observers reported displacement direction and letter identity in different blocks. Breaking object correspondence by blanking improved displacement identification but deteriorated postsaccadic letter recognition. In Experiment 2, object correspondence was broken by changing the object’s contrast-polarity. There were no object displacements and observers only reported letter identity. Again, breaking object correspondence deteriorated postsaccadic letter recognition. These findings identify transsaccadic object correspondence as a key determinant of object recognition across the saccade. This is in line with the recent hypothesis that breaking object correspondence results in separate representations of presaccadic and postsaccadic objects which then compete for limited attentional processing resources (Schneider, 2013. Postsaccadic

  13. Data quality objectives

    Energy Technology Data Exchange (ETDEWEB)

    Haeberer, F. [Environmental Protection Agency, Washington, DC (United States)

    1993-12-31

    The U.S. Environmental Protection Agency (EPA) spends about $500 million annually in collecting environmental data for scientific research and regulatory decision making. In addition, the regulated community may spend as much as ten times more each year in responding to EPA compliance requirements. Among the EPA and the regulated community there are several important common concerns: both want to make informed decisions using the right type, quality, and quantity of data. Collecting new data is very resource intensive to all parties. Neither EPA nor the regulated community can afford to collect more or {open_quotes}better{close_quotes} data than are really needed; the Data Quality Objectives (DQO) process is a systematic planning tool for ensuring that the right data will be collected for arriving at a decision within the desired confidence constraints. Using the DQO process to plan environmental data collections can help improve their effectiveness and efficiency, and enhance the defensibility of the decisions for which the data are used.

  14. Beyond the Object

    Directory of Open Access Journals (Sweden)

    2007-01-01

    Full Text Available Object orientation (OO is regained not only in all components of integrate development media but it remarks in the rest of software world from operating system to last application domain - of course, with different intensity and success. A clear prove of OO application in all situations is the development of a wide range of industrial applications. OO technology allows drawing of relation between the geometry, topology and dimensions of data on a class hierarchy; thus, the observation of the amount of data gained by research in many scientific domains is facilitated through class libraries both for graphic primitives and for events examination. In conformity to all waiting, OO asserts in every distributive system, there are very important the applications for making open systems customer-server and dis-tributed applications in Java. Finally OO application in robot's programming and modeling needn't be omitted. However, far to be panacea, OO has also shades which will be researched so on.

  15. [Abortion and conscientious objection].

    Science.gov (United States)

    Czarkowski, Marek

    2015-03-01

    Polish laws specify the parties responsible for lawful medical care in the availability of abortion differently than the Resolution of the Council of Europe. According to Polish regulations they include all Polish doctors while according to the Resolution, the state. Polish rules should not discriminate against anyone in connection with his religion or belief, even more so because the issue of abortion is an example of an unresolved ethical dispute. The number of lawful abortion in Poland does not exceed 1000 per year and can be carried out by only a few specialists contracted by the National Health Fund. Sufficient information and assistance should be provided to all pregnant women by the National Health Fund. The participation of all physicians in the informing process is not necessary, as evidenced by the lack of complaints to provide information on where in vitro fertilization treatment can be found - until recently only available when paid for by the individual and performed in much larger numbers than abortion. Entities performing this paid procedure made sure to provide information on their own. The rejection of the right to the conscientious objection clause by negating the right to refuse information may lead some to give up the profession or cause the termination of certain professionals on the basis of the professed worldview. Meanwhile, doctors are not allowed to be discriminated against on the basis of their conscience or religion. © 2015 MEDPRESS.

  16. [Viral load test conducive to excluding negative subjects from suspects in HIV antibody detections].

    Science.gov (United States)

    Hei, Fa-Xin; Zhang, Qi-Yun; Sun, Wei-Dong; Zhang, Qin; Ye, Jing-Rong; Liu, Hai-Lin; Lu, Hong-Yan

    2008-01-01

    To study whether plasma viral load testing is helpful to exclude ones free from Human immunodeficiency virus (HIV) infections from suspects in HIV antibody detections. 19 Specimens, which showed disconcordant results of the two HIV EIA testing (S/CO test, were selected. Viral load of the specimens were detected. A six-month follow up survey in detecting HIV antibody was conducted in these subjects. None of these 19 cases was observed to be positive HIV viral loads and there was no any progress in WB bands development during the follow-up period. The possibility of HIV infection could be excluded. When the specimens react with very low intensity in both EIA and WB, negative viral load result is conducive to exclude negative subjects from suspects in HIV antibody detections.

  17. Magnetic resonance angiography evidence of vasospasm in children with suspected acute hemiplegic migraine.

    Science.gov (United States)

    Safier, Robert; Cleves-Bayon, Catalina; Vaisleib, Inna; Siddiqui, Ali; Zuccoli, Giulio

    2014-06-01

    Hemiplegic migraine is a rare subtype of migraine that is differentiated by motor weakness in the aura phase. The purpose of this case series was to examine the magnetic resonance angiogram findings of patients suffering from suspected acute hemiplegic migraine. This was a retrospective institutional board review protocol study of 8 patients. All patients received full brain magnetic resonance imaging under a 1.5-T magnet. The scans were subsequently evaluated by a neuroradiologist and 2 neurologists who were blinded to the study. The magnetic resonance angiogram findings of this study showed the presence of vasospasm within the intracranial vasculature during suspected acute hemiplegic migraine. This case series suggests that routine use of magnetic resonance angiography might be beneficial in both managing patients with acute hemiplegic migraine and helping to further understand the pathophysiology of this complicated disease process. © The Author(s) 2013.

  18. Comparison of cortisol and thyroid hormones between tuberculosis-suspect and healthy elephants of Nepal.

    Science.gov (United States)

    Paudel, Sarad; Brown, Janine L; Thapaliya, Sharada; Dhakal, Ishwari P; Mikota, Susan K; Gairhe, Kamal P; Shimozuru, Michito; Tsubota, Toshio

    2016-12-01

    We compared cortisol and thyroid hormone (T3 and T4) concentrations between tuberculosis (TB)-suspected (n=10) and healthy (n=10) elephants of Nepal. Whole blood was collected from captive elephants throughout Nepal, and TB testing was performed using the ElephantTB STAT-PAK® and DPP VetTB® serological assays that detect antibodies against Mycobacterium tuberculosis and M. bovis in elephant serum. Cortisol, T3 and T4 were quantified by competitive enzyme immunoassays, and the results showed no significant differences in hormone concentrations between TB-suspect and healthy elephants. These preliminary data suggest neither adrenal nor thyroid function is altered by TB disease status. However, more elephants, including those positively diagnosed for TB by trunk wash cultures, need to be evaluated over time to confirm results.

  19. The assessment of children with suspected laryngopharyngeal reflux: An Otorhinolaringological perspective.

    Science.gov (United States)

    Galluzzi, Francesca; Schindler, Antonio; Gaini, Renato Maria; Garavello, Werner

    2015-10-01

    The assessment of pediatric laryngopharyngeal reflux (LPR) is controversial. Otorhinolaryngologists may play a role in the evaluation of children with suspected LPR detecting typical airway endoscopic findings and/or associated diseases and may help in the selection of children to be subjected to further instrumental tests. In this perspective the present review aims at examining the available evidence in the literature regarding the assessment of LPR in children. After careful literature search there are no current validated symptoms assessment questionnaires for LPR evaluation in children; flexible fiberoptic nasopharyngolaryngoscopy remains controversial as a diagnostic tool in suspect LPR cases; even though the multichannel intraluminal impedance with pH monitoring has been proposed as the instrumental gold standard, further evidence need to be found for validation in children with typical features of LPR. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Neurological signs in 23 dogs with suspected rostral cerebellar ischaemic stroke

    DEFF Research Database (Denmark)

    Thomsen, Barbara Blicher; Garosi, Laurent; Skerritt, Geoff

    2016-01-01

    Background: In dogs with ischaemic stroke, a very common site of infarction is the cerebellum. The aim of this study was to characterise neurological signs in relation to infarct topography in dogs with suspected cerebellar ischaemic stroke and to report short-term outcome confined...... to the hospitalisation period. A retrospective multicentre study of dogs with suspected cerebellar ischaemic stroke examined from 2010–2015 at five veterinary referral hospitals was performed. Findings from clinical, neurological, and paraclinical investigations including magnetic resonance imaging were assessed....... Results: Twenty-three dogs, 13 females and 10 males with a median age of 8 years and 8 months, were included in the study. The Cavalier King Charles Spaniel (n = 9) was a commonly represented breed. All ischaemic strokes were located to the vascular territory of the rostral cerebellar artery including...

  1. 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.

  2. Rapid tests for the diagnosis of visceral leishmaniasis in patients with suspected disease

    Science.gov (United States)

    Boelaert, Marleen; Verdonck, Kristien; Menten, Joris; Sunyoto, Temmy; van Griensven, Johan; Chappuis, Francois; Rijal, Suman

    2014-01-01

    Background The diagnosis of visceral leishmaniasis (VL) in patients with fever and a large spleen relies on showing Leishmania parasites in tissue samples and on serological tests. Parasitological techniques are invasive, require sophisticated laboratories, consume time, or lack accuracy. Recently, rapid diagnostic tests that are easy to perform have become available. Objectives To determine the diagnostic accuracy of rapid tests for diagnosing VL in patients with suspected disease presenting at health services in endemic areas. Search methods We searched MEDLINE, EMBASE, LILACS, CIDG SR, CENTRAL, SCI-expanded, Medion, Arif, CCT, and the WHO trials register on 3 December 2013, without applying language or date limits. Selection criteria This review includes original, phase III, diagnostic accuracy studies of rapid tests in patients clinically suspected to have VL. As reference standards, we accepted: (1) direct smear or culture of spleen aspirate; (2) composite reference standard based on one or more of the following: parasitology, serology, or response to treatment; and (3) latent class analysis. Data collection and analysis Two review authors independently extracted data and assessed quality of included studies using the QUADAS-2 tool. Discrepancies were resolved by a third author. We carried out a meta-analysis to estimate sensitivity and specificity of rapid tests, using a bivariate normal model with a complementary log-log link function. We analysed each index test separately. As possible sources of heterogeneity, we explored: geographical area, commercial brand of index test, type of reference standard, disease prevalence, study size, and risk of bias (QUADAS-2). We also undertook a sensitivity analysis to assess the influence of imperfect reference standards. Main results Twenty-four studies containing information about five index tests (rK39 immunochromatographic test (ICT), KAtex latex agglutination test in urine, FAST agglutination test, rK26 ICT, and r

  3. Aparasitemic serological suspects in Trypanosoma brucei gambiense human African trypanosomiasis : a potential human reservoir of parasites ?

    OpenAIRE

    Koffi, Mathurin; Solano, Philippe; Denizot, M.; Courtin, D.; Garcia, André; Lejon, V.; Buscher, P.; Cuny, Gérard; Jamonneau, Vincent

    2006-01-01

    The serological and parasitological tests used for Trypanosoma brucei gambiense human African trypanosomiasis (HAT) diagnosis have low specificity and sensitivity, respectively, and in the field, control program teams are faced with subjects with positive serology but negative parasitology who remain untreated. The aim of this work was to explore, using PCR tool, the significance of these aparasitemic serological suspects. Since discordant PCR results have been observed earlier with different...

  4. An approach to the patient with a suspected tachycardia in the ...

    African Journals Online (AJOL)

    SVT with a right or left BBB or an intra- ventricular conduction abnormality. This. An approach to the patient with a suspected tachycardia in the emergency department. A Chin,1 MB ChB, MPhil, FHRS; B Vezi,2 MB ChB, FCP (SA), Cert Cardiology (SA); M Namane,3 MB ChB, MPhil;. H Weich,4 MB ChB, MRCP (UK), MMed ...

  5. Performance characteristics of the suspected blood indicator feature in capsule endoscopy according to indication for study.

    Science.gov (United States)

    Buscaglia, Jonathan M; Giday, Samuel A; Kantsevoy, Sergey V; Clarke, John O; Magno, Priscilla; Yong, Elaine; Mullin, Gerard E

    2008-03-01

    The suspected blood indicator (SBI) feature of wireless capsule endoscopy (WCE) was developed for rapid screening of intestinal lesions with bleeding potential. Our aim was to assess the accuracy and performance characteristics of the SBI according to the indications for study in a large cohort of patients. We reviewed collected data on all WCE studies performed at Johns Hopkins Hospital from January 2006 to June 2007. Study indications were as follows: anemia of unknown origin (n = 53), obscure gastrointestinal bleeding (n = 112), suspected Crohn's disease (n = 122), and other (n = 4). Concordant and discordant findings between gastroenterologists' readings and SBI were recorded for each patient. A total of 221 lesions with bleeding potential was detected. The overall sensitivity, specificity, positive predictive value, and negative predictive value for the SBI were 56.4%, 33.5%, 24.0%, and 67.3%, respectively. For actively bleeding lesions, the SBI sensitivity and positive predictive value were only 58.3% and 70%, respectively. The sensitivity was highest (64%) in patients undergoing WCE for suspected Crohn's disease, with a negative predictive value of 80.4%. The sensitivity was only 58.3% and 41.3%, respectively, in studies performed for obscure gastrointestinal bleeding and anemia. Performance characteristics of the currently available SBI feature in WCE are suboptimal and insufficient to screen for lesions with bleeding potential. Even in patients with active intestinal bleeding, the sensitivity of SBI was less than 60%, which is lower than previously reported. However, in patients with suspected Crohn's disease, the high sensitivity and negative predictive value of SBI may make it a useful tool for the detection of large areas of abnormal mucosa.

  6. 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.)

  7. Suspected Pulmonary Infection with Trichoderma longibrachiatum after Allogeneic Stem Cell Transplantation

    OpenAIRE

    Akagi, Tomoaki; Kawamura, Chizuko; Terasawa, Norio; Yamaguchi, Kohei; Kubo, Kohmei

    2017-01-01

    Aspergillus and Candida species are the main causative agents of invasive fungal infections in immunocompromised human hosts. However, saprophytic fungi are now increasingly being recognized as serious pathogens. Trichoderma longibrachiatum has recently been described as an emerging pathogen in immunocompromised patients. We herein report a case of isolated suspected invasive pulmonary infection with T. longibrachiatum in a 29-year-old man with severe aplastic anemia who underwent allogeneic ...

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

    Science.gov (United States)

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

    2015-01-01

    Skeletal surveys are routinely performed in cases of suspected child abuse, but there are limited data regarding the yield of high-detail skeletal surveys in infants. To determine the diagnostic yield of high-detail radiographic skeletal surveys in suspected infant abuse. We reviewed the high-detail American College of Radiology standardized skeletal surveys performed for suspected abuse in 567 infants (median: 4.4 months, SD 3.47; range: 4 days-12 months) at a large urban children's hospital between 2005 and 2013. Skeletal survey images, radiology reports and medical records were reviewed. A skeletal survey was considered positive when it showed at least one unsuspected fracture. In 313 of 567 infants (55%), 1,029 definite fractures were found. Twenty-one percent (119/567) of the patients had a positive skeletal survey with a total of 789 (77%) unsuspected fractures. Long-bone fractures were the most common injuries, present in 145 children (26%). The skull was the site of fracture in 138 infants (24%); rib cage in 77 (14%), clavicle in 24 (4.2%) and uncommon fractures (including spine, scapula, hands and feet and pelvis) were noted in 26 infants (4.6%). Of the 425 infants with neuroimaging, 154 (36%) had intracranial injury. No significant correlation between positive skeletal survey and associated intracranial injury was found. Scapular fractures and complex skull fractures showed a statistically significant correlation with intracranial injury (P = 0.029, P = 0.007, respectively). Previously unsuspected fractures are noted on skeletal surveys in 20% of cases of suspected infant abuse. These data may be helpful in the design and optimization of global skeletal imaging in this vulnerable population.

  9. A Case of Suspected Breast Cancer Metastasis to Brachial Plexus Detected by Magnetic Resonance Neurography

    Directory of Open Access Journals (Sweden)

    Atsushi Mizuma

    2016-07-01

    Full Text Available Metastasis of breast cancer is often detected through a long-term course and difficult to diagnose. We report a case of brachial plexopathy suspected to be the initial lesion of breast cancer metastasis, which was only detected by magnetic resonance (MR neurography. A 61-year-old woman was admitted to our hospital within 2 years after operation for breast cancer because of progressive dysesthesia and motor weakness initially in the upper limb on the affected side and subsequently on the contralateral side. Enhanced computed tomography, axillary lymph node echo, gallium scintigraphy, and short tau inversion recovery MR images showed no abnormalities. MR neurography revealed a swollen region in the left brachial plexus. We suspected neuralgic amyotrophy and initiated treatment with intravenous immunoglobulin therapy and steroid therapy. However, there was no improvement, and the progression of motor weakness in the bilateral lower limbs appeared over 4 years. Concomitant elevation of carbohydrate antigen 15-3 level (58.9 U/ml led us to suspect breast cancer metastasis, which was associated with the worsening of neurological findings, although gallium scintigraphy and bone scintigraphy showed no inflammatory and metastatic lesions. Swelling of the cauda equina in enhanced lumbar MR imaging and abnormal accumulation at the brachial plexus and cervical spinal cord in positron-emission tomography were newly detected contrary to the normal findings on the gallium scintigraphy, which suggested cerebrospinal fluid seeding. We suspected breast cancer metastasis about the initial brachial plexopathy based on the clinical course. MR neurography may be a helpful tool to detect metastatic lesion, especially in nerve roots.

  10. 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.)

  11. 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

  12. Terrorism, governmentality and the simulated city: the Boston Marathon bombing and the search for suspect two

    OpenAIRE

    Topinka, Robert

    2016-01-01

    This article examines the online circulation of a photograph of the immediate aftermath of the 2013 Boston Marathon bombings taken by David Green, a Boston Marathon runner. The photograph fortuitously captured an image of Dzhokhar Tsarnaev, the younger Tsarnaev brother, running from the scene. Initially, Tsarnaev went unnoticed by online message board users and FBI investigators – he was just another face in the urban crowd. However, after he was identified as suspect two, he emerged in the p...

  13. [A case of Reye's-like syndrome due to suspected Bordetella pertussis infection in an adult].

    Science.gov (United States)

    Ikeda, Kenichi; Sonoda, Ken

    2009-11-01

    We report a rare case of Reye's-like syndrome associated with suspected pertussis infection. A 26-year-old woman admitted comatose and found in laboratory studies to have acute liver dysfunction, severe hypoglycemia and prolonged prothrombin time, was diagnosed with clinical Reye's-like syndrome due to aspirin use. Her child was probably infected with pertussis, which she contracted and which, in turn, triggered Reye's-like syndrome.

  14. When the Child is Suspected to Have Autism Spectrum Disorder: Recommendation for Parents

    OpenAIRE

    Borodina L.G.; Soldatenkova E.N.

    2015-01-01

    Experts in the area of treatment and intervention for autism spectrum disorders provide parents with recommenda¬tions for situations when their children are suspected to have autism or have been diagnosed. These recommenda¬tions are universal and are appropriate for raising a child with any spectrum disorder. Following these recommenda¬tions will allow parents to comprehend the situation with the child’s development, access approaches, that are used by professionals, and will help them to not...

  15. 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.

  16. Case Report: Clinical Features of a Case of Suspected Borrelia miyamotoi Disease in Hokkaido, Japan.

    Science.gov (United States)

    Yamano, Kimiaki; Ito, Takuya; Kiyanagi, Kaori; Yamazaki, Hirotaka; Sugawara, Mutsubu; Saito, Takashige; Ohashi, Norio; Zamoto-Niikura, Aya; Sato, Kozue; Kawabata, Hiroki

    2017-07-01

    We herein report a case of suspected Borrelia miyamotoi disease in Hokkaido, Japan. The patient complained of lassitude, arthralgia, and high fever after a tick bite. Furthermore, at the time of consultation, the patient exhibited momentary loss of consciousness and low blood pressure. Laboratory tests revealed elevation of liver enzymes, thrombocytopenia, and increased C-reactive protein. Seroconversion to B. miyamotoi glycerophosphoryl diester phosphodiesterase antigen suggested the patient was infected with a relapsing fever group Borrelia species.

  17. Assessment and management of a child with suspected acute neck injury.

    Science.gov (United States)

    Jones, Chris

    2012-04-01

    Any child presenting at an emergency department after trauma, such as road traffic accidents, falls, sports and head injuries, should be assessed for risk of injury to the cervical spine. The aim of this article is to provide an overview of the assessment and nursing management of a child with a suspected cervical spine injury. Basic anatomy is covered along with neck injury assessment, how to measure a cervical collar correctly, safe immobilisation, and communication.

  18. Shortening Isolation of Patients With Suspected Tuberculosis by Using Polymerase Chain Reaction Analysis

    DEFF Research Database (Denmark)

    Fløe, Andreas; Hilberg, Ole; Thomsen, Vibeke Østergaard

    2015-01-01

    Background. Isolation of patients suspected for pulmonary tuberculosis is guided by serial sputum smears. This can result in isolation for days for patients with noncontagious tuberculosis. To determine whether a single sample negative for Mycobacterium tuberculosis complex at polymerase chain re......-positive/PCR-negative cases underlines the importance of increasing the quantity and quality of samples. Moreover, it is important that samples analyzed with PCR are cultured, owing to higher-sensitivity drug susceptibility testing, differential diagnosis, and surveillance....

  19. [Air embolism during lumbar discal hernia repair. Retroperioneal vessels lesions have to be suspected].

    Science.gov (United States)

    Lieutaud, T; Terrier, A; Linne, M; Farhat, F; Tahon, F

    2006-03-01

    Occurrence of deep PETCO(2) drop during surgical lumbar disk repair is rare but dramatic. This case report leads to the diagnosis of retroperitoneal vessels lesions. We review the different diagnosis related to the drop of the PETCO(2) during surgery in the genupectoral position. We recommend that the diagnosis of retroperitoneal vessels lesion have to be suspected early if air embolism occurs during lumbar disk surgery.

  20. Target-object integration, attention distribution, and object orientation interactively modulate object-based selection.

    Science.gov (United States)

    Al-Janabi, Shahd; Greenberg, Adam S

    2016-10-01

    The representational basis of attentional selection can be object-based. Various studies have suggested, however, that object-based selection is less robust than spatial selection across experimental paradigms. We sought to examine the manner by which the following factors might explain this variation: Target-Object Integration (targets 'on' vs. part 'of' an object), Attention Distribution (narrow vs. wide), and Object Orientation (horizontal vs. vertical). In Experiment 1, participants discriminated between two targets presented 'on' an object in one session, or presented as a change 'of' an object in another session. There was no spatial cue-thus, attention was initially focused widely-and the objects were horizontal or vertical. We found evidence of object-based selection only when targets constituted a change 'of' an object. Additionally, object orientation modulated the sign of object-based selection: We observed a same-object advantage for horizontal objects, but a same-object cost for vertical objects. In Experiment 2, an informative cue preceded a single target presented 'on' an object or as a change 'of' an object (thus, attention was initially focused narrowly). Unlike in Experiment 1, we found evidence of object-based selection independent of target-object integration. We again found that the sign of selection was modulated by the objects' orientation. This result may reflect a meridian effect, which emerged due to anisotropies in the cortical representations when attention is oriented endogenously. Experiment 3 revealed that object orientation did not modulate object-based selection when attention was oriented exogenously. Our findings suggest that target-object integration, attention distribution, and object orientation modulate object-based selection, but only in combination.

  1. Low rate of positive bronchoscopy for suspected foreign body aspiration in infants.

    Science.gov (United States)

    Sheehan, Cameron C; Lopez, Joseph; Elmaraghy, Charles A

    2018-01-01

    To describe our institution's low rate of positive bronchoscopy in infants suspected of inhaling a foreign body. Retrospective chart review. A retrospective review was performed of patients at a tertiary children's hospital with suspected inhalation of a foreign body. Charts were reviewed for demographic information, radiologic findings, operative reports, and respiratory viral panels were reviewed. Sixteen pediatric patients under 12 months of age were identified from 2008 to 2016 with a diagnosis of possible airway foreign body inhalation who underwent emergent bronchoscopy. Of these patients, only one was positive for a foreign body present in the airway. The remaining 15 children were found to have a negative direct laryngoscopy and bronchoscopy evaluation for a foreign body. Of these fifteen patients, 14 were found to have structural airway abnormalities and 7 tested positive for a respiratory viral infection. Our institution has a low rate of positive bronchoscopy for highly suspected foreign body inhalation in a group of patients less than 12 months of age. Patients presenting with respiratory distress, stridor, or other airway symptoms were often found to have an underlying airway abnormality or viral infection, which coupled with an unclear history, would increase the suspicion for an airway foreign body and subsequent decision to perform bronchoscopy. In stable patients, diagnostic evaluation for an underlying respiratory infection should be performed in these cases. Case Series. Copyright © 2017. Published by Elsevier B.V.

  2. Towards rational use of antibiotics for suspected secondary infections in Buruli ulcer patients.

    Science.gov (United States)

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

    2013-01-01

    The emerging disease Buruli ulcer is treated with streptomycin and rifampicin and surgery if necessary. Frequently other antibiotics are used during treatment. Information on prescribing behavior of antibiotics for suspected secondary infections and for prophylactic use was collected retrospectively. Of 185 patients that started treatment for Buruli ulcer in different centers in Ghana and Bénin 51 were admitted. Forty of these 51 admitted patients (78%) received at least one course of antibiotics other than streptomycin and rifampicin during their hospital stay. The median number (IQR) of antibiotic courses for admitted patients was 2 (1, 5). Only twelve patients received antibiotics for a suspected secondary infection, all other courses were prescribed as prophylaxis of secondary infections extended till 10 days on average after excision, debridement or skin grafting. Antibiotic regimens varied considerably per indication. In another group of BU patients in two centers in Bénin, superficial wound cultures were performed. These cultures from superficial swabs represented bacteria to be expected from a chronic wound, but 13 of the 34 (38%) S. aureus were MRSA. A guide for rational antibiotic treatment for suspected secondary infections or prophylaxis is needed. Adherence to the guideline proposed in this article may reduce and tailor antibiotic use other than streptomycin and rifampicin in Buruli ulcer patients. It may save costs, reduce toxicity and limit development of further antimicrobial resistance. This topic should be included in general protocols on the management of Buruli ulcer.

  3. Assessment Of Suspected Skin Lesion Depth By Multispectral Digital Dermatoscopy: In-Vivo Tests

    Science.gov (United States)

    Scalise, L.; Munaretto, R.; Serresi, S.; Tomasini, E. P.

    2010-05-01

    The aim of the present study is to demonstrate the possibility to assess the depth of suspected skin lesion in-vivo, using multispectral digital dermatoscopy (MDD); being malignant lesion depth an important factor related to survival rate. The system realised in this work is based on a special multi-wavelength LED illuminator (700 nm, 940 nm and 950 nm) and an high quality CCD camera which allows to acquire a detailed image of the suspected skin lesion. A statistically significant correlation between contrast of the area of the lesion at single wavelength and the depth of the lesions in vivo (as determined by histopathology survey) has been found using 39 samples. Interesting results, have been especially obtained using illuminating wavelength at 940 nm and 950 nm. Using a linear fitting of our data the maximum depth of melanoma has been overestimation of 0.43 ± 0.26 mm. The present study shows a possible use of our MDD system as in the assessment of maximum depth of suspected skin lesions.

  4. 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.

  5. Uncertainty and anxiety during the diagnostic period for women with suspected breast cancer.

    Science.gov (United States)

    Liao, Mei-Nan; Chen, Miin-Fu; Chen, Shin-Cheh; Chen, Ping-Ling

    2008-01-01

    A possible diagnosis of breast cancer imposes a huge psychological impact on most women, but few studies have addressed uncertainty and anxiety changes at different diagnostic stages in women with suspected breast cancer. Thus, this longitudinal study examined uncertainty and anxiety and predictive factors for uncertainty in women with suspected breast cancer. Data were collected on uncertainty (Uncertainty in Illness Scale) and anxiety (State Anxiety Inventory) from 127 women at 3 times: upon notice of a breast biopsy, before biopsy, and after diagnosis. The results showed that uncertainty and anxiety levels were significantly higher before than after diagnosis. At the 3 data collection times, uncertainty and anxiety were significantly lower for participants diagnosed with benign tumors than for those with malignant diagnoses. Uncertainty and anxiety were positively, moderately correlated. Uncertainty was predicted by age, marital status, education level, religious status, family history of benign breast tumor, regular breast self-examination, self-perceived probability of receiving a breast cancer diagnosis, and biopsy result. Therefore, nursing professionals should be aware of the uncertainty and anxiety changes and impact of personal attributes on women with suspected breast cancer during the diagnostic period and provide care programs to alleviate their psychological distress.

  6. Routine deferred computed tomography for patients with suspected urolithiasis is low-value healthcare.

    Science.gov (United States)

    Rosenlund, Ingvild M; Førde, Olav H; Revhaug, Arthur

    2017-02-01

    The aim of this study was to investigate the benefits of deferred routine computed tomography of the kidneys, ureters and bladder (CT KUB) for patients with a self-limiting episode of suspected urolithiasis. The study comprised a case series of consecutive patients examined with deferred routine CT KUB for control of suspected urolithiasis. Patients examined with CT KUB at the University Hospital of North Norway, between 1 January 2010 and 31 December 2013, were included. The final analysis included 189 CT KUBs (response rate 48%). All data were extracted from the patient case files. The primary endpoint was the proportion of asymptomatic patients with a confirmed diagnosis of urolithiasis on CT KUB that led to surgical intervention within 1 year from the initial CT scan. At the time of CT KUB, 171 patients (90%) were asymptomatic, of whom three (1.8%) were treated. Urolithiasis was confirmed on CT KUB in 23% of asymptomatic patients. Deferred CT KUB did not alter the clinical outcome for the great majority of asymptomatic patients. The majority of patients who received adequate pain relief in primary care remained asymptomatic, and did not need specialized healthcare. Refraining from CT KUB involves little risk. Deferred CT KUB for patients with suspected urolithiasis is a low-value healthcare service.

  7. 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.)

  8. Positron emission tomography myocardial perfusion imaging in children with suspected coronary abnormalities.

    Science.gov (United States)

    Singh, T P; Muzik, O; Forbes, T F; Di Carli, M F

    2003-01-01

    Positron emission tomography (PET) myocardial perfusion imaging has higher spatial resolution than conventional single photon emission computed tomography (SPECT) imaging and allows accurate and reproducible quantification of myocardial blood flow (MBF). In this article, we describe the role of PET myocardial perfusion imaging in clinical decision making in children with suspected coronary abnormalities. We performed a PET myocardial perfusion study using N-13 ammonia in 10 children (median age, 14 years; range, 1-17 years). The indications included exercise-induced chest pain and ST segment changes during exercise testing, coronary artery ectasia, hypertrophic cardiomyopathy with myocardial bridging of the left anterior descending coronary artery, and suspected left coronary stenosis in an infant with William's syndrome. MBF was assessed at baseline and during adenosine hyperemia in all 10 patients and postexercise in 8 patients. Myocardial perfusion was homogeneous at baseline in all 10 patients, during adenosine perfusion in 9 of 10 patients, and postexercise in all 8 patients. Three patients with homogeneous rest and stress perfusion had impaired myocardial flow reserve. The infant with William's syndrome developed a large, reversible perfusion defect in the left coronary territory during adenosine stress and underwent surgical repair. Myocardial flow reserve findings were valuable for clinical decision making in individual patients. We conclude that MBF quantification with N-13 ammonia and PET provides supplemental perfusion information and is helpful in clinical decision making in children with suspected coronary abnormalities.

  9. Incidental findings at MRI-enterography in patients with suspected or known Crohn's disease

    DEFF Research Database (Denmark)

    Jensen, Michael Dam; Nathan, Torben; Kjeldsen, Jens

    2010-01-01

    AIM: To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging (MRI)-enterography in patients with suspected or known Crohn's disease (CD). METHODS: Incidental findings were defined as unexpected lesions outside the small intestine, not previou......AIM: To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging (MRI)-enterography in patients with suspected or known Crohn's disease (CD). METHODS: Incidental findings were defined as unexpected lesions outside the small intestine......, not previously known or suspected at the time of referral, and not related to inflammatory bowel disease. Through a systematic review of medical charts we analyzed the clinical impact of incidental findings, and compared the MRI findings with subsequent diagnostic procedures. RESULTS: A total of 283 patients...... were included in the analysis, and MRI detected active CD in 31%, fistula in 1.4% and abscess in 0.7%. Extra-intestinal findings not related to CD were recorded in 72 patients (25%), of which 58 patients (20%) had 74 previously unknown lesions. Important or incompletely characterized findings were...

  10. Use of /sup 131/I-MIBG scintigraphy in the evaluation of suspected pheochromocytoma

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-05-01

    Studies at the University of Michigan have shown that /sup 131/I-metaiodobenzylguanidine (/sup 131/I-MIBG) is an effective agent for the diagnosis and localization of pheochromocytomas and paragangliomas. The authors conducted a study that confirmed and expanded that finding. From January 1983 to March 1984, 48 patients at our institution had 51 /sup 131/I-MIBG scans during the workup of suspected sporadic or metastatic pheochromocytoma. Scintigrams were obtained after 500 microCI of /sup 131/I-MIBG had been administered intravenously. The final diagnosis (true-positive, false-negative, or false-positive result) was made at operation and pathologic examination. A true-negative diagnosis was confirmed by normal plasma and fractionated urinary levels of catecholamines and metabolites and, in most patients, computed tomography (CT). The overall sensitivity of /sup 131/I-MIBG scanning was 77%, specificity was 96%, and accuracy was 86%. This test is fairly sensitive in the workup of patients with known or suspected recurrent or metastatic pheochromocytoma. It may also be helpful in the evaluation of suspected sporadic pheochromocytoma when CT findings are normal.

  11. Detection of herpes viruses in the cerebrospinal fluid of adults with suspected viral meningitis in Malawi.

    Science.gov (United States)

    Benjamin, L A; Kelly, M; Cohen, D; Neuhann, F; Galbraith, S; Mallewa, M; Hopkins, M; Hart, I J; Guiver, M; Lalloo, D G; Heyderman, R S; Solomon, T

    2013-02-01

    We looked for herpes simplex virus types 1 and 2 (HSV-1 and HSV-2, respectively), varicella zoster virus (VZV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV) DNA in Malawian adults with clinically suspected meningitis. We collected cerebrospinal fluid (CSF) from consecutive adults admitted with clinically suspected meningitis to Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi, for a period of 3 months. Those with proven bacterial or fungal meningitis were excluded. Real-time polymerase chain reaction (PCR) was performed on the CSF for HSV-1 and HSV-2, VZV, EBV and CMV DNA. A total of 183 patients presented with clinically suspected meningitis. Of these, 59 (32 %) had proven meningitis (bacterial, tuberculous or cryptococcal), 39 (21 %) had normal CSF and 14 (8 %) had aseptic meningitis. For the latter group, a herpes virus was detected in 9 (64 %): 7 (50 %) had EBV and 2 (14 %) had CMV, all were human immunodeficiency virus (HIV)-positive. HSV-2 and VZV were not detected. Amongst those with a normal CSF, 8 (21 %) had a detectable herpes virus, of which 7 (88 %) were HIV-positive. The spectrum of causes of herpes viral meningitis in this African population is different to that in Western industrialised settings, with EBV being frequently detected in the CSF. The significance of this needs further investigation.

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

    Science.gov (United States)

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

    2017-01-01

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

  13. Patient selection for later delivery timing with suspected previa-accreta.

    Science.gov (United States)

    Perlman, Nicola C; Little, Sarah E; Thomas, Ann; Cantonwine, David E; Carusi, Daniela A

    2017-08-01

    We identified patients with previa and suspected accreta who are at lowest risk of unscheduled delivery or major morbidity with planned delivery beyond 34 weeks' gestation. This was a retrospective cohort study of patients who had reached 34.0 weeks' gestational age with a suspected previa-accreta. We evaluated rates of unscheduled and emergent delivery based on known risk factors for premature birth. In a second analysis, we stratified patients based on level of preoperative morbidity concern and evaluated rates of major transfusion and Intensive Care Unit admission by delivery week (34 weeks, 35 weeks or 36 weeks and beyond). Of 84 available patients, we classified 31 patients as low risk for unscheduled delivery and 52 as high risk. The low risk group was scheduled later (36.6 vs. 36.0 weeks; p delivery prior to 36 weeks (3% vs. 19%, p = 0.05). Of the patients with no prior cesarean section, only one (7%) experienced massive blood loss even though 36% had unscheduled deliveries. We observed no significant increase in major transfusion or massive blood loss with advancing gestational age, likely due to selection of the most concerning patients for early, scheduled delivery. Patients with suspected previa-accreta and no risk factors for preterm birth are at low risk for an unscheduled delivery prior to 36 weeks. Those with no concern for percreta or increta or no prior cesarean section may also be candidates for later delivery. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  14. Common Allergens Identified Based on Patch Test Results in Patients with Suspected Contact Dermatitis of the Scalp

    Science.gov (United States)

    Aleid, Nouf M.; Fertig, Raymond; Maddy, Austin; Tosti, Antonella

    2017-01-01

    Background Contact dermatitis of the scalp is common and might be caused by many chemicals including metals, ingredients of shampoos and conditioners, dyes, or other hair treatments. Eliciting a careful history and patch tests are necessary to identify the responsible allergen and prevent relapses. Objectives To identify allergens that may cause contact dermatitis of the scalp by reviewing patch test results. Methods We reviewed the records of 1,015 patients referred for patch testing at the Dermatology Department of the University of Miami. A total of 226 patients (205 females and 21 males) with suspected scalp contact dermatitis were identified, and the patch test results and clinical data for those patients were analyzed. Most patients were referred for patch testing from a specialized hair clinic at our institution. Results The most common allergens in our study population were nickel (23.8%), cobalt (21.0%), balsam of Peru (18.2%), fragrance mix (14.4%), carba mix (11.6%), and propylene glycol (PG) (8.8%). The majority of patients were females aged 40–59 years, and scalp itching or burning were reported as the most common symptom. Conclusion Frequent sources of allergens for metals include hair clasps, pins, and brushes, while frequent sources of allergens for preservatives, fragrance mix, and balsam of Peru include shampoos, conditioners, and hair gels. Frequent sources of allergens for PG include topical medications. PMID:28611994

  15. Cutaneous manifestations associated with antiphospholipid antibodies in patients with suspected primary antiphospholipid syndrome: a case-control study.

    Science.gov (United States)

    Naldi, L; Locati, F; Marchesi, L; Cortelazzo, S; Finazzi, G; Galli, M; Brevi, A; Cainelli, T; Barbui, T

    1993-01-01

    OBJECTIVE: To study the association of a variety of dermatological manifestations related to vascular abnormalities with antiphospholipid antibodies in patients with suspected primary antiphospholipid syndrome. METHOD: Case-control study. Consecutive patients referred to the coagulation and haemostasis service of a general hospital for the first determination of antiphospholipid antibodies (lupus anticoagulant and anticardiolipin antibodies) and newly diagnosed disorders (for example, thrombocytopenia, thrombotic disorders, and unexplained repeated abortions) were selected. Patients were examined by two dermatologists according to predefined criteria, and information about general characteristics and relevant dermatological and medical histories were collected using an ad hoc questionnaire. The study was limited to patients without evidence of systemic lupus erythematosus. A total of 35 patients was examined; 13 subjects were positive for lupus anticoagulant or anticardiolipin antibodies, or both (cases), and 22 were negative (controls). RESULTS: Moderate to severe livedo reticularis and acrocyanosis were significantly associated with antiphospholipid antibodies, with relative risks of 13.1 (95% confidence interval 1.1 to 149.0) and 8.6 (95% confidence interval 1.1 to 65.1). Capillaritis was also associated with the antibodies. Histories of Raynaud's phenomenon and superficial thrombophlebitis were more common in cases than controls. CONCLUSIONS: This study provides quantitative evidence of the association of antiphospholipid antibodies with several cutaneous diseases in which vascular abnormalities seem to play a major part. The study suggests that these manifestations might appear early in the development of the antiphospholipid syndrome. PMID:8484676

  16. Current Practice in the Referral of Individuals with Suspected Dementia for Neuroimaging by General Practitioners in Ireland and Wales

    Science.gov (United States)

    Ciblis, Aurelia S.; Butler, Marie-Louise; Quinn, Catherine; Clare, Linda; Bokde, Arun L. W.; Mullins, Paul G.; McNulty, Jonathan P.

    2016-01-01

    Objectives While early diagnosis of dementia is important, the question arises whether general practitioners (GPs) should engage in direct referrals. The current study investigated current referral practices for neuroimaging in dementia, access to imaging modalities and investigated related GP training in Ireland and North Wales. Methods A questionnaire was distributed to GPs in the programme regions which included approximately two thirds of all GPs in the Republic of Ireland and all general practitioners in North Wales. A total of 2,093 questionnaires were issued. Results 48.6% of Irish respondents and 24.3% of Welsh respondents directly referred patients with suspected dementia for neuroimaging. Irish GPs reported greater direct access to neuroimaging than their Welsh counterparts. A very small percentage of Irish and Welsh GPs (4.7% and 10% respectively) had received training in neuroimaging and the majority who referred patients for neuroimaging were not aware of any dementia-specific protocols for referrals (93.1% and 95% respectively). Conclusions The benefits of direct GP access to neuroimaging investigations for dementia have yet to be established. Our findings suggest that current GP speciality training in Ireland and Wales is deficient in dementia-specific and neuroimaging training with the concern being that inadequate training will lead to inadequate referrals. Further training would complement guidelines and provide a greater understanding of the role and appropriateness of neuroimaging techniques in the diagnosis of dementia. PMID:27007435

  17. Evaluation of Two Diuresis Renography Decision Support Systems to Determine the Need for Furosemide in Patients with Suspected Obstruction

    Science.gov (United States)

    Taylor, Andrew; Hill, Andrew N.; Binongo, José N. E.; Manatunga, Amita K.; Halkar, Raghuveer; Dubovsky, Eva V.; Garcia, Ernest V.

    2013-01-01

    OBJECTIVE The purpose of this study was to compare the decisions regarding the need for furosemide made by two independent renal decision support systems, RENEX and CARTAN, with the need for furosemide determined in clinical practice and by expert reviewers using the baseline plus furosemide protocol. SUBJECTS AND METHODS RENEX and CARTAN are independent decision support systems that reach their conclusions without operator input. RENEX is a knowledge-based system and CARTAN is a statistical decision support system. Both were trained using the same pilot group of 31 adult patients (61 kidneys) referred for suspected obstruction. Subsequently, both systems were prospectively applied to 102 patients (200 kidneys) of whom 70 received furosemide; decisions regarding the need for furosemide were compared with the clinical decisions and the decisions of three experts who independently scored each kidney on the need for furosemide. Differences were resolved by consensus. RESULTS RENEX agreed with the clinical and experts’ decisions to give furosemide in 97% (68/70) and 98% (65/66) of patients, respectively, whereas CARTAN agreed in 90% (63/70) and 89% (59/66), respectively, p furosemide in 78% of kidneys (87/111), whereas RENEX agreed in only 69% of kidneys (77/111), p = 0.008. CONCLUSION Use of RENEX or CARTAN as decision support tools in the baseline plus furosemide protocol has the potential to help the radiologist avoid unnecessary imaging and reduce the technologist, computer, camera, and physician time required to perform the procedure. PMID:17449788

  18. 99mTc-apcitide scintigraphy in patients with clinically suspected deep venous thrombosis and pulmonary embolism.

    Science.gov (United States)

    Dunzinger, Andreas; Hafner, Franz; Schaffler, Gottfried; Piswanger-Soelkner, Jutta-Claudia; Brodmann, Marianne; Lipp, Rainer W

    2008-11-01

    Detection of acute deep venous thrombosis (DVT) in patients presenting with clinical symptoms suggesting DVT and pulmonary embolism (PE) with (99m)Tc-apcitide, a synthetic polypeptide, binding to glycoprotein IIb/IIIa receptors expressed on activated platelets is the objective of the study. Nineteen patients (11 males, eight females) received within 24h after admission to the hospital a mean of 841 MBq (range 667 to 1,080) (99m)Tc-apcitide i.v. followed by planar recordings 10, 60, and 120 min after injection. Images were compared to the results of compression ultrasonography and/or phlebography. Patients with clinically suspected PE underwent spiral computed tomography or lung perfusion scans. (99m)Tc-apcitide scintigraphy showed acute clot formation in 14 out of 16 patients where the other imaging modalities suggested DVT. Positive scintigraphic results were seen up to 17 days after the onset of clinical symptoms. In three out of three patients without any proof of DVT, (99m)Tc-apcitide scintigraphy was truly negative. Glycoprotein receptor imaging showed only one segmental PE in six patients with imaging-proven subsegmental (N = 3) or segmental PE (N = 3). (99m)Tc-apcitide scintigraphy may be an easy and promising tool for the detection of acute clot formation in patients with DVT up to 17 days after the onset of clinical symptoms with a sensitivity of 87% and a specificity of 100%. However, it failed to demonstrate PE in 83% of examined patients with proven PE.

  19. Effectiveness of a fluid chart in outpatient management of suspected dengue fever: A pilot study.

    Science.gov (United States)

    Nasir, Nazrila Hairin; Mohamad, Mohazmi; Lum, Lucy Chai See; Ng, Chirk Jenn

    2017-01-01

    Dengue infection is the fastest spreading mosquito-borne viral disease in the world. One of the complications of dengue is dehydration which, if not carefully monitored and treated, may lead to shock, particularly in those with dengue haemorrhagic fever. WHO has recommended oral fluid intake of five glasses or more for adults who are suspected to have dengue fever. However, there have been no published studies looking at self-care intervention measures to improve oral fluid intake among patients suspected of dengue fever. To assess the feasibility and effectiveness of using a fluid chart to improve oral fluid intake in patients with suspected dengue fever in a primary care setting. This feasibility study used a randomized controlled study design. The data was collected over two months at a primary care clinic in a teaching hospital. The inclusion criteria were: age > 12 years, patients who were suspected to have dengue fever based on the assessment by the primary healthcare clinician, fever for > three days, and thrombocytopenia (platelets chart and a cup (200ml). Baseline clinical and laboratory data, 24-hour fluid recall (control group), and fluid chart were collected. The main outcomes were: hospitalization rates, intravenous fluid requirement and total oral fluid intake. Among the 138 participants who were included in the final analysis, there were fewer hospital admissions in the intervention group (n = 7, 10.0%) than the control group (n = 12, 17.6%) (p = 0.192). Similarly, fewer patients (n = 9, 12.9%) in the intervention group required intravenous fluid compared to the control group (n = 15, 22.1%), (p = 0.154). There was an increase in the amount of daily oral fluid intake in the intervention group (about 3,000 ml) compared to the control group (about 2,500 ml, p = 0.521). However, these differences did not reach statistical significance. This is a feasible and acceptable study to perform in a primary care setting. The fluid chart is a simple, inexpensive

  20. Quantifying sociodemographic and income disparities in medical therapy and lifestyle among symptomatic patients with suspected coronary artery disease: a cross-sectional study in North America

    Science.gov (United States)

    Ladapo, Joseph A; Coles, Adrian; Dolor, Rowena J; Mark, Daniel B; Cooper, Lawton; Lee, Kerry L; Goldberg, Jonathan; Shapiro, Michael D; Hoffmann, Udo; Douglas, Pamela S

    2017-01-01

    Objectives To evaluate potential gaps in preventive medical therapy and healthy lifestyle practices among symptomatic patients with suspected coronary artery disease (CAD) seeing primary care physicians and cardiologists and how gaps vary by sociodemographic characteristics and baseline cardiovascular risk. Design Cross-sectional study assessing potential preventive gaps. Participants 10 003 symptomatic outpatients evaluated by primary care physicians, cardiologists or other specialists for suspected CAD. Setting PROspective Multicenter Imaging Study for Evaluation of Chest Painfrom 2010 to 2014. Measures Primary measures were absence of an antihypertensive, statin or angiotensin-converting enzyme inhibitor/angiotensin receptor blocker for renal protection in patients with hypertension, dyslipidaemia or diabetes, respectively, and being sedentary, smoking or being obese. Results Preventive treatment gaps affected 14% of patients with hypertension, 36% of patients with dyslipidaemia and 32% of patients with diabetes. Overall, 49% of patients were sedentary, 18% currently smoked and 48% were obese. Women were significantly more likely to not take a statin for dyslipidaemia and to be sedentary. Patients with lower socioeconomic status were also significantly more likely to not take a statin. Compared with Whites, Blacks were significantly more likely to be obese, while Asians were less likely to smoke or be obese. High-risk patients sometimes experienced larger preventive care gaps than low-risk patients. For patients with dyslipidaemia, the presence of a treatment gap was associated with a higher risk of an adverse event (HR 1.35, 95% CI 1.02 to 1.82). Conclusions Among contemporary, symptomatic patients with suspected CAD, significant gaps exist in preventive care and lifestyle practices, and high-risk patients sometimes had larger gaps. Differences by sex, age, race/ethnicity, socioeconomic status and geography are modest but contribute to disparities and have

  1. Haptic perception of mutiple objects

    NARCIS (Netherlands)

    Plaisier, M.A.

    2010-01-01

    In this thesis a series of investigations into haptic (touch) perception of multiple objects is presented. When we hold a collection of objects in our hand, we can extract different types of information about these objects. We can, for instance, identify which objects we are holding. The first

  2. Aggregating and Disaggregating Flexibility Objects

    DEFF Research Database (Denmark)

    Siksnys, Laurynas; Valsomatzis, Emmanouil; Hose, Katja

    2015-01-01

    of such objects while preserving flexibility. Hence, this paper formally defines the concept of flexibility objects (flex-objects) and provides a novel and efficient solution for aggregating and disaggregating flex-objects. Out of the broad range of possible applications, this paper will focus on smart grid...... the energy domain show that the proposed solutions provide good performance while satisfying the strict requirements....

  3. Tracking Object Existence From an Autonomous Patrol Vehicle

    Science.gov (United States)

    Wolf, Michael; Scharenbroich, Lucas

    2011-01-01

    An autonomous vehicle patrols a large region, during which an algorithm receives measurements of detected potential objects within its sensor range. The goal of the algorithm is to track all objects in the region over time. This problem differs from traditional multi-target tracking scenarios because the region of interest is much larger than the sensor range and relies on the movement of the sensor through this region for coverage. The goal is to know whether anything has changed between visits to the same location. In particular, two kinds of alert conditions must be detected: (1) a previously detected object has disappeared and (2) a new object has appeared in a location already checked. For the time an object is within sensor range, the object can be assumed to remain stationary, changing position only between visits. The problem is difficult because the upstream object detection processing is likely to make many errors, resulting in heavy clutter (false positives) and missed detections (false negatives), and because only noisy, bearings-only measurements are available. This work has three main goals: (1) Associate incoming measurements with known objects or mark them as new objects or false positives, as appropriate. For this, a multiple hypothesis tracker was adapted to this scenario. (2) Localize the objects using multiple bearings-only measurements to provide estimates of global position (e.g., latitude and longitude). A nonlinear Kalman filter extension provides these 2D position estimates using the 1D measurements. (3) Calculate the probability that a suspected object truly exists (in the estimated position), and determine whether alert conditions have been triggered (for new objects or disappeared objects). The concept of a probability of existence was created, and a new Bayesian method for updating this probability at each time step was developed. A probabilistic multiple hypothesis approach is chosen because of its superiority in handling the

  4. Challenges of conservation: working objects

    Directory of Open Access Journals (Sweden)

    Professor Elizabeth Pye

    2016-11-01

    Full Text Available This paper discusses the concepts and practice of museum conservation, and the role of conservation in preserving both material and significance of objects. It explores the conservation of science and industry collections and the fact that the significance of many of these objects lies in their operation. It considers alternatives to operating original objects but emphasises the value of experiencing the real thing, and argues that visitors should be given greater physical access to museum objects, including being enabled to handle and work functioning objects. It finishes by calling for research into the effects of operation on the objects themselves, and into what constitutes a satisfying experience of working objects.

  5. Emergency unenhanced multi-slice computed tomography in suspected urinary calculi—with dose reduction method (care dose 4D

    Directory of Open Access Journals (Sweden)

    Syed Nabir

    2012-09-01

    Full Text Available Objectives: To assess urinary calculi and the secondary signs of obstruction, in patients referred from the accident and emergency department, by unenhanced computed tomography examination and to review the radiation dose the patients received with the use of automatic dose modulation technique, care dose 4D. Material and methods: Medical records of unenhanced multi-slice computed tomography (MSCT examinations for 114 patients referred to the emergency department for analysis of suspected urinary calculi were reviewed retrospectively. Their treatment involved automatic tube current modulation, a dose reduction method (care dose 4D, in Hamad General Hospital. The cases were analyzed for the presence of stones, size, site, density and the secondary signs of obstruction, namely hydronephrosis, hydroureter, perinephric fat stranding, peri-ureteric fat stranding and renal enlargement. A search for alternate diagnosis was made if no stone was found. The final diagnosis was noted from the discharge summary in medical records. The radiation dose, Computed Tomographic Dose Index volume (CTDI and Dose Length Product (DLP in each patient was recorded from patient protocol. Results: Of 114 patients referred to CT scan for suspected urinary calculi, between March and June 2008, urinary calculi were noted in 75.4 %. An alternate diagnosis was offered to 5.3 % and a diagnosis of normal was given to 19.3 %. The size of stones detected varied from 2mm-35mm. Density of stones varied from 110-1250 hounsfield units (HU. Solitary stones were seen in 54.4 % of cases observed and multiple stones in 22 %. Renal stones were observed in 6.1 % of cases, urteric stones in 26.3%, vesico-uretric junction stones in 18.4%, multiple sites in 23.7%. Hydronephrosis was seen in 68% of cases, hydroureter in 63%, perinephric fat stranding in 51%, periureteral fat stranding in 34%, ureteric rim sign in 28% and renomegaly in 24%. Time interval between onset of symptoms to imaging

  6. Object-Interviews: Folding, Unfolding, and Refolding Perceptions of Objects

    Directory of Open Access Journals (Sweden)

    Susan Naomi Nordstrom PhD

    2013-02-01

    Full Text Available This article describes the object-interview as a Deleuzian space in which subjects and objects, living and nonliving, entangle together. I developed the object-interview to understand the connections that 11 Midwestern family history genealogists made between objects (e.g., documents, photographs, and other artifacts and their ancestors. The object-interview suggests an alternative way to think and do qualitative interviews informed by poststructural theories. The method draws on French philosopher Deleuze's concepts of the fold, events, and a life, as well as conventional qualitative interview literature. Deleuze's concepts offer a way to rethink objects and subjects as fibrous, connective, and folding entities in qualitative interviews. Such a rethinking offers an alternative to subject-centered conventional qualitative interviews in which subjects are teased apart from objects and subjects primarily produce knowledge. The object-interview, then, is a Deleuzian space in which the supposed distinctions between subjects and objects, as well as other binary divisions, become indistinct, or entangled, as both subjects and objects produce knowledge. That space enabled me to create the concept ensemble of life—a constantly shifting group of objects associated with a person's life. In this article, I describe the theoretical entanglement of the object-interview, the object-interview itself, the data it produced in my dissertation study, and the significance of the method to the field of qualitative research methods.

  7. Healthcare responsibilities and conscientious objection.

    Science.gov (United States)

    Cook, Rebecca J; Olaya, Mónica Arango; Dickens, Bernard M

    2009-03-01

    The Constitutional Court of Colombia has issued a decision of international significance clarifying legal duties of providers, hospitals, and healthcare systems when conscientious objection is made to conducting lawful abortion. The decision establishes objecting providers' duties to refer patients to non-objecting providers, and that hospitals, clinics, and other institutions have no rights of conscientious objection. Their professional and legal duties are to ensure that patients receive timely services. Hospitals and other administrators cannot object, because they do not participate in the procedures they are obliged to arrange. Objecting providers, and hospitals, must maintain knowledge of non-objecting providers to whom their patients must be referred. Accordingly, medical schools must adequately train, and licensing authorities approve, non-objecting providers. Where they are unavailable, midwives and perhaps nurse practitioners may be trained, equipped, and approved for appropriate service delivery. The Court's decision has widespread implications for how healthcare systems must accommodate conscientious objection and patients' legal rights.

  8. Making CORBA objects persistent: The object database adapter approach

    Energy Technology Data Exchange (ETDEWEB)

    Reverbel, F.C.R.

    1997-05-01

    In spite of its remarkable successes in promoting standards for distributed object systems, the Object Management Group (OMG) has not yet settled the issue of object persistence in the Object Request Broker (ORB) environment. The Common Object Request Broker Architecture (CORBA) specification briefly mentions an Object-Oriented Database Adapter that makes objects stored in an object-oriented database accessible through the ORB. This idea is pursued in the Appendix B of the ODMG standard, which identifies a number of issues involved in using an Object Database Management System (ODBMS) in a CORBA environment, and proposes an Object Database Adapter (ODA) to realize the integration of the ORB with the ODBMS. This paper discusses the design and implementation of an ODA that integrates an ORB and an ODBMS with C++ bindings. For the author`s purposes, an ODBMS is a system with programming interfaces. It may be a pure object-oriented DBMS (an OODBMS), or a combination of a relational DBMS and an object-relational mapper.

  9. Single versus multiple objective(s) decision making: an application ...

    African Journals Online (AJOL)

    Single objective approach is most widely used whereas consideration of multiple objectives is the rule rather than an exception in many real life decision-making circumstances. This paper, therefore, investigates whether or not single and multiple criteria/objective approaches necessarily lead to differing conclusions.

  10. Added value of fetal MRI in fetuses with suspected brain abnormalities on neurosonography : a systematic review and meta-analysis

    NARCIS (Netherlands)

    van Doorn, Martine; Oude Rengerink, K|info:eu-repo/dai/nl/375367292; Newsum, Esther A; Reneman, Liesbeth; Majoie, Charles B; Pajkrt, Eva

    PURPOSE: To evaluate the additional diagnostic value of fetal Magnetic Resonance Imaging (MRI) in fetuses with suspected brain abnormalities identified with advanced neurosonography (NS). METHODS: A systematic literature search was performed for studies reporting on a comparison between diagnosis

  11. Study of sonography sensitivity and specificity to the diagnosis of acute appendicitis in suspected patients referred to Khorramabad Ashayer hospital

    Directory of Open Access Journals (Sweden)

    mojtaba Ahmai Nejad

    2012-03-01

    Conclusion: As the study suggests, sonography before sugery can help and leads to definite diagnosis in suspected patients to appendicitis and it can prevent unnecessary surgeries, as well as it can prevent delay in treatment and related complications .

  12. EuroClonality/BIOMED-2 guidelines for interpretation and reporting of Ig/TCR clonality testing in suspected lymphoproliferations

    National Research Council Canada - National Science Library

    Langerak, A.W; Groenen, P.J.T.A; Bruggemann, M; Beldjord, K; Bellan, C; Bonello, L; Boone, E; Carter, G.I; Catherwood, M; Davi, F; Delfau-Larue, M.H; Diss, T; Evans, P.A; Gameiro, P; Garcia Sanz, R; Gonzalez, D; Grand, D; Hakansson, A; Hummel, M; Liu, H; Lombardia, L; Macintyre, E.A; Milner, B.J; Montes-Moreno, S; Schuuring, E; Spaargaren, M; Hodges, E; Dongen, J.J. van

    2012-01-01

    PCR-based immunoglobulin (Ig)/T-cell receptor (TCR) clonality testing in suspected lymphoproliferations has largely been standardized and has consequently become technically feasible in a routine diagnostic setting...

  13. Scheduling delay in suspected cases of oral cancer Atraso de agendamento em casos suspeitos de câncer bucal

    National Research Council Canada - National Science Library

    Luciana Meneses Souza; Edgard Michel-Crosato; Maria Gabriela Haye Biazevic; José Leopoldo Ferreira Antunes

    2011-01-01

    ... of São Paulo of patients suspected of having oral cancer. A cross-sectional study was performed in which telephone conversations simulated clinical situations that represented two types of patients...

  14. Retrospective histopathological classification of 1,108 skin biopsies from patients clinically suspected of having leprosy from Bahia, Northeast Brazil

    Directory of Open Access Journals (Sweden)

    Barbosa Júnior Aryon de Almeida

    1998-01-01

    Full Text Available We report a retrospective histopathological classification carried out under laboratory conditions by the method of Ridley & Jopling of 1,108 skin biopsies from patients clinically suspected of having leprosy from Bahia, Northeast Brazil.

  15. Viral etiology of mumps-like illnesses in suspected mumps cases reported in Catalonia, Spain.

    Science.gov (United States)

    Barrabeig, Irene; Costa, Josep; Rovira, Ariadna; Marcos, M Angeles; Isanta, Ricard; López-Adalid, Rubén; Cervilla, Ana; Torner, Nuria; Domínguez, Angela

    2015-01-01

    We investigated the etiology of reported sporadic suspected mumps cases with a negative RT-PCR result for the mumps virus in the Barcelona-South region in 2007-2011. Samples from mumps virus-negative patients presenting unilateral or bilateral parotitis or other salivary gland swelling were tested for Epstein-Barr virus (EBV) by real-time PCR and for respiratory viruses by two multiplex-PCR-based assays to detect parainfluenza virus (PIV) 1-4, influenza virus (InV) A, B and C, respiratory syncytial virus (RSV), enterovirus, coronavirus 229E, coronavirus OC43, and rhinovirus. 101 samples were analyzed in persons aged 8 months to 50 years. Oral samples were collected on the first day of glandular swelling in 53 patients (52.5%), and on the first two days in 74 patients (73.3%). Viruses were detected in 52 (51.5%) of samples: one virus (25 EBV, 8 PIV3, 4 adenovirus, 4 PIV2, 1 PIV1, 1 InVA, and 1 enterovirus) was detected in 44 patients (84.6%), two viruses in 7 patients, and three viruses in one patient. In 58 patients (57.5%) whose sample was collected in the first 2 days after onset of parotitis and had received two doses of MMR vaccine and in 15 patients (14.8%) whose sample was collected on the first day, it is very likely that the cause was not the mumps virus. This would mean that 72.3% (73/101) of the reported sporadic suspected mumps cases were not mumps cases. The timing of oral-sample collection is crucial to correctly interpret the negative results for mumps virus RNA, especially when suspected cases occur in vaccinated persons.

  16. Multivariable prediction model for suspected giant cell arteritis: development and validation

    Science.gov (United States)

    Ing, Edsel B; Lahaie Luna, Gabriela; Toren, Andrew; Ing, Royce; Chen, John J; Arora, Nitika; Torun, Nurhan; Jakpor, Otana A; Fraser, J Alexander; Tyndel, Felix J; Sundaram, Arun NE; Liu, Xinyang; Lam, Cindy TY; Patel, Vivek; Weis, Ezekiel; Jordan, David; Gilberg, Steven; Pagnoux, Christian; ten Hove, Martin

    2017-01-01

    Purpose To develop and validate a diagnostic prediction model for patients with suspected giant cell arteritis (GCA). Methods A retrospective review of records of consecutive adult patients undergoing temporal artery biopsy (TABx) for suspected GCA was conducted at seven university centers. The pathologic diagnosis was considered the final diagnosis. The predictor variables were age, gender, new onset headache, clinical temporal artery abnormality, jaw claudication, ischemic vision loss (VL), diplopia, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and platelet level. Multiple imputation was performed for missing data. Logistic regression was used to compare our models with the non-histologic American College of Rheumatology (ACR) GCA classification criteria. Internal validation was performed with 10-fold cross validation and bootstrap techniques. External validation was performed by geographic site. Results There were 530 complete TABx records: 397 were negative and 133 positive for GCA. Age, jaw claudication, VL, platelets, and log CRP were statistically significant predictors of positive TABx, whereas ESR, gender, headache, and temporal artery abnormality were not. The parsimonious model had a cross-validated bootstrap area under the receiver operating characteristic curve (AUROC) of 0.810 (95% CI =0.766–0.854), geographic external validation AUROC’s in the range of 0.75–0.85, calibration pH–L of 0.812, sensitivity of 43.6%, and specificity of 95.2%, which outperformed the ACR criteria. Conclusion Our prediction rule with calculator and nomogram aids in the triage of patients with suspected GCA and may decrease the need for TABx in select low-score at-risk subjects. However, misclassification remains a concern. PMID:29200816

  17. 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

  18. Peripapillary retinal splitting visualized on OCT in glaucoma and glaucoma suspect patients.

    Directory of Open Access Journals (Sweden)

    Dilraj S Grewal

    Full Text Available To identify the risk factors for development of peripapillary retinal splitting (schisis in patients with glaucoma or suspicion of glaucoma.Glaucoma Clinic, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL.In this institutional cross-sectional study, 495 patients (990 eyes who had undergone spectral-domain optical coherence tomography (OCT Spectralis HRA-OCT, Heidelberg Engineering optic nerve head (ONH imaging and did not have identifiable optic nerve pits, pseudopits or coloboma were included. OCT scans were reviewed by two observers.Presence of peripapillary retinal splitting identified on OCT raster scans.Eleven of 990 glaucoma and glaucoma suspect eyes (1.1% of 7 patients (2 females, 5 males, mean age 64.5 ± 9.2 years had peripapillary retinal splitting. Two of these 11 eyes had extension of the splitting into the macula but none to the fovea. Of these 11 patients, 2 (28.6% were glaucoma suspects, 3 (42.9% had primary open-angle glaucoma, 1 (14.3% had chronic angle-closure glaucoma and 1 (14.3% had pigmentary glaucoma. 7/11 (63.6% eyes had vitreous traction to the disc visualized on OCT and 6/11 eyes (54.5% had beta-zone peripapillary atrophy.We observed peripapillary retinal splitting in 1.1% of a series of 990 glaucoma and glaucoma-suspect eyes. Evidence of adherent vitreous with traction and peripapillary atrophy was found in a majority of the involved eyes. A comparison to an age and axial length matched cohort is required to determine if this is a condition that is associated with glaucoma.

  19. PET/MR Outperforms PET/CT in Suspected Occult Tumors.

    Science.gov (United States)

    Sekine, Tetsuro; Barbosa, Felipe de Galiza; Sah, Bert-Ram; Mader, Cäcilia E; Delso, Gaspar; Burger, Irene A; Stolzmann, Paul; Ter Voert, Edwin E; von Schulthess, Gustav K; Veit-Haibach, Patrick; Huellner, Martin W

    2017-02-01

    To compare the diagnostic accuracy of PET/MR and PET/CT in patients with suspected occult primary tumors. This prospective study was approved by the institutional review board. Sequential PET/CT-MR was performed in 43 patients (22 male subjects; median age, 58 years; range, 20-86 years) referred for suspected occult primary tumors. Patients were assessed with PET/CT and PET/MR for the presence of a primary tumor, lymph node metastases, and distant metastases. Wilcoxon signed-rank test was performed to compare the diagnostic accuracy of PET/CT and PET/MR. According to the standard of reference, a primary lesion was found in 14 patients. In 16 patients, the primary lesion remained occult. In the remaining 13 patients, lesions proved to be benign. PET/MR was superior to PET/CT for primary tumor detection (sensitivity/specificity, 0.85/0.97 vs 0.69/0.73; P = 0.020) and comparable to PET/CT for the detection of lymph node metastases (sensitivity/specificity, 0.93/1.00 vs 0.93/0.93; P = 0.157) and distant metastases (sensitivity/specificity, 1.00/0.97 vs 0.82/1.00; P = 0.564). PET/CT tended to misclassify physiologic FDG uptake as malignancy compared with PET/MR (8 patients vs 1 patient). PET/MR outperforms PET/CT in the workup of suspected occult malignancies. PET/MR may replace PET/CT to improve clinical workflow.

  20. MRI-suspected low-grade glioma: is there a need to perform dynamic FET PET?

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, Nathalie L.; Graute, Vera; Cumming, Paul; Bartenstein, Peter; Fougere, Christian la [Ludwig-Maximilians-University Munich, Department of Nuclear Medicine, Munich (Germany); Armbruster, Lena; Suchorska, Bogdana; Tonn, Joerg-Christian; Kreth, Friedrich Wilhelm [Ludwig-Maximilians-University Munich, Department of Neurosurgery, Munich (Germany); Lutz, Juergen [Ludwig-Maximilians-University Munich, Department of Neuroradiology, Munich (Germany); Eigenbrod, Sabina [Ludwig-Maximilians-University Munich, Department of Neuropathology, Munich (Germany)

    2012-06-15

    Since differentiation between low-grade glioma (LGG) and high-grade glioma (HGG) remains challenging according to MRI criteria alone, we investigated the discriminative value of additional dynamic FET PET in patients with MRI-suspected LGG. Included in this retrospective study were 127 patients with newly diagnosed MRI-suspected LGG and dynamic FET PET prior to histopathological assessment. FET PET lesions were visually classified as having reduced, normal, or increased tracer uptake. Maximal tumour uptake scaled to the mean background uptake (SUV{sub max}/BG), mean tumour uptake (SUV{sub mean}/BG), biological tumour volume and kinetics were evaluated and correlated with individual histopathological findings. Histopathological analysis revealed 71 patients with LGG, 47 patients with HGG (including 5 glioblastoma multiforme), 2 patients with low-grade ganglioglioma and 7 patients with non-neoplastic lesions. Of the 127 patients, 97 had lesions with increased FET uptake, of which 93 were neoplastic. Increased uptake was found in 49/71 LGG (69 %) and 42/47 HGG (89 %). None of the conventional uptake parameters differed significantly between the HGG and LGG groups. Kinetic analysis reliably identified HGG (sensitivity 95 %, specificity 72 %, PPV 74 %, NPV 95 %). Normal tracer uptake was observed in 19 patients (15 with LGG, 1 with HGG and 3 with non-neoplastic lesions) and reduced uptake in 11 patients (7 with LGG and 4 with HGG). Among the MRI-suspected LGG, kinetic but not conventional analysis of FET uptake enabled remarkably high sensitivity for detection of HGG. This held true even for lesions with low or diffuse tracer uptake. Lesions with reduced tracer uptake must be interpreted with caution, as they can also harbour HGG tissue. (orig.)