Sample records for suspected principal etiological

  1. ?Suspects? in Etiology of Endemic Nephropathy: Aristolochic Acid versus Mycotoxins


    Pepeljnjak, Stjepan; Klari?, Maja ?egvi?


    Despite many hypotheses that have been challenged, the etiology of endemic nephropathy (EN) is still unknown. At present, the implications of aristolochic acid (AA) and mycotoxins (ochratoxin A—OTA and citrinin—CIT) are under debate. AA-theory is based on renal pathohistological similarities between Chinese herbs nephropathy (CHN) and EN, findings of AA-DNA adducts in EN and in patients with urinary tract tumors (UTT), as well as the domination of A:T→T:A transversions in the p53 mutational s...

  2. Lyme disease: a selective medium for isolation of the suspected etiological agent, a spirochete. (United States)

    Johnson, S E; Klein, G C; Schmid, G P; Bowen, G S; Feeley, J C; Schulze, T


    A simple procedure with a new selective culture medium for the isolation of the suspected etiological agent of Lyme disease from ticks is described. Live ticks (Ixodes dammini) were ground with a mortar and pestle, and the suspensions were inoculated into a selective and nonselective medium. The selective medium, which contained kanamycin and 5-fluorouracil, yielded positive spirochete cultures from 100% of the pooled ticks and from 79% of the single tick specimens. The isolation rate for the nonselective medium was 0% from the tick pools and 58% from the single tick specimens. PMID:6361065

  3. Etiology of maculopapular rash in measles and rubella suspected patients from Belarus.

    Directory of Open Access Journals (Sweden)

    Marina A Yermalovich

    Full Text Available As a result of successful implementation of the measles/rubella elimination program, the etiology of more and more double negative cases remains elusive. The present study determined the role of different viruses as causative agents in measles or rubella suspected cases in Belarus. A total of 856 sera sent to the WHO National Laboratory between 2009 and 2011 were tested for specific IgM antibodies to measles virus (MV, rubella virus (RV and human parvovirus B19 (B19V. The negatives were further investigated for antibodies to enterovirus (EV and adenovirus (AdV. Children of up to 3 years were tested for IgM antibodies to human herpesvirus 6 (HHV6. A viral etiology was identified in 451 (52.7% cases, with 6.1% of the samples being positive for MV; 2.6% for RV; 26.2% for B19V; 9.7% for EV; 4.6% for AdV; and 3.6% for HHV6. Almost all measles and rubella cases occurred during limited outbreaks in 2011 and nearly all patients were at least 15 years old. B19V, EV and AdV infections were prevalent both in children and adults and were found throughout the 3 years. B19V occurred mainly in 3-10 years old children and 20-29 years old adults. EV infection was most common in children up to 6 years of age and AdV was confirmed mainly in 3-6 years old children. HHV6 infection was mostly detected in 6-11 months old infants. Laboratory investigation of measles/rubella suspected cases also for B19V, EV, AdV and HHV6 allows diagnosing more than half of all cases, thus strengthening rash/fever disease surveillance in Belarus.

  4. Viral etiology of mumps-like illnesses in suspected mumps cases reported in Catalonia, Spain. (United States)

    Barrabeig, Irene; Costa, Josep; Rovira, Ariadna; Marcos, M Angeles; Isanta, Ricard; López-Adalid, Rubén; Cervilla, Ana; Torner, Nuria; Domínguez, Angela


    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.

  5. «Suspects» in Etiology of Endemic Nephropathy: Aristolochic Acid versus Mycotoxins

    Directory of Open Access Journals (Sweden)

    Stjepan Pepeljnjak


    Full Text Available Despite many hypotheses that have been challenged, the etiology of endemic nephropathy (EN is still unknown. At present, the implications of aristolochic acid (AA and mycotoxins (ochratoxin A—OTA and citrinin—CIT are under debate. AA-theory is based on renal pathohistological similarities between Chinese herbs nephropathy (CHN and EN, findings of AA-DNA adducts in EN and in patients with urinary tract tumors (UTT, as well as the domination of A:T→T:A transversions in the p53 mutational spectrum of UTT patients, which corresponds with findings of such mutations in AA-treated rats. However, exposure pathways of EN residents to AA are unclear. Experimental studies attempting to deduce whether nephrotoxins OTA and CIT appear at higher frequencies or levels (or both in the food and blood or urine of EN residents support the mycotoxin theory. Also, some molecular studies revealed the presence of OTA-DNA adducts in the renal tissue of EN and UTT patients. In this review, data supporting or arguing against AA and mycotoxin theory are presented and discussed.

  6. «Suspects» in etiology of endemic nephropathy: aristolochic acid versus mycotoxins. (United States)

    Pepeljnjak, Stjepan; Klarić, Maja Šegvić


    Despite many hypotheses that have been challenged, the etiology of endemic nephropathy (EN) is still unknown. At present, the implications of aristolochic acid (AA) and mycotoxins (ochratoxin A-OTA and citrinin-CIT) are under debate. AA-theory is based on renal pathohistological similarities between Chinese herbs nephropathy (CHN) and EN, findings of AA-DNA adducts in EN and in patients with urinary tract tumors (UTT), as well as the domination of A:T®T:A transversions in the p53 mutational spectrum of UTT patients, which corresponds with findings of such mutations in AA-treated rats. However, exposure pathways of EN residents to AA are unclear. Experimental studies attempting to deduce whether nephrotoxins OTA and CIT appear at higher frequencies or levels (or both) in the food and blood or urine of EN residents support the mycotoxin theory. Also, some molecular studies revealed the presence of OTA-DNA adducts in the renal tissue of EN and UTT patients. In this review, data supporting or arguing against AA and mycotoxin theory are presented and discussed.

  7. «Suspects» in Etiology of Endemic Nephropathy: Aristolochic Acid versus Mycotoxins (United States)

    Pepeljnjak, Stjepan; Klarić, Maja Šegvić


    Despite many hypotheses that have been challenged, the etiology of endemic nephropathy (EN) is still unknown. At present, the implications of aristolochic acid (AA) and mycotoxins (ochratoxin A—OTA and citrinin—CIT) are under debate. AA-theory is based on renal pathohistological similarities between Chinese herbs nephropathy (CHN) and EN, findings of AA-DNA adducts in EN and in patients with urinary tract tumors (UTT), as well as the domination of A:T®T:A transversions in the p53 mutational spectrum of UTT patients, which corresponds with findings of such mutations in AA-treated rats. However, exposure pathways of EN residents to AA are unclear. Experimental studies attempting to deduce whether nephrotoxins OTA and CIT appear at higher frequencies or levels (or both) in the food and blood or urine of EN residents support the mycotoxin theory. Also, some molecular studies revealed the presence of OTA-DNA adducts in the renal tissue of EN and UTT patients. In this review, data supporting or arguing against AA and mycotoxin theory are presented and discussed. PMID:22069645

  8. Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients

    Directory of Open Access Journals (Sweden)

    Felipe Torres Pacheco


    Full Text Available Objective The potential of computed tomography angiography (CTA was assessed for early determination of stroke subtypes in a Brazilian cohort of patients with stroke. Method From July 2011 to July 2013, we selected patients with suspected hyperacute stroke (< 6 hours. Intracranial and cervical arteries were scrutinized on CTA and their imaging features were correlated with concurrent subtype of stroke. Results Stroke was documented in 50/106 selected patients (47.2% based on both clinical grounds and imaging follow-up (stroke group, with statistically significant arterial stenosis and vulnerable plaques on CTA. Intracranial large artery disease was demonstrated in 34% of patients in the stroke group. Partial territorial infarct prevailed (86% while artery-to-artery embolization was the most common stroke mechanism (52%. Conclusion Multidetector CTA was useful for the etiologic work-up of hyperacute ischemic stroke and facilitated the knowledge about the topographic pattern of brain infarct in accordance with its causative mechanism.

  9. The etiology of small and fresh rectal bleeding in not-sick neonates: should we initially suspect food protein-induced proctocolitis? (United States)

    Jang, Hyo-Jeong; Kim, Ae Suk; Hwang, Jin-Bok


    This study was performed to identify the cause and frequency of food protein-induced proctocolitis (FPIPC) in not-sick neonates with small and fresh rectal bleeding and to verify the effectiveness of oral food elimination and challenge test (ECT) as a diagnostic method of FPIPC. We prospectively analyzed neonates with small and fresh rectal bleeding who were clinically normal. We investigated age at symptom onset, feeding at onset of bleeding, the time of bleeding disappearance, stool smear and culture, endoscopic findings, and histopathologies in the biopsy specimens of 16 not-sick neonates. We performed food ECT in cases with over 4 days of persistent rectal bleeding in the absence of any other etiology. In 16 not-sick neonates with rectal bleeding, the median age at symptom onset was 8.5 (1-43) days. Endoscopic abnormalities were observed in all 16 patients, and in 10 cases satisfying the pathological guidelines for FPIPC, two (12.5 %) were confirmed as FPIPC by food ECT. In the other 14 (87.5 %) cases, rectal bleeding spontaneously disappeared after on average at 4 (1-8) days and thus was diagnosed as idiopathic neonatal transient colitis (INTC). FPIPC is rare as a cause of small and fresh rectal bleeding in not-sick newborns and most of cases proved to be INTC. Although clinical findings are suspected as its symptoms and histological results satisfy its diagnostic criteria, FPIPC should be carefully confirmed through food ECT.

  10. Detection of prospective memory deficits in mild cognitive impairment of suspected Alzheimer's disease etiology using a novel event-based prospective memory task.

    LENUS (Irish Health Repository)

    Blanco-Campal, Alberto


    We investigated the relative discriminatory efficacy of an event-based prospective memory (PM) task, in which specificity of the instructions and perceptual salience of the PM cue were manipulated, compared with two widely used retrospective memory (RM) tests (Rivermead Paragraph Recall Test and CERAD-Word List Test), when detecting mild cognitive impairment of suspected Alzheimer\\'s disease etiology (MCI-AD) (N = 19) from normal controls (NC) (N = 21). Statistical analyses showed high discriminatory capacity of the PM task for detecting MCI-AD. The Non-Specific-Non-Salient condition proved particularly useful in detecting MCI-AD, possibly reflecting the difficulty of the task, requiring more strategic attentional resources to monitor for the PM cue. With a cutoff score of <4\\/10, the Non-Specific-Non-Salient condition achieved a sensitivity = 84%, and a specificity = 95%, superior to the most discriminative RM test used (CERAD-Total Learning: sensitivity = 83%; specificity = 76%). Results suggest that PM is an early sign of memory failure in MCI-AD and may be a more pronounced deficit than retrospective failure, probably reflecting the greater self-initiated retrieval demands involved in the PM task used. Limitations include the relatively small sample size, and the use of a convenience sample (i.e. memory clinic attenders and healthy active volunteers), reducing the generalizability of the results, which should be regarded as preliminary. (JINS, 2009, 15, 154-159.).

  11. Spooky Suspects (United States)

    Pacifici, Lara


    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.)

  12. Contact vitiligo: etiology and treatment

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    Singh P


    Full Text Available Fifty patients of contact vitiligo were studied. EtiologicaI agents of contact vitiligo were identified by clinical history, distribution of lesions and patch testing with suspected material. All patients were advised to avoid the suspected agent and treated with PUVASOL and topical steroid. Out of 50 patients (Male 8%, Female 92% age 14-60 years., etiological agent of contact vitiligo was found to be sticking bindi alone in 24 (48%, while bindi along with other etiological agents were found to be purse, foot wear, plastic watch strap, lipstick and tooth paste in 14 ( 28% cases. 14 (28% patients also had disseminated lesions of vitiligo along with contact vitiligo. Positive reaction with patch testing was observed in 18 (36% while depigmentation was seen in 4 ( 8% cases. We observed that response of treatment was better in patients with shorter duration of disease while poor response was seen in patients with longer duration of disease.

  13. Intrathoracic neoplasia: Epidemiology and etiology

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.


    Neoplasms of the thorax encompass those derived from the thoracic wall, trachea, mediastinum, lungs and pleura. They represent a wide variety of lesions including benign and malignant tumors arising from many tissues. The large surface area, 60 to 90 m{sup 2} in man, represented by the respiratory epithelium and associated thoracic structures are ideal targets for carcinogens carried by inspired air. The topic of discussion in this report is the epidemiology, etiology, and mechanisms of spontaneous intrathoracic neoplasia in animals and man. Much of what we know or suspect about thoracic neoplasia in animals has been extrapolated from experimentally-induced neoplasms.

  14. Female Principals and Gender Equity: Dreams Deferred

    National Research Council Canada - National Science Library

    Barbara Polnick; Dianne Reed; Sylvia Taube; Carrie Butler


    ...). One would suspect that there would be an increase in the number of gender equity practices and strategies incorporated in female led schools and that female principals would feel a responsibility...

  15. Principal Ports (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Principal Ports are defined by port limits or US Army Corps of Engineers (USACE) projects, these exclude non-USACE projects not authorized for publication. The...

  16. Principal components

    NARCIS (Netherlands)

    Hallin, M.; Hörmann, S.; Piegorsch, W.; El Shaarawi, A.


    Principal Components are probably the best known and most widely used of all multivariate analysis techniques. The essential idea consists in performing a linear transformation of the observed k-dimensional variables in such a way that the new variables are vectors of k mutually orthogonal

  17. Pediatric glaucoma suspects

    Directory of Open Access Journals (Sweden)

    Kooner K


    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. Etiology of Spastic Diplegia

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    J Gordon Millichap


    Full Text Available The clinical and etiologic profile of spastic diplegia was studied in a retrospective chart review of 54 patients diagnosed during a 12-year period at Montreal Children’s Hospital, Quebec, Canada.

  19. Etiology of Inguinal Hernias

    DEFF Research Database (Denmark)

    Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob


    BACKGROUND: The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias. RESULTS: Lateral...... with patients with lateral hernias. However, connective tissue alteration may play a role in development of both subtypes. Inguinal hernias have a hereditary component with a complex inheritance pattern, and inguinal hernia susceptible genes have been identified that also are involved in connective tissue...... homeostasis. CONCLUSION: The etiology of lateral and medial hernias are at least partly different, but the final explanations are still lacking on certain areas. Further investigations of inguinal hernia genes may explain the altered connective tissue observed in patients with inguinal hernias. The precise...

  20. The Etiology of Giftedness (United States)

    Thompson, Lee Anne; Oehlert, Jeremy


    Many theories of giftedness either explicitly or implicitly acknowledge the role of genetic influences; yet, empirical work has not been able to establish the impact that genes have specifically on gifted behavior. In contrast, a great deal of research has been targeted at understanding the etiology of individual differences in general and…

  1. The Principal's Role in Reporting Child Abuse. (United States)

    Payne, Beth


    The role of the principal in identifying and reporting child abuse and neglect is discussed in this bulletin. Although all 50 states and the District of Columbia have laws that require educators to report cases in which they have knowledge or reasonable cause to suspect child abuse, passage of legislation does not always lead to compliance.…

  2. 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


    ...), 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...

  3. [Role of biliary MRI in etiological diagnosis of cholestatic icteruses in Dakar]. (United States)

    Badji, Nfally; Akpo, Geraud; Deme, Hamidou; Toure, Mouhamadou Hamine; Ly, Mamadou; Ndong, Boucar; Niang, El Hadji


    Biliary MRI is a relatively new diagnostic test in the arsenal of exploration techniques in biliopancreatic pathology. This is a reproducible and reliable non invasive technique for direct visualization of biliary and pancreatic ducts. This study aims to evaluate the morphological features of major abnormalities and the role of biliary MRI in the etiological diagnosis of cholestatic icteruses. This is a retrospective study of 17 patients conducted in the Imaging Unit of the University Hospital of Fann and of the Principal hospital of Dakar over a period of 4 years and six months (January 2008 at July 2012). All patients underwent MRI (1.5T) according to the standardized protocols for the explored pathology. Only medical records of patients whose diagnosis was established based on laboratory tests and who underwent biliary MRI and surgical exploration were retained. The study involved 5 women and 12 men with a sex ratio of 2.4. The average age of patients was 58 years, ranging between 35 and 81 years. Klatskin tumors were found in 7 patients with infiltrative form in 71% of cases and exophytic form was found in 28% of cases. Cancers of the gallbladder were found in 28% of cases. Cancers in the head of the pancreas accounted for 28% of cases. Major bile duct lithiasis was detected in 5 patients, choledocholithiasis in 60% of cases and a single lithiasis in 40% of cases. All these lesions were responsible for an expansion of intrahepatic bile duct (IHBD). One case of intra and extrahepatic bile ducts dilatation was found without biliopancreatic cause. Biliary MRI is the test of choice for the exploration of cholestatic icteruses. It should be recommended as first-line examination when residual lithiasis is suspected and as second-line examination after ultrasound, when the latter shows a suspected bile ducts tumoral obstruction. Its association with CT scan is the best combination of screening tests for etiologic diagnosis and pre-operative assessment of tumoral

  4. [Etiology of affective disorders]. (United States)

    Shinohara, M; Kariya, T


    We discussed mainly neurochemical etiology of affective disorders (A.D.). Neurochemically, decreased 5-HT uptake in the platelet, increased 5-HT2 receptor in the platelet and cortex of suicides, increased beta receptor in the brains of suicide, functional abnormality of alpha 2 receptor in clonidine, DMI test, GABAB receptor up-regulation after chronic administration of antidepressants and mood stabilizers, participation of neuropeptide Y, and abnormality of HPA axis were recognized. Moreover, we referred to the importance of psychosocial and genetic factors. As for the etiology of A.D., while predisposition and environment participate, the method of participation will be different in subtypes. Frailty to stress in a broad sense, however is commonly seen in A.D. Though psychosocial factors are important, the physical condition, which involves fatigue, cannot be ignored. And, it is the most important that the biological and genetical factors which cause A.D., in the face of stimuli, must first be elucidated.

  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


    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. Etiological relationships in atopy

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; Kyvik, Kirsten Ohm; Backer, Vibeke


    respiratory allergic symptoms, that is, asthma and hay fever, to be between .47 and .95. Furthermore, atopic traits share a portion of their genetic determinants with other complex disorders like obesity and behavioral traits. A correlation of about .3 and .34 has been reported between genes associated...... with asthma and obesity, and between genes associated with asthma and depression, respectively. We emphasize that multivariate methods applied to twin studies, especially when genetic marker information is available, provide a valuable framework within which complex etiological mechanisms underlying atopy can...

  7. [FAI - concept and etiology]. (United States)

    Leunig, M; Ganz, R


    Femoroacetabular impingement (FAI), a recently proposed mechanical concept regarding the development of osteoarthritis (OA) of the hip, is gaining increased acceptance. Both osseous deformity and use of the hip may result in hip damage. Osseous deformities are seen on the acetabular (pincer) or the femoral (cam) side of the hip, leading to characteristic alterations of the acetabular rim. Cam FAI is found in 20-30-year-old athletic men, revealing deep cartilage avulsions from the acetabular rim while the labrum is frequently intact. In pincer FAI, found in 30-40-year-old women, the labrum is frequently significantly destroyed with only minor damage to the acetabular rim. Professional or athletic impact activities can trigger even mild FAI deformities to become symptomatic. For some FAI deformities, the etiologies are known, but for most of them the exact causes are unknown. An improved understanding of the etiology of FAI and its role in the development of hip OA might lead to a reduction in the prevalence of so-called primary OA of the hip.

  8. [Less frequent etiology in uveitis]. (United States)

    Ignat, F; Preda, M; Perovic, I


    This material intends to present three clinical observations regarding the uveitis etiology, that is represented by the association of some etiological factors less known: Toxoplasma gondii, Listeria monocytogenes, Leptospira icterohaemorrhagiae. The uveitis described here have been severe in the fast evolution and with trends of reappearence. This work demonstrates that the strict etiological antibacteria and antiparasite therapy is not enough and only corticotherapy is able to fight against the accentuated inflammatory phenomena that go along with type of uveitis.

  9. The Brazilian School Principals

    Directory of Open Access Journals (Sweden)

    Ângelo Ricardo de Souza


    Full Text Available This article discusses the policy nature of school principal, considering the thoughts of many authors about school administration and the debate about politics, power and burocracy. The study still presents a profile of Brazilian school principals with the data of Basic Education Evaluation System – SAEB, of 2003, specially comparing elements about gender, experience and formation of school principals, and aspects linked with methodology to provide/indicate the school principal and its possible democratic vocation.

  10. The Provident Principal. (United States)

    McCall, John R.

    This monograph offers leadership approaches for school principals. Discussion applies the business leadership theory of Warren Bennis and Burt Nanus to the role of the principal. Each of the booklet's three parts concludes with discussion questions. Part 1, "Visions and Values for the Provident Principal," demonstrates the importance of…

  11. Elementary School Principal Effectiveness. (United States)

    Cross, Ray

    A review of research linking elementary principal "antecedents" (defined as traits), behaviors, school conditions, and student outcomes furnishes few supportable generalizations. The studies relating principal antecedents with behavior and principal antecedents with organizational variables reveals that the trait theory of leadership has…

  12. 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...

  13. The Etiology of Primary Hyperhidrosis

    DEFF Research Database (Denmark)

    Hashmonai, Moshe; Cameron, Alan E.P.; Connery, Cliff P.


    Purpose: Primary hyperhidrosis is a pathological disorder of unknown etiology, affecting 0.6-5% of the population, and causing severe functional and social handicaps. As the etiology is unknown, it is not possible to treat the root cause. Recently some differences between affected and non......-affected people have been reported. The aim of this review is to summarize these new etiological data. Methods: Search of the literature was performed in the PubMed/Medline Database and pertinent articles were retrieved and reviewed. Additional publications were obtained from the references of these articles...... of patients with hyperhidrosis has been reported. Conclusions: Despite these accumulated data, the etiology of primary hyperhidrosis remains obscure. Nevertheless, three main lines for future research seem to be delineated: genetics, histological observations, and enzymatic studies....

  14. Principal Ports and Facilities (United States)

    California Department of Resources — The Principal Port file contains USACE port codes, geographic locations (longitude, latitude), names, and commodity tonnage summaries (total tons, domestic, foreign,...

  15. Etiology and risk factors of meningitis in patients admitted at a ...

    African Journals Online (AJOL)

    Objective: To determine etiology and risk factors of meningitis in patients admitted a tertiary referral Hospital in Harare. Design: Cross-Sectional Study. Setting: Urban Referral Health Facility. Subjects: Patients suspected of having Meningitis admitted at Parirenyatwa Hospital were consecutively consented and recruited into ...

  16. The dental occlusion as a suspected cause for TMDs: epidemiological and etiological considerations. (United States)

    Türp, J C; Schindler, H


    The relationship between the dental occlusion and temporomandibular disorders (TMDs) has been one of the most controversial topics in the dental community. In a large epidemiological cross-sectional survey - the Study of Health in Pomerania (Germany) - associations between 15 occlusion-related variables and TMD signs or symptoms were found. In other investigations, additional occlusal variables were identified. However, statistical associations do not prove causality. By using Hill's nine criteria of causation, it becomes apparent that the evidence of a causal relationship is weak. Only bruxism, loss of posterior support and unilateral posterior crossbite show some consistency across studies. On the other hand, several reported occlusal features appear to be the consequence of TMDs, not their cause. Above all, however, biological plausibility for an occlusal aetiology is often difficult to establish, because TMDs are much more common among women than men. Symptom improvement after insertion of an oral splint or after occlusal adjustment does not prove an occlusal aetiology either, because the amelioration may be due to the change of the appliance-induced intermaxillary relationship. In addition, symptoms often abate even in the absence of therapy. Although patients with a TMD history might have a specific risk for developing TMD signs, it appears more rewarding to focus on non-occlusal features that are known to have a potential for the predisposition, initiation or perpetuation of TMDs. © 2012 Blackwell Publishing Ltd.

  17. Etiologic Factors in Erythema Nodosum

    Directory of Open Access Journals (Sweden)

    Mehmet Ali Gürer


    Full Text Available Background and Design: Erythema nodosum (EN is the most common type of inflammatory nodules. Etiologic factors that lead to EN show a wide spectrum including drugs, infections, malignant and inflammatory diseases. The aim of our study was to investigate frequency of etiologic factors, clinical and laboratory findings of EN patients treated in our clinic, and to identify whether these findings were predictive for a specific etiology in these patients or not. Material and Method: A total of 72 patients diagnosed with EN in our clinic during the period 2003-2007 were included. Results: Patients were divided into two groups with regard to their etiologies. Group I was consisting of 30 cases (41.6% in whom no underlying disease or precipitating factor were found and Group II was consisting of 42 cases (58.4% in whom an etiologic factor was identified. Infections (n=24 were the most common identified etiologic factors followed by Behcet's disease (BD, drugs, pregnancy, and sarcoidosis. Statistical analysis revealed no difference according to age and sex characteristics, localization of disease, and the presence of fever and arthralgia as accompanying findings between the groups (p>0.05. The duration of disease was longer in Group II and patients in Group II were found to have more frequently >1 attack of EN, culture positivity and elevated ASO level when compared with that of Group I (p0.05.Conclusion: Infections, BD and drugs were the most frequently detected etiologic factors in our study. Our results revealed that the localization of lesions and laboratory findings like elevated ESR and CRP, leukocytosis, and anemia were not predictors of secondary EN, and that a further search for an underlying disease is necessary in patients having relapsing EN with a long disease duration. (Turkderm 2008; 42: 113-7

  18. Etiology of molar incisor hypomineralization - A systematic review. (United States)

    Silva, Mihiri J; Scurrah, Katrina J; Craig, Jeffrey M; Manton, David J; Kilpatrick, Nicky


    Molar incisor hypomineralization (MIH) is a common developmental dental defect of permanent teeth, which can increase the risk of dental caries, infection and hospitalization. The etiology is currently unclear although prenatal or early childhood health factors are suspected. The aim of this systematic review was to assess the strength of evidence linking etiological factors with MIH. A systematic search was conducted using the Medline and Embase electronic databases for studies investigating environmental etiological factors of MIH. Two reviewers assessed the eligibility of studies. The level of evidence and bias was determined for all eligible studies according to Australian National Health and Medical Research Council guidelines for systematic reviews of etiology and the Newcastle-Ottawa Scale. From a total of 2254 studies identified through electronic and hand searching, 28 were eligible for inclusion. Twenty-five of these investigated MIH and three investigated a related condition in primary teeth, hypomineralized second primary molars (HSPM), and these were analysed separately. A limited number of studies reported significant associations between MIH and pre- and perinatal factors such as maternal illness and medication use in pregnancy, prematurity and birth complications. Early childhood illness was implicated as an etiological factor in MIH in several studies, in particular fever, asthma and pneumonia. The studies investigating HSPM revealed an association with maternal alcohol consumption, infantile fever and ethnicity. However, the validity of these findings is impaired by study design, lack of adjustment for confounders, lack of detail and consistency of exposures investigated and poor reporting. Childhood illness is likely to be associated with MIH. Further prospective studies of the etiology of MIH/HSPM are needed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. An etiological model of perfectionism.

    Directory of Open Access Journals (Sweden)

    Gayle K Maloney

    Full Text Available OBJECTIVE: Perfectionism has been recognized as a transdiagnostic factor that is relevant to anxiety disorders, eating disorders and depression. Despite the importance of perfectionism in psychopathology to date there has been no empirical test of an etiological model of perfectionism. METHOD: The present study aimed to address the paucity of research on the etiology of perfectionism by developing and testing an etiological model using a sample of 311 clients seeking treatment. RESULTS: Structural equation modeling showed a direct relationship between high Parental Expectations and Criticism, and Perfectionism. There was also an indirect relationship between Parental Bonding and Perfectionism that was mediated by core schemas of disconnection and rejection. Finally, it was found that Neuroticism had both an indirect relationship, which was mediated by core schemas, and a direct relationship with perfectionism. CONCLUSIONS: The study provided the first direct test of an etiological model of perfectionism to date. Clinical implications include investigating whether the inclusion of etiological factors in the understanding and treatment of perfectionism is effective.

  20. Spectrum of etiologies causing hydrometrocolpos. (United States)

    Cerrah Celayir, Aysenur; Kurt, Gökmen; Sahin, Ceyhan; Cici, Inanç


    Hydrometrocolpos (HMC) develops as a result of vaginal outflow obstruction and the accumulation of secretions. It might be secondary to persistent cloaca, urogenital sinus, some syndromes, presence of the vaginal septum, vaginal atresia, and imperforate hymen. Each of them has different treatment options and follow-up protocols. This study was performed to identify the etiology and the related management of patients with HMC. A descriptive series of patients with HMC managed in our hospital between 2004 and 2011 is being presented. The medical record of these patients was analyzed for etiology, management, and outcome. Eight patients with HMC were managed during 7 years at our department. Underlying etiologies included urogenital sinus (n=3), and 1 each of imperforate hymen, transverse vaginal septum, Herlyn-Werner-Wunderlich syndrome, persistent cloaca, and a variant of the cloaca. Four patients were prenatally diagnosed. The patient with imperforate hymen was managed successfully with incision and drainage. Abdominal vaginostomy was done in three patients with urogenital sinus as initial procedure. In patient with persistent cloaca, a colostomy and abdominal vaginostomy were performed. Patient with cloaca variant died due to persistent acidosis and salt wasting. HMC may have different etiological factors which may dictate different surgical management. Etiology of HMC can be as simple as imperforate hymen to the most severe cloacal malformations.

  1. Nonlinear Principal Component Analysis


    de Leeuw, Jan


    Two quite different forms of nonlinear principal component analysis have been proposed in the literature. The first one is associated with the names of Guttman, Burt, Hayashi, Benzécri, McDonald, De Leeuw, Hill, Nishisato. We call it multiple correspondence analysis. The second form has been discussed by Kruskal, Shepard, Roskam, Takane, Young, De Leeuw, Winsberg, Ramsay. We call it nonmetric principal component analysis. The two forms have been related and combined, both geometricall...

  2. Epidemiology of suspected wrist joint infection versus inflammation. (United States)

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


    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.

  3. Myofascial Pain: etiological factors and therapeutical methods ; a systematic literature review of the last thirteen years


    Roldán Barraza, Carolina Isabel


    Myofacial Pain is the most common form of temporomandibular disorders (TMD), affecting principally women in reproductive age. The etiology of TMD is still controversial. Currently a multifactorial theory has received a great support among the scientific community. This theory draws attention to the interaction of psychological, neuromuscular and oral pathogenic factors. Objectives: to describe the possible etiological factors of the Myofacial Pain; and to evaluate the effectiveness of the cur...


    Turovskiy, Yevgeniy; Noll, Katia Sutyak; Chikindas, Michael L.


    Bacterial vaginosis (BV) is the most common vaginal infection among women of childbearing age. This condition is notorious for causing severe complications related to the reproductive health of women. Five decades of intense research established many risk factors for acquisition of BV, however due to the complexity of BV and due to lack of a reliable animal model for this condition, its exact etiology remains elusive. In this manuscript we use a historical perspective to critically review the development of major theories on the etiology of BV, ultimately implicating BV-related pathogens, healthy vaginal microbiota, bacteriophages and the immune response of the host. None of these theories on their own can reliably explain the epidemiological data. Instead, BV is caused by a complex interaction of multiple factors, which include the numerous components of the vaginal microbial ecosystem and their human host. Many of these factors are yet to be characterized because a clear understanding of their relative contribution to the etiology of BV is pivotal to formulation of an effective treatment for and prophylaxis of this condition. PMID:21332897

  5. Suspected levamisole intoxication in calves. (United States)

    Müller, K R; Dwyer, C


    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.

  6. Strategic Principal Communication (United States)

    Henry, Jake; Woody, Aaron


    As communities become increasingly diverse and criticism of traditional public schools intensifies, some states, such as North Carolina, have enacted legislation that encourages alternative forms of schooling. This condition has resulted in new challenges for principals to communicate broadly and often with stakeholders in an effort to build…

  7. Euler principal component analysis

    NARCIS (Netherlands)

    Liwicki, Stephan; Tzimiropoulos, Georgios; Zafeiriou, Stefanos; Pantic, Maja

    Principal Component Analysis (PCA) is perhaps the most prominent learning tool for dimensionality reduction in pattern recognition and computer vision. However, the ℓ 2-norm employed by standard PCA is not robust to outliers. In this paper, we propose a kernel PCA method for fast and robust PCA,

  8. Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment

    Directory of Open Access Journals (Sweden)

    Enrico Bellato


    Full Text Available Fibromyalgia syndrome is mainly characterized by pain, fatigue, and sleep disruption. The etiology of fibromyalgia is still unclear: if central sensitization is considered to be the main mechanism involved, then many other factors, genetic, immunological, and hormonal, may play an important role. The diagnosis is typically clinical (there are no laboratory abnormalities and the physician must concentrate on pain and on its features. Additional symptoms (e.g., Raynaud’s phenomenon, irritable bowel disease, and heat and cold intolerance can be associated with this condition. A careful differential diagnosis is mandatory: fibromyalgia is not a diagnosis of exclusion. Since 1990, diagnosis has been principally based on the two major diagnostic criteria defined by the ACR. Recently, new criteria have been proposed. The main goals of the treatment are to alleviate pain, increase restorative sleep, and improve physical function. A multidisciplinary approach is optimal. While most nonsteroidal anti-inflammatory drugs and opioids have limited benefit, an important role is played by antidepressants and neuromodulating antiepileptics: currently duloxetine (NNT for a 30% pain reduction 7.2, milnacipran (NNT 19, and pregabalin (NNT 8.6 are the only drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. In addition, nonpharmacological treatments should be associated with drug therapy.

  9. Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment (United States)

    Bellato, Enrico; Marini, Eleonora; Castoldi, Filippo; Barbasetti, Nicola; Mattei, Lorenzo; Bonasia, Davide Edoardo; Blonna, Davide


    Fibromyalgia syndrome is mainly characterized by pain, fatigue, and sleep disruption. The etiology of fibromyalgia is still unclear: if central sensitization is considered to be the main mechanism involved, then many other factors, genetic, immunological, and hormonal, may play an important role. The diagnosis is typically clinical (there are no laboratory abnormalities) and the physician must concentrate on pain and on its features. Additional symptoms (e.g., Raynaud's phenomenon, irritable bowel disease, and heat and cold intolerance) can be associated with this condition. A careful differential diagnosis is mandatory: fibromyalgia is not a diagnosis of exclusion. Since 1990, diagnosis has been principally based on the two major diagnostic criteria defined by the ACR. Recently, new criteria have been proposed. The main goals of the treatment are to alleviate pain, increase restorative sleep, and improve physical function. A multidisciplinary approach is optimal. While most nonsteroidal anti-inflammatory drugs and opioids have limited benefit, an important role is played by antidepressants and neuromodulating antiepileptics: currently duloxetine (NNT for a 30% pain reduction 7.2), milnacipran (NNT 19), and pregabalin (NNT 8.6) are the only drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. In addition, nonpharmacological treatments should be associated with drug therapy. PMID:23213512

  10. Etiological factors of preterm delivery

    Directory of Open Access Journals (Sweden)

    Elvira Brkičević


    Full Text Available Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. Preterm birth is a major course of neonatal morbidity and mortality, the incidence of premature delivery in developedcountries is 5 to 9%. Aims of this study were to determine the common etiological factors for preterm delivery, most common weeks of gestation for pretern delivery, and most commom way of delivery for preterm delivery.Methods: The study included 600 patients divided into two groups, experimental group (included 300 preterm delivered pregnant women, control group (included 300 term delivered women.Results: The incidence of preterm delivery in pregnant women younger than 18 years was 4.4%, and in pregnant women older than 35 years was 14%. 44.6 % of preterm delivered women at the experimentalgroup had lower education. In the experimental group burdened obstetrical history had 29%, 17.2% had a preterm delivery, 35.6% had a premature rupture of membranes, 15% had a preterm delivery before32 weeks of gestation, 12.4% between 32-33.6 weeks of gestation, while 72.6% of deliveries were between 34- 36.6 weeks of gestation. Multiple pregnancy as an etiological factor was present in 10.07% ofcases. Extragenital diseases were present in 10.4%. In the experimental group there were 29%, while in the control group there were 15% subjects with burdened obstetrical history.Conclusions: Preterm birth more often occurs in a pregnant women younger than 18 and older than 35 years, and in a pregnant women of lower educational degree. Preterm delivery in the most commoncases was fi nished in period from 34 to 36.6 weeks of gestation. The most common etiological factor of preterm delivery in the experimental group was preterm rupture of membranes and idiopathic pretermdelivery.

  11. Etiology of Nasal Bone Fractures. (United States)

    Hwang, Kun; Ki, So Jung; Ko, Sang Hyun


    The aim of this study was to perform a systematic review of the etiology of nasal bone fractures (NBFs).In PubMed (500 titles) and Scopus (272), the search terms "nasal bone fracture" AND "etiology OR cause" were used. Among the 772 titles, 137 were duplicated and excluded. The 552 titles were excluded and 83 abstracts were read. Subsequently, 42 abstracts were excluded and 41 full articles providing data on etiologies of NBFs were reviewed. Finally, 26 papers were incorporated into this analysis.The causes of NBFs were different between adults and children. In adults, the most frequent causes were fights (36.3%), traffic accidents (20.8%), sports (15.3%), and falls (13.4%). In children, the most frequent causes were sports (59.3%), fights (10.8%), traffic accidents (8.3%), collisions (5.0%), and falls (3.3%). It is noticeable that fights, traffic accidents, and falls were more frequent in adults than in children, although sports and collisions were more frequent in children than in adults (P causes of NBFs varied geographically. Fights were the most frequent cause in Asia (36.7%), South America (46.5%), and Europe (40.8%). In North America, however, traffic accidents were the most frequent cause (33.6%), followed by fights (20.7%) and sports (17.3%). Among the sports injuries, ball-related sports were the most frequent cause (84.2%). Fighting-related sports (6.4%) contributed to relatively small proportion of NBFs.In efforts to prevent NBFs in children, sports injuries should be primarily considered. Restraining devices such as seatbelts are needed to prevent NBFs caused by traffic accidents, especially in North America.

  12. A case of suspect “cyanosis”


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


    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...

  13. Teacher and Principal Beliefs about Principal Leadership Behavior (United States)

    Morris, Mary Beth


    The purpose of this study was to examine whether or not there is a difference between teacher and principal beliefs about principal leadership behavior using a 360-degree evaluation tool. The study also examined whether the difference between teacher and principal beliefs was related to the status of a school relative to the state growth target…

  14. Administrative Dilemmas of the Principal. (United States)

    Sackney, Larry E.


    After examining dilemmas that principals face in conducting their jobs, the author offers fresh perspectives on the role of the principal as a system analyst, an adapter, and an instructional leader. (IRT)

  15. Protein localization as a principal feature of the etiology and comorbidity of genetic diseases (United States)

    Park, Solip; Yang, Jae-Seong; Shin, Young-Eun; Park, Juyong; Jang, Sung Key; Kim, Sanguk


    Proteins targeting the same subcellular localization tend to participate in mutual protein–protein interactions (PPIs) and are often functionally associated. Here, we investigated the relationship between disease-associated proteins and their subcellular localizations, based on the assumption that protein pairs associated with phenotypically similar diseases are more likely to be connected via subcellular localization. The spatial constraints from subcellular localization significantly strengthened the disease associations of the proteins connected by subcellular localizations. In particular, certain disease types were more prevalent in specific subcellular localizations. We analyzed the enrichment of disease phenotypes within subcellular localizations, and found that there exists a significant correlation between disease classes and subcellular localizations. Furthermore, we found that two diseases displayed high comorbidity when disease-associated proteins were connected via subcellular localization. We newly explained 7584 disease pairs by using the context of protein subcellular localization, which had not been identified using shared genes or PPIs only. Our result establishes a direct correlation between protein subcellular localization and disease association, and helps to understand the mechanism of human disease progression. PMID:21613983

  16. Draft Genome Sequence of the Principal Etiological Agent of Farmer’s Lung Disease, Saccharopolyspora rectivirgula (United States)

    Barrera, Coralie; Rognon, Bénédicte; Zaugg, Christophe; Monod, Michel; Millon, Laurence


    Saccharopolyspora rectivirgula is the main cause of farmer’s lung disease. The development of recombinant antigens to standardize the serodiagnosis of the disease requires knowledge of the S. rectivirgula genome. We sequenced the genome of an environmental strain, S. rectivirgula DSM 43113. A total of 3,221 proteins were found to be encoded in a short 3.9-Mb genome. PMID:25523783

  17. Principals' Relationship with Computer Technology (United States)

    Brockmeier, Lantry L.; Sermon, Janet M.; Hope, Warren C.


    This investigation sought information about principals and their relationship with computer technology. Several questions were fundamental to the inquiry. Are principals prepared to facilitate the attainment of technology's promise through the integration of computer technology into the teaching and learning process? Are principals prepared to use…

  18. RE Rooted in Principal's Biography

    NARCIS (Netherlands)

    ter Avest, Ina; Bakker, C.


    Critical incidents in the biography of principals appear to be steering in their innovative way of constructing InterReligious Education in their schools. In this contribution, the authors present the biographical narratives of 4 principals: 1 principal introducing interreligious education in a

  19. School Principals' Emotional Coping Process (United States)

    Poirel, Emmanuel; Yvon, Frédéric


    The present study examines the emotional coping of school principals in Quebec. Emotional coping was measured by stimulated recall; six principals were filmed during a working day and presented a week later with their video showing stressful encounters. The results show that school principals experience anger because of reproaches from staff…

  20. Microscopic colitis: A review of etiology, treatment and refractory disease. (United States)

    Park, Tina; Cave, David; Marshall, Christopher


    Microscopic colitis is a common cause of chronic, nonbloody diarrhea. Microscopic colitis is more common in women than men and usually affects patients in their sixth and seventh decade. This article reviews the etiology and medical management of microscopic colitis. The etiology of microscopic colitis is unknown, but it is associated with autoimmune disorders, such as celiac disease, polyarthritis, and thyroid disorders. Smoking has been identified as a risk factor of microscopic colitis. Exposure to medications, such as non-steroidal anti-inflammatory drugs, proton pump inhibitors, and selective serotonin reuptake inhibitors, is suspected to play a role in microscopic colitis, although their direct causal relationship has not been proven. Multiple medications, including corticosteroids, anti-diarrheals, cholestyramine, bismuth, 5-aminosalicylates, and immunomodulators, have been used to treat microscopic colitis with variable response rates. Budesonide is effective in inducing and maintaining clinical remission but relapse rate is as high as 82% when budesonide is discontinued. There is limited data on management of steroid-dependent microscopic colitis or refractory microscopic colitis. Immunomodulators seem to have low response rate 0%-56% for patients with refractory microscopic colitis. Response rate 66%-100% was observed for use of anti-tumor necrosis factor (TNF) therapy for refractory microscopic colitis. Anti-TNF and diverting ileostomy may be an option in severe or refractory microscopic colitis.

  1. Patch Testing in Suspected Allergic Contact Dermatitis to Cosmetics (United States)

    Paulose, Rekha


    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

  2. Etiology of Pericarditis in a Prospective Cohort of 1162 Cases. (United States)

    Gouriet, Frédérique; Levy, Pierre-Yves; Casalta, Jean-Paul; Zandotti, Christine; Collart, Frédéric; Lepidi, Hubert; Cautela, Jennifer; Bonnet, Jean Louis; Thuny, Franck; Habib, Gilbert; Raoult, Didier


    Pericarditis is a common disorder that is present in various pathologies and may be the first manifestation of an underlying systemic disease. The aims of this study were to describe the different causes of infectious and noninfectious pericarditis and compare them with those in the literature. Between May 2007 and September 2012, we prospectively evaluated a strategy using a systematic prescription of tests for the different etiological causes of pericarditis in patients with acute pericarditis who were hospitalized in the Cardiology and Cardiac Surgery Department or admitted to the Emergency Department (University Hospital of Marseille). A total of 1162 patients with suspected pericarditis were included. A standardized diagnosis procedure was performed for 800 patients, and 362 had pericardiocentesis. Acute pericarditis was diagnosed in 933 patients. No diagnosis was established in 516 patients (55%), 197 patients suffered from postinjury syndromes, and 156 had previously known diseases that were associated with pericarditis. Our survey allowed us to relate the probable cause of pericarditis in 64 cases. An infectious etiological diagnosis was established in 53 cases. In our study, postinjury syndrome was the leading cause of pericarditis, a new diagnosis was made in 6.7% of cases, and 16% of the diagnoses were linked to a secondary, underlying disease. Using this strategy, we were able to reduce the number of idiopathic cases. In many cases, the etiologies were still identified. Long-term follow-up in the management of idiopathic pericarditis should remain of great interest for the future diagnosis of other disorders that remain hidden. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Syncope: epidemiology, etiology and prognosis.

    Directory of Open Access Journals (Sweden)

    Rose M F Lisboa Da Silva


    Full Text Available Syncope is a common medical problem, with a frequency between 15% and 39%. In the general population, the annual number episodes are 18.1 to 39.7 per 1000 patients, with similar incidence between genders. The first report of the incidence of syncope is 6.2 per 1000 person-years. However, there is a significant increase in the incidence of syncope after 70 years of age with rate annual 19.5 per thousand individuals after 80 years. It presents a recurrence rate of 35% and 29% of physical injury. Among the causes of syncope, the mediated neural reflex, known as neurocardiogenic or vasovagal syncope, is the most frequent. The others are of cardiac origin, orthostatic hypotension, carotid sinus hypersensitivity, neurological and endocrinological causes and psychiatric disorders. The diagnosis of syncope can be made by clinical method associated with the electrocardiogram in up 50% of patients. Its prognosis is determined by the underlying etiology specifically the presence and severity of cardiac disease. The annual mortality can reach between 18 and 33% if cardiac cause, and between 0 and 12% if the noncardiac cause. Thus, it is imperative to identify its cause and risk stratification for positive impact in reducing morbidity and mortality.

  4. Priapism: etiology, pathophysiology and management

    Directory of Open Access Journals (Sweden)

    Van Der Horst C.


    Full Text Available The understanding of erectile physiology has improved the prompt diagnosis and treatment of priapism. Priapism is defined as prolonged and persistent erection of the penis without sexual stimulation and failure to subside despite orgasm. Numerous etiologies of this condition are considered. Among others a disturbed detumescence mechanism, which may due to excess release of contractile neurotransmitters, obstruction of draining venules, malfunction of the intrinsic detumescence mechanism or prolonged relaxation of intracavernosal smooth muscle are postulated. Treatment of priapism varies from a conservative medical to a drastic surgical approach. Two main types of priapism; veno-occlusive low flow (ischemic and arterial high flow (non-ischemic, must be distinguished to choose the correct treatment option for each type. Patient history, physical examination, penile hemodynamics and corporeal metabolic blood quality provides distinction between a static or dynamic pathology. Priapism can be treated effectively with intracavernous vasoconstrictive agents or surgical shunting. Alternative options, such as intracavernous injection of methylene blue (MB or selective penile arterial embolization (SPEA, for the management of high and low flow priapism are described and a survey on current treatment modalities is given.

  5. Melasma. Etiologic and therapeutic considerations. (United States)

    Grimes, P E


    Melasma is a common acquired symmetric hypermelanosis characterized by irregular light- to gray-brown macules and patches involving sun-exposed areas of skin. Etiologic factors in the pathogenesis of melasma include genetic influences, exposure to UV radiation, pregnancy, hormonal therapies, cosmetics, phototoxic drugs, and antiseizure medications. Melasma is often a therapeutically challenging disease, and current treatments include hypopigmenting agents, chemical peels, and lasers. Hypopigmenting agents include phenolic and nonphenolic derivatives. Phenolic agents include hydroquinone and hydroquinone combination preparations. Despite controversies regarding the issue of hydroquinone-induced ochronosis, hydroquinone remains the most effective topically applied bleaching agent approved by the Food and Drug Administration for the treatment of melasma. Nonphenolic bleaching agents include tretinoin and azelaic acid. Superficial, medium, and deep chemical peels are more often used in lighter-complexioned patients. Such peels should be used with caution in blacks. Although lasers have demonstrated significant efficacy in the treatment of a variety of hyperpigmentary disorders, their precise efficacy and place in the therapy of melasma have yet to be established. In the hierarchy of therapies for melasma, the treating physician must consider the devastating psychosocial impact of pigmentary imperfections within the realm of the benefits and risks associated with each treatment.

  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. Le principe roman

    CERN Document Server

    Ferrari, Jérôme


    Fasciné par la figure du physicien allemand Werner Heisenberg (1901-1976), fondateur de la mécanique quantique, inventeur du célèbre "principe d'incertitude" et Prix Nobel de physique en 1932, un jeune aspirant-philosophe désenchanté s'efforce, à l'aube du XXIe siècle, de considérer l'incomplétude de sa propre existence à l'aune des travaux et de la destinée de cet exceptionnel homme de sciences qui incarne pour lui la rencontre du langage scientifique et de la poésie, lesquels, chacun à leur manière, en ouvrant la voie au scandale de l'inédit, dessillent les yeux sur le monde pour en révéler la mystérieuse beauté que ne cessent de confisquer le matérialisme à l'œuvre dans l'Histoire des hommes.

  8. Principals' Perceptions Regarding Their Supervision and Evaluation (United States)

    Hvidston, David J.; Range, Bret G.; McKim, Courtney Ann


    This study examined the perceptions of principals concerning principal evaluation and supervisory feedback. Principals were asked two open-ended questions. Respondents included 82 principals in the Rocky Mountain region. The emerging themes were "Superintendent Performance," "Principal Evaluation Components," "Specific…

  9. A case of suspect “cyanosis”

    Directory of Open Access Journals (Sweden)

    Elisabetta Antonucci


    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.

  10. Endosonography for suspected obstructive jaundice with no definite pathology on ultrasonography. (United States)

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


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

  11. 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 ...

  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. MRI for clinically suspected appendicitis during pregnancy.

    NARCIS (Netherlands)

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


    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

  14. Biomechanical properties of keratoconus suspect eyes. (United States)

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


    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.

  15. Characterization of suspected illegal skin whitening cosmetics. (United States)

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


    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.

  16. 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 ...

  17. [Etiology and diagnosis of intellectual disability]. (United States)

    Yang, Pu; Gui, Bao-Heng; Wu, Ling-Qian


    Intellectual disability, occurring in 1%-3% of the general population, is a common disease of the nervous system in children. Since diverse genetic and environmental factors contribute to its pathogenesis, the etiological diagnosis of intellectual disability is challenging with respect to the selection of diagnostic tests. It is important to determine the etiology of intellectual disability for the assessment of prognosis, treatment and the family plan. This paper summarizes the research progress in etiology and diagnosis for intellectual disability and introduces the recommended clinical genetics diagnostic approach from the American Academy of Pediatrics.

  18. Etiological approach to chronic urticaria

    Directory of Open Access Journals (Sweden)

    Krupa Shankar D


    Full Text Available Background: In 1769, William Cullen introduced the word "urticaria" (transient edematous papules, plaque with itching. Urticaria affects 15-25% of people at least once in their life time. It is a clinical reaction pattern triggered by many factors causing the liberation of vasoactive substances such as histamine, prostaglandins and kinins. Urticaria is classified according to its duration into acute (< 6 weeks duration and chronic (>6 weeks duration. Various clinical investigations may be initiated to diagnosis the cause. Aims: To evaluate the types of chronic urticaria with reference to etiology from history and investigations . Materials and Methods: A total of 150 patients with chronic urticaria of more than six weeks were studied. Autologous serum skin test (ASST was performed after physical urticarias were excluded. Standard batteries of tests were performed after ASST in all patients; and other specific investigations were done where necessary. Skin prick test was done in idiopathic urticaria. Results: The study sample consisted of 62 male and 88 female patients with a mean age of 21-40 years. About 50% of patients showed an ASST positive reaction, 3.9% were positive for antinuclear antibody (ANA, IgE titer was elevated in 37%, H. pylori antibodies was positive in 26.7%. Thyroid antibodies were positive in 6.2%. Giardia and entamoeba histolytica was reported in 3.3% on routine stool examination and on urinalysis 8% had elevated WBC counts; 12% showed para nasal sinusitis, with maxillary sinusitis of 7.3%. Random blood sugar was high in 5.3%. Four patients had ASOM, two had positive KOH mount for dermatophytes, abdominal USG showed cholecystitis in two patients. Recurrent tonsillitis was noted in two patients. Urticaria following intake of NSAIDs was observed in four patients and with oral contraceptive pills in one patient. Contact urticaria to condom (latex was seen in one patient. Cholinergic (4.7% and dermographic (4.7% urticaria were

  19. Principal Curves on Riemannian Manifolds

    DEFF Research Database (Denmark)

    Hauberg, Søren


    from Hastie & Stuetzle to data residing on a complete Riemannian manifold. We show that for elliptical distributions in the tangent of spaces of constant curvature, the standard principal geodesic is a principal curve. The proposed model is simple to compute and avoids many of the pitfalls...

  20. What Do Effective Principals Do? (United States)

    Protheroe, Nancy


    Much has been written during the past decade about the changing role of the principal and the shift in emphasis from manager to instructional leader. Anyone in education, and especially principals themselves, could develop a mental list of responsibilities that fit within each of these realms. But research makes it clear that both those aspects of…

  1. Restructuring the Assistant Principal's Role. (United States)

    Williams, Fredonia B.


    Assistant principals should be expected, encouraged, and empowered to work beyond their disciplines, outside their cultures, and above their traditional roles. The assistant principal's role in team management is to become an advocate for excellence, a visionary leader, a change agent, a communicator, a motivator, and a determinant of school…

  2. Innovation Management Perceptions of Principals (United States)

    Bakir, Asli Agiroglu


    This study is aimed to determine the perceptions of principals about innovation management and to investigate whether there is a significant difference in this perception according to various parameters. In the study, descriptive research model is used and universe is consisted from principals who participated in "Acquiring Formation Course…

  3. Burnout among Elementary School Principals (United States)

    Combs, Julie; Edmonson, Stacey L.; Jackson, Sherion H.


    As the understanding of burnout continues to be refined, studies that examine school principals and burnout will be helpful to those who provide support to school leaders and are concerned about principal attrition and pending shortages. The purpose of this study was to examine the relationship between burnout and gender, age, and years experience…

  4. The Principal as Curriculum Leader (United States)

    Jenkins, Judy; Pfeifer, R. Scott


    Today's reform landscape transcends instructional leadership and data-based decision-making skills. This is not to say that those behaviors are not essential to a principal's success, but they no longer suffice. Principals do not need to be curriculum experts, but they do need to lead their schools with full knowledge of the Common Core State…

  5. Etiology of Cervicitis and Treatment with Minocycline

    Directory of Open Access Journals (Sweden)

    William R Bowie


    Full Text Available Objective: To evaluate the etiology of cervicitis using the recommended Canadian definition, and to evaluate the efficacy and tolerability of seven days of minocycline treatment, 100 versus 200 mg at bedtime.

  6. Etiology of Shock in the Emergency Department

    DEFF Research Database (Denmark)

    Holler, Jon Gitz; Jensen, Helene Kildegaard; Henriksen, Daniel Pilsgaard


    were included. Discharge diagnoses defined the etiology and were grouped as; distributive septic shock (SS), distributive non-septic shock (NS)), cardiogenic shock (CS), hypovolemic shock (HS), obstructive shock (OS) and other conditions (OC). Outcomes were etiology-based characteristics, annual IR per......INTRODUCTION: The knowledge of the etiology and associated mortality of undifferentiated shock in the emergency department (ED) is limited. We aimed to describe the etiology based proportions and incidence rates (IR) of shock, as well as the associated mortality in the ED. METHODS: Population......-based cohort study at an University Hospital ED in Denmark from January 1, 2000, to December 31, 2011. Patients aged ≥18 years living in the ED-catchment area (N = 225,000) with a first time ED presentation with shock (n = 1,646) defined as hypotension (systolic blood pressure ≤100 mmHg)) and ≥1 organ failures...

  7. Suspected poisoning of domestic animals by pesticides. (United States)

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


    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

  8. Rhabdomyolysis with different etiologies in childhood


    Alaygut, Demet; Torun Bayram, Meral; Kasap, Belde; Soylu, Alper; Türkmen, Mehmet; Kavukcu, Salih


    AIM To investigate different etiologies and management of the rhabdomyolysis in children. METHODS Eight pediatric rhabdomyolysis cases who applied to the Dokuz Eylul University Faculty of Medicine Department of Pediatric Nephrology with different etiologies between January 2004 and January 2012 were evaluated in terms of age, gender, admission symptoms, physical examination findings, factors provoking rhabdomyolysis, number of rhabdomyolysis attacks, laboratory results, family history and the...

  9. The evaluation of suspected child physical abuse. (United States)

    Christian, Cindy W


    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.

  10. Suspects in criminal investigations of rape

    Directory of Open Access Journals (Sweden)

    Marinković Darko


    Full Text Available Investigations of sexual assaults mostly focus on victims and their credibility, which may cause lack of firm evidence in relation to suspects. Given the fact that the criminal offence of rape is characterised by a high incidence of false reports and accusations, frequently indicating specific persons as the perpetrators, certain caution is necessary in the investigation in order to avoid false accusations and/or convictions. As regards the personality of the rapist and motives for committing a forcible sexual act, certain types or rather certain categories of perpetrators can be distinguished, although it should be noted that a large number of rapists do not belong to one category only, but rather combine characteristics of several different types. During a criminal investigation it is of vital importance to differentiate between a rape as a surprise attack and a rape as abuse of trust, as they are compatible with the nature of the suspect's defence. The suspect shall be subjected to a forensic examination in the course of the investigation in order to find traces which prove vaginal, anal or oral penetration, coerced sexual intercourse and identity of the rapist. While conducting an interrogation of a suspected rapist, a crime investigating officer shall use either factual or emotional approach to his interviewee, depending on his psychological and motivational characteristics. In this regard, the factual approach is believed to be more efficient with anger rapists and sadistic rapists, whereas the compassionate approach gives good results with the gentlemen-rapists and partly with the power asserting rapists.

  11. Glaucoma suspect & Humphrey Field Analyzer a correlation

    Directory of Open Access Journals (Sweden)

    P Dahal


    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:

  12. Tocolytics for suspected intrapartum fetal distress. (United States)

    Kulier, R; Hofmeyr, G J


    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.

  13. The etiology and significance of fractures in infants and young children: a critical multidisciplinary review. (United States)

    Servaes, Sabah; Brown, Stephen D; Choudhary, Arabinda K; Christian, Cindy W; Done, Stephen L; Hayes, Laura L; Levine, Michael A; Moreno, Joëlle A; Palusci, Vincent J; Shore, Richard M; Slovis, Thomas L


    This paper addresses significant misconceptions regarding the etiology of fractures in infants and young children in cases of suspected child abuse. This consensus statement, supported by the Child Abuse Committee and endorsed by the Board of Directors of the Society for Pediatric Radiology, synthesizes the relevant scientific data distinguishing clinical, radiologic and laboratory findings of metabolic disease from findings in abusive injury. This paper discusses medically established epidemiology and etiologies of childhood fractures in infants and young children. The authors also review the body of evidence on the role of vitamin D in bone health and the relationship between vitamin D and fractures. Finally, the authors discuss how courts should properly assess, use, and limit medical evidence and medical opinion testimony in criminal and civil child abuse cases to accomplish optimal care and protection of the children in these cases.

  14. Virginia Principals and School Law


    Brabrand, Scott Sorensen


    Virginia Principals and School Law Scott S. Brabrand (ABSTRACT) This study sought to determine Virginia Public School principalsâ knowledge of school law as it related to the type, length/quantity, and recency of law preparation they received. Other variables measured included how their level of knowledge was associated with their length of administrative experience and with their description of the school community in which they worked. An on-line survey instrument wa...


    Directory of Open Access Journals (Sweden)

    G.V. Volynets


    Full Text Available In the article the data on the study of the etiological factors of various types of chronic gastritis in children are presented. Based on revealing of the auto antibodies to parietal gastric cells in 40,0% of children autoimmune gastritis (a type gastritis is diagnosed. Helicobacterr pylori infection is revealed in 44,8% of children. In 27,6% of children type c gastritis is diagnosed. Autoimmune gastritis in children has been linked to the active phase of chronic epsteinbbarr virus infection. the etiological factors of nonautoimmune gastritis are Helicobacter pylori infection (type b gastritis and multiple duodenogastric refluxes (type c gastritis.Key words: children, chronic gastritis, etiological factors, autoimmune gastritis, nonautoimmune gastritis, active phase of chronic Epstein-Barr virus infection, Helicobacter pylori infection.

  16. 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 ...

  17. Pancreatitis in pregnancy: etiology, diagnosis, treatment, and outcomes. (United States)

    Mali, Padmavathi


    Acute pancreatitis in pregnancy is a rare and dangerous disease. This study aimed to examine the etiology, treatment, and outcomes of pancreatitis in pregnancy. A total of 25 pregnant patients diagnosed with pancreatitis during the period of 1994 and 2014 was analyzed retrospectively. The pregnant patients were diagnosed with pancreatitis during a period of 21 years. Most (60%) of the patients were diagnosed with pancreatitis in the third trimester. The mean age of the patients at presentation was 25.7 years, with a mean gestational age of 24.4 weeks. Abdominal pain occurred in most patients and vomiting in one patient was associated hyperemesis gravidarum. The common cause of the disease was gallstone-related (56%), followed by alcohol-related (16%), post-ERCP (4%), hereditary (4%) and undetermined conditions (20%). The level of triglycerides was minimally high in three patients. ERCP and wire-guided sphincterotomy were performed in 6 (43%) of 14 patients with gallstone-related pancreatitis and elevated liver enzymes with no complications. Most (84%) of the patients underwent a full-term, vaginal delivery. There was no difference in either maternal or fetal outcomes after ERCP. Acute pancreatitis is rare in pregnancy, occurring most commonly in the third trimester, and gallstones are the most common cause. When laparoscopic cholecystectomy is not feasible and a common bile duct stone is highly suspected on imaging, endoscopic sphincterotomy or stenting may help to prevent recurrence and postpone cholecystectomy until after delivery.

  18. Nuclear Pedigree Criteria of Suspected HNPCC

    Directory of Open Access Journals (Sweden)

    Kładny Józef


    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


    Directory of Open Access Journals (Sweden)



    Full Text Available Background: Vocal fold polyp is one of the most common causes for hoarseness. Many different etiological factors contribute to vocal fold polyp formation. The aim of the study was to find out whether the etiological factors for polyp formation have changed in the last 30 years.Methods: Eighty-one patients with unilateral vocal fold polyp were included in the study. A control group was composed of 50 volunteers without voice problems who matched the patients by age and gender. The data about etiological factors and the findings of phoniatric examination were obtained from the patients' medical documentation and from the questionnaires for the control group. The incidence of etiological factors was compared between the two groups. The program SPSS, Version 18 was used for statistical analysis.Results: The most frequent etiological factors were occupational voice load, GER, allergy and smoking. In 79% of patients 2 – 6 contemporary acting risk factors were found. Occupational voice load (p=0,018 and GER (p=0,004 were significantly more frequent in the patients than in the controls. The other factors did not significantly influence the polyp formation.Conclusions: There are several factors involved simultaneously in the formation of vocal fold polyps both nowadays and 30 years ago. Some of the most common factors remain the same (voice load, smoking, others are new (GER, allergy, which is probably due to the different lifestyle and working conditions than 30 years ago. Occupational voice load and GER were significantly more frequently present in the patients with polyp than in the control group. Regarding the given results it is important to instruct workers with professional vocal load about etiological factors for vocal fold polyp formation.

  20. [Tendinitis in athletes: etiology, diagnosis and treatment]. (United States)

    Gremion, G; Zufferey, P


    Tendinopathy is one of the most common diagnosis in sports. Knowledges about their etiology, the repair process to their diagnosis and their treatment have improved thanks to the development of imaging, especially ultra- sound. The disorder whose etiology could be mechanical or degenerative can cause long- term disability and sometimes the end of the sport carreer. The risk of reccurence is com- mon; this may lead to tendon rupture whose functional effects can be significative. The management should be early: it must respect the deadlines for tendon healing and pro- pose a gradual recovery efforts after elimina tion of the contributing factors involved.

  1. Principal component proxy tracer analysis

    CERN Document Server

    Mills, Peter


    We introduce a powerful method for dynamical reconstruction of long-lived tracers such as ozone. It works by correlating the principal components of a matrix representation of the tracer dynamics with a series of sparse measurements. The method is tested on the 500 K isentropic surface using a simulated tracer and with ozone measurements from the Polar Aerosol and Ozone Measurement (POAM) III satellite instrument. The Lyapunov spectrum is measured and used to quantify the lifetime of each principal component. Using a 60 day lead time and five (5) principal components, cross validation of the reconstructed ozone and comparison with ozone sondes return root-mean-square errors of 0.20 ppmv and 0.47 ppmv, respectively.

  2. Principal bundles the classical case

    CERN Document Server

    Sontz, Stephen Bruce


    This introductory graduate level text provides a relatively quick path to a special topic in classical differential geometry: principal bundles.  While the topic of principal bundles in differential geometry has become classic, even standard, material in the modern graduate mathematics curriculum, the unique approach taken in this text presents the material in a way that is intuitive for both students of mathematics and of physics. The goal of this book is to present important, modern geometric ideas in a form readily accessible to students and researchers in both the physics and mathematics communities, providing each with an understanding and appreciation of the language and ideas of the other.

  3. Recent Research on the Etiologies of Autism. (United States)

    Fisher, Eileen; Van Dyke, Don C.; Sears, Lonnie; Matzen, Jane; Lin-Dyken, Deborah; McBrien, Dianne M.


    Reviews recent research on the etiologies of autism, including genetic research, anatomic and neuroimaging studies, topics in neurophysiology research (including serotonin, dopamine, and opiods), immunologic research, studies of autism phenotype, and electroencephalographic studies. It concludes that, as of yet, research has found no clear…

  4. Oropharyngeal Dysphagia: neurogenic etiology and manifestation. (United States)

    Sebastian, Swapna; Nair, Prem G; Thomas, Philip; Tyagi, Amit Kumar


    To determine the type, severity and manifestation of dysphagia in patients with neurogenic etiology. Clinical documentation was done on the different etiologies, its manifestation, assessment findings and management strategies taken for patients with neurogenic oropharyngeal dysphagia who were referred for assessment and management of dysphagia over a period of three months in a tertiary care teaching hospital. Flexible endoscopic examination was done in all the patients. The severity of dysphagia in these patients were graded based on Gugging Swallowing Screen (GUSS). A total of 53 patients with neurogenic oropharyngeal dysphagia were evaluated by an otolaryngologist and a speech language pathologist over a period of three months. The grading of severity based on GUSS for these patients were done. There were 30 patients with recurrent laryngeal nerve injury due to various etiologies, one patient with Neurofibroma-vestibular schwanoma who underwent surgical excision, 16 patients with stroke, two patients with traumatic brain injury, two patients with Parkinsonism and two patients with myasthenia gravis. The manifestation of dysphagia was mainly in the form of prolonged masticatory time, oral transit time, and increased number of swallows required for each bolus, cricopharyngeal spasms and aspiration. Among the dysphagia patients with neurogenic etiology, dysphagia is manifested with a gradual onset and is found to have a progressive course in degenerative disorders. Morbidity and mortality may be reduced with early identification and management of neurogenic dysphagia.

  5. Etiology and pathogenesis of adolescent idiopathic scoliosis

    NARCIS (Netherlands)

    Schlösser, Tom P C; Colo, Dino; Castelein, RM


    Despite many years of dedicated research into the etio-pathogenesis, not one single cause for adolescent idiopathic scoliosis has been identified. The purpose of this review is to give a comprehensive overview of the current evidence and main etiological theories. Intrinsic causal mechanisms are

  6. Etiology of Inguinal Hernias: A Comprehensive Review. (United States)

    Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob


    The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias. Lateral and medial hernias seem to have common as well as different etiologies. A patent processus vaginalis and increased cumulative mechanical exposure are risk factors for lateral hernias. Patients with medial hernias seem to have a more profoundly altered connective tissue architecture and homeostasis compared with patients with lateral hernias. However, connective tissue alteration may play a role in development of both subtypes. Inguinal hernias have a hereditary component with a complex inheritance pattern, and inguinal hernia susceptible genes have been identified that also are involved in connective tissue homeostasis. The etiology of lateral and medial hernias are at least partly different, but the final explanations are still lacking on certain areas. Further investigations of inguinal hernia genes may explain the altered connective tissue observed in patients with inguinal hernias. The precise mechanisms why processus vaginalis fails to obliterate in certain patients should also be clarified. Not all patients with a patent processus vaginalis develop a lateral hernia, but increased intraabdominal pressure appears to be a contributing factor.

  7. Solving the Assistant Principal's Puzzle (United States)

    Hartley, Douglas


    How does an assistant principal complete the large number of managerial duties and, at the same time, serve as a credible instructional leader? This book provides practical recommendations for successfully filling the dual role as manager and instructional leader, building effective relationships, using power appropriately, and productively…

  8. School Uniforms: Guidelines for Principals. (United States)

    Essex, Nathan L.


    Principals desiring to develop a school-uniform policy should involve parents, teachers, community leaders, and student representatives; beware restrictions on religious and political expression; provide flexibility and assistance for low-income families; implement a pilot program; align the policy with school-safety issues; and consider legal…

  9. Do Principals Engineer the Job? (United States)

    Faulkner, Raymond T. B.; O'Reilly, Robert R.

    Based on Fiedler's Contingency Model of Leadership Effectiveness and Leader-Match program, this study's hypothesis is that experienced school principals increase their effectiveness by changing key organizational variables to suit their personal leadership styles. Following V. D. McNamara's application of Fiedler's contingency model in a study of…

  10. [Acute hepatitis of unspecified etiology: etiological structure and clinical-laboratory characteristics]. (United States)

    Iushchuk, N D; Tsyganova, E V; Znoĭko, O O; Karetkina, G N; Solonin, S A; Mikhaĭlov, M I; Isaguliants, M G; Petrova, T V; Kashirin, V I; Cheshik, D S


    The straight line nucleic acids detection method of viruses and wide spectrum of virus antigens immunodiagnostics in acute hepatitis of unknown etiology patients has allowed verifying the diagnosis at 19% cases (a viral hepatitis A, C or E). Results of research do not allow to consider hepatotropic viruses HGV, TTV, PV B19, EBV, CMV, HHV 1, 2, 6 and 8 type, NV-F as etiological agents at the majority of patients of investigated group, and the data of the anamnesis and a clinical and laboratory picture of a current of disease does not allow to exclude at 29.4% of patients a drug-induced hepatitis. Despite detailed molecular-biological and immunological inspection of patients, at 37.9% of acute hepatitis of unknown etiology patients it was not possible to establish a connection with hepatitis and defined etiological factor (the infectious agent).

  11. Research advances in liver failure of unknown etiology

    Directory of Open Access Journals (Sweden)

    ZHU Bing


    Full Text Available A high proportion of the causes of liver failure remain unknown. This paper reviews the progress in the epidemiology, etiology, treatment, and prognosis of liver failure of unknown etiology. The possible causes of liver failure of unknown etiology may include occult hepatitis B virus infection, herpesvirus infection, transfusion-transmitted virus infection, hepatitis G virus infection, human parvovirus Bl9 infection, autoimmune and hepatitis. Aciclovir can be considered in the empirical treatment for patients with liver failure of unknown etiology. The mortality in patients with liver failure of unknown etiology is high. The research on the etiology and treatments should be strengthened.

  12. Imaging the child with right lower quadrant pain and suspected appendicitis: current concepts

    Energy Technology Data Exchange (ETDEWEB)

    Sivit, Carlos J. [Departments of Radiology and Pediatrics, Rainbow Babies and Childrens Hospital of the University Hospitals of Cleveland and Case Western Reserve School of Medicine, Euclid Avenue, 11100, 44106-5056, Cleveland, OH (United States)


    Acute appendicitis is the most common condition presenting with right lower quadrant pain requiring acute surgical intervention in childhood. The clinical diagnosis of acute appendicitis is often not straightforward and can be challenging. Approximately one-third of children with the condition have atypical clinical findings and are initially managed non-operatively. Complications usually result from perforation and include abscess formation, peritonitis, sepsis, bowel obstruction and death. Cross-sectional imaging with sonography and computed tomography (CT) have proven useful for the evaluation of suspected acute appendicitis in children. The principal advantages of sonography are its lower cost, lack of ionizing radiation, and ability to precisely delineate gynecologic disease. The principal advantages of CT are its operator independency with resultant higher diagnostic accuracy, enhanced delineation of disease extent in perforated appendicitis, and improved patient outcomes including decreased negative laparotomy and perforation rates. (orig.)

  13. [Critical Study of the last jurisprudence of the Supreme Court on requirements and guarantees regarding DNA sampling from suspects]. (United States)

    de Hoyos Sancho, Montserrat


    A critical study will be made of recent jurisprudence of Spanish Supreme Court in relation to the principal requirements that current legislation establishes for so-called "DNA testing", specially in connection with the rules on lawful evidence. In particular, the various hypotheses and circumstances that might concur in the collection of tissue samples from the suspect will be analyzed, as well as questions relating to the need, or otherwise, of legal assistance during such an act.

  14. [Is it possible to identify dengue in children on the basis of Ministry of Health criteria for suspected dengue cases?]. (United States)

    Rodrigues, Marisa B P; Freire, Heliane B M; Corrêa, Paulo R L; Mendonça, Marislaine L; Silva, Maria Regina I; França, Elizabeth B


    To identify clinical characteristics indicative of dengue and to evaluate the applicability to children of the Health Ministry criteria for suspected cases. A cross-sectional study undertaken at the General Pediatrics Center of the Fundação Hospitalar de Minas Gerais. Children were enrolled if presenting acute febrile conditions with no definite etiology, lasting > 24 hours and disease. The subset of children who did have dengue was compared with the subset of nonspecific acute febrile diseases. The Health Ministry criteria for suspected cases was evaluated. Dengue was diagnosed in 50.4% of the 117 children studied. There were no statistically significant associations between the disease and the majority of the symptoms analyzed. Only exanthema was more often associated with dengue (Prevalence Ratio = 1.49; 95% CI: 1.05-2.11). The criteria for suspected cases of dengue had a sensitivity of just 50.8% and a positive predictive value of 62.5%. These values were greater among schoolchildren and during the period of greater disease incidence. Dengue is common among febrile diseases of childhood, with prevalence that varies according to the epidemiological situation. The clinical status of children with dengue was very similar to that of children with other nonspecific diseases. The Health Ministry criteria for suspected cases was shown to be of little use, particularly with smaller children and during periods of reduced incidence.

  15. Principal's Time Use and School Effectiveness (United States)

    Horng, Eileen Lai; Klasik, Daniel; Loeb, Susanna


    School principals have complex jobs. To better understand the work lives of principals, this study uses observational time use data for all high school principals in one district. This article examines the relationship between the time principals spent on different types of activities and school outcomes, including student achievement, teacher and…

  16. How Teachers Perceive a Principal's Power. (United States)

    Porter, Ann W.; Lemon, Donald K.


    Discusses the use of power by principals and teachers' perceptions of the principal's power. A study of elementary principals in North Dakota and Minnesota identifies seven power strategies used by principals: assertiveness, ingratiation, rationality, sanctions, exchange, upward appeal, and coalitions. Includes nine references. (MD)

  17. Three Principals Who Make a Difference. (United States)

    Sagor, Richard D.


    Principals who are transformative leaders consistently use three building blocks to promote school success: a clear, unified purpose; a common cultural perspective; and a constant push for improvement. In one study, an opinionated, assertive middle school principal; a nurturing, supportive principal; and a high-energy, charismatic principal all…

  18. Etiology of inflammatory bowel disease: A unified hypothesis (United States)

    Qin, Xiaofa


    Inflammatory bowel disease (IBD), including both ulcerative colitis (UC) and Crohn’s disease (CD), emerged and dramatically increased for about a century. Despite extensive research, its cause remains regarded as unknown. About a decade ago, a series of findings made me suspect that saccharin may be a key causative factor for IBD, through its inhibition on gut bacteria and the resultant impaired inactivation of digestive proteases and over digestion of the mucus layer and gut barrier (the Bacteria-Protease-Mucus-Barrier hypothesis). It explained many puzzles in IBD such as its emergence and temporal changes in last century. Recently I further found evidence suggesting sucralose may be also linked to IBD through a similar mechanism as saccharin and have contributed to the recent worldwide increase of IBD. This new hypothesis suggests that UC and CD are just two symptoms of the same morbidity, rather than two different diseases. They are both caused by a weakening in gut barrier and only differ in that UC is mainly due to increased infiltration of gut bacteria and the resultant recruitment of neutrophils and formation of crypt abscess, while CD is mainly due to increased infiltration of antigens and particles from gut lumen and the resultant recruitment of macrophages and formation of granulomas. It explained the delayed appearance but accelerated increase of CD over UC and many other phenomena. This paper aims to provide a detailed description of a unified hypothesis regarding the etiology of IBD, including the cause and mechanism of IBD, as well as the relationship between UC and CD. PMID:22553395

  19. Magnetic resonance imaging of suspected atrial tumors. (United States)

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


    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.

  20. Childhood hydrocephalus – is radiological morphology associated with etiology

    DEFF Research Database (Denmark)

    Foss-Skiftesvik, Jon; Andresen, Morten; Juhler, Marianne


    Clinicians use a non-standardized, intuitive approach when correlating radiological morphology and etiology of hydrocephalus.......Clinicians use a non-standardized, intuitive approach when correlating radiological morphology and etiology of hydrocephalus....

  1. Laboratory methods for determining pneumonia etiology in children

    NARCIS (Netherlands)

    Murdoch, David R.; O'Brien, Katherine L.; Driscoll, Amanda J.; Karron, Ruth A.; Bhat, Niranjan; Black, Robert E.; Bhutta, Zulfiqar A.; Campbell, Harry; Cherian, Thomas; Crook, Derrick W.; de Jong, Menno D.; Dowell, Scott F.; Graham, Stephen M.; Klugman, Keith P.; Lanata, Claudio F.; Madhi, Shabir A.; Martin, Paul; Nataro, James P.; Piazza, Franco M.; Qazi, Shamim A.; Zar, Heather J.; Levine, Orin S.; Knoll, Maria Deloria; Feikin, Daniel R.; Scott, J. Anthony G.; Driscoll, Amanda; DeLuca, Andrea; Crawley, Jane


    Laboratory diagnostics are a core component of any pneumonia etiology study. Recent advances in diagnostic technology have introduced newer methods that have greatly improved the ability to identify respiratory pathogens. However, determining the microbial etiology of pneumonia remains a challenge,

  2. Etiology of hearing loss in children.

    Directory of Open Access Journals (Sweden)

    José Ignacio BENITO-OREJAS


    Full Text Available Introduction and objective: The neonatal hearing loss is one of the most common disabilities, with lifelong implications for the child and his family. The implementation of the universal newborn hearing screening and the development in molecular medicine, genetic and integrative neuroscience has perfected the early diagnosis of the hearing loss children and consequently its intervention. With this work, we want to clarify the audiological aspects and causes of the permanent hearing loss diagnosed during the past 20 years. Method: We reviewed retrospectively the records of the children diagnosed with less than 3 years of age of permanent hearing loss, during the period 1994-2015, in a tertiary center. Evaluate the time of home, laterality, type and degree of hearing loss. Depending on the background, genetic testing and other complementary explorations, we present the results of our diagnostic study. Results: In the study-population (n = 183, 71% of the permanent hearing loss > 30 dB HL was diagnosed at birth (congenital. Its main features are the bilaterality (81%, the predominance sensorineural (85% and the grade profound (42% or moderate (30%, more prevalent in the unilateral forms. About the etiologic diagnosis, a 47% of the cases are of origin genetic (29% of which are syndromic, a 25% of cause environmental and a 28% unknown. Discussion: Our results are consistent for the generally accepted distribution of causes, but there are discrepancies in the literature. Despite the different tests used, we had to infer the etiology in 62% of children with hearing loss, finally unknown by 28%. Conclusions: We consider fundamental the monitoring for a consensus standardized etiological protocol that orient in the diagnostic process of hearing loss in children.

  3. Etiological study of microcytic hypochromic anemia

    Directory of Open Access Journals (Sweden)

    S Kafle


    Full Text Available Background: Microcytic hypochromic anemia is a distinct morphologic subtype of anemia with well- de ned etiology and treatment. The objective of this study was to determine the etiology and frequency of microcytic hypochromic anemia. Materials and Methods: This cross-sectional observational study was conducted at Kathmandu Medical College Teaching Hospital. One hundred cases of microcytic hypochromic anemia were included. Relevant clinical history, hemogram, reticulocyte count, iron pro les were documented in a proforma. Bone marrow aspiration and hemoglobin electrophoresis was conducted when required. Data was analysed by Microsoft SPSS 16 windows. Result: Iron de ciency was the commonest etiology (49%. Dysfunctional uterine bleeding (20.8% was the commonest cause of iron de ciency, malignancy (24.3% was the commonest cause of anemia of chronic disease. Mean value of Mean Corpuscular Volume was lowest in hemolytic anemia (71.0 . Mean Red cell Distribution Width was normal (14.0% in hemolytic anemia but was raised in other types. Mean serum iron was reduced in iron de ciency anemia (32.2μg/dl and chronic disease (34.8μg/dl, normal in hemolytic anemia (83μg/dl and raised in sideroblastic anemia (295μg/dl. Mean serum ferritin was reduced in iron de ciency anemia (7.6ng/ml, raised in chronic disease (158.6ng/ml and normal in hemolytic anemia (99.2ng/ml. Serum ferritin was normal in sideroblastic anemia (93ng/ml. Mean Total Iron Binding Capacity was raised in iron de ciency anemia (458μg/dl and normal in other microcytic hypochromic anemias. Conclusion: Diagnosis of microcytic hypochromic anemia requires a standardized approach which includes clinical details, hemogram, peripheral blood smear, reticulocyte count, iron pro le, hemoglobin electrophoresis and bone marrow examination. 

  4. 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 ...

  5. 48 CFR 803.806 - Processing suspected violations. (United States)


    ... 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...

  6. 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.


    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

  7. Etiology and pathogenesis of periodontal diseases. (United States)

    Tatakis, Dimitris N; Kumar, Purnima S


    The two most prevalent and most investigated periodontal diseases are dental plaque-induced gingivitis and chronic periodontitis. The last 10 to 15 years have seen the emergence of several important new findings and concepts regarding the etiopathogenesis of periodontal diseases. These findings include the recognition of dental bacterial plaque as a biofilm, identification and characterization of genetic defects that predispose individuals to periodontitis, host-defense mechanisms implicated in periodontal tissue destruction, and the interaction of risk factors with host defenses and bacterial plaque. This article reviews current aspects of the etiology and pathogenesis of periodontal diseases.

  8. Etiology, evaluation, and management of xerostomia. (United States)

    Millsop, Jillian W; Wang, Elizabeth A; Fazel, Nasim

    Xerostomia is defined as the complaint of oral dryness. It is a condition that primarily affects older adults and can have a significant negative effect on one's quality of life. Patients with xerostomia often do not have objective signs of hyposalivation. The underlying etiology of xerostomia includes a variety of systemic diseases and local factors. Our aim is to provide a comprehensive review of the differential diagnosis, evaluation, and management of xerostomia. Prompt diagnosis and management can alleviate the clinical manifestations of this debilitating condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Ankle osteoarthritis: etiology, diagnostics, and classification. (United States)

    Barg, Alexej; Pagenstert, Geert I; Hügle, Thomas; Gloyer, Marcel; Wiewiorski, Martin; Henninger, Heath B; Valderrabano, Victor


    Osteoarthritis (OA) is defined as the syndrome of joint pain and dysfunction caused by substantial joint degeneration. In general, OA is the most common joint disease and is one of the most frequent and symptomatic health problems for middle-aged and older people: OA disables more than 10% of people who are older than 60 years. This article reviews the etiology of ankle OA, and describes the onset and development of posttraumatic ankle OA, the most common form of OA in the tibiotalar joint. Various methods of clinical and radiographic assessment are described in detail. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Etiology of pediatric acute liver failure

    Directory of Open Access Journals (Sweden)

    GUO Jing


    Full Text Available Pediatric acute liver failure (PALF is a complex syndrome with rapid progression, and the cause of PALF is age-dependent. This article analyzes the common causes of PALF in clinical practice, including infection factors, inherited metabolic factors, poisoning and drugs, abnormal perfusion, and autoimmune diseases, among which infection factors are the most common cause. With the improvement in diagnosis and treatment techniques, the diagnostic rate of PALF caused by inherited metabolic diseases and autoimmune diseases keeps increasing. Due to the small number of PALF patients, there lacks experience in etiological diagnosis. This article summarizes related reports, in order to provide a reference for screening the causes of PALF.

  11. Etiology and Management of Sexual Dysfunction

    Directory of Open Access Journals (Sweden)

    Narendra Kumar Muthugaduru Shivarudrappa


    Full Text Available Sexual dysfunction is the impairment or disruption of any of the three phases of normal sexual functioning, including loss of libido, impairment of physiological arousal and loss, delay or alteration of orgasm. Each one of these can be affected by an orchestra of factors like senility, medical and surgical illnesses, medications and drugs of abuse. Non-pharmacological therapy is the main stay in the treatment of sexual dysfunction and drugs are used as adjuncts for a quicker and better result. Management in many of the cases depends on the primary cause. Here is a review of the major etiological factors of sexual dysfunction and its management

  12. Parametric functional principal component analysis. (United States)

    Sang, Peijun; Wang, Liangliang; Cao, Jiguo


    Functional principal component analysis (FPCA) is a popular approach in functional data analysis to explore major sources of variation in a sample of random curves. These major sources of variation are represented by functional principal components (FPCs). Most existing FPCA approaches use a set of flexible basis functions such as B-spline basis to represent the FPCs, and control the smoothness of the FPCs by adding roughness penalties. However, the flexible representations pose difficulties for users to understand and interpret the FPCs. In this article, we consider a variety of applications of FPCA and find that, in many situations, the shapes of top FPCs are simple enough to be approximated using simple parametric functions. We propose a parametric approach to estimate the top FPCs to enhance their interpretability for users. Our parametric approach can also circumvent the smoothing parameter selecting process in conventional nonparametric FPCA methods. In addition, our simulation study shows that the proposed parametric FPCA is more robust when outlier curves exist. The parametric FPCA method is demonstrated by analyzing several datasets from a variety of applications. © 2017, The International Biometric Society.

  13. Seasonal variation among tuberculosis suspects in four countries

    DEFF Research Database (Denmark)

    Mabaera, Biggie; Naranbat, Nymadawa; Katamba, Achilles


    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...

  14. Etiology and epidemiological analysis of glaucoma-filtering bleb infections in a tertiary eye care hospital in south India

    Directory of Open Access Journals (Sweden)

    R Ramakrishnan


    Full Text Available Purpose : To evaluate the microbial etiology and associated risk factors among patients with blebitis following trabeculectomy. Materials and Methods : A retrospective analysis of all culture-proven blebitis was performed in patients who underwent trabeculectomy between January 2004 and December 2008. A standardized form was filled out for each patient, documenting sociodemographic features and information pertaining to risk factors. Swabbing of the infected bleb surface was performed for all suspected cases and further subjected to microbiological analysis. Results : A total of 23 patients with culture-proven blebitis were treated during the study period, with a mean age of 59.2 years (59.2 ± SD: 12.8; range, 30-81 years. Duration of onset was early (≤36 months in six (26% cases and late (> 36 months in 17 (74% cases with a range between 15 and 144 months (mean, 82.91 months; SD: 41.89. All 23 blebs were located superiorly and of which, 21 (91% were microcystic avascular, 1 (4% diffuse avascular, and 1 (4% vascular flattened. The predominant risk factor identified was bleb leak (35%; 8 of 23 followed by thin bleb (22%; 5 of 23 and blepharitis (17%; 4 of 23. Bleb leaks (100% were recorded only in patients with late onset (≥ 9 years of infection (P< 0.001, while the incidence of ocular surface disease (100% occurred early (≤3 years (P< 0.001. Use of topical steroids was associated frequently with cases of thin blebs (80%; 4 of 5 (P< 0.001, while topical antibiotics showed bleb leaks (88%; 7 of 8 (P< 0.001. Coagulase-positive staphylococci were frequently recovered from blebitis with thin blebs (71%; 5 of 7 (P = 0.001, Coagulase-negative staphylococci (CoNS with bleb leak (100%; 8 of 8 (P< 0.001, Corynebacterium with blepharitis (100%; 3 of 3 (P = 0.001, and Streptococci with releasable sutures (75%; 3 of 4 (P = 0.001. Conclusion : Bleb leak is the principal risk factor responsible for late-onset blebitis, while early-onset blebitis could

  15. Epilepsy in the tropics: Emerging etiologies. (United States)

    Carrizosa Moog, Jaime; Kakooza-Mwesige, Angelina; Tan, Chong Tin


    Epilepsy is considered by the World Health Organization a public health priority with more than 50 million human beings affected by the disease. More than 80% of persons with epilepsy live in low and middle income countries and most of them in tropical areas. Several emerging, re-emerging and neglected diseases are symptomatic etiologies that jointly contribute to the enormous global burden of epilepsy. Besides the clinical strengths to reduce diagnostic and treatment gaps, other strategies in social, economic, cultural, educational and health policies are needed to prevent and treat appropriately vulnerable and affected persons with epilepsy. From the public health point of view, several of those strategies could be more effective in reducing the incidence and burden of the disease than the clinical approach of diagnosis and treatment. Special attention has to be given to stigma reduction and promotion of human rights. Several aspects mentioned in this abstract slip away the scope of the article, but it is a remainder to approach epilepsy in an inter- and transdisciplinary manner, an integral and pertinent approach needed and requested in tropical counties. The article focuses only on emergent and re-emergent etiologies of epilepsy in the tropics like malaria, HIV, neurocysticercosis, viral encephalitis and traumatic brain injury. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  16. Terminology, epidemiology, etiology, and pathophysiology of nocturia. (United States)

    Van Kerrebroeck, Philip; Andersson, Karl-Erik


    Nocturia, awaking from sleep to void, has a negative impact on health and well-being. Nocturia affects men and women and is more prevalent among the elderly. More than two nocturnal voids is considered to be a clinically meaningful threshold associated with significant negative outcomes for health and well-being, and the timing of awakening has a significant bearing on the negative consequences of nocturia. Several serious underlying pathophysiologic conditions may be associated with nocturia. A thorough history and assessment of number and times of voids, void volume, and fluid intake is essential for determining the etiology of a patient's nocturia. With data obtained from the frequency-volume chart (FVC), which is used to collect quantitative voiding data, a patient's nocturia may be classified as global polyuria, nocturnal polyuria, reduced bladder capacity, or a combination of these categories. Global polyuria is defined as 24-hr urinary output that exceeds 40 ml/kg body weight and results in increased 24-hr urinary frequency. Nocturnal polyuria is defined as more than 20% of daily urine output at night in young patients and more than 33% in elderly patients. Reduced bladder capacity may be a result of idiopathic or neurogenic detrusor overactivity, bladder outlet obstruction, or reduced nocturnal bladder capacity. The pathophysiology underlying the findings of the FVC falls into five main categories: global polyuria, nocturnal polyuria, reduced bladder capacity, sleep disorders, and circadian clock disorders. This review discusses the epidemiology, etiology, and pathophysiology of nocturia. © 2014 Wiley Periodicals, Inc.

  17. Thrombocytosis. Etiologic analysis of 663 patients. (United States)

    Yohannan, M D; Higgy, K E; al-Mashhadani, S A; Santhosh-Kumar, C R


    Six hundred sixty-three children aged 1 to 16 years with thrombocytosis (defined as a platelet count of more than 500 x 10(9)/L) seen in a university hospital over a 1-year period were studied prospectively for etiology. The causes of thrombocytosis were infection (30.6%), hemolytic anemia (19.3%), tissue damage (15.2%), rebound thrombocytosis (14.8%), chronic inflammation (4.1%), renal disorders (4.1%), and malignancy (2%). Thrombocytosis associated with multiple, simultaneous causative factors was seen in 3.3% of cases. Among all patients with infections, osteomyelitis and septic arthritis were associated with higher platelet counts than other infections (P Thrombocytosis secondary to infections was significantly more common in children under 5 years of age, whereas chronic inflammation, malignancy, and renal disorders were more common causes of thrombocytosis in children over 5 years of age. Thrombocytosis of 1 million or more platelets was seen in 13 (2%) children. No thrombocytosis-related complications were seen in any children, and none required any specific treatment. Thrombocytosis is a frequent finding in children. It is due to a variety of etiologic factors and is of little clinical discriminatory value. It is often due to an acute-phase phenomenon in response to infection, tissue damage, blood loss, or anemia, and is rarely due to malignancy.

  18. Rhabdomyolysis with different etiologies in childhood. (United States)

    Alaygut, Demet; Torun Bayram, Meral; Kasap, Belde; Soylu, Alper; Türkmen, Mehmet; Kavukcu, Salih


    To investigate different etiologies and management of the rhabdomyolysis in children. Eight pediatric rhabdomyolysis cases who applied to the Dokuz Eylul University Faculty of Medicine Department of Pediatric Nephrology with different etiologies between January 2004 and January 2012 were evaluated in terms of age, gender, admission symptoms, physical examination findings, factors provoking rhabdomyolysis, number of rhabdomyolysis attacks, laboratory results, family history and the final diagnosis received after the treatment. Average diagnosis ages of eight cases were 129 (24-192) ± 75.5 mo and five of them were girls. All of them had applied with the complaint of muscle pain, calf pain, and dark color urination. Infection (pneumonia) and excessive physical activity were the most important provocative factors and excessive licorice consumption was observed in one case. In 5 cases, acute kidney injury was determined and two cases needed hemodialysis. As a result of the further examinations; the cases had received diagnoses of rhabdomyolysis associated with mycoplasma pneumoniae, sepsis associated rhabdomyolysis, licorice-induced hypokalemic rhabdomyolysis, carnitine palmitoyltransferase II deficiency, very long-chain acyl-CoA dehydrogenase deficiency, congenital muscular dystrophy and idiopathic paroxysmal rhabdomyolysis (Meyer-Betz syndrome). It is important to distinguish the sporadic and recurrent rhabdomyolysis cases from each other. Recurrent rhabdomyolysis cases should follow up more regardful and attentive.

  19. Etiology of liver cirrhosis in Mexico. (United States)

    Méndez-Sánchez, Nahum; Aguilar-Ramírez, Juan R; Reyes, Angel; Dehesa, Margarita; Juórez, Alberto; Castñeda, Beatriz; Sánchez-Avila, Francisco; Poo, Jorge L; Guevara González, Luis; Lizardi, Javier; Valdovinos, Miguel A; Uribe, Misael; Contreras, Ana M; Tirado, Patricia; Aguirre, Jesús; Rivera-Benítez, Cesar; Santiago-Santiago, Ramón; Bosques-Padilla, Francisco; Muñoz, Linda; Guerroro, Arnoldo; Ramos, Mayra; Rodríguez-Hernández, Heriberto; Jacobo-Karam, Jannett


    In the last decades it has been suggested that the main cause of liver cirrhosis in Mexico is alcohol. Currently in Western countries hepatitis C virus stage liver disease and liver transplantation. In Mexico, we have no data relative to the etiology of liver cirrhosis. The aim of this study was to investigate the main causes of liver cirrhosis in Mexico. Eight hospitals located in different areas of the country were invited to participate in this study. Those hospitals provide health care to different social classes of the country. The inclusion criteria were the presence of either an histological or a clinical and biochemical diagnosis of liver cirrhosis. A total 1,486 cases were included in this study. The etiology of liver cirrhosis was alcohol in 587 (39.5%), HCV 544 (36.6%), cryptogenic 154 (10.4%), PBC 84 (5.7%), HBV 75 (5.0%) and other 42 (2.8%). There was no statistical difference between alcohol and HCV. We conclude that the main causes of liver cirrhosis in Mexico are alcohol and HCV.

  20. Congenital orofacial clefts: Etiology and Frequency

    Directory of Open Access Journals (Sweden)

    Kamil Serkan Ağaçayak


    Full Text Available Orofacial clefts are congenital structural anomalies of the lip and/or palate. These anomalies affect ~1/1000 in the community. The etiology of orofacial clefts is complex, including various genetic and environmental agents. Syndrome is not accompanied by any isolated orofacial clefts are more common, although environmental factors often play a role in the etiology. Mendelian or teratogenic origins; the non-syndromic forms of orofacial clefts are more common and are likely due to secondary gene–environment interactions. Latest researches in both molecular and quantitative approaches have begun to identify the genes responsible for the rare syndromic forms of cleft and have also identified both candidate genes and loci for the more common and complex non-syndromic variants. Animal models, have also contributed greatly to an comprehension of these anomalies. We aimed to describes genes that are involved in orofacial clefts in humans and animal models and explores genetic approaches to identifying additional genes and gene–environment interactions that constitute the many factors of orofacial clefts in this review.

  1. Dual diagnosis: a review of etiological theories. (United States)

    Mueser, K T; Drake, R E; Wallach, M A


    The etiology of the high prevalence of substance use disorders in patients with severe mental illness (schizophrenia or bipolar disorder) is unclear. We review the evidence of different theories of increased comorbidity, organized according to four general models: common factor models, secondary substance use disorder models, secondary psychiatric disorder models, and bidirectional models. Among common factor models, evidence suggests that antisocial personality disorder accounts for some increased comorbidity. Among secondary substance use disorder models, there is support for the supersensitivity model, which posits that biological vulnerability of psychiatric disorders results in sensitivity to small amounts of alcohol and drugs, leading to substance use disorders. There is minimal support for the self-medication model, but the accumulation of multiple risk factors related to mental illness, including dysphoria, may increase the risk of substance use disorder. Secondary psychiatric disorder models remain to be convincingly demonstrated. Bidirectional models have not been systematically examined. Further clarification of etiologic factors, including the identification of subtypes of dual diagnosis, may have implications for developing more effective prevention efforts and treatment.

  2. Respiratory viral infections in infants with clinically suspected pertussis

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    Angela E. Ferronato


    Conclusion: the results suggest that viral infection can be present in hospitalized infants with clinical suspicion of pertussis, and etiological tests may enable a reduction in the use of macrolides in some cases. However, the etiological diagnosis of respiratory virus infection, by itself, does not exclude the possibility of infection with BP.

  3. Principal genetic syndromes and autism: from phenotypes, proteins to genes. (United States)

    Hou, Meng; Wang, Man-jie; Zhong, Nanbert


    Autism is a neurodevelopmental disorder characterized by impairments in social skills, language, and behavior. It is now clear that autism is not a disease, but a syndrome characterized by phenotypic and genetic complexity. The etiology of autism is still poorly understood. Available evidence from a variety of sources strongly suggests that many genetic disorders are frequently associated with autism for their similar phenotypes. Based on this fact, this review begins by highlighting several principal genetic syndromes consistently associated with autism (fragile X, tuberous sclerosis, Angelman syndrome, Pader-Willi syndrome, Rett syndrome, Down syndrome and Turner syndrome). These genetic disorders include both chromosome disorders and single gene disorders. By comparing the similar phenotype, protein marker and candidate genes, we might make some breakthrough in the mechanism of autism and other genetic disorders.

  4. Principal Metabolic Flux Mode Analysis. (United States)

    Bhadra, Sahely; Blomberg, Peter; Castillo, Sandra; Rousu, Juho; Wren, Jonathan


    In the analysis of metabolism, two distinct and complementary approaches are frequently used: Principal component analysis (PCA) and stoichiometric flux analysis. PCA is able to capture the main modes of variability in a set of experiments and does not make many prior assumptions about the data, but does not inherently take into account the flux mode structure of metabolism. Stoichiometric flux analysis methods, such as Flux Balance Analysis (FBA) and Elementary Mode Analysis, on the other hand, are able to capture the metabolic flux modes, however, they are primarily designed for the analysis of single samples at a time, and not best suited for exploratory analysis on a large sets of samples. We propose a new methodology for the analysis of metabolism, called Principal Metabolic Flux Mode Analysis (PMFA), which marries the PCA and stoichiometric flux analysis approaches in an elegant regularized optimization framework. In short, the method incorporates a variance maximization objective form PCA coupled with a stoichiometric regularizer, which penalizes projections that are far from any flux modes of the network. For interpretability, we also introduce a sparse variant of PMFA that favours flux modes that contain a small number of reactions. Our experiments demonstrate the versatility and capabilities of our methodology. The proposed method can be applied to genome-scale metabolic network in efficient way as PMFA does not enumerate elementary modes. In addition, the method is more robust on out-of-steady steady-state experimental data than competing flux mode analysis approaches. Matlab software for PMFA and SPMFA and data set used for experiments are available in,,, Detailed results are in Supplementary files. Supplementary data are available at

  5. Prediction of Suspect Location Based on Spatiotemporal Semantics

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    Lian Duan


    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.

  6. Teacher Supervision Practices and Principals' Characteristics (United States)

    April, Daniel; Bouchamma, Yamina


    A questionnaire was used to determine the individual and collective teacher supervision practices of school principals and vice-principals in Québec (n = 39) who participated in a research-action study on pedagogical supervision. These practices were then analyzed in terms of the principals' sociodemographic and socioprofessional characteristics…

  7. Principal Perceptions of New Teacher Effectiveness (United States)

    Shepherd, Dan; Devers, Christopher


    Relatively little research has been conducted on the professional satisfaction of principals with recently hired beginning teachers. This study surveyed principals to learn their perspectives on these new teachers in relation to National Board Standards. Data were gathered using an online survey of 423 principals throughout the state of Indiana…

  8. Who Teaches, Who Principals, Who Learns? (United States)

    O'Reilly, Gabrielle; Latimer, Milree

    An alternative framework that supports the collaboration of principals and teachers, with a focus on the changing roles of teachers and principals as learners and leaders, is presented. A conclusion is that as teachers' belief systems change to respect the image of the learner, principals' belief systems also change to reflect a new image of the…

  9. New Principal Coaching as a Safety Net (United States)

    Celoria, Davide; Roberson, Ingrid


    This study examines new principal coaching as an induction process and explores the emotional dimensions of educational leadership. Twelve principal coaches and new principals--six of each--participated in this qualitative study that employed emergent coding (Creswell, 2008; Denzin, 2005; Glaser & Strauss, 1998; Spradley, 1979). The major…

  10. Leadership Coaching for Principals: A National Study (United States)

    Wise, Donald; Cavazos, Blanca


    Surveys were sent to a large representative sample of public school principals in the United States asking if they had received leadership coaching. Comparison of responses to actual numbers of principals indicates that the sample represents the first national study of principal leadership coaching. Results indicate that approximately 50% of all…

  11. Gender and Perceptions: Females as Secondary Principals (United States)

    Nogay, Kathleen; Beebe, Robert J.


    The purpose of this study was to investigate the perceptions of teachers and supervisors toward the principal leadership behaviors of female secondary principals in Ohio. Principal self-perceptions were also included to complete the study. The literature shows that women continue to be underrepresented in a field in which the majority of…

  12. An Investigation of Principals' Leadership Orientations. (United States)

    Reed, Patricia; Smith, Michael; Beekley, Cynthia

    Effective school leadership requires an understanding of the tension between the technical and symbolic aspects of leadership. This paper presents findings of a study that examined principals' self-reported leadership orientations. A survey (the Principal Behavior Inventory) mailed to 865 secondary principals at Ohio public and private schools…

  13. 12 CFR 561.39 - Principal office. (United States)


    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Principal office. 561.39 Section 561.39 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY DEFINITIONS FOR REGULATIONS AFFECTING ALL SAVINGS ASSOCIATIONS § 561.39 Principal office. The term principal office means the home...

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

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    Mertz, D.W.


    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.

  15. Anterior cruciate ligament injuries: etiology and prevention. (United States)

    Brophy, Robert H; Silvers, Holly J; Mandelbaum, Bert R


    The relatively high risk of noncontact anterior cruciate ligament (ACL) rupture among female athletes has been a major impetus for investigation into the etiology of this injury. A number of risk factors have been identified, both internal and external to the athlete, including neuromuscular, anatomical, hormonal, shoe-surface interaction, and environmental, such as weather. The anatomic and neuromuscular risk factors, often gender related, are the focus of most ACL injury prevention programs. Although studies have shown that biomechanic- centered prevention programs can reduce the risk of ACL injury, many questions remain unanswered. More research is needed to increase our understanding of the risk factors for ACL injury; how injury prevention programs work and can the clinical application of such programs be optimized.

  16. Acute Pancreatitis: Etiology, Pathology, Diagnosis, and Treatment. (United States)

    Majidi, Shirin; Golembioski, Adam; Wilson, Stephen L; Thompson, Errington C


    Acute pancreatitis is a fascinating disease. In the United States, the two most common etiologies of acute pancreatitis are gallstones and excessive alcohol consumption. The diagnosis of acute pancreatitis is made with a combination of history, physical examination, computed tomography scan, and laboratory evaluation. Differentiating patients who will have a benign course of their pancreatitis from patients who will have severe pancreatitis is challenging to the clinician. C-reactive protein, pro-calcitonin, and the Bedside Index for Severity of Acute Pancreatitis appeared to be the best tools for the early and accurate diagnosis of severe pancreatitis. Early laparoscopic cholecystectomy is indicated for patients with mild gallstone pancreatitis. For patients who are going to have a prolonged hospitalization, enteral nutrition is preferred. Total parenteral nutrition should be reserved for patients who cannot tolerate enteral nutrition. Prophylactic antibiotics are not indicated for patients with pancreatic necrosis. Surgical intervention for infected pancreatic necrosis should be delayed as long as possible to improve patient outcomes.

  17. Complex Neurodevelopmental Disorders And Their Genetic Etiologies

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    Amna Batool


    Full Text Available Complex Neurodevelopmental disorders NDDs exhibit complex etiological and genetic features and the mutations have a fundamental role in this complexity including common polymorphisms and rare variations in a single gene or cluster of genes. The analysis of complex NDDs have shown that the genetics has the major role in causation of such complex diseases. Interestingly both mutations and polymorphisms are involved occurring in a single gene or clusters of genes. Likewise a single gene variation may also be involved in multiple neurological disorders making the diagnosis of neurological diseases more difficult. Many candidate genes and chromosomal regions have been identified that are widely involved in neurological symptoms which necessitates the genotypic approach for describing the phenotype.

  18. Etiologies and distribution of neonatal leukomalacia. (United States)

    Iida, K; Takashima, S; Takeuchi, Y


    Neonatal leukomalacia was classified into 4 groups: focal (F), widespread (W), diffuse (D), and multicystic encephalomalacia (MCE) according to the distribution of ischemic necrosis in the cerebral hemisphere. The highest and lowest values of PaCO2, PaO2, and pH and the lowest systolic and diastolic blood pressures were compared among each group and controls. The lowest PaCO2 values were significantly lower in MCE than in the F, W, and D (F + W + D) group or controls. The lowest values of systolic and diastolic blood pressures in the W and F + W + D groups were significantly lower than in the controls; therefore, hypocarbia can be an etiologic factor of MCE rather than periventricular leukomalacia. Hypotension may be closely related to a causal factor of neonatal leukomalacia.

  19. Etiology and Pathogenesis of Epithelial Ovarian Cancer

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    Samuel C. Mok


    Full Text Available Ovarian cancer is complex disease composed of different histological grades and types. However, the underlying molecular mechanisms involved in the development of different phenotypes remain largely unknown. Epidemiological studies identified multiple exogenous and endogenous risk factors for ovarian cancer development. Among them, an inflammatory stromal microenvironment seems to play a critical role in the initiation of the disease. The interaction between such a microenvironment, genetic polymorphisms, and different epithelial components such as endosalpingiosis, endometriosis, and ovarian inclusion cyst in the ovarian cortex may induce different genetic changes identified in the epithelial component of different histological types of ovarian tumors. Genetic studies on different histological grades and types provide insight into the pathogenetic pathways for the development of different disease phenotypes. However, the link between all these genetic changes and the etiological factors remains to be established.

  20. Current and future etiologic therapy of bacterial pneumonia. 1. Antibiotic therapy for community-acquired pneumonia

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    А.Е. Abaturov


    Full Text Available The progressive increase in the prevalence of respiratory infections caused by multiresistant pathogenic agents is a serious problem requiring strict indications and development of algorithms for prescribing antibacterial drugs for pneumonia treatment. Amoxicillin is a drug of choice for the treatment of community-acquired pneumonia with a mild and uncomplicated course in children. The indications for prescribing macrolides are the patient’s allergy to β-lactam antibiotics or suspect mycoplasmal or chlamydial etiology of pneumonia. The choice of amoxicillin/clavulanate or cephalosporins for oral administration is proved by the laboratory data or a clinical suspicion of pneumonia caused by pathogens producing β-lactamases. The treatment strategy with the use of non-antibiotic agents for antibiotic-associated diseases therapy is being actively developed currently.

  1. Community acquired pneumonia with shock, severe hypoxemia and leucopenia: Is the etiology methicillin resistant Staphylococci?

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    Garima Kapoor


    Full Text Available A young, male presented to the emergency department with respiratory signs and symptoms along with shock and leucopenia. The suspected diagnosis of methicillin resistant Staphylococcus aureus (MRSA necrotizing pneumonia was confirmed later radiographically and microbiologically. This entity is common in childhood, but rarely reported in adults. This form of pneumonia affects young individuals without any comorbid illness. This is the first reported case of necrotizing pneumonia caused by community acquired-MRSA from Indian subcontinent. The probability to predict etiology of pneumonia from clinical signs is low; yet in the presence of shock, severe hypoxemia and leucopenia suspicion of MRSA should be kept high and hence that prompt initiation of appropriate antimicrobials may reduce mortality.

  2. Etiology research on different types of uveitis

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    Zhe Yang


    Full Text Available AIM:To analysis and discuss etiology of different types of uveitis. METHODS:We selected 60 patients(120 eyeswith uveitis treated in our hospital from June 2012 to June 2015. All patients examined by the same uveitis specialist with unified standards. According to international standards, uveitis was customized into:anterior uveitis(AU, intermediate uveitis(IU, posterior uveitis(PU, panuveitis(PanU. Age, gender, type of uveitis and causes of the disease were analyzed. RESULTS:Through the analysis of the etiology and clinical types of patients, the main types were idiopathic(26 cases, 21.7%, VKH syndrome(18 cases, 15.0%, HLA-B27 related(14 cases, 11.7%, viral(12 cases, 10.0%, Fuchs syndrome(8 cases, 6.7%, Behcet's disease(8 eyes, 6.7%, diabetes(6 eyes, 5.0%, syphilis(6 eyes, 5.0%, Posner-Schlossman syndrome(6 eyes, 5.0%, juvenile chronic arthritis(4 eyes, 3.3%, sympathetic ophthalmia(4 eyes,3.3%, traumatic(2 eyes, 1.7%, sarcoid(2 eyes, 1.7%, endophthalmitis(2 eyes, 1.7%and others(2 eyes, 1.7%. By the observation for different types uveitis, the main cause of AU was idiopathic, followed by HLA-B27-related and viral; for PanU, it was VKH syndrome, idiopathic ones and Behcet's disease; for PU, it was idiopathic, then viral; for IU, it was idiopathic. CONCLUSION:Through observation and analysis for clinical patients, male patients were more than female; idiopathic, caused by VKH syndrome, viral and Behcet's disease are the common types of uveitis.

  3. Principal component regression analysis with SPSS. (United States)

    Liu, R X; Kuang, J; Gong, Q; Hou, X L


    The paper introduces all indices of multicollinearity diagnoses, the basic principle of principal component regression and determination of 'best' equation method. The paper uses an example to describe how to do principal component regression analysis with SPSS 10.0: including all calculating processes of the principal component regression and all operations of linear regression, factor analysis, descriptives, compute variable and bivariate correlations procedures in SPSS 10.0. The principal component regression analysis can be used to overcome disturbance of the multicollinearity. The simplified, speeded up and accurate statistical effect is reached through the principal component regression analysis with SPSS.

  4. Groundwater studies: principal aquifer surveys (United States)

    Burow, Karen R.; Belitz, Kenneth


    In 1991, the U.S. Congress established the National Water-Quality Assessment (NAWQA) program within the U.S. Geological Survey (USGS) to develop nationally consistent long-term datasets and provide information about the quality of the Nation’s streams and groundwater. The USGS uses objective and reliable data, water-quality models, and systematic scientific studies to assess current water-quality conditions, to identify changes in water quality over time, and to determine how natural factors and human activities affect the quality of streams and groundwater. NAWQA is the only non-regulatory Federal program to perform these types of studies; participation is voluntary. In the third decade (Cycle 3) of the NAWQA program (2013–2023), the USGS will evaluate the quality and availability of groundwater for drinking supply, improve our understanding of where and why water quality is degraded, and assess how groundwater quality could respond to changes in climate and land use. These goals will be addressed through the implementation of a new monitoring component in Cycle 3: Principal Aquifer Surveys.

  5. Stopping and Questioning Suspected Shoplifters Without Creating Civil Liability (United States)

    Reed, Jack R., Jr.


    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)


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    S. R. Gilarevsky


    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. 

  7. Suspect confession of child sexual abuse to investigators. (United States)

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


    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.

  8. Etiology and Outcome of Chronic Kidney Disease in Iranian Children


    Neamatollah Ataei; Mostafa Hosseini; Masoud Baeikpour; Fatemeh Ataei; Hosein Bloori Jirandeh; Behnaz Bazargani; Mahmoud Yousefifard; Arash Abbasi


    Background Considering the significant geographical and ethnical differences in pattern of incidence, etiology and outcome of chronic kidney disease (CKD), the present study aimed to assess the etiology and outcome of CKD in Iranian children. Materials and Methods In a cross-sectional study etiology and outcome of 372 children aged 3 months to 18 years with CKD was studied during the period 1991 –2014. Children (186 boys, 186 girls) with Stage 3 to 5 CKDs, defined as a glomerular filtration r...

  9. Suspect aggression and victim resistance in multiple perpetrator rapes. (United States)

    Woodhams, Jessica; Cooke, Claire


    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.

  10. Interviewing strategically to elicit admissions from guilty suspects. (United States)

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


    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).

  11. Etiology and risk factors of meningitis in patients admitted at a Central Hospital in Harare. (United States)

    Matubu, A; Rusakaniko, S; Robertson, V; Gwanzura, L


    To determine etiology and risk factors of meningitis in patients admitted a tertiary referral Hospital in Harare. Cross-Sectional Study. Urban Referral Health Facility. Patients suspected of having Meningitis admitted at Parirenyatwa Hospital were consecutively consented and recruited into the study until sample size accrual. Prevalence of pathogens associated with Meningitis. Risk factors of meningitis. Two Hundred and Ninety Six (296) clinically suspected meningitis patients were recruited into the study, 51.7 %( n=115) were male. Meningitis was confirmed in 20.6% (n=61) cases with the following pathogen proportions, C. neoformans - 45.9 %( n=28), S. pneumoniae – 27.9 % (n=17), TBM – 4.9 %( n=3), probable viral meningitis – 6.6% (n=4 and other bacteria- 14.8% (n=9). Patients from crowded households were also more likely to suffer from meningitis than those from sparsely populated households (pstain and culture. Cryptococcus neoformans and S. pneumoniae are the leading causes of meningitis in patients admitted at Parirenyatwa Hospital.

  12. [Etiological factors for developing carpal tunnel syndrome in people who work with computers]. (United States)

    Lewańska, Magdalena; Wagrowska-Koski, Ewa; Walusiak-Skorupa, Jolanta


    Carpal tunnel syndrome (CTS) is the most frequent mononeuropathy of upper extremities. From the early 1990's it has been suggested that intensive work with computers can result in CTS development, however, this relationship has not as yet been proved. The aim of the study was to evaluate occupational and non-occupational risk factors for developing CTS in the population of computer-users. The study group comprised 60 patients (58 women and 2 men; mean age: 53.8 +/- 6.35 years) working with computers and suspected of occupational CTS. A survey as well as both median and ulnar nerve conduction examination (NCS) were performed in all the subjects. The patients worked with use of computer for 6.43 +/- 1.71 h per day. The mean latency between the beginning of employment and the occurrence of first CTS symptoms was 12.09 +/- 5.94 years. All patients met the clinical and electrophysiological diagnostic criteria of CTS. In the majority of patients etiological factors for developing CTS were non-occupational: obesity, hypothyroidism, oophorectomy, past hysterectomy, hormonal replacement therapy or oral contraceptives, recent menopause, diabetes, tendovaginitis. In 7 computer-users etiological factors were not identified. The results of our study show that CTS is usually generated by different causes not related with using computers at work.

  13. Childhood Septicemia in Nepal: Documenting the Bacterial Etiology and Its Susceptibility to Antibiotics

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    Shamshul Ansari


    Full Text Available Introduction. Children are among the most vulnerable population groups to contract illnesses. The varying microbiological pattern of septicemia warrants the need for an ongoing review of the causative organisms and their antimicrobial susceptibility pattern. Therefore, the objective of this study was to document the bacterial etiology of childhood septicemia and its antibiotic susceptibility profile. Methods. Cross-sectional type of study in 1630 suspected patients was conducted at CMCTH from January 2012 to December 2013. Blood samples were collected aseptically for culture. The organisms grown were identified by standard microbiological methods recommended by American Society for Microbiology (ASM and subjected to antibiotic susceptibility testing by modified Kirby-Bauer disk diffusion method. Methicillin resistance was confirmed using cefoxitin and oxacillin disks methods. Results. Septicemia was detected in 172 (10.6% cases. Among Gram-positive organisms, coagulase negative staphylococci (CoNS were leading pathogen and Acinetobacter spp. were leading pathogen among Gram-negative isolates. Vancomycin, teicoplanin, and clindamycin were the most effective antibiotics against Gram-positive isolates while amikacin was effective against Gram-positive as well as Gram-negative isolates. Methicillin resistance was detected in 44.4% of Staphylococcus aureus. Conclusions. This study has highlighted the burden of bacterial etiology for septicemia among children in a tertiary care center of central Nepal.

  14. Hepatitis A as an etiologic agent of acute liver failure in Latin America. (United States)

    Ciocca, Mirta; Moreira-Silva, Sandra Fagundes; Alegría, Sylvia; Galoppo, Maria Cristina; Ruttiman, Ricardo; Porta, Gilda; Da Silvera, Themis Reverbel; Rubio, Pilar; Macias, Mercedes; Cervantes, Yolanda; Avila-Aguero, Maria Luisa; Clemens, Sue Anne Costa; Clemens, Ralf; Weil, John


    This prospective, multicenter study examined the importance of hepatitis viruses as etiological agents of acute liver failure (ALF) and the outcome of ALF cases in Latin American children and adolescents. The study was conducted for minimum 12 months in 9 centers in Argentina, Brazil, Chile, Colombia, Costa Rica, and Mexico during 2001-2002. Hospitalized patients aged 1-20 years with a suspected diagnosis of ALF were included in the study and tested for serologic markers for hepatitis A, B, and C viruses. Of the 106 patients enrolled, 88 were included in the analysis. Median age was 5 years, and 55% with ALF were aged 1-5 years. A total of 37 individuals (43%) tested positive for anti-hepatitis A virus (HAV) immunoglobulin M (IgM) as marker of acute HAV infection; one was positive for anti-hepatitis B core antigen IgM and negative for hepatitis B surface antigen. None had markers of hepatitis C virus infection. Mortality rates in the overall study cohort (45%) and for those who tested anti-HAV IgM positive (41%) were similar. Forty-one percent of all patients and 46% of those positive for anti-HAV IgM underwent transplantation. The mortality rate in those with liver transplantation was half of that in patients who were not transplanted (28% versus 57%). HAV was the main etiologic agent of ALF in the population studied.

  15. Childhood septicemia in Nepal: documenting the bacterial etiology and its susceptibility to antibiotics. (United States)

    Ansari, Shamshul; Nepal, Hari Prasad; Gautam, Rajendra; Shrestha, Sony; Neopane, Puja; Rimal, Brihaspati; Mandal, Fuleshwar; Ansari, Safiur Rahman; Chapagain, Moti Lal


    Introduction. Children are among the most vulnerable population groups to contract illnesses. The varying microbiological pattern of septicemia warrants the need for an ongoing review of the causative organisms and their antimicrobial susceptibility pattern. Therefore, the objective of this study was to document the bacterial etiology of childhood septicemia and its antibiotic susceptibility profile. Methods. Cross-sectional type of study in 1630 suspected patients was conducted at CMCTH from January 2012 to December 2013. Blood samples were collected aseptically for culture. The organisms grown were identified by standard microbiological methods recommended by American Society for Microbiology (ASM) and subjected to antibiotic susceptibility testing by modified Kirby-Bauer disk diffusion method. Methicillin resistance was confirmed using cefoxitin and oxacillin disks methods. Results. Septicemia was detected in 172 (10.6%) cases. Among Gram-positive organisms, coagulase negative staphylococci (CoNS) were leading pathogen and Acinetobacter spp. were leading pathogen among Gram-negative isolates. Vancomycin, teicoplanin, and clindamycin were the most effective antibiotics against Gram-positive isolates while amikacin was effective against Gram-positive as well as Gram-negative isolates. Methicillin resistance was detected in 44.4% of Staphylococcus aureus. Conclusions. This study has highlighted the burden of bacterial etiology for septicemia among children in a tertiary care center of central Nepal.

  16. Isolated acute nontraumatic cortical subarachnoid hemorrhage: Etiologies based on MRI findings

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    Cho, Eun; Kang, Myung Jin; Kim, Sang Hyeon [Dept. of Radiology, Dong-A University Medical Center, Busan (Korea, Republic of)


    The purpose of this study was to identify common underlying etiologies that may be responsible for isolated acute nontraumatic cortical subarachnoid hemorrhage (cSAH) by analysis of magnetic resonance imaging (MRI) findings of the brain. From August 2005 to February 2014, 15 cSAH patients were admitted to our institution. All patients with cSAH underwent brain MRI and magnetic resonance angiography as a part of their initial evaluation. An analysis of the patients' medical history, clinical presentations, and brain MRI findings was retrospectively performed. Among the combined pathologies that were suspected causes of cSAH, 11 patients showed acute or subacute cerebral infarctions at the ipsilateral hemisphere of cSAH on the diffusion-weighted images. Four of 11 patients had only cerebral infarction, but the other 7 had combined vasculopathy of extra- and intracranial arteries. Four of 15 patients who did not have cerebral infarction, had intracranial artery stenosis, or showed possible cerebral amyloid angiopathy, or no abnormal findings on the brain MRI. Ischemic stroke, such as cerebral infarction or vasculopathy of the extra and intracranial arteries is regarded as a common underlying etiology of the cSAH based on MRI findings.

  17. Etiological factors for developing carpal tunnel syndrome in people who work with computers

    Directory of Open Access Journals (Sweden)

    Magdalena Lewańska


    Full Text Available Background: Carpal tunnel syndrome (CTS is the most frequent mononeuropathy of upper extremities. From the early 1990's it has been suggested that intensive work with computers can result in CTS development, however, this relationship has not as yet been proved. The aim of the study was to evaluate occupational and non-occupational risk factors for developing CTS in the population of computer-users. Material and Methods: The study group comprised 60 patients (58 women and 2 men; mean age: 53.8±6.35 years working with computers and suspected of occupational CTS. A survey as well as both median and ulnar nerve conduction examination (NCS were performed in all the subjects. Results: The patients worked with use of computer for 6.43±1.71h per day. The mean latency between the beginning of employment and the occurrence of first CTS symptoms was 12.09±5.94 years. All patients met the clinical and electrophysiological diagnostic criteria of CTS. In the majority of patients etiological factors for developing CTS were non-occupational: obesity, hypothyroidism, oophorectomy, past hysterectomy, hormonal replacement therapy or oral contraceptives, recent menopause, diabetes, tendovaginitis. In 7 computer-users etiological factors were not identified. Conclusion: The results of our study show that CTS is usually generated by different causes not related with using computers at work. Med Pr 2013;64(1:37–45

  18. 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.

  19. A rare etiology of Fournier's gangrene: Pubic tubercle fracture complicated with hematoma and acute osteomyelitis

    Directory of Open Access Journals (Sweden)

    Chien-Liang Fang


    Full Text Available The etiologies of Fournier's gangrene are well described into four groups: anorectal, genitourinary, dermatologic, and idiopathic. Here, we present the case of a hematoma and acute osteomyelitis (related to a closed fracture of the pubis, which progressed to Fournier's gangrene 1 month after trauma. A 68-year-old woman was admitted to our emergency department because she had sustained a left side pubic bone fracture from a fall. On her first admission to our emergency department, conservative treatment had been prescribed; however, she was readmitted to our emergency department due to septic shock, local swelling, and pus discharge from the pubis and the left labium majus. A whole abdomen computed tomography scan revealed fluid accumulation in the left suprapubic and perineum region in addition to acute osteomyelitis of the pubis. Acute osteomyelitis-related Fournier's gangrene and sepsis were suspected; hence, she underwent urgent fasciotomy and sequestrectomy. After three rounds of sequestrectomies, partial wound reconstruction with local flap and 24-day hospitalization, she was discharged from our hospital with continuing wound care management. Conservative treatment of closed stable fractures of the pelvic bone along with bed rest is suggested by most orthopedists. However, surgical drainage of hematoma is necessary due to the poor hematoma absorption owing to pelvic fracture. The patient subsequently contracted acute osteomyelitis, a secondary infection associated with the etiology of Fournier's gangrene, particularly in the case of patients with diabetes mellitus. We concluded that this was a rare etiology of Fournier's gangrene and examined the complications of pelvic bone fracture in this context.

  20. [An etiological survey on a foodborne disease epidemic outbreak caused by Salmonella enteritidis]. (United States)

    Yang, Jin-chuan; Xia, Yang; Guo, Hui; Xu, Jing-jing; Wang, Lu-mei; Tong, Jing; Zhang, Lei; Liang, Jun-rong; Jing, Huai-qi; Li, Zhen-jun


    To conduct an etiological molecular epidemiological survey and laboratory test on a foodborne disease epidemic outbreak to make clear of the cause and implement effective prevention and control on it. On May 12th 2012, 135 kindergarten children were sent to Xuzhou City People's Hospital and Children's Hospital with gastrointestinal infection disease. A total of 34 anus swab samples and 4 vomit samples were collected from the patients. Real-time PCR rapid detection, strains separation and cultivation, phage lysis experiments, ATB automated identification system were used to make etiological detection and identification. The genomic DNA of salmonella enteritidis were typed with the pulsed-field gel electrophoresis (PFGE), cluster analysis were carried out together with the patterns of local Salmonella infections. Children in 20 classes were suffered from the gastrointestinal infection among the 21 classes. There were no significant aggregation of class distribution. Among the 135 patients, 76 were boys (56.3%) and 59 were girls (43.7%). The main symptoms were fever (above 38°C), diarrhea and bellyache. Through real-time PCR detection and strains separation, 19 salmonella enteritidis were isolated from 34 anus swab samples of suspected cases and the detection rate was 56%. There were no strains detected from vomit samples. All of the 19 salmonella enteritidis showed the same serological subtype, biochemical reaction, drug sensitivity and phage lysis pattern. The salmonella enteritidis had the identical PFGE pattern (100% similarity), and were different from the pattern of local sporadic infection cases. It was confirmed that this was an epidemic outbreak of foodborne disease caused by homologous salmonella enteritidis by epidemiological survey, clinical information, lab etiological test and molecular typing.

  1. The chronobiology, etiology and pathophysiology of obesity (United States)

    Garaulet, M; Ordovás, JM; Madrid, JA


    The effect of CD on human health is an emerging issue. Many records link CD with diseases such as cancer, cardiovascular, cognitive impairment and obesity, all of them conducive to premature aging. The amount of sleep has declined by 1.5 h over the past century, accompanied by an important increase in obesity. Shift work, sleep deprivation and exposure to bright light at night increase the prevalence of adiposity. Animal models have shown that mice with Clock gene disruption are prone to developing obesity and MetS. This review summarizes the latest developments with regard to chronobiology and obesity, considering (1) how molecular clocks coordinate metabolism and the specific role of the adipocyte; (2) CD and its causes and pathological consequences; (3) the epidemiological evidence of obesity as a chronobiological illness; and (4) theories of circadian disruption and obesity. Energy intake and expenditure, relevance of sleep, fat intake from a circadian perspective and psychological and genetic aspects of obesity are examined. Finally, ideas about the use of chronobiology in the treatment of obesity are discussed. Such knowledge has the potential to become a valuable tool in the understanding of the relationship between the chronobiology, etiology and pathophysiology of obesity. PMID:20567242

  2. Etiological Aspects of Human Trafficking in Kosovo

    Directory of Open Access Journals (Sweden)

    Emine Abdyli


    Full Text Available Human trafficking is considered one of the most serious criminal offences, which is presented as a contemporary form of slavery and which implies the most brutal violation of basic human rights, which are guaranteed by international and law and national law. The phenomenon of human trafficking is present in many countries in transition (such as Kosovo, namely in those countries which were affected by internal political, economic, social, educational, etc. changes, and in such situations the perpetrators of this offense are in a very favorable position to victimize society. Therefore, this paper will focus on external criminogenic factors that influence the growth of this negative phenomenon, including the difficult economic situation, poverty and unemployment, poor housing, migration of people, domestic violence, the impact of mass media in society, lack of border control and insufficient effectiveness of institutions to deal with law enforcement. The paper is based on literature review, statistical data and interviews by treating the subject theoretically, legislatively and practically. To successfully fight against human trafficking, relevant authorities should more closely approach the etiological treatment of this negative phenomenon.

  3. Bulimia: clinical characteristics, development, and etiology. (United States)

    Kirkley, B G


    Bulimia is characterized by recurrent episodes of binge eating and severe self-deprecation, often accompanied by self-induced vomiting and/or laxative abuse. It is most often found among young women in their late teens to mid-30s. Estimates of the disorder's prevalence vary widely, depending on the diagnostic criteria used, but usually range from 5% to 20% of college age women. Binge eating typically begins in late adolescence, frequently after a period of dieting to lose weight. Self-induced vomiting usually follows the onset of binge eating by about a year. To date, theories of the disorder's etiology have included several biological models, a psychosocial model, and a biopsychosocial model. The biological models proposed have viewed bulimia as a form of biological depression, neurological disturbance, or metabolic disturbance. The psychosocial model suggests that society's pressure on young women for extreme thinness leads to excessive dietary restraint, deprivation, and, paradoxically, binge eating. The presence of anxiety or depression exacerbates the process. The biopsychosocial model appears to be the most promising. It proposes that young women with biological predispositions toward overweight, depression, or metabolic disturbance are particularly vulnerable to social pressure for thinness, the binge eating that may result from excessive dieting, and, hence, bulimia. The complex nature of bulimia suggests that a multidisciplinary team approach treatment is appropriate.

  4. Understanding and determining the etiology of autism. (United States)

    Currenti, Salvatore A


    Worldwide, the rate of autism has been steadily rising. There are several environmental factors in concert with genetic susceptibilities that are contributing to this rise. Impaired methylation and mutations of mecp2 have been associated with autistic spectrum disorders, and related Rett syndrome. Genetic polymorphisms of cytochrome P450 enzymes have also been linked to autism, specifically CYP27B1 that is essential for proper vitamin D metabolism. Vitamin D is important for neuronal growth and neurodevelopment, and defects in metabolism or deficiency have been implicated in autistic individuals. Other factors that have been considered include: maternally derived antibodies, maternal infection, heavy metal exposure, folic acid supplementation, epigenetics, measles, mumps, rubella vaccination, and even electromagnetic radiation. In each case, the consequences, whether direct or indirect, negatively affect the nervous system, neurodevelopment, and environmental responsive genes. The etiology of autism is a topic of controversial debate, while researchers strive to achieve a common objective. The goal is to identify the cause(s) of autism to understand the complex interplay between environment and gene regulation. There is optimism that specific causes and risk factors will be identified. The results of future investigations will facilitate enhanced screening, prevention, and therapy for "at risk" and autistic patients.

  5. Molar Incisor Hypomineralization, Prevalence, and Etiology

    Directory of Open Access Journals (Sweden)

    Sulaiman Mohammed Allazzam


    Full Text Available Aim. To evaluate the prevalence and possible etiological factors associated with molar incisor hypomineralization (MIH among a group of children in Jeddah, Saudi Arabia. Methods. A group of 8-12-year-old children were recruited (n=267  from the Pediatric Dental Clinics at the Faculty of Dentistry, King Abdulaziz University. Children had at least one first permanent molar (FPM, erupted or partially erupted. Demographic information, children’s medical history, and pregnancy-related data were obtained. The crowns of the FPM and permanent incisors were examined for demarcated opacities, posteruptive breakdown (PEB, atypical restorations, and extracted FPMs. Children were considered to have MIH if one or more FPM with or without involvement of incisors met the diagnostic criteria. Results. MIH showed a prevalence of 8.6%. Demarcated opacities were the most common form. Maxillary central incisors were more affected than mandibular (P=0.01. The condition was more prevalent in children with history of illnesses during the first four years of life including tonsillitis (P=0.001, adenoiditis (P=0.001, asthma (P=0.001, fever (P=0.014, and antibiotics intake (P=0.001. Conclusions. The prevalence of MIH is significantly associated with childhood illnesses during the first four years of life including asthma, adenoid infections, tonsillitis, fever, and antibiotics intake.

  6. Papilledema: epidemiology, etiology, and clinical management

    Directory of Open Access Journals (Sweden)

    Rigi M


    Full Text Available Mohammed Rigi,1 Sumayya J Almarzouqi,2 Michael L Morgan,2 Andrew G Lee2–4 1Robert Cizik Eye Clinic, University of Texas, 2Department of Ophthalmology, Houston Methodist Hospital, Blanton Eye Institute, 3Baylor College of Medicine, 4Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College, Houston, UTMB Galveston, UT MD Anderson Cancer Center, Houston, TX, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA Abstract: Papilledema is optic disc swelling due to high intracranial pressure. Possible conditions causing high intracranial pressure and papilledema include intracerebral mass lesions, cerebral hemorrhage, head trauma, meningitis, hydrocephalus, spinal cord lesions, impairment of cerebral sinus drainage, anomalies of the cranium, and idiopathic intracranial hypertension (IIH. Irrespective of the cause, visual loss is the feared morbidity of papilledema, and the main mechanism of optic nerve damage is intraneuronal ischemia secondary to axoplasmic flow stasis. Treatment is directed at correcting the underlying cause. In cases where there is no other identifiable cause for intracranial hypertension (ie, IIH the available options include both medical and surgical modalities. Weight loss and diuretics remain the mainstays for treatment of IIH, and surgery is typically reserved for patients who fail, are intolerant to, or non-compliant with maximum medical therapy. Keywords: papilledema, intracranial hypertension, idiopathic intracranial hypertension, epidemiology, papilledema management, papilledema etiology, acetazolamide, optic nerve sheath fenestration, ventriculoperitoneal shunt, lumboperitoneal shunt, venous sinus stenting

  7. Maternal sepsis: epidemiology, etiology and outcome. (United States)

    van Dillen, Jeroen; Zwart, Joost; Schutte, Joke; van Roosmalen, Jos


    Sepsis is a major cause of maternal death worldwide. Little is known on the incidence of severe maternal morbidity related to sepsis. In this review, we focus on new findings concerning epidemiology, etiology and outcome of maternal sepsis in low-income as well as high-income countries. It is estimated that puerperal sepsis causes at least 75,000 maternal deaths every year, mostly in low-income countries. Studies from high-income countries report incidence of maternal morbidity due to sepsis of 0.1-0.6 per 1000 deliveries. The causative microorganisms are generally polymicrobial with beta-haemolytic streptococci group A (GAS) often being the cause of severe cases of puerperal fever. The single most important risk factor for postpartum infection seems to be caesarean section, and prophylactic antibiotics during the procedure substantially reduce the infection risk. Improvements in service provision as promoted through the Surviving Sepsis Campaign can reduce the overall risk of mortality and morbidity from maternal sepsis in high-income as well as in low-income countries. Maternal sepsis is an infrequent, but important complication of pregnancy, childbirth and puerperium, resulting in significant maternal morbidity and mortality worldwide. Improved outcome is possible through improved service provision.

  8. The Pathophysiology and Etiology of Vaginismus

    Directory of Open Access Journals (Sweden)

    Cherng-Jye Jeng


    Full Text Available Vaginismus is defined as an involuntary spasm of the pelvic muscles surrounding the outer third of the vagina, especially the perineal muscles and the levator ani muscles. Its severe form usually makes penetration virtually impossible and causes a severe, burning pain, and leads to unconsummated marriage. There appears to be basic agreement that vaginismus is a psychosociologic disorder with phobic elements resulting from actual or imagined negative experiences with penetration attempts. Fear and anxiety concerning penetration is expressed physiologically via the involuntary vaginal muscle spasm that characterizes vaginismus. Since 1547, when vaginismus was first described, thousands of research papers have been published on this female sexual disorder. However, the etiology of vaginismus remains controversial. Women with vaginismus generally experience shame, disgust and dislike toward their genitals. They frequently have or have had other phobias. They are usually overprotected by their fathers and have been “good girls” since childhood. Their sexual partners are usually kind, gentle, considerate and passive “nice guys”. The male partner's lack of aggressiveness actually leads to unconsummation of the marriage. The sexually secure husband can usually overcome mild degrees of vaginismus by persistent but firm penile insertion. For moderate to severe degrees of vaginismus, medical intervention is usually necessary to lead to consummation of the marriage.

  9. Etiology and immunology of infectious bronchitis virus

    Directory of Open Access Journals (Sweden)

    LF Caron


    Full Text Available Infectious bronchitis virus (IBV of chickens is currently one of the main diseases associated with respiratory syndrome in domestic poultry, as well as with losses related to egg production. The etiological agent is a coronavirus, which presents structural differences in the field, mainly in the S1 spike protein. The immune response against this virus is complicated by the few similarities among serotypes. Environmental and management factors, as well as the high mutation rate of the virus, render it difficult to control the disease and compromise the efficacy of the available vaccines. Bird immune system capacity to respond to challenges depend on the integrity of the mucosae, as an innate compartment, and on the generation of humoral and cell-mediated adaptive responses, and may affect the health status of breeding stocks in the medium run. Vaccination of day-old chicks in the hatchery on aims at eliciting immune responses, particularly cell-mediated responses that are essential when birds are first challenged. Humoral response (IgY and IgA are also important for virus clearance in subsequent challenges. The presence of antibodies against the S1 spike protein in 3- to 4-week-old birds is important both in broilers and for immunological memory in layers and breeders.

  10. Etiology and perinatal outcome of polyhydramnios. (United States)

    Kollmann, M; Voetsch, J; Koidl, C; Schest, E; Haeusler, M; Lang, U; Klaritsch, P


    To determine causes of polyhydramnios and the respective perinatal outcome. We retrospectively analyzed cases with polyhydramnios at the Medical University Graz, Austria from 2003 - 2011. Inclusion criteria were single deepest pocket ≥ 8  cm, amniotic fluid index ≥ 25  cm, each of the latter parameters > 95th percentile or subjective impression. Etiologies, including TORCH infection, diabetes and congenital malformations, as well as perinatal outcome were evaluated. Out of 860 singleton pregnancies with polyhydramnios, 2.9 % had positive TORCH serology, 8.5 % had congenital anomalies, 19.8 % had maternal diabetes, and 68.8 % were idiopathic. The most common fetal anomalies were cardiac defects (32.9 %). Elective caesarean sections were more common in the groups with malformations and maternal diabetes. Low birth weight combined with severe polyhydramnios or maternal diabetes was associated with malformations. Diagnosis of polyhydramnios should prompt glucose-tolerance testing, detailed sonography including fetal echocardiography, and TORCH serology. Especially pregnancies with polyhydramnios and small fetuses as well as those with maternal diabetes should be carefully evaluated for malformations. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Cervicogenic vertigo: etiology, diagnosis and treatment

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    Elham Tavanai


    Full Text Available Background and Aim: Cervicogenic dizziness is induced by a specific neck position and the earth’s gravity has no effect on provoking of it. The precise incidence of cervicogenic dizziness is not certain but, 20-58% of patients following sudden head injuries experience its symptoms . In this article, the etiology, diagnosis and treatment of cervicogenic vertigo is discussed. Methods: At first, articles of cervicogenic dizziness from electronic databases of Google scholar , PubMed, Scopus, Ovid and CINAHL were searched from 1987 up to 2012. Then, the articles in them vertigo, disequilibrium or nystagmus were consistent with neck disorders were searched. Conclusion: Articles with title of cervicogenic vertigo (cervical vertigo were limited. Clinical researches about cervicogenic vertigo up to now implicate on several points; all signify that we cannot diagnose it certainly and there is not any specific single test for that. Recently, smooth pursuit neck torsion test (SPNTT has introduced for diagnosis of cervicogenic vertigo that is not valid yet. There is no protocol for diagnosis of cervicogenic vertigo and diagnosis is often based on limited clinical experiences of clinicians. Physiotherapy, medication and manual therapies are options for treatment but there is no distinct and effective treatment for it and in just one article, a combination of treatments for cervicogenic vertigo as a protocol has recommended.


    Directory of Open Access Journals (Sweden)

    O. E. Iryshkin


    Full Text Available Biliary atresia is an inflammatory fibrosing process, which invades both extrahepatic and intrahepatic bile ducts. There are two forms of biliary atresia: embryonic form, associated with another visceral malformations, and perinatal form, which is an isolated disease. Biliary atresia is a heterogeinc disease which may appear as a result of different etiological factors, the most important of them are genetics, viral infection, vascular factors, toxins and disregulation of immune system. The characteristic morphological features of biliaryatresia are: intracellular and ductular cholestasis, ductular proliferation, giant cell transformation, portal and perilobular oedema and/or fibrosis. As the patalogical process progresses, ductopenia appears, and fibrosis turns to cirrhosis. Embryonic form mophologically manifests with ductal plate malformation is, what is an important diagnostic criterion. Pro- gnosis of biliary atresia depends on form of disease, age of patient and type of surgical operation. Today surgical treatment includes two steps: palliative portoenterostomia, performed in neonatal period and further liver trans- plantation. However liver transplantation is more preferable as first and single-step treatment. 

  13. The chronobiology, etiology and pathophysiology of obesity. (United States)

    Garaulet, M; Ordovás, J M; Madrid, J A


    The effect of CD on human health is an emerging issue. Many records link CD with diseases such as cancer, cardiovascular, cognitive impairment and obesity, all of them conducive to premature aging. The amount of sleep has declined by 1.5 h over the past century, accompanied by an important increase in obesity. Shift work, sleep deprivation and exposure to bright light at night increase the prevalence of adiposity. Animal models have shown that mice with Clock gene disruption are prone to developing obesity and MetS. This review summarizes the latest developments with regard to chronobiology and obesity, considering (1) how molecular clocks coordinate metabolism and the specific role of the adipocyte; (2) CD and its causes and pathological consequences; (3) the epidemiological evidence of obesity as a chronobiological illness; and (4) theories of circadian disruption and obesity. Energy intake and expenditure, relevance of sleep, fat intake from a circadian perspective and psychological and genetic aspects of obesity are examined. Finally, ideas about the use of chronobiology in the treatment of obesity are discussed. Such knowledge has the potential to become a valuable tool in the understanding of the relationship between the chronobiology, etiology and pathophysiology of obesity.

  14. Heart failure etiology impacts survival of patients with heart failure

    DEFF Research Database (Denmark)

    Pecini, Redi; Møller, Daniel Vega; Torp-Pedersen, Christian


    BACKGROUND: The impact of heart failure (HF) etiology on prognosis of HF is not well known. METHODS: 3078 patients (median age 75years, 61% male) hospitalized with HF were studied. Patients were classified into six etiology groups: hypertension (HTN, 13.9%), ischemic heart disease (IHD, 42...

  15. Etiology and incidence of chronic ulcers in Blantyre, Malawi

    NARCIS (Netherlands)

    Zeegelaar, Jim E.; Stroïnk, Aimee C.; Steketee, Willemyn H.; Faber, William R.; van der Wal, Allard C.; Komolafe, Isaac O. O.; Dzamalala, Charles; Chibwana, Cecilia; Wendte, Johannes F.; Zijlstra, Eduard E.


    BACKGROUND: Little information is available on the incidence and etiology of chronic ulcers in the tropics. Therefore, the incidence and etiology of chronic skin ulcers were assessed in out-patients at the Department of Dermatology and in in-patients at the Departments of Dermatology, Surgery,

  16. Epidemiologie et etiologies des epistaxis dans notre pratique: A ...

    African Journals Online (AJOL)

    Introduction: A frequent ailment in ENT, the epistaxis is an emergency that can put the vital prognosis at stake. An adequate follow up care deserves some knowledge of etiology. Objectives: Study the epidemiological and etiological aspects of the epistaxis. Methodology: A retrospective and descriptive study conducted on ...

  17. Etiology and pathogenesis of anterior open bite: A review | Wanjau ...

    African Journals Online (AJOL)

    Objective: To review the etiology and pathogenesis of anterior open bite malocclusion. Data source: Review of literature was affected through Pubmed, Google scholar and Science direct. References identified from articles found from the primary search were also reviewed. Study selection: Published data on etiology and ...

  18. Etiology and oncogenesis of pancreatic carcinoma. (United States)

    Dobrila-Dintinjana, Renata; Vanis, Nenad; Dintinjana, Marijan; Radić, Mladen


    Pancreatic cancer is the fourth leading cause of cancer death overall. The factors that favor the development of pancreatic cancer can be divided into hereditary and acquired. Cancerogenesis is best explained by a "multi-hit" hypothesis, charcterized with the developmental sequence of cellular mutatitions, forcing mutant cell to inappropriate proliferation and preventing its repair and programmed cell death (apoptosis). The most common mutations involve K-ras gene, epidermal growth factor (EGF-R) and HER2 gene. Continuous stimulation and secretion of vascular endothelial growth factor (VEGF) enhances the permeability of blood vessels provides nutrient supply to tumor site through newly formed vascular channels. This phenomena is known as vasculogenic mimicry. Loss of function of tumor-suppressor genes has been documented in pancreatic cancer, especially in CDKN2a, p53, DPC4 and BRCA2 genes. SDKN2A gene inactivation occurs in 95% of pancreatic adenocarcinoma. As regards acquired factors, smoking is only confirmed risk factor that increases the risk of pancreatic cancer. Diabetes, alcohol consumption, central obesity in men, infection with Helicobacter pylori and chronic pancreatitis are suspected, but not proven risk factors. Consumption of fruits and vegetables does not protect, while the consumption of meat processed at high temperatures increases the risk of pancreatic cancer. According to some studies, lykopene and folate levels are reduced in pancreatic carcinoma patients, reduced folate intake increases the risk of pancreatic carcinoma (48%), and this risk can be diminished by introducing folate-rich foods to diet, not by using pharmaceutical products. Occupational exposure to chlorinated hydrocarbons, vinyl chloride, nickel, chromium, insecticides and acrylic amide minimally increases the risk for pancreatic cancer. Exposure to cadmium (metal industry) associated with smoking result in the accumulation of cadmium in pancreatic tissue and the possible impact

  19. Postinfectious encephalomyelitis: etiologic and diagnostic trends. (United States)

    Hung, K L; Liao, H T; Tsai, M L


    Fifty cases of postinfectious encephalomyelitis admitted to our Pediatric Department during the period 1980 to 1997 were consecutively collected and reviewed. There were 28 males and 22 females. The age of onset ranged from 9 months to 14 years. The antecedent infections included measles (6 cases), rubella (5 cases), mumps (4 cases), chicken pox (4 cases), Epstein-Barr virus infection (11 cases), mycoplasma infection (6 cases), and unknown etiology (14 cases). The cessation of measles, rubella, and mumps as causes for encephalomyelitis in our patients corresponds with the introduction of a measles-mumps-rubella nationwide vaccination program in Taiwan commencing in 1992. The main clinical symptoms were fever, headache, and/or vomiting, seizure, and motor weakness. The presenting signs included altered consciousness, meningeal signs, cranial nerve palsy, brainstem signs, involuntary movement, and cerebellar signs. Computed tomography scans were abnormal for 14 (56%) of 25 patients studied, whereas magnetic resonance imaging (MRI) disclosed lesions in 14 (82%) of 17 patients, with abnormal signals in various parts of the cerebral hemisphere, as well as in the basal ganglion, diencephalon, midbrain, brain stem, and cerebellum. Of the three patients with negative MRI findings, an abnormal finding on somatosensory evoked potential was noted for one patient, and a focal decrease in tracer uptake on single photon emission computed tomography (SPECT) was found for the other two patients. This study demonstrates that the causative agents of postinfectious encephalomyelitis in Taiwan have changed from those of traditional exanthematous diseases to nonspecific respiratory infections and suggests that this may also be the case in other parts of the world. MRI remains the imaging method of choice, whereas other neurofunctional studies such as evoked potentials and SPECT are complementary for the diagnosis.

  20. [Definition, etiology, classification and presentation forms]. (United States)

    Mas Garriga, Xavier


    Osteoarthritis is defined as a degenerative process affecting the joints as a result of mechanical and biological disorders that destabilize the balance between the synthesis and degradation of joint cartilage, stimulating the growth of subchondral bone; chronic synovitis is also present. Currently, the joint is considered as a functional unit that includes distinct tissues, mainly cartilage, the synovial membrane, and subchondral bone, all of which are involved in the pathogenesis of the disease. Distinct risk factors for the development of osteoarthritis have been described: general, unmodifiable risk factors (age, sex, and genetic makeup), general, modifiable risk factors (obesity and hormonal factors) and local risk factors (prior joint anomalies and joint overload). Notable among the main factors related to disease progression are joint alignment defects and generalized osteoarthritis. Several classifications of osteoarthritis have been proposed but none is particularly important for the primary care management of the disease. These classifications include etiological (primary or idiopathic forms and secondary forms) and topographical (typical and atypical localizations) classifications, the Kellgren and Lawrence classification (radiological repercussions) and that of the American College of Rheumatology for osteoarthritis of the hand, hip and knee. The prevalence of knee osteoarthritis is 10.2% in Spain and shows a marked discrepancy between clinical and radiological findings. Hand osteoarthritis, with a prevalence of symptomatic involvement of around 6.2%, has several forms of presentation (nodal osteoarthritis, generalized osteoarthritis, rhizarthrosis, and erosive osteoarthritis). Symptomatic osteoarthritis of the hip affects between 3.5% and 5.6% of persons older than 50 years and has different radiological patterns depending on femoral head migration. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  1. Alcohol-nutrient interactions in cancer etiology. (United States)

    Ziegler, R G


    The cancers for which there is the most compelling epidemiologic evidence of associations with both diet and alcohol are oral, pharyngeal, laryngeal, esophageal, and liver cancer. For lung, breast, stomach, and colorectal cancer, there is reasonably strong epidemiologic evidence of associations with diet, but only moderate or equivocal evidence of associations with alcohol. For pancreatic cancer there is suggestive evidence of associations with both exposures. It is probable that the quantitative relationship and the underlying biological mechanisms of the diet-alcohol interaction will not be the same for all cancers. Heavy alcohol consumption and generally poor nutrition, possibly a deficiency of several micronutrients and food groups, were the major risk factors for esophageal cancer in a case-control study of the unusually high rates for this cancer among Washington, DC black men. It is proposed that alcohol might increase risk of esophageal cancer, in part, by reducing nutrient intake. Two descriptive studies are presented that suggest that as the percent of caloric intake from alcohol increases, the daily consumption of protein, carbohydrate, fiber, and many micronutrients steadily and significantly decreases. Alcohol consumption and low fruit and vegetable intake, as well as snuff dipping and cigarette smoking, were shown to be risk factors for oral-pharyngeal cancer in a case-control study of the high rates of these cancers among North Carolina women. Since these women were not heavy drinkers, it is not likely that alcohol functioned by altering nutritional status. A number of mechanisms for the action of alcohol in cancer etiology are presented.

  2. Interpretation of recurring weak associations obtained from epidemiologic studies of suspected human teratogens. (United States)

    Khoury, M J; James, L M; Flanders, W D; Erickson, J D


    Epidemiological studies of suspected human teratogens not infrequently lead to recurring weak or moderate associations (relative risks or odds ratios ranging from greater than 1 to 3 for adverse effects and from 1/3 to less than 1 for protective effects) between specific defects and prenatal exposures. Examples of such associations include cigarette smoking and oral clefts (odds ratios between 1 and 2) and periconceptional multivitamin/folic acid supplementation and neural tube defects (odds ratios from 1/3 to 1). In this paper, we illustrate that low relative risk recurring in well-designed studies may reflect underlying biologic mechanisms and should not be readily dismissed. Low relative risks could be the result of a combination of the following factors: 1) unmeasured confounding, 2) exposure misclassification (often related to the inability to pinpoint relevant dose and timing), 3) outcome misclassification (related to the etiologic heterogeneity of birth defects), 4) biologic interactions (related to teratogenic effects in population subgroups defined by genetic susceptibility or the presence of other exposures), and 5) differential prenatal survival (related to the combined impact of the exposure and the defect on prenatal survival). These issues can be addressed in epidemiologic studies by using biological markers of exposure and susceptibility, dysmorphologic evaluation of affected infants, subgroup analysis for etiologic heterogeneity, a search for biologic interactions, and the use of prospective cohort studies. Finally, low relative risks in the face of common exposures can reflect an important public health contribution of the exposure to the occurrence of the defect in the population.

  3. Sarcomas: etiología y síntomas Sarcomas: etiology and symptoms

    Directory of Open Access Journals (Sweden)

    Roberto Gabriel Albín Cano


    Full Text Available Debido a la amplia diversidad de sarcomas, casi son inexistentes los textos que incluyen todas las variedades de este tipo de cáncer. Generalmente, su descripción y revisión se incluyen en las del sistema de órganos afectados específicamente, y la literatura que los aborda está muy fragmentada en las diferentes especialidades médicas. Se realiza una revisión bibliográfica sobre la etiología y síntomas de la mayor parte de los diferentes tipos de sarcomas. Es objetivo de esta revisión, lograr unir la información más actual disponible acerca de la etiología y síntomas de los sarcomas. Se han identificado diferentes factores de riesgo y factores etiológicos, tanto genéticos, infecciosos, como ambientales. Los grandes descubrimientos en relación con los mecanismos genéticos involucrados en los diferentes tipos de sarcoma, han abierto un camino de inestimable valor para introducir nuevos tratamientos, que incluyen ensayos con anticuerpos monoclonales y nuevos fármacos de terapia génica.

    Due to the wide diversity of sarcomas, almost no texts include all varieties of this type of cancer. Generally, their description and review is included in those of the specifically affected organ system, and the literature containing that information is very fragmented in different medical specialties. We performed a literature review on the etiology and symptoms of most types of sarcomas. It is aimed at achieving a recompilation of most current information available on the causes and symptoms of sarcomas. Different risks and etiologic factors have been identified regarding genetics, infections, and environment. The great discoveries regarding genetic mechanisms involved in different types of sarcomas, have opened an invaluable way to introduce new treatments, including monoclonal antibodies and new drugs of gene therapy.

  4. Should Principals Know More about Law? (United States)

    Doctor, Tyrus L.


    Educational law is a critical piece of the education conundrum. Principals reference law books on a daily basis in order to address the wide range of complex problems in the school system. A principal's knowledge of law issues and legal decision-making are essential to provide effective feedback for a successful school.

  5. Social Media Strategies for School Principals (United States)

    Cox, Dan; McLeod, Scott


    The purpose of this qualitative study was to describe, analyze, and interpret the experiences of school principals who use multiple social media tools with stakeholders as part of their comprehensive communications practices. Additionally, it examined why school principals have chosen to communicate with their stakeholders through social media.…

  6. Principal Leadership: Factors Sustaining Successful School Innovation (United States)

    Alvarez, Cristina Candelaria


    The study examines how urban school principals lead schools that make a difference for children in challenging settings. This research delves deeply into the experiences of three urban public school principals in the School District of Philadelphia in Pennsylvania, who used technology as an avenue to improve educational options for their students.…

  7. Principals as Maverick Leaders: Rethinking Democratic Schools (United States)

    Walker, Sharron Goldman; Chirichello, Michael


    After her school wins the coveted United States National Secondary Education Award, a school principal embarks upon an educational odyssey. The principal discovers that the reasons for winning the award are a sham! As her school falls apart, she begins to reflect on the stagnant school organization and the ineffective prescriptions for…

  8. Bennett Public Schools Principal Induction Program (United States)

    Wilson, Ross; Beaudoin, Colleen; Carmona, Ruben; Delahanty, Michael; Gartside, William; Oyedele, Abidemi; Teta, Lynne Mooney


    Ensuring equity in education and academic success for all students requires a highly skilled principal engages others in continually improving the instructional program in order to meet the needs of students. Over the past few years, a number of reports have indicated that the role of principal is becoming more challenging. School districts are…

  9. The Daily Practices of Successful Principals (United States)

    Brock, Barbara L.; Grady, Marilyn L.


    While many books outline the attributes of successful school leaders, few describe how those traits manifest in daily practice. "The Daily Practices of Successful Principals" goes beyond the outward picture of excellence and provides a compendium of daily practices used by successful principals in various settings. Written by former administrators…

  10. Comparative Analysis of Principals' Management Strategies in ...

    African Journals Online (AJOL)

    ... management strategies adopted by principals of schools in public and private secondary schools in Anambra State showed no significant differences. It was recommended among others that principals of secondary schools should adopt all the management strategies in this study as this will improve school administration ...

  11. A Latina Principal Leading for Social Justice (United States)

    Hernandez, Frank; Murakami, Elizabeth T.; Cerecer, Patricia Quijada


    In this study, the role that racial identity plays among Latina school principals is examined through a case study of a principal in a K-3 elementary school. Based on a Latina/o critical race framework and a phenomenological research approach, the study explores the degree to which having a strong understanding of one's racial identity formation…

  12. Principals' Knowledge of and Attitudes toward Inclusion. (United States)

    Barnett, Carol; Monda-Amaya, Lisa E.


    A survey of 65 elementary, junior, and high school principals investigated attitudes toward and knowledge of inclusion. No clear definition of inclusion emerged, but principals generally viewed inclusion as most appropriate for students with mild disabilities. Also, results indicated that teachers were not adequately prepared to implement…

  13. Assistant Principals: Their Readiness as Instructional Leaders (United States)

    Searby, Linda; Browne-Ferrigno, Tricia; Wang, Chih-hsuan


    This article reports findings from a study investigating the capacity of assistant principals to be instructional leaders. Analyses of survey responses yielded four interesting findings: (a) years of experience as a teacher and age had no significance on assistant principals' perceived readiness as an instructional leader; (b) those completing…

  14. The Awesome Power of the Principal (United States)

    Fullan, Michael


    After more than 20 years of vague reference to the principal as instructional leader, progress is finally being made, and the specificity and results are truly awesome. In 1989, William Smith and Richard Andrews wrote a monograph titled "Instructional Leadership: How Principals Make a Difference." In their study of 1,200 school…

  15. Principals: Human Capital Managers at Every School (United States)

    Kimball, Steven M.


    Being a principal is more than just being an instructional leader. Principals also must manage their schools' teaching talent in a strategic way so that it is linked to school instructional improvement strategies, to the competencies needed to enact the strategies, and to success in boosting student learning. Teacher acquisition and performance…

  16. Perceived Educational Values of Omani School Principals (United States)

    Al-Ani, Wajeha Thabit; Al-Harthi, Aisha Salim


    This qualitative study investigated the perceived educational values of Omani school principals. Data were collected using a semi-structured interview form which focused on the core values of school administration as perceived by a sample of 44 school principals; a focus group interview was also held. Data were analysed using Nvivo software. The…

  17. Principal G-bundles on nodal curves

    Indian Academy of Sciences (India)

    Springer Verlag Heidelberg #4 2048 1996 Dec 15 10:16:45

    If Y is reducible these notions depend on parameters a = (a1,...,aI ). The study of G-bundles on Y is done by extending the notion of (generalized) parabolic vector bundles [U1] to generalized parabolic principal G-bundles (called GPGs in short) on the curve C and using the correspondence between them and principal ...

  18. Integrating Technology: The Principals' Role and Effect (United States)

    Machado, Lucas J.; Chung, Chia-Jung


    There are many factors that influence technology integration in the classroom such as teacher willingness, availability of hardware, and professional development of staff. Taking into account these elements, this paper describes research on technology integration with a focus on principals' attitudes. The role of the principal in classroom…

  19. Professional Development: Perceptions of Benefits for Principals (United States)

    Blaik Hourani, Rida; Stringer, Patricia


    Schools in Abu Dhabi are going through change and reform. Abu Dhabi Education Council (ADEC) has initiated professional development for principals to facilitate change and school improvement. This paper explores principals' perception on the benefits of professional development received in light of managing school change and reforms.…

  20. Framing Research on School Principals' Identities (United States)

    Crow, Gary; Day, Christopher; Møller, Jorunn


    This paper provides a basis for a tentative framework for guiding future research into principals' identity construction and development. It is situated in the context of persisting emphases placed by government policies on the need for technocratic competencies in principals as a means of demonstrating success defined largely as compliance with…

  1. Building Leadership Capacity to Support Principal Succession (United States)

    Escalante, Karen Elizabeth


    This study applies transformational leadership theory practices, specifically inspiring a shared vision, modeling the way and enabling others to act to examine the purposeful ways in which principals work to build the next generation of teacher leaders in response to the dearth of K-12 principals. The purpose of this study was to discover how one…

  2. 37 CFR 2.46 - Principal Register. (United States)


    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Principal Register. 2.46 Section 2.46 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.46 Principal Register. All...

  3. Primary School Principals' Self-Monitoring Skills (United States)

    Konan, Necdet


    The aim of the present study is to identify primary school principals' self-monitoring skills. The study adopted the general survey model and its population comprised primary school principals serving in the city of Diyarbakir, Turkey, while 292 of these constituted the sample. Self-Monitoring Scale was used as the data collection instrument. In…

  4. Evaluation Priorities of Students, Teachers, and Principals. (United States)

    Nevo, David; Stufflebeam, Daniel L.

    The main purposes of this study were to identify the evaluation needs of students, teachers, and principals, and to develop recommendations for an evaluation system within the school building. Students, teachers, and principals were surveyed to depict the availability and importance of eight different categories of evaluative information derived…

  5. Women Principals Leading Learning at "Poverty's Edge" (United States)

    Lyman, Linda L.


    The author profiles two women principals of color who have successfully enhanced student learning in high-poverty schools. In their leadership narratives, the principals address how the complexity of poverty affects their work, how they affirm the worth and dignity of all, how they influence beliefs and attitudes of staff, why they think their…

  6. Relationship Between Secondary School Principals' Leadership ...

    African Journals Online (AJOL)

    ... in order to enhance better job performance among teachers. As such, principals could use the democratic style of leadership in some occasions. They should be autocratic in certain situations in order to increase productivity among teachers. Keywords: Academic Performance, Job Performance, Leadership and Principals ...

  7. Teachers' Perceptions of Principals Affect Collaborative Efforts. (United States)

    Kirby, Peggy C.; Blase, Joseph J.


    If teachers perceive their principals as "closed"--inaccessible, unsupportive, and insecure--they are wary of efforts toward increased collaboration. With closed principals, teachers resort to micropolitical strategies, including avoidance, excessive rationality, ingratiation, confrontation, coalition-building, and deliberate noncompliance.…

  8. Professional Development for Rural School Assistant Principals (United States)

    Enomoto, Ernestine K.


    Given rural school administrators' challenges and the need to support their leadership development, this qualitative study describes how one rural school district delivered professional development through a university-school partnership to prepare its assistant principals for their work. Methods: Eight assistant principals from nine schools…

  9. Perceptions of Online Credentials for School Principals (United States)

    Richardson, Jayson W.; McLeod, Scott; Dikkers, Amy Garrett


    Purpose: The purpose of this study is to investigate the perceptions of human resource directors in the USA about online credentials earned by K-12 school principals and principal candidates. Design/methodology/approach: In this mixed methods study, a survey was sent to a random sample of 500 human resource directors in K-12 school districts…

  10. The Relationship between Principals' Managerial Approaches and ...

    African Journals Online (AJOL)

    Nekky Umera

    It is therefore expected that principals who involve teachers and parents in discipline management are likely to benefit higher student discipline levels compared to those who do not. Statement of the Problem: This study investigated the relationship between the principals discipline management approaches and the levels ...

  11. New Principals' Perspectives of Their Multifaceted Roles (United States)

    Gentilucci, James L.; Denti, Lou; Guaglianone, Curtis L.


    This study utilizes Symbolic Interactionism to explore perspectives of neophyte principals. Findings explain how these perspectives are modified through complex interactions throughout the school year, and they also suggest preparation programs can help new principals most effectively by teaching "soft" skills such as active listening…

  12. Principals' Perceptions of School Public Relations (United States)

    Morris, Robert C.; Chan, Tak Cheung; Patterson, Judith


    This study was designed to investigate school principals' perceptions on school public relations in five areas: community demographics, parental involvement, internal and external communications, school council issues, and community resources. Findings indicated that principals' concerns were as follows: rapid population growth, change of…

  13. Special Topic/The Principal's Priority 1 (United States)

    Johnson, Jean


    Five Public Agenda surveys--A Mission of the Heart (2008); Lessons Learned (2008); Reality Check 2006; Rolling Up Their Sleeves (2003); and Stand by Me (2003)--provide snapshots of how instructional leadership is working in schools. Most principals see instructional leadership as a key mission. "Transformer" principals are able to focus squarely…

  14. Face recognition for criminal identification: An implementation of principal component analysis for face recognition (United States)

    Abdullah, Nurul Azma; Saidi, Md. Jamri; Rahman, Nurul Hidayah Ab; Wen, Chuah Chai; Hamid, Isredza Rahmi A.


    In practice, identification of criminal in Malaysia is done through thumbprint identification. However, this type of identification is constrained as most of criminal nowadays getting cleverer not to leave their thumbprint on the scene. With the advent of security technology, cameras especially CCTV have been installed in many public and private areas to provide surveillance activities. The footage of the CCTV can be used to identify suspects on scene. However, because of limited software developed to automatically detect the similarity between photo in the footage and recorded photo of criminals, the law enforce thumbprint identification. In this paper, an automated facial recognition system for criminal database was proposed using known Principal Component Analysis approach. This system will be able to detect face and recognize face automatically. This will help the law enforcements to detect or recognize suspect of the case if no thumbprint present on the scene. The results show that about 80% of input photo can be matched with the template data.

  15. The use of psychoactive prescription drugs among DUI suspects. (United States)

    Karjalainen, Karoliina; Haukka, Jari; Lintonen, Tomi; Joukamaa, Matti; Lillsunde, Pirjo


    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.

  16. Elementary school principals' perceptions of childhood obesity. (United States)

    Price, J H; Desmond, S M; Stelzer, C M


    This survey assessed school principals' perceptions regarding childhood obesity and the schools' role in dealing with the problem. A randomly selected group of 300 school principals was obtained from the National Association of Elementary School Principals; 227 (76%) administrators returned the questionnaire. Fifty-one percent of the principals believed normal weight was important to child health. Although 35% believed schools were not doing enough to alleviate childhood obesity, responses suggested principals oppose schools becoming obesity treatment centers. They do not believe teachers or parents would support such programs. They perceived the school's role to be educational and referral in nature. However, they supported elimination of "junk food" machines (71%) and provision of low calorie lunches (60%). They believed school nurses play the most important role in treating childhood obesity at school.

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

    Directory of Open Access Journals (Sweden)

    Thomas Nash


    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 (, Burlington Vermont Police Department, Internet Crime against Children Task Force. Adjunct Instructor, Champlain College, Burlington VT.In this must read for any aspiring novice cybercrime investigator as well as the seasoned professional computer guru alike, Brett Shaver takes the reader into the ever changing and dynamic world of Cybercrime investigation.  Shaver, an experienced criminal investigator, lays out the details and intricacies of a computer related crime investigation in a clear and concise manner in his new easy to read publication, Placing the Suspect behind the Keyboard. Using Digital Forensics and Investigative techniques to Identify Cybercrime Suspects. Shaver takes the reader from start to finish through each step of the investigative process in well organized and easy to follow sections, with real case file examples to reach the ultimate goal of any investigation: identifying the suspect and proving their guilt in the crime. Do not be fooled by the title. This excellent, easily accessible reference is beneficial to both criminal as well as civil investigations and should be in every investigator’s library regardless of their respective criminal or civil investigative responsibilities.(see PDF for full review

  18. Suspected Rhinolithiasis Associated With Endodontic Disease in a Cat. (United States)

    Ng, Kevin; Fiani, Nadine; Peralta, Santiago


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

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

    DEFF Research Database (Denmark)

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


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

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

    DEFF Research Database (Denmark)

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


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

  1. Intrauterine growth retardation (IUGR): epidemiology and etiology. (United States)

    Romo, Agustín; Carceller, Raquel; Tobajas, Javier


    Intrauterine growth retardation (IUGR) is mainly due to a pathologic slow-down in the fetal growth pace, resulting in a fetus that is unable to reach its growth potential. IUGR frequency will vary depending on the discrimination criteria adopted. It is extremely important to use local or national fetal growth graphs in order to avoid some confounding factors. IUGR incidence in newborns would be between 3% and 7% of the total population. In our experience it is 5.13% a figure similar to the one obtained by other authors but with a progressively higher incidence during the last decade. There are multiple maternal factors that can generally be grouped into constitutional and general factors given that they affect age, weight, race, maternal cardiac volume, etc, socioeconomic factors with key incidence in the mother's nutrition level, where a poor maternal nutrition level would be the key factor in this group. We have evaluated multiple factors as possible contributors to the IUGR risk: race, parents' age, mother's height (cm), mother's birth weight and before pregnancy (kg), ponderal gain and blood pressure during pregnancy, and previous SGA newborns. Socioeconomic factors like social class, parents' profession, habitual residence, salary, immigration, and diet were also evaluated. We also included variables such as total daily working time and time mothers spent standing up, daily sleeping time (hrs), stress self-perception test at work and primiparity age. Toxic factors during pregnancy: tobacco (active and passive), alcohol, drugs and coffee consumption. Fetal or utero-placental factors were considered. In our study, the most significant etiologic factors were: Active and passive tobacco consuming, mother's stress level, increase of total months worked during pregnancy, total daily working hours and time mothers spent standing up and finally, the parent's height. Our data support the main objective of reducing the incidence of SGA newborns after IUGR by fighting

  2. Abfraction lesions: etiology, diagnosis, and treatment options

    Directory of Open Access Journals (Sweden)

    Nascimento MM


    Full Text Available Marcelle M Nascimento,1 Deborah A Dilbone,1 Patricia NR Pereira,1 Wagner R Duarte,2,3 Saulo Geraldeli,1 Alex J Delgado1 1Department of Restorative Dental Sciences, Division of Operative Dentistry, 2Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA; 3Private Practice, Brasilia, DF, Brazil Abstract: Abfraction is a type of noncarious cervical lesion (NCCL characterized by loss of tooth tissues with different clinical appearances. Evidence supports that abfraction lesions, as any NCCLs, have a multifactorial etiology. Particularly, the cervical wear of abfraction can occur as a result of normal and abnormal tooth function and may also be accompanied by pathological wear, such as abrasion and erosion. The interaction between chemical, biological, and behavioral factors is critical and helps to explain why some individuals exhibit more than one type of cervical wear mechanism than others. In an era of personalized dentistry, patient risk factors for NCCLs must be identified and addressed before any treatment is performed. Marked variations exist in dental practice concerning the diagnosis and management of these lesions. The lack of understanding about the prognosis of these lesions with or without intervention may be a major contributor to variations in dentists’ management decisions. This review focuses on the current knowledge and available treatment strategies for abfraction lesions. By recognizing that progressive changes in the cervical area of the tooth are part of a physiologically dynamic process that occurs with aging, premature and unnecessary intervention can be avoided. In cases of asymptomatic teeth, where tooth vitality and function are not compromised, abfraction lesions should be monitored for at least 6 months before any invasive procedure is planned. In cases of abfraction associated with gingival recession, a combined restorative-surgical approach may be performed. Restorative

  3. Spoken language outcomes after hemispherectomy: factoring in etiology. (United States)

    Curtiss, S; de Bode, S; Mathern, G W


    We analyzed postsurgery linguistic outcomes of 43 hemispherectomy patients operated on at UCLA. We rated spoken language (Spoken Language Rank, SLR) on a scale from 0 (no language) to 6 (mature grammar) and examined the effects of side of resection/damage, age at surgery/seizure onset, seizure control postsurgery, and etiology on language development. Etiology was defined as developmental (cortical dysplasia and prenatal stroke) and acquired pathology (Rasmussen's encephalitis and postnatal stroke). We found that clinical variables were predictive of language outcomes only when they were considered within distinct etiology groups. Specifically, children with developmental etiologies had lower SLRs than those with acquired pathologies (p =.0006); age factors correlated positively with higher SLRs only for children with acquired etiologies (p =.0006); right-sided resections led to higher SLRs only for the acquired group (p =.0008); and postsurgery seizure control correlated positively with SLR only for those with developmental etiologies (p =.0047). We argue that the variables considered are not independent predictors of spoken language outcome posthemispherectomy but should be viewed instead as characteristics of etiology. Copyright 2001 Elsevier Science.

  4. Epidemiology of superficial and cutaneous mycosis in 5500 suspected patients in Tehran

    Directory of Open Access Journals (Sweden)

    Ayatollah Nasrollahi Omran


    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Identification of the determatophytosis species and superficial mycosis agents may be useful in directing the survey for environmental and animal sources of infection to educate the danger of acquiring infections from infected persons and other animals. Based on this background the identification of cutaneous mycosis distribution was the main purpose."n"nMethods: From March 2005 to Feb 2009 we examined 5500 patients suspected to superficial and cutaneous mycosis referred to medical mycology labs in Tehran, Iran for Medical Mycology examination. Skin, hair and nail sampling were taken by scraping from patients and collected for diagnosis. Diagnosis was confirmed by direct microscopy and culture according to the mycology routine laboratory methods."n"nResults: A total of 2271 cases (41.3% suffered from superficial and cutaneous mycosis. The most common infections were dermatophytosis 1279 cases (56.31%, Tinea Versicolor 356 cases (15.47%, Erythersma 283 cases (12.46%, cutaneous candidiosis 243 cases (10.7% and sacrophytic cutaneous mycosis 110 cases (4.83%. Tichophyton mentagrophytes was the most common etiological agent with 198 cases (41.56%. The most common clinical type of cutaneous candidiasis was

  5. Principal Time Management Skills: Explaining Patterns in Principals' Time Use, Job Stress, and Perceived Effectiveness (United States)

    Grissom, Jason A.; Loeb, Susanna; Mitani, Hajime


    Purpose: Time demands faced by school principals make principals' work increasingly difficult. Research outside education suggests that effective time management skills may help principals meet job demands, reduce job stress, and improve their performance. The purpose of this paper is to investigate these hypotheses. Design/methodology/approach:…

  6. Relationship between Principals' Sense of Achievement and Teachers' Perceptions of Their Principals' Leadership Behaviors (United States)

    Siddiqi, Javaid Edward


    The purpose of the study was to examine the relationship between principals' sense of achievement and teachers' perceptions of their principals' leadership behaviors. This was determined by examining job satisfaction of principals and leadership style using the Minnesota Satisfaction Questionnaire (MSQ) and the School District's Climate Survey.…

  7. Principal Self-Efficacy and Work Engagement: Assessing a Norwegian Principal Self-Efficacy Scale (United States)

    Federici, Roger A.; Skaalvik, Einar M.


    One purpose of the present study was to develop and test the factor structure of a multidimensional and hierarchical Norwegian Principal Self-Efficacy Scale (NPSES). Another purpose of the study was to investigate the relationship between principal self-efficacy and work engagement. Principal self-efficacy was measured by the 22-item NPSES. Work…

  8. Why Do Principals Change Schools? A Multivariate Analysis of Principal Retention (United States)

    Papa, Frank, Jr.


    This study uses multivariate analysis of a large panel dataset to examine the determinants of principal retention (and, thus, the determinants of attracting a principal away from her current position). The empirical model incorporates measures of a principal's traits and of the organizational structure, culture, and situational context within a…

  9. Immorally obtained principal increases investors' risk preference.

    Directory of Open Access Journals (Sweden)

    Chuqian Chen

    Full Text Available Capital derived from immoral sources is increasingly circulated in today's financial markets. The moral associations of capital are important, although their impact on investment remains unknown. This research aims to explore the influence of principal source morality on investors' risk preferences. Three studies were conducted in this regard. Study 1 finds that investors are more risk-seeking when their principal is earned immorally (through lying, whereas their risk preferences do not change when they invest money earned from neutral sources after engaging in immoral behavior. Study 2 reveals that guilt fully mediates the relationship between principal source morality and investors' risk preferences. Studies 3a and 3b introduce a new immoral principal source and a new manipulation method to improve external validity. Guilt is shown to the decrease the subjective value of morally flawed principal, leading to higher risk preference. The findings show the influence of morality-related features of principal on people's investment behavior and further support mental account theory. The results also predict the potential threats of "grey principal" to market stability.

  10. 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,

  11. 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

  12. 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 · · AJOL African Journals ...

  13. Talking heads : interviewing suspects from a cultural perspective

    NARCIS (Netherlands)

    Beune, K.


    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

  14. 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.


    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

  15. 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.

  16. Cognitive Linguistic Performances of Multilingual University Students Suspected of Dyslexia (United States)

    Lindgren, Signe-Anita; Laine, Matti


    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…

  17. Differential Diagnosis of Children with Suspected Childhood Apraxia of Speech (United States)

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


    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…

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


    Lambacher, Bianca; Wittek, Thomas


    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.

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

    African Journals Online (AJOL)

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

  20. Correlates and Suspected Causes of Obesity in Children (United States)

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


    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…

  1. Medical Evaluation of Suspected Child Sexual Abuse: 2011 Update (United States)

    Adams, Joyce A.


    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…

  2. 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 ...

  3. Sexual Health Before Treatment in Women with Suspected Gynecologic Malignancy. (United States)

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


    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.

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

    DEFF Research Database (Denmark)

    Bisgaard, H; Pedersen, S; Nikander, K


    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...

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

    African Journals Online (AJOL)


    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-.

  6. 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.

  7. 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.


    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

  8. 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.


    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

  9. 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 ...

  10. The Effects of Cortical Hypometabolism and Hippocampal Atrophy on Clinical Trajectories in Mild Cognitive Impairment with Suspected Non-Alzheimer's Pathology: A Brief Report. (United States)

    Chung, Jun Ku; Plitman, Eric; Nakajima, Shinichiro; Caravaggio, Fernando; Shinagawa, Shunichiro; Iwata, Yusuke; Gerretsen, Philip; Kim, Julia; Takeuchi, Hiroyoshi; Patel, Raihaan; Chakravarty, M Mallar; Strafella, Antonio; Graff-Guerrero, Ariel


    The clinical and structural trajectories of suspected non-Alzheimer' pathology (SNAP) remain elusive due to its heterogeneous etiology. Baseline and longitudinal clinical (global cognition, daily functioning, symptoms of dementia, and learning memory) and hippocampal volume trajectories over two years were compared between patients with amnestic mild cognitive impairment (aMCI) with SNAP with reduced hippocampal volumes (SNAP+HIPPO) and aMCI patients with SNAP without reduced hippocampal volumes. SNAP+HIPPO showed overall worse baseline cognitive functions. Longitudinally, SNAP+HIPPO showed faster deterioration of clinical symptoms of dementia. Having both hippocampal atrophy and cortical hypometabolism without amyloid pathology may exacerbate symptoms of dementia in aMCI.

  11. Opioid analgesic administration in patients with suspected drug use. (United States)

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


    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.

  12. Direct Identification of Enteroviruses in Cerebrospinal Fluid of Patients with Suspected Meningitis by Nested PCR Amplification

    Directory of Open Access Journals (Sweden)

    Alexandr Krasota


    Full Text Available Enteroviruses, the most common human viral pathogens worldwide, have been associated with serous meningitis, encephalitis, syndrome of acute flaccid paralysis, myocarditis and the onset of diabetes type 1. In the future, the rapid identification of the etiological agent would allow to adjust the therapy promptly and thereby improve the course of the disease and prognosis. We developed RT-nested PCR amplification of the genomic region coding viral structural protein VP1 for direct identification of enteroviruses in clinical specimens and compared it with the existing analogs. One-hundred-fifty-nine cerebrospinal fluids (CSF from patients with suspected meningitis were studied. The amplification of VP1 genomic region using the new method was achieved for 86 (54.1% patients compared with 75 (47.2%, 53 (33.3% and 31 (19.5% achieved with previously published methods. We identified 11 serotypes of the Enterovirus species B in 2012, including relatively rare echovirus 14 (E-14, E-15 and E-32, and eight serotypes of species B and 5 enteroviruses A71 (EV-A71 in 2013. The developed method can be useful for direct identification of enteroviruses in clinical material with the low virus loads such as CSF.

  13. Sudden Suspected Death in Emergency Department: Autopsy Results

    Directory of Open Access Journals (Sweden)

    Mehtap GURGER


    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

  14. 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)


    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.)

  15. Etiología del colesteatoma ótico Etiology of otic cholesteatoma

    Directory of Open Access Journals (Sweden)

    Julianis Loraine Quintero Noa


    Full Text Available El colesteatoma es una estructura quística caracterizada por la presencia de epitelio escamoso productor de queratina, que sustituye o recubre la mucosa normal en la hendidura del oído medio y ápex petroso, y puede ser causa de hipoacusia irreversible, destrucción ósea y graves complicaciones por su crecimiento expansivo. Clásicamente se describen los colesteatomas en congénitos y adquiridos. La etiología de su formación es multifactorial y continúa siendo poco claro y controversial. Se reportan diferentes teorías que han tratado de explicar el colesteatoma congénito, la transición de un bolsillo de retracción hasta la aparición del colesteatoma adquirido primario, y otras en la génesis del colesteatoma adquirido secundario. Se describe la presencia de algunas citoquinas dentro del colesteatoma que inducen la hiperproliferación e invasión incoordinada de los queratinocitos de la piel del conducto auditivo externo y la pars fláccida, más agresiva en el colesteatoma adquirido pediátrico, y que desempeñan un papel fundamental en la proliferación y en la apoptosis del queratinocito. En cultivo in vitro de una muestra de tejido colesteatomatoso, se ha identificado recientemente que el TNF-a estimula la producción de la IL-8. Se considera de interés ofrecer esta revisión sobre la etiología del colesteatoma, que aún se mantiene en el campo de la investigación y continúa siendo un reto para los otocirujanos por su alta incidencia de recidivas y posibles complicaciones.Cholesteatoma is a cystic structure characterized by presence of squamous epithelium producing keratin substituting or recovering the normal mucosa in the groove of middle ear and petrous apex and may to be caused by irreversible hypoacusia, bone destruction and severe complications due to its expansive growth. Typically the cholesteatomas are described as congenital and acquired. The etiology of its formation is multifactor and still remains a subject not

  16. In vitro evaluation of antibiotics' combinations for empirical therapy of suspected methicillin resistant Staphylococcus aureus severe respiratory infections

    Directory of Open Access Journals (Sweden)

    Nicola Lucia


    Full Text Available Abstract Background Methicillin resistant Staphylococcus aureus (MRSA is an increasingly common cause of nosocomial infections, causing severe morbidity and mortality worldwide, and accounting in some hospitals for more than 50% of all S. aureus diseases. Treatment of infections caused by resistant bacterial pathogens mainly relies on two therapeutic modalities: development of new antimicrobials and use of combinations of available antibiotics. Combinations of antibiotics used in the empiric treatment of infections with suspected methicillin resistant Staphylococcus aureus etiology were investigated. Methods Double (vancomycin or teicoplanin with either levofloxacin or cefotaxime and triple (vancomycin or teicoplanin + levofloxacin + one among amikacin, ceftazidime, cefepime, imipenem, piperacillin/tazobactam combinations were evaluated by means of checkerboard assay and time kill curves. Mutational rates of single and combined drugs at antimicrobial concentrations equal to the resistance breakpoints were also calculated. Results Vancomycin or teicoplanin + levofloxacin showed synergy in 16/50 and in 9/50 strains respectively, while vancomycin or teicoplanin + cefotaxime resulted synergic for 43/50 and 23/50 strains, respectively. Triple combinations, involving teicoplanin, levofloxacin and ceftazidime or piperacillin/tazobactam gave synergy in 20/25 strains. Teicoplanin + levofloxacin gave synergy in triple combinations more frequently than vancomycin + levofloxacin. For single antibiotics, mutational frequencies ranged between 10-5 and -9 for levofloxacin, cefotaxime, amikacin and imipenem, and -9 for vancomycin and teicoplanin. When tested in combinations, mutational frequencies fell below 10-9 for all the combinations. Conclusion In vitro evidence of synergy between glycopeptides, fluoroquinolones (levofloxacin and β-lactams and of reduction of mutational frequencies by combinations are suggestive for a potential role in empirical therapy

  17. Burden, etiology and predictors of visual impairment among children ...

    African Journals Online (AJOL)

    . Knowledge of CVI is important in planning preventive measures. The aim of this study was determine the prevalence, etiology and the factors associated with childhood visual impairment among the children attending the eye clinic in Mulago ...

  18. Critical analysis of vestibular rehabilitation outcome according to dizziness etiology. (United States)

    Bittar, Roseli Saraiva Moreira; Pedalini, Maria Elisabete Bovino; Ramalho, Jeanne Oiticica; Yoshimura, Ricardo


    Vestibular rehabilitation (VR) is an excellent therapy for dizziness patients. However, despite well managed, sometimes results are not suitable. evaluate VR outcome between patients according to dizziness etiology. Retrospective review of medical records. Patients records were analyzed between January 2002 and December 2004. As for inclusion criteria, patients should have had finished VR therapy and an established diagnosis. Patients were included in three VR outcome groups and compared according to etiology. according to VR outcome 13 patients had no improvement, 24 had partial improvement and 22 complete improvement. The main etiologies were cervical syndrome, trauma, metabolic disorders, central nervous system disorders, anxiety and mood disorders, autoimmune disease and orthostatic intolerance. Patients with metabolic disorders showed better VR outcome than the others. VR therapy combined with clinical etiology treatment is an excellent approach for dizziness patients.

  19. Editorial comment on “Etiology of male urethral strictures ...

    African Journals Online (AJOL)

    Etiology of male urethral strictures—Evaluation of temporal changes at a single center, and review of the literature”. Guido Barbagli. ∗. Professor of Urology, Head of the Center for Reconstructive Urethral Surgery. Center for Reconstructive Urethral ...

  20. A Principal's Guide to Reading Terminology. (United States)

    Dowhower, Sarah L.


    To enlarge principals' professional vocabulary, this article defines general reading terms and terms pertaining to reading approaches and instructional reading strategies. Includes 20 references and an extensive "further information" bibliography classified according to 18 specialized topics. (MLH)

  1. Principal Hawaiian Islands Geoid Heights (GEOID96) (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This 2' geoid height grid for the Principal Hawaiian Islands is distributed as a GEOID96 model. The computation used 61,000 terrestrial and marine gravity data held...

  2. It's the Principal of the Thing (United States)

    Landers, Thomas J.; Silverman, Robert S.


    No matter what variables of personal leadership style may exist, certain constant qualities mark the effective principal. Since accountability presupposes effectiveness, you may wish to check your leadership traits against those discussed here. (Editor)

  3. Paranoia: Perceptions of Public School Principals. (United States)

    Salmon, Daniel A.


    Examines forces which are undermining the principal's leadership role and ability to effectively administer the school: teachers and unions; the competency movement; political and community interest groups; and media pundits. (SJL)

  4. Perfuração espontânea da via biliar principal na infância

    Directory of Open Access Journals (Sweden)

    Pedro J. A. Aratanha

    Full Text Available The authors report a case of spontaneous perforation of the biliary tract (S.P.B.T in a three-month-old infant. The diagnosis was suspected before the operation by clinical signs and diagnostic tests. The importance of paracentesis and scintigraphy is stressed. A surgical approach was chosen and drainage procedure of the area around the perforation and a cholecystostomy were done. S.P.B.T. is rare and its etiology is controversial, but cannot be forgotten in association between biliary ascites and cholestatic jaundice during the first months of life.

  5. Pediatric Dental Trauma:Wide Horizon of Ignored Etiological Factors


    Anegundi, Rajesh T; Patil, Shruthi B.; M, Shubha; Havale, Raghavendra


    Trauma of the oral and peroral structures are one of the most common and frequent complaints after dental caries with which a child is being referred to a dental clinic. As an emergency, we tend to treat the injuries without understanding or neglecting the cause of trauma. The different possible etiological factors are unnoticed, not revealed or not noted while taking the history of the patient. Sometimes negligence of the etiology by the dentist himself or the accompanying person could influ...

  6. Etiology and pathogenesis of pectus excavatum in children

    Directory of Open Access Journals (Sweden)

    I. O. Kulik


    Full Text Available Funnel chest is the most common chest deformity characterized by the depression of sternum and rib cartilages. In spite of the centuries-old history of pectus excavatum investigation, plenty of publications on etiology and pathogenesis and many theories on this theme no one of them is generally accepted. This article is to summarize the modern views on the etiology and pathogenesis of funnel chest.

  7. Criteria for early etiological diagnosis of serous meningitis in children

    Directory of Open Access Journals (Sweden)

    Лариса Анатольевна Ходак


    Full Text Available To improve early etiological diagnosis of serous meningitis in children, the differential diagnostic algorithms have been developed.Methods. 220 children with serous meningitis(SM aged 1 to 17 years were divided into 3 groups depending on the etiological factor: 1 enterovirus SM (n=130; 2 herpesvirus SM (n=14; 3 enterovirus SM combined with persistent herpes virus infection (n=76. In the alternative groups of patients (in all combinations, the differential diagnostic significance of clinical and laboratory parameters has been evaluated by means of Wald–Genkin heterogeneous sequential procedure. All studied traits were divided into gradations and then differential diagnostic coefficients (DC and diagnostic information (I were obtained separately for the clinical indicators, CSF indicators and full blood count. The indicators were distributed in the descending order of their self-descriptiveness that, in future, taking into account the most significant of them, allowed to form a generalized diagnostic algorithms in each comparison group.Results. Differential algorithmic diagnosis is obtained by means of algebraic summation of DC until the diagnostic threshold is reached. For 95 percent confidence level, the threshold sum is DK≥13,0. Etiologic diagnosis of SM involves the use of all three algorithms, that is, differentiation is conducted between SM herpesvirus, enterovirus etiology and SM enterovirus etiology in combination with persistent herpes virus infection. When reaching the diagnostic threshold in favor of certain etiology, the appropriate diagnosis is made. In case the diagnostic threshold for two etiological factors is reached, the final diagnosis is formulated on the basis of the differential diagnosis data.Conclusions. The developed algorithms of early etiological diagnosis of SM in children are highly reliable (≥95% and minimize the number of indicators required for diagnosis with a given level of reliability



    Prasad, K.M.R.; Girimaji, S.R.; Manjunatha, K.R.; Khanna, Neelam; Rao, B.S.S.; Ravi, V.; MURTHY, R. SRINIVASA; Vani, K.R.


    Microcephaly with mental retardation forms a distinct subgroup among mentally retarded individuals. The paucity of studies on the etiology of this condition in India made the investigators to study this population. It HTO aimed to study the demographic and clinical characteristics, and the etiologic pattern in children with microcepltaly and mental retardation The sample consisted of 82 children who were examined by detailed clinical assessment and a battery of investigations. A definite etio...

  9. Heart failure etiology impacts survival of patients with heart failure

    DEFF Research Database (Denmark)

    Pecini, Redi; Møller, Daniel Vega; Torp-Pedersen, Christian


    BACKGROUND: The impact of heart failure (HF) etiology on prognosis of HF is not well known. METHODS: 3078 patients (median age 75years, 61% male) hospitalized with HF were studied. Patients were classified into six etiology groups: hypertension (HTN, 13.9%), ischemic heart disease (IHD, 42...... risk, HR 1.71 (CI: 1.3-2.2, p/=30% (HR 1.3, CI: 1.0-1.5, p=0.03), compared to the reference (p-value for interaction...

  10. [Infectious mononucleosis: etiology, immunological variants, methods of correction]. (United States)

    Gordeets, A V; Savina, O G; Beniova, S N; Chernikova, A A


    Clinical options of infectious mononucleosis course depending on infecting agent etiology are presented for Epstein-Barr virus (EBV), cytomegalovirus (CMV), mono and mixed forms of the disease. Examined cytokine profiles demonstrate analogous changes of serum cytokines in the acute stage of the disease irrespective of etiological factors. Data show that it is important and useful clinically and immunologically to include immunomodulators--in particular, cycloferon--info a complex therapy of different types of mononucleosis.

  11. Microscopic colitis: A review of etiology, treatment and refractory disease


    Park, Tina; Cave, David; Marshall, Christopher


    Microscopic colitis is a common cause of chronic, nonbloody diarrhea. Microscopic colitis is more common in women than men and usually affects patients in their sixth and seventh decade. This article reviews the etiology and medical management of microscopic colitis. The etiology of microscopic colitis is unknown, but it is associated with autoimmune disorders, such as celiac disease, polyarthritis, and thyroid disorders. Smoking has been identified as a risk factor of microscopic colitis. Ex...

  12. Principal components analysis in clinical studies


    Zhang, Zhongheng; Castelló, Adela


    In multivariate analysis, independent variables are usually correlated to each other which can introduce multicollinearity in the regression models. One approach to solve this problem is to apply principal components analysis (PCA) over these variables. This method uses orthogonal transformation to represent sets of potentially correlated variables with principal components (PC) that are linearly uncorrelated. PCs are ordered so that the first PC has the largest possible variance and only som...

  13. Unsupervised Bump Hunting Using Principal Components


    Díaz-Pachón, Daniel A; Dazard, Jean-Eudes; Rao, J. Sunil


    Principal Components Analysis is a widely used technique for dimension reduction and characterization of variability in multivariate populations. Our interest lies in studying when and why the rotation to principal components can be used effectively within a response-predictor set relationship in the context of mode hunting. Specifically focusing on the Patient Rule Induction Method (PRIM), we first develop a fast version of this algorithm (fastPRIM) under normality which facilitates the theo...

  14. Nutrition education for adolescents: principals' views. (United States)

    Lai-Yeung, Wai-Ling Theresa


    This study aimed to examine school principals' perceptions of the school environment in Hong Kong as a context for the dissemination of food knowledge and inculcation of healthy eating habits. A questionnaire survey was administered in secondary schools in Hong Kong to survey Principals' views of students' food choices, operation of the school tuck shop, and promotion of healthy eating at school. Questionnaires were disseminated to all the secondary schools offering Home Economics (300 out of 466), and 188 schools responded, making up a response rate of 63%. Collected data were analyzed using SPSS. Most of the schools (82%) claimed to have a food policy to monitor the operation of the school canteen, and about half (52%) asserted there were insufficient resources to promote healthy eating at school. Principals (88%) generally considered it not acceptable for the school tuck shop to sell junk food; however, 45% thought that banning junk food at school would not help students develop good eating habits. Only 4% of the principals believed nutrition education influenced eating habits; whereas the majority (94%) felt that even with acquisition of food knowledge, students may not be able to put theory into practice. Cooking skills were considered important but principals (92%) considered transmission of cooking skills the responsibility of the students' families. Most of the principals (94%) believed that school-family collaboration is important in promoting healthy eating. Further efforts should be made to enhance the effectiveness of school food policies and to construct healthy school environments in secondary schools.

  15. Bilateral Vestibular Hypofunction: Insights in Etiologies, Clinical Subtypes, and Diagnostics. (United States)

    Lucieer, F; Vonk, P; Guinand, N; Stokroos, R; Kingma, H; van de Berg, Raymond


    To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH) and the value of diagnostic tools in the diagnostic process of BVH. A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised (1) imbalance and/or oscillopsia during locomotion and (2) summated slow phase velocity of nystagmus of less than 20°/s during bithermal caloric tests. The definite etiology of BVH was determined in 47% of the cases and the probable etiology in 22%. In 31%, the etiology of BVH remained idiopathic. BVH resulted from more than 20 different etiologies. In the idiopathic group, the percentage of migraine was significantly higher compared to the non-idiopathic group (50 versus 11%, p development of BVH. The distribution of etiologies of BVH probably depends on the clinical setting. In the diagnostic process of BVH, the routine use of some blood tests can be reconsidered and a low-threshold use of audiometry and cerebral imaging is advised. The torsion swing test is not the "gold standard" for diagnosing BVH due to its lack of sensitivity. Future diagnostic criteria of BVH should consist of standardized vestibular tests combined with a history that is congruent with the vestibular findings.


    Directory of Open Access Journals (Sweden)

    Nunes Neto Nei Freitas Freitas


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    ABSTRACT. In this paper, we argue for a taxonomy of approaches to function based on different epistemological perspectives assumed with regard to the treatment of this central concept in the life sciences. We distinguish between etiological and organizational perspectives on function, analyzing two distinct theories related to each perspective: Wright’s selectionist etiological approach and Godfrey-Smith’s modern history theory of functions, in the case of the etiological perspective; and Cummins’ functional analysis and Collier’s interactivist approach to function, among organizational accounts. We explain differences and similarities between these theories and the broader perspectives on function, arguing for a particular way of understanding the consensus without unity in debates about function. While explaining the accounts of function, we also deal with the relationship between this concept and other important biological concepts, such as adaptation, selection, complexity, and autonomy. We also advance an argument for the limits and prospects of the explanatory role of function in evolution. By arguing that changes in functionality are always grounded on changes in systems’ organization, we show that function can never explain the origins of traits. Nevertheless, it can explain the spread of traits in populations, but only when we are dealing with functionally novel traits. Finally, we stress that organizational accounts of function are needed to understand how new functions appear by means of changes in systems

  17. A rational clinical approach to suspected insulin allergy

    DEFF Research Database (Denmark)

    Bødtger, Uffe; Wittrup, M


    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...

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

    Directory of Open Access Journals (Sweden)

    Lia Leão Ciuffo


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

  19. Atlantoaxial subluxation and nasopharyngeal necrosis complicating suspected granulomatosis with polyangiitis. (United States)

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


    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.

  20. Suspected side effects to the quadrivalent human papilloma vaccine

    DEFF Research Database (Denmark)

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


    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    Biello, D.R.


    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 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.

  2. Radiotherapy in three suspect cases of feline thymoma. (United States)

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


    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.

  3. Percutaneous cholecystocentesis in cats with suspected hepatobiliary disease. (United States)

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


    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.

  4. Interviewing strategically to elicit admissions from guilty suspects


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


    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...

  5. MRI for clinically suspected pediatric appendicitis: case interpretation

    Energy Technology Data Exchange (ETDEWEB)

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


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

  6. 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)


    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.)

  7. Suspected spinocellular carcinoma of the inferior eyelid resulted multiple chalazion. (United States)

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


    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.

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

    Directory of Open Access Journals (Sweden)

    Steven Henderson


    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.

  9. Promoting principals' managerial involvement in instructional improvement (United States)

    Gillat, Alex; Sulzer-Azaroff, Beth


    Studies of school leadership suggest that visiting classrooms, emphasizing achievement and training, and supporting teachers are important indicators of the effectiveness of school principals. The utility of a behavior-analytic program to support the enhancement of these behaviors in 2 school principals and the impact of their involvement upon teachers' and students' performances in three classes were examined in two experiments, one at an elementary school and another at a secondary school. Treatment conditions consisted of helping the principal or teacher to schedule his or her time and to use goal setting, feedback, and praise. A withdrawal design (Experiment 1) and a multiple baseline across classrooms (Experiment 2) showed that the principal's and teacher's rates of praise, feedback, and goal setting increased during the intervention, and were associated with improvements in the academic performance of the students. In the future, school psychologists might analyze the impact of involving themselves in supporting the principal's involvement in improving students' and teachers' performances or in playing a similar leadership role themselves. PMID:16795819


    Directory of Open Access Journals (Sweden)

    Suleyman Goksoy


    Full Text Available The research aims to determine the leadership levels the deputy principals feel, their perceptions of their personal features and the environment of the organization in which they demonstrate leadership role. In the research, case study method from qualitative research methods was used. The data were collected by one of the qualitative data collection tools; interviewing. The data were analysed with descriptive analysis techniques. The following results were obtained in the research: Deputy Principals consider themselves as leaders in terms of personal features and behaviours. The competencies of deputy principals in terms of leadership are; technical competencies, interpersonal competencies, conceptual and cognitive competencies. The aspects that deputy principals think that they need to improve and enhance are; human relations, determinedness, consistency, sensitivity, talkativeness and hurriedness. According to research results, it is found that deputy principals are of the opinion that schools have the centralist, inflexible, disaggregated, officialised and non-creative features of the organizational structure in terms of institution, culture, legislation and management.

  11. [Three cases of suspected re-infection of mumps virus]. (United States)

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


    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.

  12. Ten-day observation of live rabies suspected dogs. (United States)

    Tepsumethanon, V; Wilde, H; Sitprija, V


    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.

  13. 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)


    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.)

  14. Low dose computed tomography in suspected acute renal colic. (United States)

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


    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.

  15. The economics of cardiac biomarker testing in suspected myocardial infarction. (United States)

    Goodacre, Steve; Thokala, Praveen


    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.

  16. Limitation of personal freedom by detention of suspect

    Directory of Open Access Journals (Sweden)

    Knežević Saša


    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.

  17. 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.


    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 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.

  18. Principal component regression for crop yield estimation

    CERN Document Server

    Suryanarayana, T M V


    This book highlights the estimation of crop yield in Central Gujarat, especially with regard to the development of Multiple Regression Models and Principal Component Regression (PCR) models using climatological parameters as independent variables and crop yield as a dependent variable. It subsequently compares the multiple linear regression (MLR) and PCR results, and discusses the significance of PCR for crop yield estimation. In this context, the book also covers Principal Component Analysis (PCA), a statistical procedure used to reduce a number of correlated variables into a smaller number of uncorrelated variables called principal components (PC). This book will be helpful to the students and researchers, starting their works on climate and agriculture, mainly focussing on estimation models. The flow of chapters takes the readers in a smooth path, in understanding climate and weather and impact of climate change, and gradually proceeds towards downscaling techniques and then finally towards development of ...


    Prasad, K.M.R.; Girimaji, S.R.; Manjunatha, K.R.; Khanna, Neelam; Rao, B.S.S.; Ravi, V.; Murthy, R. Srinivasa; Vani, K.R.


    Microcephaly with mental retardation forms a distinct subgroup among mentally retarded individuals. The paucity of studies on the etiology of this condition in India made the investigators to study this population. It HTO aimed to study the demographic and clinical characteristics, and the etiologic pattern in children with microcepltaly and mental retardation The sample consisted of 82 children who were examined by detailed clinical assessment and a battery of investigations. A definite etiology could be found in 56% of children which have been grouped into prenatal embryonic, prenatal maternal/environmental, and birth and neonatal causes. Non-genetic causes were the most common. The prenatal etiology constituted nearly twice that of birth and neonatal causes. Majority of the etiologic factors were preventable. The role of socio-environmental factors has been discussed As a group, the neurological disorders were found to be the most commonly associated medical condition. Malnutrition, specially of severe degree, was significantly associated with this group compared to the general population. The study findings indicate that there is a significant place for prevention. PMID:21743719

  20. Etiological diagnosis of undervirilized male/XY disorder of sex development. (United States)

    Atta, Irum; Ibrahim, Mohsina; Parkash, Arit; Lone, Saira Waqar; Khan, Yasir Naqi; Raza, Jamal


    To do clinical, hormonal and chromosomal analysis in undervirilized male / XY disorder of sex development and to make presumptive etiological diagnosis according to the new Disorder of Sex Development (DSD) classification system. Case series. Endocrine Unit at National Institute of Child Health, Karachi, Pakistan, from January 2007 to December 2012. Patients of suspected XY DSD / undervirilized male visiting endocrine clinic were enrolled in the study. Criteria suggested XY DSD include overt genital ambiguity, apparent female/male genitalia with inguinal/labial mass, apparent male genitalia with unilateral or bilateral non-palpable testes, micropenis and isolated hypospadias or with undescended testis. The older children who had delayed puberty were also evaluated with respect to DSD. As a part of evaluation of XY DSD, abdominopelvic ultrasound, karyotype, hormone measurement (testosterone, FSH, LH), FISH analysis with SRY probing, genitogram, laparoscopy, gonadal biopsy and HCG stimulation test were performed. Frequencies and percentages applied on categorical data whereas mean, median, standard deviation were calculated for continuous data. A total of 187 patients met the criteria of XY DSD. Age ranged from 1 month to 15 years, 55 (29.4%) presented in infancy, 104 (55.6%) between 1 and 10 years and 28 (15%) older than 10 years. Twenty five (13.4%) were raised as female and 162 as (86.6%) male. The main complaints were ambiguous genitalia, unilateral cryptorchidism, bilateral cryptorchidism, micropenis, delayed puberty, hypospadias, female like genitalia with gonads, inguinal mass. The karyotype was 46 XY in 183 (97.9%), 46 XX in 2 (1.1%), 47 XXY in 1 (0.5%), 45 X/46 XY in 1 (0.5%) patient. HCG stimulation test showed low testosterone response in 43 (23 %), high testosterone response in 62 (33.2%), partial testosterone response in 32 (17.1%) and normal testosterone response in 50 (26.7%). Genitogram was carried out in 86 (45.98%) patients. Presumptive etiological

  1. An etiologic prediction model incorporating biomarkers to predict the bladder cancer risk associated with occupational exposure to aromatic amines: a pilot study. (United States)

    Mastrangelo, Giuseppe; Carta, Angela; Arici, Cecilia; Pavanello, Sofia; Porru, Stefano


    No etiological prediction model incorporating biomarkers is available to predict bladder cancer risk associated with occupational exposure to aromatic amines. Cases were 199 bladder cancer patients. Clinical, laboratory and genetic data were predictors in logistic regression models (full and short) in which the dependent variable was 1 for 15 patients with aromatic amines related bladder cancer and 0 otherwise. The receiver operating characteristics approach was adopted; the area under the curve was used to evaluate discriminatory ability of models. Area under the curve was 0.93 for the full model (including age, smoking and coffee habits, DNA adducts, 12 genotypes) and 0.86 for the short model (including smoking, DNA adducts, 3 genotypes). Using the "best cut-off" of predicted probability of a positive outcome, percentage of cases correctly classified was 92% (full model) against 75% (short model). Cancers classified as "positive outcome" are those to be referred for evaluation by an occupational physician for etiological diagnosis; these patients were 28 (full model) or 60 (short model). Using 3 genotypes instead of 12 can double the number of patients with suspect of aromatic amine related cancer, thus increasing costs of etiologic appraisal. Integrating clinical, laboratory and genetic factors, we developed the first etiologic prediction model for aromatic amine related bladder cancer. Discriminatory ability was excellent, particularly for the full model, allowing individualized predictions. Validation of our model in external populations is essential for practical use in the clinical setting.

  2. Imaging trends in suspected appendicitis-a Canadian perspective. (United States)

    Tan, Victoria F; Patlas, Michael N; Katz, Douglas S


    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

  3. Predictors of bacteremia in emergency department patients with suspected infection. (United States)

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


    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

  4. International Study on Syncope of Uncertain Etiology 2: the management of patients with suspected or certain neurally mediated syncope after the initial evaluation Rationale and study design

    NARCIS (Netherlands)

    Brignole, M.; Sutton, R.; Menozzi, C.; Moya, A.; Garcia-Civera, R.; Benditt, D.; Vardas, P.; Wieling, W.; Andresen, D.; Migliorini, R.; Hollinworth, D.


    Study design Multi-centre, prospective observational study Objectives Main objective is to verify the value of implantable loop recorder (ILR) in assessing the mechanism of syncope and the efficacy of the ILR-guided therapy after syncope recurrence. Inclusion criteria Patients who met the following

  5. Consequence etiology and biological teleology in Aristotle and Darwin. (United States)

    Depew, David J


    Aristotle's biological teleology is rooted in an epigenetic account of reproduction. As such, it is best interpreted by consequence etiology. I support this claim by citing the capacity of consequence etiology's key distinctions to explain Aristotle's opposition to Empedocles. There are implications for the relation between ancient and modern biology. The analysis reveals that in an important respect Darwin's account of adaptation is closer to Aristotle's than to Empedocles's. They both rely on consequence etiological considerations to evade attributing the purposiveness of organisms to chance. Two implications follow: (l) Darwinian explanations of adaptation are as teleological as Aristotle's, albeit differently; and (2) these differences show how deeply resistant Aristotle's version of biological teleology is to descent from a common ancestor.

  6. The etiology of vocal fold nodules in adults. (United States)

    Karkos, Petros D; McCormick, Maxwell


    To review the recent literature on the etiology and pathophysiology of vocal fold nodules in adults. Research regarding the etiology of vocal nodules over the past 2 years supports previous thinking regarding the central role of voice misuse, overuse, and phonatory trauma. Advanced modeling techniques have helped elucidate mechanisms by which this may occur such as vibration-induced rise in capillary pressures and varying fluid dynamics in the layered vocal fold structure. Contributory roles of personality traits, reflux, and allergy have also been hypothesized. Current research supports long-held beliefs that phonatory trauma is a central cause of vocal fold nodule formation. Innovative basic science research has unraveled mechanisms of traumatic damage and clinical research continues to identify crucial lifestyle behavior and contributing comorbid conditions that play a role in the pathogenesis of vocal fold nodules. The multifactorial etiology of vocal fold nodules requires a comprehensive history to identify contributing factors and a multidisciplinary approach to optimize treatment outcome.

  7. Etiology of Sarcoidosis: Does Infection Play a Role? (United States)

    Saidha, Shiv; Sotirchos, Elias S.; Eckstein, Christopher


    Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology, which is known to affect multiple organ systems including the lungs, heart, skin, central nervous system, and eyes, among others. For this reason, sarcoidosis represents a systemic medical disorder that is clinically relevant to multiple medical sub-specialties. Despite extensive research, the etiology of sarcoidosis has yet to be elucidated, although most evidence supports that the pathogenetic mechanism of sarcoidosis is an aberrant immune response, driven by an unidentified antigen (or antigens) in genetically susceptible individuals. Multiple candidate etiologic agents, including microbial organisms and environmental agents, have been investigated, but study results are inconclusive. In this review, we describe the known histologic and immunologic features of sarcoidosis and discuss the evidence supporting a role for infectious processes in the pathogenesis of sarcoidosis. PMID:22461752

  8. [Ventricular tachyarrhythmias. A retrospective analysis of etiology, demography and treatment

    DEFF Research Database (Denmark)

    Christensen, A.H.; Henningsen, K.; Svendsen, Jesper Hastrup


    INTRODUCTION: The aim of this study was to investigate the age, sex, etiology, frequency of implantable cardioverter-defibrillator (ICD) and previous cardiac arrest among patients discharged from the Department of Cardiology, Rigshospitalet (Copenhagen University Hospital), Denmark, due to ventri......INTRODUCTION: The aim of this study was to investigate the age, sex, etiology, frequency of implantable cardioverter-defibrillator (ICD) and previous cardiac arrest among patients discharged from the Department of Cardiology, Rigshospitalet (Copenhagen University Hospital), Denmark, due...... unknown etiology; 492 (50%) of the patients overall had an ICD implanted, the majority of whom had been categorized as having ventricular tachycardia (92%); 168 patients had previous cardiac arrest, 127 of whom did not have a potential reversible cause. Of this group 75 (59%) had an ICD implanted...

  9. Appendicular fractures of traumatic etiology in dogs: 955 cases (2004-2013

    Directory of Open Access Journals (Sweden)

    Renato do Nascimento Libardoni


    Full Text Available ABSTRACT:Orthopedic diseases are common in dogs and cats, especially, those caused by traumatic injury. Overall, among the significant changes in this group, the fractures are the major cause of pain and dysfunction in dogs of all ages, sizes and breeds. Therefore, a retrospective study of dogs examined between January 2004 and December 2013 at the University Veterinary Hospital of Universidade Federal de Santa Maria, was conducted aiming to identify and determine the prevalence of appendicular fractures caused by trauma and characterizing the population/etiology. In a population of 1,200 dogs with suspected traumatic orthopedic diseases in the locomotor system, 955 (79.6% had appendicular fractures. Of the dogs 23.5% had fractures on the femur (n=225, 23.4% had pelvic fractures (n=223, 22% had tibial and fibular fractures (n=210, 17.6% had radius and ulna fractures (n=168, 7.5% had humeral fractures (n=72 and 6% had distal limb fractures (tarsus, carpus, metacarpus, metatarsus and phalanges (n=57. The most frequent cause was car accidents (72.2%. Most affected dogs were male (52.5%, juvenile (42%, mixed breed (51.4% and small size (42.7%. In conclusion, the profile of dogs with fractures in the Central Region of Rio Grande do Sul State is: male dogs, mixed breed, immature and small size, presenting femoral fractures by car accident.

  10. Quemaduras y etiología medicolegal Burns and medicolegal etiology

    Directory of Open Access Journals (Sweden)

    Héctor Barreiro Ramos


    Full Text Available Las muertes por quemaduras plantean a la instrucción policial y al médico legista diversos problemas, entre los que se encuentran, determinar su causa medicolegal, es decir, si se trata de un homicidio, suicidio o accidente, pero para tan trascendental afirmación solo contamos con las versiones de testigo del hecho, sin contar con los elementos científicos que nos orienten, como pudiera ser algún indicador somático o de otro tipo. En tal caso nos preguntamos si existen variables que nos orienten en la causa medicolegal de la muerte. El propósito, por tanto, del trabajo consiste en evaluar un grupo de variables como posibles indicadores de la causa medicolegal de las muertes por llamas. El universo de trabajo fueron 135 fallecidos atendidos en el Centro Provincial de Medicina Legal de La Habana en el decenio 1994-2003, y la muestra la formaron 75 de ellos. Los resultados señalan que el 62 % de los fallecidos fueron suicidios, el 32 % accidentes y el 5 % homicidios, con un predominio del sexo femenino. El suicidio tiene una media de 70 años, para el accidente es 45, y para el homicidio 58. El lugar del hecho más frecuente fue la casa. El agente causal más encontrado fue en primer lugar el alcohol y en segundo el queroseno; en el suicidio el alcohol fue el más empleado, mientras que en el accidente, por el contrario, el más causal fue el queroseno. En el homicidio solo se empleó el alcohol. Se concluye que no existe un solo indicador que nos pueda confirmar la etiología medicolegal de estas muertes, pero el conjunto de ellos sí nos puede señalar con bastante certeza la causa probable.Deaths caused by burns pose diverse problems to the police instruction and to the legist physician. One of these problems is to determine its medicolegal cause, that is, wether it is a homicide, suicide or accident, but for such a trascendental affirmation we only have the versions of the witness, without the scientific elements that may orientate us

  11. Principal Self-Efficacy, Teacher Perceptions of Principal Performance, and Teacher Job Satisfaction (United States)

    Evans, Molly Lynn


    In public schools, the principal's role is of paramount importance in influencing teachers to excel and to keep their job satisfaction high. The self-efficacy of leaders is an important characteristic of leadership, but this issue has not been extensively explored in school principals. Using internet-based questionnaires, this study obtained…

  12. A Conceptual Framework for Understanding the Working Relationship between School Principals and Vice-Principals (United States)

    Wong, Ping-Man


    Vice-principals' role and their relationship with principals are of paramount importance in shaping the effectiveness of school management, particularly after the implementation of school-based management (SBM) worldwide. This paper reports primarily on prior studies on the vice-principalship and suggests a framework to help explain the different…

  13. 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


    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...

  14. Constructing principals' professional identities through life stories ...

    African Journals Online (AJOL)

    Adopting a humanistic perspective to the study of leadership, I discuss and describe how school principals adapt to their new roles, owing to the new education policies and educational restructuring within the South African Department of Education. The Life History approach was used to collect data from six selected school ...

  15. The Principal's Role in Interscholastic Sports. (United States)

    Ruffin, Santee

    Principals are ultimately responsible and accountable for all scheduled activities that are part of the school's program, including interscholastic athletics. Among their responsibilities are supervising athletic directors, treating coaches as teachers first and as glory-winners for the school second, maintaining responsible conduct among…

  16. Principal component analysis of psoriasis lesions images

    DEFF Research Database (Denmark)

    Maletti, Gabriela Mariel; Ersbøll, Bjarne Kjær


    A set of RGB images of psoriasis lesions is used. By visual examination of these images, there seem to be no common pattern that could be used to find and align the lesions within and between sessions. It is expected that the principal components of the original images could be useful during future...

  17. Principals, Shared Decision Making, and School Reform. (United States)

    Weiss, Carol H.; Cambone, Joseph


    The attitudes of six principals serving in shared decision-making (SDM) high schools toward SDM were studied. Although three supported SDM as a vehicle for improving education, the others supported it for its own sake, to democratize schools. Problems in instituting the reforms in these schools are discussed. (SLD)

  18. Closed-chain principal vector linkages

    NARCIS (Netherlands)

    van der Wijk, V.; Flores, Paulo; Viadero, Fernando


    For high-speed robotics dynamic balance is an important property for low base vibrations and short cycle times. To consider dynamic balance in the beginning of the design process of a manipulator, mechanism solutions can be synthesized from principal vector linkages, which are fundamental kinematic

  19. Women principals' reflections of curriculum management challenges ...

    African Journals Online (AJOL)

    ... to schools. The findings imply a need for greater capacity building amongst principals,as well as further research into continuous curriculum changes in the South African education system. Keywords: Annual National Assessments, management styles, rural primary schools, transformational leadership,women managers ...

  20. Principals' Transformational Leadership in School Improvement (United States)

    Yang, Yingxiu


    Purpose: This paper aims to contribute experience and ideas of the transformational leadership, not only for the principal want to improve leadership himself (herself), but also for the school at critical period of improvement, through summarizing forming process and the problem during the course and key factors that affect the course.…

  1. Principals' Leadership Styles and Student Achievement (United States)

    Harnish, David Alan


    Many schools struggle to meet No Child Left Behind's stringent adequate yearly progress standards, although the benchmark has stimulated national creativity and reform. The purpose of this study was to explore teacher perceptions of principals' leadership styles, curriculum reform, and student achievement to ascertain possible factors to improve…

  2. Great Schools Have Great Principals: Link Crew (United States)

    Roberts, Rebecca


    The author describes the Link Crew transition program that she implemented in 2012 as assistant principal for curriculum and guidance at Villa Park High School in California. She states that administrative and counseling teams at her school had noticed that ninth-grade students struggled in their transitions to high school, with over half of the…

  3. Kernel principal component analysis for change detection

    DEFF Research Database (Denmark)

    Nielsen, Allan Aasbjerg; Morton, J.C.


    Principal component analysis (PCA) is often used to detect change over time in remotely sensed images. A commonly used technique consists of finding the projections along the two eigenvectors for data consisting of two variables which represent the same spectral band covering the same geographical...

  4. Principal Connection / Amazon and the Whole Teacher (United States)

    Hoerr, Thomas R.


    A recent controversy over Amazon's culture has strong implications for the whole child approach, and it offers powerful lessons for principals. A significant difference between the culture of so many businesses today and the culture at good schools is that in good schools, the welfare of the employees is very important. Student success is the…

  5. relationship between principals' management approaches and ...

    African Journals Online (AJOL)


    relationship between principals' management approaches and level of students' discipline in selected public secondary schools in Nyandarua and Laikipia districts, Kenya. Analysis of the relationship was based on school- size. Data were collected using a self-administered questionnaire from a sample of. 211 teachers, 28 ...

  6. Constructing principals' professional identities through life stories ...

    African Journals Online (AJOL)

    the ideas of democracy and participative leadership in their roles and duties, they will always receive positive and meaningful feedback from their staff which would assist them in maturing in their behaviour and constructing their professional identity. While learning from their teachers, the principals also improved on their.

  7. An Exploration of Principal Instructional Technology Leadership (United States)

    Townsend, LaTricia Walker


    Nationwide the demand for schools to incorporate technology into their educational programs is great. In response, North Carolina developed the IMPACT model in 2003 to provide a comprehensive model for technology integration in the state. The model is aligned to national educational technology standards for teachers, students, and principals.…

  8. Islamitisch financieren tussen principes en realiteit

    NARCIS (Netherlands)

    Wolters, W.G.


    ‘De financiële crisis zou niet hebben plaatsgevonden, als de wereld de principes van islamitisch bankieren en financieren zou hebben aangenomen.’ Dat was één van de kenmerkende reacties van de kant van de islamitische bankiers, in de laatste maanden van 2008. Toen begon de wereldwijde financiële

  9. Managerial Leadership and the Effective Principal. (United States)

    Yukl, Gary

    To help relate management ideas and knowledge to educational administration, the author reviews the major theories and findings from the last 20 years on managerial leadership and discusses their relevance for school principals. He first summarizes findings from three approaches: the traits approach, emphasizing managerial motivation and skills;…

  10. Elementary Teachers' Perceptions of Elementary Principals' Effectiveness (United States)

    Fridenvalds, Kriss R.


    This dissertation examined the beliefs of elementary teachers to determine if their perceptions of effective principal leadership align to transformational leadership theory vis-a-vis the Educational Leadership Policy Standards (ELPS). A phenomenological, single-case study approach was utilized by means of a mixed-methodological, Web-based survey,…

  11. Selecting a Principal: Keep It Complicated! (United States)

    Naso, Paul A.


    When searching for a new principal, many search committees tend to use the lists of competencies published in the literature and provided by state departments of education as if they were checklists. Instead, they should focus on more complicated competencies, such as acumen, judgment, and ability to manage the dilemmas of practice.

  12. Real-Time Principal-Component Analysis (United States)

    Duong, Vu; Duong, Tuan


    A recently written computer program implements dominant-element-based gradient descent and dynamic initial learning rate (DOGEDYN), which was described in Method of Real-Time Principal-Component Analysis (NPO-40034) NASA Tech Briefs, Vol. 29, No. 1 (January 2005), page 59. To recapitulate: DOGEDYN is a method of sequential principal-component analysis (PCA) suitable for such applications as data compression and extraction of features from sets of data. In DOGEDYN, input data are represented as a sequence of vectors acquired at sampling times. The learning algorithm in DOGEDYN involves sequential extraction of principal vectors by means of a gradient descent in which only the dominant element is used at each iteration. Each iteration includes updating of elements of a weight matrix by amounts proportional to a dynamic initial learning rate chosen to increase the rate of convergence by compensating for the energy lost through the previous extraction of principal components. In comparison with a prior method of gradient-descent-based sequential PCA, DOGEDYN involves less computation and offers a greater rate of learning convergence. The sequential DOGEDYN computations require less memory than would parallel computations for the same purpose. The DOGEDYN software can be executed on a personal computer.

  13. My School Principal Is Not a Leader! (United States)

    Okutan, Mehmet


    The emergence of new approaches in educational management, have made mandatory to consider the school administration as "school leader". School principals of today's schools, are obliged to become individuals who influence teachers and students by dint of their personal characteristics, getting rid of being one who utilizes legal powers…

  14. Conceptualizing Social Justice: Interviews with Principals (United States)

    Wang, Fei


    Purpose: Today, as the understanding of diversity is further expanded, the meaning of social justice becomes even more complicated, if not confusing. The purpose of this paper is to explore how school principals with social justice commitment understand and perceive social justice in their leadership practices. Design/methodology/approach: A…

  15. Attaining Success: Tips for New Principals (United States)

    Roe, Chris


    Leading a school today takes courage, energy and lots of knowledge. Today's principals certainly manage the site and keep all aspects key to running a school smoothly at their fingertips. In addition, leaders today also must have curricular knowledge, model instructional leadership and build community among the constituents. Sometimes, new leaders…

  16. Primary School Principals' Experiences with Smartphone Apps (United States)

    Çakir, Rahman; Aktay, Sayim


    Smartphones are not just pieces of hardware, they at same time also dip into software features such as communication systems. The aim of this study is to examine primary school principals' experiences with smart phone applications. Shedding light on this subject means that this research is qualitative. Criterion sampling has been intentionally…

  17. Burnout And Lifestyle Of Principals And Entrepreneurs

    Directory of Open Access Journals (Sweden)

    Jasna Lavrenčič


    Full Text Available Research Question (RQ: What kind of lifestyle do the principals and entrepreneurs lead? Does the lifestyle of principals and entrepreneurs influence burnout? Purpose: To find out, based on the results of a questionnaire, what kind of lifestyle both researched groups lead. Does lifestyle have an influence on the occurrence of the phenomenon of burnout. Method: We used the method of data collection by questionnaire. Acquired data were analyzed using SPSS, descriptive and inference statistics. Results: Results showed, that both groups lead a similar lifestyle and that lifestyle influences burnout with principals, as well as entrepreneurs. Organization: School principals and entrepreneurs are the heads of individual organizations or companies, the goal of which is success. To be successful in their work, they must adapt their lifestyle, which can be healthy or unhealthy. If their lifestyle is unhealthy, it can lead to burnout. Society: With results of the questionnaire we would like to answer the question about the lifestyle of both groups and its influence on the occurrence of burnout. Originality: The study of lifestyle and the occurrence of burnout in these two groups is the first study in this area. Limitations/Future Research: In continuation, research groups could be submitted to the research fields of effort physiology and tracking of certain haematological parameters, such as cholesterol, blood sugar and stress hormones - adrenaline, noradrenalin, cortisol. Thus, we could carry out an even more in depth research of the connection between lifestyle and burnout.

  18. Spatial control of groundwater contamination, using principal ...

    Indian Academy of Sciences (India)

    A study on the geochemistry of groundwater was carried out in a river basin of Andhra Pradesh to probe into the spatial controlling processes of groundwater contamination, using principal component analysis (PCA). The PCA transforms the chemical variables, pH, EC, Ca2+, Mg2+, Na+, K+, HCO 3 − , Cl−, SO 4 2 − , NO 3 ...

  19. Computer Use by Secondary School Principals (United States)

    Afshari, Mojgan; Bakar, Kamariah Abu; Luan, Wong Su; Afshari, Marjan; Fooi, Foo Say; Samah, Bahaman Abu


    The purpose of this study was firstly to identify the extent to which Iranian secondary school principals used computers and secondly to explore the relationship between a number of variables related to the use of information and communications technology (ICT). Findings indicated that four factors played a role in explaining the level of computer…

  20. Principal normal indicatrices of closed space curves

    DEFF Research Database (Denmark)

    Røgen, Peter


    A theorem due to J. Weiner, which is also proven by B. Solomon, implies that a principal normal indicatrix of a closed space curve with nonvanishing curvature has integrated geodesic curvature zero and contains no subarc with integrated geodesic curvature pi. We prove that the inverse problem alw...

  1. The Relationship between Principals' Managerial Approaches and ...

    African Journals Online (AJOL)

    Data were collected using a selfadministered questionnaire from a sample of 211 teachers, 28 principals and 22 chairpersons of the Parent-Teachers Association. The raw data were analysed using frequency counts, the mean and standard deviation and hypotheses tested using the t-test and one way ANOVA at alpha ...

  2. Relationship between principals' management approaches and ...

    African Journals Online (AJOL)

    Students' discipline is critical to the attainment of positive school outcomes. Level of students' discipline depends on whether the principal- as the chief executive of the school- enlists the support of teachers and parents in discipline management. The study hypothesized that an inclusive discipline management approach is ...

  3. Probabilistic Principal Component Analysis for Metabolomic Data.

    LENUS (Irish Health Repository)

    Nyamundanda, Gift


    Abstract Background Data from metabolomic studies are typically complex and high-dimensional. Principal component analysis (PCA) is currently the most widely used statistical technique for analyzing metabolomic data. However, PCA is limited by the fact that it is not based on a statistical model. Results Here, probabilistic principal component analysis (PPCA) which addresses some of the limitations of PCA, is reviewed and extended. A novel extension of PPCA, called probabilistic principal component and covariates analysis (PPCCA), is introduced which provides a flexible approach to jointly model metabolomic data and additional covariate information. The use of a mixture of PPCA models for discovering the number of inherent groups in metabolomic data is demonstrated. The jackknife technique is employed to construct confidence intervals for estimated model parameters throughout. The optimal number of principal components is determined through the use of the Bayesian Information Criterion model selection tool, which is modified to address the high dimensionality of the data. Conclusions The methods presented are illustrated through an application to metabolomic data sets. Jointly modeling metabolomic data and covariates was successfully achieved and has the potential to provide deeper insight to the underlying data structure. Examination of confidence intervals for the model parameters, such as loadings, allows for principled and clear interpretation of the underlying data structure. A software package called MetabolAnalyze, freely available through the R statistical software, has been developed to facilitate implementation of the presented methods in the metabolomics field.

  4. Principal component analysis implementation in Java (United States)

    Wójtowicz, Sebastian; Belka, Radosław; Sławiński, Tomasz; Parian, Mahnaz


    In this paper we show how PCA (Principal Component Analysis) method can be implemented using Java programming language. We consider using PCA algorithm especially in analysed data obtained from Raman spectroscopy measurements, but other applications of developed software should also be possible. Our goal is to create a general purpose PCA application, ready to run on every platform which is supported by Java.

  5. Teachers' Perceptions Regarding School Principals' Coaching Skills (United States)

    Yirci, Ramazan; Özdemir, Tuncay Yavuz; Kartal, Seçil Eda; Kocabas, Ibrahim


    The purpose of this study was to find out teachers' perceptions about school principals' coaching skills. The study was carried out within qualitative research methods. The study group included 76 teachers in Elazig and 73 teachers in Kahramanmaras provinces of Turkey. All the data were processed using Nvivo 9 software. The results indicate that…

  6. Principals' Learning Mechanisms: Exploring an Emerging Construct (United States)

    Schechter, Chen; Qadach, Mowafaq


    This exploration of principal learning mechanisms (PLM) to support a learning-centered school aimed to develop, field-test, and validate a PLM-measuring instrument. Following exploratory and confirmatory factor analyses of items to examine factorial validity, the developed scale was correlated with other work-related established constructs (e.g.,…

  7. Transformational Leadership Behaviors in Elementary School Principals (United States)

    Ergle, Barbara


    School leaders face high expectations from society for leadership effectiveness. While it is commonly accepted that leadership practices contribute to school excellence, specific behaviors of effective elementary principals in the local context were not well understood. The purpose of this mixed methods study was to investigate self-reported…

  8. A Principal's Guide to Children's Allergies. (United States)

    Munoz-Furlong, Anne


    Discusses several common children's allergies, including allergic rhinitis, asthma, atopic dermatitis, food allergies, and anaphylactic shock. Principals should become familiar with various medications and should work with children's parents and physicians to determine how to manage their allergies at school. Allergen avoidance is the best…

  9. Study on etiological factors on mental retardation in Kathmandu. (United States)

    Chakrabarti, Kajal; Aryal, Umesh


    The study of etiological factors on mental retardation was conducted at family counselling and resource school of Association of Welfare of Menta+lly Retarded (AWMR), Hattisar, Kathmandu. A total of 91 mental retarded cases were studied in the year 2000 and 2001 for etiological factors. The present study shows significant relationship of mental retardation and age in both the year. The higher rate of mental retardation in the 0 to 5 years age group in both the year. About 70.0% with mental retardation (MR) are first born babies in both the year. Majority of the families have unfavourable attitude towards the mentally retarded individual.

  10. Bilateral vestibular hypofunction: Insights in etiologies, clinical subtypes and diagnostics

    Directory of Open Access Journals (Sweden)

    F. eLucieer


    Full Text Available Objective:To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH and the value of diagnostic tools in the diagnostic process of BVH.Materials and methods: A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised 1 imbalance and/or oscillopsia during locomotion, and 2 summated slow phase velocity of nystagmus of less than 20 degrees per second during bithermal caloric tests.Results:The definite etiology of BVH was determined in 47% of the cases and the probable etiology in 22%. In 31%, the etiology of BVH remained idiopathic. BVH resulted from more than 20 different etiologies. In the idiopathic group, the percentage of migraine was significantly higher compared to the non-idiopathic group (50% versus 11%, p<0.001. Among all patients, 23.4% were known with autoimmune disorders in their medical history. All 4 clinical subtypes (recurrent vertigo with BVH, rapidly progressive BVH, slowly progressive BVH and slowly progressive BVH with ataxia were found in this population. Slowly progressive BVH with ataxia comprised only 4.5% of the cases. The head impulse test was abnormal in 94% of the cases. The torsion swing test was abnormal in 66%. Bilateral normal hearing to moderate hearing loss was found in 49%. Blood tests did not often contribute to the determination of the etiology of the disease. Abnormal cerebral imaging was found in 21 patients.Conclusion:BVH is a heterogeneous condition with various etiologies and clinical characteristics. Migraine seems to play a significant role in idiopathic BVH and auto-immunity could be a modulating factor in the development of BVH. The distribution of etiologies of BVH probably depends on the clinical setting. In the diagnostic process of BVH, the routine use of some blood tests can be reconsidered and a low-threshold use of audiometry and cerebral imaging is

  11. Lepra: various etiologies from miasma to bacteriology and genetics. (United States)

    Grzybowski, Andrzej; Sak, Jarosław; Suchodolska, Elżbieta; Virmond, Marcos


    Leprosy is a chronic infectious disease caused by a close relative of Mycobacterium tuberculosis: Mycobacterium leprae. There have been various beliefs in its etiology with two main concepts emerging: anticontagion and contagion. From ancient times through the early Middle Ages, the miasmatic theory of leprosy was the main anticontagion view. The development of histopathologic and cytologic studies in the second half of the 19th century provided a starting point to explain the etiology of leprosy bacteriologically. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Recurrent spontaneous miscarriage: controversies in etiology and pathogenesis

    Directory of Open Access Journals (Sweden)

    O. S. Kryvopustov


    Full Text Available Aim. We have studied and analyzed the available scientific sources over the past five years in order to systematize the available literature of recent years about research regarding recurrent spontaneous miscarriage. Methods. During this studying we used methods of observation, systematization and content analysis. Results. Modern views on etiology and pathogenesis of recurrent spontaneous miscarriage, in particular were presented in the article. Attention is focused on risk factors such as genetic disorders, anatomical abnormalities, endocrine pathology, infectious agents, autoimmune and immune disorders. Conclusions. Our research iindicated role of progesterone and highlighted importance of genetic polymorphisms in the etiology and pathogenesis of recurrent spontaneous miscarriage.

  13. The Leadership careers of selected primary school principals


    McHugh, Gerard


    This thesis explored the leadership role of the Primary School Principal in Ireland. It examined the making of a principal (formation), becoming a principal (accession) and being a principal (incumbency). It painted a portrait of accession to principalship and investigated how participating principals perceive the role of principal early in the second decade of 21st century and moreover what inspires and sustains them in their work. A review of literature included works on leadership, lea...

  14. Icare rebound tonometry in children with known and suspected glaucoma. (United States)

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


    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.

  15. Herbal hepatotoxicity: suspected cases assessed for alternative causes. (United States)

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


    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.

  16. Benefits of sonography in diagnosing suspected uncomplicated acute diverticulitis. (United States)

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


    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.

  17. A Suspected Pelvic Aneurysmal Bone Cyst in Pregnancy

    Directory of Open Access Journals (Sweden)

    Rayan Elkattah


    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.

  18. Patch Testing in Suspected Allergic Contact Dermatitis to Cosmetics


    Pramod Kumar; Rekha Paulose


    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...

  19. Etiological agents of viral meningitis in children from a dengue-endemic area, Southeast region of Brazil. (United States)

    de Oliveira, Danilo B; Candiani, Talitah M; Franco-Luiz, Ana Paula M; Almeida, Gabriel M F; Abrahão, Jônatas S; Rios, Maria; Coimbra, Roney S; Kroon, Erna G


    Meningitis is a disease with a global distribution that constitutes a worldwide burden, with viruses as the primary etiologic agents. The range of viral meningitis severity depends mainly on age, immune status and etiological agent. The aim of this work was to investigate the suspected cases of viral meningitis using molecular techniques to confirm the viral infection. The diagnosed virus was correlated with clinical findings and cytochemical parameters in cerebrospinal liquid (CSF) of patients. CSF of 70 children with the presumptive diagnosis of viral meningitis was analyzed by real time PCR (qPCR). Viruses were identified by qPCR in 44 CSF samples (62.9%). Among them, 31 were identified as Enterovirus (ENTV) (70.4%), six as Human herpes virus 3 (HHV-3) (13.6%), five as Dengue virus (DENV) (11.7%), one as Human herpes virus 1-2 (2.3%) and one as Human herpes virus 5 (2.3%). Patients in the HHV-positive groups had increased percentage of polymorphonuclear neutrophils (PMN) (mean of 81%) while the groups of patients with DENV and ENTV had a mean of 30.9%. This study contributes to the knowledge of the epidemiological distribution of viral agents in CNS infections in children. In addition, it raises the relevance of DENV as an agent of CNS infection, and reinforces the importance for molecular in the cases of CNV infection. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. etiology and pathogenesis of anterior open bite: a review

    African Journals Online (AJOL)


    Nov 11, 2010 ... population (3-5). Children with this condition suffer from among others psychosocial and functional problems. This article reviews the etiology and ..... Class. III Malocclusion with Posterior Crossbite and Anterior. Open Bite Treated with Extraction. Expansion and. Habit Control!: A Case Report and Review of ...

  1. Epilepsy In Nigeria – A Review Of Etiology, Epidemiology And ...

    African Journals Online (AJOL)

    Epilepsy is a major public health issue especially in developing African countries. The etiologies and approach to management are significantly different in developed and developing countries, with infectious causes and treatment with phenobarbitone being the peculiarities of the developing sub-Saharan African countries.

  2. Etiology, prevalence, and treatment of dry eye disease

    Directory of Open Access Journals (Sweden)

    Johnny L Gayton


    Full Text Available Johnny L GaytonEyesight Associates, Warner Robins, GA, USAPurpose: This review article examines the prevalence, etiology, and current therapies of dry eye disease, with special focus on postmenopausal women.Method: A systematic literature search utilizing MEDLINE was conducted to identify peer-reviewed articles related to dry eye published prior to September 2008. The terms “dry eye” and “women” were searched in combination with one or more of the following words or phrases: prevalence, postmenopausal, etiology, risk factors, therapy, medications, surgery, tear film, and quality of life. Articles were selected based on their direct applicability to the subject matter. A manual search was also conducted based on citations in the published literature.Results: Epidemiologic studies identified prevalence rates ranging from 7% in the United States to 33% in Taiwan and Japan. Risk factors include advanced age, female sex, smoking, extreme heat or cold weather conditions, low relative humidity, use of video display terminals, refractive surgery, contact lens wear, and certain medications.Conclusion: The last decade has brought about a better understanding of the etiology of dry eye disease. New therapies that can alleviate the signs and symptoms of dry eye disease and, consequently, improve the quality of life of dry eye patients are available in the market.Keywords: dry eye disease, etiology, prevalence, postmenopausal women

  3. Seeking Professional Help: Etiology Beliefs about Mental Illness across Cultures (United States)

    Chen, Sylvia Xiaohua; Mak, Winnie W. S.


    In the present study, the authors examined the contributions of cultural beliefs about the etiology of mental illness to the seeking of help from mental health professionals among college students in 4 cultural groups, European Americans, Chinese Americans, Hong Kong Chinese, and Mainland Chinese. Group differences were found in help-seeking…

  4. [Pancoast and Tobias syndrome of benign etiology (author's transl)]. (United States)

    Aubert, M; Perdrix, A; Bouchet, C; Paramelle, B; Latreille, R; Barrie, J


    The authors report a case of Pancoast and Tobias syndrome due to a hydatic cyst on the apex of the left lung. This parasitosis is together with tuberculosis and least infrequent benign etiology of Pancoast and Tobias syndrome. In our observation it was a young cyst without complications as opposed to previously reported cases.

  5. [A rare and benign etiology of Pancoast-Tobias syndrome]. (United States)

    Souabny, A; Trombati, N; Afif, H; Aichane, A; Aammal, K; Ridai, M; Bahlaoui, A; Bouayad, Z


    Although lung cancer is the leading cause of Pancoast-Tobias syndrome, benign etiologies have been rarely described in the literature. We report two cases of Pancoast-Tobias syndrome caused by hydatidosis of the apex. Outcome was favorable after surgical treatment.

  6. Anemia in chronic heart failure : etiology and treatment options

    NARCIS (Netherlands)

    Westenbrink, B. Daan; de Boer, Rudolf A.; Voors, Adriaan A.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    Purpose of review Anemia is common in patients with chronic heart failure, and is related to increased morbidity and mortality. The etiology of anemia in heart failure is complex and still not fully resolved. The review will describe current advances in the understanding of the pathophysiology of

  7. Burden, etiology and predictors of visual impairment among children ...

    African Journals Online (AJOL)


    Sep 3, 2017 ... Abstract. Background: Childhood visual impairment (CVI) has not been given due attention. Knowledge of CVI is important in plan- ning preventive measures. The aim of this study was determine the prevalence, etiology and the factors associated with child- hood visual impairment among the children ...

  8. Etiological Attributions Of Alms-Begging Among People With Special ...

    African Journals Online (AJOL)

    Many people opine that the society, religious persuasions, the government and beggars themselves are causal agents of begging behaviour among people with special needs. Therefore, this study aimed at investigating differential etiological attributions of alms-begging among people with special needs in Oyo State, ...

  9. Etiologies of unilateral exophthalmia in children at University ...

    African Journals Online (AJOL)

    Traumatic orbital haematoma (50%), retinoblastoma (22.91%) and orbital cellulitis (20.83%) were the main etiologies. Metastases (6/18) and ophthalmoplegia (4/18) were the major complications. The overall mortality rate was 20.83%, with a share of retinoblastomarelated mortality at 80%. Conclusion: Early diagnosis of ...

  10. Etiology and electroclinical pattern of late onset epilepsy in Ibadan ...

    African Journals Online (AJOL)

    Late onset epilepsy (LOE) is a common neurological problem throughout the world. It is an area that has not been fully explored in the developing countries like Nigeria. The aim of the present study is to determine the pattern of presentation of late onset epilepsy with the view to identifying the etiologic as well as describe ...

  11. A Study of the Etiology of Referred Otalgia

    Directory of Open Access Journals (Sweden)

    Mohammad Hosein Taziki


    Conclusion:  In view of the fact that a significant proportion of the patients who complained of otalgia had no pathologies in the ear, thorough physical examination in adjacent structures especially teeth should be performed and malignancies should be considered as a possible etiology of otalgia.

  12. Etiology and clinical management of adult meningitis in Indonesia

    NARCIS (Netherlands)

    Rizal Ganiem, A.


    This thesis consists of 8 chapters and addresses the etiology, diagnosis, outcome and treatment of adult meningitis in Indonesia. The studies were conducted in Hasan Sadikin Hospital, Bandung, the referral hospital for West Java province, Indonesia between December 2006 and August 2012. In a

  13. A survey of etiologic hypotheses among testicular cancer researchers

    DEFF Research Database (Denmark)

    Stang, A; Trabert, B; Rusner, C


    Basic research results can provide new ideas and hypotheses to be examined in epidemiological studies. We conducted a survey among testicular cancer researchers on hypotheses concerning the etiology of this malignancy. All researchers on the mailing list of Copenhagen Testis Cancer Workshops and ...... etiologic hypotheses that include factors related to endocrine disruption, DNA damage, inflammation, and nutrition during pregnancy. The survey results may stimulate a multidisciplinary discussion about new etiologic hypotheses of testicular cancer.......Basic research results can provide new ideas and hypotheses to be examined in epidemiological studies. We conducted a survey among testicular cancer researchers on hypotheses concerning the etiology of this malignancy. All researchers on the mailing list of Copenhagen Testis Cancer Workshops...... and corresponding authors of PubMed-indexed articles identified by the search term 'testicular cancer' and published within 10 years (in total 2750 recipients) were invited to respond to an e-mail-based survey. Participants of the 8th Copenhagen Testis Cancer Workshop in May 2014 were subsequently asked to rate...

  14. Glutathione dysregulation and the etiology and progression of human diseases.

    NARCIS (Netherlands)

    Ballatori, N.; Krance, S.M.; Notenboom, S.; Shi, S.; Tieu, K.; Hammond, C.L.


    Glutathione (GSH) plays an important role in a multitude of cellular processes, including cell differentiation, proliferation, and apoptosis, and as a result, disturbances in GSH homeostasis are implicated in the etiology and/or progression of a number of human diseases, including cancer, diseases

  15. Gingival Recession in a Child‑Patient; Easily Missed Etiologies ...

    African Journals Online (AJOL)

    frenal attachment is more important in gingival recession in the child‑patient. A healthy child‑patient with impeccable oral hygiene presented with localized gingival recession without plaque‑induced inflammation which led to the exploration of other possible etiologies. Multiple factors appeared to be acting in consonance ...

  16. Role of psychosocial factors in the etiology of bruxism

    NARCIS (Netherlands)

    Manfredini, D.; Lobbezoo, F.


    AIMS: To summarize literature data about the role of psychosocial factors in the etiology of bruxism. METHODS: A systematic search in the National Library of Medicine's PubMed Database was performed to identify all peer-reviewed papers in the English literature dealing with the bruxism-psychosocial

  17. Childhood Urinary Tract Infection in Abakaliki: Etiological Organisms ...

    African Journals Online (AJOL)

    Background: Urinary tract infection (UTI) is a common childhood infection in the Tropics which causes significant illness and is frequently missed, probably because of its non-specific presentation and similarity with other common illnesses. Objectives: To determine the prevalence, common etiological agents, and the ...

  18. Frequency and Etiology of ADHD in New Onset Epilepsy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available The prevalence, complications and etiology of ADHD were determined in 75 children (age 8-18 years with new/recent onset idiopathic epilepsy nd 62 healthy first-degree cousin controls, in a study at University of Wisconsin School of Medicine and Public Health, Madison, WI; and Rosalind Franklin University of Medicine and Science, North Chicago, IL.

  19. Ketosis in dairy cows: etiologic factors, monitoring, treatment

    NARCIS (Netherlands)

    van der Drift, S.G.A.


    Ketosis is a metabolic disorder that mainly occurs during the negative energy balance in early-lactation dairy cows. It is characterized by elevated concentrations of ketone bodies in blood (hyperketonemia), urine, and milk. The thesis of Saskia van der Drift covers investigations on etiologic

  20. A Review of Etiological Formulations and Possible Treatments of Enuresis. (United States)

    Odebunmi, Akin

    This literature review discusses enuresis from various etiological formulations: pyschoanalytic and psychodynamic; medical and physiological; and behavioral. Both historical and current perspectives on a definition of enuresis are offered. Treatment methodologies are reviewed. An emphasis is placed on the ruling out of medical causes before any…

  1. Infectious uveitis. New developments in etiology and pathogenesis

    NARCIS (Netherlands)

    de Visser, L.


    Uveitis is an inflammation of the inner-eye and is initiated by various infectious and noninfectious causes. In a large portion of patients the etiology is unknown and might be associated with until now undiagnosed infections.The identification of infectious uveitis is of crucial importance since

  2. Depression in later life : three etiologically different subgroups

    NARCIS (Netherlands)

    Van den Berg, M.D.; Oldehinkel, A.J.; Bouhuys, A.L.; Brilman, E.I.; Beekman, A.T.F.; Ormel, J.

    Background: Various studies support the notion that early onset depression and late onset depression have different etiological pathways. Late onset depression has been found to be a heterogeneous group. This study attempts to divide the late onset group in two subgroups with different aetiology and

  3. Epidemiology, etiology, and treatment of chronic leg ulcer ...

    African Journals Online (AJOL)

    Background: Chronic leg ulcer (CLU) is reported to have an impact on virtually all aspects of life. Treatment is expensive and has large economic burden on many countries' health services. This presentation is to determine the impact, etiology, and presentation of CLU as well as the procedures for processing in a Nigeria ...

  4. Bronchiolitis in Abha, Southwest Saudi Arabia: viral etiology and ...

    African Journals Online (AJOL)

    Objectives: To determine the viral etiology and predictors for hospital admission of children with bronchiolitis in Abha city, southwest Saudi Arabia. Methods ... Results: Prematurity, chronic lung diseases, atopic dermatitis, pure formula feeding, passive smoking and age = one year were significant predictors of admission.

  5. The etiology and antimicrobial susceptibility patterns of urinary tract ...

    African Journals Online (AJOL)

    The etiology and antimicrobial susceptibility patterns of urinary tract infections at a private Nigerian teaching hospital in South West Nigeria. ... The risk factors for UTI were female gender (p = 0.00), Diabetes mellitus (p = 0.03) and genitourinary surgery (p = 0.04). Effective antibiotics in-vitro to Escherichia coli were ...

  6. Duodenal Obstruction: Etiology, Morbidity and Mortality among Edo ...

    African Journals Online (AJOL)

    Duodenal obstruction in children is associated with poor outcome which has improved in developed but remained poor in developing countries. The objective of this study was to ascertain the etiology, morbidity, mortality and factors that contributed to poor outcome in a developing country. Retrospective analysis of pediatric ...

  7. Investigation of suspected chronic fatigue syndrome/myalgic encephalopathy. (United States)

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


    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.

  8. Perioperative sexual interest in women with suspected gynecologic malignancies. (United States)

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


    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.

  9. 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)


    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.

  10. MRI diagnosis of suspected atlanto-occipital dissociation in childhood. (United States)

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


    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.

  11. 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


    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.

  12. Ocular lesions following suspected lightning injury in a horse. (United States)

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


      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.

  13. Suspected side effects to the quadrivalent human papilloma vaccine. (United States)

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


    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.

  14. Feline toxicological emergencies: when to suspect and what to do. (United States)

    Grave, Tobias W; Boag, Amanda K


    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.

  15. The impact of incontinence etiology on artificial urinary sphincter outcomes

    Directory of Open Access Journals (Sweden)

    Adam R. Miller


    Full Text Available Purpose: To evaluate the impact of incontinence etiology on artificial urinary sphincter (AUS device outcomes. Materials and Methods: We identified 925 patients who underwent primary AUS placement from 1983 to 2011. The etiology of incontinence was categorized as radical prostatectomy alone, radical prostatectomy with radiation, benign prostate resection, and those with cryotherapy as a salvage prostate cancer treatment. Hazard regression and competing risk analyses were used to determine the association of the etiology of incontinence with device outcomes. Results: The distribution of the 4 etiologies of incontinence included: 598 patients (64.6% treated with prostatectomy alone, 206 (22.2% with prostatectomy and pelvic radiation therapy, 104 (11.2% with benign prostate resection, and 17 (1.8% with prior cryotherapy. With a median follow-up of 4.9 years (interquartile range, 1.2–8.8 years, there was significant difference in the cumulative incidence of device infection/urethral erosion events between the four etiologies (p=0.003. On multivariable analysis, prior cryotherapy (reference prostatectomy alone; hazard ratio [HR], 3.44; p=0.01, older age (HR, 1.07; p=0.0009 and history of a transient ischemic attack (HR, 2.57; p=0.04 were associated with an increased risk of device infection or erosion. Notably, pelvic radiation therapy with prostatectomy was not associated with an increased risk of device infection or erosion (reference prostatectomy alone, p=0.30. Conclusions: Compared to prostatectomy alone, prior treatment with salvage cryotherapy for recurrent prostate cancer was associated with an increased risk of AUS infection/erosion, whereas radiation (in addition to prostatectomy was not.

  16. Etiologic Ischemic Stroke Phenotypes in the NINDS Stroke Genetics Network (United States)

    Ay, Hakan; Arsava, Ethem Murat; Andsberg, Gunnar; Benner, Thomas; Brown, Robert D.; Chapman, Sherita N.; Cole, John W.; Delavaran, Hossein; Dichgans, Martin; Engström, Gunnar; Giralt-Steinhauer, Eva; Grewal, Raji P.; Gwinn, Katrina; Jern, Christina; Jimenez-Conde, Jordi; Jood, Katarina; Katsnelson, Michael; Kissela, Brett; Kittner, Steven J.; Kleindorfer, Dawn O.; Labovitz, Daniel L.; Lanfranconi, Silvia; Lee, Jin-Moo; Lehm, Manuel; Lemmens, Robin; Levi, Chris; Li, Linxin; Lindgren, Arne; Markus, Hugh S.; McArdle, Patrick F.; Melander, Olle; Norrving, Bo; Peddareddygari, Leema Reddy; Pedersén, Annie; Pera, Joanna; Rannikmäe, Kristiina; Rexrode, Kathryn M.; Rhodes, David; Rich, Stephen S.; Roquer, Jaume; Rosand, Jonathan; Rothwell, Peter M.; Rundek, Tatjana; Sacco, Ralph L.; Schmidt, Reinhold; Schürks, Markus; Seiler, Stephan; Sharma, Pankaj; Slowik, Agnieszka; Sudlow, Cathie; Thijs, Vincent; Woodfield, Rebecca; Worrall, Bradford B.; Meschia, James F.


    Background and Purpose NINDS Stroke Genetics Network (SiGN) is an international consortium of ischemic stroke studies that aims to generate high quality phenotype data to identify the genetic basis of etiologic stroke subtypes. This analysis characterizes the etiopathogenetic basis of ischemic stroke and reliability of stroke classification in the consortium. Methods Fifty-two trained and certified adjudicators determined both phenotypic (abnormal test findings categorized in major etiologic groups without weighting towards the most likely cause) and causative ischemic stroke subtypes in 16,954 subjects with imaging-confirmed ischemic stroke from 12 US studies and 11 studies from 8 European countries using the web-based Causative Classification of Stroke System. Classification reliability was assessed with blinded re-adjudication of 1509 randomly selected cases. Results The distribution of etiologic categories varied by study, age, sex, and race (p<0.001 for each). Overall, only 40% to 54% of cases with a given major ischemic stroke etiology (phenotypic subtype) were classified into the same final causative category with high confidence. There was good agreement for both causative (kappa 0.72, 95%CI:0.69-0.75) and phenotypic classifications (kappa 0.73, 95%CI:0.70-0.75). Conclusions This study demonstrates that etiologic subtypes can be determined with good reliability in studies that include investigators with different expertise and background, institutions with different stroke evaluation protocols and geographic location, and patient populations with different epidemiological characteristics. The discordance between phenotypic and causative stroke subtypes highlights the fact that the presence of an abnormality in a stroke patient does not necessarily mean that it is the cause of stroke. PMID:25378430

  17. Principal components analysis in clinical studies. (United States)

    Zhang, Zhongheng; Castelló, Adela


    In multivariate analysis, independent variables are usually correlated to each other which can introduce multicollinearity in the regression models. One approach to solve this problem is to apply principal components analysis (PCA) over these variables. This method uses orthogonal transformation to represent sets of potentially correlated variables with principal components (PC) that are linearly uncorrelated. PCs are ordered so that the first PC has the largest possible variance and only some components are selected to represent the correlated variables. As a result, the dimension of the variable space is reduced. This tutorial illustrates how to perform PCA in R environment, the example is a simulated dataset in which two PCs are responsible for the majority of the variance in the data. Furthermore, the visualization of PCA is highlighted.

  18. COPD phenotype description using principal components analysis

    DEFF Research Database (Denmark)

    Roy, Kay; Smith, Jacky; Kolsum, Umme


    BACKGROUND: Airway inflammation in COPD can be measured using biomarkers such as induced sputum and Fe(NO). This study set out to explore the heterogeneity of COPD using biomarkers of airway and systemic inflammation and pulmonary function by principal components analysis (PCA). SUBJECTS...... AND METHODS: In 127 COPD patients (mean FEV1 61%), pulmonary function, Fe(NO), plasma CRP and TNF-alpha, sputum differential cell counts and sputum IL8 (pg/ml) were measured. Principal components analysis as well as multivariate analysis was performed. RESULTS: PCA identified four main components (% variance...... associations between the variables within components 1 and 2. CONCLUSION: COPD is a multi dimensional disease. Unrelated components of disease were identified, including neutrophilic airway inflammation which was associated with systemic inflammation, and sputum eosinophils which were related to increased Fe...

  19. A Genealogical Interpretation of Principal Components Analysis (United States)

    McVean, Gil


    Principal components analysis, PCA, is a statistical method commonly used in population genetics to identify structure in the distribution of genetic variation across geographical location and ethnic background. However, while the method is often used to inform about historical demographic processes, little is known about the relationship between fundamental demographic parameters and the projection of samples onto the primary axes. Here I show that for SNP data the projection of samples onto the principal components can be obtained directly from considering the average coalescent times between pairs of haploid genomes. The result provides a framework for interpreting PCA projections in terms of underlying processes, including migration, geographical isolation, and admixture. I also demonstrate a link between PCA and Wright's fst and show that SNP ascertainment has a largely simple and predictable effect on the projection of samples. Using examples from human genetics, I discuss the application of these results to empirical data and the implications for inference. PMID:19834557

  20. Principals' transformational leadership and teachers' collective efficacy. (United States)

    Dussault, Marc; Payette, Daniel; Leroux, Mathieu


    The study was designed to test the relationship of principals' transformational, transactional, and laissez-faire leadership with teachers' collective efficacy. Bandura's theory of efficacy applied to the group and Bass's transformational leadership theory were used as the theoretical framework. Participants included 487 French Canadian teachers from 40 public high schools. As expected, there were positive and significant correlations between principals' transformational and transactional leadership and teachers' collective efficacy. Also, there was a negative and significant correlation between laissez-faire leadership and teachers' collective efficacy. Moreover, regression analysis showed transformational leadership significantly enhanced the predictive capabilities of transactional leadership on teachers' collective efficacy. These results confirm the importance of leadership to predict collective efficacy and, by doing so, strengthen Bass's theory of leadership.

  1. 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.

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

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


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

  3. Principal bundles on the projective line

    Indian Academy of Sciences (India)

    M. Senthilkumar (Newgen Imaging) 1461 1996 Oct 15 13:05:22

    LetX be a complete nonsingular curve over the algebraic closurek ofk andGa reductive group over k. Let E → X be a principal G-bundle on X. E is said to be semistable if, for every reduction of structure group EP ⊂ E to a maximal parabolic subgroup P of G, we have degree EP (p) ≤ 0, where p is the Lie algebra of P and EP ...

  4. Integrating Data Transformation in Principal Components Analysis


    Maadooliat, Mehdi; Huang, Jianhua Z.; Hu, Jianhua


    Principal component analysis (PCA) is a popular dimension reduction method to reduce the complexity and obtain the informative aspects of high-dimensional datasets. When the data distribution is skewed, data transformation is commonly used prior to applying PCA. Such transformation is usually obtained from previous studies, prior knowledge, or trial-and-error. In this work, we develop a model-based method that integrates data transformation in PCA and finds an appropriate data ...

  5. A principal components model of soundscape perception. (United States)

    Axelsson, Östen; Nilsson, Mats E; Berglund, Birgitta


    There is a need for a model that identifies underlying dimensions of soundscape perception, and which may guide measurement and improvement of soundscape quality. With the purpose to develop such a model, a listening experiment was conducted. One hundred listeners measured 50 excerpts of binaural recordings of urban outdoor soundscapes on 116 attribute scales. The average attribute scale values were subjected to principal components analysis, resulting in three components: Pleasantness, eventfulness, and familiarity, explaining 50, 18 and 6% of the total variance, respectively. The principal-component scores were correlated with physical soundscape properties, including categories of dominant sounds and acoustic variables. Soundscape excerpts dominated by technological sounds were found to be unpleasant, whereas soundscape excerpts dominated by natural sounds were pleasant, and soundscape excerpts dominated by human sounds were eventful. These relationships remained after controlling for the overall soundscape loudness (Zwicker's N(10)), which shows that 'informational' properties are substantial contributors to the perception of soundscape. The proposed principal components model provides a framework for future soundscape research and practice. In particular, it suggests which basic dimensions are necessary to measure, how to measure them by a defined set of attribute scales, and how to promote high-quality soundscapes.

  6. Principal Component Analysis of Students Academic Performance

    Directory of Open Access Journals (Sweden)

    Frank B. K. Twenefour


    Full Text Available The purpose of this study was to identify a metric for measuring students’ performance in mathematics and statistics in the Department of Mathematics and Statistics of a public university in Ghana. Some of the students of the department are of the view that the current grading system used by the Department does not do a good job of distinguishing between the performances of students, as at times students of different academic performance could end up with the same Grade Point Average (GPA, a performance measure. Data for the research which covers the 2012/2013 third year students of the Department were obtained from the university’s student records unit. Principal Component Analysis (PCA was used to analyze the data. Three principal components were retained as rules or indices for the classification of students’ performance. A derivative of the first principal component, RSI, could serve as a new performance measure for the Department as it takes into consideration differences in the raw scores of the students.

  7. Principal component analysis for authorship attribution

    Directory of Open Access Journals (Sweden)

    Amir Jamak


    Full Text Available Background: To recognize the authors of the texts by the use of statistical tools, one first needs to decide about the features to be used as author characteristics, and then extract these features from texts. The features extracted from texts are mostly the counts of so called function words. Objectives: The data extracted are processed further to compress as a data with less number of features, such a way that the compressed data still has the power of effective discriminators. In this case feature space has less dimensionality then the text itself. Methods/Approach: In this paper, the data collected by counting words and characters in around a thousand paragraphs of each sample book, underwent a principal component analysis performed using neural networks. Once the analysis was complete, the first of the principal components is used to distinguish the books authored by a certain author. Results: The achieved results show that every author leaves a unique signature in written text that can be discovered by analyzing counts of short words per paragraph. Conclusions: In this article we have demonstrated that based on analyzing counts of short words per paragraph authorship could be traced using principal component analysis. Methodology could be used for other purposes, like fraud detection in auditing.

  8. Clinical and diagnostic characteristics of patients with suspected polyneuropathy

    Directory of Open Access Journals (Sweden)

    Mikhailova Е.V.


    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.

  9. Different Types of Fantastic Etiology in Hafez Poetry

    Directory of Open Access Journals (Sweden)

    Ghodrat Ghasemipour


    Full Text Available  Abstract Fantastic etiology in Persian poetry has such a high status that we can say that this figure of speech is one of the most interested figures between classic Persian poets. This figure is frequently used by Hafez in his poetries so that after equivocalness it is the second rhetorical figure in his poetries. The definition of fantastic etiology is that causality in poetry is based on similarity and it must be aesthetical and satisfactory, not scientific and discursive. By Fantastic etiology poets create imaginative connection between two phenomena; in the other hand, this figure rationally proves the possibility of the impossible and thus presents the lies disguised as truth. The poet’s goal in fantastic etiology is not to invent the cause, but rather to make the conventional descriptions sound unusual. For example, in the line “Because the cloud weeps without reason, tulips and roses laugh at it,” it is the groundless tears of the cloud which cause mockery on the part of the tulips and roses. In this example, two conventional expressions- “the cloud’s tears” (describing the spring rain and “the flowers’ laughter” (describing their blossoming - are connected by a causal relationship which does not exist in reality.   In classical Persian poetry Hafez, along with equivocalness, utilized of fantastic etiology in the best form . His uses of this literary device, like another figures of speech in his poetry, is very natural and unassuming. Understanding, interpreting and aesthetical purpose of some Hafez poetries is based on fantastic etiology.   Companionship, concomitancy and admixture of poetical figures are factors that must be discussed in stylistic analysis of poetry. Literary figures occasionally uses alone in poetry and some when uses together. Though fantastic etiology in rhetoric or figure of thought is an independent figure, but this devise occasionally uses with another

  10. Development and Validation of a Principal Implementation Practices Measure: The Principal Implementation Questionnaire (United States)

    Nettles, Stephen M.; Petscher, Yaacov


    Measurement of principal implementation behaviors has proved difficult to researchers in educational leadership due to a lack of consensus on the operational definitions of leadership constructs. The Principal Implementation Questionnaire (PIQ) was developed and validated with the intention of providing clarity in the assessment of principal leadership behaviors in the implementation of effective reading programs. Constructs were operationally defined within the context of the population of interest, with subsequent item writing centered around the constructs. A resulting calibration sample of principals from Florida Reading First schools was used to test the hypothesized measurement model to determine how well the items were described by the proposed factors. Results from LISREL analyses revealed a well-fitted model, based on numerous fit indices. PMID:26366043

  11. Anglo-American views of Gavrilo Princip

    Directory of Open Access Journals (Sweden)

    Markovich Slobodan G.


    Full Text Available The paper deals with Western (Anglo-American views on the Sarajevo assassination/attentat and Gavrilo Princip. Articles on the assassination and Princip in two leading quality dailies (The Times and The New York Times have particularly been analysed as well as the views of leading historians and journalists who covered the subject including: R. G. D. Laffan, R. W. Seton-Watson, Winston Churchill, Sidney Fay, Bernadotte Schmitt, Rebecca West, A. J. P. Taylor, Vladimir Dedijer, Christopher Clark and Tim Butcher. In the West, the original general condemnation of the assassination and its main culprits was challenged when Rebecca West published her famous travelogue on Yugoslavia in 1941. Another Brit, the remarkable historian A. J. P. Taylor, had a much more positive view on the Sarajevo conspirators and blamed Germany and Austria-Hungary for the outbreak of the Great War. A turning point in Anglo-American perceptions was the publication of Vladimir Dedijer’s monumental book The Road to Sarajevo (1966, which humanised the main conspirators, a process initiated by R. West. Dedijer’s book was translated from English into all major Western languages and had an immediate impact on the understanding of the Sarajevo assassination. The rise of national antagonisms in Bosnia gradually alienated Princip from Bosnian Muslims and Croats, a process that began in the 1980s and was completed during the wars of the Yugoslav succession. Although all available sources clearly show that Princip, an ethnic Serb, gradually developed a broader Serbo-Croat and Yugoslav identity, he was ethnified and seen exclusively as a Serb by Bosnian Croats and Bosniaks and Western journalists in the 1990s. In the past century imagining Princip in Serbia and the West involved a whole spectrum of views. In interwar Anglo-American perceptions he was a fanatic and lunatic. He became humanised by Rebecca West (1941, A. J. P. Taylor showed understanding for his act (1956, he was fully

  12. [Cost-effectiveness of chest x-rays in infants with clinically suspected viral bronchiolitis in Colombia]. (United States)

    Rodríguez Martínez, Carlos E; Sossa Briceño, Mónica P


    Estimate the cost-effectiveness of not taking chest x-rays of any infant with clinically suspected viral bronchiolitis versus routinely taking them of all such patients, the most common practice today in Colombia. A cost-effectiveness study was conducted, comparing strategies of taking chest x-rays of all infants with clinically suspected viral bronchiolitis and not x-raying any of these infants. The principal outcome was the proportion of correct diagnoses. The time horizon was the clinical course of the bronchiolitis. The perspective was that of the third-party payer, and the costs were obtained from the rates in effect in a clinic in Bogotá. Deterministic and probabilistic sensitivity analyses were performed. The strategy of not taking a chest x-ray of any patient prevailed over that of routinely taking one in all cases, with an average cost of US$ 111.00 and a correct diagnosis rate of 0.8020, versus the respective values of US$ 129.00 and 0.7873 for the strategy of routinely x-raying all of these patients. The most influential variable was pneumonia-related hospital costs. In the probabilistic sensitivity analysis, the strategy of not x-raying any infant prevailed in 61.1% of the simulations. The results suggest that not taking routine chest x-rays of infants with clinically suspected viral bronchiolitis is a cost-effective strategy compared with the common practice of taking them in all cases, since the former yields a greater proportion of correct diagnoses at a lower average cost per patient. Nevertheless, new studies will be needed that have more representative samples from all of the health facilities and include the strategy of taking chest x-rays only of patients with predictors of radiologic abnormalities.

  13. The Interdependence of Principal School Leadership and Student Achievement (United States)

    Soehner, David; Ryan, Thomas


    This review illuminated principal school leadership as a variable that impacted achievement. The principal as school leader and manager was explored because these roles were thought to impact student achievement both directly and indirectly. Specific principal leadership behaviors and principal effectiveness were explored as variables potentially…

  14. Principals' perceptions of the motivation potential of performance ...

    African Journals Online (AJOL)

    The article explores the proposed performance agreement and its potential influence on principals' motivation to improve their own, and therefore also the teachers' and learners' academic performance. The focus group interviews conducted with principals and deputy principals indicate that principals do not want to be held ...

  15. Stress and Job Satisfaction among Secondary School Principals in Texas (United States)

    Romney, Angela G.


    The role of a secondary school principal continues to expand and increase principals' daily workload. The high stakes testing environment also places pressure on principals to ensure that students score high on standardized tests. With a heavy workload, principals find themselves faced with numerous work-related stressors that influence job…

  16. Using Internet Artifacts to Profile a Child Pornography Suspect

    Directory of Open Access Journals (Sweden)

    Marcus K. Rogers


    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

  17. Teicoplanin versus vancomycin for proven or suspected infection. (United States)

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


    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

  18. Comparison Costs of ERCP and MRCP in Patients with Suspected Biliary Obstruction Based on a Randomized Trial. (United States)

    Adam, Viviane; Bhat, Mamatha; Martel, Myriam; da Silveira, Eduardo; Reinhold, Caroline; Valois, Eric; Barkun, Jeffrey S; Barkun, Alan N


    The optimal management of patients with suspected biliary obstruction remains unclear, and includes the possible performance of magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). To complete a cost analysis based on a medical effectiveness randomized trial comparing an ERCP-first approach with an MRCP-first approach in patients with suspected bile duct obstruction. The management strategies were based on a medical effectiveness trial of 257 patients over a 12-month follow-up period. Direct and indirect costs were included, adopting a societal perspective. The cost values are expressed in 2012 Canadian dollars. Total per-patient direct costs were Can$3547 for ERCP-first patients and Can$4013 for MRCP-first patients. Corresponding indirect costs were Can$732 and Can$694, respectively. Causes for differences in direct costs included a more frequent second procedure and a greater mean number of hospital days over the year in patients of the MRCP-first group. In contrast, it is the ERCP-first patients whose indirect costs were greater, principally due to more time away from activities of daily living. Choosing an ERCP-first strategy rather than an MRCP-first strategy saved on average Can$428 per patient over the 12-month follow-up duration; however, there existed a large amount of overlap when varying total cost estimates across a sensitivity analysis range based on observed resources utilization. This cost analysis suggests only a small difference in total costs, favoring the ERCP-first group, and is principally attributable to procedures and hospitalizations with little impact from indirect cost measurements. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. Viral Etiology of acute respiratory tract infections in hospitalized children and adults in Shandong Province, China. (United States)

    Liu, Ti; Li, Zhong; Zhang, Shengyang; Song, Shaoxia; Julong, Wu; Lin, Yi; Guo, Nongjian; Xing, Chunyan; Xu, Aiqiang; Bi, Zhenqiang; Wang, Xianjun


    The dominant viral etiologies responsible for acute respiratory infections (ARIs) are poorly understood, particularly among hospitalized patients. Improved etiological insight is needed to improve clinical management and prevention of ARIs. Clinical and demographic information and throat swabs were collected from 607 patients from 2011 to 2013 in Shandong Province, China. Multiplex RT-PCR (SeeplexTM RV detection, Seegene) was performed to detected 12 respiratory viral pathogens. A total of 607 hospitalized patients were enrolled from 2011 to 2013. Viruses were identified in 35.75 % (217/607) of cases, including 78 influenza virus A and B (IVA and IVB), 47 para-influenza viruses (PIVs), 41 respiratory syncytial virus (RSV) and 38 adenovirus (ADV). For the children under 15 year old, the common detected viruses were influenza viruses, RSV, PIVS and ADV, while the principal respiratory viruses were human coronaviruses (HCoV), PIVs, influenza viruses for the old adults. Co-infections with multiple viruses were detected in 15.67 % of patients. Children under 5 years were more likely to have one or more detectable virus associated with their ARI. The peak of ARI caused by the respiratory viruses occurred in winter. This study demonstrated respiratory viruses were the major cause of hospitalized ARI patients in Shandong Province, influenza virus was the most common detected, RSV was the highest incidence among the young children (≤5 years). These findings also gave a better understand of virus distribution among different age and seasons, which help to consider potential therapeutic approaches and develop effective prevention strategies for respiratory virus infection.

  20. Do Qualification, Experience and Age Matter for Principals Leadership Styles?


    Muhammad Javed Sawati; Saeed Anwar; Muhammad Iqbal Majoka


    The main focus of present study was to find out the prevalent leadership styles of principals in government schools of Khyber Pakhtunkhwa and to find relationship of leadership styles with qualifications, age and experience of the principals. On the basis of analyzed data, four major leadership styles of the principals were identified as Eclectic, Democratic, Autocratic, and Free-rein. However, a small proportion of the principal had no dominant leadership style. This study shows that princip...

  1. Trust Me, Principal, or Burn Out! The Relationship between Principals' Burnout and Trust in Students and Parents (United States)

    Ozer, Niyazi


    The purpose of this study was to determine the primary school principals' views on trust in students and parents and also, to explore the relationships between principals' levels of professional burnout and their trust in students and parents. To this end, Principal Trust Survey and Friedman Principal Burnout scales were administered on 119…

  2. Pararenal splenosis encountered during the evaluation of a suspected pheochromocytoma. (United States)

    Brown, Joel D; Kwee, Sandi


    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.

  3. Seroprevalance of brucellosis among suspected cases in Malaysia. (United States)

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


    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.

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

    DEFF Research Database (Denmark)

    Chabanova, Elizaveta; Balslev, Ingegerd; Achiam, Michael


    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...

  5. 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)


    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.)

  6. Cost-effectiveness of routine imaging of suspected appendicitis. (United States)

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


    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.

  7. Reliability of Examination Findings in Suspected Community-Acquired Pneumonia. (United States)

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


    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.

  8. 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:; 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)


    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

  9. Role of DR-70 immunoassay in suspected malignant pleural effusion (United States)

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


    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

  10. Relationship between trauma mechanism and etiology on mandibular fracture patterns

    Directory of Open Access Journals (Sweden)

    Fakhrurrazi Fakhrurrazi


    Full Text Available Background: Mandibular fracture occurs more commonly than maxillary fracture because of its prominent position and its arrow arch like bone anatomy. Many factors may cause mandibular fracture. Motorcycle accident is the main etiology of mandibular fracture in the world. Based on the literature, 43% mandibular fractures are caused by motorcycle accident, 34% by violence, 7% by accident at work, 7% by fall, 4% by sports and the others were caused by various things. Purpose: The purpose of this study was to know the relation between the etiology and mechanisms of trauma and the patterns of mandibular fracture at Hasan Sadikin Hospital, Bandung, from January 2006 to October 2007. Method: The study was taken on patients with mandibular fractures who came to Hasan Sadikin Hospital Bandung. The data were taken retrospectively by documenting the etiologies of mandibular fracture, the mechanisms of fracture, and the location of mandibular fracture. The data were analyzed with Chi Square statistic test. Result: The result showed that There were 83 mandibular fractures. The mandibular fracture more commonly attacks men about 77%, and women about 22.9%. Mandibular fracture occurs more often between the age group of 21-30 years old, about 31 people (37.3%. Mandibular fracture was mostles often caused by motorcycle accident, affecting about 71 people (85.5%. Parasymphysis fracture is the most common fracture location among mandibular fracture cases, about 47 people (56.6%. Conclusion: It can be concluded that there is no significant relationship between the etiology and mechanisms of trauma and the pattern of mandibular fracture.Latar belakang: Fraktur mandibula lebih sering terjadi dibandingkan dengan fraktur maksilla karenaposisinya yang lebihprominen dan bentuk anatomi tulang seperti busur panah. Banyak faktor yang dapat menyebabkan terjadinya fraktur mandibula. Kecelakaan kendaraan bermotor merupakan etiologi utama penyebab fraktur mandibula di dunia

  11. Space adaptation syndrome: multiple etiological factors and individual differences (United States)

    Lackner, J. R.; DiZio, P.


    Space motion sickness is a significant operational concern in the American and Soviet space programs. Nearly 70% of all astronauts and cosmonauts are affected to some degree during their first several days of flight. It is now beginning to appear that space motion sickness like terrestrial motion sickness is the consequence of multiple etiological factors. As we come to understand basic mechanisms of spatial orientation and sensory-motor adaptation we can begin to predict etiological factors in different motion environments. Individuals vary greatly in the extent to which they are susceptible to these different factors. However, individuals seem to be relatively self-consistent in terms of their rates of adaptation to provocative stimulation and their retention of adaptation. Attempts to relate susceptibility to motion sickness during the microgravity phases of parabolic flight maneuvers to vestibular function under 1G and 0G test conditions are described.

  12. Controversies about a common etiology for eating and mood disorders

    Directory of Open Access Journals (Sweden)

    Clara eRossetti


    Full Text Available Obesity and depression represent a growing health concern worldwide. For many years, basic science and medicine have considered obesity as a metabolic illness, while depression was classified a psychiatric disorder. Despite accumulating evidence suggesting that obesity and depression may share commonalities though, the causal link between eating and mood disorders remains to be fully understood. This etiology is highly complex, consisting of multiple environmental and genetic risk factors that interact with each other. In this review, we sought to summarize the preclinical and clinical evidence supporting a common etiology for eating and mood disorders, with a particular emphasis on signaling pathways involved in the maintenance of energy balance and mood stability, among which orexigenic and anorexigenic neuropeptides, metabolic factors, stress responsive hormones, cytokines and neurotrophic factors.

  13. The etiology of primary femoroacetabular impingement: genetics or acquired deformity? (United States)

    Packer, Jonathan D; Safran, Marc R


    The etiology of primary femoroacetabular impingement (FAI) remains controversial. Both genetic and acquired causes have been postulated and studied. While recent studies suggest that genetic factors may have a role in the development of FAI, there is no conclusive evidence that FAI is transmitted genetically. Currently, the most popular theory for the development of cam-type deformities is that a repetitive injury to the proximal femoral physis occurs during a critical period of development. There is a correlation between a high volume of impact activities during adolescence and the development of cam-type deformities. Multiple studies have found a high prevalence of FAI in elite football, ice hockey, basketball and soccer players. In this article, we review the current literature relating to the etiology of primary FAI.

  14. Etiologies and Treatments of Odontogenic Maxillary Sinusitis: A Systematic Review (United States)

    Akhlaghi, Fahimeh; Esmaeelinejad, Mohammad; Safai, Pooria


    Context: Maxillary sinusitis is an important issue in dentistry and maxillofacial surgery. This study aims to present a systematic review of etiologies and treatments of odontogenic maxillary sinusitis. Evidence Acquisition: An electronic database search was performed based on related MeSH keywords. Articles published between January 2001 and December 2014 was selected according to the inclusion criteria. The information extracted from various studies was categorized in various tables. Results: The study selected 19 studies. In most studies, oroantral fistula (OAF) was the most common etiology of odontogenic sinusitis. Alpha-hemolytic streptococcus was the most common flora in sinusitis with dental origin. The literature shows that the Caldwell-Luc approach may be the best method for treating sinusitis in cases of displaced teeth. Conclusions: OAF is a common cause of odontogenic maxillary sinusitis and may easily be treated by endoscopy and fistula closure. Maxillofacial surgeons and dentists should consider this problem to avoid misdiagnosis and prevent complications. PMID:26756016

  15. Microprolactinoma with visual field defect: An unsuspected etiology

    Directory of Open Access Journals (Sweden)

    K. V. S. Hari Kumar


    Full Text Available Microprolactinomas present usually with menstrual disturbance and galactorrhoea. The presence of visual field defects is not expected in these patients as the tumor does not involve structures outside the sella. Visual field defects in a case of microprolactinoma confuse the clinician and warrant extensive search for an alternate etiology. We present a young lady with microprolactinoma and visual field defects. Etiological work-up revealed a diagnosis of idiopathic intracranial hypertension (IIH associated with microprolactinoma. Treatment with Acetazolamide and Cabergoline completely resolved the clinical symptoms and visual defects. The unusual occurrence of IIH in a case of microprolactinoma as the cause of visual field defect is highlighted in our case report.

  16. Affine Flag Manifolds and Principal Bundles

    CERN Document Server

    Schmitt, Alexander HW


    Affine flag manifolds are infinite dimensional versions of familiar objects such as Gramann varieties. The book features lecture notes, survey articles, and research notes - based on workshops held in Berlin, Essen, and Madrid - explaining the significance of these and related objects (such as double affine Hecke algebras and affine Springer fibers) in representation theory (e.g., the theory of symmetric polynomials), arithmetic geometry (e.g., the fundamental lemma in the Langlands program), and algebraic geometry (e.g., affine flag manifolds as parameter spaces for principal bundles). Novel

  17. The principal components of response strength. (United States)

    Killeen, P R; Hall, S S


    As Skinner (1938) described it, response strength is the "state of the reflex with respect to all its static properties" (p. 15), which include response rate, latency, probability, and persistence. The relations of those measures to one another was analyzed by probabilistically reinforcing, satiating, and extinguishing pigeons' key pecking in a trials paradigm. Reinforcement was scheduled according to variable-interval, variable-ratio, and fixed-interval contingencies. Principal components analysis permitted description in terms of a single latent variable, strength, and this was validated with confirmatory factor analyses. Overall response rate was an excellent predictor of this state variable.

  18. [Etiological and molecular-epidemiological analysis on enterovirus associated encephalitis in Zhejiang, 2008-2012]. (United States)

    Yan, Ju-ying; Miao, Zi-ping; Lü, Hua-kun; Zhou, Jia-yue; Chen, Yin; Lu, Yi-yu; Zhang, Yan-jun


    In order to investigate etiology and molecular-epidemiological characteristics of enterovirus associated encephalitis (EAE) in Zhejiang, 2008-2012. Method Cerebrospinal fluid and stool specimens were collected from suspected EAE patients, who were admitted to our hospitals. RD and Hep-2 cell lines were used to isolate enterovirus (EV). Serotypes of these EV isolates were identified through neutralization test by using serotype specific anti-sera. VP1 genes of these isolates were sequenced, compared and used for the construction of phylogenetic tree. 127 (20.6%) human enterovirus (HEV) strains were isolated from 616 samples, which were collected from 610 patients. Serotypes of these EV isolates, including 60 coxsackievirus (CV), and 67 Echovirus (E)appeared to be CVA9, CVB1, CVB3-5, E3, E4, E6, E9, E14, E25 and E30, respectively. Predominant EV serotypes on EAE from 2008 to 2012 were seen as CVB3, CVB5, E6, E30 and E30, respectively. The full length of VP1 genes from different EV isolates was between 834 and 918 nucleotides. The VP1 gene similarities between these isolates and the reference strains were from 76.7% to 85.0% (nucleotides level) and 91.1% to 97.9% (amino acids level). The VP1 genes from E6 serotype isolates appeared most diverged, reaching 20.4% (nucleotides level) and 4.8% (amino acids level). Based on the generated phylogenetic tree, all the EV isolates were fallen on the same branch of HEV-B, and the isolates in the same serotype formed one sub-branch, suggesting there existed geographical and temporal effects. E6 isolates diverged into two branchlets. EVs from HEV-B were the etiologic agents for EAE in Zhejiang province from 2008 to 2012. All these EV isolates showed 12 serotypes, with predominant isolates varied every year. E30 was determined as the most dominant serotype while serotype E6 diverged into two sub-gene types.

  19. Etiology and Outcome of Diffuse Acute Infectious Bronchiolitis in Adults. (United States)

    Ryu, Kai; Takayanagi, Noboru; Ishiguro, Takashi; Kanauchi, Tetsu; Kawate, Eriko; Kagiyama, Naho; Sugita, Yutaka


    The etiology and outcome of diffuse acute infectious bronchiolitis (DAIB) in adults is not well known. To retrospectively review adult patients with DAIB without pneumonia, document the etiologies and outcomes, and assess the relation between DAIB and postinfectious bronchiolitis obliterans. We retrospectively analyzed medical records of 1,664 patients with lower respiratory tract infections admitted to our institution in Saitama, Japan. DAIB was diagnosed when patients developed acute feverish lower respiratory tract infection and chest computed tomography demonstrated mainly multiple centrilobular nodules in four or more lobes. Pneumonia was diagnosed when patients developed acute feverish lower respiratory tract infection and chest computed tomography demonstrated consolidation and/or ground-glass opacities with or without centrilobular nodules. Of the 1,664 patients, 20 (1.2%) and 1,644 (98.8%) patients were diagnosed as having DAIB and pneumonia, respectively. Of the 20 patients with DAIB, the etiology was determined in 16 (80%): 13 (65.0%) had a single pathogen and 3 (15.0%) had two pathogens. Detected organisms included Mycoplasma pneumoniae in eight (40.0%) patients, influenza virus in two (10.0%), influenza virus and Streptococcus pneumoniae in two (10.0%), Haemophilus influenzae in three (15.0%), and respiratory syncytial virus and rhinovirus in one (5.0%) patient. All patients improved and none developed postinfectious bronchiolitis obliterans. The three most common etiologies of DAIB in the studied adults were M. pneumoniae, influenza virus, and H. influenzae. None of the patients with DAIB developed postinfectious bronchiolitis obliterans.

  20. Sarcopenia: its assessment, etiology, pathogenesis, consequences and future perspectives. (United States)

    Rolland, Y; Czerwinski, S; Abellan Van Kan, G; Morley, J E; Cesari, M; Onder, G; Woo, J; Baumgartner, R; Pillard, F; Boirie, Y; Chumlea, W M C; Vellas, B


    Sarcopenia is a loss of muscle protein mass and loss of muscle function. It occurs with increasing age, being a major component in the development of frailty. Current knowledge on its assessment, etiology, pathogenesis, consequences and future perspectives are reported in the present review. On-going and future clinical trials on sarcopenia may radically change our preventive and therapeutic approaches of mobility disability in older people.

  1. Prevalence, etiology, diagnosis, treatment and complications of supernumerary teeth


    Ata-Ali Mahmud, Fadi; Ata-Ali Mahmud, Francisco Javier; Peñarrocha Oltra, David; Peñarrocha Diago, Miguel


    The aim of this article was to review the literature on supernumerary teeth, analyzing their prevalence, etiology, diagnosis, treatment and possible complications. An electronic search was made in the Pubmed-Medline database up to January 2014 using the key search terms ?multiple supernumerary teeth? (n=279), ?prevalence supernumerary teeth? (n=361), and ?supernumerary teeth? (n=2412). In addition to the articles initially identified, others were included in the review proceeding from a manua...

  2. Bilateral vestibular hypofunction: Insights in etiologies, clinical subtypes and diagnostics


    F. eLucieer; P. eVonk; N. eGuinand; R. eStokroos; H. eKingma; R. evan de Berg


    Objective:To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH) and the value of diagnostic tools in the diagnostic process of BVH.Materials and methods: A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised 1) imbalance and/or oscillopsia during locomotion, and 2) summated slow phase velocity of nystagmus of less than 20 degrees per second ...

  3. Bilateral Vestibular Hypofunction: Insights in Etiologies, Clinical Subtypes, and Diagnostics


    Lucieer, F.; Vonk, P.; Guinand, N; Stokroos, R.; Kingma, H.; van de Berg, Raymond


    Objective To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH) and the value of diagnostic tools in the diagnostic process of BVH. Materials and methods A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised (1) imbalance and/or oscillopsia during locomotion and (2) summated slow phase velocity of nystagmus of less than 20°/s duri...

  4. The etiology of primary femoroacetabular impingement: genetics or acquired deformity?


    Packer, Jonathan D.; Safran, Marc R.


    The etiology of primary femoroacetabular impingement (FAI) remains controversial. Both genetic and acquired causes have been postulated and studied. While recent studies suggest that genetic factors may have a role in the development of FAI, there is no conclusive evidence that FAI is transmitted genetically. Currently, the most popular theory for the development of cam-type deformities is that a repetitive injury to the proximal femoral physis occurs during a critical period of development. ...

  5. Etiology and Pathogenesis of Diabetic Microangiopathy. Biochemical and Molecular Considerations


    Milagros Lisset León Regal; Lázaro Hermes González Otero; Zoe Alina González Otero; José Omar de Armas García; Alexis Urquiza Hurtado; Gerardo Rodríguez Caña


    Diabetes mellitus is a metabolic disease widely spread today, causing high costs to health and the global economy. Microangiopathy is one of its most significant late complications and the leading cause of disabling complications in advanced diabetes. This paper aimed at describing the etiology and pathogenesis of diabetic microangiopathy considering the current knowledge about the involved molecular events and their particular manifestation in diabetic nephropathy and retinopathy. It was con...

  6. Prognostic value of EEG in different etiological types of coma. (United States)

    Khaburzania, M; Beridze, M


    Study aimed at evaluation of prognostic value of standard EEG in different etiology of coma and the influence of etiological factor on the EEG patterns and coma outcome. Totally 175 coma patients were investigated. Patients were evaluated by Glasgow Coma Scale (GCS), clinically and by 16 channel electroencephalography. Auditory evoked potentials studied by EEG -regime for evoked potentials in patients with vegetative state (VS). Patients divided in 8 groups according to coma etiology. All patients were studied for photoreaction, brainstem reflexes, localization of sound and pain, length of coma state and outcome. Brain injury visualized by conventional CT. Outcome defined as death, VS, recovery with disability and without disability. Disability was rated by Disability Rating Scale (DRS). Recovered patients assessed by Mini Mental State Examination (MMSE) scale. Statistics performed by SPSS-11.0. From 175 coma patients 55 patients died, 23 patients found in VS, 97 patients recovered with and without disability. In all etiological groups of coma the background EEG patterns were established. Correspondence analysis of all investigated factors revealed that sound localization had the significant association with EEG delta and theta rhythms and with recovery from coma state (Chi-sqr. =31.10493; p= 0.000001). Among 23 VS patients 9 patients had the signs of MCS and showed the long latency waves (p300) after binaural stimulation. The high amplitude theta frequencies in frontal and temporal lobes significantly correlated with prolongation of latency of cognitive evoked potentials (r=+0.47; pcoma outcome only in hemorrhagic and traumatic coma (chi-sqr.=12.95; pcoma outcome. Low amplitude decreased power delta and theta frequencies correlated with SND in survived coma patients (r=+0.21; pcoma patients with a high probability to recover as well as those patients, who are at high risk of SND in case of recovery from coma state.



    I. D. Rozanov; E. A. Rozanova; E. I. Shirikov; A. S. Balkanov; L. E. Gaganov; E. A. Stepanova


    Pulmonary embolism in breast cancer is one of the causes of major deterioration of health status of the patients. Pulmonary artery occlusion is most often a  consequence of venous thromboembolism; this condition is referred to as "pulmonary thromboembolism". Significantly less common cause of occlusion of the pulmonary artery branches can be embolism by a  cluster of tumor cells, accompanied by development of pulmonary tumor thrombotic microangiopathy. This paper reviews data on the etiology ...

  8. Early-onset dementias: diagnostic and etiological considerations


    Masellis, Mario; Sherborn, Kayla; Neto, Pedro Rosa; Sadovnick, Dessa A; Hsiung, Ging-Yuek R.; Black, Sandra E.; Prasad, Sadhana; Williams, Meghan; Gauthier, Serge


    This paper summarizes the body of literature about early-onset dementia (EOD) that led to recommendations from the Fourth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia. A broader differential diagnosis is required for EOD compared with late-onset dementia. Delays in diagnosis are common, and the social impact of EOD requires special care teams. The etiologies underlying EOD syndromes should take into account family history and comorbid diseases, such as cerebrovascu...

  9. Etiology of congenital hypothyroidism in Isfahan: Does it different?

    Directory of Open Access Journals (Sweden)

    Mahin Hashemipour


    Conclusion: Seven years of our experiences in CH screening program indicated that the etiology of CH in Isfahan, with a higher rate of CH, with a predominance of thyroid dyshormonogenesis is different from most of the studies world-wide and similar to other reports from Iran. The findings of the current study provide us baseline information for determination of CH pathogenesis in this region.

  10. [Multiple sclerosis: etiology, epidemiology, some questions of pathogenicity]. (United States)

    Chuprina, H M


    In the article the questions of ways of development of the dissipated sclerosis, as nosologies, are affected from the group of autoimmune diseases. Examined etiology, epidedemiologiya, separate links of pathogeny of the dissipated sclerosis. The analysis of multifaktors of his origin is conducted, with the detailed study of internal and external factors, marked on the important role of inherited predisposition, infectious and klimato-geograficheskogo factors in genesis of the dissipated sclerosis.

  11. Etiology, prevalence, and treatment of dry eye disease


    Gayton, Johnny


    Johnny L GaytonEyesight Associates, Warner Robins, GA, USAPurpose: This review article examines the prevalence, etiology, and current therapies of dry eye disease, with special focus on postmenopausal women.Method: A systematic literature search utilizing MEDLINE was conducted to identify peer-reviewed articles related to dry eye published prior to September 2008. The terms “dry eye” and “women” were searched in combination with one or more of the follo...

  12. Etiology and Outcome of Chronic Kidney Disease in Iranian Children

    Directory of Open Access Journals (Sweden)

    Neamatollah Ataei


    Full Text Available Background Considering the significant geographical and ethnical differences in pattern of incidence, etiology and outcome of chronic kidney disease (CKD, the present study aimed to assess the etiology and outcome of CKD in Iranian children. Materials and Methods In a cross-sectional study etiology and outcome of 372 children aged 3 months to 18 years with CKD was studied during the period 1991 –2014. Children (186 boys, 186 girls with Stage 3 to 5 CKDs, defined as a glomerular filtration rate below 60 ml/min per 1.73 m2body surface area, were identified. Results Etiology was congenital anomalies of the kidney and urinary tract in 125 (33.60%, cystic/ hereditary/ congenital diseases in 91 (24.46%, glomerulopathy in 73(19.62%, and cause unknown in 71 (19.09% patients. Forty-eight (13.22% were on conservative treatment, 174(47.93% had end-stage renal disease (ESRD with chronic hemodialysis, 24 (6.61% were on continuous ambulatory peritoneal dialysis. Sixty-eight (18.74% underwent on renal transplant which was successful in 52 (14.33% patients but was associated with abnormal renal function in 16(4.41% children. Finally, 49 (13.50% patients died. Conclusion A large number of children developed CKD secondary to congenital anomalies of the kidney and urinary tract. Planning for screening, early detection and instituting timely treatment of preventable causes could lead to a lower incidence of CKD in this group of children.

  13. Postcoital Bleeding: A Review on Etiology, Diagnosis, and Management

    Directory of Open Access Journals (Sweden)

    Christopher M. Tarney


    Full Text Available Postcoital bleeding refers to spotting or bleeding that occurs after intercourse and is not related to menstruation. The prevalence of postcoital bleeding ranges from 0.7 to 9.0 percent of menstruating women. There are multiple etiologies for this common complaint in which most are benign such as cervicitis or cervical polyps. However, the most serious cause of postcoital bleeding is cervical cancer. There are currently no recommendations from governing bodies such as the American College of Obstetricians and Gynecologists on evaluating and treating women with postcoital bleeding. The purpose of this paper is to discuss the common causes of postcoital bleeding, the etiologies of postcoital bleeding, and the likelihood that malignancy is the underlying cause. After an extensive literature review, we compiled a paper illustrating the key concepts a practitioner should know when it comes to postcoital bleeding. Finally, this review will conclude with treatment options for women who are found to have an identifiable source for their bleeding and a discussion on the natural history of postcoital bleeding in women who are found to have no identifiable etiology on evaluation.

  14. Etiology of Acute Bacterial Meningitis in Iran: a Systematic Review. (United States)

    Ghotaslou, Reza; Yeganeh-Sefidan, Fatemeh; Salahi-Eshlaqi, Behnaz; Ebrahimzadeh-Leylabadlo, Hamed


    Acute bacterial meningitis (ABM) is one of the most severe infectious diseases, causing neurologic sequel, and a case fatality rate of 20-30%. The aim of this paper was to summarize the main causes of ABM in Iran. We searched the data for relevant articles using meningitis, etiology, and Iran as search terms. We found 23 papers for inclusion in the review that focused specifically on the ABM, addressing etiology and acute meningitis. Finally, during the 23 years, a total of 18163 cases were recorded, and 1074 cases of which met the criteria for bacterial meningitis. The most common agent associated with bacterial meningitis was S. pneumoniae, followed by H. influenzae, Enterobacter spp., N. meningitidis, and group B streptococcus. The total incidence of ABM during 1991 to 2002 was higher than during 2003-2013. S. pneumoniae still remains a main cause of bacterial meningitis. For improved outcomes, studies are needed to further clarify the etiology of meningitis in Iran, explore simple, accurate, and practical diagnostic tools as PCR, and investigate the most appropriate specific and supportive interventions to manage and prevent meningitis as vaccination.

  15. Delinquent peer affiliation as an etiological moderator of childhood delinquency. (United States)

    Burt, S A; Klump, K L


    Prior research has indicated that affiliation with delinquent peers activates genetic influences on delinquency during adolescence. However, because other studies have indicated that the socializing effects of delinquent peers vary dramatically across childhood and adolescence, it is unclear whether delinquent peer affiliation (DPA) also moderates genetic influences on delinquency during childhood. Method The current study sought to evaluate whether and how DPA moderated the etiology of delinquency in a sample of 726 child twins from the Michigan State University Twin Registry (MSUTR). The results robustly supported etiological moderation of childhood delinquency by DPA. However, this effect was observed for shared environmental, rather than genetic, influences. Shared environmental influences on delinquency were found to be several-fold larger in those with higher levels of DPA as compared to those with lower levels. This pattern of results persisted even when controlling for the overlap between delinquency and DPA. Our findings bolster prior work in suggesting that, during childhood, the association between DPA and delinquency is largely (although not solely) attributable to the effects of socialization as compared to selection. They also suggest that the process of etiological moderation is not specific to genetic influences. Latent environmental influences are also amenable to moderation by measured environmental factors.

  16. Pilonidal sinus disease - Etiological factors, pathogenesis and clinical features

    Directory of Open Access Journals (Sweden)

    Kazim Duman


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

  17. Influence of Intermediate Principal Stress on Undrained Behavior of Intact Clay under Pure Principal Stress Rotation

    Directory of Open Access Journals (Sweden)

    Jian Zhou


    Full Text Available This study presents the accumulations of the excess pore water pressure and the deformation as well as the noncoaxial behavior of intact soft clay subjected to pure principal stress rotation. Series of tests were carried out by using a dynamic hollow cylinder apparatus to highlight the influence of intermediate principal stress parameter b. It was found that the rate of PWP evolution was greatly influenced by b, but the influence was not monotonous. Specimens under the condition b = 0.75 had the highest accumulation of pore water pressure while under the condition b = 0 had the strongest resistance to the pore pressure generation. PWP accumulated mainly in the first cycle. The failure of specimens under principal stress rotation was controlled by the strain other than the pore pressure. The shear stiffness decreased more quickly with higher b value. The direction of the principal strain increment was strongly dependent on the principal stress increment orientation and less influenced by the b value and the number of cycles.

  18. Etiologies and treatments of abnormal blinking in children

    Directory of Open Access Journals (Sweden)

    Fen Du


    Full Text Available AIM:To analyze the etiology and effective therapies of abnormal blinking in children. METHODS:Children with abnormal blinking in our hospital were collected into the study from July 2012 to July 2015. The etiologies and corresponding treatments, according to the result of interrogation and examination of eyes were analyzed and the therapeutic effect was observed. RESULTS:Totally, 5 561 cases were collected into the study including 4 025 cases of male, 1536 cases of female, and the ratio was 2.6:1; age range was 2~14 years old with average age was(6.9±0.6years old. Etiologies were as follows:refractive(hyperopia, myopia and astigmatism2054 cases(36.9%; allergic conjunctivitis 1670 cases(30.0%; children dry eyes 982 cases(17.7%; partial eclipse children with 605 cases(10.9%; lead pollution 590 care(10.6%; strabismus 156 cases(2.8%; trichiasis with 129 cases(2.3%; trace element deficiency(calcium, iron, zinc, magnesium and copperfor a total of 102 cases(1.8%; chalazion 37 cases(0.7%; keratitis and corneal injury 24 cases(0.4%, palpebral dermatitis, allergic rhinitis, dermatitis, 37 cases(0.7%; conjunctival stone 8 cases(0.1%; tic disorders of 30 patients(0.5%, asthenopia of 6 cases(0.1%; lacrimal duct obstruction, dacryocystitis 9 cases(0.1%. The etiologies of children with abnormal blinking were not caused by single factors. After examination, its etiology in children was resulted by one kind or more of a combination of factors. All of them were carried out ear acupoint application therapy and psychological intervention therapy, and symptomatic treatment was given after finding the cause. Following all the cases 1~3mo, blinking can obviously relieve,in which 4 560 cases(81.9%were cured, 5286 cares were improved, the recovery(including curedwas 95.1%; slightly improved(including relapse cases102 cases(1.8%; No significant changes in 173 cases(3.1%. CONCLUSION:A variety of causes that can lead to children's abnormal blinking, refractive error

  19. Etiology of convulsions in neonatal and infantile period. (United States)

    Kurokawa, T; Yokata, K; Takashima, S; Nambu, Y; Hanai, T


    1) Etiology of convulsions starting prior to two years of age was discussed in 418 cases. Neonatal seizures before 30 days old appeared in 86 cases (53 boys and 33 girls). Three hundred and thirty-two patients (172 boys and 160 girls) had convulsions in infancy. Twelve patients (9 boys and 3 girls) suffered from convulsions both in neonatal and infantile period. 2)Etiology of convulsions was prenatal in 67 cases (16%), natal in 49 cases (12%), postnatal in 158 cases (38%) and unknown in 144 cases (34%). Prenatal factors consisted of cerebral malformation (23 cases, 6%), associated physical minor anomaly such as cataracta or finger abomaly (11 cases, 3%), abnormal pernatal history (8 cases, 2%), congenital heart disease 3) cases, 1%), tuberose scleorsis (7 cases, 2%) and positive family history (13 cases, 3%). Postnatal causes included hypocalcemia or hypoglycemia (7 cases, 2%), brain tumors (3 cases, 1%), breath-holding spells (21 cases, 5%), febrile convulsion (44 cases, 11%), bathing (3 cases, 1%), afebrile colds (3 cases, 1%), purulent meningitis (17 cases, 4%), DPT immunization (10 cases 2%), vaccination (7 cases, 2%) and acute hemiplegia (10 cases, 2%). The group of unknown etiology were as fns (38 cases, 9%), epilepsy associated with interictal signs (23 cases, 6%), benign infantile convulsions (57 cases, 14%), neonatal convulsion of unknown etiology (12 cases, 3%) and miscellaneous categories (4%). 3) Pregnancy was abnormal in 53% of cases with cerebral malformation. Asphyxia at birth was noted in 43% of patients with tuberose sclerosis and in 35% of congenital cerebral abomaly. 4) Pneumoencephalographic examinations revealed midline anomaly in 50% of cerebral malformation. It was abnormal in all cases with tuberose sclerosis, head injury and epilepsy with interseizure neurological signs. 5) There were no correlations between the seizure pattern and the etiology in neonatal convulsion. In infancy, focal-unilateral convulsions and infantile spasms were

  20. Revisiting the Etiology of Hemifacial Microsomia / Retomando la etiología de la microsomía hemifacial


    Eseonu, Chijioke O.; University of Pittsburgh / Pontificia Universidad Javeriana; Vieira, Alexandre R.; University of Pittsburgh


    Background: Hemifacial microsomia (HM) is one of the most common congenital facial malformations of newborns worldwide. Despite its prevalence, little is known about its etiology. Features of HM vary among different reports in the literature, affecting ears, mouth, and mandible on one or both sides. Purpose and Methods: We performed a systematic literature review to determine if there is new evidence regarding the pathological origins of HM. During a seven-month period (September 2010-April 2...

  1. Severe Drug Hypersensitivity Reactions: Clinical Pattern, Diagnosis, Etiology and Therapeutic Options. (United States)

    Paulmann, Maren; Mockenhaupt, Maja


    Severe cutaneous adverse reactions (SCAR) are known for a high morbidity and mortality. They may be life-threatening for the affected patient and difficult to accomplish for the patient's family and the treating physician. Such conditions include not only bullous reactions like toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), but also acute generalized exanthematous pustulosis (AGEP) and drug reaction with eosinophilia and systemic symptoms (DRESS). Since clinical pattern, etiology, prognosis and treatment differ among these severe skin reactions, a clear diagnosis based on a comprehensive clinical examination, skin biopsy, and specific laboratory tests is necessary. Because most of these reactions are caused by drug intake, a thorough history of medication use has to be obtained. However, there are cases with an infectious or idiopathic cause. In any case it is crucial to identify the most likely cause and rapidly discontinue the inducing agent, if a drug cause is suspected. This is associated with the patient`s prognosis which is often poor for bullous reaction. In addition, patient's age, underlying conditions, and the extent of skin detachment play a major role in terms of prognosis. Severe cutaneous adverse reactions are T-cell-mediated reactions, and certain alleles of human leukocyte antigens (HLA) are involved in the activation of T-cells with cytotoxic effect. The therapeutic options depend on the clinical diagnosis. For all reactions a symptomatic and adequate supportive therapy is necessary, in some cases a systemic immunomodulating therapy can be useful. Copyright© Bentham Science Publishers; For any queries, please email at

  2. A study on etiologic agents and clinical manifestations of dermatophytosis in Yazd, Iran (United States)

    Rashidian, S; Falahati, M; Kordbacheh, P; Mahmoudi, M; Safara, M; Sadeghi Tafti, H; Mahmoudi, S; Zaini, F


    Background and Purpose: Dermatophytosis is one of the most common infections of skin, hair, and nails, caused by a group of keratinophilic fungi known as dermatophytes. Species identification of these fungi is of great significance from epidemiological and therapeutic points of view. The objective of the present study was to investigate dermatophytosis and its causative agents in patients, referring to the Central Mycology Laboratory of Yazd University of Medical Sciences, Yazd, Iran. Materials and Methods: In total, 139 clinically suspected cases of dermatophytosis were examined during 12 months from February 2014 to February 2015. Skin scrapings were assessed through direct microscopic examinations and culture studies. Dermatophyte isolates were identified based on colony morphology on potato dextrose agar and dermatophyte test medium, nutritional requirements, urease and hair perforation tests, and microscopic characteristics on slide cultures. Results: Dermatophytosis was mycologically confirmed in 26 (18.70%) out of 139 cases. Although there was a statistically insignificant difference between male and female subjects, men were dominantly affected. Infection was significantly common in the age group of ≤ 29 years (P<0.043). The most common clinical manifestation of dermatophytosis was tinea corporis (69.2%), followed by tinea cruris (15.4%), tinea manuum (11.5%), and tinea pedis (3.8%). Trichophyton mentagrophytes complex was the main etiologic agent (38.5%), followed by T. rubrum (23%), T. violaceum (15.5%), T. verrucosum (11.5%), Microsporum canis (7.7%), and Epidermophyton floccosum (3.8%). Conclusion: In comparison with previous research, epidemiology of dermatophytosis has changed in Yazd over the past decades. Therefore, periodical investigations on the epidemiological aspects of this infection are required for efficient control and prevention of this cutaneous dermatophytic disease. PMID:28681000

  3. Incidence and etiology of hospitalized acute respiratory infections in the Egyptian Delta. (United States)

    Rowlinson, Emily; Dueger, Erica; Mansour, Adel; Azzazy, Nahed; Mansour, Hoda; Peters, Lisa; Rosenstock, Summer; Hamid, Sarah; Said, Mayar M; Geneidy, Mohamed; Abd Allah, Monier; Kandeel, Amr


    Acute Respiratory Infections (ARI) are responsible for nearly two million childhood deaths worldwide. A limited number of studies have been published on the epidemiology of viral respiratory pathogens in Egypt. A total of 6113 hospitalized patients >1 month of age with suspected ARI were enrolled between June 23, 2009 and December 31, 2013. Naso- and oropharyngeal specimens were collected and tested for influenza A and B, respiratory syncytial virus, human metapneumovirus, adenovirus, and parainfluenza viruses 1-3. Blood specimens from children 1-11 months were cultured and bacterial growth was identified by polymerase chain reaction. Results from a healthcare utilization survey on the proportion of persons seeking care for ARI was used to calculate adjusted ARI incidence rates in the surveillance population. The proportion of patients with a viral pathogen detected decreased with age from 67% in patients age 1-11 months to 19% in patients ≥65 years of age. Influenza was the dominant viral pathogen detected in patients ≥1 year of age (13.9%). The highest incidence rates for hospitalized ARI were observed in children 1-11 months (1757.9-5537.5/100 000 population) and RSV was the most commonly detected pathogen in this age group. In this study population, influenza is the largest viral contributor to hospitalized ARIs and children 1-11 months of age experience a high rate of ARI hospitalizations. This study highlights a need for surveillance of additional viral pathogens and alternative detection methods for bacterial pathogens, which may reveal a substantial proportion of as yet unidentified etiologies in adults. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  4. Bacterial Etiology of Lower Respiratory Tract Infections and Their Antimicrobial Susceptibility. (United States)

    Uzoamaka, Maduakor; Ngozi, Onyemelukwe; Johnbull, Ogboi Sonny; Martin, Ohanu


    Lower respiratory tract infection (LRTI) is one of the common major health problems in Nigeria causing morbidity and mortality. The study was conducted to determine the current trends of bacterial etiology of LRTIs among patients who attended the University of Nigeria Teaching Hospital (UNTH) and their antimicrobial susceptibility profile with special interest on pandrug resistance. The study was conducted between February 2014 and June 2016 in the bacteriology laboratory of UNTH. Sputum samples of 954 patients with suspected LRTIs were received, after obtaining patients' informed consent and ethical clearance from the UNTH. The samples were collected and processed according to standard laboratory procedures. The mean age of the patients was 42.6 ± 16.8 years. Of the total 954 sputum samples, 431 (45.2%) were positive for micro-organisms. A single, unique pathogen was recovered in 415 patients (96.3%), and 16 (3.7%) were polymicrobial. The most predominant single pathogen was Klebsiella pneumoniae, 215 (49.9%), and the most prevalent bacterial combination was Klebsiella spp and Pseudomonas aeruginosa, 6 (1.4%). Antimicrobial susceptibility testing shows that most isolates of K pneumoniae were susceptible to imipenem (94.8%). Among the bacteria, Escherichia coli (13.3%) ranked highest, followed by P aeruginosa (12.5%), and the least was Staphylococcus aureus (2.1%). Knowledge of the diversity of pathogens responsible for LRTIs and their susceptibility patterns to antibiotics, as well as antibiotic resistance surveillance, are important in the effective management of LRTI with prompt clinical and laboratory diagnosis along with appropriate treatment strategies. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  5. High-resolution magnetic resonance imaging reveals hidden etiologies of symptomatic vertebral arterial lesions. (United States)

    Chung, Jong-Won; Kim, Beom Joon; Choi, Byung Se; Sohn, Chul Ho; Bae, Hee-Joon; Yoon, Byung-Woo; Lee, Seung-Hoon


    Symptomatic intracranial vertebral artery (VA) disease has various clinical features and poor neurological outcomes. The disease is believed to result from atherosclerotic stenosis, occlusion, or spontaneous VA dissection. The underlying histopathology of symptomatic intracranial VA disease has only been studied at postmortem, and no in vivo imaging investigation has been conducted despite the increased sophistication of imaging techniques. The authors performed high-resolution magnetic resonance imaging (HR-MRI) of intracranial vertebral arteries in 9 patients, suspected of a VA pathology by magnetic resonance imaging (MRI), magnetic resonance angiography, and digital subtraction angiography. HR-MRI allowed the authors to determine the following: (1) atherosclerotic plaque is composed of a large lipid core with intraplaque hemorrhage and calcification, (2) nonstenotic atherosclerosis exhibits diffuse vessel wall thickening and plaque protruding toward perforating arteries, and (3) spontaneous VA dissection exhibits large intramural hematoma in a false lumen with complete occlusion of the true lumen. In addition, VA hypoplasia was easily differentiated from atherosclerotic stenosis, by direct visualization of a narrow lumen diameter without arterial wall thickening. Furthermore, etiologic diagnoses based on classical MRI, angiography, and digital subtraction angiography were changed in 3 patients after HR-MRI. Additional information on plaque stability, indicating the possibility of unstable plaque, was found in 4 patients. The application of HR-MRI in stroke patients with VA pathologies enabled the authors to determine the underlying pathophysiologies. These findings could be used to improve risk stratification and treatment decision making in symptomatic intracranial VA disease. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  6. Pre-admission antibiotics for suspected cases of meningococcal disease. (United States)

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


    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

  7. Suspected vitreous seeding of uveal melanoma: relevance of diagnostic vitrectomy. (United States)

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


    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

  8. Cost analysis of inappropriate treatments for suspected dermatomycoses

    Directory of Open Access Journals (Sweden)

    Emanuela Fiammenghi


    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

  9. Principal components analysis of Jupiter VIMS spectra (United States)

    Bellucci, G.; Formisano, V.; D'Aversa, E.; Brown, R.H.; Baines, K.H.; Bibring, J.-P.; Buratti, B.J.; Capaccioni, F.; Cerroni, P.; Clark, R.N.; Coradini, A.; Cruikshank, D.P.; Drossart, P.; Jaumann, R.; Langevin, Y.; Matson, D.L.; McCord, T.B.; Mennella, V.; Nelson, R.M.; Nicholson, P.D.; Sicardy, B.; Sotin, Christophe; Chamberlain, M.C.; Hansen, G.; Hibbits, K.; Showalter, M.; Filacchione, G.


    During Cassini - Jupiter flyby occurred in December 2000, Visual-Infrared mapping spectrometer (VIMS) instrument took several image cubes of Jupiter at different phase angles and distances. We have analysed the spectral images acquired by the VIMS visual channel by means of a principal component analysis technique (PCA). The original data set consists of 96 spectral images in the 0.35-1.05 ??m wavelength range. The product of the analysis are new PC bands, which contain all the spectral variance of the original data. These new components have been used to produce a map of Jupiter made of seven coherent spectral classes. The map confirms previously published work done on the Great Red Spot by using NIMS data. Some other new findings, presently under investigation, are presented. ?? 2004 Published by Elsevier Ltd on behalf of COSPAR.

  10. Nonlinear principal component analysis and its applications

    CERN Document Server

    Mori, Yuichi; Makino, Naomichi


    This book expounds the principle and related applications of nonlinear principal component analysis (PCA), which is useful method to analyze mixed measurement levels data. In the part dealing with the principle, after a brief introduction of ordinary PCA, a PCA for categorical data (nominal and ordinal) is introduced as nonlinear PCA, in which an optimal scaling technique is used to quantify the categorical variables. The alternating least squares (ALS) is the main algorithm in the method. Multiple correspondence analysis (MCA), a special case of nonlinear PCA, is also introduced. All formulations in these methods are integrated in the same manner as matrix operations. Because any measurement levels data can be treated consistently as numerical data and ALS is a very powerful tool for estimations, the methods can be utilized in a variety of fields such as biometrics, econometrics, psychometrics, and sociology. In the applications part of the book, four applications are introduced: variable selection for mixed...

  11. Integrating Data Transformation in Principal Components Analysis

    KAUST Repository

    Maadooliat, Mehdi


    Principal component analysis (PCA) is a popular dimension reduction method to reduce the complexity and obtain the informative aspects of high-dimensional datasets. When the data distribution is skewed, data transformation is commonly used prior to applying PCA. Such transformation is usually obtained from previous studies, prior knowledge, or trial-and-error. In this work, we develop a model-based method that integrates data transformation in PCA and finds an appropriate data transformation using the maximum profile likelihood. Extensions of the method to handle functional data and missing values are also developed. Several numerical algorithms are provided for efficient computation. The proposed method is illustrated using simulated and real-world data examples.

  12. Reinvention and the Principal-Agent Model

    Directory of Open Access Journals (Sweden)

    J. Ramón Gil García


    Full Text Available Existe una interesante polémica en el sector público, derivada de las tensiones existentes entre desempeño y flexibilidad administrativa por un lado, y rendición de cuentas y control, por el otro. El propósito de este artículo es discutir la utilidad del modelo agente principal para un mejor entendimiento de las tensiones entre desempeño y rendición de cuentas, así como analizar las similitudes y contradicciones de esta perspectiva teórica en comparación con el movimiento de “reinvención del gobierno” de la década de los noventa en Estados Unidos.

  13. Study of the Genetic Etiology of Primary Ovarian Insufficiency: FMR1 Gene (United States)

    Barasoain, Maitane; Barrenetxea, Gorka; Huerta, Iratxe; Télez, Mercedes; Criado, Begoña; Arrieta, Isabel


    Menopause is a period of women’s life characterized by the cessation of menses in a definitive way. The mean age for menopause is approximately 51 years. Primary ovarian insufficiency (POI) refers to ovarian dysfunction defined as irregular menses and elevated gonadotrophin levels before or at the age of 40 years. The etiology of POI is unknown but several genes have been reported as being of significance. The fragile X mental retardation 1 gene (FMR1) is one of the most important genes associated with POI. The FMR1 gene contains a highly polymorphic CGG repeat in the 5′ untranslated region of exon 1. Four allelic forms have been defined with respect to CGG repeat length and instability during transmission. Normal (5–44 CGG) alleles are usually transmitted from parent to offspring in a stable manner. The full mutation form consists of over 200 repeats, which induces hypermethylation of the FMR1 gene promoter and the subsequent silencing of the gene, associated with Fragile X Syndrome (FXS). Finally, FMR1 intermediate (45–54 CGG) and premutation (55–200 CGG) alleles have been principally associated with two phenotypes, fragile X tremor ataxia syndrome (FXTAS) and fragile X primary ovarian insufficiency (FXPOI). PMID:27983607

  14. Principal components regression of body measurements in five ...

    African Journals Online (AJOL)

    Principal component regression can be used to classify independent and informative variables thereby eliminating redundant information for the purpose of reducing costs of chicken genetic programmes. Keywords: Body weight, Biometric traits, Principal component, Orthogonal, Eigenvalues and Linear measurement ...

  15. L'analyse en composantes principales : principes et applications


    Palm, Rodolphe


    This note describes the principles of principal component analysis and gives two examples. Cette note décrit les principes de l'analyse en composantes principales et donne deux exemples numériques d'application.

  16. Principals' and Teachers' Views of Spirituality in Principal Leadership in Three Primary Schools (United States)

    Gibson, Alaster


    This article discusses key findings from my doctoral research involving a qualitative case study inquiring into the lived experiences of spirituality in principal leadership and its influence on teachers and their teaching within three public primary school contexts in New Zealand. Spirituality is understood in this article as a complex and…

  17. Principals and the Human Condition: Reflections of an Elementary School Principal. (United States)

    Latimer, Milree H.

    Educational leaders must be perceived to act consistently and with integrity. When leaders are conscious of beliefs and values, they will act spontaneously in a consistent manner, and their actions, embedded in their beliefs, will have an underlying harmony. School principals must embrace the concept of empowerment and dignity of the individual…

  18. A Preliminary Examination of the Impact of a Structured Principal Network on Principal Burnout (United States)

    Tillery, Denise Artus


    This study examined the extent to which participation in a formal network has on a principal's personal perception of burnout as measured by the Maslach Burnout Inventory for Educators (MBI-E). The MBI-E consists of 22 questions with responses indicated on a 7 point Likert scale ranging from 0-6. It measures three constructs of emotional…

  19. Teacher and Principal Perceptions of How Principal Transformational and Instructional Leadership Behaviors Relate to Student Achievement (United States)

    Steele, Gayle


    Because of public concern over the effectiveness of our schools, a new evaluation system was put in place to hold principals and teachers directly accountable for student academic achievement. Part of this evaluation included student performance on state assessments. The purpose of this qualitative study sought to examine how the transformation…

  20. [Suspected pathogenic mutation identified in two cases with oculocutaneous albinism]. (United States)

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


    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.