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Sample records for swept-field differential aspiration

  1. Osseous differentiation in cystosarcoma phyllodes - diagnosed by fine needle aspiration cytology

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    Krishnamurthy Jayashree

    2010-01-01

    Full Text Available Osseous differentiation within a phyllodes tumor is extremely rare. Cytological and histological findings of a case of malignant phyllodes tumor with osseous differentiation are presented. A 45-year-old female had a malignant phyllodes tumor with osseous stroma diagnosed by fine needle aspiration cytology. The cytological findings were representative of the histological features. The diagnosis of these tumors preoperatively is important in planning the most appropriate treatment. It is also important to follow up these patients postoperatively for long periods for recurrence and metastasis.

  2. Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration: Differentiating Pneumonia From Pneumonitis.

    Science.gov (United States)

    Lascarrou, Jean Baptiste; Lissonde, Floriane; Le Thuaut, Aurélie; Bachoumas, Konstantinos; Colin, Gwenhael; Henry Lagarrigue, Matthieu; Vinatier, Isabelle; Fiancette, Maud; Lacherade, Jean Claude; Yehia, Aihem; Joret, Aurélie; Lebert, Christine; Bourdon, Sandra; Martin Lefèvre, Laurent; Reignier, Jean

    2017-08-01

    To determine the proportion of patients with documented bacterial aspiration pneumonia among comatose ICU patients with symptoms suggesting either bacterial aspiration pneumonia or non-bacterial aspiration pneumonitis. Prospective observational study. University-affiliated 30-bed ICU. Prospective cohort of 250 patients admitted to the ICU with coma (Glasgow Coma Scale score ≤ 8) and treated with invasive mechanical ventilation. None. The primary outcome was the proportion of patients with microbiologically documented bacterial aspiration pneumonia. Patients meeting predefined criteria for aspiration syndrome routinely underwent telescopic plugged catheter sampling during bronchoscopy before starting probabilistic antibiotic treatment. When cultures were negative, the antibiotic treatment was stopped. Of 250 included patients, 98 (39.2%) had aspiration syndrome, including 92 before mechanical ventilation discontinuation. Telescopic plugged catheter in these 92 patients showed bacterial aspiration pneumonia in 43 patients (46.7%). Among the remaining 49 patients, 16 continued to receive antibiotics, usually for infections other than pneumonia; of the 33 patients whose antibiotics were discontinued, only two subsequently showed signs of lung infection. In the six patients with aspiration syndrome after mechanical ventilation, and therefore without telescopic plugged catheter, antibiotic treatment was continued for 7 days. Mechanical ventilation duration, ICU length of stay, and mortality did not differ between the 43 patients with bacterial aspiration pneumonia and the 49 patients with non-bacterial aspiration pneumonitis. The 152 patients without aspiration syndrome did not receive antibiotics. Among comatose patients receiving mechanical ventilation, those without clinical, laboratory, or radiologic evidence of bacterial aspiration pneumonia did not require antibiotics. In those with suspected bacterial aspiration pneumonia, stopping empirical antibiotic therapy

  3. Peripheral blood aspirates overexpressing IGF-I via rAAV gene transfer undergo enhanced chondrogenic differentiation processes.

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    Frisch, Janina; Orth, Patrick; Rey-Rico, Ana; Venkatesan, Jagadeesh Kumar; Schmitt, Gertrud; Madry, Henning; Kohn, Dieter; Cucchiarini, Magali

    2017-11-01

    Implantation of peripheral blood aspirates induced towards chondrogenic differentiation upon genetic modification in sites of articular cartilage injury may represent a powerful strategy to enhance cartilage repair. Such a single-step approach may be less invasive than procedures based on the use of isolated or concentrated MSCs, simplifying translational protocols in patients. In this study, we provide evidence showing the feasibility of overexpressing the mitogenic and pro-anabolic insulin-like growth factor I (IGF-I) in human peripheral blood aspirates via rAAV-mediated gene transfer, leading to enhanced proliferative and chondrogenic differentiation (proteoglycans, type-II collagen, SOX9) activities in the samples relative to control (reporter rAAV-lacZ) treatment over extended periods of time (at least 21 days, the longest time-point evaluated). Interestingly, IGF-I gene transfer also triggered hypertrophic, osteo- and adipogenic differentiation processes in the aspirates, suggesting that careful regulation of IGF-I expression may be necessary to contain these events in vivo. Still, the current results demonstrate the potential of targeting human peripheral blood aspirates via therapeutic rAAV transduction as a novel, convenient tool to treat articular cartilage injuries. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  4. Differential Cell Count of Bone Marrow Aspirates in Steady-state ...

    African Journals Online (AJOL)

    Bone marrow was aspirated from the posterior superior iliac spine. Slides were stained with MayGrünwald-Giemsa stain. Proportions of erythroid, myeloid, lymphoid and megakaryocytic cells out of 250 nucleated bone marrow cells were determined. Results: Steady state mean packed cell volume (PCV) was 0.2 ± 0.017 L/L.

  5. Huge pelvic parachordoma: fine needle aspiration cytology and histological differential diagnosis

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    Mona A. Kandil

    2012-10-01

    Full Text Available Parachordoma is an extremely rare soft tissue tumor of unknown lineage. Parachordoma develops most often on the extremities. Only 2 cases have been reported as pelvic parachordoma. A 46-year old Egyptian woman with a huge painful pelvic mass was found to have a parachordoma with ectopic pelvic right kidney. There is only one report in the literature of fine needle aspiration cytology in this setting. The microscopic picture of parachordoma is not new to pathologists but the gross picture of this rare tumor has not previously been published; not even in the World Health Organization classification of soft tissues tumors. Diagnosis was confirmed by immuno-histochemistry. The patient is in good clinical condition without any evidence of recurrence or metastasis after 84 months of follow up.

  6. Cytologic Characteristics of Thymic Adenocarcinoma with Enteric Differentiation: A Study of Four Fine-Needle Aspiration Specimens

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    Ah-Young Kwon

    2017-09-01

    Full Text Available Thymic adenocarcinoma is extremely rare. Although its histologic features have been occasionally reported, a lack of description of the cytologic features has hampered the prompt and accurate diagnosis of this condition. Herein, we describe the cytologic findings and histology of four aspiration cytology specimens of thymic adenocarcinoma. The specimens were obtained from primary tumors, metastatic lymph nodes, and pericardial effusions. All four specimens showed three-dimensional glandular clusters with a loss of polarity and nuclear overlapping. One specimen had extensive extracellular mucinous material. Three specimens contained tumor cells with intracytoplasmic vacuoles. While the specimen with extracellular mucin showed relatively mild cytologic atypia, other specimens exhibited more atypical cytologic changes: irregular nuclear membranes, a coarse chromatin pattern, and prominent nucleoli. The cytologic features were correlated with the histologic features in each case of enteric type thymic adenocarcinoma. The differential diagnosis included other thymic carcinomas, yolk sac tumors, and metastatic adenocarcinoma from the lung or colorectum.

  7. Aspiration pneumonia

    Science.gov (United States)

    Anaerobic pneumonia; Aspiration of vomitus; Necrotizing pneumonia; Aspiration pneumonitis ... The type of bacteria that caused the pneumonia depends on: Your ... facility, for example) Whether you were recently hospitalized ...

  8. Two-miRNA classifiers differentiate mutation-negative follicular thyroid carcinomas and follicular thyroid adenomas in fine needle aspirations with high specificity

    DEFF Research Database (Denmark)

    Stokowy, Tomasz; Wojtas, Bartosz; Jarzab, Barbara

    2016-01-01

    , since no single miRNA had satisfactory predictive power, classifiers comprising two differentially expressed miRNAs were designed with the aim to improve the classification. Six two-miRNA classifiers were established and quantitative polymerase chain reaction validated in fine needle aspiration samples...

  9. Risk factors differentiating mild/moderate from severe meconium aspiration syndrome in meconium-stained neonates.

    Science.gov (United States)

    Choi, Woneui; Jeong, Heejeong; Choi, Suk-Joo; Oh, Soo-Young; Kim, Jung-Sun; Roh, Cheong-Rae; Kim, Jong-Hwa

    2015-01-01

    The aim of this study was to compare the risk factors associated with mild/moderate meconium aspiration syndrome (MAS) with those associated with severe in meconium-stained term neonates. Consecutive singleton term neonates (n=671) with meconium staining at birth from all deliveries (n=14,666) in our institution from January 2006 to December 2012 were included. Both maternal and neonatal variables were examined. Among the study population, for women who underwent the trial of labor (n=644), variables associated with labor were also examined. These variables were compared between the mild/moderate MAS group, the severe MAS group, and the MAS-absent group. MAS developed in 10.6% (71/671) of neonates with meconium staining at birth. Among the neonates with MAS, 81.7% had mild MAS, 5.6% had moderate MAS, and 12.7% had severe MAS. The presence of minimal variability was significantly increased in both the mild/moderate and the severe MAS groups. The frequencies of nulliparity, fetal tachycardia, and intrapartum fever were significantly increased in the mild/moderate MAS group, but not in the severe MAS group. While a longer duration of the second stage of labor was significantly associated with mild/moderate MAS, severe MAS was associated with a shorter duration of the second stage. Notably, low mean cord pH (7.165 [6.850-7.375]) was significantly associated with mild/moderate MAS, but not with severe MAS (7.220 [7.021-7.407]) compared with the absence of MAS (7.268 [7.265-7.271]). Our data suggest the development of severe MAS is not simply a linear extension of the same risk factors driving mild/moderate MAS.

  10. Bone marrow aspiration

    Science.gov (United States)

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  11. Strategic Aspirations

    DEFF Research Database (Denmark)

    Christensen, Lars Thøger; Morsing, Mette; Thyssen, Ole

    2016-01-01

    aspirations, in other words, have exploratory and inspirational potential—two features that are highly essential in complex areas such as sustainability and CSR. This entry takes a communicative focus on strategic aspirations, highlighting the value of aspirational talk, understood as ideals and intentions...

  12. Bone marrow aspiration

    Science.gov (United States)

    Bain, B

    2001-01-01

    Bone marrow aspiration biopsies are carried out principally to permit cytological assessment but also for immunophenotypic, cytogenetic, molecular genetic, and other specialised investigations. Often, a trephine biopsy is carried out as part of the same procedure. Bone marrow aspirations should be carried out by trained individuals who are aware of the indications, contraindications, and hazards of the procedure. They should follow a standard operating procedure. The operator should have made an adequate assessment of clinical and haematological features to ensure both that appropriate indications exist and that all relevant tests are performed. For the patient's comfort and safety, the posterior iliac crest is generally the preferred site of aspiration. Films of aspirated marrow and, when appropriate, films of crushed particles should be made and labelled. Once thoroughly dry, films should be fixed and stained. As a minimum, a Romanowsky stain and a Perls' stain are required. A cover slip should be applied. The bone marrow films should be assessed and reported in a systematic manner so that nothing of importance is overlooked, using a low power, then intermediate, then high power objective. A differential count should be performed. An interpretation of the findings, in the light of the clinical and haematological features, should be given. The report should be signed or computer authorised, using a secure password, and issued in a timely manner. Key Words: bone marrow aspirate • haematological diagnosis PMID:11533068

  13. Application of polymerase chain reaction to differentiate herpes simplex virus 1 and 2 serotypes in culture negative intraocular aspirates

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    Shyamal G

    2005-01-01

    Full Text Available Purpose: To standardize and apply a polymerase chain reaction (PCR on the glycoprotein D gene to differentiate Herpes simplex virus (HSV 1 & 2 serotypes in culture negative intraocular specimens. Methods: Twenty-one intraocular fluids collected from 19 patients were subjected to cultures for HSV and uniplex PCR (uPCR for DNA polymerase gene. To differentiate HSV serotypes, as 1 & 2, a seminested PCR (snPCR targeting the glycoprotein D gene was standardised and applied onto 21 intraocular fluids. The specificity of the snPCR was verified by application onto ATCC strains of HSV 1 and 2, clinical isolates and DNA sequencing of the amplified products. All specimens were also tested for the presence of cytomegalovirus (CMV and varicella zoster virus (VZV by nucleic acid amplification methods. Results: Four of the 21 intraocular fluids were positive for HSV by uPCR. snPCR detected HSV in three additional specimens (total of seven specimens, and identified three as HSV 1 and four as HSV 2. DNA sequencing of PCR products showed 100% homology with the standard strains of HSV 1 and 2 respectively. None of the samples were positive in culture. Among the other patients, CMV DNA was detected in two and VZV DNA in five others. Conclusions: The standardized snPCR can be applied directly onto the culture negative specimens for rapid differentiation of HSV serotypes.

  14. Differential expression of galectin-3, CK19, HBME1, and Ret oncoprotein in the diagnosis of thyroid neoplasms by fine needle aspiration biopsy

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    Saleh Husain

    2009-01-01

    Full Text Available Background: Fine needle aspiration biopsy (FNAB is a common and excellent procedure for the evaluation of thyroid lesions that require surgical resection. At times, the FNAB diagnosis can be difficult, particularly of follicular-patterned lesions. Previous studies have shown that some immunohistochemical (IHC markers may be helpful in establishing more accurate diagnosis. In this study, our goal was to evaluate four of the recently investigated markers in differentiating benign from malignant thyroid nodules on FNABs. Materials and Methods: We performed IHC staining of galectin-3, Ret oncoprotein (Ret, HBME-1, and cytokeratin 19 (CK19, on cell block sections of thyroid FNAB cases that had corresponding surgical resections. They included 44 benign lesions (37 hyperplastic or cellular nodules, HN; and 7 follicular adenomas, FA and 27 malignant tumors (6 follicular carcinoma, FC; 19 classic papillary carcinoma, PTC; and 2 follicular variant of papillary carcinoma, FVPC. The stains were done according to the standard avidin-biotin-peroxidase method. Results: Statistical analysis showed that immunoexpression was significantly higher in the malignant group for all four markers. The sensitivity for positive expression for all benign lesions versus malignant tumors was as follows: 10/44 (22.7% versus 25/27 (92.6% for galectin-3; 14/44 (31.8% versus 23/27 (85% for Ret; 12/44 (27.3% versus 24/27 (88.8% for HBME-1; and 13/44 (29.5% versus 23/27 (85% for CK19. The sensitivity and specificity was highest for galectin-3 (92.6% and 77.3%, respectively followed by HMBE-1 (88.9% and 72.7%, respectively. When combining the markers′ expressions, the panel of galectin-3 + HBME-1 showed the highest sensitivity and specificity (90.7% and 75%, respectively, but this was, however, lower than galectin-3 alone (92.3% and 77.3%, respectively. Conclusion: We conclude that galectin-3 is the best single marker in differentiating benign from malignant thyroid lesions with

  15. Joint Aspiration (Arthrocentesis)

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    ... aspiration is diagnostic but it also can be therapeutic, helping to relieve pain and swelling caused by ... syringe. Sometimes, imaging with an X-ray or ultrasound is required to guide the aspiration needle to ...

  16. Meconium aspiration syndrome

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    ... this page: //medlineplus.gov/ency/article/001596.htm Meconium aspiration syndrome To use the sharing features on this page, please enable JavaScript. Meconium aspiration syndrome (MAS) refers to breathing problems that a newborn ...

  17. Poverty and aspirations failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.

    We develop a theoretical framework to study the psychology of poverty and ‘aspirations failure’, defined as the failure to aspire to one’s own potential. In our framework, rich and the poor persons share the same preferences and same behavioral bias in setting aspirations. We show that poverty can

  18. Aspiration and leadership

    NARCIS (Netherlands)

    Jagersma, P.K.

    2007-01-01

    Purpose - Management needs an aspiration as to how the company will work in the future. It needs a guide for corporate priorities. Any company - local or global - must be driven by an aspiration that energizes and motivates the company from top to bottom. Yet very few managers and executives know

  19. Aspiration and leadership

    NARCIS (Netherlands)

    Jagersma, P.K.

    2007-01-01

    Management needs an aspiration as to how the company will work in the future. It needs a guide for corporate priorities. Any company - local or global - must be driven by an aspiration that energizes and motivates the company from top to bottom. Yet very few managers and executives know how a

  20. Poverty and Aspirations Failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.

    2011-01-01

    We develop a theoretical framework to study the psychology of poverty and 'aspirations failure'. In our framework, the rich and the poor share the same preferences - and also a behavioral bias in setting aspirations. Greater downside risks imposed by poverty exacerbates the effects of this

  1. Aspiration of a cockroach

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    Albert Bousso

    2008-12-01

    Full Text Available It is described a five-month-old infant admitted to our pediatricintensive care unit who aspirated a cockroach. The cockroach wasremoved through bronchoscopy. The child arrived at the emergencyroom in cardiopulmonary arrest and despite full respiratory andcardiovascular support was discharged with evidence of severeneurological sequelae. It is known that this is the first case of acockroach aspiration in a five-month-old infant and reinforces thataspiration of an insect must be considered a possibility in patientswith an unidentified organic foreign body aspiration.

  2. Full Length Article Role of glypican-3 immunocytochemistry in differentiating hepatocellular carcinoma from metastatic carcinoma of the liver utilizing fine needle aspiration cytology

    International Nuclear Information System (INIS)

    Zaakook, M.; Abu Sinna, E.; Ayoub, M.; El-Sheikh, S.

    2013-01-01

    Purpose: Evaluation of the sensitivity and specificity of glypican3 (GPC3) in differentiating hepatocellular carcinoma (HCC) from metastatic carcinomas of the liver in cell block material. Patients and methods: Sixty cell blocks were prepared from liver FNAs performed in the radiodiagnosis department, National Cancer Institute, in the period between August 2011 and May 2012. Cases diagnosed as hepatocellular carcinoma, or metastatic carcinoma were included in the study. Cell block sections were stained with anti GPC-3. Sensitivity, specificity, and positive and negative predictive values, of GPC3 were calculated. The final diagnosis was based on the triple approach of clinical data, radiological findings, as well as cytomorphologic features aided by GPC-3 results. Results: 70% of cases were diagnosed as HCC, and 30% as metastatic carcinomas. 95.2% of HCC cases expressed GPC3. Poorly differentiated cases showed the highest GPC3 sensitivity (100%), followed by moderately differentiated cases (96.5%), while well differentiated cases expressed GPC3 in 90% of cases. 83.3% of metastatic carcinomas were negative for GPC3. In this study, sensitivity of GPC-3 in HCC was 95.2%, specificity was 83.3%, positive and negative predictive values were 93% and 88.2% respectively, and total accuracy was 91.7%. Conclusion: Immunocytochemical staining for GPC3 in cell block material is a highly sensitive and specific method capable of distinguishing HCC from the vast majority of metastatic carcinomas of the liver

  3. Report of a case of acinar cell carcinoma with its differential diagnosis on endoscopic ultrasound-guided fine-needle aspiration cytology

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    Misao Yoneda

    2014-01-01

    Full Text Available Acinar cell carcinomas (ACCs of the pancreas are a rare tumor accounting for only about 2% of all pancreas tumors. We report herein on this case and discuss how to distinguish ACCs from neuroendocrine tumors (NETs and solid pseudo-papillary tumor (SPTs morphologically and immunohistochemically. In cytological findings, the nuclear-cytoplasmic ratio was high, and the cytoplasm was granular, but zymogen granules were not evident. The nucleus was biased in location, assuming small circular and irregular forms. Chromatin was fine granular in shape and distributed nonuniformly, accompanied by evident nucleoli. Immunohistochemically was positive for β-catenin (cell membrane and part of nuclei, synaptophysin (focal, chromogranin A (focal and chymotrypsin were all positive. Although the cytological distinction of ACCs from NETs and SPTs is difficult, the nuclear chromatin pattern and nuclear inclusion bodies, pseudopapillary arrangement and hyaline globules seem to play an important role in the cytological differential diagnosis. Furthermore, not only enzymatic and neuroendocrine markers, but also antibodies to β-catenin, vimentin and so on seem to be useful in the differential diagnosis.

  4. Aspiration lung disorders in bovines: A case report and review

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    Anthony S. Shakespeare

    2012-04-01

    Full Text Available Lung aspiration disorders in bovines are invariably diagnosed as infectious aspiration pneumonias. There is a distinct differentiation between aspiration pneumonia and aspiration pneumonitis in humans that can be applied to bovines. The nature and quantity of the aspirate can result in differing pathogeneses which can require differing therapeutic approaches. Whilst blood gases were important in detecting and prognosticating lung problems, changes in barometric pressure with altitude have to be considered when interpreting partial pressures of oxygen. Anatomical differences in the lungs of bovines can explain why this species is more prone to certain pneumonic problems. Pulmonary physiotherapy is important in treating lung disorders in humans and should be considered as an adjunct therapy in bovine respiratory conditions. A case work-up was used to highlight some of the points discussed in this article.

  5. Small intestine aspirate and culture

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    ... ency/article/003731.htm Small intestine aspirate and culture To use the sharing features on this page, please enable JavaScript. Small intestine aspirate and culture is a lab test to check for infection ...

  6. Rising Aspirations Dampen Satisfaction

    Science.gov (United States)

    Clark, Andrew E.; Kamesaka, Akiko; Tamura, Teruyuki

    2015-01-01

    It is commonly believed that education is a good thing for individuals. Yet, its correlation with subjective well-being is most often only weakly positive, or even negative, despite the many associated better individual-level outcomes. We here square the circle using novel Japanese data on happiness aspirations. If reported happiness comes from a…

  7. Meconium aspiration syndrome

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    I.O. Bushtyreva

    2010-06-01

    Full Text Available Pathophysiological aspects of formation and development of meconium aspiration syndrome, as well as peculiaritues of its development based on data from native and foreign literature are studied. Special emphasis is pointed out to possible diagnostic techniques and prevention of syndrome

  8. Religious orientation and life aspirations.

    Science.gov (United States)

    Steffen, Patrick R; Clayton, Spencer; Swinyard, William

    2015-04-01

    The effects of religiosity on well-being appear to depend on religious orientation, with intrinsic orientation being related to positive outcomes and extrinsic orientation being related to neutral or negative outcomes. It is not clear, however, why intrinsic and extrinsic religiosity has the relationships they do. Self-determination theory may provide a useful framework of intrinsic and extrinsic aspirations that may help to answer this question. The purpose of the present study was to examine whether intrinsic and extrinsic religiosity would be related to intrinsic and extrinsic life aspirations. We hypothesized that intrinsic religiosity would be positively related to intrinsic life aspirations and negatively related with extrinsic life aspirations, and that extrinsic religiosity would be positively related to extrinsic life aspirations and negatively related to intrinsic aspirations, and that life aspirations would partially mediate the relationships between religious orientation and outcome. To study these hypotheses, a random national sample (total number of 425, average age of 52, 59 % female) completed the measures of religious orientation, life aspirations, affect, and life satisfaction. It was found that intrinsic religiosity was positively related to positive affect, life satisfaction, and intrinsic life aspirations and was negatively related to negative affect and extrinsic life aspirations. Extrinsic religiosity was positively related to extrinsic life aspirations and was not related to the intrinsic life aspirations. When both religious orientation and life aspiration variables were included together in the model predicting outcome, both remained significant indicating that religious orientation and life aspirations are independent predictors of outcome. In conclusion, although religious orientation and life aspirations are significantly related to each other and to outcome, life aspirations did not mediate the effects of religious orientation

  9. CSR as Aspirational Talk

    DEFF Research Database (Denmark)

    Christensen, Lars Thøger; Morsing, Mette; Thyssen, Ole

    2013-01-01

    Most writings on corporate social responsibility (CSR) treat lack of consistency between organizational CSR talk and action as a serious problem that needs to be eliminated. In this article, we argue that differences between words and action are not necessarily a bad thing and that such discrepan......Most writings on corporate social responsibility (CSR) treat lack of consistency between organizational CSR talk and action as a serious problem that needs to be eliminated. In this article, we argue that differences between words and action are not necessarily a bad thing...... and that such discrepancies have the potential to stimulate CSR improvements. We draw on a research tradition that regards communication as performative to challenge the conventional assumption that CSR communication is essentially superficial, as opposed to CSR action. In addition, we extend notions of organizational...... hypocrisy to argue that aspirational CSR talk may be an important resource for social change, even when organizations do not fully live up to their aspirations....

  10. Aspiration of Barium Contrast

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    Cristina Fuentes Santos

    2014-01-01

    Full Text Available The aspiration of barium contrast is a rare complication that may occur during studies of the digestive tract. Barium is an inert material that can cause anywhere from an asymptomatic mechanical obstruction to serious symptoms of respiratory distress that can result in patient death. We present the case of a 79-year-old male patient in whom we observed the presence of contrast medium residue in the lung parenchyma as an incidental finding during hospitalization. When the patient’s medical file was reviewed, images were found of a barium swallow study that the patient had undergone months earlier, and we were able to observe the exact moment of the aspiration of the contrast material. The patient had been asymptomatic since the test.

  11. Aspiration of Barium Contrast

    OpenAIRE

    Fuentes Santos, Cristina; Steen, Bárbara

    2014-01-01

    The aspiration of barium contrast is a rare complication that may occur during studies of the digestive tract. Barium is an inert material that can cause anywhere from an asymptomatic mechanical obstruction to serious symptoms of respiratory distress that can result in patient death. We present the case of a 79-year-old male patient in whom we observed the presence of contrast medium residue in the lung parenchyma as an incidental finding during hospitalization. When the patient’s medical fil...

  12. Liver CT-guided aspirative biopsies

    International Nuclear Information System (INIS)

    Santos, Gilda da Cunha; Carvalho, Leda Viegas de; Chojniak, Rubens; Morini, Sandra Regina

    1996-01-01

    Sixty-eight CT-guided aspirative biopsies of hepatic nodules were performed at A.C. Camargo Hospital, Sao Paulo, Brazil, from 1992 to 1995. The cases were distributed as follow: 44(64.7%) with a positive diagnosis for neoplastic cells, 6(8.8%) with a negative diagnosis, and 14 (20.5%) with insufficient material. Of the positive cases (primary neoplasias and metastases), the cytological diagnosis was achieved in 39 cases. There were 36 cases of carcinoma (7 hepato carcinomas, 18 adenocarcinomas, 1 small cell carcinoma and 10 cases of unspecified differentiation), 2 cases of melanoma and 1 case of melanoma and 1 case of sarcoma. The correlation with histopathological exams showed no false positive cases and concordance between cytological and histopathological diagnosis. The results demonstrate that CT-guided aspirative biopsy of hepatic nodules permits a rapid diagnosis of neoplastic lesions, especially for the evaluation of metastases. (author)

  13. ASPIRE: Added-value Sensing

    DEFF Research Database (Denmark)

    Anggorojati, Bayu; Cetin, Kamil; Mihovska, Albena D.

    2010-01-01

    FP7 ICT project ASPIRE is one of the coordinated European efforts to further the advancement of this technology, in the areas of enabling technology development for RFID. The focus of ASPIRE is on the design, development and adoption of an innovative, programmable, royalty-free, lightweight...

  14. Workload, Aspiration, and Fun

    DEFF Research Database (Denmark)

    Muhr, Sara Louise; Pedersen, Michael; Alvesson, Mats

    2012-01-01

    Contemporary working life highlights the challenge between exploitation and exploration both on a general and a more individual level. Here, we focus on the latter, and connect the critical debate regarding selfmanagement to March’s exploitation/exploration trade-off, as this forms a useful...... theoretical frame to understand how employees make sense of their self-management efforts. The employee is subjected to an individual responsibility to understand and manage an exploration of the self while handling the norms of self-exploitation that a self-management culture creates. Through an empirical...... study of a large group of management consultants, we explore how they perform and make sense of selfexploitation and self-exploration through three specific discourses: the discourse of workload, the discourse of aspiration, and the discourse of fun. Through these, the consultants try to identify...

  15. Aspiration dynamics of multi-player games in finite populations

    Science.gov (United States)

    Du, Jinming; Wu, Bin; Altrock, Philipp M.; Wang, Long

    2014-01-01

    On studying strategy update rules in the framework of evolutionary game theory, one can differentiate between imitation processes and aspiration-driven dynamics. In the former case, individuals imitate the strategy of a more successful peer. In the latter case, individuals adjust their strategies based on a comparison of their pay-offs from the evolutionary game to a value they aspire, called the level of aspiration. Unlike imitation processes of pairwise comparison, aspiration-driven updates do not require additional information about the strategic environment and can thus be interpreted as being more spontaneous. Recent work has mainly focused on understanding how aspiration dynamics alter the evolutionary outcome in structured populations. However, the baseline case for understanding strategy selection is the well-mixed population case, which is still lacking sufficient understanding. We explore how aspiration-driven strategy-update dynamics under imperfect rationality influence the average abundance of a strategy in multi-player evolutionary games with two strategies. We analytically derive a condition under which a strategy is more abundant than the other in the weak selection limiting case. This approach has a long-standing history in evolutionary games and is mostly applied for its mathematical approachability. Hence, we also explore strong selection numerically, which shows that our weak selection condition is a robust predictor of the average abundance of a strategy. The condition turns out to differ from that of a wide class of imitation dynamics, as long as the game is not dyadic. Therefore, a strategy favoured under imitation dynamics can be disfavoured under aspiration dynamics. This does not require any population structure, and thus highlights the intrinsic difference between imitation and aspiration dynamics. PMID:24598208

  16. The social contagion of aspirations

    DEFF Research Database (Denmark)

    Folmann, Birgitte

    2017-01-01

    succeed, making some progress along this path seems important and fuels their ongoing aspiration for the good life. Having a ‘life style’ means being able to choose and consume, and getting a ‘life style’ reflects an aspiration for social mobility. Taking the emic approach helps to explain how social......Discussions of health-related behaviors and lifestyle often become theoretical and morally laden owing to their individualistic view on risk factors and life choices. This article uses the analytical concepts of contagion and configuration to explore the spread of aspirations for the good life...... among young men in Northern Uganda. The potential social contagion of aspirations is unfolded to provide a deeper understanding of social processes not only as dynamics between people but also as processes between people and their surroundings in a society which is subject to rapid change...

  17. Habits, aspirations and endogenous fertility

    OpenAIRE

    Luciano Fanti

    2012-01-01

    Motivated by the increasing literature on endogenous preferences as well as on endogenous fertility, this paper investigates the implications of the interaction of the endogenous determination of the number of children with habit and aspiration formation in an OLG model. In contrast with the previous literature, we show that greater aspirations may lead to higher savings, and more interestingly, always increase the neoclassical economic growth.

  18. Supersymmetry: aspirations and prospects

    International Nuclear Information System (INIS)

    Tata, Xerxes

    2015-01-01

    The realization in the early 1980s that weak scale supersymmetry stabilizes the Higgs sector of the spectacularly successful Standard Model (SM) led several authors to explore whether low energy supersymmetry could play a role in particle physics. Among these were Richard Arnowitt, Ali Chamseddine and Pran Nath who constructed a viable locally supersymmetric grand unified theory (GUT), laying down the foundation for supergravity GUT models of particle physics. Supergravity models continue to be explored as one of the most promising extensions of the SM. After a quick overview of some of the issues and aspirations of early researchers working to bring supersymmetry into the mainstream of particle physics, we re-examine early arguments that seemed to imply that superpartners would be revealed in experiments at LEP2 or at the Tevatron. Our purpose is to assess whether the absence of any superpartners in searches at LHC8 presents a crisis for supersymmetry. Toward this end, we re-evaluate fine-tuning arguments that lead to upper bounds on (some) superpartner masses. We conclude that phenomenologically viable superpartner spectra that could arise within a high scale model tuned no worse than a few percent are perfectly possible. While no viable underlying model of particle physics that leads to such spectra has yet emerged, we show that the (supergravity-based) radiatively driven natural supersymmetry framework serves as a surrogate for a phenomenological analysis of an underlying theory with modest fine-tuning. We outline the phenomenological implications of this framework, with emphasis on those LHC and electron–positron collider signatures that might point to the underlying natural origin of gauge and Higgs boson masses. We conclude that the supergravity GUT paradigm laid down in 1982 by Arnowitt, Chamseddine and Nath, and others, remains a vibrant possibility. (invited comment)

  19. Lifelong Learning: Capabilities and Aspirations

    Science.gov (United States)

    Ilieva-Trichkova, Petya

    2016-01-01

    The present paper discusses the potential of the capability approach in conceptualizing and understanding lifelong learning as an agency process, and explores its capacity to guide empirical studies on lifelong learning. It uses data for 20 countries from the Adult Education Survey (2007; 2011) and focuses on aspirations for lifelong learning. The…

  20. Meconium aspiration in South Africa

    African Journals Online (AJOL)

    This retrospective study of 569 cases of meconium aspiration from 11 institutions in South Africa reveals a high incidence varying from 4 to 11/1 000 and a mortality rate of. 12%. Mortality was significantly related to the degree of asphyxia at birth. Twenty-five per cent of the babies. (136/569) required intensive care and 36% ...

  1. Neonatal aspiration syndrome due to vernix caseosa

    International Nuclear Information System (INIS)

    Ohlsson, A.; Najjar, H.; Cumming, W.A.

    1985-01-01

    Fetal aspiration of meconium in amniotic fluid is a well-known cause of respiratory distress in newborn infants. It causes an irregular, coarse, nodular pattern on chest radiographs. Less known is that aspiration of vernix caseoasa causes a similar syncrome. We present a post-mature infant in whom aspiration of vernix caseosa caused respiratory distress, ventilatory difficulty, and radiographic changes essentially the same as aspiration of meconium. (orig.)

  2. Neonatal aspiration syndrome due to vernix caseosa

    Energy Technology Data Exchange (ETDEWEB)

    Ohlsson, A.; Najjar, H.; Cumming, W.A.

    1985-02-01

    Fetal aspiration of meconium in amniotic fluid is a well-known cause of respiratory distress in newborn infants. It causes an irregular, coarse, nodular pattern on chest radiographs. Less known is that aspiration of vernix caseoasa causes a similar syncrome. We present a post-mature infant in whom aspiration of vernix caseosa caused respiratory distress, ventilatory difficulty, and radiographic changes essentially the same as aspiration of meconium.

  3. Aspirations of Latina Adolescent Suicide Attempters

    Science.gov (United States)

    Hausmann-Stabile, Carolina; Gulbas, Lauren; Zayas, Luis H.

    2013-01-01

    Parents' aspirations and expectations are communicated to their offspring. Children internalize their parents' aspirations and accept some of the expectations while rejecting others, all part of the developmental process and identity-consolidation. When the aspirations and expectations of youth and parents are incongruent, the outcomes…

  4. Aspiration pneumonia: a review of modern trends.

    Science.gov (United States)

    DiBardino, David M; Wunderink, Richard G

    2015-02-01

    The purpose was to describe aspiration pneumonia in the context of other lung infections and aspiration syndromes and to distinguish between the main scenarios commonly implied when the terms aspiration or aspiration pneumonia are used. Finally, we aim to summarize current evidence surrounding the diagnosis, microbiology, treatment, risks, and prevention of aspiration pneumonia. Medline was searched from inception to November 2013. All descriptive or experimental studies that added to the understanding of aspiration pneumonia were reviewed. All studies that provided insight into the clinical aspiration syndromes, historical context, diagnosis, microbiology, risk factors, prevention, and treatment were summarized within the text. Despite the original teaching, aspiration pneumonia is difficult to distinguish from other pneumonia syndromes. The microbiology of pneumonia after a macroaspiration has changed over the last 60 years from an anaerobic infection to one of aerobic and nosocomial bacteria. Successful antibiotic therapy has been achieved with several antibiotics. Various risks for aspiration have been described leading to several proposed preventative measures. Aspiration pneumonia is a disease with a distinct pathophysiology. In the modern era, aspiration pneumonia is rarely solely an anaerobic infection. Antibiotic treatment is largely dependent on the clinical scenario. Several measures may help prevent aspiration pneumonia. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. [Foreign body aspiration in children].

    Science.gov (United States)

    Ibarz, J A Esteban; Samitier, A Sáinz; Alvira, R Delgado; Prades, P Burgués; Martínez-Pardo, N González; Pollina, J Elías

    2007-01-01

    The aim to this study is evaluate the history, symptoms, radiographic and endoscopic findings in 420 children who were admitted for suspected foreign body aspiration in our hospital between 1972 and 2005. In 13 children we didn't find foreign body and in 16 children the foreign bodies were lodged in larynx. The mean age was 33 months. The medical history, phisical exploration, auscultation and radiological findings were positive in 91,4%, 78,3%, 91,6% and 81%. The frecuency or foreign body aspiration is undervaluate and sometimes is excluded as diagnosis. Only 218 (51,9%) patients went to the hospital in the first 24 hours, although 87,8% of patients presented symptoms and 75,4% presented severe symptoms. Moreover the removed foreign bodies and suspected foreign bodies are the same in 82,95%. We think that bronchoscopy should by performed in all children who have had a choking episode.

  6. Tracheobronchial Foreign Body Aspiration: Dental Prosthesis

    Directory of Open Access Journals (Sweden)

    Ataman Köse

    2014-01-01

    Full Text Available It is important to extract foreign bodies for avoiding life-threatening complications. They can lead to death if they are not treated. Different signs and symptoms could occur according to the complete or partial airway obstruction. Foreign body aspiration is a rare incident in adults. The organic foreign materials such as foods are found to be aspirated more commonly and are usually settled in the right bronchial system. However, dental prosthesis and teeth aspirations are rare in literature. In our study, a 52-year-old male patient who had aspirated the front part of his lower dental prosthesis accidentally is presented and the foreign body is extracted by using rigid bronchoscopy. There are many causes of aspiration but dental prosthetic aspirations should be kept in mind during sleep. For this reason, dental apparatus must be taken out while asleep.

  7. Meconium aspiration syndrome: historical aspects.

    Science.gov (United States)

    Fanaroff, A A

    2008-12-01

    The meconium aspiration syndrome (MAS) is a common problem that continues to concern perinatologists and neonatologists. MAS is defined as respiratory distress in an infant born through meconium-stained amniotic fluid (MSAF) whose symptoms cannot be otherwise explained. This disorder may be life threatening, complicated by respiratory failure, pulmonary air leaks and persistent pulmonary hypertension. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. This report details the management of babies delivered with associated MSAF before the accumulation of evidence for best practice through appropriately powered, prospective randomized controlled trials.

  8. Suicidal ideation and migration aspirations among youth in central Mexico.

    Science.gov (United States)

    Hoffman, Steven

    2013-10-16

    Over the past 100 years the state of Guanajuato has consistently been one of the highest migrant sending states in Mexico. Youth living in high migratory states such as Guanajuato are heavily influenced by the expectation that they will travel to the US, and research has shown that those who do not migrate may be looked down upon by members of their community. This secondary analysis looks at the connection between suicidal ideation and migration aspirations among a group of adolescents living in Guanajuato, Mexico. Data were originally collected in 2007 as part of a comprehensive health survey of youth attending an alternative high schooling program. Regression analyses show that suicidal ideation predicts intentions to migrate among both males and females, while other factors differentially influence the adolescents by gender. The results indicate that suicidal ideation may be associated with migration aspirations among Mexican youth living in high migratory communities. Study limitations and implications are discussed.

  9. Fine-needle aspiration of the thyroid: an overview

    Directory of Open Access Journals (Sweden)

    Nguyen Gia-Khanh

    2005-06-01

    Full Text Available Abstract Thyroid nodules (TN are a common clinical problem. Fine needle aspiration (FNA of the thyroid now is practiced worldwide and proves to be the most economical and reliable diagnostic procedure to identify TNs that need surgical excision and TNs that can be managed conservatively. The key for the success of thyroid FNA consists of an adequate or representative cell sample and the expertise in thyroid cytology. The FNA cytologic manifestations of TNs may be classified into seven working cytodiagnostic groups consisting of a few heterogenous lesions each to facilitate the differential diagnosis. Recent application of diagnostic molecular techniques to aspirated thyroid cells proved to be useful in separating benign from malignant TNs in several cases of indeterminate lesions.

  10. Punção aspirativa por agulha fina: desempenho no diagnóstico diferencial de nódulos mamários palpáveis Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses

    Directory of Open Access Journals (Sweden)

    Orlando José de Almeida

    1998-09-01

    Full Text Available Objetivo: avaliar, de forma prospectiva, o desempenho da punção aspirativa por agulha fina (PAAF no diagnóstico diferencial de nódulos mamários palpáveis. Método: avaliaram-se a sensibilidade, a especificidade, os valores preditivos e a acurácia deste teste em 102 mulheres com idade superior a 30 anos, com nódulos mamários palpáveis, atendidas na Universidade Estadual de Campinas. As punções foram realizadas por um único examinador. Resultados: o procedimento teve sensibilidade de 97%, especificidade de 87%, valor preditivo positivo de 94% e negativo de 93%. A taxa de material insuficiente ou insatisfatório foi de 16% na primeira punção, diminuindo para 2% com uma nova PAAF. Conclusões: Este teste mostrou-se altamente sensível e específico no diagnóstico diferencial de nódulos mamários palpáveis, reafirmando-se a sua grande importância na abordagem clínica de nódulos palpáveis.Purpose: to evaluate, in a prospective way, the performance of the fine needle aspiration biopsy in the differential diagnosis of palpable breast masses. Method: the sensitivity, specificity, positive and negative predictive values for this test were evaluated in 102 women with age above 30 years and a palpable breast mass, who were attended at the University of Campinas. All punctures were performed by the same examiner. Results: the procedure had a sensitivity of 97%, specificity of 87%, positive predictive value of 94% and negative predictive value of 93%. The insufficient or unsatisfactory sample rate was 16% for the first aspiration, decreasing to 2% with a new procedure. Conclusions: this test showed to be highly sensitive and specific for the differential diagnosis of palpable breast masses, reassuring its great importance for the clinical approach of palpable masses.

  11. Meconium Aspiration Syndrome: An Insight.

    Science.gov (United States)

    Raju, U; Sondhi, V; Patnaik, S K

    2010-04-01

    Meconium aspiration syndrome (MAS) is respiratory distress in a newborn baby caused by the presence of meconium in the tracheobronchial airways. The aspiration of meconium stained amniotic fluid by the fetus can happen during antepartum or intrapartum periods and can result in airway obstruction, interference with alveolar gas exchange, chemical pneumonitis as well as surfactant dysfunction. These pulmonary effects cause gross ventilation-perfusion mismatching. To complicate matters further, many infants with MAS have primary or secondary persistent pulmonary hypertension of the newborn as a result of chronic in utero stress and thickening of the pulmonary vessels. Although meconium is sterile, its presence in the air passages can predispose the infant to pulmonary infection. MAS is essentially a clinical diagnosis and should always be suspected in a child with respiratory distress and meconium-stained amniotic fluid at delivery. Though a known entity for a long time, its management still remains contentious. Intubation and direct tracheal suction is performed when meconium is observed in the amniotic fluid and the infant is not vigorous. Subsequent management involves ventilation, surfactant instillation and lavage, inhaled nitric oxide and high frequency ventilation. The role of steroids continues to be controversial.

  12. Choosing VET: Aspirations, Intentions and Choice

    Science.gov (United States)

    Hargreaves, Jo; Osborne, Kristen

    2017-01-01

    This summary brings together the findings from two research projects: "Choosing VET: Investigating the VET Aspirations of School Students" and "In Their Words: Student Choice in Training Markets--Victorian Examples." The research investigated school students' post-school aspirations for vocational education and training (VET),…

  13. Endometrial aspiration cytology in gynecological disorders

    Directory of Open Access Journals (Sweden)

    Meenal V Jadhav

    2016-01-01

    Full Text Available Context: Endometrial aspiration is not a popular modality for the study of the endometrium despite its simplicity and potential utility. Aim: The present study was aimed at evaluating the utility of endometrial aspiration in various gynecological disorders. Materials and Methods: In this diagnostic accuracy study, 55 prospectively registered women with various gynecological disorders were evaluated clinically and subjected to endometrial aspiration cytology and study of endometrial histology. Endometrial aspiration was performed by infant feeding tube in 10 cases and intra cath cannula in 45 cases. The slides were stained with rapid Papanicolaou (PAP stain and Leishman stain. Results: Endometrial aspiration cytology showed 90% and 94.6% sampling adequacy with infant feeding tube and intra cath cannula, respectively. Intra cath cannula was very convenient to handle and superior to infant feeding tube in aspirating the endometrium. Of the two stains used, rapid PAP stain was less time-consuming and superior to Leishman stain in studying the nuclear details. Leishman stain was helpful in detecting cytoplasmic vacuoles of secretory endometrium. Overall diagnostic accuracy of endometrial cytology was 90.4% while that for morphological hormonal evaluation was 97.6%. It enjoyed a sensitivity of 91.66%, a specificity of 88.23%, positive predictive value of 94.28%, and negative predictive value of 83.33%. Conclusion: Intra cath cannula emerged as an inexpensive, effective, and convenient device for endometrial aspiration. Endometrial aspiration proved to be a fairly effective, simple, and informative diagnostic modality.

  14. Aspiration Curettage and its Outpatient Usage

    African Journals Online (AJOL)

    Aspiration Curettage and its Outpatient Usage. D. A. G. BARFORD, M, NOTELOVITZ. SUMMARY ... its use on a number of outpatients without anaesthesia is discussed. S. Afr. Med. l., 48, 22 (1974). In order to ... plastic aspiration chamber and suction is applied centrally at the base of the chamber, a cylindrical filter within the.

  15. Entrepreneurial aspirations, motivations, and their drivers

    NARCIS (Netherlands)

    S.J.A. Hessels (Jolanda); A.M. van Gelderen (Marco); A.R. Thurik (Roy)

    2008-01-01

    textabstractSeveral drivers of entrepreneurial aspirations and entrepreneurial motivations are investigated using country-level data from the Global Entrepreneurship Monitor (GEM) for the years 2005 and 2006. We estimate a two-equation model explaining aspirations using motivations and socioeconomic

  16. Entrepreneurial aspirations, motivations, and their drivers

    NARCIS (Netherlands)

    Hessels, J.; van Gelderen, M.W.; Thurik, A.R.

    2008-01-01

    Several drivers of entrepreneurial aspirations and entrepreneurial motivations are investigated using country-level data from the Global Entrepreneurship Monitor (GEM) for the years 2005 and 2006. We estimate a two-equation model explaining aspirations using motivations and socioeconomic variables,

  17. Shareholders’ expectations, aspiration levels, and mergers

    NARCIS (Netherlands)

    Diecidue, E.; van de Ven, J.; Weitzel, U.

    This paper offers a new explanation of value-reducing mergers and stock market driven takeovers by introducing recent research on aspiration levels and individual decision making under risk. If market valuation constitutes an aspiration level for managers, we show that managers may be tempted to

  18. An Aspirational Community Theory of the Firm

    DEFF Research Database (Denmark)

    Li, Xin

    contractual labor and aspirational labor, the former being defined as services provided by a laborer in fulfillment of a contract while the latter as services provided by a laborer in pursuit of an aspiration; and argue that firms exist because while the market may be effective and efficient for allocating...

  19. Epidemiology of Anaemia Necesitating Bone Marrow Aspiration ...

    African Journals Online (AJOL)

    Objective: The study aims at investigating, identifying and classifying the various causes of anaemia necessitating bone marrow aspiration cytology in our environment. Methodology: A retrospective review of all bone marrow aspiration cytology reports of patients referred to Haematology and Blood Transfusion department ...

  20. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ... Aspiration Biopsy of the Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During ...

  1. When aspirations and achievements don't meet. A longitudinal examination of the differential effect of education and occupational attainment on declines in self-rated health among Canadian labour force participants.

    Science.gov (United States)

    Smith, Peter; Frank, John

    2005-08-01

    To examine the association of a mismatch between educational qualifications and occupational attainment and subsequent declines in self-rated health (SRH) in a longitudinal nationally representative Canadian population sample. This study used longitudinal data from 4045 healthy, working respondents of the Canadian National Population Health Survey. Respondents were categorized as either qualified, overqualified, or underqualified based on the match between their education and the skills required for their current occupation over a 2-year period. Logistic regression analysis estimated the odds of decline in SRH over the following 4-year period, using the match between occupation and education as the main independent variable. Analyses were controlled for a number of confounding variables including health behaviours, mental health, self-esteem, job control, and demographic information. Relative to respondents with university education working in occupations for which they were qualified, respondents with university education, working in occupations for which they were overqualified had a significant risk of decline in SRH between 1996 and 2000, even after adjusting for a number of potential confounders (OR = 2.08, 95% CI 1.11-3.91). In respondents with secondary education or less, differences in occupational attainment were not associated with differences in the odds of decline in SRH. The effect of occupational attainment on health is important for individuals who have invested the most time in their education. Conversely, differential occupational attainment is not associated with differences in the odds of decline in health for participants with lower levels of education.

  2. Aspirated Compressors for High Altitude Engines, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Aurora Flight Sciences proposes to incorporate aspirated compressor technology into a high altitude, long endurance (HALE) concept engine. Aspiration has been proven...

  3. Aspiration pneumonia in patients with cleft palate

    International Nuclear Information System (INIS)

    Lee, Seung Hun; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Uhm, Ki Il

    2003-01-01

    To assess the incidence of aspiration pneumonia in infants with cleft palate and to compare the incidence between complete and incomplete types of cleft palate. A review of medical records revealed 100 infants who had undergone initial surgery to repair cleft palate in our hospital during a recent three-year period. Aspiration pneumonia was defined as the coexistence of pneumonia at chest radiography with a history of frequent choking during feeding. The anatomic distribution of aspiration pneumonia was analyzed, and the incidences of aspiration pneumonia in infants with complete and incomplete cleft palate were compared. Among 100 children, aspiration pneumonia was found in 35 (35%). Those with complete and incomplete cleft palate showed similar incidences of the condition (27 of 70 [39%] vs 8 of 30 [27%], p=0.36). Pneumonia was most commonly seen in the left lower lobe (11 of 35), followed by the right upper and lower lobes. Aspiration pneumonia is frequently associated with infants with cleft palate. There is no statistical difference in the incidence of aspiration pneumonia between the complete and the incomplete cleft palate group

  4. Aspiration pneumonia in patients with cleft palate

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hun; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Uhm, Ki Il [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2003-03-01

    To assess the incidence of aspiration pneumonia in infants with cleft palate and to compare the incidence between complete and incomplete types of cleft palate. A review of medical records revealed 100 infants who had undergone initial surgery to repair cleft palate in our hospital during a recent three-year period. Aspiration pneumonia was defined as the coexistence of pneumonia at chest radiography with a history of frequent choking during feeding. The anatomic distribution of aspiration pneumonia was analyzed, and the incidences of aspiration pneumonia in infants with complete and incomplete cleft palate were compared. Among 100 children, aspiration pneumonia was found in 35 (35%). Those with complete and incomplete cleft palate showed similar incidences of the condition (27 of 70 [39%] vs 8 of 30 [27%], p=0.36). Pneumonia was most commonly seen in the left lower lobe (11 of 35), followed by the right upper and lower lobes. Aspiration pneumonia is frequently associated with infants with cleft palate. There is no statistical difference in the incidence of aspiration pneumonia between the complete and the incomplete cleft palate group.

  5. Aspirant candidate behaviour and progressive political ambition

    Directory of Open Access Journals (Sweden)

    Peter Allen

    2017-02-01

    Full Text Available In this paper we take account of the role of aspirant candidate behaviour in progressive political ambition, specifically how some individuals signal their political ambition to political actors by approaching them to discuss running for office. We examine how the effect of this behaviour compares to the more prominently studied effect of elite recruitment. We conclude that signalling behaviour by an aspirant candidate has a substantial effect, particularly with regard to actually acting on initial considerations of whether to stand, and that elite recruitment makes a difference but only in conjunction with the aspirant candidate themselves signalling their ambition to political actors.

  6. Clinical profile of children with kerosene aspiration.

    Science.gov (United States)

    Venkatesh, C; Sriram, P; Adhisivam, B; Mahadevan, S

    2011-07-01

    Accidental aspiration of kerosene is a common problem among children in developing countries. This descriptive study involved the retrospective analysis of children admitted with kerosene aspiration in a tertiary care hospital in South India for a year. Kerosene aspiration contributed to 60.4% of poisoning cases. Boys aged less than three years and from a rural background formed a significant proportion. Tachypnoea, cough and crepitations were the predominant clinical findings. Male gender and malnutrition (weight for age <80%) were significantly associated with prolonged hospital stay.

  7. Combined assessment (aspiration cytology and mammography) of ...

    African Journals Online (AJOL)

    Combined assessment (aspiration cytology and mammography) of clinically suspicious breast masses. W.F. van Wyk, D Dent, E Anne Hacking, Genevieve Learmonth, R.E. Kottler, C Anne Gudgeon, A Tiltman ...

  8. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    2011-06-15

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various ...

  9. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various other investigations ...

  10. MECONIUM ASPIRATION SYNDROME : A CLINICAL STUDY

    OpenAIRE

    BEHERA, MK; KULKARNI, SD; GUPTA, RK

    1998-01-01

    Forty two babies with Meconium aspiration syndrome managed in neonatal intensive care unit of a service hospital were analysed. Incidence was 1.7 per cent. Twelve babies were delivered by caserean section and 30 babies by vaginal route. Seventeen deliveries were conducted by team of gynaecologists, pediatrician and nursing staff whereas 25 deliveries were conducted by nursing staff alone. Out of total babies with meconium aspiration syndrome, thin meconium detected in 9 and thick meconium det...

  11. Meconium aspiration syndrome: challenges and solutions

    OpenAIRE

    Goel,Ankita; Nangia,Sushma

    2017-01-01

    Ankita Goel, Sushma Nangia Department of Neonatology, Lady Hardinge Medical College and Kalawati Saran Children Hospital, Shaheed Bhagat Singh Marg, New Delhi, India Abstract: Meconium aspiration syndrome (MAS) is an important cause of morbidity and mortality among term newborns. A result of antepartum or postpartum aspiration of meconium stained amniotic fluid (MSAF), MAS causes respiratory distress of varying severity, often complicated by air leaks or persistent pulmonary...

  12. Aspiring and Aspiration Shaming: Primary Schooling, English, and Enduring Inequalities in Liberalizing Kerala (India)

    Science.gov (United States)

    Mathew, Leya

    2018-01-01

    This paper analyzes narratives about the radical socio-economic changes accompanying liberalization in India to consider how English-medium schooling is becoming an aspirational resource for non-elite parents. I suggest that aspiring is a practice of ethics that marginalized mothers mobilize to negotiate memories of deprivation and yearnings for…

  13. Bronchoalveolar lavage amylase is associated with risk factors for aspiration and predicts bacterial pneumonia.

    Science.gov (United States)

    Weiss, Curtis H; Moazed, Farzad; DiBardino, David; Swaroop, Mamta; Wunderink, Richard G

    2013-03-01

    Aspiration of oropharyngeal or gastric contents into the respiratory tract leads to a spectrum of disorders with high morbidity. Aspiration is a diagnostic dilemma, because clinical characteristics and diagnostic tests are not effective predicting or confirming aspiration. We sought to determine whether α-amylase, a protein secreted by salivary glands and the pancreas, is elevated in bronchoalveolar lavage specimens in patients with clinical risk factors for aspiration and whether bronchoalveolar lavage amylase predicts bacterial pneumonia. Retrospective analysis. Five adult ICUs at a tertiary care urban medical center. Mechanically ventilated patients who underwent either bronchoscopic or nonbronchoscopic bronchoalveolar lavage within 72 hrs of endotracheal intubation between August 1, 2008 and June 30, 2010. A total of 296 bronchoalveolar lavage amylase results from 280 patients were included in the analysis, and 155 bronchoalveolar lavage amylase specimens were obtained from patients with at least one predefined preintubation risk factor (altered consciousness, swallowing dysfunction, difficult intubation, peri-intubation vomiting, or cardiac arrest). Bronchoalveolar lavage amylase concentration increased as the number of preintubation risk factors increased (p bronchoalveolar lavage amylase was elevated in patients with bacterial pneumonia (cfu/mL ≥ 10) (p bronchoalveolar lavage amylase to differentiate between positive and negative bronchoalveolar lavage culture was 0.67 (95% confidence interval, 0.60-0.75). The lower 95% confidence interval for bronchoalveolar lavage amylase in patients with at least one preintubation risk factor for aspiration was 125.9 units/L. In multivariate analysis, bronchoalveolar lavage amylase bronchoalveolar lavage amylase is associated with risk factors for aspiration and may predict bacterial pneumonia. Bronchoalveolar lavage amylase may be useful as an early screening tool to guide management of patients suspected of

  14. Aspiration Deaths Among Adults in Istanbul

    Directory of Open Access Journals (Sweden)

    Haşim Asil

    2014-06-01

    Full Text Available Massive aspiration of food is rare, but most common in people under the influence of alcohol or a drug and comatose patients who have impaired functioning of the central nervous system. The finding of small amounts of food material in the airway at autopsy does not indicate the true vital aspiration because of agonal or even early post-mortem overspills. Occlusion of the small airways, mainly the membranous and respiratory bronchioles, partial or total filling of bronchiolar lumen and the alveolar spaces with food or gastric content were typical morphologic findings. In our 10 year retrospective study we presented the data of 21 male and 4 female cases with a final diagnosis of fatal aspiration in age from 23 to 78 years (45.43±14.61 from the records of Morgue Specialization Department of the Council of Forensic Medicine. 13 cases found death at the scene without an eyewitness. All deaths were accidental in manner except one homicide. Toxicological analysis revealed blood alcohol concentration levels between 161 and 339 mg/dL in 7 cases. Morphine metabolites, benzodiazepine and barbituric acid derivatives, toluene and acetone were detected in 5 subjects. Aspirated materials were food in 14 cases, chewing gum in 3 cases, gastric content in 7 cases and a fabric gag in one case. The history, other evidence of external vomit on the clothing or immediate surroundings and toxicological analysis are by no means as significant as autopsy findings especially in cases of aspiration. Key words : adult; aspiration; death; autopsy

  15. Adolescents' educational aspirations and ethnic background: The case of students of African and Latin American migrant origins in Spain

    Directory of Open Access Journals (Sweden)

    Carlos J. Gil-Hernández

    2018-02-01

    Full Text Available Background: Minority students were found to have high educational aspirations, considering their background characteristics. This finding is often attributed to 'migrant optimism.' Yet, whether socioeconomic, educational, or demographic differences between and within ethnic groups mediate and/or moderate students' educational aspirations remains an inconclusive question. Objective: This study investigates the educational aspirations of children of African and Latin American migrants in Spain, looking at four critical factors: (1 family background, (2 educational performance, (3 years lived in Spain, and (4 language used at home. Methods: Data comes from the 2010 General Evaluation of Educational Diagnostic (GEED on lower-secondary students aged 14 (n = 19,293, on average. Multivariate logistic models are applied using mediation and moderation analyses. Results: Results show that (1 minority students have higher college aspirations than students of Spanish origin after accounting for parental socioeconomic status and educational performance; (2 ethnic differentials in aspirations - especially for pupils with Latin American origin - are concentrated among low-performing and disadvantaged students; (3 recent arrival in Spain is not significantly associated with differences in educational aspirations within minority groups; (4 speaking Spanish at home does not lead to differences in aspirations for pupils of African origin. Conclusions: Migrant optimism, as opposed to family language use and years of contact with the Spanish culture and society, seems to be an important factor for the high (net educational aspirations of students from African and Latin American backgrounds. Contribution: The article provides new evidence on ethnic heterogeneity in educational aspirations, being the first that uses representative data from the whole Spanish educational system.

  16. The sweet lung: Chewing gummi bear aspiration.

    Science.gov (United States)

    Tavladaki, Theonimfi; Fitrolaki, Michaela-Diana; Spanaki, Anna-Maria; Ilia, Staurula; Geromarkaki, Elissabet; Briassoulis, George

    2012-07-01

    Inhalation of foreign bodies, a leading cause of accidental death, is most common in preschool children. In this article we report our experience with a 5-year-old Greek girl who presented with a 24-hour history of sore throat, chest pain, and shortness of breath. Emergency bronchoscopy was performed and multiple small chewing gummi bear (HARIBO) particles impacted in the orifices of the right main bronchus and right lobar and segmentalinic bronchi were successfully removed and aspirated. Aspiration of gummi bears, which is for the first time reported, may cause a silent choking episode leading to life-threatening bronchi obstruction at multiple sites, even in children older than 4 years.

  17. Hepatic epithelioid hemangioendothelioma: A diagnostic pitfall in aspiration cytology

    Directory of Open Access Journals (Sweden)

    Gupta Ruchika

    2009-01-01

    Full Text Available Hepatic epithelioid hemangioendothelioma (EH is a rare vascular neoplasm. An accurate radiologic diagnosis is usually difficult due to the presence of multiple nodules, simulating metastatic carcinoma. Though histologic features of this tumor are well described, cytologic reports of hepatic EH are very few in the available literature. We describe a case of a young healthy adult male who was found to have multiple hepatic masses on radiologic investigations. A guided fine needle aspiration demonstrated a poorly differentiated neoplasm. The diagnosis was made on core biopsy assisted by immunohistochemistry, which showed characteristic features of EH. He is doing well 14 months after diagnosis, without surgical excision or chemotherapy. An accurate diagnosis of hepatic EH on aspiration cytology requires an adequate specimen and awareness of its cytologic features, including discohesive atypical cells with intracytoplasmic lumina and intranuclear inclusions. Since this tumor is usually unresectable but has a favorable prognosis as compared to hepatocellular carcinoma, a correct diagnosis is essential for appropriate management and prognostication.

  18. Aspirations and occupational achievements of Dutch fathers and mothers

    NARCIS (Netherlands)

    van der Horst, Mariska; van der Lippe, Tanja; Kluwer, Esther

    2014-01-01

    Purpose - To investigate how work and family aspirations relate to occupational achievements and gender differences herein. Design/methodology/approach - Using data from 2009 we examined the relationship between career and childrearing aspirations and occupational achievements of Dutch parents.

  19. Combined assessment (aspiration cytology and mammography) of ...

    African Journals Online (AJOL)

    We examined the safety and utility of the combined assessment of aspiration cytology and mammography in. 705 women who had clinically suspicious or malignant palpable breast masses. Histological assessment confirmed 176 benign and 529 malignant lesions. There were no incorrect (false positive) diagnoses made ...

  20. Identity talk of aspirational ethical leaders

    NARCIS (Netherlands)

    Koning, J.B.M.; Waistell, J.

    2012-01-01

    This study investigates how business leaders dynamically narrate their aspirational ethical leadership identities. In doing so, it furthers understanding of ethical leadership as a process situated in time and place. The analysis focuses on the discursive strategies used to narrate identity and

  1. Gender Differences, Career Aspirations and Career Development ...

    African Journals Online (AJOL)

    The purpose of this study therefore is to explore gender differences in adolescents' career aspirations and career development barriers among secondary school students in Kisumu municipality, Kenya. The study was conducted on 348 form four secondary school students. The major findings of this study show that there ...

  2. Educational Aspirations, What Matters? A Literature Review.

    Science.gov (United States)

    Deosaran, Ramesh

    The literature review attempted to identify: 1) what we know and don't know about post-secondary aspirations, expectations, and access; and 2) where and how it is possible for us to embark on solutions or further investigation. The research in this area has been heavily sociological. Socio-economic background, family size, community origins,…

  3. EDUCATIONAL ASPIRATIONS OF FARM BOYS AND GIRLS.

    Science.gov (United States)

    SLOCUM, WALTER L.

    THE EDUCATIONAL AND OCCUPATIONAL ASPIRATIONS OF RURAL HIGH SCHOOL STUDENTS WERE STUDIED IN RELATION TO SOCIAL, CULTURAL, AND ECONOMIC FACTORS. QUESTIONNAIRES WERE ADMINISTERED TO AND COMPLETED BY 3,535 RURAL HIGH SCHOOL STUDENTS. SUPPLEMENTAL INFORMATION WAS GATHERED BY PERSONAL INTERVIEWS WITH 992 STUDENTS. COUNSELORS, ADMINISTRATORS, AND…

  4. Income Aspirations and Cooperation : Experimental Evidence

    NARCIS (Netherlands)

    Dalton, P.S.

    2010-01-01

    This article is the first attempt to study the empirical link between income aspirations and cooperation in a one shot public good game. By combining experimental with survey data, we find evidence that the more frustrated people are with their income, the lower is their propensity to cooperate with

  5. Educational Aspirations: Individual Freedom or Social Injustice?

    Science.gov (United States)

    Deosaran, Ramesh A.

    1977-01-01

    The author examines the concepts of aspiration level (what a student would like to do) and expectation level (more "realistic" choices of action or goal) and the gap that exists between them, a gap primarily due to social class and gender. (MJB)

  6. Extrapulmonary tuberculosis: Fine needle aspiration cytology ...

    African Journals Online (AJOL)

    Background: The increasing prevalence of extrapulmonary manifestation of tuberculosis with the HIV scourge is a cause for concern. Objective: To determine the role of fine needle aspiration cytology (FNAC) in the diagnosis of extrapulmonary tuberculosis. Patients and Methods: This is a consecutive 9-year analysis of ...

  7. FOREIGN BODY ASPIRATION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Nafia Ozlem Kazanci

    2013-03-01

    Full Text Available Foreign body aspiration (FBA is common under 3 years of age. FBA can cause sudden respiratory failure. Furthermore, it leads to many respiratory system complications. Therefore, FBA is an important cause of mortality and morbidity for this age group. FBA cases are usually followed by diagnoses like pneumonia, bronchitis or bronchial asthma in the late period that history, clinical and laboratory findings suggesting foreign body aspiration can not be detected. We reported a 2-year-old male patient with pneumonia, who were administered various treatments. In thorax CT of this case, an image compatible with foreign body was seen in the right middle lobe-upper lobe separation area. Granulation tissue was detected in the entrance of the right main bronchus by rigid bronchoscopy and marked improvement occured in lung aeration after bronchoscopy. This case was reported to emphasize the importance of early diagnosis of foreign body aspiration because of high mortality and morbidity and the necessity of considering the foreign body aspiration in children with recurrent pulmonary infections. [J Contemp Med 2013; 3(1.000: 58-61

  8. Dysphagia, dystussia, and aspiration pneumonia in elderly people

    OpenAIRE

    Ebihara, Satoru; Sekiya, Hideki; Miyagi, Midori; Ebihara, Takae; Okazaki, Tatsuma

    2016-01-01

    Despite the development and wide distribution of guidelines for pneumonia, death from pneumonia is increasing due to population aging. Conventionally, aspiration pneumonia was mainly thought to be one of the infectious diseases. However, we have proven that chronic repeated aspiration of a small amount of sterile material can cause the usual type of aspiration pneumonia in mouse lung. Moreover, chronic repeated aspiration of small amounts induced chronic inflammation in both frail elderly peo...

  9. Does cytokine profiling of aspirate from jaw cysts and tumors have a role in diagnosis?

    Science.gov (United States)

    Kolokythas, Antonia; Karas, Maria; Sarna, Thomas; Flick, William; Miloro, Michael

    2012-05-01

    The objective of the present study was twofold: first, to assess aspirates for use in cytokine profiling and second, to initiate pilot analyses to determine whether the cytokine profiling can serve as an aid in the diagnosis of jaw lesions. The aspirates from 12 benign odontogenic cysts and tumors of the jaw were collected and randomized, and a formal incisional biopsy was performed to establish the tissue diagnosis. The biopsies revealed keratocystic odontogenic tumor, ameloblastoma, and dentigerous cyst. The cystic aspirate was analyzed using the Q-Plex Human Cytokine Screen to detect cytokine expression and determine the level of expression for each pathologic entity. An array of 16 cytokines was investigated, including interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13, IL-15, IL-17, IL-23, interferon-γ, tumor necrosis factor (TNF)-α, and TNF-β. Tables were developed to determine the ratio of expression for the candidate cytokine pairs that were differentially expressed among the 3 pathologic entities encountered. One-way analysis of variance was used to search for significant differences in the ratio of expression of the candidate pairs among the 3 entities. Cytokines expressed by the 3 distinct jaw lesions were detected in the aspirate without the need for tissue biopsy. Cytokine profiling of these entities is possible owing to differential expression of the various cytokines studied. The ratio of expression was significant (P lesion type for the 15 cytokine pairs. Cytokines, expressed by the 3 groups of jaw lesions, can be detected in the cystic aspirate, and a comparison of the ratio of the expression of the aspirates demonstrated a differential expression pattern of cytokines among the 3 groups. These ratios could assist in establishing a prompt and accurate diagnosis of lesions that might be difficult to discern clinically and radiographically. The use of a simple, minimally invasive aspiration procedure can help to

  10. Gender and Leadership Aspiration : The Impact of the Organizational Environment

    NARCIS (Netherlands)

    C. Fritz (Claudia)

    2016-01-01

    markdownabstractSummary The aim of this dissertation is to examine gender differences in leadership aspiration. Although some important work regarding gender-specific aspiration has been done already, conditions fostering leadership aspiration – particularly among women – are not completely

  11. Risk of aspiration in care home residents and associated factors

    NARCIS (Netherlands)

    Maarel-Wierink, C.D. van der; Putten, G.J. van der; Visschere, L.M. De; Bronkhorst, E.M.; Baat, C. de; Schols, J.M.

    2015-01-01

    Pneumonia is a prevalent cause of death in care home residents. Dysphagia is a significant risk factor of aspiration pneumonia. The purpose of the current study was to screen for risk of aspiration in care home residents in the Netherlands and assess potential risk factors of aspiration. Five

  12. Autoaspiration versus manual aspiration in transbronchial needle aspiration in diagnosis of intrathoracic lymphadenopathy.

    Science.gov (United States)

    Boonsarngsuk, Viboon; Pongtippan, Atcharaporn; Juthakarn, Sabaitip; Boonsarngsuk, Wison; Kurimoto, Noriaki

    2009-10-01

    Traditionally, aspiration with high negative pressure is recommended to obtain a specimen in transbronchial needle aspiration (TBNA). Undeniably, however, the assistant experiences difficulty in the generation of the negative pressure and precise control of the syringe while performing the procedure. To evaluate the effectiveness of the autoaspiration method created by our plunger lock in comparison with the conventional manual aspiration in the diagnosis of intrathoracic lymphadenopathy by TBNA. A prospective study was conducted on all patients referred for diagnostic TBNA of enlarged intrathoracic lymph nodes. Both automatic and manual aspiration techniques were performed after the needle had been completely inserted into the nodes. The diagnostic yield and the numbers of diagnostic cells or benign lymphoid cells obtained by each technique were compared in the same node. A total of 31 intrathoracic lymph nodes in 24 patients were prospectively studied. Twenty-four nodes (77.4%) were malignancies whereas 7 nodes (22.6%) were benign disease. Adequate lymph node samples were obtained in 30 targets (96.8%), and TBNA revealed definite diagnosis for 25 nodes (80.6%). Both aspiration techniques showed exactly the same diagnostic yield. However, the autoaspiration technique provided significantly more adequate samples than manual aspiration techniques did (P=0.003). The autoaspiration method using our plunger lock was superior to the manual method in obtaining the numbers of adequate samples in TBNA procedures.

  13. Sequential voluntary cough and aspiration or aspiration risk in Parkinson's disease.

    Science.gov (United States)

    Hegland, Karen Wheeler; Okun, Michael S; Troche, Michelle S

    2014-08-01

    Disordered swallowing, or dysphagia, is almost always present to some degree in people with Parkinson's disease (PD), either causing aspiration or greatly increasing the risk for aspiration during swallowing. This likely contributes to aspiration pneumonia, a leading cause of death in this patient population. Effective airway protection is dependent upon multiple behaviors, including cough and swallowing. Single voluntary cough function is disordered in people with PD and dysphagia. However, the appropriate response to aspirate material is more than one cough, or sequential cough. The goal of this study was to examine voluntary sequential coughing in people with PD, with and without dysphagia. Forty adults diagnosed with idiopathic PD produced two trials of sequential voluntary cough. The cough airflows were obtained using pneumotachograph and facemask and subsequently digitized and recorded. All participants received a modified barium swallow study as part of their clinical care, and the worst penetration-aspiration score observed was used to determine whether the patient had dysphagia. There were significant differences in the compression phase duration, peak expiratory flow rates, and amount of air expired of the sequential cough produced by participants with and without dysphagia. The presence of dysphagia in people with PD is associated with disordered cough function. Sequential cough, which is important in removing aspirate material from large- and smaller-diameter airways, is also impaired in people with PD and dysphagia compared with those without dysphagia. There may be common neuroanatomical substrates for cough and swallowing impairment in PD leading to the co-occurrence of these dysfunctions.

  14. Discriminant ability of the Eating Assessment Tool-10 to detect aspiration in individuals with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Plowman, E K; Tabor, L C; Robison, R; Gaziano, J; Dion, C; Watts, S A; Vu, T; Gooch, C

    2016-01-01

    Oropharyngeal dysphagia is prevalent in individuals with amyotrophic lateral sclerosis (ALS) leading to malnutrition, aspiration pneumonia, and death. These factors necessitate early detection of at-risk patients to prolong maintenance of safe oral intake and pulmonary function. This study aimed to evaluate the discriminant ability of the Eating Assessment Tool (EAT-10) to identify ALS patients with unsafe airway protection during swallowing. Seventy ALS patients completed the EAT-10 survey and underwent a standardized videofluoroscopic evaluation of swallowing. Two blinded raters determined airway safety using the Penetration Aspiration Scale (PAS). A between groups anova (safe vs penetrators vs aspirators) was conducted and sensitivity, specificity, area under the curve (AUC), and likelihood ratios calculated. Mean EAT-10 scores for safe swallowers, penetrators, and aspirators (SEM) were: 4.28 (0.79) vs 7.10 (1.79) vs 20.50 (3.19), respectively, with significant differences noted for aspirators vs safe swallowers and aspirators vs penetrators (p EAT-10 demonstrated good discriminant ability to accurately identify ALS penetrator/aspirators (PAS ≥3) with a cut off score of 3 (AUC: 0.77, sensitivity: 88%, specificity: 57%). The EAT-10 demonstrated excellent accuracy at identifying aspirators (PAS ≥6) utilizing a cut off score of 8 (AUC: 0.88, sensitivity: 86%, specificity: 72%, likelihood ratio: 3.1, negative predictive value: 95.5%). The EAT-10 differentiated safe vs unsafe swallowing in ALS patients. This patient self-report scale could represent a quick and meaningful aide to dysphagia screening in busy ALS clinics for the identification and referral of dysphagic patients for further instrumental evaluation. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  15. Dysphagia, dystussia, and aspiration pneumonia in elderly people.

    Science.gov (United States)

    Ebihara, Satoru; Sekiya, Hideki; Miyagi, Midori; Ebihara, Takae; Okazaki, Tatsuma

    2016-03-01

    Despite the development and wide distribution of guidelines for pneumonia, death from pneumonia is increasing due to population aging. Conventionally, aspiration pneumonia was mainly thought to be one of the infectious diseases. However, we have proven that chronic repeated aspiration of a small amount of sterile material can cause the usual type of aspiration pneumonia in mouse lung. Moreover, chronic repeated aspiration of small amounts induced chronic inflammation in both frail elderly people and mouse lung. These observations suggest the need for a paradigm shift of the treatment for pneumonia in the elderly. Since aspiration pneumonia is fundamentally based on dysphagia, we should shift the therapy for aspiration pneumonia from pathogen-oriented therapy to function-oriented therapy. Function-oriented therapy in aspiration pneumonia means therapy focusing on slowing or reversing the functional decline that occurs as part of the aging process, such as "dementia → dysphagia → dystussia → atussia → silent aspiration". Atussia is ultimate dysfunction of cough physiology, and aspiration with atussia is called silent aspiration, which leads to the development of life-threatening aspiration pneumonia. Research pursuing effective strategies to restore function in the elderly is warranted in order to decrease pneumonia deaths in elderly people.

  16. Air Bag Momentum Force Including Aspiration

    Directory of Open Access Journals (Sweden)

    Guy Nusholtz

    1995-01-01

    Full Text Available A gas-jet momentum force drives the air bag into position during a crash. The magnitude of this force can change as a result of aspiration. To determine the potential magnitude of the effect on the momentum force and mass flow rate in an aspirated system, a series of experiments and simulations of those experiments was conducted. The simulation consists of a two-dimensional unsteady isentropic CFD model with special “infinite boundaries”. One of the difficulties in simulating the gas-jet behavior is determining the mass flow rate. To improve the reliability of the mass flow rate input to the simulation, a sampling procedure involving multiple tests was used, and an average of the tests was adopted.

  17. Meconium aspiration syndrome: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Goel A

    2017-08-01

    Full Text Available Ankita Goel, Sushma Nangia Department of Neonatology, Lady Hardinge Medical College and Kalawati Saran Children Hospital, Shaheed Bhagat Singh Marg, New Delhi, India Abstract: Meconium aspiration syndrome (MAS is an important cause of morbidity and mortality among term newborns. A result of antepartum or postpartum aspiration of meconium stained amniotic fluid (MSAF, MAS causes respiratory distress of varying severity, often complicated by air leaks or persistent pulmonary hypertension (PPHN. There has been a tremendous change in the concepts of pathophysiology and management of MAS over the last few decades. Routine endotracheal suctioning is no longer recommended in both vigorous and nonvigorous neonates with MSAF. Supportive management, along with newer therapies such as surfactant, inhaled nitric oxide, and high-frequency ventilation, has resulted in marked improvement in the overall outcome of MAS. The present review highlights the challenges in understanding the complex pathophysiology and optimal management approach to MAS. Potential future therapies and drugs in trial are also discussed briefly. Keywords: meconium aspiration syndrome, endotracheal suction, surfactant, inhaled nitric oxide, high-frequency ventilation, persistent pulmonary hypertension

  18. CT guided puncture aspiration and sclerosing treatment of ovary cyst

    International Nuclear Information System (INIS)

    Peng Yongjun; Du Xiumei; Yuan Jinrong; Chen Chanqing

    2007-01-01

    Objective: To analyze the method and the curative effect with CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst. Method: 22 ovary cysts in 22 patients were treated with percutaneous puncture aspiration and underwent repeated sclerotherapy with 99.7% ethanol injection. Among the 22 patients, 18 patients had solitary ovary cyst and was aspirated with an 18-22G gauge aspiration needle. The amount of aspirated fluid varied from 30ml-500ml and 25%-30% cyst volume was replaced by appropriate ethanol Post treatment follow-up were achieved every 3 months. Results All the Punctures were successfully completed. During the 3 months to one year follow-up, 16 ovary cyst disappeared, 6 cysts were small over 50%, without main complication. Conclusion CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst is a treatment of choice because of its safety, low complication, and high curative effect. (authors)

  19. When Aspirations Exceed Expectations: Quixotic Hope Increases Depression among Students.

    Directory of Open Access Journals (Sweden)

    Katharine H Greenaway

    Full Text Available A paradox exists in modern schooling: students are simultaneously more positive about the future and more depressed than ever. We suggest that these two phenomena may be linked. Two studies demonstrated that students are more likely to be depressed when educational aspirations exceed expectations. In Study 1 (N = 85 aspiring to a thesis grade higher than one expected predicted greater depression at the beginning and end of the academic year. In Study 2 (N = 2820 aspiring to a level of education (e.g., attending college higher than one expected to achieve predicted greater depression cross-sectionally and five years later. In both cases the negative effects of aspiring high while expecting low persisted even after controlling for whether or not students achieved their educational aspirations. These findings highlight the danger of teaching students to aspire higher without also investing time and money to ensure that students can reasonably expect to achieve their educational goals.

  20. When Aspirations Exceed Expectations: Quixotic Hope Increases Depression among Students.

    Science.gov (United States)

    Greenaway, Katharine H; Frye, Margaret; Cruwys, Tegan

    2015-01-01

    A paradox exists in modern schooling: students are simultaneously more positive about the future and more depressed than ever. We suggest that these two phenomena may be linked. Two studies demonstrated that students are more likely to be depressed when educational aspirations exceed expectations. In Study 1 (N = 85) aspiring to a thesis grade higher than one expected predicted greater depression at the beginning and end of the academic year. In Study 2 (N = 2820) aspiring to a level of education (e.g., attending college) higher than one expected to achieve predicted greater depression cross-sectionally and five years later. In both cases the negative effects of aspiring high while expecting low persisted even after controlling for whether or not students achieved their educational aspirations. These findings highlight the danger of teaching students to aspire higher without also investing time and money to ensure that students can reasonably expect to achieve their educational goals.

  1. Correlation of gastroesophageal reflex with aspiration pneumonia after surgery

    International Nuclear Information System (INIS)

    Hirashima, Tokuji; Hashimoto, Hajime; Noro, Toshio; Takahashi, Tadao; Hino, Yasunori; Kuroiwa, Kouzirou

    1996-01-01

    In order to elucidate the correlation of gastroesophageal reflex (GER) with aspiration pneumonia after surgery, 48 patients (mean, 75.6 years) with gastric cancer treated at the hospital from March, 1994 to December, 1994 were subjected to this prospective study. The pharyngeal stimulation test, nutritional assessment, radionuclide esophageal scintigraphy (34 cases) were performed before surgery and relationship between those results and aspiration pneumonia were studied. Aspiration pneumonia occurred in 3 cases, and all of them were in, significantly, poor nutritional status, compared with other. A significant increase in the frequency of GER was observed when a naso-gastric tube (NGT) was placed, but surprisingly, all the patients with aspiration pneumonia were 3 out of 4 patients who had continuous GER without NGT. It is noteworthy, continuous GER without NGT was significantly (p<0.001) affected postoperative aspiration pneumonia and impaired phalyngeal reflex was frequently correlated with development of aspiration pneumonia, when malnutritional status existed. (author)

  2. Aspirating and Nonaspirating Swallow Sounds in Children: A Pilot Study.

    Science.gov (United States)

    Frakking, Thuy; Chang, Anne; O'Grady, Kerry; David, Michael; Weir, Kelly

    2016-12-01

    Cervical auscultation (CA) may be used to complement feeding/swallowing evaluations when assessing for aspiration. There are no published pediatric studies that compare the properties of sounds between aspirating and nonaspirating swallows. To establish acoustic and perceptual profiles of aspirating and nonaspirating swallow sounds and determine if a difference exists between these 2 swallowing types. Aspiration sound clips were obtained from recordings using CA simultaneously undertaken with videofluoroscopic swallow study. Aspiration was determined using the Penetration-Aspiration Scale. The presence of perceptual swallow/breath parameters was rated by 2 speech pathologists who were blinded to the type of swallow. Acoustic data between groups were compared using Mann Whitney U-tests, while perceptual differences were determined by a test of 2 proportions. Combinations of perceptual parameters of 50 swallows (27 aspiration, 23 no aspiration) from 47 children (57% male) were statistically analyzed using area under a receiver operating characteristic (aROC), sensitivity, specificity, and positive and negative predictive values to determine predictors of aspirating swallows. The combination of post-swallow presence of wet breathing and wheeze and absence of GRS and normal breathing was the best predictor of aspiration (aROC = 0.82, 95% CI, 0.70-0.94). There were no significant differences between these 2 swallow types for peak frequency, duration, and peak amplitude. Our pilot study has shown that certain characteristics of swallow obtained using CA may be useful in the prediction of aspiration. However, further research comparing the acoustic swallowing sound profiles of normal children to children with dysphagia (who are aspirating) on a larger scale is required. © The Author(s) 2016.

  3. Gender and Leadership Aspiration: The Impact of the Organizational Environment

    OpenAIRE

    Fritz, Claudia

    2016-01-01

    markdownabstractSummary The aim of this dissertation is to examine gender differences in leadership aspiration. Although some important work regarding gender-specific aspiration has been done already, conditions fostering leadership aspiration – particularly among women – are not completely understood. Therefore, the focus of this dissertation is on assessing the potential impact of the organizational environment, including formal and informal elements, as well as relevant actors and their re...

  4. Risk Factors for Aspiration Pneumonia in Older Adults

    OpenAIRE

    Manabe, Toshie; Teramoto, Shinji; Tamiya, Nanako; Okochi, Jiro; Hizawa, Nobuyuki

    2015-01-01

    Backgrounds Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly. Methodology and Principal Findings We conducted an observational study using data from a nationwide survey of g...

  5. Hydatid Cyst of Parotid Gland: An Unusual Case Diagnosed by Fine Needle Aspiration Biopsy

    Directory of Open Access Journals (Sweden)

    Tuba KARA

    2017-05-01

    Full Text Available Hydatid disease is a zoonotic disease caused by the parasite Echinococcus granulosus. This infection frequently infects the liver and the lung and even in endemic regions rarely occurs in the head and neck region. This is also true for the parotid gland. The diagnosis relies on imaging techniques and the medical history. Another method that is helpful in the diagnosis is serological tests. Fine-needle aspiration biopsy is usually not recommended due to the potential risk of anaphylactic shock or spreading of daughter cysts. The preferred treatment method of hydatid cysts in the salivary gland is surgical excision. We introduce a rare case of hydatid cyst in the parotid gland diagnosed preoperatively by fine-needle aspiration biopsy and discuss the differential diagnosis.

  6. Diagnostic Value of Processing Cytologic Aspirates of Renal Tumors in Agar Cell (Tissue) Blocks

    DEFF Research Database (Denmark)

    Smedts, F.; Schrik, M.; Horn, T.

    2010-01-01

    smears were prepared after each aspiration for conventional cytology and the remaining aspirate was processed for the improved agar microbiopsy (AM) method. Conventional cytology slides, AM slides and surgical specimens were diagnosed separately, after which the diagnoses were compared....... Immunohistochemistry was performed as required on the AM sections. Surgical specimens served as the gold standard. Results In 53% of conventional cytologic smears, the cellular yield was sufficient to render a correct diagnosis. In 12% the diagnosis was incorrect, in 21% only a differential diagnosis could be fin......-initiated, and in 14% too few diagnostic cells were present in the conventional smears for cytologic diagnosis. It was, however, possible to correctly diagnose histologic sections from 97% of AM tissue blocks. In 11 cases this was facilitated with immunochemistry. In only 1 case did the AM tissue block contain too few...

  7. Silent aspiration: results of 2,000 video fluoroscopic evaluations.

    Science.gov (United States)

    Garon, Bernard R; Sierzant, Tess; Ormiston, Charles

    2009-08-01

    The purpose of this retrospective study of aspiration and the lack of a protective cough reflex at the vocal folds (silent aspiration) was to increase the awareness of nursing staffs of the diagnostic pathology groups associated with silent aspiration. Of the 2,000 patients evaluated in this study, 51% aspirated on the video fluoroscopic evaluation. Of the patients who aspirated, 55% had no protective cough reflex (silent aspiration). The diagnostic pathology groups with the highest rates of silent aspiration were brain cancer, brainstem stroke, head-neck cancer, pneumonia, dementia/Alzheimer, chronic obstructive lung disease, seizures, myocardial infarcts, neurodegenerative pathologies, right hemisphere stroke, closed head injury, and left hemisphere stroke. It is of high concern that the diagnostic groups identified in this research as having the highest risk of silent aspiration be viewed as "red-flag" patients by the nursing staff caring for them. Early nursing dysphagia screens, with close attention to the clinical symptoms associated with silent aspiration, and early referral for formal dysphagia evaluation are stressed.

  8. Leukocytes Mediate Acid Aspiration Induced Multi-Organ Injury

    National Research Council Canada - National Science Library

    Goldman, Gideon

    1991-01-01

    .... This study investigates whether localized acid aspiration triggers both local and remote PMN sequestration and whether these cells are responsible for pulmonary edema and systemic organ injury...

  9. Identification of distinct genes associated with seawater aspiration-induced acute lung injury by gene expression profile analysis

    Science.gov (United States)

    Liu, Wei; Pan, Lei; Zhang, Minlong; Bo, Liyan; Li, Congcong; Liu, Qingqing; Wang, Li; Jin, Faguang

    2016-01-01

    Seawater aspiration-induced acute lung injury (ALI) is a syndrome associated with a high mortality rate, which is characterized by severe hypoxemia, pulmonary edema and inflammation. The present study is the first, to the best of our knowledge, to analyze gene expression profiles from a rat model of seawater aspiration-induced ALI. Adult male Sprague-Dawley rats were instilled with seawater (4 ml/kg) in the seawater aspiration-induced ALI group (S group) or with distilled water (4 ml/kg) in the distilled water negative control group (D group). In the blank control group (C group) the rats' tracheae were exposed without instillation. Subsequently, lung samples were examined by histopathology; total protein concentration was detected in bronchoalveolar lavage fluid (BALF); lung wet/dry weight ratios were determined; and transcript expression was detected by gene sequencing analysis. The results demonstrated that histopathological alterations, pulmonary edema and total protein concentrations in BALF were increased in the S group compared with in the D group. Analysis of differential gene expression identified up and downregulated genes in the S group compared with in the D and C groups. A gene ontology analysis of the differential gene expression revealed enrichment of genes in the functional pathways associated with neutrophil chemotaxis, immune and defense responses, and cytokine activity. Kyoto Encyclopedia of Genes and Genomes analysis revealed that the cytokine-cytokine receptor interaction pathway was one of the most important pathways involved in seawater aspiration-induced ALI. In conclusion, activation of the cytokine-cytokine receptor interaction pathway may have an essential role in the progression of seawater aspiration-induced ALI, and the downregulation of tumor necrosis factor superfamily member 10 may enhance inflammation. Furthermore, IL-6 may be considered a biomarker in seawater aspiration-induced ALI. PMID:27509884

  10. Study of Educational Aspirations of Preparatory School Students in Yemen.

    Science.gov (United States)

    Edington, Everett D.

    To identify causes for low enrollment in secondary agricultural schools in Yemen, the United States Agency for International Development and the Yemen Ministry of Education surveyed 990 preparatory (junior high) students, examining their educational aspirations, differences between rural and urban youth, major influences on student aspirations,…

  11. Aspirations and occupational achievements of Dutch fathers and mothers

    NARCIS (Netherlands)

    Horst, M.F.J. van der; Lippe, A.G. van der; Kluwer, E.S.

    2014-01-01

    Purpose: The purpose of this paper is to investigate how work and family aspirations relate to occupational achievements and gender differences herein. Design/methodology/approach: Using data from 2009 the authors examined the relationship between career and childrearing aspirations and occupational

  12. Relationships of Teenage Smoking to Educational Aspirations and Parents' Education.

    Science.gov (United States)

    Waldron, Ingrid; Lye, Diane

    Past research has shown that teenagers with less educated parents and teenagers with lower academic aspirations are more likely than their peers to smoke. This study was conducted to provide additional descriptive data concerning the relationships of smoking to parents' education and students' educational aspirations and to provide preliminary…

  13. Total bilirubin in nasogastric aspirates: A potential new indicator of ...

    African Journals Online (AJOL)

    Background: The aim of our study was to investigate if total bilirubin (T-bil), amylase (Amy), and sodium (Na) in nasogastric (NG) aspirates can refl ect gastrointestinal motility reliably. Materials and Methods: NG aspirates from all laparotomies lasting more than 150 min in children less than 12 months old were studied for 3 ...

  14. Diagnosis Of Thyroid Enlargement: Use Of Fine Needle Aspiration ...

    African Journals Online (AJOL)

    One hundred and ten Fine Needle Aspiration Biopsies (FNAC) obtained from 87 patients with thyroid enlargement or nodules were retrospectively reviewed. Aspiration biopsy was accomplished using 21-gauge needle attached with 20-ml plastic syringe. There were 14 males and 73 females involved in the study. Sixty- four ...

  15. Rural Aspirations, Rural Futures: From "Problem" to Possibility

    Science.gov (United States)

    Tieken, Mara Casey; San Antonio, Donna M.

    2016-01-01

    Young people aspire, make choices, and develop within a particular place and historical context. Recently, federal and state governments, policy and research institutes, and advocacy organizations have shown a growing interest in the aspirations and transitions of rural youth--and, in particular, the role that schools play in shaping and…

  16. The role of information and aspiration in bargaining behaviour ...

    African Journals Online (AJOL)

    The dependent variable was bargaining behavior and was considered as aspiration, opening bids and bargaining outcomes. Data obtained revealed that participants with incomplete information had higher aspiration level and higher opening bid than those with complete information. Those with complete information and ...

  17. 21 CFR 886.4150 - Vitreous aspiration and cutting instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vitreous aspiration and cutting instrument. 886.4150 Section 886.4150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... cutting instrument. (a) Identification. A vitreous aspiration and cutting instrument is an electrically...

  18. Cold Antimatter Plasmas, and Aspirations for Cold Antihydrogen

    Science.gov (United States)

    2002-06-24

    UNCLASSIFIED Defense Technical Information Center Compilation Part Notice ADP012494 TITLE: Cold Antimatter Plasmas, and Aspirations for Cold...part numbers comprise the compilation report: ADP012489 thru ADP012577 UNCLASSIFIED Cold Antimatter Plasmas, and Aspirations for Cold Antihydrogen G...and positrons. The antiprotons come initially from the new Antiproton Decel- erator facility at CERN. Good control of such cold antimatter plasmas is

  19. Discordance Rate between Thyroid Fine Needle Aspiration Cytology ...

    African Journals Online (AJOL)

    Discordance Rate between Thyroid Fine Needle Aspiration Cytology and Histopathologic Diagnosis. Wondwossen Ergete, Daniel Abebe. Abstract. Fine Needle Aspiration (FNA) of the thyroid is a low cost procedure, which can give an accurate diagnosis promptly. The objective of this study was to assess the diagnostic ...

  20. Aspiration Pneumonia in Acute Stroke | SALAMI | Sahel Medical ...

    African Journals Online (AJOL)

    Abstract. This was a prospective study that was conducted between July 2000 and September 2001. It was designed to determine the incidence and the risk factor(s) of aspiration pneumonia in patients with acute cerebrovascular accident. Aspiration pneumonia was recorded in 23.5% of the 68 patients that were recruited.

  1. Aspirations and occupational achievements of Dutch fathers and mothers

    NARCIS (Netherlands)

    van der Horst, Mariska; van der Lippe, Tanja; Kluwer, Esther

    2014-01-01

    Purpose – The purpose of this paper is to investigate how work and family aspirations relate to occupational achievements and gender differences herein. Design/methodology/approach – Using data from 2009 the authors examined the relationship between career and childrearing aspirations and

  2. TABU SEARCH WITH ASPIRATION CRITERION FOR THE TIMETABLING PROBLEM

    Directory of Open Access Journals (Sweden)

    Oscar Chávez-Bosquez

    2015-01-01

    Full Text Available The aspiration criterion is an imperative element in the Tabu Search, with aspiration-by-default and the aspiration-by-objective the mainly used criteria in the literature. In this paper a new aspiration criterion is proposed in order to implement a probabilistic function when evaluating an element classified as tabu which improves the current solution, the proposal is called Tabu Search with Probabilistic Aspiration Criterion (BT- CAP. The test case used to evaluate the performance of the Probabilistic Aspiration Criterion proposed consists on the 20 instances of the problem described in the First International Timetabling Competition. The results are compared with 2 additional variants of the Tabu Search Algorithm: Tabu Search with Default Aspiration Criterion (BT-CAD and Tabu Search with Objective Aspiration Criterion (BT-CAO. Wilcoxon test was applied to the generated results, and it was proved with 99 % confidence that BT-CAP algorithm gets better solutions than the two other variants of the Tabu Search algorithm.

  3. Videofluoroscopic Predictors of Penetration-Aspiration in Parkinson's Disease Patients.

    Science.gov (United States)

    Argolo, Natalie; Sampaio, Marília; Pinho, Patrícia; Melo, Ailton; Nóbrega, Ana Caline

    2015-12-01

    Parkinson's disease (PD) patients show a high prevalence of swallowing disorders and tracheal aspiration of food. The videofluoroscopic study of swallowing (VFSS) allows clinicians to visualize the visuoperceptual and temporal parameters associated with swallowing disorders in an attempt to predict aspiration risk. However, this subject remains understudied in PD populations. Our aim was to identify the predictors of penetration-aspiration in PD patients using the VFSS. Consecutive patients were evaluated using VFSS with different consistencies and volumes of food. A speech-language pathologist measured the type of intra-oral bolus organization, loss of bolus control, bolus location at the initiation of the pharyngeal swallow, the presence of multiple swallows, piecemeal deglutition, bolus residue in the pharyngeal recesses and temporal measures. Scores ≥3 on the penetration-aspiration scale (PAS) indicated the occurrence of penetration-aspiration. Using logistic marginal regression, we found that residue in the vallecula, residue in the upper esophageal sphincter and piecemeal deglutition were associated with penetration-aspiration (odds ratio (OR) = 4.09, 2.87 and 3.83; P = 0.0040, 0.0071 and 0.0009, respectively). Penetration/aspiration occurred only with fluids (both of thin and thick consistency), and no significant differences were observed between fluid types or food volumes. The mechanisms underlying dysphagia and penetration/aspiration in PD patients and indications for further studies are discussed.

  4. Importance of Fine Needle Aspiration in Evaluation of Single ...

    African Journals Online (AJOL)

    Background: Improvements in the sensitivity and specificity of biochemical thyroid tests, as well as the development of fine needle aspiration biopsy (FNA) and improved cytological techniques, have dramatically impacted clinical strategies for detecting and treating thyroid disorders. Fine needle aspiration is a safe and ...

  5. Endoscopic Ultrasound Fine Needle Aspiration in the Diagnosis of Lymphoma

    Directory of Open Access Journals (Sweden)

    Koen Creemers

    2011-01-01

    Full Text Available In recent years, endoscopic ultrasound techniques with Fine Needle Aspiration (FNA have become an increasingly used diagnostic aid in the differentiation of mediastinal lymphadenopathy. Endobronchial ultrasound (EBUS and endoesophageal ultrasound (EUS are now available for clinicians to reach mediastinal and paramediastinal masses using a minimally invasive approach. These techniques are an established component for diagnosing and staging lung cancer and their benefit in the diagnosis of lymphoma's has been highlighted in a number of case studies. However, the lack of tissue architecture obtained by cytological FNA specimens decreases the diagnostic accuracy for benign causes of thoracic lymphadenopathies, lymphomas, and histopathological subtyping of lung cancer. Accordingly, our study group have adapted the FNA sampling technique, resulting in tissue fragments that can be used for histopathological examinations. As an illustration, we report a case of follicular non-Hodgkin lymphoma, diagnosed on tissue fragments obtained by adjusted EUS FNA. We believe that this relatively simple adjustment to routine FNA sampling can help to overcome the diagnostic limitations inherent in cytology obtained by routine FNA.

  6. Syphilitic lymphadenitis diagnosed via fine needle aspiration biopsy.

    Science.gov (United States)

    Jang, David W; Khan, Alifia; Genden, Eric M; Wu, Maoxin

    2011-08-01

    Syphilis is coming back in the recent a few decades especially in the gay and HIV populations. Since syphilis can be "the great mimic" clinically and pathologically, a case report with updated review can be helpful to the medical community. We report, a case of syphilitic lymphadenitis diagnosed via fine needle aspiration biopsy (FNAB). The pitfalls associated with the diagnosis of syphilitic lymphadenitis will be discussed. The patient's medical records were reviewed. The pertinent history, clinical course, and ancillary studies including FNAB cytology with special stains are presented. In addition to the case report, we discuss the diagnosis of syphilitic lymphadenitis and the role of FNAB cytology. This was a 37-year-old man presenting with a two-month history of a growing neck mass, night sweats, and a ten pound weight loss. The patient had been treated one month earlier for primary syphilis. Examination of the head and neck revealed a 3 cm right level II mass. FNAB cytology showed heterogeneous population of lymphocytes and plasma cells suggesting reactive changes. Modified silver staining of the cell block slide was performed and revealed spirochetes, consistent with syphilis. The patient's lymphadenitis resolved with a course of antibiotic treatment. Although lymphadenopathy is a rare presentation of syphilis, it should be included in the differential diagnosis for patients who offer a suspect history. FNAB with silver staining is an effective, minimally invasive way to confirm the diagnosis. Copyright © 2010 Wiley-Liss, Inc.

  7. Procalcitonin as Predictor of Bacterial Infection in Meconium Aspiration Syndrome.

    Science.gov (United States)

    K, Mahendiran; Batra, Prerna; Faridi, M M A; Singh, N P

    2017-12-29

     There is a lack of definite consensus on indications for initiating antibiotics in neonates with meconium aspiration syndrome (MAS), instigating researchers to search for a biomarker that can help differentiate MAS from MAS with bacterial infection.  Our primary objective was to compare serum procalcitonin (PCT) levels in full-term vigorous neonates having MAS with or without bacterial infection.  Seventy term vigorous neonates with diagnosis of MAS were enrolled. Blood samples were taken for sepsis screen, C-reactive protein (CRP), PCT, and blood culture at 6 ± 2 hours of respiratory distress. Neonates were categorized into group 1 (MAS without bacterial infection) and group 2 (MAS with bacterial infection) based on blood culture. The duration of our study was 18 months.  Mean ± standard deviation PCT level was 2.52 ± 3.99 in group 1 and 2.71 ± 4.22 in group 2, which was comparable. At cutoff of 0.1 ng/mL, PCT had a sensitivity of 90% and specificity of 8% in detecting bacterial infection. Mean total leukocyte count, absolute neutrophil count, immature to total leucocyte ratio, microerythrocyte sedimentation rate, and CRP were comparable.  Though PCT is an early and reliable marker of neonatal infection, the levels were increased in neonates with MAS irrespective of the presence of bacterial infection. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. Recurrent Aspiration Pneumonia due to Anterior Cervical Osteophyte

    Directory of Open Access Journals (Sweden)

    Jae Jun Lee

    2017-02-01

    Full Text Available A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.

  9. The Astrophysics Project Integrating Research and Education (ASPIRE)

    Science.gov (United States)

    Callahan, J.

    The Astrophysics Science Project Integrating Research and Education (ASPIRE) is funded by the National Science Foundation as the public education and outreach (EPO) component the High Resolution Fly's Eye Cosmic Ray Research Group. Since 1997, ASPIRE has been creating some of the most engaging and interactive science lessons and lab activities on the World Wide Web. In this poster, we will present an overview of the ASPIRE project, and report on the the most recent usage statistics. In addition to creating and maintaining lessons and the website, ASPIRE provides direct outreach to local teachers and students. These contacts include, in particular, local groups that are under-represented in the scientific and technical fields. Continuing as the EPO arm of the new Telescope Array (TA/TALE) project, ASPIRE will also be conducting summer workshops for students and teachers in Millard County, where the new experiment is under construction.

  10. Destroyed lung due to aspiration of phenolphthalein.

    Science.gov (United States)

    De Wulf, M; Ceuppens, H; Gheysens, B; Inderadjaja, N

    2005-01-01

    A 76-year-old female, presented with a recurrent cough and haemoptysis after an aspiration of a 'grain de Valls'. Chest radiography and computed tomography demonstrated an atelectasis of the medial segment of the right middle pulmonary lobe. Bronchoscopy was negative for any malignancy but the onco-PET-scan showed a pathologic hypermetabolic lesion in the right middle lobe. A lobectomy was performed and pathology revealed a 'destroyed lung' with images of foreign body reactions and microabscesses without any sign of malignancy. Postoperatively, clinical improvement with complete resolution of the symptoms was observed. With this case report we demonstrate the irritative and clastogenic characteristics of phenolphtalein, the main active ingredient of the 'grain de Valls'. This case also illustrates an example of a false positive PET-scan.

  11. Transbronchial needle aspiration "by the books"

    Directory of Open Access Journals (Sweden)

    Kupeli Elif

    2011-01-01

    Full Text Available Background : Training for advanced bronchoscopic procedures is acquired during the interventional pulmonology (IP Fellowship. Unfortunately a number of such programs are small, limiting dissemination of formal training. Objective : We studied success of conventional transbronchial needle aspiration (C-TBNA in the hands of physicians without formal IP training. Methods : A technique of C-TBNA was learned solely from the literature, videos and practicing on inanimate models at "Hands-On" courses. Conventional TBNA with 21 and/or 19 gauge Smooth Shot Needles (Olympus® , Japan was performed on consecutive patients with undiagnosed mediastinal lymphadenopathy. Results : Thirty-four patients (male 23, mean age 54.9 ± 11.8 years underwent C-TBNA. Twenty-two patients had nodes larger than 20 mms. Suspected diagnoses were malignancy in 20 and nonmalignant conditions in 14. Final diagnoses were malignancy 17, sarcoidosis 4, reactive lymph nodes 12, and tuberculosis 1. Final diagnosis was established by C-TBNA in 14 (11 malignancy, 3 sarcoidosis; yield 41.1%, mediastinoscopy in 14, transthoracic needle aspiration in 3, peripheral lymph node biopsies in 2 and by endobronchial biopsy in 1. Nodal size had an impact on outcome (P = 0.000 while location did not (P = 0.33. C-TBNA was positive in 11/20 when malignancy was suspected (yield 55%, while 3/14 when benign diagnosis was suspected (yield 21.4% (P = 0.05. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 66.6%, 100%, 100%, 65%, and 79.4%, respectively. There were no complications or scope damage. Conclusion : Conventional-TBNA can be learned by the books and by practicing on inanimate models without formal training and results similar to those published in the literature could be achieved.

  12. Aspiration Risk and Respiratory Complications in Patients with Esophageal Atresia.

    Science.gov (United States)

    Kovesi, Thomas

    2017-01-01

    Chronic, long-term respiratory morbidity (CRM) is common in patients with a history of repaired congenital esophageal atresia, typically associated with tracheoesophageal fistula (EA/TEF). EA/TEF patients are at high risk of having aspiration, and retrospective studies have associated CRM with both recurrent aspiration and atopy. However, studies evaluating the association between CRM in this population and either aspiration or atopy have reported conflicting results. Furthermore, CRM in this population may be due to other related conditions as well, such as tracheomalacia and/or recurrent infections. Aspiration is difficult to confirm, short of lung biopsy. Moreover, even within the largest evidence base assessing the association between CRM and aspiration, which has evaluated the potential relationship between gastroesophageal reflux and asthma, findings are contradictory. Studies attempting to relate CRM to prior aspiration events may inadequately estimate the frequency and severity of previous aspiration episodes. There is convincing evidence documenting that chronic, massive aspiration in patients with repaired EA/TEF is associated with the development of bronchiectasis. While chronic aspiration is likely associated with other CRM in patients with repaired EA/TEF, this does not appear to have been confirmed by the data currently available. Prospective studies that systematically evaluate aspiration risk and allergic disease in patients with repaired EA/TEF and document subsequent CRM will be needed to clarify the causes of CRM in this population. Given the prevalence of CRM, patients with repaired EA/TEF should ideally receive regular follow-up by multidisciplinary teams with expertise in this condition, throughout both childhood and adulthood.

  13. Risk Factors for Aspiration Pneumonia in Older Adults.

    Science.gov (United States)

    Manabe, Toshie; Teramoto, Shinji; Tamiya, Nanako; Okochi, Jiro; Hizawa, Nobuyuki

    2015-01-01

    Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly. We conducted an observational study using data from a nationwide survey of geriatric medical and nursing center in Japan. The study subjects included 9930 patients (median age: 86 years, women: 76%) who were divided into two groups: those who had experienced an episode of aspiration pneumonia in the previous 3 months and those who had not. Data on demographics, clinical status, activities of daily living (ADL), and major illnesses were compared between subjects with and without aspiration pneumonia. Two hundred and fifty-nine subjects (2.6% of the total sample) were in the aspiration pneumonia group. In the univariate analysis, older age was not found to be a risk factor for aspiration pneumonia, but the following were: sputum suctioning (odds ratio [OR] = 17.25, 95% confidence interval [CI]: 13.16-22.62, p risk factors associated with aspiration pneumonia after propensity-adjustment (258 subjects each) were sputum suctioning (OR = 3.276, 95% CI: 1.910-5.619), deterioration of swallowing function in the past 3 months (OR = 3.584, 95% CI: 1.948-6.952), dehydration (OR = 8.019, 95% CI: 2.720-23.643), and dementia (OR = 1.618, 95% CI: 1.031-2.539). The risk factors for aspiration pneumonia were sputum suctioning, deterioration of swallowing function, dehydration, and dementia. These results could help improve clinical management for preventing repetitive aspiration pneumonia.

  14. Diffraction enhanced imaging of a rat model of gastric acid aspiration pneumonitis.

    Science.gov (United States)

    Connor, Dean M; Zhong, Zhong; Foda, Hussein D; Wiebe, Sheldon; Parham, Christopher A; Dilmanian, F Avraham; Cole, Elodia B; Pisano, Etta D

    2011-12-01

    Diffraction-enhanced imaging (DEI) is a type of phase contrast x-ray imaging that has improved image contrast at a lower dose than conventional radiography for many imaging applications, but no studies have been done to determine if DEI might be useful for diagnosing lung injury. The goals of this study were to determine if DEI could differentiate between healthy and injured lungs for a rat model of gastric aspiration and to compare diffraction-enhanced images with chest radiographs. Radiographs and diffraction-enhanced chest images of adult Sprague Dawley rats were obtained before and 4 hours after the aspiration of 0.4 mL/kg of 0.1 mol/L hydrochloric acid. Lung damage was confirmed with histopathology. The radiographs and diffraction-enhanced peak images revealed regions of atelectasis in the injured rat lung. The diffraction-enhanced peak images revealed the full extent of the lung with improved clarity relative to the chest radiographs, especially in the portion of the lower lobe that extended behind the diaphragm on the anteroposterior projection. For a rat model of gastric acid aspiration, DEI is capable of distinguishing between a healthy and an injured lung and more clearly than radiography reveals the full extent of the lung and the lung damage. Copyright © 2011 AUR. All rights reserved.

  15. Three-dimensional cytomorphology in fine needle aspiration biopsy of medullary thyroid carcinoma.

    Science.gov (United States)

    Chang, T C; Lai, S M; Wen, C Y; Hsiao, Y L; Huang, S H

    2001-01-01

    To elucidate three-dimensional (3-D) cytomorphology in fine needle aspiration biopsy (FNAB) of medullary thyroid carcinoma (MTC). ENAB was performed on tumors from five patients with MTC. The aspirate was stained and observed under a light microscope (LM). The aspirate was also fixed, dehydrated, critical point dried, spattered with gold ions and observed with a scanning electron microscope (SEM). For transmission electron microscopy (TEM), the specimen was fixed, dehydrated, embedded in an Epon mixture, cut with an ultramicrotome, mounted on copper grids, electron doubly stained with uranium acetate and lead citrate, and observed with TEM. Findings under SEM were correlated with those under LM and TEM. Under SEM, 3-D cytomorphology of MTC displayed a disorganized cellular arrangement with indistinct cell borders in three cases. The cell surface was uneven and had granular protrusions that corresponded to secretory granules observed under TEM. In one case with multiple endocrine neoplasia type IIB, there were abundant granules on the cell surface. In one case of sporadic MTC with multinucleated tumor giant cells and small cells, granular protrusions also were noted on the cell surface. Granular protrusion was a characteristic finding in FNAB of MTC tinder SEM and might be helpful in the differential diagnosis.

  16. Pre-hospital aspiration is associated with increased pulmonary complications.

    Science.gov (United States)

    Fawcett, Vanessa J; Warner, Keir J; Cuschieri, Joseph; Copass, Michael; Grabinsky, Andreas; Kwok, Heemun; Rea, Thomas; Evans, Heather L

    2015-04-01

    Rates of ventilator-associated pneumonia (VAP) are highest among patients intubated on an emergency basis following trauma. We reported previously a retrospective analysis demonstrating an association between subjective aspiration and VAP after pre-hospital intubation. We hypothesize that by directing paramedics to note features of aspiration at intubation, we will confirm prospectively the association between pre-hospital aspiration and subsequent pneumonia in trauma patients. Paramedics collected data regarding aspiration at the time of intubation. All intubated patients admitted to a level 1 trauma center intensive care unit (ICU) were included. Data comprised a clinical impression of pre-hospital aspiration, as well as the presence and timing of blood and emesis in the airway. Injury severity, co-morbidities, and outcomes were collected from the trauma registry. Healthcare-associated pneumonia (HAP) was identified by medical record review of both bronchoalveolar lavage culture results and discharge diagnosis. Descriptive statistics and univariate analysis of outcomes by aspiration status, as well as covariable adjustment using propensity scores, were performed. Of the 228 patients, 89 (39%) were determined by paramedics to have aspirated. The majority of those who aspirated (84 [94%]) did so prior to intubation. Patients who aspirated had higher Injury Severity Scores than those who did not aspirate (25.0 ± 1.7 vs. 21.9 ± 1.5 points; p=0.04) and lower preintubation Glasgow Coma Scale scores (8.2 ± 0.50 vs. 9.6 ± 0.40; p=0.02). Of the 89 patients who aspirated around the time of intubation, 14 (16%) developed HAP vs. five (3.6%) of those who did not aspirate (paspiration (deaths: 21 [23.6%] vs. 23 [16.6%]; p=0.19; ICU LOS: 5.3 ± 0.9 vs. 4.1 ± 0.5 days; p=0.13; duration of mechanical ventilation: 5.3 ± 1.2 vs. 3.2 ± 0.5 days; p=0.10). Aspiration prior to intubation was reported commonly by paramedics and was associated with a higher risk of HAP.

  17. Comparison of manual and suction pump aspiration techniques for performing bronchoalveolar lavage in 18 dogs with respiratory tract disease.

    Science.gov (United States)

    Woods, K S; Defarges, A M N; Abrams-Ogg, A C G; Viel, L; Brisson, B A; Bienzle, D

    2014-01-01

    Different aspiration techniques to retrieve bronchoalveolar lavage fluid (BALF) affect sample quality in healthy dogs. Studies evaluating these techniques in dogs with respiratory disease are lacking. To compare sample quality of BALF acquired by manual aspiration (MA) and suction pump aspiration (SPA). Eighteen client-owned dogs with respiratory disease. Randomized, blinded prospective clinical trial. Manual aspiration was performed with a 35-mL syringe attached directly to the bronchoscope biopsy channel and SPA was performed with a maximum of 50 mmHg negative pressure applied to the bronchoscope suction valve using the suction trap connection. Both aspiration techniques were performed in each dog on contralateral lung lobes, utilizing 2 mL/kg lavage volumes per site. Samples of BALF were analyzed by percentage of retrieved infusate, total nucleated cell count (TNCC), differential cell count, semiquantitative assessment of slide quality, and diagnosis score. Data were compared by paired Student's t-test, Wilcoxon signed-rank test, chi-squared test, and ANOVA. Cohen's kappa coefficient was used to assess agreement. The percentage of retrieved BALF (P = .001) was significantly higher for SPA than MA. Substantial agreement was found between cytologic classification of BALF obtained with MA and SPA (kappa = 0.615). There was no significant difference in rate of definitive diagnosis achieved with cytologic assessment between techniques (P = .78). Suction pump aspiration, compared to MA, improved BALF retrieval, but did not significantly affect the rate of diagnostic success of bronchoalveolar lavage (BAL) in dogs with pulmonary disease. Copyright © 2014 by the American College of Veterinary Internal Medicine.

  18. Fine needle aspiration cytology in a case of fibrous dysplasia of jaw.

    Science.gov (United States)

    Gupta, Nalini; Gupta, Ruchi; Bakshi, Jaimanti; Rajwanshi, Arvind

    2009-12-01

    Fibro-osseous lesions of the jaw comprise of a spectrum of diseases which include osseous dysplasia, fibrous dysplasia, and ossifying fibroma. The differentiation amongst these individual pathological lesions is difficult and a combined clinico-radiological and histological correlation is essential for exact categorization. Fine needle aspiration cytology (FNAC) is frequently carried out to distinguish between benign and malignant lesions of the jaw as is a quick and reliable modality of investigation which guides in further management. We report, a case of a jaw swelling in a young male, diagnosed as fibrous dysplasia on FNAC.

  19. Predictors of mortality in neonates with meconium aspiration syndrome.

    Science.gov (United States)

    Louis, Deepak; Sundaram, Venkataseshan; Mukhopadhyay, Kanya; Dutta, Sourabh; Kumar, Praveen

    2014-08-01

    To identify risk factors for mortality in neonates with meconium aspiration syndrome. All neonates (2004-2010) with meconium aspiration syndrome, irrespective of gestation were included. Risk factors were compared between those who died and survived. Out of 172 included neonates, 44 (26%) died. Mean (SD) gestation and birth weight were 37.9 (2.3) weeks and 2545 (646g), respectively. Myocardial dysfunction [aOR 28.4; 95% CI (8.0-101); PMeconium aspiration syndrome is associated with significant mortality. Myocardial dysfunction, birth weight, and initial oxygen requirement are independent predictors of mortality.

  20. Comparison between manual aspiration via polyethylene tubing and aspiration via a suction pump with a suction trap connection for performing bronchoalveolar lavage in healthy dogs.

    Science.gov (United States)

    Woods, Katharine S; Defarges, Alice M N; Abrams-Ogg, Anthony C G; Dobson, Howard; Viel, Laurent; Brisson, Brigitte A; Bienzle, Dorothee

    2013-04-01

    To compare the diagnostic quality of bronchoalveolar lavage (BAL) fluid acquired from healthy dogs by manual aspiration via polyethylene tubing (MAPT) and via suction pump aspiration (SPA) with a suction trap connection. 12 healthy adult Beagles. BAL was performed with bronchoscopic guidance in anesthetized dogs. The MAPT was performed with a 35-mL syringe attached to polyethylene tubing wedged in a bronchus via the bronchoscope's biopsy channel. The SPA was performed with 5 kPa of negative pressure applied to the bronchoscope's suction valve via a suction trap. The MAPT and SPA techniques were performed in randomized order on opposite caudal lung lobes of each dog. Two 1 mL/kg lavages were performed per site. Samples of BAL fluid were analyzed on the basis of a semiquantitative quality scale, percentage of retrieved fluid, and total nucleated and differential cell counts. Results were compared with Wilcoxon signed rank tests. Percentage of BAL fluid retrieved (median difference, 16.2%), surfactant score (median difference, 1), and neutrophil count (median difference, 74 cells/μL) were significantly higher for SPA than for MAPT. A higher BAL fluid epithelial cell score was obtained via MAPT, compared with that for samples obtained via SPA (median difference, 1). Results indicated that in healthy dogs, SPA provided a higher percentage of BAL fluid retrieval than did MAPT. The SPA technique may improve the rate of diagnostic success for BAL in dogs, compared with that for MAPT. Further evaluation of these aspiration techniques in dogs with respiratory tract disease is required.

  1. Placental Lesions in Meconium Aspiration Syndrome

    Directory of Open Access Journals (Sweden)

    Binnari Kim

    2017-09-01

    Full Text Available Background Meconium aspiration syndrome (MAS is defined by respiratory distress requiring supplemental oxygen in a meconium-stained neonate. MAS is clinically subclassified as mild, moderate, and severe according to the oxygen requirement. The aims of this study were to compare the histological findings in the placentas of MAS neonates with those of meconium-stained but non-MAS neonates and to analyze the correlation between the severity of MAS and the grade of its histological parameters. Methods We collected 160 singleton term placentas from neonates with meconium staining at birth from a tertiary medical center, Seoul, Republic of Korea. We reviewed hematoxylin and eosin sections of tissue samples (full-thickness placental disc, chorioamniotic membranes, and umbilical cord. Results Funisitis was present more frequently in MAS than in non-MAS (p < .01, of which the stage was correlated with the severity of MAS (p < .001. The histological findings consistent with maternal underperfusion and chronic deciduitis were more frequent in MAS than in non-MAS (p < .05. There was a correlation between the degree of chorionic vascular muscle necrosis and the severity of MAS (p < .05. Conclusions Our results suggest that fetal inflammatory response evidenced by funisitis occurs prenatally in MAS and that the stage of funisitis and of chorionic vascular muscle necrosis may be a predictive marker of the severity of MAS.

  2. Placental Lesions in Meconium Aspiration Syndrome.

    Science.gov (United States)

    Kim, Binnari; Oh, Soo-Young; Kim, Jung-Sun

    2017-09-01

    Meconium aspiration syndrome (MAS) is defined by respiratory distress requiring supplemental oxygen in a meconium-stained neonate. MAS is clinically subclassified as mild, moderate, and severe according to the oxygen requirement. The aims of this study were to compare the histological findings in the placentas of MAS neonates with those of meconium-stained but non-MAS neonates and to analyze the correlation between the severity of MAS and the grade of its histological parameters. We collected 160 singleton term placentas from neonates with meconium staining at birth from a tertiary medical center, Seoul, Republic of Korea. We reviewed hematoxylin and eosin sections of tissue samples (full-thickness placental disc, chorioamniotic membranes, and umbilical cord). Funisitis was present more frequently in MAS than in non-MAS (p < .01), of which the stage was correlated with the severity of MAS (p < .001). The histological findings consistent with maternal underperfusion and chronic deciduitis were more frequent in MAS than in non-MAS (p < .05). There was a correlation between the degree of chorionic vascular muscle necrosis and the severity of MAS (p < .05). Our results suggest that fetal inflammatory response evidenced by funisitis occurs prenatally in MAS and that the stage of funisitis and of chorionic vascular muscle necrosis may be a predictive marker of the severity of MAS.

  3. Lung ultrasound findings in meconium aspiration syndrome.

    Science.gov (United States)

    Piastra, Marco; Yousef, Nadya; Brat, Roselyne; Manzoni, Paolo; Mokhtari, Mostafa; De Luca, Daniele

    2014-09-01

    Meconium aspiration syndrome (MAS) is a rare and life-threatening neonatal lung injury induced by meconium in the lung and airways. Lung ultrasound (LUS) is a quick, easy and cheap imaging technique that is increasingly being used in critical care settings, also for newborns. In this paper we describe ultrasound findings in MAS. Six patients with MAS of variable severity were examined by LUS during the first hours of life. Chest X-rays were used as reference. The following dynamic LUS signs were seen in all patients: (1) B-pattern (interstitial) coalescent or sparse; (2) consolidations; (3) atelectasis; (4) bronchograms. No pattern was observed for the distribution of signs in lung areas, although the signs varied with time, probably due to the changing localisation of meconium in the lungs. LUS images corresponded well with X-ray findings. In conclusion, we provide the first formal description of LUS findings in neonates with MAS. LUS is a useful and promising tool in the diagnosis and management of MAS, providing real-time bedside imaging, with the additional potential benefit of limiting radiation exposure in sick neonates. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Fine-needle aspiration biopsy of synovial sarcoma. A cytomorphologic analysis of primary, recurrent, and metastatic tumors.

    Science.gov (United States)

    Kilpatrick, S E; Teot, L A; Stanley, M W; Ward, W G; Savage, P D; Geisinger, K R

    1996-12-01

    Thirteen fine-needle aspiration specimens from 10 patients with histologically proven synovial sarcoma are described. The aspiration biopsy specimens were obtained from the primary tumor in five cases, locally recurrent tumors in four cases, pulmonary metastases in three cases, and mediastinal metastasis in one case. Patient's ages ranged from 22 years to 65 years; there were four women and six men. All cases had a confirmation biopsy and/or resection specimen that were reviewed. Histologic subtypes included monophasic fibrous (5 cases), monophasic epithelial (1 case), biphasic (3 cases), and poorly differentiated (1 case). The majority of the aspiration biopsy specimens were similar with moderate to marked smear cellularity dominated by cohesive clusters of spindle-shaped cells with ovoid, hyperchromatic nuclei and scanty tapering cytoplasm. Nucleoli were not prominent. Epithelial tumor cells with ovoid to round, mostly regular, centrally to eccentrically located nuclei, surrounded by scant to abundant cytoplasm predominated in one case (monophasic epithelial) and were admixed with spindle cells in a second (classical biphasic). Multi-nucleated tumor giant cells were not observed in any of the tumors. In biphasic synovial sarcoma, the neoplastic spindle cells are generally more numerous and frequent than the epithelial cells, making distinction from monophasic synovial sarcoma or other spindle cell soft tissue tumors difficult. Although synovial sarcoma may be diagnosed by fine-needle aspiration cytology, clinical correlation, especially in monophasic types, is necessary to minimize errors in sarcoma classification.

  5. Career Aspirations and Emotional Adjustment of Chinese International Graduate Students

    Directory of Open Access Journals (Sweden)

    Deanna L. Cozart

    2015-12-01

    Full Text Available There are more Chinese student-scholars than any other group of international students studying in the United States. Despite this, there are relatively few studies that have focused on specific educational needs and required career support services for Chinese international students. This exploratory study was conducted to determine the relationship between career aspirations and emotional adjustment of Chinese international students. Results from Chinese students were compared with those of students from the United States. Relationships between the career aspirations and emotional adjustment of Chinese and U.S. students did not reveal statistically significant differences. However, regression analysis indicated that social stress was a statistically significant predictor of career aspirations for U.S. students. Chinese and U.S. students were more alike than different on career aspirations and emotional adjustment, and observed educational similarities appeared to outweigh any cultural differences that existed when determining these outcomes.

  6. Micronuclei in breast aspirates. Is scoring them helpful?

    Directory of Open Access Journals (Sweden)

    A Hemalatha

    2014-01-01

    Conclusion: An increase in micronuclei values was seen from fibroadenoma to infiltrating ductal carcinoma. Micronuclei scoring can be used as a biomarker on fine needle aspiration cytology smears of breast carcinoma.

  7. An analysis of students' aspirations, expectations and gains in ...

    African Journals Online (AJOL)

    Assessment Questionnaire that examined students' expectations, aspirations, perceived and envisaged needs or gains using Eisner's (1985) five orientations, namely: the development of cognitive processes; academic rationalism; personal relevance; social adaptation or reconstruction; and curriculum as technology,

  8. Aspirations of young people living in disadvantaged areas in Denmark

    DEFF Research Database (Denmark)

    Frørup, Anna Kathrine; Jensen, Niels Rosendal

    2017-01-01

    how young people's (living in a socially disadvantaged area) possibilities, aspirations and demands are raised, strengthened, transformed or put aside and in what way they feel participating within different local programmes....

  9. Measurement of membrane elasticity by micro-pipette aspiration

    DEFF Research Database (Denmark)

    Henriksen, Jonas Rosager; Ipsen, John H.

    2004-01-01

    The classical micro-pipette aspiration technique, applied for measuring the membrane bending elasticity, is in the present work reviewed and extended to span the range of pipette aspiration pressures going through the °accid (low pressures) to tense (high pressures) membrane regime. The quality...... of the conventional methods for analysing data is evaluated using numerically generated data and a new method for data analysis, based on thermodynamic analysis and detailed statistical mechanical modelling, is introduced. The analysis of the classical method, where the membrane bending modulus is obtained from micro......-pipette aspiration data acquired in the low-pressure regime, reveals a signi¯cant correction from membrane stretching elasticity. The new description, which includes the full vesicle geometry and both the membrane bending and stretching elasticity, is used for the interpretation of micro-pipette aspiration...

  10. Comparison of manual vacuum aspiration and misoprostol in the ...

    African Journals Online (AJOL)

    Comparison of manual vacuum aspiration and misoprostol in the management of inc omplete abortion. Gabkika Bray Madoue, Dangar Daniel, Adoum Tchari, Mahamat Chene, Khadidja Mahayedine Salah, Zakaria Brahim, Constant Naîm, Ndilbe Steve ...

  11. Farm practical training and job aspiration of undergraduates of ...

    African Journals Online (AJOL)

    Farm practical training and job aspiration of undergraduates of agriculture in universities in Kwara State, Nigeria. Olayinka Jelili Yusuf, Ibrahim Folorunsho Ayanda, Felicia Motunrayo Olooto, Latifat Ololade Salawu, Stephen Kayode Subair ...

  12. Current Concepts in the Management of Meconium Aspiration Syndrome.

    Science.gov (United States)

    Chettri, Subhash; Bhat, B Vishnu; Adhisivam, B

    2016-10-01

    In developing countries, meconium aspiration syndrome (MAS) is an important cause of morbidity and mortality among neonates. The concepts of pathophysiology and management of meconium stained amniotic fluid (MSAF) and meconium aspiration syndrome have undergone tremendous change in recent years. Routine intranatal and postnatal endotracheal suctioning of meconium in vigorous infants is no longer recommended. Recent studies have challenged its role even in non-vigorous infants. Supportive therapy like oxygen supplementation, mechanical ventilation and intravenous fluids are the cornerstone in the management of meconium aspiration syndrome. Availability of surfactant, inhaled nitric oxide, high frequency ventilators and extracorporeal membrane oxygenation has made it possible to salvage more infants with meconium aspiration syndrome. In this review the authors have discussed the current concepts in the pathophysiology and management of MAS. Drugs in trials and future therapeutic targets are also discussed briefly.

  13. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

    Directory of Open Access Journals (Sweden)

    P. J. Corsi

    1999-01-01

    Full Text Available Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.

  14. Cryoextraction: A novel approach to remove aspirated chewing gum

    Directory of Open Access Journals (Sweden)

    Edmundo Rubio

    2013-01-01

    Full Text Available The extraction of aspirated foreign bodies can prove challenging at times, requiring even rigid bronchoscopy. Cryotherapy probes have been reported to help with extraction of foreign bodies. We present a case where successful "cryoextraction" was performed on an aspirated chewing gum. The case highlights the fact that this technique is useful to extract all materials that have water content. This technique can be performed through flexible bronchoscopy and can save patients from more aggressive approaches.

  15. A Case of Bipolar Affective Disorder and Aspiration Pneumonia

    Directory of Open Access Journals (Sweden)

    Alessandro Gerada

    2013-01-01

    Full Text Available Adults with mental illness are at a higher risk of aspiration pneumonia than the general population. We describe the case of a patient with bipolar affective disorder and two separate episodes of aspiration pneumonia associated with acute mania. We propose that he had multiple predisposing factors, including hyperverbosity, sedative medications, polydipsia (psychogenic and secondary to a comorbidity of diabetes insipidus, and neuroleptic side effects.

  16. Advances in the Management of Meconium Aspiration Syndrome

    OpenAIRE

    Swarnam, Kamala; Soraisham, Amuchou S.; Sivanandan, Sindhu

    2011-01-01

    Meconium aspiration syndrome (MAS) is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hype...

  17. Risk Factors for Aspiration Pneumonia After Endoscopic Hemostasis.

    Science.gov (United States)

    Kawanishi, Koki; Kato, Jun; Toda, Nobuo; Yamagami, Mari; Yamada, Tomoharu; Kojima, Kentaro; Ohki, Takamasa; Seki, Michiharu; Tagawa, Kazumi

    2016-03-01

    Although all types of endoscopic procedures harbor risk of aspiration, little is understood about risk factors for aspiration pneumonia developing after endoscopic hemostasis. The present study aimed to identify risk factors for aspiration pneumonia after endoscopic hemostasis. Charts from consecutive patients with upper gastrointestinal bleeding that had been treated by endoscopic hemostasis at a single center between January 2004 and January 2015 were retrospectively reviewed. Patient information and clinical characteristics including cause of hemorrhage, established prognostic scales, laboratory data, comorbidities, medications, duration of endoscopic hemostasis, vital signs, sedative use, and the main operator during the procedure were compared between patients who developed aspiration pneumonia and those who did not. Aspiration pneumonia developed in 24 (4.8%) of 504 patients after endoscopic hemostasis. Endotracheal intubation was required for three of them, and one died of the complication. Multivariate analysis revealed that age >75 years (odds ratio (OR) 4.4; 95% confidence interval (CI) 1.5-13.6; p = 0.0073), procedural duration >30 min (OR 5.6; 95% CI 1.9-18.2; p = 0.0023), hemodialysis (OR 3.6; 95% CI 1.2-11; p = 0.024), and a history of stroke (OR 3.8; 95% CI 1-14; p = 0.041) were independent risk factors for developing aspiration pneumonia. Specific risk factors for aspiration pneumonia after endoscopic hemostasis were identified. Endoscopists should carefully consider aspiration pneumonia when managing older patients who are on hemodialysis, have a history of stroke, and undergo a longer procedure.

  18. The impact of homelessness on children's level of aspiration.

    Science.gov (United States)

    Donahue, P J; Tuber, S B

    1995-01-01

    In a sample of 39 school-age homeless children, their length of stay in shelters for the homeless was significantly correlated with an index of their level of aspiration. This correlation remained significant even when the effects of the children's intelligence and their performance on a related cognitive task were partialed out. Stories given in response to two Thematic Apperception Test cards by a small sample of these children illustrate the potentially traumatic consequences of homelessness on children's hopes and aspirations.

  19. [Gastric aspiration therapy is a possible alternative to treatment of obesity

    DEFF Research Database (Denmark)

    Christensen, Marie Møller; Jorsal, Tina; Naver, Lars Peter Skat

    2017-01-01

    Aspiration therapy with AspireAssist is a novel endoscopic obesity treatment. Patients aspirate approximately 30% of an ingested meal through a draining system connected to a percutanous endoscopic gastrostomy tube. AspireAssist was recently approved by the US Food and Drug Administration...

  20. Microbiological profile of anterior chamber aspirates following uncomplicated cataract surgery

    Directory of Open Access Journals (Sweden)

    Prajna N

    1998-01-01

    Full Text Available Anterior chamber aspirate cultures were done for 66 patients who underwent either an uncomplicated intracapsular cataract extraction, extracapsular cataract extraction with posterior-chamber intraocular lens implantation, or phacoemulsification with posterior-chamber intraocular lens implantation. The aspirate was obtained at the time of wound closure. The aspirates were immediately transferred to the microbiology laboratory where one drop of the aspirate was placed on a glass slide for gram stain, and the remainder was unequally divided and inoculated into blood agar, chocolate agar and thioglycolate broth. The cultures were incubated at 37° C with 5% CO2 and held for 5 days. Of 66 patients 4 (6%, had smear-positive anterior chamber aspirates. None of the aspirates showed any growth on any of the 3 culture media used. None of the eyes in the study developed endophthalmitis. This study concludes that there is no contamination of the anterior chamber by viable bacteria after cataract surgery, irrespective of the mode of intervention.

  1. Quality of canine spermatozoa retrieved by percutaneous epididymal sperm aspiration.

    Science.gov (United States)

    Varesi, S; Vernocchi, V; Faustini, M; Luvoni, G C

    2013-02-01

    To investigate the feasibility of percutaneous epididymal sperm aspiration in dogs and whether it might provide a population of epididymal spermatozoa similar to the population that can be obtained by processing isolated epididymis caudae. Concentration and total sperm number, motility, morphology and acrosomal integrity of spermatozoa retrieved by percutaneous epididymal sperm aspiration, in vitro aspiration and mincing of the cauda of the epididymis were compared. Percutaneous epididymal sperm aspiration is a feasible procedure to retrieve a population of spermatozoa in dogs. Quality is similar to that of spermatozoa collected in vitro, although a wide variation amongst animals was observed. In case of ejaculation failure due to pathological conditions in dogs, the collection of spermatozoa from the cauda of the epididymis could be an option for providing gametes for assisted reproductive technologies. Percutaneous epididymal sperm aspiration can be used in dogs with compromised reproductive performance, in which orchiectomy cannot be performed for medical or owner reasons. Further studies aimed to investigate whether the percutaneous epididymal sperm aspiration technique might be feasible for repeated semen collection and to accurately evaluate side effects are required. © 2013 British Small Animal Veterinary Association.

  2. Blood lactate level and meconium aspiration syndrome.

    Science.gov (United States)

    Karabayir, Nalan; Demirel, Ali; Bayramoglu, Elvan

    2015-04-01

    Approximately 5% of infants born with a meconium-stained amniotic fluid (MSAF) develop meconium aspiration syndrome (MAS). Early recognition of infants at highest risk for the development of MAS and the prediction of disease severity are important for optimizing the clinical strategies for prevention and treatment. The aim of the present study was to identify the risk factors for MAS and to investigate the effect of blood lactate level on the development of MAS. Between January 2011 and January 2012, data were recorded with regard to gender, mode of delivery, gestational week, birth weight, 5-min Apgar score, and need for resuscitation of the meconium-stained depressed infants who underwent tracheal aspiration. Moreover, the number of cases developing MAS, blood pH value, and lactate level in capillary blood gases obtained during the first hour after delivery, duration of oxygen supplementation, the number of cases receiving mechanical ventilation and surfactant therapy, duration of hospital stay, and outcomes of the infants were recorded. The number of live births during the study period was 17,202, and of them, 1,341 (7.8%) infants were born through MSAF. Of 195 infants who were meconium-stained depressed, 90 were girls and 105 were boys. Their mean gestational week was 39.37 ± 0.89 weeks and mean birth weight was 3,426 ± 634 g. Eighty-four of them were born through cesarean section (C/S), and 111 were born via normal spontaneous labor. For 40 infants, Apgar score at fifth minute was less than 6. In total, resuscitation was performed on 43 (22.9%) infants. Of the infants, 141 did not develop MAS and 54 developed MAS. While there were no significant differences between infants with and without MAS with regard to gender, delivery route, gestational week, and birth weight, a significant difference was observed regarding the Apgar score (p = 0.0001). The blood pH value in capillary blood gas analysis was less than 7.25 in 18 (28.5%) cases with MAS and four (3

  3. Meconium aspiration syndrome: do we know?

    Science.gov (United States)

    Yurdakök, Murat

    2011-01-01

    Meconium is a common finding in amniotic fluid and placental specimens, particularly in the term or post-term pregnancy. The most important consequence of meconium-stained amniotic fluid (MSAF) is meconium aspiration syndrome (MAS), and at least 5% of infants born through MSAF develop MAS. MAS continues to be a threat to many newborns throughout the world, with a case fatality rate of 5% (as much as 40%), in addition to short- and long-term pulmonary and neurodevelopmental sequelae. The exact pathophysiology of meconium passage into the amniotic fluid and consequences of meconium aspiration are unknown. There are three prevailing and possibly compatible theories for mechanisms of meconium release. Firstly, meconium passage is probably related with the maturation of the gastrointestinal tract, because meconium passage in the preterm third trimester fetus has been reported to be a rare event, as typically it occurs near or post-term. Secondly, an alternate hypothesis for in utero meconium passage is that pathologic processes, such as stress via hypoxia or infection, can trigger meconium passage. However, the predictive values of MSAF for fetal distress and acidosis at birth are poor and controversial. Thirdly, an alternative route for the presence of MSAF in the presence of fetal hypoxia is reduced clearance of defecated meconium due to impaired fetal swallowing or unidentified placental dysfunction in addition to or instead of an increase in its passage. The pathophysiology of MAS is multifactorial and extremely complex. Meconium causes mechanical obstruction and pulmonary air leak, induces surfactant inactivation, causes pulmonary inflammation, and induces apoptosis. Preventing prolonged pregnancy by labor induction might reduce the risk of MSAF. Labor induction with prostaglandins appears to be associated with the occurrence of MSAF. Amnioinfusion for suspected umbilical cord compression has no clear effect on the occurrence of MSAF. Intrapartum suctioning of the

  4. Inflammatory indices in meconium aspiration syndrome.

    Science.gov (United States)

    Hofer, Nora; Jank, Katharina; Strenger, Volker; Pansy, Jasmin; Resch, Bernhard

    2016-06-01

    Meconium aspiration syndrome (MAS) is linked to inflammation, but data on the patterns of hematological indices and C-reactive protein (CRP) in MAS are lacking. The aim of the study was to evaluate CRP, white blood cell count (WBC), absolute neutrophil count (ANC), and immature-to-total neutrophil ratio (IT-ratio) in MAS and to assess their association with disease severity. Retrospective cross-sectional study including 239 consecutively admitted neonates with MAS to a level III NICU. Neonates with early onset sepsis were excluded. Results Neonates with severe MAS (invasive mechanical ventilation for <7 days) and very severe MAS (invasive mechanical ventilation for ≥7 days or high frequency ventilation or ECMO) had higher CRP and IT-ratio compared to neonates with non-severe MAS (no invasive mechanical ventilation) during the first 2 days of life (CRP: 13.0 and 40.9 vs. 9.5 mg/L, P = 0.039 and <0.001, respectively) and neonates with very severe MAS had lower WBC and ANC. All four inflammatory indices correlated significantly with duration of invasive mechanical ventilation, duration of respiratory support and with length of hospital stay, arterial hypotension, and persistent pulmonary hypertension. Neonates with all four inflammatory indices beyond the normal range had a more than 20-fold increase in risk for very severe MAS. High CRP and IT-ratio and low WBC and ANC values were closely linked to a more severe course of MAS during the early phases of the disease. These findings reflect the role of inflammation in the pathogenesis of MAS. Pediatr Pulmonol. 2016;51:601-606. 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  5. Risk Factors for Aspiration Pneumonia in Older Adults.

    Directory of Open Access Journals (Sweden)

    Toshie Manabe

    Full Text Available Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly.We conducted an observational study using data from a nationwide survey of geriatric medical and nursing center in Japan. The study subjects included 9930 patients (median age: 86 years, women: 76% who were divided into two groups: those who had experienced an episode of aspiration pneumonia in the previous 3 months and those who had not. Data on demographics, clinical status, activities of daily living (ADL, and major illnesses were compared between subjects with and without aspiration pneumonia. Two hundred and fifty-nine subjects (2.6% of the total sample were in the aspiration pneumonia group. In the univariate analysis, older age was not found to be a risk factor for aspiration pneumonia, but the following were: sputum suctioning (odds ratio [OR] = 17.25, 95% confidence interval [CI]: 13.16-22.62, p < 0.001, daily oxygen therapy (OR = 8.29, 95% CI: 4.39-15.65, feeding support dependency (OR = 8.10, 95% CI: 6.27-10.48, p < 0.001, and urinary catheterization (OR = 4.08, 95% CI: 2.81-5.91, p < 0.001. In the multiple logistic regression analysis, the risk factors associated with aspiration pneumonia after propensity-adjustment (258 subjects each were sputum suctioning (OR = 3.276, 95% CI: 1.910-5.619, deterioration of swallowing function in the past 3 months (OR = 3.584, 95% CI: 1.948-6.952, dehydration (OR = 8.019, 95% CI: 2.720-23.643, and dementia (OR = 1.618, 95% CI: 1.031-2.539.The risk factors for aspiration pneumonia were sputum suctioning, deterioration of swallowing function, dehydration, and dementia. These results could help improve clinical management for preventing

  6. Introductory course on differential equations

    CERN Document Server

    Gorain, Ganesh C

    2014-01-01

    Introductory Course on DIFFERENTIAL EQUATIONS provides an excellent exposition of the fundamentals of ordinary and partial differential equations and is ideally suited for a first course of undergraduate students of mathematics, physics and engineering. The aim of this book is to present the elementary theories of differential equations in the forms suitable for use of those students whose main interest in the subject are based on simple mathematical ideas. KEY FEATURES: Discusses the subject in a systematic manner without sacrificing mathematical rigour. A variety of exercises drill the students in problem solving in view of the mathematical theories explained in the book. Worked out examples illustrated according to the theories developed in the book with possible alternatives. Exhaustive collection of problems and the simplicity of presentation differentiate this book from several others. Material contained will help teachers as well as aspiring students of different competitive examinations.

  7. Evaluation of the natural history of patients who aspirate.

    Science.gov (United States)

    Bock, Jonathan M; Varadarajan, Varun; Brawley, Mary C; Blumin, Joel H

    2017-12-01

    The natural clinical progression of aspiration to eventual pulmonary compromise is not well understood. We hypothesized that dietary modification recommendations, Penetration-Aspiration Scale (PAS) score, and dysphagia etiology would be associated with changes in time to first pulmonary event and overall survival for patients with documented aspiration on radiologic testing. This study identified a cohort of patients with detectable unsensed penetration or aspiration on videofluoroscopic swallowing study (VFSS), and followed this cohort over time for development of pulmonary events and death. We then evaluated the association of aspiration severity and dietary modification recommendations on incidence of these endpoints. Retrospective chart review. A total of 2,616 VFSS exam reports were reviewed from our institution performed between January 1, 2009 and December 31, 2010. Aspiration or unsensed penetration (PAS of 5 or greater) was detected in 564 (21.5%) of these patients, who were then included in the study cohort. Medical records were reviewed retrospectively for development of pulmonary events (pneumonia, pneumonitis, or other life-threatening pulmonary illness) and all-cause mortality for up to 54 months after initial VFSS. Univariate Kaplan-Meier analysis and multivariate Cox regression were performed for time to first pulmonary event and survival predicted by recommended diet, PAS score, and dysphagia etiology. Dysphagia etiology was highly associated with increased development of pulmonary events for some patients, especially those with generalized nonspecific dysphagia due to deconditioning or frailty (hazard ratio [HZ] vs. stroke 2.95, 95% confidence interval [CI]: 1.53-5.69, P = .001) and esophageal dysphagia (HZ: 2.66, 95% CI: 1.17-6.02, P = .019). Dysphagia etiology was also associated with increased mortality for patients with generalized nonspecific dysphagia due to deconditioning or frailty (HZ: 3.32, 95% CI: 2.0-5.52, P penetration or aspiration

  8. [Pulmonary function in children after neonatal meconium aspiration syndrome].

    Science.gov (United States)

    Djemal, N; Ben Ammar, H; Masmoudi, K; Rguaieg, R; Trigui, L; Ben Hmad, A; Kannou, M; Hmida, N; Gargouri, A; Zouari, N; Rekik, A

    2008-02-01

    Meconium aspiration syndrome is a disease of the newborn mature or post mature. The acute pulmonary consequences can be extremely severe. In the few studies of the long-term pulmonary sequelae, it seems that certain children surviving meconium aspiration syndrome keep an obstructive syndrome. The aim of our study was to assess long term respiratory residual damage from meconium aspiration syndrome. During a seven-year period going from 1994 to 2000, we reviewed the files of children hospitalized in neonatology department of Sfax for meconium aspiration syndrome. The children who were convoked (group M: n=27), underwent spirometry, followed by an exercise stress. An age matched control group (group C: n=23) of healthy children was investigated in the same way. The group M comprised 15 boys and 12 girls aged four to 11, an average of 7+/-1.9 years. With the study of the respiratory function, we did not find an obstructive syndrome. Spirometry revealed a total pulmonary capacity in an average of 133+/-55.65% of theoretical (group M) versus 105.5+/-27.96% of theoretical (group C) (Pmeconium aspiration syndrome tend to develop alveolar hyperinflation and airway hyperreactivity to exercise.

  9. The effects of timing of fine needle aspiration biopsies on gene expression profiles in breast cancers

    International Nuclear Information System (INIS)

    Wong, Vietty; Wang, Dong-Yu; Warren, Keisha; Kulkarni, Supriya; Boerner, Scott; Done, Susan Jane; Leong, Wey Liang

    2008-01-01

    DNA microarray analysis has great potential to become an important clinical tool to individualize prognostication and treatment for breast cancer patients. However, with any emerging technology, there are many variables one must consider before bringing the technology to the bedside. There are already concerted efforts to standardize protocols and to improve reproducibility of DNA microarray. Our study examines one variable that is often overlooked, the timing of tissue acquisition, which may have a significant impact on the outcomes of DNA microarray analyses especially in studies that compare microarray data based on biospecimens taken in vivo and ex vivo. From 16 patients, we obtained paired fine needle aspiration biopsies (FNABs) of breast cancers taken before (PRE) and after (POST) their surgeries and compared the microarray data to determine the genes that were differentially expressed between the FNABs taken at the two time points. qRT-PCR was used to validate our findings. To examine effects of longer exposure to hypoxia on gene expression, we also compared the gene expression profiles of 10 breast cancers from clinical tissue bank. Using hierarchical clustering analysis, 12 genes were found to be differentially expressed between the FNABs taken before and after surgical removal. Remarkably, most of the genes were linked to FOS in an early hypoxia pathway. The gene expression of FOS also increased with longer exposure to hypoxia. Our study demonstrated that the timing of fine needle aspiration biopsies can be a confounding factor in microarray data analyses in breast cancer. We have shown that FOS-related genes, which have been implicated in early hypoxia as well as the development of breast cancers, were differentially expressed before and after surgery. Therefore, it is important that future studies take timing of tissue acquisition into account

  10. Aspiration biopsy of testis: another method for histologic examination

    International Nuclear Information System (INIS)

    Nseyo, U.O.; Englander, L.S.; Huben, R.P.; Pontes, J.E.

    1984-01-01

    The most important method for evaluating the pathogenesis of male infertility is open testicular biopsy. Herein the authors describe a method of aspiration biopsy of testis for histologic examination. Sexually mature dogs and rats treated with chemotherapeutic agents and ionizing radiation were followed with periodic testicular aspiration biopsy during and after treatment. The histologic findings from the aspiration biopsy compare with the results of routine histologic examination in assessing spermatogenetic activity and delineating pathologic changes. The puncture in the experimental animals was performed under general anesthesia. In human patients testicular biopsy could be done under local anesthesia in an outpatient clinic. The procedure would be less painful, minimally invasive, and more cost-effective

  11. Squalene aspiration pneumonia : thin-section CT and histopathologic findings

    International Nuclear Information System (INIS)

    Lee, Jin Seong; Gong, Gyung Yub; Lim, Tae Hwan

    1998-01-01

    The purpose of this study was to describe the thin-section computed tomography (CT) findings and histopathologic findings of squalene aspiration pneumonia. Thin-section CT scans were obtained from nine patients with proven exogenous lipoid pneumonia resulting from aspiration of squalene (derived from shark liver oil). The condition was diagnosed by biopsy (n=3), bronchoalveolar lavage(n=4), or sputum cytology and clinical history (n=2) of squalene use was confirmed in all patients. Specimens of transbronchial lung biopsy were also reviewed and compared with thin-section CT findings. On the basis of these results, we concluded that squalene aspiration pneumonia can be reliably diagnosed by thin-section CT findings particularly when the appropriate history is known. (author). 19 refs., 3 figs

  12. [Recommendations for the prevention of foreign body aspiration].

    Science.gov (United States)

    Lluna, Javier; Olabarri, Mikel; Domènech, Anna; Rubio, Bárbara; Yagüe, Francisca; Benítez, María T; Esparza, María J; Mintegi, Santiago

    2017-01-01

    The aspiration of a foreign body remains a common paediatric problem, with serious consequences that can produce both acute and chronic disease. Aspiration usually causes a medical emergency that requires a prompt diagnosis and an urgent therapeutic approach as it may result in the death of the child or severe brain injury. It typically involves organic foreign bodies (mainly food or nuts) aspirated by children under 5 years old, and usually at home. In this statement, the Committee on Safety and Prevention of Non-Intentional Injury in Childhood of the Spanish Paediatrics Association provides a series of recommendations, both educational (while eating and playing), as well as legal, to prevent such episodes. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Regional and individual determinants of entrepreneurial growth aspirations

    Directory of Open Access Journals (Sweden)

    Joan-Lluís Capelleras

    2018-01-01

    Full Text Available This paper investigates the unique and joint effects of population density and early-stage entrepreneurs’ human capital endowments (higher education, entrepreneurship training and owner-manager experience on entrepreneurial growth aspirations. We test a number of hypotheses using data that combine individual and province level information in Spain over the period 2008-2010. We argue that growth aspirations of early-stage entrepreneurs are higher in more densely populated regions, but that such environmental influence is stronger for individuals with greater human capital. This is because they will be more aware that denser regions offer more favorable conditions for new businesses and also requires greater firm growth to compensate for a higher risk of business failure. Consistent with our view, we find that the growth aspirations of entrepreneurs with higher education are higher in densely populated provinces.

  14. Expression of Mesenchymal Stem Cells-Related Genes and Plasticity of Aspirated Follicular Cells Obtained from Infertile Women

    Directory of Open Access Journals (Sweden)

    Edo Dzafic

    2014-01-01

    Full Text Available After removal of oocytes for in vitro fertilization, follicular aspirates which are rich in somatic follicular cells are discarded in daily medical practice. However, there is some evidence that less differentiated cells with stem cell characteristics are present among aspirated follicular cells (AFCs. The aim of this study was to culture AFCs in vitro and to analyze their gene expression profile. Using the RT2 Profiler PCR array, we investigated the expression profile of 84 genes related to stemness, mesenchymal stem cells (MCSs, and cell differentiation in AFCs enriched by hypoosmotic protocol from follicular aspirates of infertile women involved in assisted reproduction programme in comparison with bone marrow-derived mesenchymal stem cells (BM-MSCs and fibroblasts. Altogether the expression of 57 genes was detected in AFCs: 16 genes (OCT4, CD49f, CD106, CD146, CD45, CD54, IL10, IL1B, TNF, VEGF, VWF, HDAC1, MITF, RUNX2, PPARG, and PCAF were upregulated and 20 genes (FGF2, CASP3, CD105, CD13, CD340, CD73, CD90, KDR, PDGFRB, BDNF, COL1A1, IL6, MMP2, NES, NUDT6, BMP6, SMURF2, BMP4, GDF5, and JAG1 were downregulated in AFCs when compared with BM-MSCs. The genes which were upregulated in AFCs were mostly related to MSCs and connected with ovarian function, and differed from those in fibroblasts. The cultured AFCs with predominating granulosa cells were successfully in vitro differentiated into adipogenic-, osteogenic-, and pancreatic-like cells. The upregulation of some MSC-specific genes and in vitro differentiation into other types of cells indicated a subpopulation of AFCs with specific stemness, which was not similar to those of BM-MSCs or fibroblasts.

  15. Aspiration pneumonia of mineral oil: a case report

    International Nuclear Information System (INIS)

    Malheiros, Noemia Reis; Costa Praxedes, Marcia da; Machado, Dianne Mello; Marchiori, Edson

    1995-01-01

    The authors report a case of 14 month-old boy with clinical features of dyspnea, cough and acrocyanosis following aspiration of mineral oil used in the treatment of partial small bowel obstruction by Ascaris lumbricoides. A chest roentgenogram was reported as extensive bilateral confluent consolidation that showed progressive improvement and the presence of a bilateral infiltration. The diagnosis of aspiration pneumonia of mineral oil was confirmed by lung biopsy. Radiological and anatomo pathological aspects are presented as well as a review of the medical literature about the case. (author). 6 refs., 3 figs

  16. Migration and Social Aspirations: Chinese Cosmopolitanism in Wenzhou Region (China

    Directory of Open Access Journals (Sweden)

    Irene Rodrigues

    2018-04-01

    Full Text Available This article explores what motivates the movements of Chinese migrants from China to Portugal. It presents an ethnographic account of social aspirations in Wenzhou, a port city located in South Zhejiang (Southeast China, where post-Mao economic prosperity, allied to the existence of networks of trade and migration, resulted in social and economic inequalities and great social pressure to become rich and successful. Based on ethnographic fieldwork conducted in Wenzhou and in Lisbon (Portugal between 2008 and 2010, this paper argues that Wenzhou migratory projects are a result of modernity aspirations and desires for material modernization articulated with core Chinese values such as filial piety.

  17. AstroBiology Explorer Mission Concepts (ABE/ASPIRE)

    Science.gov (United States)

    Sandford, Scott; Ennico, Kimberly A.

    2006-01-01

    The AstroBiology Explorer (ABE) and the Astrobiology Space InfraRed Explorer (ASPIRE) Mission Concepts are two missions designed to address the questions (1) Where do we come from? and (2) Are we alone? as outlined in NASA s Origins Program using infrared spectroscopy to explore the identity, abundance, and distribution of molecules of astrobiological importance throughout the Universe. The ABE mission s observational program is focused on six tasks to: (1) Investigate the evolution of ice and organics in dense clouds and star formation regions, and the young stellar/planetary systems that form in them; (2) Measure the evolution of complex organic molecules in stellar outflows; (3) Study the organic composition of a wide variety of solar system objects including asteroids, comets, and the planets and their satellites; (4) Identify organic compounds in the diffuse interstellar medium and determine their distribution , abundance, and change with environment; (5) Detect and identify organic compounds in other galaxies and determine their dependence on galactic type; and (6) Measure deuterium enrichments in interstellar organics and use them as tracers of chemical processes. The ASPIRE mission s observational program expands upon ABE's core mission and adds tasks that (7) Address the role of silicates in interstellar organic chemistry; and (8) Use different resolution spectra to assess the relative roles and abundances of gas- and solid-state materials. ABE (ASPIRE) achieves these goals using a highly sensitive, cryogenically-cooled telescope in an Earth drift-away heliocentric orbit, armed with a suite of infrared spectrometers that cover the 2.5-20(40) micron spectral region at moderate spectral resolution (R>2000). ASPIRE's spectrometer complement also includes a high-resolution (R>25,000) module over the 4-8 micron spectral region. Both missions target lists are chosen to observe a statistically significant sample of a large number of objects of varied types in

  18. FINE NEEDLE ASPIRATION CYTOLOGY OF EPIDIDYMAL SWELLINGS IN RIMS HOSPITAL, IMPHAL: A FIVE-YEAR STUDY

    Directory of Open Access Journals (Sweden)

    Rajesh Singh Laishram

    2016-06-01

    Full Text Available BACKGROUND Epididymal nodules are frequently encountered in surgical practice. They are easily accessible to fine needle aspiration cytology (FNAC. Clinically, these nodules present as worrisome nodules to the patients as well to the patients. This study was conducted to study the clinico-pathological profile of patients presenting with epididymal nodule using fine needle aspiration cytology (FNAC. METHODS A retrospective study was done by critically analysing the FNAC reports of palpable epididymal swellings in last five years (January 2010 to December 2015 at the Department of Pathology, Regional Institute of Medical Sciences (RIMS Hospital, Imphal, Manipur. Review of all the reports were done and diagnosis was made according to standard guidelines and correlated with patient’s age, sex, and side of involvement to explore the disease pattern. RESULTS A total of 71 cases were retrieved and divided as follows: Tuberculous epididymitis 20(28.17%, spermatocoele 11(15.49%, non-specific chronic epididymitis 10(14.08%, spermatic granulomas 6(8.45%, acute epididymitis 6(8.45%, hydrocoele 5 (7.04%, adenomatoid tumour 4(6.63% and microfilaria 1(1.41%. FNAC material was inadequate for opinion in 8 cases (11.28% cases. CONCLUSION FNAC has a definite important role in the differential diagnosis of epididymal nodules as it can identify neoplastic and nonneoplastic conditions. FNAC can thus be used to segregate the group of patients requiring a surgical intervention and a biopsy

  19. A Randomized Trial Among Compression Plus Nonsteroidal Antiinflammatory Drugs, Aspiration, and Aspiration With Steroid Injection for Nonseptic Olecranon Bursitis.

    Science.gov (United States)

    Kim, Joon Yub; Chung, Seok Won; Kim, Joo Hak; Jung, Jae Hong; Sung, Gwang Young; Oh, Kyung-Soo; Lee, Jong Soo

    2016-03-01

    Olecranon bursitis might be a minor problem in the outpatient clinic but relatively be common to occur. However, there are few well-designed studies comparing approaches to treatment. (1) Which treatment (compression bandaging with nonsteroidal antiinflammatory drugs [NSAIDs], aspiration, or aspiration with steroid injections) is associated with the highest likelihood of resolution of nonseptic olecranon bursitis? (2) Which treatment is associated with earliest resolution of symptoms? (3) What factors are associated with treatment failure by 4 weeks? We enrolled 133 patients from two centers; after applying prespecified exclusions (septic bursitis or concomitant inflammatory arthritis, intraarticular elbow pathology, recent aspiration or steroid injection done elsewhere, and refusal to participate), 90 patients were randomly allocated to receive compression bandaging with NSAIDs (C), aspiration (A), or aspiration with steroid injection (AS) groups (30 patients in each). The groups were similar at baseline in terms of age and gender. Seven patients (four from Group A and three from Group AS) were lost to followup. All patients were followed up weekly for 4 weeks, and the same treatment procedure was repeated if the bursitis recurred with any substantial fluid collection. At 4 weeks, the state of resolution and pain visual analog scale (VAS) were evaluated. Failed resolution was defined as presence of persistent olecranon bursal fluid collection at Week 4 after the initiation of the treatment; on the contrary, if bursal fluid collection was clinically reduced or completely disappeared by the end of Week 4, the treatment was considered successful. We compared the proportion of resolution by Week 4 and the median times to resolution among the treatment groups. In addition, we evaluated whether the resolution affected pain VAS and what factors were associated with the resolution. There were no differences in the proportion of patients whose bursitis resolved by Week 4

  20. The Effect of Maternal Employment on Schoolchildren's Educational Aspirations in Korea.

    Science.gov (United States)

    Ju, Dong-Beom; Chung, Il-Hwan

    2000-01-01

    Examined the relationships between maternal employment and schoolchildren's educational aspirations in Korea. Found that children whose mothers were working full-time had lower educational aspirations, although maternal involvement and parents' educational expectations mitigated these effects. (JPB)

  1. Clinical audit of ultrasound guided fine needle aspiration in a general cytopathology service

    Directory of Open Access Journals (Sweden)

    Gunjan Mangla

    2015-01-01

    Conclusions: Reporting practices varied and did not conform to a uniform structure. The inadequacy rates of breast and thyroid aspirates were comparable to the rates in the literature. Comparable studies were not available for intra-abdominal aspirates.

  2. Clinical audit of repeat fine needle aspiration in a general cytopathology service

    Directory of Open Access Journals (Sweden)

    Rachna Goyal

    2014-01-01

    Conclusions: Inadequate aspirates, non-diagnostic descriptive reports, and FNAC/FNAB from thyroid, lymph nodes, and breast contribute to repeats. We suggest steps to reduce the number of repeat aspirates to eliminate extra work.

  3. Understanding Graduate School Aspirations: The Effect of Good Teaching Practices

    Science.gov (United States)

    Hanson, Jana M.; Paulsen, Michael B.; Pascarella, Ernest T.

    2016-01-01

    This study examined the effects of good teaching practices on post-baccalaureate degree aspirations using logistic regression techniques on a multi-institutional, longitudinal sample of students at 4-year colleges and universities in the USA. We examined whether eight good teaching practices (non-classroom interactions with faculty, prompt…

  4. The Hierarchical Personality Structure of Aspiring Creative Writers

    Science.gov (United States)

    Maslej, Marta M.; Rain, Marina; Fong, Katrina; Oatley, Keith; Mar, Raymond A.

    2014-01-01

    Empirical studies of personality traits in creative writers have demonstrated mixed findings, perhaps due to issues of sampling, measurement, and the reporting of statistical information. The goal of this study is to quantify the personality structure of aspiring creative writers according to a modern hierarchal model of trait personality. A…

  5. Weblogs as learning tools for aspirant reflective practitioners

    NARCIS (Netherlands)

    Wopereis, Iwan; Sloep, Peter

    2013-01-01

    Wopereis, I., & Sloep, P. B. (2013, January-February). Weblogs as learning tools for aspirant reflective practitioners. Position paper presented at the Workshop on Technology support for reflecting on experiences and sharing them across learning contexts at the Alpine Rendez-Vous 2013,

  6. Counseling Implications of Black Women's Market Position, Aspirations and Expectancies.

    Science.gov (United States)

    Gurin, Patricia; Pruitt, Anne

    The major premise of this paper is that career and educational counseling for women, and particularly for black women, needs to be based on an understanding of their market position. Data on black women's options and choices in a discriminatory market, on their occupational and educational aspirations, and on the role of expectations in their work…

  7. Performance of Naturally Aspirating IC Engines Operating at High ...

    African Journals Online (AJOL)

    The loss of power and the increase of fuel consumption of naturally aspirating IC engines operating with low atmospheric pressure at high altitude as well as changes in the mixture quality with non adapting mixture formation systems are principally known. Other effects like the additional advance of ignition timing in petrol ...

  8. Diagnostic accuracy of fine needle aspiration cytology in patients ...

    African Journals Online (AJOL)

    thyroid carcinoma being the most predominant type and colloid goiter was the most predominant benign thyroid disease. The sensitivity was 61.5% and specificity 89.5% . Conclusion: This study revealed high specificity and low sensitivity of Fine Needle Aspiration Cytology (FNAC) at detecting malignancy in thyroid nodules.

  9. Who Wants a Job in Biology? Student Aspirations and Perceptions

    Science.gov (United States)

    Henderson, Danielle; Stanisstreet, Martin; Boyes, Edward

    2007-01-01

    This paper describes the results of a questionnaire survey of UK Year 3 biology undergraduates' career aspirations, and their perceptions of employment in teaching, research and conservation. Although most students sought material benefits in their potential careers, even more wished to gain job satisfaction. None of the careers in biology was…

  10. Microfilaria in thyroid gland fine needle aspiration cytology - an ...

    African Journals Online (AJOL)

    Involvement of thyroid gland by filariasis is an unusual finding. We report a case in which microfilaria was found in thyroid aspirate smear. Patient did not have any symptoms or signs suggestive of filariasis. The patient was treated with diethylcarbamazine and a later hemithyroidectomy was performed. We reviewed the ...

  11. Fine Needle Aspiration: A simple and convenient alternative for ...

    African Journals Online (AJOL)

    Nine patients followed up to hospital for other medical problems unrelated to ganglion cysts and only one patient had to undergo surgical excision due to the large size of the cyst. No patient returned with a recurrence. Conclusion: Fine needle aspiration is a simple, non traumatic, inexpensive and low risk alternative method ...

  12. Educational and Occupational Aspirations and Expectations of Rural Youth.

    Science.gov (United States)

    Slocum, Walter L.; Garrett, Gerald R.

    Some of the more significant responses to a questionnaire on educational and occupational aspirations and expectations which was administered to a statewide sample of sophomores, juniors, and seniors in 30 rural high schools by the Department of Rural Sociology at Washington State University were presented in this report. A principal objective of…

  13. Experience With Manual Vacuum Aspiration in Jos, Nigeria | Mutihir ...

    African Journals Online (AJOL)

    Incomplete abortion was the indication for manual vacuum aspiration in 85.3% of the cases, missed abortion in 7.8%, and the evacuation of molar pregnancies in 6.2%. Sedation ... It has eliminated the admissions of the patients to the ward for more than 24 hours, thereby drastically reducing costs from hospital bed charges.

  14. Manual Vacuum Aspiration In The Management Of Post Abortal ...

    African Journals Online (AJOL)

    Eleven (11) patients with tetanus were managed by uterine evacuation using the manual vacuum aspiration at the University of Port Harcourt Teaching Hospital, Nigeria over a period of ten years. Eight (8) of the patients had uterine evacuation while in coma, while three (3) were conscious but had spasm and features of ...

  15. Uncertain aspirations for continuing in education: antecedents and associated outcomes.

    Science.gov (United States)

    Gutman, Leslie Morrison; Schoon, Ingrid; Sabates, Ricardo

    2012-11-01

    Relatively little is known about adolescents who hold uncertain aspirations, that is, those who do not know what they would like to do in the future regarding their educational or occupational plans. Drawing upon the Longitudinal Study of Young People in England born in 1989-1990, the authors tested a pathway model to investigate the antecedents of uncertain aspirations for continuing in education past compulsory schooling age (i.e., 16 years) and associated later educational outcomes. Gender differences in the pathways are also tested. Findings indicate that the relationship linking socioeconomic status to uncertain aspirations is mediated through parents' educational expectations and the relationship linking academic performance at age 11 to uncertain aspirations is mediated through parents' educational expectations and adolescents' self-perceived ability, which, in turn, predict academic performance at age 16 and educational enrollment at age 18. Gender differences in these processes are also evident: young males not only hold greater uncertainty about continuing in education, the consequences of uncertainty regarding later academic performance are worse for males than females.

  16. The impact of the manual vacuum aspiration (MVA) technique on ...

    African Journals Online (AJOL)

    Objectives. To assess the impact of the manual vacuum aspiration (MVA) technique on health care services and its acceptability to patients and staff. Design. Prospective descriptive survey. Setting. The university teaching hospital, Blantyre, Malawi. Participants. All 456 patients who had MVA for treatment or investigation ...

  17. Parents' occupation as correlate of students' career aspiration in ...

    African Journals Online (AJOL)

    This study investigated the relationship between parents' occupation and students' career aspiration in public secondary schools in Esan West Local Government Area of Edo State. The correlational research design was adopted for the study. A sample of 320 students was drawn for by simple random sampling technique ...

  18. Fine Needle Aspiration Cytology In Tumour Diagnosis | Obaseki ...

    African Journals Online (AJOL)

    Fine needle aspiration cytology (FNAC), a technique for obtaining cellular material for cytological examination and diagnosis using a 21- gauge or smaller needle, is performed using a 5, 10, or 20ml syringe either freehand or using special syringe holders. It allows a minimally invasive, rapid diagnosis of tissue samples but

  19. Working Memory: The Influence of Culture on Aspirations.

    Science.gov (United States)

    Lawrence, Barbara Kent

    1998-01-01

    Describes an ethnographic dissertation that portrays how patterns of culture and history in a rural community in Maine negatively influence many rural students' academic aspirations. Consolidated schools exacerbate the effect by separating students from their parents and communities and alienating them in school. (TD)

  20. Experience with manual vacuum aspiration at the Imo State ...

    African Journals Online (AJOL)

    Background: Criminal or illegal abortions and it's attendant complications contribute significantly to maternal morbidity and mortality in developing countries. Manual vacuum aspiration provides a cheap, safe and effective means of reducing this morbidity and mortality. Aim: To evaluate the usefulness of manual vacuum ...

  1. Fine Needle Aspiration Cytology [FNAC] Technique As A Diagnostic ...

    African Journals Online (AJOL)

    Background: The Fine needle aspiration technique is frequently done in the University of Maiduguri Teaching Hospital for swellings from any anatomical site of the body. Objective: This paper is aimed at highlighting the importance of the technique in the diagnosis of tumours in any health care institution. Methods: A ...

  2. Diagnostic accuracy of fine needle aspiration cytology in patients ...

    African Journals Online (AJOL)

    Background: Thyroid disease affects about 5% of the World's population. Fine Needle Aspiration Cytology (FNAC) helps in planning extent of surgery. In some studies, FNAC has been found to have a low accuracy for malignancy. Objective: To estimate the sensitivity and specificity of FNAC in detecting malignancy for ...

  3. Fine needle aspiration cytology of breast lumps with histopathologic ...

    African Journals Online (AJOL)

    Objective: To determine the histopathologic correlation of fine needle aspiration cytology FNAC of breast masses seen in the department of histopathology of the Federal Medical Center Owo, Southwestern Nigeria. Design: This is a 5-year retrospective study of breast lumps seen at Department of Histopathology, Federal ...

  4. The impact of the manual vacuum aspiration (MVA) technique on ...

    African Journals Online (AJOL)

    Objectives. To assess the impact of the manual vacuum aspiration (MVA) technique on health care services and its acceptability to patients and staff. Design. Prospective descriptive survey. Setting. The university teaching hospital, Blantyre,. Malawi. Participants. All 456 patients who had MVA for treatment or investigation ...

  5. The cost-effectiveness of introducing manual vacuum aspiration ...

    African Journals Online (AJOL)

    Background. Despite the proven efficacy of manual vacuum aspiration (MVA) for incomplete miscarriages its use is low in Swaziland, including Raleigh Fitkin Memorial (RFM) Hospital, Manzini. Uncertainty about the cost implications of introducing MVA to replace dilatation and curettage (D&C) is probably the major obstacle ...

  6. The Challenges facing Women aspiring for School Leadership ...

    African Journals Online (AJOL)

    ... a manager's position.The study shows that although the professional profile of women in management posts differs from that of their male counterparts in schools, women can also effectively lead and manage schools. Key words: aspirations to principalship; female principals; gender discrimination; school management ...

  7. Determinants of career aspirations of medical students in southern China.

    Science.gov (United States)

    She, LingBing; Wu, BingLi; Xu, LiYan; Wu, JianYi; Zhang, PiXian; Li, EnMin

    2008-12-11

    With recent changes in both the Chinese medical system and compensation of medical doctors, the career aspirations of Chinese medical students have become more diverse. Shantou University Medical College has conducted evaluations and instituted programs to enhance student preparedness to enter a variety of medical careers. A survey was conducted with 85 students to evaluate medical career aspirations and their association with family background, personal skills, English language proficiency, and interest in biomedical research, which were considered as possible factors affecting their career interest. Chinese students aspire to traditional as well as nontraditional medical careers. A significant minority of students are now interested in nontraditional careers such as medical teaching or research. However, poor proficiency in the English language and lack of computer skills may limit their academic and career opportunities. Career aspirations have changed among medical undergraduates. Although many wish to pursue a traditional clinical doctor career, many are interested in research and teaching careers. Factors such as family background, personal characteristics, school mentoring, and extracurricular support may play a role.

  8. Determinants of career aspirations of medical students in southern China

    Directory of Open Access Journals (Sweden)

    Zhang PiXian

    2008-12-01

    Full Text Available Abstract Background With recent changes in both the Chinese medical system and compensation of medical doctors, the career aspirations of Chinese medical students have become more diverse. Shantou University Medical College has conducted evaluations and instituted programs to enhance student preparedness to enter a variety of medical careers. Methods A survey was conducted with 85 students to evaluate medical career aspirations and their association with family background, personal skills, English language proficiency, and interest in biomedical research, which were considered as possible factors affecting their career interest. Results Chinese students aspire to traditional as well as nontraditional medical careers. A significant minority of students are now interested in nontraditional careers such as medical teaching or research. However, poor proficiency in the English language and lack of computer skills may limit their academic and career opportunities. Conclusion Career aspirations have changed among medical undergraduates. Although many wish to pursue a traditional clinical doctor career, many are interested in research and teaching careers. Factors such as family background, personal characteristics, school mentoring, and extracurricular support may play a role.

  9. Analysis Of Career Aspirations Of Agricultural Science Graduates ...

    African Journals Online (AJOL)

    The objective of this study was to identify the career aspirations of agricultural science graduates from Nigerian Universities of Agriculture. A random sample of 215 graduating students of agriculture was selected using stratified random sampling method. Data were collected with the aid of a structured questionnaire and the ...

  10. Desired Mobility or Satisfied Immobility? Migratory Aspirations among Knowledge Workers

    Science.gov (United States)

    Ferro, Anna

    2006-01-01

    Among the aspects discussed within the globalisation process, the international mobility of professional workers assumes considerable relevance. This paper focuses on migratory aspirations among knowledge workers within the context of economic globalisation and market restructuring in Romania. Due to a lack of literature dealing with these issues,…

  11. Aspiration of a perforated pen cap: complete tracheal obstruction ...

    African Journals Online (AJOL)

    Foreign body aspiration is a common but underestimated event in children with potentially fatal outcome. Because of unreliable histories and inconsistent clinical and radiologic findings, diagnosis and treatment can represent a challenge. Inhaled pen caps predispose for complete airway obstruction and are difficult to ...

  12. A Cross Section Study to Correlate Fine Needle Aspiration Cytology ...

    African Journals Online (AJOL)

    ADMIN

    Background: Needle Aspiration Cytology (FNAC) is cheap, simple, quick, minimally invasive procedure that is widely used for preoperative diagnosis of Parotid tumours. Methods: Twenty five patients were prospectively studied over a two-year period at four major hospitals in Zambia. FNAC was done using a 10cc syringe ...

  13. An Assessment Of The Level Of Entrepreneurial Aspiration Of Ogun ...

    African Journals Online (AJOL)

    ... as giving interest free loan, free consultancy services, establishment of centre for enterprises development in tertiary institutions, so as to assist students to realize their entrepreneurial aspirations and launch them into the business world. African Journal of Cross-Cultural Psychology and Sport Facilitation Vol. 10 2008: pp.

  14. Fine needle aspiration cytology of breast lumps with histopathologic ...

    African Journals Online (AJOL)

    E-mail: tunjiomotayo@yahoo.co.uk. Conflict of interest: None declared. SUMMARY. Objective: To determine the histopathologic correlation of fine needle aspiration cytology FNAC of breast masses seen in the department of histopathology of the Federal Medical Center Owo, Southwestern Nigeria. Design: This is a 5-year ...

  15. Tumour reduction with a Cavitron Ultrasonic Surgical Aspirator ® in ...

    African Journals Online (AJOL)

    A 54-year-old woman developed a fungating locally invasive anaplastic thyroid cancer with distant metastases, and was treated with aggressive tumour reduction, using a Cavitron® Ultrasonic Surgical Aspirator. This mode of treatment, applied for the first time in this context, proved to be effective, safe and improved her ...

  16. Efficacy of Fine Needle Aspiration Cytology in the Diagnosis of ...

    African Journals Online (AJOL)

    Background: Fine needle aspiration cytology (FNAC) is a safe, easy to perform, cost effective and an accurate procedure used in the diagnosis of thyroid lesions. Objective: In this study we aimed to demonstrate the effectiveness of FNAC in the diagnosis of thyroid swellings in Red Sea State, Sudan. Methods: FNAC from ...

  17. Comparision of Fine Needle Aspiration Cytology and Fine Needle ...

    African Journals Online (AJOL)

    Background: Open biopsy of the breast used to be the main traditional method of diagnosis of breast lumps. Fine Needle Aspiration Cytology (FNAC) was later introduced which depends on suction and thus yields hemorrhagic material for cytological study.This study was undertaken to find out if there is a difference in ...

  18. Bio rapid prototyping by extruding/aspirating/refilling thermoreversible hydrogel

    Energy Technology Data Exchange (ETDEWEB)

    Iwami, K; Noda, T; Ishida, K; Umeda, N [Department of Mechanical Systems and Engineering, Tokyo University of Agriculture and Technology, 2-24-16 Nakacho, Koganei, Tokyo 184-8588 (Japan); Morishima, K [Department of Bio-Applications and Systems Engineering, Tokyo University of Agriculture and Technology, 2-24-16 Nakacho, Koganei, Tokyo 184-8588 (Japan); Nakamura, M, E-mail: k_iwami@cc.tuat.ac.j [Department of Life Sciences and Bioengineering, University of Toyama, 3190 Gofuku, Toyama, 930-8555 (Japan)

    2010-03-15

    This paper reports a method for rapid prototyping of cell tissues, which is based on a system that extrudes, aspirates and refills a mixture of cells and thermoreversible hydrogel as a scaffold. In the extruding mode, a cell-mixed scaffold solution in the sol state is extruded from a cooled micronozzle into a temperature-controlled substrate, which keeps the scaffold in the gel state. In the aspiration mode, the opposite process is performed by Bernoulli suction. In the refilling mode, the solution is extruded into a groove created in the aspiration mode. The minimum width of extruded hydrogel pattern is 114 +- 15 mum by employing a nozzle of diameter 100 mum, and that of aspirated groove was 355 +- 10 mum using a 500 mum-diameter nozzle. Gum arabic is mixed with the scaffold solution to avoid peeling-off of the gel pattern from the substrate. Patterning of Sf-9 cell tissue is demonstrated, and the stability of the patterned cell is investigated. This system offers a procedure for rapid prototyping and local modification of cell scaffolds for tissue engineering.

  19. Auditing Inequity: Teaching Aspiring Administrators to Be Social Justice Leaders

    Science.gov (United States)

    Hernandez, Frank; Marshall, Joanne

    2017-01-01

    While much has been written about preparing educational leaders to lead for social justice, much less has been written about how to do so. This study is one of the first to analyze the reflections and written assignments of aspiring administrators to determine what they are currently thinking about poverty, race/ethnicity, and social justice…

  20. Fournier's gangrene - a rare complication of hydrocele aspiration

    International Nuclear Information System (INIS)

    Ali, M.Z.

    2004-01-01

    A case of Fournier's gangrene of scrotum with systemic inflammatory response syndrome resulting from hydrocele aspiration in young male patient is presented. He was treated with antibiotics, wide local debridement of scrotal skin with evacuation of pus and gas; followed by serial debridements and dressings. Secondary suturing of scrotal defect was done after 02 weeks. (author)

  1. Aspirations for a Master's-Level Teaching Profession in England

    Science.gov (United States)

    Thomas, Lorraine

    2016-01-01

    This research investigates aspirations for a master's-level teaching profession in England, providing key stakeholder perceptions in one densely populated region within a multiple case study. Although this intended move to a master's-level profession represented a major shift in teachers' professional development in England, only limited…

  2. Comparison of the CDC Backpack aspirator and the Prokopack aspirator for sampling indoor- and outdoor-resting mosquitoes in southern Tanzania

    Directory of Open Access Journals (Sweden)

    Mgando Joseph

    2011-06-01

    Full Text Available Abstract Background Resting mosquitoes can easily be collected using an aspirating device. The most commonly used mechanical aspirator is the CDC Backpack aspirator. Recently, a simple, and low-cost aspirator called the Prokopack has been devised and proved to have comparable performance. The following study evaluates the Prokopack aspirator compared to the CDC backpack aspirator when sampling resting mosquitoes in rural Tanzania. Methods Mosquitoes were sampled in- and outdoors of 48 typical rural African households using both aspirators. The aspirators were rotated between collectors and households in a randomized, Latin Square design. Outdoor collections were performed using artificial resting places (large barrel and car tyre, underneath the outdoor kitchen (kibanda roof and from a drop-net. Data were analysed with generalized linear models. Results The number of mosquitoes collected using the CDC Backpack and the Prokopack aspirator were not significantly different both in- and outdoors (indoors p = 0.735; large barrel p = 0.867; car tyre p = 0.418; kibanda p = 0.519. The Prokopack was superior for sampling of drop-nets due to its smaller size. The number mosquitoes collected per technician was more consistent when using the Prokopack aspirator. The Prokopack was more user-friendly: technicians preferred using the it over the CDC backpack aspirator as it weighs considerably less, retains its charge for longer and is easier to manoeuvre. Conclusions The Prokopack proved in the field to be more advantageous than the CDC Backpack aspirator. It can be self assembled using simple, low-cost and easily attainable materials. This device is a useful tool for researchers or vector-control surveillance programs operating in rural Africa, as it is far simpler and quicker than traditional means of sampling resting mosquitoes. Further longitudinal evaluations of the Prokopack aspirator versus the gold standard pyrethrum spray catch for indoor resting

  3. Fine needle aspiration cytology of chondroblastoma: A report of two cases with brief review of pitfalls

    Directory of Open Access Journals (Sweden)

    Amita Krishnappa

    2016-01-01

    Full Text Available Chondroblastoma is a rare, giant cell-rich, benign neoplasm of bone. Since the past few decades fine needle aspiration cytology (FNAC has gained momentum in preoperative diagnosis of bone lesions. At cytology, other giant cell-rich tumors and tumorlike lesions such as aneurysmal bone cyst (ABC, giant cell tumor, and chondromyxoid fibroma fall under the differential diagnosis of chondroblastoma. Due to the difference in the treatment protocol and prognosis, preoperative diagnosis is mandatory. We describe the cytomorphology in two cases of chondroblastoma diagnosed at FNAC and confirmed by histopathology. At cytology, the presence of giant cells, chondroid matrix, mononuclear cells with nuclear indentation, and grooving along with glassy, vacuolated cytoplasm are characteristic of chondroblastoma. In addition to this, the presence of chicken wire calcification is a useful clue to the accurate diagnosis of chondroblastoma at FNAC.

  4. Interfacing an aspiration ion mobility spectrometer to a triple quadrupole mass spectrometer

    International Nuclear Information System (INIS)

    Adamov, Alexey; Viidanoja, Jyrki; Kaerpaenoja, Esko; Paakkanen, Heikki; Ketola, Raimo A.; Kostiainen, Risto; Sysoev, Alexey; Kotiaho, Tapio

    2007-01-01

    This article presents the combination of an aspiration-type ion mobility spectrometer with a mass spectrometer. The interface between the aspiration ion mobility spectrometer and the mass spectrometer was designed to allow for quick mounting of the aspiration ion mobility spectrometer onto a Sciex API-300 triple quadrupole mass spectrometer. The developed instrumentation is used for gathering fundamental information on aspiration ion mobility spectrometry. Performance of the instrument is demonstrated using 2,6-di-tert-butyl pyridine and dimethyl methylphosphonate

  5. Housing aspiration in an informal urban settlement: A case study

    Directory of Open Access Journals (Sweden)

    Akunnaya P. OPOKO

    2015-11-01

    Full Text Available Housing aspiration is an important aspect of housing market analysis. However, there is a paucity of empirical research on housing aspiration among residents in informal settlements in developing countries. This study therefore investigated housing aspiration among the residents of Ayobo, Lagos, Nigeria. A cross-sectional survey of 1,151 households in Ayobo was conducted using a structured questionnaire as the data-collection instrument. The data were analysed using descriptive statistical and categorical regression analyses. The results show that a majority of the respondents were low-income earners living in rented and rooming-house types of accommodation. Around 73% of them expressed an intention to move to another residence, and 56% of this category of respondents intend to move into self-contained flats. The reasons for the planned relocation include poor condition of their present dwellings, changes in tenure status and household size, and the desire for exclusive use of facilities in their homes. In addition to these reasons, the waste-disposal method, sharing facilities, employment, and age and marital status of the residents emerged as the strongest predictors of housing aspiration among the respondents in the survey. This implies that, in order to meet the housing preferences and aspirations of residents in informal urban settlements in Nigeria, housing developers need to give adequate attention to the marital, age, employment and tenure status of the residents and place emphasis on developing affordable single-family houses and block of flats, as well as strategies for improving access to basic social amenities and services.

  6. A gel aspiration-ejection system for the controlled production and delivery of injectable dense collagen scaffolds

    International Nuclear Information System (INIS)

    Kamranpour, Neysan O; Miri, Amir K; James-Bhasin, Mark; Nazhat, Showan N

    2016-01-01

    A gel aspiration-ejection (GAE) system has been developed for the advanced production and delivery of injectable dense collagen (I-DC) gels of unique collagen fibrillar densities (CFDs). Through the creation of negative pressure, GAE aspirates prefabricated highly hydrated collagen gels into a needle, simultaneously inducing compaction and meso-scale anisotropy (i.e., fibrillar alignment) on the gels, and by subsequent reversal of the pressure, I-DC gels can be controllably ejected. The system generates I-DC gels with CFDs ranging from 5 to 32 wt%, controlling the initial scaffold microstructure, anisotropy, hydraulic permeability, and mechanical properties. These features could potentially enable the minimally invasive delivery of more stable hydrogels. The viability, metabolic activity, and differentiation of seeded mesenchymal stem cells (MSCs) was investigated in the I-DC gels of distinct CFDs and extents of anisotropy produced through two different gauge needles. MSC osteoblastic differentiation was found to be relatively accelerated in I-DC gels that combined physiologically relevant CFDs and increased fibrillar alignment. The ability to not only support homogenous cell seeding, but also to direct and accelerate their differentiation through tissue-equivalent anisotropy, creates numerous opportunities in regenerative medicine. (paper)

  7. Treatment of bacterial brain abscess by repeated aspiration. Follow up by serial computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Masaaki; Fukushima, Takeo; Hirakawa, Katsuyuki; Kimura, Hideo; Tomonaga, Masamichi [Fukuoka Univ. (Japan). School of Medicine

    2000-02-01

    Bacterial brain abscess often requires repeated aspiration before the abscess finally resolves. However, there are no guidelines for treatment by aspiration; for example, when should the abscess be tapped again, or when can an abscess be treated by antibiotics alone without further aspiration. Eleven patients with bacterial brain abscess treated by aspiration were evaluated to establish treatment guidelines for brain abscess, in particular the abscess size on serial computed tomography (CT) after aspiration. CT was performed about 24 hours after aspiration to evaluate the size of the abscess, and almost weekly during follow up. The diameter of the brain abscess before and after the initial and last aspirations were reviewed. In eight of the 11 patients, abscesses were aspirated repeatedly: two to three times in most patients. The diameter of the abscesses was 2.5-4.5 cm (mean 3.5 cm) before the last aspiration, and 1.4-3.4 cm (mean 2.3 cm) after the last aspiration, or when continuous drainage was discontinued. Perifocal edema was moderately decreased within 3 weeks after the last aspiration by medical treatment alone, with a concomitant decrease in the volume of the abscess. There were no deaths, and most patients had a favorable outcome. These results suggest that after the diameter of the abscess becomes less than 2 to 3 cm and does not increase anymore on serial CT, medical treatment alone can be anticipated to give satisfactory results without further aspiration. (author)

  8. Treatment of bacterial brain abscess by repeated aspiration. Follow up by serial computed tomography

    International Nuclear Information System (INIS)

    Yamamoto, Masaaki; Fukushima, Takeo; Hirakawa, Katsuyuki; Kimura, Hideo; Tomonaga, Masamichi

    2000-01-01

    Bacterial brain abscess often requires repeated aspiration before the abscess finally resolves. However, there are no guidelines for treatment by aspiration; for example, when should the abscess be tapped again, or when can an abscess be treated by antibiotics alone without further aspiration. Eleven patients with bacterial brain abscess treated by aspiration were evaluated to establish treatment guidelines for brain abscess, in particular the abscess size on serial computed tomography (CT) after aspiration. CT was performed about 24 hours after aspiration to evaluate the size of the abscess, and almost weekly during follow up. The diameter of the brain abscess before and after the initial and last aspirations were reviewed. In eight of the 11 patients, abscesses were aspirated repeatedly: two to three times in most patients. The diameter of the abscesses was 2.5-4.5 cm (mean 3.5 cm) before the last aspiration, and 1.4-3.4 cm (mean 2.3 cm) after the last aspiration, or when continuous drainage was discontinued. Perifocal edema was moderately decreased within 3 weeks after the last aspiration by medical treatment alone, with a concomitant decrease in the volume of the abscess. There were no deaths, and most patients had a favorable outcome. These results suggest that after the diameter of the abscess becomes less than 2 to 3 cm and does not increase anymore on serial CT, medical treatment alone can be anticipated to give satisfactory results without further aspiration. (author)

  9. The Role of Aspirations in Young Children's Emotional and Behavioural Problems

    Science.gov (United States)

    Moulton, Vanessa; Flouri, Eirini; Joshi, Heather; Sullivan, Alice

    2015-01-01

    Using data from a large UK cohort (n = 11,656), we investigated the determinants of 7-year-old children's aspirations, and the role of these aspirations in emotional and behavioural problems, as reported by both parents and teachers. Aspirations were classified to reflect their occupational status, masculinity/femininity and intrinsic/extrinsic…

  10. Serum cytokine and chemokine profiles in neonates with meconium aspiration syndrome.

    Science.gov (United States)

    Okazaki, Kaoru; Kondo, Masatoshi; Kato, Masahiko; Kakinuma, Ryota; Nishida, Akira; Noda, Masahiro; Taniguchi, Kiyosu; Kimura, Hirokazu

    2008-04-01

    Various inflammatory cytokines and chemokines are thought to be associated with the pathophysiology of meconium aspiration syndrome. To clarify any such association, we compared various serum cytokine and chemokine profiles in patients with and without meconium aspiration syndrome. Using a highly sensitive fluorescence microsphere method, 17 types of cytokines and chemokines in sera were measured in 11 neonatal patients with meconium aspiration syndrome, 16 neonatal patients without meconium aspiration syndrome, and 9 healthy children. The concentrations of 8 types of proinflammatory cytokines and chemokines were significantly higher in the meconium aspiration syndrome group than in healthy controls: interleukin-1beta, interleukin-6, interleukin-8, granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, interferon-gamma, macrophage inflammatory protein-1beta, and tumor necrosis factor-alpha. Six types of proinflammatory cytokines and chemokines were significantly higher in the meconium aspiration syndrome group than in the nonmeconium aspiration syndrome group: interleukin-6, interleukin-8, granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, interferon-gamma, and tumor necrosis factor-alpha. Serum concentrations of interleukin-10 (anti-inflammatory cytokine) in the meconium aspiration syndrome group were higher than those in both the nonmeconium aspiration syndrome group and healthy children group (P = .007 and 0.001, respectively). Most types of proinflammatory cytokines and chemokines in sera of neonates with meconium aspiration syndrome were higher than those without meconium aspiration syndrome, giving support to the suggestion that elevated levels are associated with the pathogenesis of meconium aspiration syndrome.

  11. Crohn's disease-associated silent aspiration in the outpatient setting: Anesthesiologists beware.

    Science.gov (United States)

    Snell, Christopher; Coleman, Scott; Van Hal, Michele; Rashidian, Farshad; Okum, Gary; Green, Michael Stuart

    2018-01-01

    Every anesthesia provider fears aspiration of gastric contents during an anesthetic, and it may occur even in the absence of overt signs such as coughing or choking. Whether the aspiration is frank or silent, catastrophic and deleterious consequences may ensue. Therefore, familiarity with risk factors for silent aspiration is essential. Crohn's disease reportedly delays gastric emptying making these patients more susceptible to silent aspiration during surgery. Anesthesia providers must be cognizant of this risk and vigilant in the recognition to formulate a specific treatment plan preoperatively. We present a case of an ambulatory surgical patient with suspected silent aspiration undiagnosed by the anesthesia care team before induction of anesthesia.

  12. High Resolution Computed Tomography Appearences of late sequelae of Barium Aspiration in an asymptomatic young child

    International Nuclear Information System (INIS)

    Venkatraman, Bhat; Rahman, Hatim A.; Abdul-Wahab, Atiqa

    2005-01-01

    Barium aspiration is a well-known complication of upper gastro-intestinal studies. Consequences of aspiration are generally insignificant and leave no permanent changes in the lung parenchyma. However, large quantities of high density barium, if aspirated, lead to silent interstitial changes and fibrosis. High-resolution computed tomography HRCT appearances of lung changes have been demonstrated in adults; few such reports are available in the pediatric literature. We report a case of a child who aspirated barium 3 months before this presentation. The HRCT appearances of barium aspiration are presented with a review of the literature. (author)

  13. ASPIRE: Teachers and researchers working together to enhance student learning

    Directory of Open Access Journals (Sweden)

    Lollie Garay

    2014-11-01

    Full Text Available Abstract Science, Technology, Engineering, and Math (STEM disciplines have become key focus areas in the education community of the United States. Newly adopted across the nation, Next Generation Science Standards require that educators embrace innovative approaches to teaching. Transforming classrooms to actively engage students through a combination of knowledge and practice develops conceptual understanding and application skills. The partnerships between researchers and educators during the Amundsen Sea Polynya International Research Expedition (ASPIRE offer an example of how academic research can enhance K-12 student learning. In this commentary, we illustrate how ASPIRE teacher–scientist partnerships helped engage students with actual and virtual authentic scientific investigations. Crosscutting concepts of research in polar marine science can serve as intellectual tools to connect important ideas about ocean and climate science for the public good.

  14. Art in Science Promoting Interest in Research and Exploration (ASPIRE)

    Science.gov (United States)

    Fillingim, M.; Zevin, D.; Thrall, L.; Croft, S.; Raftery, C.; Shackelford, R.

    2015-11-01

    Led by U.C. Berkeley's Center for Science Education at the Space Sciences Laboratory in partnership with U.C. Berkeley Astronomy, the Lawrence Hall of Science, and the YMCA of the Central Bay Area, Art in Science Promoting Interest in Research and Exploration (ASPIRE) is a NASA EPOESS-funded program mainly for high school students that explores NASA science through art and highlights the need for and uses of art and visualizations in science. ASPIRE's aim is to motivate more diverse young people (especially African Americans) to learn about Science, Technology, Engineering, and Mathematics (STEM) topics and careers, via 1) Intensive summer workshops; 2) Drop-in after school workshops; 3) Astronomy visualization-focused outreach programming at public venues including a series of free star parties where the students help run the events; and 5) A website and a number of social networking strategies that highlight our youth's artwork.

  15. ENGLISH TEACHERS’ MASTERY OF THE ENGLISH ASPIRATION AND STRESS RULES

    Directory of Open Access Journals (Sweden)

    Arina Isti'anah

    2014-01-01

    Full Text Available This  paper  tries  to  observe  the  English  teachers’  awareness  and representation  of  the  English  aspiration  and  stress  rules.  The research purposes to find out whether or not the teachers are aware of the English aspiration and stress rules,  and to find out how the teachers represent the English aspiration and stress rules. Based on the analysis, it can be concluded that the teachers’ awareness of the English aspiration and stress rules is very low. It is indicated with the percentage which equals to 44% and 48% for English aspiration and  stress  rules.  In  representing  the  English  aspiration  and  stress rules, the teachers face the problems in producing aspiration in the pronunciation,  placing  the  right  stress  and  pronouncing  three  and four  X  in  the  coda  position.  There  are  two  reasons  affecting  the teachers’  awareness  of  the  English  aspiration  and  stress  rules namely exposure and L1 influence. Artikel  ini  bertujuan  untuk  meneliti  kesadaran  dan  representasi aturan aspirasi dan tekanan oleh guru bahasa Inggris. Penelitian ini bertujuan  untuk  menjelaskan  apakah  guru  bahasa  Inggris mempunyai  kesadaran  atas  aturan  aspirasi  dan  tekanan  dalam bahasa  Inggris,  dan    untuk  menunjukkan  bagaimana  guru  Bahasa Inggris  mewujudkan  aturan  aspirasi  dan  tekanan  dalam  pelafalan mereka.  Berdasarkan  analisis  yang  dilakukan,  dapat  disimpulkan bahwa  kesadaran  guru  Bahasa  Inggris  atas  aturan  aspirasi  dan tekanan  dalam  Bahasa  Inggris  masih  sangat  rendah.  Hal  tersebut ditunjukkan  oleh  rendahnya  prosentase  dalam  perwujudan  aturan aspirasi  dan  tekanan:  44%  dan  48%.  Dalam  mewujudkan  aturan aspirasi dan tekanan, guru Bahasa Inggris menemui masalah dalam menghasilkan  aspirasi  dalam  pelafalan,  meletakkan  tekanan  pada

  16. Ultrasound guided aspiration cytology of neck mass except thyroid mass

    International Nuclear Information System (INIS)

    Kim, Myeong Jin; Lee, Jong Tae; Yoo, Hyung Sik; Suh, Jung Ho; Park, Cheong Soo; Lee, Gwang Gil

    1988-01-01

    Results of ultrasound guided aspiration cytology of extrathyroidal neck masses of 73 patients were reviewed. Included cases were 23 malignant lesions; 16 metastatic tumors, 4 lymphomas, 3 salivary gland tumors and 50 benign lesions: 24 tuberculous lymphadenites, 15 abscess, 3 benign lymph node hyperplasias, etc. There were one case of false negative and none of false positive result for malignancy. In two cases of malignancy, insufficient cellular material was obtained. In one case of lymphoma, and a benign lymph node hyperplasia, it was difficult to distinguish between benignancy and malignancy on cytologic smear. For the malignant lesions, sensitivity was 83%, specificity was 98%, and overall accuracy was 93%. There were none who had suffered adverse effect from the procedure. Ultrasound guided aspiration cytology seems to be simple, accurate and safe diagnostic modality for neck masses especially in condition that malignancy can not be excluded

  17. Advances in the Management of Meconium Aspiration Syndrome

    Directory of Open Access Journals (Sweden)

    Kamala Swarnam

    2012-01-01

    Full Text Available Meconium aspiration syndrome (MAS is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hypertension of newborn (PPHN. This disorder can be life threatening, often complicated by respiratory failure, pulmonary air leaks, and PPHN. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. The use of surfactant and inhaled nitric oxide (iNO has led to the decreased mortality and the need for extracorporeal membrane oxygenation (ECMO use. In this paper, we review the current understanding of the pathophysiology and management of MAS.

  18. Advances in the Management of Meconium Aspiration Syndrome

    Science.gov (United States)

    Swarnam, Kamala; Soraisham, Amuchou S.; Sivanandan, Sindhu

    2012-01-01

    Meconium aspiration syndrome (MAS) is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hypertension of newborn (PPHN). This disorder can be life threatening, often complicated by respiratory failure, pulmonary air leaks, and PPHN. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. The use of surfactant and inhaled nitric oxide (iNO) has led to the decreased mortality and the need for extracorporeal membrane oxygenation (ECMO) use. In this paper, we review the current understanding of the pathophysiology and management of MAS. PMID:22164183

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

    Science.gov (United States)

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

    2009-07-01

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

  20. Recurrent aspiration pneumonia associated with giant aortic aneurysm

    OpenAIRE

    Hoff, Leonardo Santos; Schestatsky, Pedro

    2014-01-01

    A 83-year-old woman presented to the emergency department with fever, productive cough and dyspnea. She was previously diagnosed with dementia and systemic hypertension, and was heavy smoker for nearly 50 years. Her relatives reported that in the past four months she was admitted two times for aspiration pneumonia. Chest radiography showed right lower lobe consolidation and a large mediastinal mass (Panel A). A computed tomography angiography revealed a 10,2 cm descending aortic aneurysm comp...

  1. ROLE OF BONE MARROW ASPIRATION IN DIAGNOSIS OF HAEMATOLOGICAL DISORDER

    Directory of Open Access Journals (Sweden)

    Poonam Nanwani

    2017-03-01

    Full Text Available BACKGROUND The bone marrow examination is an essential investigation for the diagnosis of disorders of the blood and bone marrow. This simple and relatively safe procedure is important, particularly in resource poor centres since access to adjuvant diagnostic techniques are often lacking or absent. MATERIALS AND METHODS 189 patients of all age groups were studied for haematological and non-haematological disorders by bone marrow aspiration in the Department of Pathology, MGM Medical College during the period of 2014 to 2016. RESULTS Majority of the patients who had bone marrow aspiration were aged 0-15 years. The male-to-female ratio was 1:1.03. Most (97% of the marrow aspirate examined had definitive pathologic features, while 14 (7% were normal marrow elements. Out of 189 cases of bone marrow aspiration, acute leukaemia was the most common haematological disease diagnosed using this procedure. Acute lymphoblastic leukaemia was more common than acute myeloid leukaemia. Aplastic anaemia was seen in 16% cases. Megaloblastic anaemia occurred more commonly than other anaemias. Megaloblastic anaemia was seen in 13 cases (7% and microcytic anaemia was seen in 5 cases (3%. There were 10 cases (5% of Idiopathic Thrombocypenic Purpura. Myelodysplastic syndrome and multiple myeloma was seen in 7% and 2% cases respectively. Storage disorder was seen in 3 cases (2%, out of this 02 cases were Gaucher’s disease and one case was Niemann-Pick’s disease. CONCLUSION Bone marrow examination is an important step to arrive at the confirmatory diagnosis of many haematological disorders. This procedure remains a veritable tool in the diagnosis and management of a wide range of haematological diseases, especially in a resource poor centre.

  2. Aspiration for acute pilonidal abscess-a cohort study.

    Science.gov (United States)

    Lasithiotakis, Konstantinos; Aghahoseini, Assad; Volanaki, Dimitra; Peter, Mark; Alexander, David

    2018-03-01

    The traditional open incision and drainage of a pilonidal abscess is associated with slow healing and delayed return to normal daily activities. The aim of this study is to assess safety, effectiveness, and patient satisfaction of aspiration followed by antibiotics for a pilonidal abscess. All patients presenting with an acute pilonidal abscess during the period December 2010 and December 2014 in York Hospital, UK, were treated with bedside aspiration under local anesthetic, followed by oral cefalexin and metronidazole for 7 days. Patients with immunosuppression, diabetes, overlying skin necrosis, and perforation were excluded. Complications of the procedure were prospectively recorded. Long-term outcomes and overall patients' satisfaction were assessed with the use of mailed questionnaires and Visual Analogue Scales (VAS) (0 = not satisfied at all, 10 = very satisfied). One hundred sixty-nine patients presented with an acute pilonidal abscess and a total of 100 patients were treated with aspiration and antibiotics. There were 50 women (50%) and the median (interquartile range [IQR]) age of the cohort was 24 (14) years. Eleven patients had a history of a previous pilonidal procedure. Seven patients were treated successfully with a reaspiration. Overall, 10 patients required incision and drainage after a median (IQR) follow-up time of 29 (47) months. Fifty-six patients returned completed questionnaires. The median (IQR) of the VAS for the overall satisfaction of the procedure was 9 (5). Aspiration of a pilonidal abscess in selected patients is effective in 83%, and it is associated with high overall satisfaction rates. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Fine Needle Aspiration Biopsy in a Rural Family Practice

    African Journals Online (AJOL)

    ultrasound scan. A 21-gauge 1½-inch or 23-gauge 1¼-inch needle, attached to a 10-mL disposable plastic syringe, was used for FNAB of superficial masses. For percutaneous FNAB of deep-seated organs and masses, a 23 gauge 1¼-inch needle or 3½-inch spinal needle was used. The aspirate was spread on slides and ...

  4. Migration aspirations in Ukraine: Human rights violations as migration drivers

    OpenAIRE

    Borshchevska, Yuliya

    2014-01-01

    Ukraine is ranked highly among emigration countries and in particular among countries supplying labor migrants to the EU and Russia. The slumping economy and deteriorating political situation with an increasing number of authoritarian traits logically evoke the question of how non-economic motivation factors impact migration aspirations in Ukraine. The worsening human rights situation in the country is, in a way, seen as a separate matter and is not always associated with migration. This arti...

  5. Nurses' leadership self-efficacy, motivation, and career aspirations.

    Science.gov (United States)

    Cziraki, Karen; Read, Emily; Spence Laschinger, Heather K; Wong, Carol

    2018-02-05

    Purpose This paper aims to test a model examining precursors and outcomes of nurses' leadership self-efficacy, and their aspirations to management positions. Design/methodology/approach A cross-sectional survey of 727 registered nurses across Canada was conducted. Structural equation modelling using Mplus was used to analyse the data. Findings Results supported the hypothesized model: χ 2 (312) = 949.393; CFI = 0.927; TLI = 0.919; RMSEA = 0.053 (0.049-0.057); SRMR 0.044. Skill development opportunities ( ß = 0.20), temporary management roles ( ß = 0.12) and informal mentoring ( ß = 0.11) were significantly related to nurses' leadership self-efficacy, which significantly influenced motivation to lead ( ß = 0.77) and leadership career aspirations ( ß = 0.23). Motivation to lead was significantly related to leadership career aspirations ( ß = 0.50). Practical implications Nurses' leadership self-efficacy is an important determinant of their motivation and intention to pursue a leadership career. Results suggest that nurses' leadership self-efficacy can be influenced by providing opportunities for leadership mastery experiences and mentorship support. Leadership succession planning should include strategies to enhance nurses' leadership self-efficacy and increase front-line nurses' interest in leadership roles. Originality value With an aging nurse leader workforce, it is important to understand factors influencing nurses' leadership aspirations to develop and sustain nursing leadership capacity. This research study makes an important contribution to the nursing literature by showing that nurses' leadership self-efficacy appears to be an important determinant of their motivation to lead and desire to pursue a career as a nurse leader.

  6. The effect of hyperbaric oxygen treatment on aspiration pneumonia.

    Science.gov (United States)

    Sahin, Sevtap Hekimoglu; Kanter, Mehmet; Ayvaz, Suleyman; Colak, Alkin; Aksu, Burhan; Guzel, Ahmet; Basaran, Umit Nusret; Erboga, Mustafa; Ozcan, Ali

    2011-08-01

    We have studied whether hyperbaric oxygen (HBO) prevents different pulmonary aspiration materials-induced lung injury in rats. The experiments were designed in 60 Sprague-Dawley rats, ranging in weight from 250 to 300 g, randomly allotted into one of six groups (n = 10): saline control, Biosorb Energy Plus (BIO), hydrochloric acid (HCl), saline + HBO treated, BIO + HBO treated, and HCl + HBO treated. Saline, BIO, HCl were injected into the lungs in a volume of 2 ml/kg. A total of seven HBO sessions were performed at 2,4 atm 100% oxygen for 90 min at 6-h intervals. Seven days later, rats were sacrificed, and both lungs in all groups were examined biochemically and histopathologically. Our findings show that HBO inhibits the inflammatory response reducing significantly (P edema, alveolar exudate, alveolar histiocytes, interstitial fibrosis, granuloma, and necrosis formation in different pulmonary aspiration models. Pulmonar aspiration significantly increased the tissue HP content, malondialdehyde (MDA) levels and decreased (P < 0.05) the antioxidant enzyme (SOD, GSH-Px) activities. HBO treatment significantly (P < 0.05) decreased the elevated tissue HP content, and MDA levels and prevented inhibition of SOD, and GSH-Px (P < 0.05) enzymes in the tissues. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase, TUNEL and arise in the expression of surfactant protein D in lung tissue of different pulmonary aspiration models with HBO therapy. It was concluded that HBO treatment might be beneficial in lung injury, therefore, shows potential for clinical use.

  7. Effect of increased vacuum and aspiration rates on phacoemulsification efficiency.

    Science.gov (United States)

    Gupta, Isha; Cahoon, Judd M; Gardiner, Gareth; Garff, Kevin; Henriksen, Bradley S; Pettey, Jeff H; Barlow, William R; Olson, Randall J

    2015-04-01

    To evaluate the effect of vacuum and aspiration rates on phacoemulsification efficiency. John A. Moran Eye Center Laboratories, University of Utah, Salt Lake City, Utah, USA. Experimental study. Formalin-soaked porcine lenses were divided into 2.0 mm cubes, and 0.9 mm 30-degree beveled 20-degree bent tips were used with micropulse ultrasound (US) (6 milliseconds on and 6 milliseconds off) and a peristaltic flow system. Vacuum levels were tested at 200, 300, 400, and 500 mm Hg, and aspiration rates were tested at 20, 35, and 50 mL/min. Efficiency (time to lens removal) and chatter (number of lens fragment repulsions from the tip) were determined. Increasing vacuum increased efficiency only when going from 200 mm Hg to higher vacuum levels. Increasing aspiration increased efficiency at all points measured (25 mL/min versus 35 mL/min, P vacuum was increased from 200 mm Hg to 300 mm Hg and up. Chatter decreased with increasing flow. Vacuum improved efficiency only up to 300 mm Hg and was more dependent on increasing flow. Similarly, chatter correlated with 200 mm Hg vacuum only and was more correlated with flow. Limitations of this study include use of only 1 US power modulation and hard nuclear material. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Racial and Ethnic Gaps in Postsecondary Aspirations and Enrollment

    Directory of Open Access Journals (Sweden)

    Barbara Schneider

    2016-09-01

    Full Text Available One major finding of the Equality of Educational Opportunity (EEO report was that a smaller proportion of African Americans than whites reported “wanting to go no further than high school in each region of the country.” Blacks in the 1960s had high college aspirations, and those aspirations have continued, but today, as then, fewer blacks than whites attend four-year colleges. Since the EEO report, the U.S. population has become increasingly diverse, and postsecondary aspirations and enrollment now vary considerably among racial and ethnic groups. Whereas the EEO report focused on the significant role of students’ concrete knowledge about college in postsecondary attendance, it paid limited attention to variation in postsecondary preparation activities. This study contrasts earlier indicators of student college knowledge with college preparation activities to understand variations in college enrollment among different racial and ethnic groups. Results indicate that concrete knowledge has less impact on minority postsecondary enrollment than taking more-advanced academic courses.

  9. School students' attitudes and aspirations in science - (Symposium SBBq Brazil

    Directory of Open Access Journals (Sweden)

    J. Dillon

    2013-05-01

    Full Text Available Low participation rates in science are a matter of  international concern and existing evidence suggests that children’s science  aspirations are largely formed within the critical 10-14 age period. This presentation explores how families can shape young children’s science aspirations, using Bourdieu’s concept of  habitusto map family resources and practices. This paper  draws on two research projects: ASPIRES and Interests andRecruitment in Science (IRIS. Findings from the ASPIRES project draw on qualitative data from 160 semi-structured interviews (92 school children age 10 and 78 parents, collected as part of an ongoing 5-year longitudinal study in theUK. Findings are contextualised with reference to a survey of over 9,000 elementary school children in England (age 10 collected as part of the wider study. A typology of eight key family ‘habituses’ is developed, ranging  from families in which science is strongly embedded, through to ambivalentcontexts and those in which science is weakly or peripherally embedded. It discusses the implications of each for promoting, or deterring, children’s science aspirations. The IRIS project was aimed to develop knowledge andrecommendations informed by evidence on how young people, and womenin particular, may be attracted to, and retained in, STEM higher education. Specifically, the project addresses the following questions: 1. What are the  priorities, values and experiences on which young people base their educational choice? 2. What are the success factors for interventions aimed at  recruiting more young people (women in particular to higher STEM education? and 3. How do STEM students who drop out/opt out before graduation, explain their choice? The main instrument is a questionnaire (IRIS Q that was completed by almost 6,000 first-year STEM students in the five IRIS consortium countries in 2010. A range of smaller-scale, qualitative and quantitative modules

  10. Multiple squamous cells in thyroid fine needle aspiration: Friends or foes?

    Science.gov (United States)

    Gage, Heather; Hubbard, Elizabeth; Nodit, Laurentia

    2016-08-01

    Abundant squamous cells are rarely encountered in thyroid FNA with only few case reports noted in the literature. Their presence and cytologic features may pose a diagnostic dilemma and challenges for proper classification and follow-up. We intend to gain more insight into the frequency of this finding and its clinical significance. Our electronic records were searched over 16 years to reveal 15 thyroid FNAs with abundant squamous cells. The available cytology and surgical resection slides were reviewed and radiologic records and clinical follow-up was documented. Only 15 out of 8811 thyroid FNAs from our department contained predominantly squamous cells (0.17%) of which two were interpreted as nondiagnostic, four as atypical, eight as benign, and one malignant. Surgical follow-up was available in eight cases only with benign lesions representing the majority of the cases (squamous metaplasia in Hashimoto thyroiditis, benign epidermoid/branchial cleft or thyroglossal duct cysts, and one case squamous cell carcinoma). The cases without surgical resection were stable on subsequent ultrasound studies. Thyroid aspirates with predominance of squamous cells cannot be classified in the current Bethesda categories. Even when interpreted as atypical or equivocal, the squamous cells present in our small case series were mostly benign. The only malignant case was easily identified cytologically because of its higher degree of differentiation. The most common pitfall for atypical squamous cells in these aspirates was squamous metaplasia in the setting of Hashimoto thyroiditis and degenerative changes. Diagn. Cytopathol. 2016;44:676-681. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Endotracheal tubes and fluid aspiration: an in vitro evaluation of new cuff technologies.

    Science.gov (United States)

    Mariyaselvam, Maryanne Z; Marsh, Lucy L; Bamford, Sarah; Smith, Ann; Wise, Matt P; Williams, David W

    2017-03-04

    Aspiration of subglottic secretions past the endotracheal tube (ETT) cuff is a prerequisite for developing ventilator-associated pneumonia (VAP). Subglottic secretion drainage (SSD) ETTs reduce aspiration of subglottic secretions and have demonstrated lower VAP rates. We compared the performance of seven SSD ETTs against a non-SSD ETT in preventing aspiration below inflated cuffs. ETTs were positioned vertically in 2 cm diameter cylinders. Four ml of a standard microbial suspension was added above inflated cuffs. After 1 h, aspiration was measured and ETTs demonstrating no leakage were subjected to rotational movement and evaluation over 24 h. Collected aspirated fluid was used to inoculate agar media and incubated aerobically at 37 °C for 24 h. The aspiration rate, volume and number of microorganisms that leaked past the cuff was measured. Experiments were repeated (×10) for each type of ETT, with new ETTs used for each repeat. Best performing ETTs were then tested in five different cylinder diameters (1.6, 1.8, 2.0, 2.2 and 2.4 cm). Experiments were repeated as above using sterile water. Volume and time taken for aspiration past the cuff was measured. Experiments were repeated (×10) for each type of ETT. Results were analysed using non-parametric tests for repeated measures. The PneuX ETT prevented aspiration past the cuff in all experiments. All other ETTs allowed aspiration, with considerable variability in performance. The PneuX ETT was statistically superior in reducing aspiration compared to the SealGuard (p aspiration across the range of diameters compared to the SealGuard (p aspiration, relating to cuff material and design. Variability in performance was likely due to the random manner in which involutional folds form in the inflated ETT cuff. The PneuX ETT was the only ETT able to consistently prevent aspiration past the cuff in all experiments.

  12. N-acetylcysteine advancement of surfactant therapy in experimental meconium aspiration syndrome: possible mechanisms.

    Science.gov (United States)

    Kopincová, J; Mokrá, D; Mikolka, P; Kolomazník, M; Čalkovská, A

    2014-01-01

    Meconium aspiration syndrome (MAS) is meconium-induced respiratory failure of newborns associated with activation of inflammatory and oxidative pathways. For severe MAS, exogenous surfactant treatment is used which improves respiratory functions but does not treat the inflammation. Oxidative process can lead to later surfactant inactivation; hence, surfactant combination with antioxidative agent may enhance the therapeutic effect. Young New Zealand rabbits were instilled by meconium suspension and treated by surfactant alone, N-acetylcysteine (NAC) alone or by their combination and oxygen-ventilated for 5 h. Blood samples were taken before and 30 min after meconium application and 30 min, 1, 3 and 5 h after the treatment for evaluating of oxidative damage, total leukocyte count, leukocyte differential count and respiratory parameters. Leukocyte differential was assessed also in bronchoalveolar lavage fluid. NAC alone had only mild therapeutic effect on MAS. However, the combination of NAC and surfactant facilitated rapid onset of therapeutic effect in respiratory parameters (oxygenation index, PaO(2)/FiO(2)) compared to surfactant alone and was the only treatment which prevented neutrophil migration into the lungs, oxidative damage and lung edema. Moreover, NAC suppressed IL-8 and IL-beta formation and thus seems to be favorable agent for improving surfactant therapy in MAS.

  13. An examination of factors related to aspiration and silent aspiration in older adults requiring long-term care in rural Japan.

    Science.gov (United States)

    Sakai, K; Hirano, H; Watanabe, Y; Tohara, H; Sato, E; Sato, K; Katakura, A

    2016-02-01

    Swallowing disorders are a growing problem among the elderly in long-term care (LTC), and they can cause aspiration pneumonia. In order to detect swallowing disorders early, simple tools are needed to assess aspiration and silent aspiration (SA). To compile a sample of elderly people requiring LTC, and categorise them as having suspected aspiration and/or SA using simple screening tools. In addition, oral ability, severity of dementia, vital functions and nutritional status were compared in these groups. A total of 393 elderly people in LTC (89 men and 304 women; age ranging from 65 to 100 years) were included in the study. The modified water swallow test, cervical auscultation and cough test were used to assess swallowing function. The participants were categorised as having suspected aspiration and/or SA, and the following assessments were performed: (i) oral ability (lips function, tongue function, rinsing and gargling ability), (ii) dementia severity, (iii) vital functions and (iv) nutritional status. Suspected aspiration was apparent in 50.5% of patients, of which 24.0% had suspected SA. Those with suspected aspiration showed worsened oral ability, dementia severity, vital functions and nutritional status. Similarly, those with suspected SA showed worsened dementia severity, vital functions and nutritional status. Logistic regression analysis revealed that lip closure, lingual movement and rinsing ability were significantly associated with suspected aspiration. Dementia severity was the best predictor of suspected SA. Simple screening tools can be used to identify suspected aspiration and SA, which may facilitate early detection of aspiration pneumonia or swallowing disorder risk. © 2015 John Wiley & Sons Ltd.

  14. Concentration of lymph node aspirate improves the sensitivity of acid fast smear microscopy for the diagnosis of tuberculous lymphadenitis in Jimma, southwest Ethiopia.

    Science.gov (United States)

    Tadesse, Mulualem; Abebe, Gemeda; Abdissa, Ketema; Bekele, Alemayehu; Bezabih, Mesele; Apers, Ludwig; Colebunders, Robert; Rigouts, Leen

    2014-01-01

    Tuberculous lymphadenitis (TBLN) is the most common form of extrapulmonary tuberculosis. The cytomorphological features of lymph node smears have reduced specificity for the diagnosis of tuberculosis. The diagnosis of TBLN with direct smear microscopy lacks sensitivity due to the limited number of bacilli in lymph node aspirate. Therefore, we aimed to assess whether the concentration of lymph node aspirate improves the sensitivity of acid fast smear microscopy for the diagnosis of tuberculous lymphadenitis. A cross-sectional comparative study was conducted on 200 patients clinically suspected for tuberculous lymphadenitis in Jimma, Ethiopia. Lymph node aspirate was collected. The first two drops were used for cytomorphological study and direct acid fast staining. The remaining aspirate was treated with N-acetyl-L-cysteine (NALC) and concentrated by centrifugation at 3000 g for 15 minutes. The sediment was used for acid fast staining and culture. Differentiation of M. tuberculosis complex (MTBC) from non-tuberculous mycobacteria (NTM) was done by para-nitrobenzoic acid susceptibility test. Complete data were available for 187 study subjects. 68% (127/187) were positive for M. tuberculosis on culture. Four isolates, 2.1% (4/187), were identified as NTM. The detection rate of direct smear microscopy was 25.1% and that of the concentration method 49.7%. Cytomorphologically, 79.7% of cases were classified as TBLN. The sensitivity of direct smear microscopy was 34.6%, for concentrated smear microscopy 66.1%, and for cytomorphology 89.8%. Two AFB positive cases on concentration method were non-tuberculosis mycobacteria (NTM). The concentration method yielded a positive result from seven cases diagnosed as suppurative abscess by cytology. Both for the direct and concentration methods the highest rate of AFB positivity was observed in smears showing caseous necrosis alone. Smear positivity rate decreased with the appearance of epithelioid cell aggregates. The concentration

  15. An investigation of the associations between contingent self-worth and aspirations among Iranian university students.

    Science.gov (United States)

    Sabzehara, Milad; Ferguson, Yuna Lee; Sarafraz, Mehdi Reza; Mohammadi, Mostafa

    2014-01-01

    This study investigated the novel associations between intrinsic and extrinsic aspirations and internal and external domains of contingent self-worth among a sample of 502 Iranian university students. We found a meaningful pattern showing that intrinsic aspirations were positively associated with internal domains, whereas extrinsic aspirations were positively associated with external domains. Our survey data also suggested that the factor structure of the Aspiration Index, as well as the factor structure of the Contingencies of Self-Worth Scale in our Iranian sample were consistent with factor structures of foreign samples. Finally, the types of aspirations and domains of contingencies of self-worth meaningfully predicted variables related to well-being, confirming previous research. We discuss the nature of the associations between the aspirations and the domains of contingent self-worth.

  16. Widening participation in medicine? New insights from school students' aspirations.

    Science.gov (United States)

    Gore, Jennifer; Patfield, Sally; Holmes, Kathryn; Smith, Maxwell

    2018-02-01

    Students from lower socio-economic status backgrounds continue to be under-represented in medical education. Although various initiatives have been implemented by universities to widen participation, their effectiveness and their timing remain contentious. Prior studies have primarily focused on students already on a medical pathway, with little analytical attention given to the aspirations of primary and secondary school-aged students. The aim of this study was to identify the characteristics of students who express early interest in medicine and ascertain the degree to which diversification of the future medical student cohort is indicated. As part of a longitudinal study of educational and occupational aspirations (2012-2015), students in Years 3-12 (n = 6492) from government schools in New South Wales, Australia, completed an annual online survey. Their individual responses were linked with prior academic achievement and demographic data. Logistic regression models were used to examine the significance of student- and school-related variables as predictors of interest in medicine. Significant predictors were: being in the early years of secondary school, possessing high cultural capital, coming from a language background other than English, being female, and perceiving oneself as 'well above average' relative to peers. Socio-economic status was a significant predictor when examined independently, but not when all variables were considered in the full regression model. For medical schools seeking to widen participation, this study underscores the importance of recognising the intersection of other factors with socio-economic status and how they contribute to students' aspirational biographies. If medical schools are to select from a more diverse range of applicants, recruitment strategies must take into account the discursive positioning of the discipline. Sustained outreach into primary and secondary schools may be critical to interrupting the current social

  17. Aspiration and swallowing in Parkinson disease and rehabilitation with EMST

    Science.gov (United States)

    Troche, M.S.; Okun, M.S.; Rosenbek, J.C.; Musson, N.; Fernandez, H.H.; Rodriguez, R.; Romrell, J.; Pitts, T.; Wheeler-Hegland, K.M.; Sapienza, C.M.

    2010-01-01

    Objective: Dysphagia is the main cause of aspiration pneumonia and death in Parkinson disease (PD) with no established restorative behavioral treatment to date. Reduced swallow safety may be related to decreased elevation and excursion of the hyolaryngeal complex. Increased submental muscle force generation has been associated with expiratory muscle strength training (EMST) and subsequent increases in hyolaryngeal complex movement provide a strong rationale for its use as a dysphagia treatment. The current study's objective was to test the treatment outcome of a 4-week device-driven EMST program on swallow safety and define the physiologic mechanisms through measures of swallow timing and hyoid displacement. Methods: This was a randomized, blinded, sham-controlled EMST trial performed at an academic center. Sixty participants with PD completed EMST, 4 weeks, 5 days per week, for 20 minutes per day, using a calibrated or sham, handheld device. Measures of swallow function including judgments of swallow safety (penetration–aspiration [PA] scale scores), swallow timing, and hyoid movement were made from videofluoroscopic images. Results: No pretreatment group differences existed. The active treatment (EMST) group demonstrated improved swallow safety compared to the sham group as evidenced by improved PA scores. The EMST group demonstrated improvement of hyolaryngeal function during swallowing, findings not evident for the sham group. Conclusions: EMST may be a restorative treatment for dysphagia in those with PD. The mechanism may be explained by improved hyolaryngeal complex movement. Classification of evidence: This intervention study provides Class I evidence that swallow safety as defined by PA score improved post EMST. GLOSSARY CI = confidence interval; EMST = expiratory muscle strength training; MEP = maximum expiratory pressure; PA = penetration–aspiration; PD = Parkinson disease; SWAL-QOL = Swallowing Quality of Life Questionnaire; UES = upper esophageal

  18. Suburbanization, Intra-Urban Mobility and Homeownership Aspirations

    DEFF Research Database (Denmark)

    Andreasen, Manja Hoppe

    are shaping and influencing processes and dynamics of urban expansion through their settlement practices, preferences and aspirations, and based on this analysis to contribute to an emerging scientific debate on how transformations of peripheral spaces of African cities can be conceptualized...... construction of housing, financed, built and inhabited by individual residents, who are predominantly long-term urban residents moving from central parts of the city and who are engaging in urban-based livelihood activities, which are often critically reliant on daily or regular mobility and access to central...

  19. Aggressive digital papillary adenocarcinoma diagnosed by fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Krishnamurthy Jayashree

    2010-01-01

    Full Text Available Aggressive digital papillary adenocarcinoma is a rare variant of eccrine sweat gland malignancy with a propensity for metastases and recurrence. We report a 45-year-old female with aggressive digital papillary adenocarcinoma diagnosed by fine needle aspiration cytology (FNAC. The cytological findings were representative of the histological features. The recognition of aggressive digital papillary adenocarcinoma as a distinct clinicopathological eccrine sweat gland neoplasm is important because of the potential for aggressive local growth and distant metastasis. FNAC plays an important role in the preoperative diagnosis and management of these lesions.

  20. Bone marrow aspiration and biopsy. Technique and considerations

    Directory of Open Access Journals (Sweden)

    R.A. Trejo-Ayala

    2015-10-01

    Full Text Available Bone marrow aspiration and bone marrow biopsy are invasive procedures in which good technical skill is crucial to obtain samples suitable for processing and diagnostic interpretation. The type and calibre of the needle is one of the main variables of the technique, and is selected on the basis of the age, gender and body mass of the patient. This article provides a practical, step-by-step guide to the technique for both procedures. It also discusses existing techniques for reducing the pain associated with the procedure, an essential aspect for the patient that if poorly handled, can force cancellation of the procedure.

  1. Aspiration of tracheoesophageal prosthesis in a laryngectomized patient

    Directory of Open Access Journals (Sweden)

    Conte Sergio C

    2012-08-01

    Full Text Available Abstract Background The voice prosthesis inserted into a tracheoesophageal fistula has become the most widely used device for voice rehabilitation in patients with total laryngectomy. Case presentation We describe a case of tracheoesophageal prosthesis’ (TEP aspiration in a laryngectomized patient, with permanent tracheal stoma, that appeared during standard cleaning procedure, despite a programme of training for the safe management of patients with voice prosthesis. Conclusions The definitive diagnosis and treatment were performed by flexible bronchoscopy, that may be considered the procedure of choice in these cases, also on the basis of the literature.

  2. Metastatic Chordoma: A Diagnostic Challenge on Fine Needle Aspiration

    Directory of Open Access Journals (Sweden)

    Ghassan Tranesh

    2016-01-01

    Full Text Available Chordomas are primary low grade malignant tumors of bone that usually arise within both ends of axial skeleton. The Notochord is a midline, ectoderm-derived structure that defines the phylum of chordates. Chordomas may pose difficult diagnostic challenges when encountered in secondary locations, such as lungs or other parenchymatous organs. We report the cytologic findings of a metastatic chordoma sampled through CT-scan guided fine needle aspiration (FNA of lower lobe lung nodule in a 54-year-old man diagnosed with recurrent chordoma involving the lumber spine and paraspinal region.

  3. Measurement of Oxygen Desaturation Is Not Useful for the Detection of Aspiration in Dysphagic Stroke Patients

    Directory of Open Access Journals (Sweden)

    Thomas Marian

    2017-03-01

    Full Text Available Background: Dysphagia is one of the most dangerous symptoms of acute stroke. Various screening tools have been suggested for the early detection of this condition. In spite of conflicting results, measurement of oxygen saturation (SpO2 during clinical swallowing assessment is still recommended by different national guidelines as a screening tool with a decline in SpO2 ≥2% usually being regarded as a marker of aspiration. This paper assesses the sensitivity of SpO2 measurements for the evaluation of aspiration risk in acute stroke patients. Methods: Fifty acute stroke patients with moderate to severe dysphagia were included in this study. In all patients, fiberoptic endoscopic evaluation of swallowing (FEES was performed according to a standardised protocol. Blinded to the results of FEES, SpO2 was monitored simultaneously. The degree of desaturation during/after swallows with aspiration was compared to the degree of desaturation during/after swallows without aspiration in a swallow-to-swallow analysis of each patient. To minimise potential confounders, every patient served as their control. Results: In each subject, a swallow with and a swallow without aspiration were analysed. Overall, aspiration seen in FEES was related to a minor decline in SpO2 (mean SpO2 without aspiration 95.54 ± 2.7% vs. mean SpO2 with aspiration 95.28 ± 2.7%. However, a significant desaturation ≥2% occurred only in 5 patients during/after aspiration. There was no correlation between aspiration/dysphagia severity or the amount of aspirated material and SpO2 levels. Conclusions: According to this study, measurement of oxygen desaturation is not a suitable screening tool for the detection of aspiration in stroke patients.

  4. Aspiration of barium contrast medium in an elderly man with disordered swallowing

    OpenAIRE

    Bağcı Ceyhan, B.; Çelikel, T.; Koç, M.; Ahıskalı, R.; Biren, T.; Ataizi Çelikel, Ç.

    1995-01-01

    The aspiration of contrast medium during the investigation of gastrointestinal diseases is a well recognized hazard, particularly in patients with swallowing disorders. A case is reported in which accidental aspiration of contrast barium occurred owing to disordered swallowing in an elderly man. The infiltration on chest x-ray persisted 2 years after barium contrast aspiration. Inflammatory reaction and retractile, granular material observed in lung biopsy specimens suggested barium-induced p...

  5. Empowering change: The effects of energy provision on individual aspirations in slum communities

    International Nuclear Information System (INIS)

    Parikh, Priti; Chaturvedi, Sankalp; George, Gerard

    2012-01-01

    This paper discusses the role of energy provision in influencing the social aspirations of people living in slums. We examine factors that influence the shift in aspirations in five slum settlements using data from 500 interviews conducted in serviced and non-serviced slums from the state of Gujarat in India. The non-serviced slums did not have access to basic services namely water, sanitation, energy, roads, solid waste and rainwater management. We find empirical evidence which suggests that when basic infrastructure provisions are met, slum dwellers shift their focus from lower order aspirations to the higher order aspirations like health, education, housing and land ownership. We argue that energy provision enhances productivity and enables slum dwellers to shift their aspirations upwards. Furthermore, we test the effect of work days lost due to illness on the relationship between higher order aspirations and aspirations for energy provision. When provision of energy is low, higher work day loss dampens higher order aspirations. For policy makers, this study highlights the critical link between the infrastructure services preferred by slum dwellers and their social aspirations for growth. - Highlights: ► We examine the role of energy provision in influencing social aspirations of people living in slums. ► 500 household interviews conducted in five Indian slum settlements used for the analysis. ► Shift in slum dwellers aspirations from non-serviced to serviced conditions examined using Herzberg’s theory. ► Link between energy provision and higher order aspirations established through a regression model. ► Policy recommendation is to encourage investment in infrastructure services as a driver for development.

  6. Utility of Eating Assessment Tool-10 in Predicting Aspiration in Patients with Unilateral Vocal Fold Paralysis.

    Science.gov (United States)

    Zuniga, Steven A; Ebersole, Barbara; Jamal, Nausheen

    2018-03-01

    Objective Examine the incidence of penetration/aspiration in patients with unilateral vocal fold immobility and investigate the relationship with self-reported perception of dysphagia. Study Design Case series with chart review. Setting Academic cancer center. Subjects and Methods Adult patients with unilateral vocal fold immobility diagnosed between 2014 and 2016 were reviewed. Patients were stratified into an aspiration group and a nonaspiration group using objective findings on flexible endoscopic evaluation of swallowing, as scored using Rosenbek's Penetration Aspiration Scale. Objective findings were compared to patient perception of dysphagia. Bivariate linear correlation analysis was performed to evaluate correlation between Eating Assessment Tool-10 scores and presence of aspiration. Tests of diagnostic accuracy were calculated to investigate the predictive value of Eating Assessment Tool-10 scores >9 on aspiration risk. Results Of the 35 patients with new-onset unilateral vocal fold immobility were evaluated, 25.7% (9/35) demonstrated tracheal aspiration. Mean ± SD Eating Assessment Tool-10 scores were 19.2 ± 13.7 for aspirators and 7.0 ± 7.8 for nonaspirators ( P = .016). A statistically significant correlation was demonstrated between increasing Eating Assessment Tool-10 scores and Penetration Aspiration Scale scores ( r = 0.511, P = .002). Diagnostic accuracy analysis for aspiration risk in patients with an Eating Assessment Tool-10 score >9 revealed a sensitivity of 77.8% and a specificity of 73.1%. Conclusion Patient perception of swallowing difficulty may have utility in predicting aspiration risk. An EAT-10 of >9 in patients with unilateral vocal fold immobility may portend up to a 5 times greater risk of aspiration. Routine swallow testing to assess for penetration/aspiration may be indicated in patients with unilateral vocal fold immobility.

  7. Identification of perioperative pulmonary aspiration in children using quality assurance and hospital administrative billing data.

    Science.gov (United States)

    Eisler, Lisa; Huang, Grace; Lee, Ka-Eun M; Busse, Jennifer A; Sun, Ming; Lin, Albert Y; Sun, Lena S; Ing, Caleb

    2018-03-01

    Perioperative aspiration is a rare but potentially devastating complication, occurring in 1-10 per 10 000 anesthetics based on studies of quality assurance databases. Quality assurance reporting is known to underestimate the incidence of adverse outcomes, but few large studies use supplementary data sources. This study aims to identify the incidence of and risk factors for perioperative aspiration in children using quality assurance data supplemented by administrative billing records, and to examine the utility of billing data as a supplementary data source. Aspiration events for children receiving anesthesia at a tertiary care pediatric hospital between 2008 and 2014 were identified using (i) a perioperative quality assurance database and (ii) hospital administrative billing records with International Classification of Diseases, Ninth Revision Clinical Modification coded diagnoses of aspiration. Records were subject to review by pediatric anesthesiologists. Following identification of all aspiration events, the incidence of perioperative aspiration was calculated and risk factors were assessed. 47 272 anesthetic cases were evaluated over 7 years. The quality assurance database identified 20 cases of perioperative aspiration occurring in surgical inpatients, same-day admissions, and outpatients. Using hospital administrative data (which excludes outpatients with shorter than a 24-hour stay), 9 cases of perioperative aspiration were identified of which 6 had not been found through quality assurance data. Overall, International Classification of Diseases, Ninth Revision coding demonstrated a positive predictive value of 94.5% for any aspiration event; however, positive predictive value was Quality assurance data offer an efficient way to measure the incidence of rare events, but may underestimate perioperative complications. International Classification of Diseases, Ninth Revision codes for aspiration used as a secondary data source were nonspecific for

  8. Risk Factors and Clinical Follow-Up Features of Meconium Aspiration Syndrome

    OpenAIRE

    Anuk İnce, Deniz; Takcı, Şahin; Altıntaş, Buket

    2015-01-01

    AbstractAim: Meconium aspiration syndrome is usually seen in full-term and post-term infants and may cause complications including respiratory failure, pulmonary air leaks, and persistent pulmonary hypertension. The aim of this study was to determine risk factors of meconium aspiration syndrome and assess the clinical course of the disease.Material and Methods: Fourteen of 508 infants diagnosed with meconium aspiration syndrome between January 2013 and April 2014 were retrospectively analyzed...

  9. Biased Aspirations and Social Inequality at School: Evidence from French Teenagers

    OpenAIRE

    Guyon, Nina; Huillery, Elise

    2016-01-01

    This paper provides empirical evidence on how aspirations are formed and affect individual behavior, decisions, and paths in the context of education. Using unique data on aspirations, academic performance and actual track assignment to high school of French ninth graders, we show that low-SES students have lower aspirations than their equally-achieving high-SES classmates, and that track assignments to high school the next year are even more unequal due to dysfunctional dynamics: first, both...

  10. Diagnostic Value of Processing Cytologic Aspirates of Renal Tumors in Agar Cell (Tissue) Blocks

    DEFF Research Database (Denmark)

    Smedts, F.; Schrik, M.; Horn, T.

    2010-01-01

    Objective To adapt a method enabling utilization of most of the harvest from a fine needle aspirate in an effort to improve diagnostic accuracy in the assessment of a renal tumor in a single histologic slide. Study Design In a series of 43 renal tumors, 2 fine needle aspirations were performed, 4...... smears were prepared after each aspiration for conventional cytology and the remaining aspirate was processed for the improved agar microbiopsy (AM) method. Conventional cytology slides, AM slides and surgical specimens were diagnosed separately, after which the diagnoses were compared...

  11. Aspiration, atelektasis, emphysema with special regard to children and adolescents

    International Nuclear Information System (INIS)

    Reither, M.; Giessen Univ.

    1982-01-01

    The most important factors of acute respiratory diseases in childhood are reported. Above all the characteristic features of airway obstructions in chest films are presented: In newborn suffering from aspiration we find diffuse patchy and illdefined densities combined with atelectasis. In patients with aspiration of foreign bodies a unilaterally localized complete or partial emphysema of the lung in in- and particulary in exspiration followed by mediastinal shifting is pathognomonic. Chest films in in- and exspiration are therefore mandatory. Atelectases are not uncommon in ventilated and operated patients. Emphysemata arise also in such patients; a particular emphysema is the so-called congenital lobar emphysema due to an upper lobe obstruction in most patients. Finally children suffering from spastic bronchitis and asthma present pulmonary emphysema. Generally chest films in different projections and not only in inspiration but also in exspiration allow to establish the correct diagnosis of the most important airway obstructions in children and to give rapid and sure informations for treatment. (orig.) [de

  12. Fine-needle aspiration biopsy of intraosseous jaw lesions.

    Science.gov (United States)

    August, M; Faquin, W C; Ferraro, N F; Kaban, L B

    1999-11-01

    This study assessed diagnostic accuracy, determined reasons for error, and evaluated modifications to improve the reliability of fine-needle aspiration biopsy (FNAB) of primary jaw lesions. This was a retrospective review of 32 FNABs of intraosseous jaw lesions performed at the Massachusetts General and Children's Hospital between 1993 and 1998. A consistent, standardized technique was used, and each case was evaluated for 1) adequacy of cells to allow diagnosis, 2) presence of malignant cells, and 3) correlation between FNAB diagnosis and the final histopathology. Material obtained by FNAB was adequate for evaluation in 30 of 32 cases. No complications were reported. Malignant cells were found in 5 of 30 cases. FNAB diagnosis was confirmed by histopathology in all 5 of these specimens (100% accuracy). The FNAB diagnosis of benign lesions was confirmed in 17 of 25 cases (68%). The most common benign lesions were odontogenic cysts, ameloblastomas, and fibro-osseous and giant cell lesions. Incorrect diagnosis was related to lack of architectural context of the FNAB material, sampling of a nonrepresentative part of a large lesion, and inadequate quantity or quality of the aspirate. FNAB is a useful technique to distinguish between malignant and benign intraosseous jaw lesions. Its simplicity, suitability as an outpatient procedure, rapidity of interpretation, and minimal morbidity potentially make it the diagnostic tool of choice in the hospital setting.

  13. Recurrent aspiration pneumonia associated with giant aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Leonardo Santos Hoff

    2014-04-01

    Full Text Available A 83-year-old woman presented to the emergency department with fever, productive cough and dyspnea. She was previously diagnosed with dementia and systemic hypertension, and was heavy smoker for nearly 50 years. Her relatives reported that in the past four months she was admitted two times for aspiration pneumonia. Chest radiography showed right lower lobe consolidation and a large mediastinal mass (Panel A. A computed tomography angiography revealed a 10,2 cm descending aortic aneurysm compressing the esophagus (Panel B and C. Serologic VDRL test was negative. Esophageal clearance was moderately diminished above the level of the aortic arch, with antiperistaltic contractions, according to videofluoroscopic swallowing study; oropharyngeal dysphagia was also present. The patient was treated for aspiration pneumonia and assessed by cardiovascular surgeons, who decided for a conservative treatment due to the characteristics of the aneurysm and her clinical condition. She was discharged with an optimized treatment for systemic hypertension including beta-blockers, and appropriate diet for dysphagia.

  14. Missing Aspirated Impacted Denture Requiring Tracheotomy for Removal

    Directory of Open Access Journals (Sweden)

    Sampan-Singh Bist

    2017-11-01

    Full Text Available Introduction:                                                     Aspirated foreign bodies continue to present challenges to otorhinolaryngologists. Removal of impacted airway foreign bodies via conventional methods can at times pose difficulty. This may berelated to the location and type of foreign body, experience of the surgeon and anesthetist, and the availability of appropriate instruments. In adults, especially in edentulous patients, a swallowed denture usually gets lodged in the esophagus and entrance into the airway is uncommon.   Case Report:  We report a case of an uncommon foreign body (3-toothed artificial denture plate impacted in the trachea of a 40-year-old male following an acute episode of an epileptic attack in which conventional methods of foreign body removal had failed. It was eventually removed via a direct laryngoscopy and tracheotomy technique.   Conclusion: This type of impaction of a large denture in the trachea is uncommon and late presentation after aspiration is even more rare. This unusual case of a foreign body in the airway is interesting due to its rarity, mode of entry, site of impaction, variable clinical presentation, and method of removal; and hence, prompted the authors to report this case.

  15. Short-cut diagnostic tool in cystinosis: Bone marrow aspiration.

    Science.gov (United States)

    Sürmeli Döven, Serra; Delibaş, Ali; Kayacan, Uğur Raşit; Ünal, Selma

    2017-11-01

    Cystinosis is a rare metabolic genetic disorder caused by a mutation in cystinosin lysosomal cystine transporter (CTNS). The diagnosis of nephropathic cystinosis (NC) is made by observing corneal cystine crystals and/or measuring the cystine content of leukocytes. CTNS mutation analysis confirms the diagnosis of cystinosis, but leukocyte cystine measurement and CTNS analysis have not been widely available, and cystine crystals in the cornea may not be apparent in the first months of life. Cystine crystal deposition can be seen in the bone marrow earlier than corneal deposition, in patients with NC. Ten patients with cystinosis diagnosis were enrolled in the study. Medical records were reviewed retrospectively to collect demographic and clinical data such as age at diagnosis, disease presentation, parental consanguinity, family history, corneal cystine deposition, leukocyte cystine level, bone marrow cystine deposition, presence of renal failure, follow-up time and prognosis. Cystine crystals were seen in all of the patients' fresh bone marrow aspiration samples. Eight patients had corneal cystine deposition. Leukocyte cystine measurement could have been performed in four patients who had come from another center. Complications such as pulmonary hypertension and idiopathic intracranial hypertension (IIH) were observed in two patients. Bone marrow aspiration might be an easy and short-cut diagnostic tool for NC especially when it is not possible to measure fibroblast cystine content. Additionally some rare complications such as pulmonary hypertension and IIH can be encountered during the course of NC. © 2017 Japan Pediatric Society.

  16. [A blind point of vent catheter: air aspiration].

    Science.gov (United States)

    Inui, K; Orita, H; Shimanuki, T; Fukasawa, M; Gotou, S; Nakamura, C; Washio, M

    1993-05-01

    We experienced a case of saphenous vein air embolism after coronary artery bypass graft, in which case we used vent catheter kept in the left atrium. Though it was considered that air bubbles were never aspirated through vent catheter, we speculated that the origin of air bubbles must be the vent catheter. And we made an experiment on the motion of air in the vent catheter using a model of left heart composed with soft reserver (atrium) and pulsatile pump (ventricle). When the pulsatile pump was arrest, the air bubbles were never aspirated from the vent catheter to the soft reserver even if we vented with strong negative pressure. But, when the pulsatile pump was in motion and the left atrium was vented with some negative pressure, some leaks of air bubbles were recognized. So we must pay much more attention to the degree of venting when the heart is in motion. Sometimes we use overpressure safety valve composed with vent catheter, but measured left atrial pressure showed that decreased left atrial pressure was only 2 mmHg. So its use should be restricted in the patients with good ventricular function.

  17. Meconium aspiration syndrome (MAS) - Where do we go? Research perspectives.

    Science.gov (United States)

    Kääpä, Pekka O

    2009-10-01

    The pathogenetic cascade of meconium aspiration syndrome (MAS) in newborn infants is complex and still incompletely studied. The variable clinical presentation of MAS is basically connected with variation of the amount and consistency of aspirated meconium and also its distribution within the affected lungs. The contributing role of other factors, like intrauterine fetal compromises, lung maturity at the time of insult as well as direct and indirect effects of meconium and its components on the lung alveolar and vascular integrity and development, remains to be studied in further detail. Better understanding of the lung injury processes in MAS, specifically inflammatory injury and non-inflammatory apoptosis and their interplay, may offer new possibilities to treat the severely affected infants, and needs therefore to be explored. Systemic dispersion of intrapulmonary meconium and its components may further induce inflammatory circulatory changes and injurious effects in distant organs, but the mechanisms and clinical significance of these systemic complications are still poorly known. It is thus evident that lung injury processes and potent long-term consequences in various extrapulmonary organs, specifically the brain, as well as development of new approaches to their treatment and prevention form great challenges for future research of MAS.

  18. Meconium aspiration syndrome: possible pathophysiological mechanisms and future potential therapies.

    Science.gov (United States)

    Lindenskov, Paal Helge Haakonsen; Castellheim, Albert; Saugstad, Ola Didrik; Mollnes, Tom Eirik

    2015-01-01

    Does meconium cause meconium aspiration syndrome (MAS) or is meconium discharge only a marker of fetal hypoxia? This dispute has lasted for centuries, but since the 1960s, detrimental effects of meconium itself on the lungs have been demonstrated in animal experiments. In clinical MAS, persistent pulmonary hypertension of the newborn is the leading cause of death in MAS. Regarding the complex chemical composition of meconium, it is difficult to identify a single agent responsible for the pathophysiology. However, considering that meconium is stored in the intestines, partly unexposed to the immune system, aspirated meconium could be recognized as ‘danger', representing damaged self. The common denominator in the pathophysiology could therefore be activation of innate immunity. Thus, a bulk of evidence implies that meconium is a potent activator of inflammatory mediators, including cytokines, complement, prostaglandins and reactive oxygen species. We hypothesize that the two main recognition systems of innate immunity, the Toll-like receptors and the complement system, recognize meconium as ‘danger', which leads not only to lung dysfunction but also to a systemic inflammatory response. This might have therapeutic implications in the future.

  19. How to overcome surfactant dysfunction in meconium aspiration syndrome?

    Science.gov (United States)

    Mokra, Daniela; Calkovska, Andrea

    2013-06-01

    Surfactant dysfunction in meconium aspiration syndrome (MAS) is caused by meconium components, by plasma proteins leaking through the injured alveolocapillary membrane and by substances originated in meconium-induced inflammation. Surfactant inactivation in MAS may be diminished by several ways. Firstly, aspirated meconium should be removed from the lungs to decrease concentrations of meconium inhibitors coming into the contact with surfactant in the alveolar compartment. Once the endogenous surfactant becomes inactivated, components of surfactant should be substituted by exogenous surfactant at a sufficient dose, and surfactant administration should be repeated, if oxygenation remains compromised. To delay the inactivation by inhibitors, exogenous surfactants may be enriched with surfactant proteins, phospholipids, or other substances such as polymers. Finally, to diminish an adverse action of products of meconium-induced inflammation on both endogenous and exogenously delivered surfactant, anti-inflammatory drugs may be administered. A combined therapeutic approach may result in better outcome in patients with MAS and in lower costs of treatment. Copyright © 2013. Published by Elsevier B.V.

  20. Detection of blood aspiration in deadly head gunshots comparing postmortem computed tomography (PMCT) and autopsy.

    Science.gov (United States)

    Scaparra, E; Peschel, O; Kirchhoff, C; Reiser, M; Kirchhoff, S M

    2016-11-01

    The aim of our study was to analyze the reliability of postmortem computed tomography (PMCT) versus autopsy in detecting signs of blood aspiration in a distinct group of patients following deadly head, mouth or floor of mouth gunshot injuries. In this study, in 41 cases PMCT was compared to autopsy reports, the gold standard of postmortem exams, regarding detection of blood aspiration. PMCT was evaluated for the presence and level of typical signs of blood aspiration in the major airways and lung using a semi-quantitative scale ranging from level 0 (no aspiration) to 3 (significant aspiration) also taking density values of the described potential aspiratory changes into account. Overall, in 29 (70.7%) of 41 enrolled cases PMCT and autopsy revealed the same level of aspiration. A difference of one level between PMCT and autopsy resulted for 5 (12.2%) of the remaining 12 cases. More than one level difference between both methods resulted for 7 cases (17.2%). Autopsy described no signs of aspiration in 10 cases, compared to 31 cases with reported blood aspiration. In contrast, PMCT revealed no signs of blood aspiration in 15 cases whereas 26 cases were rated as positive for signs of aspiration in the major airways. In 18 of these 26 cases considered positive for blood aspiration by autopsy and PMCT, clear signs of aspiration signs were also described bilaterally by both methods. The presented study provides evidence for the assumption that PMCT seems to be helpful in the detection of blood aspiration in cases of deadly head gunshots. In conclusion, it seems reasonable to suggest performing PMCT additionally to traditional postmortem exams in cases of suspected aspiration to rule out false-negative cases and to possibly allow for a more detailed and rather evidence based examination reconnoitering the cause of death. However, the adequate use of PMCT in this context needs further evaluation and the definition of an objective scale for aspiration detection on PMCT needs

  1. The Educational and Employment Aspirations of Adolescents from Areas of High Deprivation in London.

    Science.gov (United States)

    Frostick, Caroline; Phillips, Gemma; Renton, Adrian; Moore, Derek

    2016-06-01

    Adolescents from areas of high deprivation are often assumed to have low aspirations for the future. However, recent research has suggested otherwise and there have been calls for more substantial investigation into the relationship between poverty and aspiration. This article reports levels and variation in aspiration from 1214 adolescents (49.5 % male; 50.5 % female) living in areas of high deprivation across 20 London boroughs. A strength of this study is our large and diverse population of low socio-economic status (SES) adolescents, comprising of white British (22 %), black African (21 %), black Caribbean (9 %), Indian/Pakistani/Bangladeshi/Other Asian (24 %), mixed ethnicity (9 %), and 15 % defining themselves as Other. Our measures indicated a high group level of reported aspiration with notable variations. Females reported higher educational (but not occupational) aspirations than males; white British students reported lower educational and occupational aspirations than other ethnic groups; and black African children reported the highest educational aspirations. Perceived parental support for education had the largest positive association with aspirations. In contrast to previous findings from studies carried out in the United States, aspirations were found to be negatively associated with perceptions of school and school peer environment. These measures explored feelings of safety, happiness and belonging within the school environment and school peer group. We discuss possible explanations for this unexpected finding within our population of adolescents from UK state schools and how it might affect future policy interventions. This study makes an important contribution to the literature on adolescent aspirations because of the unique nature of the data sample and the multiple domains of functioning and aspiration measured.

  2. [Fine-needle Aspiration of Thyroid Nodules: Is it Worth Repeating?

    Science.gov (United States)

    Fernandes, Vera; Pereira, Tânia; Eloy, Catarina

    2017-06-30

    The fine-needle aspiration has a significant role in assessing the malignancy risk of thyroid nodules. There is uncertainty regarding the value of repeat fine-needle aspiration in benign nodules. This study aims to evaluate the concordance of results in consecutive fine-needle aspiration and to study the relevance of repetition in benign results. Retrospective study of the 4800 thyroid nodules fine-needle aspiration held in Instituto de Patologia e Imunologia Molecular da Universidade do Porto between January 1, 2014 and May 2, 2016. Of the initial sample, we selected the repeated fine-needle aspiration on the same nodule. The first fine-needle aspiration result of the 309 nodules underwent revaluation was non-diagnostic in 103 (33.3%), benign in 120 (38.8%) and atypia/follicular lesion of undetermined significance in 86 (27.8%). The agreement between the first and second fine-needle aspiration was significantly higher in cases with an initial benign result (benign: 85.8%, non-diagnostic: 27.2% and atypia/follicular lesion of undetermined significance: 17.4%, p < 0.005). The fine-needle aspiration repeating motifs in initially benign nodules (n = 78) were repetition suggestion in 58, nodule growth in 17 and suspicious ultrasonographic features in 3. The fine-needle aspiration repetition in nodules with initial non-diagnostic and atypia/follicular lesion of undetermined significance result changed the initial diagnosis in a significant proportion of patients, modifying their therapeutic approach. The high concordance of results in initially benign nodules makes fine-needle aspiration repetition not cost-effective in most cases. The fine-needle aspiration should be repeated when the initial cytology result is non-diagnostic or atypia/follicular lesion of undetermined significance.

  3. Artificial neural network model to distinguish follicular adenoma from follicular carcinoma on fine needle aspiration of thyroid.

    Science.gov (United States)

    Savala, Rajiv; Dey, Pranab; Gupta, Nalini

    2018-03-01

    To distinguish follicular adenoma (FA) and follicular carcinoma (FC) of thyroid in fine needle aspiration cytology (FNAC) is a challenging problem. In this article, we attempted to build an artificial neural network (ANN) model from the cytological and morphometric features of the FNAC smears of thyroid to distinguish FA from FC. The cytological features and morphometric analysis were done on the FNAC smears of histology proven cases of FA (26) and FC (31). The cytological features were analysed semi-quantitatively by two independent observers (RS and PD). These data were used to make an ANN model to differentiate FA versus FC on FNAC material. The performance of this ANN model was assessed by analysing the confusion matrix and receiving operator curve. There were 39 cases in training set, 9 cases each in validation and test sets. In the test group, ANN model successfully distinguished all cases (9/9) of FA and FC. The area under receiver operating curve was 1. The present ANN model is efficient to diagnose follicular adenoma and carcinoma cases on cytology smears without any error. In future, this ANN model will be able to diagnose follicular adenoma and carcinoma cases on thyroid aspirate. This study has immense potential in future. This is an open ended ANN model and more parameters and more cases can be included to make the model much stronger. © 2017 Wiley Periodicals, Inc.

  4. Personality-Career Fit and Freshman Medical Career Aspirations: A Test of Holland's Theory.

    Science.gov (United States)

    Antony, James Soto

    1998-01-01

    Using Holland's personality theory of occupational decision making, a study examined the influence of personality/career fit on initial medical career aspirations of college freshmen, and the extent to which the fit is associated with maintaining or abandoning these aspirations. Overall, results support the theory and illustrate how personality…

  5. Acute respiratory failure caused by aspiration of high density barium: A case report

    International Nuclear Information System (INIS)

    Park, Ki Soon; Jung, Eun A; Yang, Ik; Lee, Yul; Chung, Soo Young

    1994-01-01

    Accidental aspiration of barium contrast medium during the upper gastrointestinal study can occur in patients with swallowing disorder, especially in the elderly patients. We experienced a case of respiratory failure followed by death within a few hours in 85 year-old patient after barium aspiration

  6. Aspiration pneumonitis primes the host for an exaggerated inflammatory response during pneumonia

    NARCIS (Netherlands)

    van Westerloo, David J.; Knapp, Sylvia; van't Veer, Cornelis; Buurman, Wim A.; de Vos, Alex F.; Florquin, Sandrine; van der Poll, Tom

    2005-01-01

    Objective. Nosocomial pneumonia is a feared complication in the critically ill patient. Aspiration pneumonitis is frequently complicated by infections. The objective of this study was to determine the influence of aspiration pneumonitis on the host response to a common nosocomial respiratory

  7. The Role of Relative Intrinsic Aspirations in Chinese Adolescents' Prosocial Behaviors

    Science.gov (United States)

    Fu, Xinyuan; Liu, Xiaolan; Yang, Ying; Zhang, Mengyuan; Kou, Yu

    2018-01-01

    We examined Chinese adolescents' aspirations and explored the relationship between relative intrinsic aspirations (RIA) and prosocial behaviors and whether adolescents with different levels of RIA have different emphases on self- and other-oriented considerations during prosocial decision making. In Study 1, 236 participants were recruited and…

  8. Conclusiveness of fine needle aspiration in 2419 histologically confirmed benign and malignant breast lesions

    NARCIS (Netherlands)

    Kooistra, B.; Wauters, C.; Wobbes, T.; Strobbe, L.

    2011-01-01

    We aimed to retrospectively assess (1) the conclusiveness of breast fine needle aspiration (FNA) in a histologically confirmed population and (2) the clinical and radiologic determinants of a conclusive diagnosis. Aspirates were diagnosed as inadequate, benign, atypical, suspicious or malignant. We

  9. Oral health care and aspiration pneumonia in frail older people: a systematic literature review

    NARCIS (Netherlands)

    Maarel-Wierink, C.D. van der; Vanobbergen, J.N.; Bronkhorst, E.M.; Schols, J.M.; Baat, C. de

    2013-01-01

    OBJECTIVE: To systematically review the literature on oral health care interventions in frail older people and the effect on the incidence of aspiration pneumonia. BACKGROUND: Oral health care seems to play an important role in the prevention of aspiration pneumonia in frail older people. METHODS:

  10. The relationship among educational achievement, career aspiration, and oral hygiene behaviours in Iranian adolescents.

    Science.gov (United States)

    Dorri, Mojtaba; Sheiham, Aubrey; Watt, Richard G

    2011-02-01

    The objectives of this study were to examine: (i) the association between toothbrushing frequency and educational achievement; (ii) the influence of social status and career aspiration on this association; and (iii) whether educational achievement and career aspiration explain the gender difference in oral hygiene behaviours in Iranian adolescents in Mashhad. The sample population was sixth-grade adolescents in Mashhad, Iran. Participants completed a 37-item questionnaire with questions on socio-demographic variables, frequency of toothbrushing, educational achievement, and their career aspiration. The associations between toothbrushing frequency and other study-outcome variables were tested using binary logistic regression. The association between toothbrushing frequency and educational achievement was significant only after adjusting for the father's level of education and the child's career aspiration. Toothbrushing frequency was highly significantly associated with gender, and this association remained unaltered after adjusting for educational achievement and career aspiration. Career aspiration and toothbrushing frequency were significantly associated. In conclusion, educational achievement was not an independent indicator of reported toothbrushing frequency in Iranian adolescents in Mashhad. Father's educational level and child's career aspiration mediated the association between toothbrushing frequency and educational achievement. Educational achievement and career aspiration did not explain the gender difference in toothbrushing behaviours of Iranian adolescents. © 2011 Eur J Oral Sci.

  11. Youth self-formation and the 'capacity to aspire': The itinerant ...

    African Journals Online (AJOL)

    The article employs the lenses of 'aspiration', 'space', and 'technologies of self' to present the argument that his 'capacity to aspire' has to be understood on the basis of his active self-formation and disciplining, accumulated across the itinerant spaces of his life. The aim of this article is to open a window onto how young ...

  12. Constructing New Identities? The Role of Gender and Education in Rural Girls' Life Aspirations in Peru

    Science.gov (United States)

    Ames, Patricia

    2013-01-01

    This paper focuses on rural and indigenous girls and their mothers in Peru, examining how they position schooling and education in their current life and future aspirations, in order to better understand girls' increasing participation in education. It is argued here that the high educational aspirations girls and their families have are not only…

  13. Educational Aspirations and Expectations of Students in Rural Washington High Schools.

    Science.gov (United States)

    Slocum, Walter L.

    Previous research studies were reviewed, and hypotheses relating to educational aspiration and occupational choice were developed. Information on educational aspirations and expectations was then obtained from a random sample of students enrolled in 1964-65 in 30 rural Washington high schools. Farm versus non-farm student differences were examined…

  14. Aspirations and Expectations of the Rural Poor--A Guide to Research.

    Science.gov (United States)

    Slocum, Walter L.

    Two research areas relating to the rural poor--educational and occupational aspirations and expectations of youth, and aspirations and expectations of adults for economic progress--are reviewed. Hypotheses are developed, and suggested research topics (e.g., attitudinal norms of the family, work history of the family head, and perceived reality and…

  15. Structuring Opportunity: The Role of School Context in Shaping High School Students' Occupational Aspirations

    Science.gov (United States)

    Rowan-Kenyon, Heather T.; Perna, Laura W.; Swan, Amy K.

    2011-01-01

    This study explores the occupational aspirations of high school students planning to attend college by drawing on a multilayered model of college enrollment, social cognitive career theory, and multiple descriptive case studies of 15 high schools. Students' occupational aspirations and their understanding of the education required to achieve these…

  16. Glioma spheroids obtained via ultrasonic aspiration are viable and express stem cell markers

    DEFF Research Database (Denmark)

    Jensen, Stine Skov; Aaberg-Jessen, Charlotte; Andersen, Claus

    2013-01-01

    Ultrasonic aspirators allow safe, rapid, and accurate removal of brain tumors. However, the tissue fragments removed are used surprisingly little in research.......Ultrasonic aspirators allow safe, rapid, and accurate removal of brain tumors. However, the tissue fragments removed are used surprisingly little in research....

  17. Counter-Stereotypes and Feminism Promote Leadership Aspirations in Highly Identified Women.

    Science.gov (United States)

    Leicht, Carola; Gocłowska, Małgorzata A; Van Breen, Jolien A; de Lemus, Soledad; Randsley de Moura, Georgina

    2017-01-01

    Although women who highly identify with other women are more susceptible to stereotype threat effects, women's identification might associate with greater leadership aspirations contingent on (1) counter-stereotype salience and (2) feminist identification. When gender counter-stereotypes are salient, women's identification should associate with greater leadership aspiration regardless of feminism, while when gender stereotypes are salient, women's identification would predict greater leadership aspirations contingent on a high level of feminist identification. In our study US-based women ( N = 208) attended to gender stereotypic (vs. counter-stereotypic) content. We measured identification with women and identification with feminism, and, following the manipulation, leadership aspirations in an imagined work scenario. The interaction between identification with women, identification with feminism, and attention to stereotypes (vs. counter-stereotypes) significantly predicted leadership aspirations. In the counter-stereotypic condition women's identification associated with greater leadership aspirations regardless of feminist identification. In the stereotypic condition women's identification predicted leadership aspirations only at high levels of feminist identification. We conclude that salient counter-stereotypes and a strong identification with feminism may help high women identifiers increase their leadership aspirations.

  18. Intralesional saline injection for effective ultrasound-guided aspiration of benign viscous cystic thyroid nodules

    International Nuclear Information System (INIS)

    Ko, Eun Sook; Shin, Jung Hee; Sung, Jin Yong

    2014-01-01

    We aimed to evaluate the efficacy and safety of vigorous saline injection for viscous cystic thyroid nodules. Eighteen patients who underwent ultrasound-guided aspiration for viscous cystic thyroid nodules using a saline injection were included in our study. After failing to aspirate the cyst by the usual method, we vigorously injected saline into the cyst in multiple directions to break up and liquefy the viscous cystic contents to enable aspiration. The initial and the residual volume of the nodule were calculated, and the volume reduction rate and the time taken to perform the aspiration were recorded. The mean volume of the cystic nodules before aspiration was 11.0 mL (range, 1.2 to 26.0 mL), while the postaspiration volume was 4.2 mL (range, 0.2 to 14.5 mL). The mean aspirated volume was 63.7% of the initial volume. The mean procedure time was 12.4 minutes (range, 5 to 26 minutes). There were no significant complications related to the procedure. A vigorous saline injection followed by aspiration can be a useful method to aspirate viscous cystic thyroid nodules as a prestep for further intervention or simple management.

  19. Individual-Level Predictors of Young Children's Aspirations

    Science.gov (United States)

    Moulton, Vanessa; Flouri, Eirini; Joshi, Heather; Sullivan, Alice

    2018-01-01

    Often young children already have some ideas about what they want to do in the future. Using data from a large UK cohort study, we investigated the individual determinants of seven-year-old children's aspirations, controlling for parental socio-economic background and parental involvement in learning. At age 7, not all children's aspirations were…

  20. Kinematic and temporal factors associated with penetration-aspiration in liquid swallowing

    Science.gov (United States)

    Molfenter, Sonja M.; Steele, Catriona M.

    2015-01-01

    In this study, we undertook careful analysis of 13 quantitative physiological variables related to oropharyngeal swallowing from a sample of 42 subacute patients referred for dysphagia assessment. Each patient underwent videofluoroscopic swallowing examination in which they swallowed up to 5 boluses of 22% w/v ultra-thin liquid barium suspension administered by teaspoon. Our goal was to determine whether scores on thirteen kinematic or temporal parameters of interest were independently associated with the presence of penetration-aspiration in the final compiled dataset of 178 swallows. Participants were classified as aspirators, based on the presence of at least one swallow demonstrating a penetration-aspiration scale score ≥ 3. The parameters of interest included: six kinematic parameters for capturing hyoid position; three swallow durations (laryngeal closure duration; hyoid movement duration; upper esophageal sphincter (UES) opening duration); and four swallow intervals (laryngeal closure to UES opening; bolus dwell time in the pharynx prior to laryngeal closure; stage transition duration; and pharyngeal transit time). Mixed model repeated measures ANOVAs were conducted to determine the association between each parameter and aspiration status. Only one of the 13 parameters tested distinguished aspirators from non-aspirators: aspirators demonstrated significantly shorter UES opening duration. Additionally, a trend towards reduced maximum superior position of the hyoid was seen in aspirators. Limitations and future considerations are discussed. PMID:24445381

  1. "There Was Something about Aspiration": Widening Participation Policy Affects in England and Australia

    Science.gov (United States)

    Sellar, Sam; Storan, John

    2013-01-01

    This paper discusses the emergence of aspiration as a keyword linked to higher education equity policy in England and Australia since 1997. Aspiration serves multiple purposes when constructed as a problematic site in which policy must intervene. For example, it can be understood as a vector for new technologies of governance that operate through…

  2. Value of fine-needle aspiration biopsy of salivary gland lesions

    DEFF Research Database (Denmark)

    Christensen, Rikke Kølby; Bjørndal, Kristine; Godballe, Christian

    2010-01-01

    BACKGROUND: The aim of this study was to assess the utility of fine-needle aspiration biopsy (FNAB) in the diagnosis and treatment planning of the lesions of the salivary gland. METHODS: Eight hundred seventy-nine aspiration biopsies of the lesion of the salivary gland over a 10-year period, from...

  3. Aspiration-Induced Acute Lung Injury in Victims with Isolated Severe Brain Injury

    Directory of Open Access Journals (Sweden)

    Yu. A. Gorodovikova

    2009-01-01

    Full Text Available Objective: to determine the time and development rate of acute lung injury (ALI in severe brain injury (SBI complicated by aspiration of gastric contents or blood. Subjects and methods. Twenty-nine patients aged 19 to 70 years, who had isolated SBI, of whom there were 24 males and 5 females, were examined. The patients were divided into 2 groups: those with aspiration of gastric contents (n=9 or blood (n=10. A control group included 10 patients with SBI without aspiration. A PiCCO plus device was used to determine pulmonary extravascular fluid. ALI was diagnosed in accordance with the recommendations of the Research Institute of General Reanimatology, Russian Academy of Medical Sciences. Results. SBI patients with aspiration of gastric contents or blood were found to have significantly increased pulmonary extravascular water (p<0.01 and a lower oxygenation index (<300, which correlated with each other. ALI was recorded in the first hours after injury in about 50% of cases in both patients with gastric contents aspiration and those with blood aspiration. Conclusion. In patients with SBI complicated by aspiration of gastric contents or blood, pulmonary extravascular fluid accumulation concurrent with other signs of injury may be regarded as a criterion for acute lung injury. Key words: severe brain injury, aspiration, acute lung lesion.

  4. Aspirations and Equality in Higher Education: Gender in a South African University

    Science.gov (United States)

    Walker, Melanie

    2018-01-01

    This paper considers ways to theorise aspirations in terms of capabilities and agency to function as human beings, as well as our resources to act and participate in this world using a South African case of women students' aspirations. In this analysis higher education should foster women's freedom as critical agents to make genuine choices about…

  5. The Influences of Career Support and Sexual Identity on Sexual Minority Women's Career Aspirations

    Science.gov (United States)

    Fisher, Lauren D.; Gushue, George V.; Cerrone, Michelle T.

    2011-01-01

    The authors examined the relationship between sexual identity, family/friend career support, and career aspirations in a sample of 381 sexual minority women. The results indicated that family career support and friend career support were positively related to career aspirations of sexual minority women. The results also indicated that the…

  6. Counter-Stereotypes and Feminism Promote Leadership Aspirations in Highly Identified Women

    Directory of Open Access Journals (Sweden)

    Carola Leicht

    2017-06-01

    Full Text Available Although women who highly identify with other women are more susceptible to stereotype threat effects, women's identification might associate with greater leadership aspirations contingent on (1 counter-stereotype salience and (2 feminist identification. When gender counter-stereotypes are salient, women's identification should associate with greater leadership aspiration regardless of feminism, while when gender stereotypes are salient, women's identification would predict greater leadership aspirations contingent on a high level of feminist identification. In our study US-based women (N = 208 attended to gender stereotypic (vs. counter-stereotypic content. We measured identification with women and identification with feminism, and, following the manipulation, leadership aspirations in an imagined work scenario. The interaction between identification with women, identification with feminism, and attention to stereotypes (vs. counter-stereotypes significantly predicted leadership aspirations. In the counter-stereotypic condition women's identification associated with greater leadership aspirations regardless of feminist identification. In the stereotypic condition women's identification predicted leadership aspirations only at high levels of feminist identification. We conclude that salient counter-stereotypes and a strong identification with feminism may help high women identifiers increase their leadership aspirations.

  7. Aspiring Principals' Perception of the Challenges of Beginning Principals and the Support That They Need

    Science.gov (United States)

    Ng, Pak Tee

    2015-01-01

    This paper presents the results of an exploratory research project about the perception of aspiring principals regarding the challenges of beginning principals and the support that they need. These aspiring principals are participants on the Leaders in Education Programme (LEP) in Singapore. According to the research findings, the LEP participants…

  8. African American Career Aspirations: Examining the Relative Influence of Internalized Racism

    Science.gov (United States)

    Brown, Danice L.; Segrist, Daniel

    2016-01-01

    The present study examined the relative influence of aspects of internalized racism on the career aspirations of a sample of African American adults. Participants (N = 315), ranging in age from 18 to 62 years, completed measures of internalized racism and career aspirations online. A hierarchical multiple regression analysis was conducted to…

  9. A Comparison Study of 12th Grade Hispanic Students' College Anticipations, Aspirations, and College Preparatory Measures

    Science.gov (United States)

    Lozano, Aliber; Watt, Karen M.; Huerta, Jeffery

    2009-01-01

    This study assessed the differences in educational aspirations and educational anticipations between four groups (AVID, GEAR UP, AVID/GEAR UP, and Control) of high school seniors who participated in a previous study as 10th graders (Watt, Huerta, & Lozano, 2007). It also measured whether any change in aspirations and anticipations occurred…

  10. Determinants and Dynamics of Business Aspirations : Evidence from Small-scale Entrepreneurs in an Emerging Market

    NARCIS (Netherlands)

    Dalton, Patricio; Rüschenpöhler, Julius; Zia, Bilal

    2018-01-01

    Small-scale entrepreneurs are ubiquitous in emerging market economies, yet very few graduate to become larger businesses. We ask whether such entrepreneurs even aspire to grow, and if so, on which dimensions of the business? What factors influence these aspirations, how realistic are they, and do

  11. [The diagnostic value of fine needle aspiration cytology in hematology: a study of 40 cases].

    Science.gov (United States)

    El Graoui, Omar; Marouane, Sophia; Zamiati, Soumaya; Faez, Saadia; Oukkach, Bouchra

    2013-01-01

    Fine-needle aspiration cytology (FNAC) is a simple and safe procedure that has proven to be accurate in the diagnosis of a variety of neoplasms. It is performed in an outpatient setting, and results are routinely available within 24 hours. To evaluate the diagnostic value of FNAC in the assessment of lymph nodes, we conducted a prospective study of patients with no history of previews malignancy, who underwent FNAC of an enlarged lymph node, during the period of January 2010 through June 2011. Cytologic findings were correlated with either histologic findings, clinical information, or both. Sensibility, specificity, and predictive values in differentiating between benign and malignant lymphadenopathy were high (81-92%). False negative results could be explained by the fact that pathology may be focal rather than widespread and therefore not seen on a cytologic smear. FNAC has become an integral part of the initial diagnosis and management of patients with persistent lymphadenopathy. However, the most important limitations are the high percentage of inadequate material (37%). Sensitivity and specificity are to be improved in our practice by improving the adequacy of the sampling, as well as the skill, experience, and familiarity of the cytopathologist.

  12. Fine needle aspiration biopsy diagnosis of dedifferentiated liposarcoma: Cytomorphology and MDM2 amplification by FISH

    Directory of Open Access Journals (Sweden)

    Al-Maghraby Hatem

    2010-01-01

    Full Text Available Lipomatous mesenchymal tumors constitute the most common type of soft tissue tumors. Well-differentiated liposarcoma (WDLS can undergo dedifferentiation to a nonlipogenic sarcoma of variable histologic grade. In the recent literature, amplification of the murine double minute 2 (MDM2 oncogene, which has a role in cell cycle control, has been successful in distinguishing WDLS from benign lesions. We present a case of dedifferentiated liposarcoma diagnosed by fine-needle aspiration (FNA, using cytomorphology and ancillary studies (immunocytochemistry and fluorescent in-situ hybridization. An 85-year old female presented to our institution with a firm soft tissue mass of the right buttock. The FNA showed atypical spindle cells, osteoclast-like giant cells and extracellular dense matrix material. The cell block showed cellular groups of highly atypical spindle cells with osteoid and adipose tissue. Fluorescence in situ hybridization (FISH studies performed on the cell block demonstrated amplification of the MDM2 gene. In addition, the findings were morphologically compatible with the previously resected retroperitoneal dedifferentiated liposarcoma with areas of osteosarcoma. This rare case illustrates the usefulness of FNA and ancillary studies in the diagnosis and subclassification of soft tissue tumors. To the best of our knowledge, this is the first report of MDM2 FISH positivity in a liposarcoma diagnosed by FNA.

  13. Bone Marrow Aspirate Concentrate-Enhanced Marrow Stimulation of Chondral Defects

    Science.gov (United States)

    Eichler, Hermann; Orth, Patrick

    2017-01-01

    Mesenchymal stem cells (MSCs) from bone marrow play a critical role in osteochondral repair. A bone marrow clot forms within the cartilage defect either as a result of marrow stimulation or during the course of the spontaneous repair of osteochondral defects. Mobilized pluripotent MSCs from the subchondral bone migrate into the defect filled with the clot, differentiate into chondrocytes and osteoblasts, and form a repair tissue over time. The additional application of a bone marrow aspirate (BMA) to the procedure of marrow stimulation is thought to enhance cartilage repair as it may provide both an additional cell population capable of chondrogenesis and a source of growth factors stimulating cartilage repair. Moreover, the BMA clot provides a three-dimensional environment, possibly further supporting chondrogenesis and protecting the subchondral bone from structural alterations. The purpose of this review is to bridge the gap in our understanding between the basic science knowledge on MSCs and BMA and the clinical and technical aspects of marrow stimulation-based cartilage repair by examining available data on the role and mechanisms of MSCs and BMA in osteochondral repair. Implications of findings from both translational and clinical studies using BMA concentrate-enhanced marrow stimulation are discussed. PMID:28607559

  14. Fine needle aspiration of primary mediastinal synovial sarcoma: cytomorphologic, immunohistochemical, and molecular study.

    Science.gov (United States)

    Huang, Cheng Cheng; Michael, Claire W; Pang, Judy C

    2014-02-01

    The cytologic diagnosis of synovial sarcoma (SS) can be difficult when it occurs in unusual locations, atypical age groups, and/or have unusual morphology. We report a case of primary mediastinal SS in a 65-year-old male with a long smoking history who presented with increasing shortness of breath and was found to have a 14.2 cm mediastinal mass. Smears from the endobronchial ultrasound guided fine needle aspiration of the mass were moderately cellular consisting of loosely cohesive clusters, some of which demonstrated nuclear molding, and dispersed single cells. The relatively uniform tumor cells had a high nuclear-to-cytoplasmic ratio, finely granular chromatin, and inconspicuous nucleoli. Some of the single cells had spindled morphology with unipolar wispy tails and naked nuclei. Based on the clinical presentation and the cytomorphologic features, our initial differential diagnoses included atypical carcinoid, small cell carcinoma, basaloid squamous cell carcinoma, sarcoma, and lymphoma. Immunohistochemical studies on the cell block sections revealed that the tumor cells were focally positive for cytokeratin and diffusely positive for CD56, while negative for CD45, synaptophysin and chromogranin. Ultimately, an immunohistochemical stain for TLE-1 demonstrated diffusely strong nuclear positivity and molecular studies showed the presence of the t(X; 18) SYT/SSX1 translocation confirming the diagnosis of SS. In this report, we describe the cytomorphologic features of SS, its diagnostic pitfalls, and potential mimics in the mediastinum. Copyright © 2012 Wiley Periodicals, Inc.

  15. Constraint Differentiation

    DEFF Research Database (Denmark)

    Mödersheim, Sebastian Alexander; Basin, David; Viganò, Luca

    2010-01-01

    We introduce constraint differentiation, a powerful technique for reducing search when model-checking security protocols using constraint-based methods. Constraint differentiation works by eliminating certain kinds of redundancies that arise in the search space when using constraints to represent...... results show that constraint differentiation substantially reduces search and considerably improves the performance of OFMC, enabling its application to a wider class of problems....

  16. Differential manifolds

    CERN Document Server

    Kosinski, Antoni A

    2007-01-01

    The concepts of differential topology form the center of many mathematical disciplines such as differential geometry and Lie group theory. Differential Manifolds presents to advanced undergraduates and graduate students the systematic study of the topological structure of smooth manifolds. Author Antoni A. Kosinski, Professor Emeritus of Mathematics at Rutgers University, offers an accessible approach to both the h-cobordism theorem and the classification of differential structures on spheres.""How useful it is,"" noted the Bulletin of the American Mathematical Society, ""to have a single, sho

  17. Aspiration Pneumonia in a Pediatric Patient under General Anesthesia despite Adequate Preoperative Fasting

    Directory of Open Access Journals (Sweden)

    Sang-Il Yoon

    2015-11-01

    Full Text Available Aspiration pneumonia rarely occurs during general anesthesia; however, it can result in fatal pulmonary complications. To reduce aspiration pneumonia, a preoperative fasting time of 8 hours is recommended. A 4-year-old boy with ankyloglossia was scheduled for frenotomy. He completed preoperative fasting time and had no digestive symptoms. Pulmonary aspiration due to unexpected massive vomiting occurred during anesthesia induction. The patient’s airway was immediately secured by endotracheal tube. The vomitus in the airway tract was removed by fiberoptic bronchoscopy. Abdomen radiograph taken after this event showed paralytic ileus which can cause aspiration of gastric contents. We describe a case of pneumonia caused by aspiration of gastric contents in a pediatric patient who followed fasting instructions and who was scheduled for outpatient surgery.

  18. Pre-aspiration in Welsh English: a case study of Aberystwyth

    DEFF Research Database (Denmark)

    Hejná, Michaela

    -aspiration and glottalisation. Glottalisation is frequently found in today’s English in words such as water, in which the t sound is missing and replaced by a glottal catch. At first blush, pre- aspiration and glottalisation would seem incompatible as the former involves spreading of the vocal folds and the latter......Lay abstract This thesis examines pre-aspiration in English spoken in Aberystwyth, mid Wales. Pre-aspiration is a sound very similar to h (as in honey), and it can be found mainly in the sequences of vowels (a, e, i, o, u, etc.) and certain consonants (p, t, k, f, th, s, sh). In English, pre......-aspiration would be manifested as a h sound inserted in the following words as indicated: paht, peht, piht, poht, puht, mahp, mahtt, mahck, ohff, mohth, mahss, mahsh. Because the sound is understudied in English, the work focuses on what other sounds condition the presence of the phenomenon and its duration...

  19. ASPIRE - Cloud Chambers as an Introduction to Cosmic Ray Observation

    Science.gov (United States)

    Callahan, Julie; Matthews, John; Jui, Charles

    2012-03-01

    ASPIRE is the K12 - Education & Public Outreach program for the Telescope Array ultra-high energy cosmic ray research project in Utah. The Telescope Array experiment studies ultra-high energy cosmic rays with an array of ˜500 surface scintillator detectors and three fluorescence telescope stations observing over 300 square miles in the West Desert of Utah. Telescope Array is a collaboration of international institutions from the United States, Japan, Korea, Russia and Belgium. Cloud chambers are an inexpensive and easy demonstration to visually observe evidence of charged particles and cosmic ray activity both for informal events as well as for K12 classroom activities. Join us in building a cloud chamber and observe cosmic rays with these table-top demonstrations. A brief overview of the Telescope Array project in Millard County, Utah will also be presented.

  20. Laryngospasm With Apparent Aspiration During Sedation With Nitrous Oxide.

    Science.gov (United States)

    Babl, Franz E; Grindlay, Joanne; Barrett, Michael Joseph

    2015-11-01

    Nitrous oxide and oxygen mixture has become increasingly popular for the procedural sedation and analgesia of children in the emergency department. In general, nitrous oxide is regarded as a very safe agent according to large case series. We report a case of single-agent nitrous oxide sedation of a child, complicated by laryngospasm and radiographically confirmed bilateral upper lobe pulmonary opacities. Although rarely reported with parenteral sedative agents, laryngospasm and apparent aspiration has not been previously reported in isolated nitrous oxide sedation. This case highlights that, similar to other sedative agents, nitrous oxide administration also needs to be conducted by staff and in settings in which airway emergencies can be appropriately managed. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  1. CT guided fine needle aspiration biopsy of biliopancreatic lesions

    International Nuclear Information System (INIS)

    Geng, Jia-Zheng; Qin, Pan-Rui; Hui, Liu-De; Po, Pei-Dong

    1987-01-01

    CT guided percutaneous fine needle aspiration biopsy was performed on 30 patients with pancreatic and periampullary neoplasms, in the Department of Surgery, China-Japan Friendship Hospital, between March 1985 and January 1986. We obtained positive cytodiagnosis from all cases of carcinoma of the pancreatic head (9 cases), body and tail (4 cases), and ampullary carcinomas (5 cases) (100 per cent). In 2 of 3 duodenal carcinomas (66.6 per cent), and 6 of 7 distal common duct carcinomas (86 per cent), a positive cytodiagnosis was also obtained. On the other hand, 2 cases of pancreatitis both gave a negative cytodiagnosis, i.e. no false positives were obtained. Out of the 30 cases who underwent CT guided biopsy, a correct diagnosis was obtained in 28, i.e. a diagnostic accuracy of 93.3 per cent. The cytodiagnosis of the other two cases was either suspicious or false negative. There have been no clinical complications noted. (author)

  2. Thyroid fine-needle aspiration and the bethesda classification system

    DEFF Research Database (Denmark)

    Larsen, Louise Vølund; Egset, Alice Viktoria; Holm, Camilla

    2018-01-01

    INTRODUCTION: Fine-needle aspiration (FNA) is a cornerstone in diagnosing thyroid nodules. For decades, Danish FNA have been categorised into the groups: “FNA not per-formed”, “Inadequate”, “Cystic”, “Inconclusive”, “Benign”, “Suspicious”, “Malignant” and “Information missing”. Internationally......, The Bethesda Classification System (TBCS) is increasingly accepted, especially owing to a detailed specification of FNA suspicious for malignancy. The Danish “Suspicious” group is very broad and includes atypia, follicular neoplasia and FNA suspicious of other malignancies. The purpose of this study...... risk of 36.4%, 13.3%, 17.2%, 16.1%, 55.3% and 88.2%, respectively. CONCLUSIONS: The Danish “Suspicious” group contains a broad spectrum of BG with varying malignancy risk. The results indicate a need for standardisation of the Danish FNA classification. A national introduction of the TBCS might secure...

  3. [Value of aspiration biopsy of subcutaneous fat in amyloidosis].

    Science.gov (United States)

    Ponce, P; Carvalho, F; Coelho, A

    1986-01-01

    Fine-needle aspiration of subcutaneous fat (FNAF) was performed in 24 patients, 12 with previously diagnosed amyloidosis presenting with proteinuria or nephrotic syndrome, and 12 presenting a nephrotic syndrome without amyloidosis on renal biopsy. FNAF was positive in 10 of 12 patients with amyloidosis (sensitivity: 83%) and negative in 12 of 12 patients with non-amyloid nephrotic syndrome (specificity: 100%). Considering a 2.5 to 10% prevalence of amyloidosis in adult patients with proteinuria or nephrotic syndrome, a positive FNAF is diagnostic of amyloidosis, and a negative FNAF rules out the diagnosis with a probability of 98 to 99%. FNAF is a simple and safe method which can be useful in patients who cannot undergo a renal biopsy.

  4. Superior mesenteric venous thrombosis treated by direct aspiration thrombectomy.

    Science.gov (United States)

    Nakayama, Satoshi; Murashima, Naoya; Isobe, Yoshinori

    2008-01-01

    A 69-year-old man, with hepatits C virus-related liver cirrhosis and hemophilia B, developed massive ascites and watery diarrhea after endoscopic injection sclerotherapy for esophageal varices. A multi detector row computed tomography revealed a superior mesenteric venous thrombus without bowel infarction. It was assumed that the thrombus was caused by transient congestion of the portal system after retrograde propagation of the sclerosant agent, in a condition where anticoagulation proteins, such as proteins C and S, had decreased. Because long systemic thrombolytic therapy was hazardous for the patient with hemorrhagic diathesis due to impaired coagulation, a direct thrombolysis was performed with urokinase followed by aspiration thrombectomy, with cannulation of the portal venous system using a transjugular intrahepatic approach. The patient had no complications in this procedure and subsequently diarrhea and refractory ascites were resolved. Direct thrombectomy via the transjugular intrahepatic route may be a useful therapy for mesenteric venous thrombus in the cirrhotic patient.

  5. Social sustainability in urban renewal: An assessment of community aspirations

    Directory of Open Access Journals (Sweden)

    Daniel Chi Wing Ho

    2012-01-01

    Full Text Available The lack of a proper building care culture has led to serious problems of urban decay in most developed cities, threatening community health and safety. To arrest urban decay, redevelopment is a commonly adopted approach for regenerating rundown areas. Redevelopment often results in negative outcomes such as disturbances to existing social networks and burgeoning construction and demolition waste. On the other hand, building rehabilitation is a more socially and environmentally friendly alternative to redevelopment, but its success depends much on residents’ active participation. With a view towards a sustainable strategy for urban renewal, it is necessary to balance the interests of different stakeholders regarding the choice between these two mainstream approaches to renewal. Although economic and physical issues are important decision making considerations, this study explores the aspirations and preferences of local residents in relation to the two options through a structured survey. The findings are conducive to the development of a balanced and socially sustainable strategy of urban renewal.

  6. Primary umbilical endometriosis - Diagnosis by fine needle aspiration

    Directory of Open Access Journals (Sweden)

    Hilda Fernandes

    2011-01-01

    Full Text Available Primary (spontaneous umbilical endometriosis is very rare with an estimated incidence of 0.5-1% of all patients with endometrial ectopia. Endometriosis is a common gynecological condition, the pelvis being the most common site of the disease. Extrapelvic site is less common and even more difficult to diagnose due to the extreme variability in presentation. A 38-year-old woman presented with a blackish nodule over the umbilicus of 3 years duration. Fine needle aspiration cytology of the lesion showed cells in clusters and sheets with background of scant stromal fragment, hemosiderin laden macrophages and RBCs, leading to a suggestion of umbilical endometriosis. Histopathological examination of the excised lesion confirmed the same.

  7. Incisional endometriosis: Diagnosed by fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    P Veda

    2010-01-01

    Full Text Available Incisional endometriosis (IE is a rare entity reported in 0.03-1.08% of women following obstetric or gynecologic surgeries. Most cases reported in literature have appeared after cesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma or lipoma. We hereby report a case of IE following a second trimester hysterotomy, which was diagnosed by fine needle aspiration cytology (FNAC. Our patient was 26 years old, presenting with a mass over anterior abdominal wall, associated with incapacitating pain during each menstrual cycle. FNAC showed epithelial cells, stromal cells and hemosiderin laden macrophages. Based on the typical history, clinical and cytological features, the diagnosis of IE was established. Wide surgical excision was done and the resulting rectus sheath defect was repaired. Patient was followed for 6 months during which time she was symptom free. This article also reviews the spectrum of cytological features and the rare possibility of malignant transformation that can occur in IE.

  8. Adaption of suction connectors for use in meconium aspiration syndrome.

    Science.gov (United States)

    Green, David Anthony

    2010-01-01

    Severe meconium aspiration syndrome is difficult to manage and has a high mortality in developing countries. Guidelines are available for the initial management. If the infant has been born through particulate meconium and is not vigorous, an inspection of the vocal cords by laryngoscopy is recommended. If meconium is seen at the cords it should, ideally, be sucked out of the trachea using an endotracheal tube as a suction device. However, as this needs a way of applying suction directly to the endotracheal tube it can be problematic. Commercially available equipment does exist, but in a resource-scarce setting, its cost could be prohibitive. We have adapted cheap suction connectors which can be adapted for this purpose.

  9. Aspiration and the risk of ventilator-associated pneumonia.

    Science.gov (United States)

    Parker, Chris M; Heyland, Daren K

    2004-12-01

    Ventilator-associated pneumonia (VAP) is a major concern in the intensive care unit. It is estimated that the risk of developing VAP may be as high as 1% per ventilated day, and the attributable mortality approaches 50% in some series. A growing body of evidence implicates the role of microaspiration of contaminated oropharyngeal and perhaps gastroesophageal secretions into the airways as an integral step in the pathogenesis of VAP. In patients who have been intubated and mechanically ventilated for >72 hours, the majority of VAP is caused by enteric gram-negative organisms, presumably of gastrointestinal origin. As a result, strategies designed to minimize the risk of these contaminated secretions into the normally sterile airways are of paramount importance in terms of VAP prevention. This review highlights the important etiological role of the gut in the development of VAP and also discusses the evidence behind interventions that may modulate the risk of both aspiration and subsequent VAP.

  10. The NHS as a learning organization: aspirations beyond the rainbow?

    Science.gov (United States)

    Timpson, J

    1998-09-01

    It is the intention of this paper to review the issues and challenges organizations face when aspiring to embrace and enact the tenets of a learning organization; and in particular the perceived impact on management strategy, structure and leadership styles. The paper is predicated on the premise that learning and knowledge act as vital strategic resources, crucial not only to organizations in terms of competitive advantage but to ethical enterprise per se. Modern life is characterized by change, against the backdrop of this continual turmoil, organizational learning has emerged as a dominant theme within contemporary management theory, with many commentators increasingly locating the capacity of an aspiring organization to accommodate the ethos of organizational learning, as the vital component in ensuring enduring efficiency, innovation and competitiveness. However, the utility of such learning needs to be scrutinized and evaluated in terms of service need and expectation. The paper will expand upon wider theoretical debates extant within the literature, by considering the concept and utility of the learning organization with specific reference to management reform extant within the British National Health Service (NHS). During the course of the review the various the theoretical positions contributing to the notion of the learning organization will be analysed, the practical ramifications of which will be examined in the context of reflective practice, clinical supervision and the wider cultural background of nursing and the NHS. The paper concludes that the NHS needs to reorientate management perspectives to focus attention more acutely on systems which are deliberately designed to facilitate shared learning, to unravel the ambiguities of organizational life, to affirm management belief in the nursing contribution and to achieve an as yet unrealized potential in terms of patient care and advanced nursing practice.

  11. ASPIRE: Teachers and researchers working together to enhance student learning

    Science.gov (United States)

    Yager, P. L.; Garay, D. L.; Warburton, J.

    2016-02-01

    Given the impact of human activities on the ocean, involving teachers, students, and their families in scientific inquiry has never been more important. Science, Technology, Engineering, and Math (STEM) disciplines have become key focus areas in the education community of the United States. Newly adopted across the nation, Next Generation Science Standards require that educators embrace innovative approaches to teaching. Transforming classrooms to actively engage students through a combination of knowledge and practice develops conceptual understanding and application skills. The partnerships between researchers and educators during the Amundsen Sea Polynya International Research Expedition (ASPIRE) offer an example of how academic research can enhance K-12 student learning. In this presentation, we illustrate how ASPIRE teacher-scientist partnerships helped engage students with actual and virtual authentic scientific investigations. Scientists benefit from teacher/researcher collaborations as well, as funding for scientific research also depends on effective communication between scientists and the public. While contributing to broader impacts needed to justify federal funding, scientists also benefit by having their research explained in ways that the broader public can understand: collaborations with teachers produce classroom lessons and published work that generate interest in the scientists' research specifically and in marine science in general. Researchers can also learn from their education partners about more effective teaching strategies that can be transferred to the college level. Researchers who work with teachers in turn gain perspectives on the constraints that teachers and students face in the pre-college classroom. Crosscutting concepts of research in polar marine science can serve as intellectual tools to connect important ideas about ocean and climate science for the public good.

  12. Aspiring Pain Practitioners in India: Assessing Challenges and Building Opportunities

    Science.gov (United States)

    Bhatnagar, Sushma; Patel, Anuradha; Raja, Srinivasa N

    2018-01-01

    Background: Pain medicine is a developing specialty, aimed at relieving pain and suffering, enhancing function, and improving the quality of life of patients. Pain is often ignored, under-reported and mismanaged by health-care providers. Aspiring pain physicians in India face many challenges and barriers in advancing their specialty. Objectives: The objective of this study is to determine the challenges in establishing a pain practice in India and to discuss the opportunities and strategies to overcome these barriers. Subjects and Methods: Face-to-face interactive sessions were held with 60 aspiring pain physicians of India who were chosen as registrants to an International Association for the Study of Pain-Indian Society for Study of Pain multidisciplinary evidence-based pain management program conducted at Delhi and Mumbai. The available opportunities, practical issues and the hurdles in becoming a pain specialist were analyzed and summarized in this commentary. Results: The major barriers identified were: (1) Inadequate knowledge and absence of structured, educational and training courses, (2) bureaucratic hurdles, and (3) concerns of opioid misuse and addiction. The opportunities for personal growth and that of the specialty that could be utilized include the creation of a pain resource team, increasing community awareness, changing attitudes of other physicians toward pain specialty, and research and evidence building of the effectiveness of pain management strategies. Conclusion: India needs a structured teaching and training program in the area of pain medicine that is affiliated by the Medical Council of India or other reputed boards of medical education and certification. There is an urgent need to include pain management in the undergraduate and postgraduate medical curriculum. Enhancing community level awareness by public health education campaigns, developing networks of pain physicians, and appropriate marketing of the specialty is needed to make pain

  13. Aspiring pain practitioners in India: Assessing challenges and building opportunities

    Directory of Open Access Journals (Sweden)

    Sushma Bhatnagar

    2018-01-01

    Full Text Available Background: Pain medicine is a developing specialty, aimed at relieving pain and suffering, enhancing function, and improving the quality of life of patients. Pain is often ignored, under-reported and mismanaged by health-care providers. Aspiring pain physicians in India face many challenges and barriers in advancing their specialty. Objectives: The objective of this study is to determine the challenges in establishing a pain practice in India and to discuss the opportunities and strategies to overcome these barriers. Subjects and Methods: Face-to-face interactive sessions were held with 60 aspiring pain physicians of India who were chosen as registrants to an International Association for the Study of Pain-Indian Society for Study of Pain multidisciplinary evidence-based pain management program conducted at Delhi and Mumbai. The available opportunities, practical issues and the hurdles in becoming a pain specialist were analyzed and summarized in this commentary. Results: The major barriers identified were: (1 Inadequate knowledge and absence of structured, educational and training courses, (2 bureaucratic hurdles, and (3 concerns of opioid misuse and addiction. The opportunities for personal growth and that of the specialty that could be utilized include the creation of a pain resource team, increasing community awareness, changing attitudes of other physicians toward pain specialty, and research and evidence building of the effectiveness of pain management strategies. Conclusion: India needs a structured teaching and training program in the area of pain medicine that is affiliated by the Medical Council of India or other reputed boards of medical education and certification. There is an urgent need to include pain management in the undergraduate and postgraduate medical curriculum. Enhancing community level awareness by public health education campaigns, developing networks of pain physicians, and appropriate marketing of the specialty is

  14. ASPIRE: Active Societal Participation in Research and Education

    Science.gov (United States)

    Garza, C.; Parrish, J.; Harris, L.; Posselt, J.; Hatch, M.

    2017-12-01

    Active Societal Participation In Research and Education (ASPIRE) aims to cultivate a generation of geoscientists with the leadership knowledge and skills, scholarship, and material support to reframe and rebrand the geosciences as socially relevant and, thereby, to broaden participation in these fields. This generation of geoscientists will do so by bridging longstanding divides that impede access to and inclusion in the geosciences: between basic and applied science, between scholars in the academy and members of historically marginalized communities, and between the places where science is needed and the places where it is typically conducted. To bring about these types of change, we draw upon, refine, and institutionalize the working group model as the Mobile Working Group (MWG), directly referencing the need to move outside of the "ivory tower" and into the community. Led by a geoscientist with one foot in the academy and the other in the community - the Boundary Spanner - each MWG will focus on a single issue linked to a single community. ASPIRE supports multiple MWGs working across the geographic, ethnographic and "in practice" community space, as well as across the body of geoscience research and application. We hypothesize that in institutionalizing a new mode of geoscience research (MWG), learning from Boundary Spanners experiences with MWG, and refining a leadership development program from our findings, that we will have a scalable leadership tool and organizational structure that will rebrand the geosciences as socially relevant and inclusive of geoscientists from diverse backgrounds even as the "science space" of geoscience expands to incorporate in-community work.

  15. Tracheobronchial foreign body aspiration in children: A continuing diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Mohammad Saquib Mallick

    2014-01-01

    Full Text Available Background: Foreign body aspiration (FBA is a common cause of respiratory compromise in early childhood. The objective of this study was to describe the features and outcomes of children with FBA in early and late presentations and to examine the reasons for the delay in diagnosis. Patients and Methods: This is a retrospective review of all children who were admitted with suspected FBA between July 2001 and June 2010. Patient′s characteristics, history, clinical, radiographic, bronchoscopic findings, reason for delay presentation, and complications were noted. Results: A total of 158 children admitted to the hospital with suspected FBA were included in this study. The average age was 3.28 years. Forty-eight (30.3% children were presented late (more than 14 days after FBA and 110 (69.7% children were presented early (0-14 days. The common clinical manifestations of FBA were persistent cough (100% and choking (72%. The most frequent radiological finding observed was air trapping (40% followed by atelectasis (14%. Chest radiographs were normal in 32.2% patients. Ten children in early diagnosis group and 29 children in late diagnosis group presented with complications. The diagnosis delay was mainly attributed to physician misdiagnosis (41.6%. Rigid bronchoscopy was performed in all patients. Foreign body was found in all of the cases except six. Watermelon seeds and peanuts accounted for 80% of the aspiration. Conclusion: FBA is difficult to diagnose in children. Delay in diagnosis appears to result from a failure to give serious consideration to the diagnosis. Early diagnosis and removal of foreign bodies must be achieved to avoid complications.

  16. The detection of pharyngeal incoordination and aspiration by radiosalivagram in cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Baikie, G.; Reddihough, D.; Olinsky, A.; South, M.J.; Bowe, J.; Cook, D.J. [Royal Children`s Hospital, Parkville, VIC, (Australia)

    1997-09-01

    Full text: Children with cerebral palsy (CP) may have abnormal respiratory function because of aspiration pneumonitis, chest deformity, upper airways obstruction or central respiratory control abnormalities. The diagnosis of aspiration has long confounded clinicians and is often made indirectly after exclusion of other causes of respiratory disease in susceptible individuals. The radiosalivagram is a technique which permits the demonstration of aspiration of pharyngeal contents in individuals with pharyngeal incoordination. It is a simple procedure which provides both qualitative and quantitative evidence of aspiration. Over an hour and while supine, 20 mL of {sup 99m}Tc-sulphur colloid is instilled into the pharynx via a thin plastic tube using a syringe pump. The neck, thorax and upper abdomen are imaged continuously In normal individuals, radioactivity is demonstrated in the pharynx, oesophagus and stomach; in the presence of pharyngeal incoordination, radioactivity is seen within one or both main bronchi and adjacent lung fields. The rate of clearance from the lungs varies and can be quantified. We have studied 31 children with severe non-ambulant CR The time to first aspiration, maximum quantity aspirated, and retention of aspirated material at 2h have been determined. These data have been compared with measurements of respiratory function. Preliminary results of this ongoing study reveal a broad range of outcomes. Seventeen children (17/31) had aspiration, in 15/17 aspiration was unilateral and in 14/17 there was spontaneous early clearance. The investigation was well tolerated by patients. The radiosalivagram is a simple, quantifiable investigation for demonstrating or excluding pharyngeal incoordination and aspiration in children with unexplained respiratory disease.

  17. The effects of hippocampal aspiration lesions on conditioning to the CS and to a background stimulus in trace conditioned suppression.

    Science.gov (United States)

    Rawlins, J N; Tanner, J

    1998-03-01

    Rats with hippocampal aspiration lesions or cortical control lesions were compared to sham operated controls in a trace conditioned suppression task, in which a long-lasting background stimulus played the role of more conventional contextual cues. In all three surgical treatment groups, conditioning to the explicit conditioned stimulus (CS) decreased, but conditioning to the background cue increased, when a longer trace interval was used. There was thus no evidence of a differential partitioning of associative conditioning as a result of the lesion, despite the evident sensitivity of the behavioural paradigm to variations in the CS-->unconditioned stimulus (US) interval. This result contrasts with earlier reports using conventional contextual cues in analogous experimental designs, and so suggests that the sensitivity of contextual conditioning to hippocampal dysfunction depends at least in part on the physical nature of conventional contextual cues, and not solely on the less precise predictive information that such cues typically provide.

  18. Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis

    OpenAIRE

    Komiya, Kosaku; Rubin, Bruce K.; Kadota, Jun-ichi; Mukae, Hiroshi; Akaba, Tomohiro; Moro, Hiroshi; Aoki, Nobumasa; Tsukada, Hiroki; Noguchi, Shingo; Shime, Nobuaki; Takahashi, Osamu; Kohno, Shigeru

    2016-01-01

    Aspiration pneumonia is thought to be associated with a poor outcome in patients with community acquired pneumonia (CAP). However, there has been no systematic review regarding the impact of aspiration pneumonia on the outcomes in patients with CAP. This review was conducted using the MOOSE guidelines: Patients: patients defined CAP. Exposure: aspiration pneumonia defined as pneumonia in patients who have aspiration risk. Comparison: confirmed pneumonia in patients who were not considered to ...

  19. Differential games.

    Science.gov (United States)

    Varaiya, P. P.

    1972-01-01

    General discussion of the theory of differential games with two players and zero sum. Games starting at a fixed initial state and ending at a fixed final time are analyzed. Strategies for the games are defined. The existence of saddle values and saddle points is considered. A stochastic version of a differential game is used to examine the synthesis problem.

  20. Intergenerational Transmission of Educational Aspirations in Chinese Families: Identifying Mediators and Moderators.

    Science.gov (United States)

    Wu, Nini; Hou, Yang; Wang, Qian; Yu, Chengfu

    2018-02-22

    Parents' educational aspirations for youth play an important role in shaping youth's own educational aspirations; however, little is known about how and in what context parents may transmit their aspirations to youth effectively. This is of particular interest and import to be examined in Chinese families, given Chinese cultural emphasis on educational achievement and Chinese youth's outstanding academic performance internationally. By integrating several key theories of motivation and parental socialization (i.e., the expectancy-value model of academic achievement, the two-step model of value transmission, the contextual model of parenting, and the self-determination theory), the current study investigated simultaneously the mediating roles of parental involvement in youth's learning and youth's perceptions of parental aspirations, as well as the moderating role of parental warmth in the intergenerational transmission process of educational aspirations in Chinese families. A two-wave longitudinal study spanning about half a year was conducted among 323 Chinese seventh graders (54% female; M age  = 13.25 years) and one of their parents (median educational attainment = completion of high school, median monthly income = USD 766-1226). It was found that parental educational aspirations for youth were related positively both indirectly through parental involvement and directly to youth's perceptions of parental aspirations, which in turn were associated positively with youth's own educational aspirations about half a year later. It was also found that parental educational aspirations for youth and youth's own educational aspirations were associated positively with each other only when youth reported experiencing high levels of parental warmth, but unrelated when youth reported experiencing low levels of parental warmth, whereas such moderating effects of parental warmth were absent on the links from parental aspirations to youth's perceptions of parental

  1. Increasing faculty diversity: How institutions matter to the PhD aspirations of undergraduate students

    Science.gov (United States)

    Deangelo, Linda Teresa

    This study used a Hierarchical Generalized Linear Model (HGLM) to investigate how the experiences a student has in college and the college they attend affects the likelihood that they will aspire to the PhD at the completion of college. This study was particularly interested in ascertaining in what ways postsecondary institutions support or thwart the PhD aspirations of underrepresented racial minority students, and how institutions might improve PhD aspiration outcomes for underrepresented racial minority students, thereby increasing faculty diversity. A three-pronged theoretical lens was used. Status attainment was used to examine how students background characteristics and significant others such as faculty influence PhD aspirations. Relative deprivation and anticipatory socialization were used to explore how institutional characteristics affect PhD aspirations. The longitudinal data came from the Higher Education Research Institute's (HERI) 1994 freshmen and 1998 follow-up survey. Five sample groups -- All Students, underrepresented racial minority students, Caucasian students, initial PhD aspirants, and other initial degree aspirants -- were derived from this dataset. Frequent faculty encouragement for graduate study was the single most important determinant of who aspires to the PhD for all of the student groups, but was particularly important to underrepresented racial minority students and students who begin college as PhD aspirants. Underrepresented racial minority students are more likely to be encouraged frequently at low selectivity institutions, and the encouragement for graduate study they receive at low selectivity institutions is a sort of equalizer that makes up for effects of attending this institutional type. The mean level of initial degree aspirations was the strongest factor at the institutional level for all of the student groups, and the magnitude of the effect was largest for underrepresented racial minority students. Attending a high

  2. Clinical features and outcomes of aspiration pneumonia compared with non-aspiration pneumonia: a retrospective cohort study.

    Science.gov (United States)

    Hayashi, Makoto; Iwasaki, Takuya; Yamazaki, Yohei; Takayasu, Hiromi; Tateno, Hidetsugu; Tazawa, Sakiko; Kato, Eisuke; Wakabayashi, Aya; Yamaguchi, Fumihiro; Tsuchiya, Yutaka; Yamashita, Jun; Takeda, Norikazu; Matsukura, Satoshi; Kokubu, Fumio

    2014-07-01

    Pneumonia is a leading cause of death among elderly patients. Although aspiration pneumonia (AP) commonly occurs with aging, its clinical features and outcomes are still uncertain. The aims of this study were to describe the clinical features and outcomes of AP and to assess whether presence of AP affects clinical outcomes in patients with community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP). We retrospectively analyzed patients with CAP and HCAP hospitalized in our institution in Japan from October 2010 to March 2012. We compared clinical features and outcomes between AP and non-AP, and investigated risk factors for recurrence of pneumonia and death. Of 214 consecutive patients, 100 (46.7%) were diagnosed as having aspiration pneumonia. These patients were older and had lower body mass index, more comorbidities, and poorer Eastern Cooperative Oncology Group performance status (ECOG PS) than the patients with non-AP. Patients with AP had more severe disease, required longer hospital stays, and had a frequent recurrence rate of pneumonia and higher mortality. In multivariate analyses, AP, age, and ECOG PS were related to recurrence of pneumonia, and the prognostic factors were CURB-65 score and ECOG PS. AP was not a significant indicator for prognosis but was the strongest risk factor for recurrence of pneumonia. Clinical background and outcomes including recurrence and mortality of AP were obviously different from those of non-AP; therefore AP should be considered as a distinct subtype of pneumonia, and it is important to prevent the recurrence of pneumonia in the patients with AP. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  3. Fine-needle aspiration accuracy in the diagnosis of primary epithelioid angiosarcoma of the adrenal gland: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Tullio Torelli

    2017-02-01

    Here we describe the case of a 55-year-old woman affected by metastatic angiosarcoma in the right adrenal gland, who died few days after the histological diagnosis made by fine-needle aspiration (FNA. This is the second case of primary epithelioid angiosarcoma diagnosed by FNA among scientific articles published in English in PubMed. Microscopically, the tumor showed a predominant epithelioid differentiation, thus making the diagnostic process more difficult than usual. Immunohistochemical examination revealed positive reactivity for cytokeratin, CD31, and CD34. The literature shows that epithelioid adrenal angiosarcoma has poor clinical outcome, especially when metastatic at presentation.

  4. [Treatment of intractable aspiration after partial laryngectomy by cuffed tracheostomy tube with inner cannula].

    Science.gov (United States)

    Wang, P; Liu, Y H; Xu, Q S; Zheng, Z S

    2017-06-07

    Objective: To evaluate the efficacy of cuffed tracheostomy tube with inner cannula for the treatment of intractable aspiration after partial laryngectomy. Methods: From May 2010 to June 2015, 15 patients with intractable aspiration after partial laryngectomy of laryngeal and hypopharyngeal carcinoma were enrolled. Cuffed tracheostomy tube with inner cannula was used in the 15 patients for treatment of intractable aspiration. The patients and their family were trained to manage the cuffed tracheostomy tube with inner cannula and to eat since the 14th day after surgery. Cuff was initially inflated with 10 ml air and then deflated of 0.5 ml air every 2-3 days. Until the inflation of cuff was no longer required, the cuffed tracheostomy tube was replaced by metal tracheostomy tube. The patients' swallowing function and aspiration were evaluated 6 months after treatment. Results: The 15 cases with intractable aspiration were treated with cuffed tracheostomy tube with inner cannula and after 2-3 months, 14 of them replaced the cuffed tracheostomy tubes with inner cannula by metal tracheostomy tubes and recovered oral eating, and tracheostomy tubes were no longer required for 12 of 14 patients in following 3-6 months, showing a total decannulation rate of 80% in the patients with refractory aspiration. Conclusion: It was safe and effective to treat aspiration after laryngeal and hypopharyngeal surgery with cuffed tracheostomy tube with inner cannula.

  5. Cooperation guided by the coexistence of imitation dynamics and aspiration dynamics in structured populations

    Science.gov (United States)

    Xu, Kuangyi; Li, Kun; Cong, Rui; Wang, Long

    2017-02-01

    In the framework of the evolutionary game theory, two fundamentally different mechanisms, the imitation process and the aspiration-driven dynamics, can be adopted by players to update their strategies. In the former case, individuals imitate the strategy of a more successful peer, while in the latter case individuals change their strategies based on a comparison of payoffs they collect in the game to their own aspiration levels. Here we explore how cooperation evolves for the coexistence of these two dynamics. Intriguingly, cooperation reaches its lowest level when a certain moderate fraction of individuals pick aspiration-level-driven rule while the others choose pairwise comparison rule. Furthermore, when individuals can adjust their update rules besides their strategies, either imitation dynamics or aspiration-driven dynamics will finally take over the entire population, and the stationary cooperation level is determined by the outcome of competition between these two dynamics. We find that appropriate synergetic effects and moderate aspiration level boost the fixation probability of aspiration-driven dynamics most effectively. Our work may be helpful in understanding the cooperative behavior induced by the coexistence of imitation dynamics and aspiration dynamics in the society.

  6. Symptomatic nonfunctioning parathyroid cysts: Role of simple aspiration and ethanol ablation

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Jin Yong [Department of Radiology, Thyroid Center, Daerim St. Mary' s Hospital, #978-13 Daerim-dong, Youngdeungpo-gu, Seoul 150-070 (Korea, Republic of); Baek, Jung Hwan, E-mail: radbaek@naver.com [Department of Radiology, Thyroid Center, Daerim St. Mary' s Hospital, #978-13 Daerim-dong, Youngdeungpo-gu, Seoul 150-070 (Korea, Republic of); Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 138-736 (Korea, Republic of); Kim, Kyu Sun [Department of Radiology, Thyroid Center, Daerim St. Mary' s Hospital, #978-13 Daerim-dong, Youngdeungpo-gu, Seoul 150-070 (Korea, Republic of); Lee, Ducky [Department of Internal Medicine, Thyroid Center, Daerim St. Mary' s Hospital, #978-13 Daerim-dong, Youngdeungpo-gu, Seoul 150-070 (Korea, Republic of); Ha, Eun Ju; Lee, Jeong Hyun [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 138-736 (Korea, Republic of)

    2013-02-15

    Objectives: To evaluate the outcomes of simple aspiration and ethanol ablation in the management of symptomatic nonfunctioning parathyroid cyst (PC). Methods: We performed simple aspirations for 12 PCs in 12 patients from March 1997 to June 2010. PC was diagnosed if the aspirated fluid was clear colorless and showed an elevated parathyroid hormone (PTH) level. Ethanol ablation (EA) was performed for recurrent PCs. Simple aspirations were performed using 23-gauge needles and EAs using 18-gauge needles with 99% ethanol under ultrasound (US) guidance. We evaluated cyst volume, cosmetic score, symptom score, and complications. Results: Mean follow-up period of all patients was 19.2 ± 12.9 months (median, 15.0 months; range, 7–40 months). Simple aspiration was successful in four patients, and the mean volume reduction after simple aspiration was 98.2 ± 3.5% (range, 92.9–100%). In eight recurrent cases, EA resulted in a significant decrease in volume (P = 0.012), as well as in cosmetic (P = 0.011) and symptom (P = 0.01) scores at last follow-up; however two cases of primary failure of EA was treated by repeat EA. No major complications occurred in any patient. Conclusions: For symptomatic nonfunctioning PCs, simple aspiration could be a first line procedure for diagnosis and treatment, while EA can be a subsequent treatment modality for recurrent cases.

  7. The internet, adolescent males, and homemade blowgun darts: a recipe for foreign body aspiration.

    Science.gov (United States)

    Walz, Patrick C; Scholes, Melissa A; Merz, Meredith N; Elmaraghy, Charles A; Jatana, Kris R

    2013-08-01

    We describe our experience with blowgun dart aspiration via an illustrative case series and review the resources available to teach children how to construct these objects. A 15-year-old boy presented with cough, wheeze, and eventually admitted to aspiration of a homemade blowgun dart. This instance heightened the awareness of our experience with blowgun dart aspiration as 3 cases presented within a 3-month period. Patients uniformly presented with cough and reported aspiration, and wheezing was noted in 2 of the 3. Although all ultimately admitted their behavior, 2 were initially reluctant to admit aspirating the blowgun dart. Radiographic findings of a needle-shaped metallic airway foreign body were consistent in all patients. Each admitted to finding instructions for blowgun dart construction on the Internet. Emergent rigid bronchoscopy with blowgun dart removal resulted in symptom resolution in all without complication. This represents the largest series of blowgun dart aspiration to date. During deep inhalation, when preparing to propel a blowgun dart, the vocal folds maximally abduct, leading to increased risk for aspiration. Twenty websites were identified providing instructions for the construction of homemade blowgun darts. With the accessibility of the Internet and number of instructional websites, this clinical entity may become more common in the future. Unfortunately, only a few of the websites provide any safety warnings. Certainly, prompt treatment can result in good outcomes; however, serious potential complications, including death, could occur especially given the hesitance our patients showed in divulging the truth of the inciting event.

  8. [Study of the predictive value of detection tests for silent aspirations].

    Science.gov (United States)

    Woisard, V; Réhault, E; Brouard, C; Fichaux-Bourin, P; Puech, M; Grand, S

    2009-01-01

    Screening for aspiration in patients with swallowing disorders is important in preventing complications. The tests used in this regard are insufficient due to silent aspiration relating to abnormal protective reflexes in many patients with swallowing problems. The aim of this study is to determine the predictive values of simple tests in screening for silent aspiration. The reference test used was videofluoroscopic examination on swallowing. In the presence of aspiration (FR+) the presence (ME+) or not (ME-) of a cough of throat clearing was noted. The tests being studied were a nasal test with isotonic saline and swallowing according to a set time. For screening for aspiration the presence of a "wet voice" was considered to be a sign of reduced protective reflexes. 1) During the nasal test, the results are 100% for the positive predictive value (VPp) and 83.3% for the negative predictive value (VPn); 2) These results are respectively 84.6% and 35.9% during the swallowing test. Regarding screening for silent aspiration, 1) during the nasal test, the results are 62.5% for the positive predictive value (VPp) and 36.3% for the negative predictive value (VPn); 2) These results are respectively 54.5% and 26.6% during the swallowing test. This preliminary study points out the lack of predictive value of the nasal test and the swallow test for the silent aspirations. However the results could be useful for other researchers developing other tests in this area.

  9. The radiological appearance of bacterial pneumonias and their differential diagnosis

    International Nuclear Information System (INIS)

    Wagner, H.H.; Fabel, H.; Medizinische Hochschule Hannover

    1985-01-01

    Under the influence of antibiotic therapy, bacterial pneumonias have undergone a remarkable change in the last few decades. Individual forms of pneumonia can be distinguished morphologically by their localization, the way in which they spread, their limitations, and their course. Clinically, opportunistic bacterial infections predominate. Increasingly, secondary pneumonias are observed in poststenotic areas, areas of infarction, in hypostatic areas, after aspiration, and in previously damaged lobes. Radiologic criteria for differentiating from atypical pneumonias (viruses, mycoplasmas and chlamydia) are discussed. (orig.) [de

  10. Differential games

    CERN Document Server

    Friedman, Avner

    2006-01-01

    This volume lays the mathematical foundations for the theory of differential games, developing a rigorous mathematical framework with existence theorems. It begins with a precise definition of a differential game and advances to considerations of games of fixed duration, games of pursuit and evasion, the computation of saddle points, games of survival, and games with restricted phase coordinates. Final chapters cover selected topics (including capturability and games with delayed information) and N-person games.Geared toward graduate students, Differential Games will be of particular interest

  11. Transvaginal Aspiration of Ovarian Cysts: Long-Term Follow-up

    International Nuclear Information System (INIS)

    Duke, D.; Colville, J.; Keeling, A.; Broe, D.; Fotheringham, T.; Lee, M.J.

    2006-01-01

    Background and purpose. Transvaginal aspiration of ovarian cysts has been advocated as a viable alternative to surgery in patients who are high-risk surgical candidates. We describe a retrospective study evaluating the results of transvaginal aspirations of benign ovarian cysts in patients at increased surgical risk, focusing on long-term follow-up for recurrence of the cyst and/or development of malignancy. Methods. Twenty-four women with ovarian cysts underwent 34 transvaginal drainages between October 1998 and December 2004. All patients were referred following diagnosis of a persistent ovarian cyst with a benign appearance on ultrasound. All patients were unsuitable candidates for surgery (history of previous pelvic surgery, n = 21; high risk for anesthesia, n = 1; and unsuitable for laparoscopy due to obesity, n = 2). Patients with a history of pregnancy, acute abdominal symptoms, or previous gynecologic malignancy were excluded. A 20G x 20 cm Chiba needle was used for transvaginal aspiration using an endocavity probe (Acuson XP, Mountain View, CA, USA; Siemens Sololine, Erlangen, Germany) and intravenous sedoanalgesia. Cysts were aspirated to dryness. Results. Long-term follow-up of patients was performed and revealed a recurrence rate of 75%. Eighty-three percent of cysts on the left and 42% of those on the right recurred. Nine of 15 (60%) patients with recurrence required further intervention. Two of 9 underwent surgical intervention only, 4 of 9 had repeat transvaginal aspiration(s) performed, and 3 of 9 had a combination of both transvaginal aspiration and surgery. No patient developed ovarian malignancy. Conclusion. Transvaginal cyst aspiration has many advantages including short hospital stay, rapid recovery, excellent patient tolerance, and a low rate of procedure-related complications. Our study demonstrates that ovarian cyst recurrence following transvaginal drainage is a more significant problem than previously documented, especially if the cyst is

  12. Risk factors for fatal outcome in surgical patients with postoperative aspiration pneumonia.

    Science.gov (United States)

    Studer, Peter; Räber, Genevieve; Ott, Daniel; Candinas, Daniel; Schnüriger, Beat

    2016-03-01

    Aspiration pneumonia in hospitalized surgical patients has been associated with a mortality of approximately 30%. The aim of this study was to assess pre-, intra- and postoperative risk factors for mortality in patients suffering aspiration pneumonia after abdominal surgery. Retrospective study from 01/2006-12/2012 of patients with clinically and radiologically confirmed aspiration pneumonia after abdominal surgery. A total of 70 patients undergoing abdominal surgery and postoperative aspiration pneumonia were identified. There were 53 (76%) male patients, the mean age was 71 ± 12 years and the mean ASA score was 3 ± 1. The surgical procedures included 32 colorectal or small bowel resections, 10 partial liver resections, 9 gastric surgeries, 8 esophageal resections, 5 pancreatic surgeries, and 6 hernia repairs. Aspiration pneumonia occurred at mean postoperative day 7 ± 10. Overall, 53% (n = 37) of patients required re-intubation, with 4 ± 5 days of additional mechanical ventilation. Mean hospital and ICU length of stay was 32 ± 25 days and 6 ± 9 days, respectively. Overall mortality was 27% (n = 19). Forward logistic regression revealed older age [OR 7.41 (95% CI: 1.29-42.62)], bilateral aspiration pneumonia [OR 7.39 (95% CI: 1.86-29.29)] and intraoperative requirement of blood component transfusion [OR 5.09 (95% CI: 1.34-19.38)] as independent risk factors for mortality (overall R(2) = 0.336). Postoperative aspiration pneumonia remains a severe complication with significant mortality. Increasing age, the need for intraoperative blood component transfusion and bilateral pulmonary infiltrates are independent risk factors for fatal outcome after aspiration pneumonia. Therefore, these patients suffering aspiration pneumonia require special attention and increased monitoring. Copyright © 2016 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  13. Incidence and risk factors for aspiration pneumonia after cardiovascular surgery in elderly patients.

    Science.gov (United States)

    Miyata, Eriko; Tanaka, Atsushi; Emori, Hiroki; Taruya, Akira; Miyai, Shinji; Sakagoshi, Nobuo

    2017-02-01

    Pneumonia after cardiovascular surgery is the leading cause of mortality. Postoperative aspiration pneumonia becomes a critical issue in the management of cardiovascular surgery in the aging society. The aim of this study was to investigate the incidence and risk factors of aspiration pneumonia after cardiovascular surgery for elderly patients. This study consisted of 123 elderly patients (>65 years old) who survived their final extubation following cardiovascular surgery at Kinan Hospital. Patients were divided into aspiration pneumonia and no pneumonia groups. Postoperative aspiration pneumonia was diagnosed by two independent physicians according to the nursing- and healthcare-associated pneumonia guidelines by the Japanese Respiratory Society. Among the patients, 12 (9.8 %) had aspiration pneumonia. There were no differences in patients' characteristics between the groups except for a history of cerebral vascular disorder (aspiration pneumonia 42 % vs no pneumonia 15 %, p = 0.04) and ejection fraction (EF) (aspiration pneumonia 56 ± 21 % vs no pneumonia 66 ± 13 %, p = 0.02). Only six (5 %) patients needed more than 12 h intubation. There was no difference in the operative factors between the groups. Neurological deficit was more frequently observed in the aspiration pneumonia group (33 vs 5 %, p = 0.005). Multivariable logistic regression analysis showed that the history of cerebral vascular disorder and neurological deficit after surgery was independent risk factors for aspiration pneumonia after cardiovascular surgery. Our results could assist in screening elderly patients who should be more carefully evaluated before oral nutrition to minimize morbidity and mortality after cardiovascular surgery.

  14. Biopsy needle advancement during bone marrow aspiration increases mesenchymal stem cell concentration

    Directory of Open Access Journals (Sweden)

    Anne E Peters

    2016-03-01

    Full Text Available Point-of-care kits to concentrate bone marrow (BM derived mesenchymal stem cells (MSCs are used clinically in horses. A maximal number of MSCs per ml of marrow aspirated might be desired prior to use of a point-of-care system to concentrate MSCs. Our objective was to test a method to increase the number of MSCs per ml of marrow collected. We collected 2 BM aspirates using 2 different collection techniques from 12 horses. The first collection technique was to aspirate BM from a single site without advancement of the biopsy needle. The second collection technique was to aspirate marrow from multiple sites within the same sternal puncture by advancing the needle 5 mm 3 times for BM aspiration from 4 sites. Numbers of MSCs in collected BM were assessed by total nucleated cell count (TNCC of BM after aspiration, total Colony-Forming-Unit-fibroblast (CFU-F assay, and total MSC number at each culture passage. The BM aspiration technique of 4 needle advancements during BM aspiration resulted in higher initial nucleated cell counts, more CFU-Fs, and more MSCs at the first passage. There were no differences in the number of MSCs at later passages. Multiple advancements of the BM needle during BM aspiration resulted in increased MSC concentration at the time of BM collection. If a point-of-care kit is used to concentrate MSCs, multiple advancements may result in higher MSC numbers in the BM concentrate after preparation by the point-of-care kit. For culture expanded MSCs beyond the first cell passage, the difference is of questionable clinical relevance.

  15. Elemental diets may reduce the risk of aspiration pneumonia in bedridden gastrostomy-fed patients.

    Science.gov (United States)

    Horiuchi, Akira; Nakayama, Yoshiko; Sakai, Ryosei; Suzuki, Manabu; Kajiyama, Masashi; Tanaka, Naoki

    2013-05-01

    Our clinical experience suggested that elemental diets were associated with a reduction in aspiration pneumonia among bedridden patients with percutaneous endoscopic gastrostomy (PEG). We compared the effects of elemental and standard liquid diets on the risk of clinical aspiration pneumonia and gastric emptying in bedridden patients receiving PEG feedings. Study 1: consecutive bedridden PEG patients received elemental diets or standard liquid diets in the same fashion. The frequency of defecation, diet aspirated from the trachea, and aspiration pneumonia during hospitalization were prospectively recorded. Study 2: a randomized, crossover trial using elemental or standard liquid diets containing (13)C sodium acetate as a tracer given to bedridden PEG patients who had experienced aspiration pneumonia. (13)C breath tests were performed to estimate gastric emptying. Study 1: 127 patients were enrolled, 60 with elemental and 67 with standard liquid diets. The diet was aspirated from the trachea in none (0%) with the elemental diet vs. 8 (11.9%) with standard liquid diets (P=0.0057); aspiration pneumonia developed none with the elemental diet vs. 5 (7.5%) with standard liquid diets (P=0.031) (number needed to treat 14, 95% confidence interval 7-85). Study 2: 19 patients were enrolled. The elemental diet was associated with a significant increase in the 10, 30 or 50% emptying (excretion) time (Pdiet (Pdiets were associated with more rapid gastric empting and fewer episodes of aspiration than standard liquid diets in bedridden PEG patients. They may be preferred for bedridden PEG patients especially who have experienced aspiration pneumonia. Properly performed randomized-controlled trials are needed to prove this potential benefit.

  16. Lung lavage for meconium aspiration syndrome in newborn infants.

    Science.gov (United States)

    Hahn, Seokyung; Choi, Hyun Jin; Soll, Roger; Dargaville, Peter A

    2013-04-30

    Meconium aspiration syndrome (MAS) can occur when a newborn infant inhales a mixture of meconium and amniotic fluid into the lungs around the time of delivery. Other than supportive measures, little effective therapy is available. Lung lavage may be a potentially effective treatment for MAS by virtue of removing meconium from the airspaces and altering the natural course of the disease. To evaluate the effects of lung lavage on morbidity and mortality in newborn infants with MAS. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, and EMBASE up to December 2012; previous reviews including cross-references, abstracts, and conference proceedings; and expert informants. We contacted authors directly to obtain additional data. We used the following subject headings and text words: meconium aspiration, pulmonary surfactants, fluorocarbons, bronchoalveolar lavage, lung lavage, pulmonary lavage. Randomised controlled trials that evaluated the effects of lung lavage in infants with MAS, including those intubated for the purpose of lavage. Lung lavage was defined as any intervention in which fluid is instilled into the lung that is followed by an attempt to remove it by suctioning and/or postural drainage. The review authors extracted from the reports of the clinical trial, data regarding clinical outcomes, including mortality, requirement for extracorporeal membrane oxygenation (ECMO), pneumothorax, duration of mechanical ventilation and oxygen therapy, length of hospital stay, indices of pulmonary function, and adverse effects of lavage. Data analysis was done in accordance with the standards of the Cochrane Neonatal Review Group. Only four small randomised controlled trials fulfilled the selection criteria. For one of these trials, no data are available for the control group. Two studies compared lavage using diluted surfactant with standard care. Meta-analysis of these two studies did not show a significant effect on

  17. Desired Destinations of Homeless Women: Realizing Aspirations Within the Context of Homelessness.

    Science.gov (United States)

    Biederman, Donna J; Forlan, Nicole

    2016-08-01

    Despite recent decreases, homelessness remains a substantial problem in the United States. Homelessness is associated with poor health, and homeless women experience earlier mortality than their housed counterparts. Understanding the aspirations of homeless women may offer service providers avenues for intervention to increase well-being among this vulnerable population. This study, a secondary analysis of transcribed interviews (n = 20), provides insight into the aspirations of homeless women. Opportunities for service providers to intervene on these aspirations within the context of homelessness are offered.

  18. Ultrasound guided percutaneous fine needle aspiration biopsy of the liver with focal lesion

    International Nuclear Information System (INIS)

    Ko, Gang Seok; Yang, Hyun Cheol; Park, Byoung Lan; Kim, Byoung Geun; Sohn, Jang Sihn

    1985-01-01

    The ultrasound-guided fine needle aspirations were performed in order to diagnose a suspected neoplastic or infectious disease in 52 patients with focal liver disease. Of these, neoplastic lesions were suspected in 31 patients and infectious lesions in 21 patients ultrasonically and/or clinically. The overall accuracy for both suspected malignant and infectious disease was 79% (41/52). The primary indication for fine needle aspiration was to document the presence of malignancy and to avoid a diagnostic laparotomy, and to drain hepatic abscess. Consequently we were convinced that the ultrasound-guided percutaneous fine needle aspiration biopsy in the focal liver disease is the best method for a conclusive diagnosis

  19. Differential Geometry

    CERN Document Server

    Stoker, J J

    2011-01-01

    This classic work is now available in an unabridged paperback edition. Stoker makes this fertile branch of mathematics accessible to the nonspecialist by the use of three different notations: vector algebra and calculus, tensor calculus, and the notation devised by Cartan, which employs invariant differential forms as elements in an algebra due to Grassman, combined with an operation called exterior differentiation. Assumed are a passing acquaintance with linear algebra and the basic elements of analysis.

  20. Rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted respiratory distress syndrome with high sensitivity

    DEFF Research Database (Denmark)

    Verder, Henrik; Heiring, Christian; Clark, Howard

    2017-01-01

    : An L/S algorithm was developed based on 89 aspirates. Subsequently, gastric aspirates were sampled in 136 infants of 24-31 weeks of gestation and 61 (45%) developed RDS. The cut-off value of L/S was 2.2, sensitivity was 92%, and specificity was 73%. In 59 cases, the oropharyngeal secretions had less...... aspirates were analysed with mid-infrared spectroscopy. Subsequently, L/S was measured in gastric aspirates and oropharyngeal secretions from another group of premature infants using spectroscopy and the results were compared with RDS development. The 10-minute analysis required 10 μL of aspirate. RESULTS...... valid L/S than gastric aspirate results. CONCLUSION: Our rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted RDS with high sensitivity....

  1. FINE NEEDLE ASPIRATION CYTOLOGY OF OSTEOBLASTOMA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Rekha Patil

    2015-02-01

    Full Text Available Osteoblastoma (OB is a rare benign osteogenic bone neoplasm. It accounts for approximately 1% of all the primary bone tumors. OB shows a notable male predominance with male to female ratio of 2:1. It usually occurs in young adults with a mean age of 20 years. The most common sites are the posterior processes of vertebrae. It can also be seen in the long bones, small bones of hands and feet , facial bones , sacrum, however any bone can be affected. The clinical symptoms are non - specific, but pain local tenderness and swelling are usually reported. There is dull progressive pain which is more generalized than that of osteoid osteoma and is less likely to be relieved by aspirin or other analgesic. Sometimes systemic symptoms like weight loss and fever can be present. (1,2,,3,4,5,6,7,8 ,9 Fine needle aspiration cytology (FNAC is a minimally invasive procedure and is used world - wide for the diagnosis of various pathological lesions. Application of FNAC in osseous neoplasm is limited due to possibility of inadequate samples. (10 Diagnosis of OB by FNAC is rare. (3 In the present case OB was diagnosed on FNA based on combined evaluation of clinical data, radiological and microscopic findings . It was later confirmed by histopathology

  2. Superficial fine needle aspiration by clinicians: a survey of utilization.

    Science.gov (United States)

    Fitzpatrick, B T; Bibbo, M

    1996-09-01

    Quality assurance is as much concerned with cost, turnaround time, and use of resources as with test reliability and outcome. The cytopathologist needs to be aware of the knowledge base and expectations of clinicians who perform fine needle aspiration (FNA) biopsies of superficial lesions without technical assistance. To this end, a single correct answer multiple choice questionnaire was sent to 82 procedure-oriented clinical faculty members. Completed answer sheets from 35 faculty members were analyzed. The score for fee and turnaround time was 63.2 per cent and for knowledge of technique 70.6 per cent. The overall score for use of FNA was 64.7 per cent and for specimen handling was 45.6 per cent. Of those 65 per cent of participants who made comments, 30 per cent stressed importance of shorter turnaround time and 27 per cent emphasized the need for training in this area of endeavor. It is concluded that the quality of diagnosis can be improved by placing greater emphasis on training and education, the provision of written material, courses or tutorials in technique, written and verbal feedback regarding specimen adequacy, and by making more extensive use of electronic transmission of results.

  3. Activation of Toll-like receptors in meconium aspiration syndrome.

    Science.gov (United States)

    Anand, V; Basu, S; Yadav, S S; Narayan, G; Bhatia, B D; Kumar, A

    2018-02-01

    Meconium aspiration syndrome (MAS) is a common cause of neonatal morbidity and mortality. Incomplete understanding of the pathogenesis of MAS has hindered the development of specific therapies. We hypothesized that activation of Toll-like receptors (TLRs) might play a role in the pathogenesis of MAS. The present study evaluated the expression of TLR 1, 4, 7, 8 and 9 in neonates with MAS. The study included 39 neonates with MAS and 17 healthy gestational age-matched neonates as controls. Neonates with maternal chorioamnionitis, perinatal asphyxia, sepsis and congenital malformations were excluded. Good-quality total RNA from umbilical cord blood was reverse transcribed to prepare cDNA using Bio-Rad reverse transcription kit. This cDNA was used to study the expression status of TLR 1, 4, 7, 8 and 9 by real-time quantitative polymerase chain reaction. Compared with controls, TLR1 and TLR4 were highly expressed, TLR9 was moderately expressed, TLR7 was weakly expressed and TLR8 expression was neutral in neonates with MAS. Within the MAS group, no difference in TLR expression was observed with respect to consistency of meconium, severity of the disease, oxygenation index and outcome. There is activation of TLRs in neonates with MAS. We speculate that these TLRs probably act as endogenous ligands for various components of meconium that initiate the inflammatory cascade of MAS and contribute to its pathogenesis.

  4. Respiratory Support in Meconium Aspiration Syndrome: A Practical Guide

    Directory of Open Access Journals (Sweden)

    Peter A. Dargaville

    2012-01-01

    Full Text Available Meconium aspiration syndrome (MAS is a complex respiratory disease of the term and near-term neonate. Inhalation of meconium causes airway obstruction, atelectasis, epithelial injury, surfactant inhibition, and pulmonary hypertension, the chief clinical manifestations of which are hypoxaemia and poor lung compliance. Supplemental oxygen is the mainstay of therapy for MAS, with around one-third of infants requiring intubation and mechanical ventilation. For those ventilated, high ventilator pressures, as well as a relatively long inspiratory time and slow ventilator rate, may be necessary to achieve adequate oxygenation. High-frequency ventilation may offer a benefit in infants with refractory hypoxaemia and/or gas trapping. Inhaled nitric oxide is effective in those with pulmonary hypertension, and other adjunctive therapies, including surfactant administration and lung lavage, should be considered in selected cases. With judicious use of available modes of ventilation and adjunctive therapies, infants with even the most severe MAS can usually be supported through the disease, with an acceptably low risk of short- and long-term morbidities.

  5. Radiological findings of meconium aspiration of the newborn

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Seok; Lee, Sung Sik; Lee, Hong Kyu; Kim, Kye Tae; Lee, Soon Il [Sohwa Children' s Hospital, Seoul (Korea, Republic of); Yeon, Kyung Mo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1985-02-15

    Authors reviewed 264 cases of meconium aspiration pneumonia of the newborn at Sohwa Children's Hospital from July 1981 to June 1984. The radiological findings were retrospectively analysed with particular attention to the degree of pulmonic infiltrations. The results were as follows: 1. The male to female ratio was 1.8 : 1 and clinical condition which commonly associated were post-term infants (41.3%), placental dysfunction syndrome (33%) and perinatal asphyxia (11.4%). 2. There were improved (76.9%) and expired cases (12.1%) as clinical course. 3. Radiologic findings were noticed as pulmonic infiltration (68.2%), hyperinflation (35.2%), pneumo-mediastinum (18.6%), pleural effusion (14.4%), pneumothorax (13.3%) and suggestive interstitial emphysema (6.8%). The more the degree of pulmonary infiltration was been severe, the more the incidence of other pulmonary lesions was increased. 4. Pulmonary infiltrations were commonly occurred in both lungs but pneumothorax, pleural effusion and hyperinflation in right. 5. Radiologic findings of 32 expired cases were noticed as pulmonic infiltrations (93.8%), hyperinflation (53.1%), pneumomediastinum (37.5%), pneumothorax (18.8%), suggestive interstitial emphysema (18.8%) and pleural effusion (18.8%)

  6. Mortality in meconium aspiration syndrome in hospitalized babies.

    Science.gov (United States)

    Anwar, Zahid; Butt, Tayyaba Khawar; Kazi, Muhammad Yaqub

    2011-11-01

    To determine the outcome of the babies in terms of mortality with the diagnosis of Meconium Aspiration Syndrome (MAS). An observational study. The Neonatal Unit of Services Institute of Medical Sciences and Services Hospital, Lahore, Pakistan, from February 2008 to January 2009. All the babies admitted to the neonatal unit during the period of study with the diagnosis of MAS were included. At admission, demographic, maternal, antenatal and natal data were recorded on a specific form. The progress of the baby, including need for ventilation, medications, complications and outcome were also followed and documented. One hundred and nine babies admitted with MAS, 32% died. Most of the babies (n=73) were admitted from our obstetrical unit and the rest through the emergency department. Majority (60 of 109) were admitted within the 1st hour of life. Most (14 of 15) of the newborns requiring intubation within 1st hour of life, died. Forty four babies were ventilated and 35 of these babies succumbed. Of ventilated babies, 11 developed pneumothoraces. Seventy two percent (13 out of 18) of expired babies stayed for less than 24 hours. Mortality rate for MAS was higher in the study group as compared to international figures. It was especially high in babies requiring mechanical ventilation in 1st hour of life or with co-existing severe hypoxic ischemic encephalopathy.

  7. Respiratory Support in Meconium Aspiration Syndrome: A Practical Guide

    Science.gov (United States)

    Dargaville, Peter A.

    2012-01-01

    Meconium aspiration syndrome (MAS) is a complex respiratory disease of the term and near-term neonate. Inhalation of meconium causes airway obstruction, atelectasis, epithelial injury, surfactant inhibition, and pulmonary hypertension, the chief clinical manifestations of which are hypoxaemia and poor lung compliance. Supplemental oxygen is the mainstay of therapy for MAS, with around one-third of infants requiring intubation and mechanical ventilation. For those ventilated, high ventilator pressures, as well as a relatively long inspiratory time and slow ventilator rate, may be necessary to achieve adequate oxygenation. High-frequency ventilation may offer a benefit in infants with refractory hypoxaemia and/or gas trapping. Inhaled nitric oxide is effective in those with pulmonary hypertension, and other adjunctive therapies, including surfactant administration and lung lavage, should be considered in selected cases. With judicious use of available modes of ventilation and adjunctive therapies, infants with even the most severe MAS can usually be supported through the disease, with an acceptably low risk of short- and long-term morbidities. PMID:22518190

  8. Lung ultrasonography to diagnose meconium aspiration syndrome of the newborn.

    Science.gov (United States)

    Liu, Jing; Cao, Hai-Ying; Fu, Wei

    2016-12-01

    Objective To investigate the diagnostic value of lung ultrasonography for neonatal meconium aspiration syndrome (MAS). Methods This prospective observational study enrolled patients diagnosed with MAS based on medical history, clinical manifestations and chest X-ray and control newborns without MAS. During ultrasonography, each lung was divided into three regions (front, lateral, and back), using anterior and posterior axillary lines as the boundary. While scanning each region of the lungs, the hand piece was perpendicular or parallel to the ribs. Results This study enrolled 117 newborns with MAS and 100 controls. The main lung ultrasonographic findings in patients with MAS were: (i) pulmonary consolidation with air bronchogram was found in all patients; (ii) pleural line anomalies and the disappearance of the A-line was found in all patients; (iii) atelectasis was found in 19 (16.2%) severe cases, who demonstrated severe massive atelectasis and visible lung pulse; (iv) pleural effusion was found in 16 patients (13.7%); and (v) alveolar-interstitial syndrome or B-line in the non-consolidation area was found in all patients with MAS. Conclusion Ultrasonography can be used routinely to diagnose MAS in an accurate, reliable, convenient, and non-invasive manner.

  9. Meconium aspiration syndrome: risk factors and predictors of severity.

    Science.gov (United States)

    Oliveira, Cláudia Patrícia Lourenço; Flôr-de-Lima, Filipa; Rocha, Gustavo Marcondes Duarte; Machado, Ana Paula; Guimarães Pereira Areias, Maria Hercília Ferreira

    2017-12-08

    To identify risk factors and predictors of severity associated with meconium aspiration syndrome (MAS) in the patients admitted to the neonatal intensive care unit (NICU). Retrospective study including newborns admitted, between 2005 and 2015, with a diagnosis of MAS. Of the newborns admitted to the NICU, 0.66% were diagnosed with MAS. These had higher prevalence of caesarean delivery (p < .001), nonreassuring or abnormal cardiotocography (CTG) (p < .001), intrapartum maternal fever (p = .002), Apgar scores at the first minute <7 (p < .001) and need of endotracheal intubation at birth (p < .001). Newborns with severe MAS had higher median reactive C protein (86.9 versus 9.65, p = .001) and 73.3% had pulmonary hypertension (p = .027). They required significantly more days of oxygen therapy, mechanical ventilation, nitric oxide, inotropic, and surfactant therapy, as well as longer hospital stay. Nonreassuring or abnormal CTG and low Apgar score at the first minute were established as risk factors for MAS and need of surfactant therapy as a predictor of severity.

  10. Fine needle aspiration cytology: sensitivity and specificity in thyroid lesions

    International Nuclear Information System (INIS)

    Musani, M.A.; Khan, F.A.; Malik, S.; Khambaty, Y.

    2011-01-01

    Background: Thyroid enlargement is one of the common problems in patients presenting at outpatients department of ENT particularly in females. Thyroid nodules are common, thyroid cancer is uncommon and the most common way for it to present is as a solitary thyroid nodule. This study was conducted to evaluate the sensitivity and specificity of Fine Needle Aspiration Cytology (FNAC) in thyroid diseases. Method: This prospective analytic study was conducted at ENT Department of Karachi Medical and Dental College/Abbasi Shaheed Hospital during year 2004-8. One hundred and five cases were enrolled who underwent thyroid surgery after complete evaluation by history, clinical examination, Thyroid profile, Thyroid Scintigraphy, Ultrasound neck and FNAC. In cases which were revealed malignant by FNAC, CT scan were done to see the extent of disease and neck node status. Surgery was done in all cases and specimens sent for histopathology. Results: Male to female ratio of the patients was 1:8.5. Most common lesion was benign nodule (96). Malignant lesions were 9 in FNAC. In histopathology, the benign nodules were 92, and malignant cases were 13. Sensitivity of FNAC was 61.53% and specificity was 98.9%. Conclusion: FNAC in Thyroid has high sensitivity and specificity. (author)

  11. Aspirated capacitor measurements of air conductivity and ion mobility spectra

    International Nuclear Information System (INIS)

    Aplin, K.L.

    2005-01-01

    Measurements of ions in atmospheric air are used to investigate atmospheric electricity and particulate pollution. Commonly studied ion parameters are (1) air conductivity, related to the total ion number concentration, and (2) the ion mobility spectrum, which varies with atmospheric composition. The physical principles of air ion instrumentation are long established. A recent development is the computerized aspirated capacitor, which measures ions from (a) the current of charged particles at a sensing electrode, and (b) the rate of charge exchange with an electrode at a known initial potential, relaxing to a lower potential. As the voltage decays, only ions of higher and higher mobility are collected by the central electrode and contribute to the further decay of the voltage. This enables extension of the classical theory to calculate ion mobility spectra by inverting voltage decay time series. In indoor air, ion mobility spectra determined from both the voltage decay inversion, and an established voltage switching technique, were compared and shown to be of similar shape. Air conductivities calculated by integration were: 5.3±2.5 and 2.7±1.1 fSm -1 , respectively, with conductivity determined to be 3 fSm -1 by direct measurement at a constant voltage. Applications of the relaxation potential inversion method include air ion mobility spectrum retrieval from historical data, and computation of ion mobility spectra in planetary atmospheres

  12. Fine-needle aspiration cytology in children with superficial lymphadenopathy

    Directory of Open Access Journals (Sweden)

    F. De Corti

    2014-04-01

    Full Text Available Introduction: In pediatric population Fine-Needle Aspiration Citology (FNAC is slowly gaining acceptance in clinical management of Superficial Lymphadenopathy (SL. Our experience adds some data about the usefulness of this technique in diagnosing the cause of a SL and therefore guiding further treatment. Patients and Methods: 238 FNAC were performed in 217 patients with SL, observed at our Institution from 2002 to 2006. The neck was the most frequent localization. The results were available within few hours. In cases of granulomatous findings, the samples were processed for microbiological and PCR test, in order to identify Mycobacteria. Results: 174 were reactive lesions, 38 granulomatous lymphadenopathies, 24 malignant lesions, 2 specimens inadequate for diagnosis. Among the 174 reactive SL, 22 required an incisional biopsy after 1 month follow-up. Among the granulomatous lymphadenopathies, 13 children with Cat-Scratch Disease recovered, 25 with Mycobacteria infection underwent surgical excision. For 24 malignant lesions, the diagnosis was confirmed by further biopsy. Two false negative and no false positive were detected (sensitivity 92%, specificity 100%. No complications were encountered. Conclusions: In our experience FNAC, performed by experienced cytopathologist, has revealed to be a fast, safe, non invasive and inexpensive method to achieve diagnosis in persistent SL. The use of FNAC gave us the possibility to select patients for further investigation and/or surgical treatment. Incisional biopsy remains necessary to confirm the diagnosis in case of malignancy or doubtful lesions.

  13. Toward improving fine needle aspiration cytology by applying Raman microspectroscopy

    Science.gov (United States)

    Becker-Putsche, Melanie; Bocklitz, Thomas; Clement, Joachim; Rösch, Petra; Popp, Jürgen

    2013-04-01

    Medical diagnosis of biopsies performed by fine needle aspiration has to be very reliable. Therefore, pathologists/cytologists need additional biochemical information on single cancer cells for an accurate diagnosis. Accordingly, we applied three different classification models for discriminating various features of six breast cancer cell lines by analyzing Raman microspectroscopic data. The statistical evaluations are implemented by linear discriminant analysis (LDA) and support vector machines (SVM). For the first model, a total of 61,580 Raman spectra from 110 single cells are discriminated at the cell-line level with an accuracy of 99.52% using an SVM. The LDA classification based on Raman data achieved an accuracy of 94.04% by discriminating cell lines by their origin (solid tumor versus pleural effusion). In the third model, Raman cell spectra are classified by their cancer subtypes. LDA results show an accuracy of 97.45% and specificities of 97.78%, 99.11%, and 98.97% for the subtypes basal-like, HER2+/ER-, and luminal, respectively. These subtypes are confirmed by gene expression patterns, which are important prognostic features in diagnosis. This work shows the applicability of Raman spectroscopy and statistical data handling in analyzing cancer-relevant biochemical information for advanced medical diagnosis on the single-cell level.

  14. Selection of developmentally competent human oocytes aspirated during cesarean section.

    Science.gov (United States)

    Duarte Alcoba, Diego; Gonsales Valério, Edimárlei; Conzatti, Maiara; Schneider, Júlia; Capp, Edison; von Eye Corleta, Helena; Brum, Ilma Simoni

    2018-03-01

    To evaluate the efficiency/safety of Brilliant Cresyl Blue (BCB) staining as a selection method of developmentally competent immature human oocytes. Immature oocytes of 32 pregnant women were recovered during cesarean section (CS). After retrieval, 92 oocytes were randomly divided into two groups: control (directly disposed to in vitro maturation - IVM) and treated - exposed to BCB 26 μM during 60 min. After staining, the treated group was classified as cytoplasm coloration, BCB positive (blue) or negative (colorless), and then disposed to IVM. Nuclear status was checked after 24 and 48 h of IVM. Nuclear maturation (polar body extrusion), meiosis resumption (absence of germinal vesicle) and degeneration rates were evaluated among the three groups (control, BCB positive and BCB negative) using Generalized Estimating Equations, followed by Bonferroni's correction for multiple comparisons. Nuclear maturation was higher in BCB positive compared to BCB negative, after 24 and 48 h of IVM (p = .004 and p = .032). The control group was equal to BCB positive. There was no difference among groups analyzing meiosis resumption and degeneration rates. The BCB test can be a good marker in pre-selection procedures of developmentally competent human oocytes aspirated during CS.

  15. Learning curve of thyroid fine-needle aspiration biopsy.

    Science.gov (United States)

    Penín, Manuel; Martín, M Ángeles; San Millán, Beatriz; García, Juana

    2017-12-01

    Fine-needle aspiration biopsy (FNAB) is the reference procedure for thyroid nodule evaluation. Its main limitation are inadequate samples, which should be less than 20%. To analyze the learning curve of the procedure by comparing the results of a non-experienced endocrinologist (endocrinologist 2) to those of an experienced one (endocrinologist 1). Sixty FNABs were analyzed from February to June 2016. Each endocrinologist made 2punctures of every nodule in a random order. This order and the professional making every puncture were unknown to the pathologist who examined the samples. Endocrinologist 1 had a higher percentage of diagnoses than endocrinologist 2 (82% vs. 72%, P=.015). In the first 20 FNABs, the difference between both physicians was remarkable and statistically significant (80% vs. 50%, P=.047). In the following 20 FNABs, the difference narrowed and was not statistically significant (90% vs. 65%, P=.058). In the final 20 FNABs, the difference was minimal and not statistically significant (75% vs. 70%, P=.723). The learning curve of ultrasound-guided FNAB may be completed in a suitable environment by performing it at least 60 times. Although the guidelines recommend at least 3punctures per nodule, 2are enough to achieve an accurate percentage of diagnoses. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. First Generation Students and Post-Undergraduate Aspirations

    Directory of Open Access Journals (Sweden)

    Morgan Teressa Carlton

    2015-11-01

    Full Text Available Equal access to education is a growing concern throughout the nation. With an increasing amount of programs aimed to support the underrepresented populations on college campuses, first generation college students have grown to be a target population of particular interest. This study examined the relationships between first generation college seniors and applications to graduate or professional programs. The goal of this study was to determine if first generation students are pursuing advanced degrees at lower rates than non-first generation students and if so, attempt to uncover factors contributing to that evidence. Data were gathered from the National Longitudinal Survey of Freshman data set, and variables were analyzed using a binary logistic regression. The results of the study indicate that first generation students are significantly less likely to pursue an advanced degree, even when controlling for race, gender, family income, and cumulative grade point average, suggesting a distinctive impact of first generation status on post-undergraduate aspirations. However, after controlling for the impact of self-reported undergraduate loans, the effect of first generation status was no longer significant. The findings in this study provide an important new perspective in the field of sociology.

  17. Understanding gendered aspects of migration aspiration and motives of university students by multivariate statistical methods

    Directory of Open Access Journals (Sweden)

    Đula Borozan

    2014-03-01

    Full Text Available The paper deals with the application of multivariate analysis of variance and logistic regression in measuring, explaining and evaluating (i gender differences in expressing migration aspirations, and (ii a gender effect on migration motivation of university students in Croatia. The results supported the thesis that migration is a complex gendering process that assumes subjective assessment of the whole set of interrelated motives. According to logistic regression, gender is a significant predictor of migration aspirations among the selected demographic and socio-economic variables. A multivariate analysis of variance showed that gender and migration aspirations in interaction matter when it comes to migration motives, particularly related to the perceived importance of social networks. Females, and especially those who aspire to migrate, assessed these motives as more important than males.

  18. Aspire Project - an integrated wellness coaching model facilitated by an online coaching technology

    Directory of Open Access Journals (Sweden)

    Paul Thomas Pook

    2015-10-01

    PT Aspire provides personal trainers and coaches with a powerful facilitator of client goal achievement and behaviour change. It encourages an innovative approach to coaching that considers the key elements of wellness delivered via digital technology.

  19. Predicting violent behavior: The role of violence exposure and future educational aspirations during adolescence.

    Science.gov (United States)

    Stoddard, Sarah A; Heinze, Justin E; Choe, Daniel Ewon; Zimmerman, Marc A

    2015-10-01

    Few researchers have explored future educational aspirations as a promotive factor against exposure to community violence in relation to adolescents' violent behavior over time. The present study examined the direct and indirect effect of exposure to community violence prior to 9th grade on attitudes about violence and violent behavior in 12th grade, and violent behavior at age 22 via 9th grade future educational aspirations in a sample of urban African American youth (n = 681; 49% male). Multi-group SEM was used to test the moderating effect of gender. Exposure to violence was associated with lower future educational aspirations. For boys, attitudes about violence directly predicted violent behavior at age 22. For boys, future educational aspirations indirectly predicted less violent behavior at age 22. Implications of the findings and suggestions for future research are discussed. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  20. A cross section study to correlate fine needle aspiration cytology and ...

    African Journals Online (AJOL)

    A cross section study to correlate fine needle aspiration cytology and histopathology in the diagnosis of parotid tumoursat four major hospitals in Zambia. S.M.E. Kazuma, L Mucheleng'anga, R Zulu, H Hanna ...

  1. Aspirations and Expectations of West Malaysian Youth: Two Models of Social Class Values

    Science.gov (United States)

    Takei, Yoshimitsu; And Others

    1973-01-01

    While the occupational aspirations of Malay and Chinese male students in the secondary schools reveal fairly similar configurations, the socio-economic expectations of Malays are higher and largely independent of social class origins. (Authors)

  2. [The comparison of different bronchial aspirate culturing methods in patients with ventilator-associated pneumonia (VAP)].

    Science.gov (United States)

    Kowalczyk, Wojciech; Rybicki, Zbigniew; Tomaszewski, Dariusz; Truszczyński, Andrzej; Guzek, Aneta

    2011-01-01

    Although broncho-alveolar lavage (BAL) culture and protected specimen brush (PSB) are regarded as the most effective methods in the diagnosis of VAP, a simple endotracheal aspiration (EA) is frequently performed during routine care, because of its simplicity and low cost. We compared the effectiveness of EA with BAL and PSB in VAP patients. Sixty-one adult VAP patients, ventilated for longer than 48 h, were cultured with all three methods. Positive cultures were obtained from 63.9% of patients, with Acinetobacter baumannii being the most common pathogen. There was a high positive correlation between simple aspirates and BAL (k 0.817, CI 0.664-0.840, p aspirates and PSB (k 0.667, CI 0.483-0.871, p aspirate culturing, compared to BAL and PSB, it can be used successfully in most cases.

  3. The mean green popsicle: using cryotherapy to remove aspirated foreign bodies.

    Science.gov (United States)

    Seaman, Joseph C; Knepler, James L; Bauer, Karen; Rashkin, Mitchell

    2010-10-01

    Foreign body (FB) aspiration can be a life-threatening event. Although more common in children, FB aspiration can occur at any age. Symptoms related to FB aspiration range from coughing and shortness of breath to asphyxiation. Chest imaging can be nonspecific and infrequently identifies an FB. Herein, we describe a case of a 54-year-old male patient who aspirated an FB and experienced respiratory arrest. He failed to improve with conservative measures and required emergent bronchoscopy. He was found to have an FB in his proximal left mainstem bronchus that could not be removed using standard bronchoscopy and he was referred to our center for definitive care. We used a cryotherapy probe to remove the FB. We propose that cryotherapy is a useful tool to remove FBs that are soft and amenable to freezing.

  4. Influence of Ovarian Side and Initiation Time of First Aspiration with Relation of Transvaginal Follicular Aspiration in HF x Sahiwal Cows

    Directory of Open Access Journals (Sweden)

    Suthar

    2010-12-01

    Full Text Available This study was carried out to observe the influence of ovarian side and initiation time of first aspiration during OPU programme in HF X Sahiwal cows. Eight cows were randomly divided in to two groups (A and B each consisting of 4 donors. Follicular aspiration was initiated on day 4 (first follicular wave and day 13 (second follicular wave of estrous cycle, respectively. From group-A donors, total 200 follicles were aspirated in eight sessions with a mean of 6.25 ± 2.05 per animal per session of which 52.50 (105/200 and 47.50 (95/200 per cent follicles were from left and right ovary, respectively. The mean numbers of small, medium and large follicles aspirated were 2.06 ± 0.87, 2.65 ± 0.88 and 1.53 ± 0.91 with the recovery rate of 33.0 (66/200 (3–5 mm, 42.50 (85/200 (6–9 mm and 24.50 (49/200 (=10 mm per cent, respectively. From group-B donors, total 179 follicles were aspirated of which 48.60 (87/179 and 51.40 (92/179 per cent follicles were from left and right ovary, respectively. The mean number of aspirated follicles per cow per session from group-B donor cows was 5.59 ± 1.03 and the mean numbers of small, medium and large follicles aspirated 1.87 ± 0.96, 2.5 ± 0.66 and 1.25 ± 0.64 with the recovery rate of 34.07 (61/179, 44.94 (80/179 and 21.22 (38/179 per cent, respectively. The number of follicles from left and right ovaries of different categories among group A and B donor cows did not differ significantly (P>0.05. This study showed that there cows no any influence of ovarian side and initiation time on follicular aspiration. [Vet. World 2010; 3(6.000: 286-288

  5. Factors associated with educational aspirations among adolescents: cues to counteract socioeconomic differences?

    Science.gov (United States)

    Madarasova Geckova, Andrea; Tavel, Peter; van Dijk, Jitse P; Abel, Thomas; Reijneveld, Sijmen A

    2010-03-24

    Our study aims to follow this effort and to explore the association between health, socioeconomic background, school-related factors, social support and adolescents' sense of coherence and educational aspirations among adolescents from different educational tracks and to contribute to the existing body of knowledge on the role of educational aspirations in the social reproduction of health inequalities. We expect that socioeconomic background will contribute to the development of educational aspirations, but this association will be modified by available social and individual resources, which may be particularly favourable for the group of adolescents who are on lower educational tracks, since for them such resources may lead to gaining a higher educational level. We collected data on the socioeconomic background (mother's and father's education and employment status, doubts about affordability of future study), school-related factors (school atmosphere, school conditions, attitudes towards school), perceived social support, sense of coherence (manageability, comprehensibility, meaningfulness) and the self-rated health of a national sample of Slovak adolescents (n = 1992, 53.5% females, mean age 16.9 years). We assessed the association of these factors with educational aspirations, overall and by educational tracks (grammar schools, specialised secondary schools, vocational schools). We found statistically significant associations with educational aspirations for the factors parental educational level, father's unemployment, doubts about the affordability of future study, school atmosphere, attitude towards school, social support from the father and a sense of coherence. Social support from the mother and friends was not associated with educational aspiration, nor was self-rated health. Besides affinity towards school, the determinants of educational aspirations differed among adolescents on different educational tracks. Educational aspirations of grammar school

  6. Transrectal ultrasound-guided aspiration in the management of prostatic abscess: A single-center experience

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    Jigish B Vyas

    2013-01-01

    Full Text Available Objectives: The safety and efficacy of transrectal ultrasound (TRUS guided aspiration of prostatic abscess (PA is known. The objective of this study is to describe a treatment algorithm for management of PA with TRUS-guided aspiration, emphasizing on indications and factors predicting the treatment outcome. Materials and Methods: After the institutional review board approval was obtained, a retrospective study was done of all patients suspected with PA on digital rectal examination (DRE and confirmed on TRUS. An 18-gauge two-part needle was used for aspiration. The real-time TRUS-guided aspiration of PA was done in the longitudinal axis. The aspiration of pus and the sequential collapse of cavity was seen "real time." A suprapubic catheter was placed, if the patient had urinary retention, persistent dysuria, and/or severe lower urinary tract symptoms (LUTS. Success was defined as complete resolution of the abscess and/or symptoms. Results: Forty-eight patients were studied with PA, with a mean age of 54.6 ± 14.6 (range 26-79 years. The DRE diagnosed PA in 22 (45.83% patients, while abdominal sonography diagnosed PA in 13 (27.08% patients. TRUS revealed a hypoechoic area with internal echoes in all 48 (100% patients. The diagnosis was confirmed in all 48 cases with aspiration. The mean size of the lesion was 3.2 ± 1.2 (range 1.5-8 cm. Mean volume aspirated was 10.2 ml (range 2.5-30 ml. Complete resolution after first aspiration was observed in 20 (41.66% patients. An average of 4.1 (range 1-7 aspirations was required for complete resolution which was seen in 41 patients (85.42%. Seven (14.58% patients required transurethral resection (deroofing of the abscess cavity. We formulated a treatment algorithm based on the above findings. Conclusion: The proposed algorithm based on our experience suggests that patients with PA larger than 2 cm with severe LUTS and/or leukocytosis benefit from TRUS-guided aspiration. In addition, these patients are

  7. Transrectal ultrasound-guided aspiration in the management of prostatic abscess: A single-center experience.

    Science.gov (United States)

    Vyas, Jigish B; Ganpule, Sanika A; Ganpule, Arvind P; Sabnis, Ravindra B; Desai, Mahesh R

    2013-07-01

    The safety and efficacy of transrectal ultrasound (TRUS) guided aspiration of prostatic abscess (PA) is known. The objective of this study is to describe a treatment algorithm for management of PA with TRUS-guided aspiration, emphasizing on indications and factors predicting the treatment outcome. After the institutional review board approval was obtained, a retrospective study was done of all patients suspected with PA on digital rectal examination (DRE) and confirmed on TRUS. An 18-gauge two-part needle was used for aspiration. The real-time TRUS-guided aspiration of PA was done in the longitudinal axis. The aspiration of pus and the sequential collapse of cavity was seen "real time." A suprapubic catheter was placed, if the patient had urinary retention, persistent dysuria, and/or severe lower urinary tract symptoms (LUTS). Success was defined as complete resolution of the abscess and/or symptoms. Forty-eight patients were studied with PA, with a mean age of 54.6 ± 14.6 (range 26-79) years. The DRE diagnosed PA in 22 (45.83%) patients, while abdominal sonography diagnosed PA in 13 (27.08%) patients. TRUS revealed a hypoechoic area with internal echoes in all 48 (100%) patients. The diagnosis was confirmed in all 48 cases with aspiration. The mean size of the lesion was 3.2 ± 1.2 (range 1.5-8) cm. Mean volume aspirated was 10.2 ml (range 2.5-30 ml). Complete resolution after first aspiration was observed in 20 (41.66%) patients. An average of 4.1 (range 1-7) aspirations was required for complete resolution which was seen in 41 patients (85.42%). Seven (14.58%) patients required transurethral resection (deroofing) of the abscess cavity. We formulated a treatment algorithm based on the above findings. The proposed algorithm based on our experience suggests that patients with PA larger than 2 cm with severe LUTS and/or leukocytosis benefit from TRUS-guided aspiration. In addition, these patients are benefitted from urinary drainage (either perurethral or

  8. Syringe and Needle Size, Syringe Type, Vacuum Generation, and Needle Control in Aspiration Procedures

    International Nuclear Information System (INIS)

    Haseler, Luke J.; Sibbitt, Randy R.; Sibbitt, Wilmer L.; Michael, Adrian A.; Gasparovic, Charles M.; Bankhurst, Arthur D.

    2011-01-01

    Purpose: Syringes are used for diagnostic fluid aspiration and fine-needle aspiration biopsy in interventional procedures. We determined the benefits, disadvantages, and patient safety implications of syringe and needle size on vacuum generation, hand force requirements, biopsy/fluid yield, and needle control during aspiration procedures. Materials and Methods: Different sizes (1, 3, 5, 10, and 20 ml) of the conventional syringe and aspirating mechanical safety syringe, the reciprocating procedure device, were studied. Twenty operators performed aspiration procedures with the following outcomes measured: (1) vacuum (torr), (2) time to vacuum (s), (3) hand force to generate vacuum (torr-cm 2 ), (4) operator difficulty during aspiration, (5) biopsy yield (mg), and (6) operator control of the needle tip position (mm). Results: Vacuum increased tissue biopsy yield at all needle diameters (P < 0.002). Twenty-milliliter syringes achieved a vacuum of −517 torr but required far more strength to aspirate, and resulted in significant loss of needle control (P < 0.002). The 10-ml syringe generated only 15% less vacuum (−435 torr) than the 20-ml device and required much less hand strength. The mechanical syringe generated identical vacuum at all syringe sizes with less hand force (P < 0.002) and provided significantly enhanced needle control (P < 0.002). Conclusions: To optimize patient safety and control of the needle, and to maximize fluid and tissue yield during aspiration procedures, a two-handed technique and the smallest syringe size adequate for the procedure should be used. If precise needle control or one-handed operation is required, a mechanical safety syringe should be considered.

  9. Endobronchial Perfluorane Therapy for Aspiration Damages to the Tracheobronchial Tree: Clinical Experience

    Directory of Open Access Journals (Sweden)

    V. P. Vvedensky

    2005-01-01

    Full Text Available The outcomes of treatment of aspiration damages to the tracheobronchial tree, by performing the goal-oriented endobronchial perfluorane treatment were analyzed in victims with severe brain injury. The specific features of the time course of pathological tracheal and bronchial mucosal changes were defined during the therapy performed. The determinants of the efficiency of endobronchial perfluorane therapy were determined in the treatment of tracheal and bronchial damages of aspiration genesis.

  10. The Eating Assessment Tool-10 Predicts Aspiration in Adults with Stable Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Regan, Julie; Lawson, Susan; De Aguiar, Vânia

    2017-10-01

    Adults with COPD frequently present with dysphagia, which often leads to clinical complications and hospital admissions. This study investigates the ability of the Eating Assessment Tool (EAT-10) to predict aspiration during objective dysphagia evaluation in adults with stable COPD. Thirty adults (20 male, 10 female; mean age = 69.07 ± 16.82) with stable COPD attended an outpatient dysphagia clinic for a fiberoptic endoscopic evaluation of swallowing (FEES) in an acute teaching hospital (January 2015-November 2016). During evaluations, individuals completed an EAT-10 rating scale followed immediately by a standardised FEES exam. Aspiration status during FEES was rated using the penetration-aspiration scale by clinicians blinded to EAT-10 scores. Data were retrospectively analysed. Significant differences in mean EAT-10 scores were found between aspirators (16.3; SEM = 2.165) and non-aspirators (7.3; SEM = 1.009) (p = 0.000). The EAT-10 predicted aspiration with a high level of accuracy (AUC = 0.88). An EAT-10 cut-off value of >9 presented a sensitivity of 91.67, specificity of 77.78 with positive and negative likelihood ratios of 4.12 and 0.11, respectively. Positive and negative predictive values were 73.30 and 93.30, respectively. Diagnostic odds ratio was 38.50 (p EAT-10 is a quick, easy to administer tool, which can accurately predict the presence of aspiration in adults with COPD. The scale can also very accurately exclude the absence of aspiration, helping clinicians to determine the need for onward referral for a comprehensive dysphagia evaluation. This may ultimately reduce clinical complications and hospital admissions resulting from dysphagia in this clinical population.

  11. Misalignment of Career and Educational Aspirations in Middle School: Differences across Race, Ethnicity, and Socioeconomic Status

    OpenAIRE

    Perry, Brea L.; Martinez, Elizabeth; Morris, Edward; Link, Tanja C.; Leukefeld, Carl

    2016-01-01

    Misalignment of educational and career goals (i.e., educational aspirations expressed are inadequate for attaining one?s desired occupation) is associated with lower educational attainment and a lack of college readiness, and may contribute to persistent educational and employment disparities. Drawing on data from 249 sixth graders in low-income schools, this research examines misalignment between educational and career aspirations across racial and ethnic and socioeconomic groups. Findings i...

  12. Reduced Maximum Pitch Elevation Predicts Silent Aspiration of Small Liquid Volumes in Stroke Patients

    Directory of Open Access Journals (Sweden)

    Akila Theyyar Rajappa

    2017-08-01

    Full Text Available Background and purposePreliminary evidence has shown that reduced ability to maximally raise vocal pitch correlates with the occurrence of aspiration (i.e., airway invasion by food or liquid. However, it is unclear if this simple task can be used as a reliable predictor of aspiration in stroke patients. Our aim was to examine whether maximum vocal pitch elevation predicted airway invasion and dysphagia in stroke.MethodsForty-five consecutive stroke patients (<1 month poststroke at a rehabilitation setting participated in a videofluoroscopic swallow study and two maximum vocal pitch elevation tasks. Maximum pitch was evaluated acoustically [maximum fundamental frequency (max F0] and perceptually. Swallowing safety was rated using the Penetration/Aspiration Scale and swallowing performance was assessed using components of the Modified Barium Swallow Impairment Profile (MBSImPTM©. Data were analyzed using simple regression and receiver operating characteristics curves to test the sensitivity and specificity of max F0 in predicting aspiration. Correlations between max F0 and MBSImP variables were also examined.ResultsMax F0 predicted silent aspiration of small liquid volumes with 80% sensitivity and 65% specificity (p = 0.023; area under the curve: 0.815; cutoff value of 359.03 Hz. Max F0 did not predict non-silent aspiration or penetration in this sample and did not significantly correlate with MBSImP variables. Furthermore, all participants who aspirated silently on small liquid volumes (11% of sample had suffered cortical or subcortical lesions.ConclusionIn stroke patients (<1 month poststroke, reduced maximum pitch elevation predicts silent aspiration of small liquid volumes with high sensitivity and moderate specificity. Future large-scale studies focusing on further validating this finding and exploring the value of this simple and non-invasive tool as part of a dysphagia screening are warranted.

  13. Risk of early onset pneumonia in neonates with abnormal gastric aspirate

    OpenAIRE

    IB. Mahendra; I Wayan Retayasa; I Made Kardana

    2008-01-01

    Background Early onset neonatal pneumonia is the risk factor for neonatal sepsis that increases risk for neonatal deaths. Recognition, prevention, and treatment of this problem is major factors in the managemant of high risk neonates. Analysis of gastric aspirate, collected soon after birth is a useful screening test for predicting pneumonia. Objective To evaluate the risk of early onset of neonatal pneumonia in neonates with abnormal gastric aspirate. Methods A case c...

  14. Childhood Aspirations, Occupational Outcomes and Exposure to Violence: Evidence from Burundi

    OpenAIRE

    Jeusette, Lionel; Verwimp, Philip

    2017-01-01

    Recent evidence points at the importance of childhood aspirations for our understanding of poverty and development. But how are these affected by the exposure to violence? This paper employs a logistic framework to study that question for Burundi, a conflict-affected, fragile state. Using data from a new nationwide survey with a panel component we distinguish between armed violence, domestic violence, violence at school and participation in violence. We find that (i) aspiring a job in the pub...

  15. Aspiration-related organizing pneumonia complicating laparoscopic adjustable gastric banding: A lung cancer mimicker

    Directory of Open Access Journals (Sweden)

    Ahmed A Aljohaney

    2016-01-01

    Full Text Available There are several described pulmonary complications due to laparoscopic adjustable gastric banding. We report a rare case of a 32-year-old male who presented with pulmonary symptoms and a solitary lung mass 12 years after laparoscopic adjustable gastric banding. A bronchoscopic lung biopsy showed organizing pneumonia that was induced by aspiration pneumonia. The atypical radiological appearance of the aspiration pneumonia may pose a diagnostic challenge, and clinicians' awareness regarding such an entity is needed to avoid unnecessary intervention.

  16. Erythropoietin Pretreatment Attenuates Seawater Aspiration-Induced Acute Lung Injury in Rats.

    Science.gov (United States)

    Ji, Mu-Huo; Tong, Jian-Hua; Tan, Yuan-Hui; Cao, Zhen-Yu; Ou, Cong-Yang; Li, Wei-Yan; Yang, Jian-Jun; Peng, Y G; Zhu, Si-Hai

    2016-02-01

    Seawater drowning-induced acute lung injury (ALI) is a serious clinical condition characterized by increased alveolar-capillary permeability, excessive inflammatory responses, and refractory hypoxemia. However, current therapeutic options are largely supportive; thus, it is of great interest to search for alternative agents to treat seawater aspiration-induced ALI. Erythropoietin (EPO) is a multifunctional agent with antiinflammatory, antioxidative, and antiapoptotic properties. However, the effects of EPO on seawater aspiration-induced ALI remain unclear. In the present study, male rats were randomly assigned to the naive group, normal saline group, seawater group, or seawater + EPO group. EPO was administered intraperitoneally at 48 and 24 h before seawater aspiration. Arterial blood gas analysis was performed with a gas analyzer at baseline, 30 min, 1 h, 4 h, and 24 h after seawater aspiration, respectively. Histological scores, computed tomography scan, nuclear factor kappa B p65, inducible nitric oxide synthase, caspase-3, tumor necrosis factor-alpha, interleukin (IL)-1β, IL-6, IL-10, wet-to-dry weight ratio, myeloperoxidase activity, malondialdehyde, and superoxide dismutase in the lung were determined 30 min after seawater aspiration. Our results showed that EPO pretreatment alleviated seawater aspiration-induced ALI, as indicated by increased arterial partial oxygen tension and decreased lung histological scores. Furthermore, EPO pretreatment attenuated seawater aspiration-induced increase in the expressions of pulmonary nuclear factor kappa B p65, inducible nitric oxide synthase, caspase-3, tumor necrosis factor-alpha, IL-1β, myeloperoxidase activity, and malondialdehyde when compared with the seawater group. Collectively, our study suggested that EPO pretreatment attenuates seawater aspiration-induced ALI by down-regulation of pulmonary pro-inflammatory cytokines, oxidative stress, and apoptosis.

  17. Fine-needle aspiration of gray zone lesions of the breast: fibroadenoma versus ductal carcinoma.

    Science.gov (United States)

    Jing, Xin; Normolle, Daniel; Michael, Claire W

    2013-09-01

    While breast lesions have characteristic cytological features, some lesions, particularly adenocarcinoma and fibroadenoma, may present with overlapping features causing erroneous diagnoses. The current study aimed to define significant cytomorphologic features predictive of fibroadenoma and adenocarcinoma, respectively. Further, we intended to evaluate the predictive characteristics for differentiation between gray zone lesions and to identify root causes contributing to misdiagnoses. First, direct smears prepared from 14 histology-confirmed fibroadenomas and 14 adenocarcinomas were reviewed and characteristics of commonly encountered morphologic features were assessed. We then retrospectively and blindly reviewed nine cytohistologic discrepant cases using the significant characteristic as a guideline, in order to assess whether these discrepant cases could be correctly categorized. Morphologic characteristics predictive of fibroadenoma included moderate cellularity, large, folded cellular sheets/aggregates, staghorn projections, smooth and round borders, monolayers, honeycomb arrangement, smaller nuclear size, and background bipolar cells. Predictive characteristics of adenocarcinoma included high cellularity, loose cohesive sheets/aggregates, pointed projections, irregular borders, larger nuclear size, irregular nuclear membrane, prominent nucleoli, and single atypical epithelial cells. Retrospective, blind review correctly re-classified seven out of nine cytohistologic discrepant cases, including five false negative cases and two false positive cases. Root causes contributing to the misdiagnoses were large branching sheets of carcinoma mimicking folded sheets of fibroadenoma; fibroblasts mimicking myoepithelial cells; apocrine cells mimicking carcinoma cells; and not recognizing the loose myxoid matrix presenting as soap bubbles in fibroadenoma. In conclusion, this study identified significant characteristics that can assist in achieving accurate diagnosis in a

  18. Coevolution of aspirations and cooperation in spatial prisoner's dilemma game

    International Nuclear Information System (INIS)

    Chen, Wei; Wu, Te; Li, Zhiwu; Wang, Long

    2015-01-01

    Suboptimal outcomes are often more acceptable than the best ones when the latter are hard or even impossible to find. In order to describe the emergence of cooperation when suboptimal alternatives prevail, an evolutionary game model is established by considering the effects of aspirations. A win-stay-lose-shift like rule for strategy updating is proposed. The rule prescribes that if the payoff of the current strategy is greater than the aspiration, the strategy remains, otherwise the strategy changes. Aspiration updating allows for individuals to adjust their expected payoff levels. It is shown that suboptimal alternatives can promote the emergence and persistence of cooperation over a wide range of the temptation to defect. Furthermore, a nontrivial phenomenon is found that cooperators prevail as the temptation increases when it is small. The aspirations are stabilized at an intermediate level which can most facilitate cooperation. The obtained results also show that the average level of aspirations decreases as the temptation increases. Furthermore, the variance of aspiration levels is minimized for an intermediate level of temptation. (paper)

  19. The analysis of the cases of aspired fuel oil and gasoline through siphonage method.

    Science.gov (United States)

    Gonullu, Hayriye; Karadas, Sevdegü; Oncü, Mehmet Resit; Dulger, A Cumhur; Keskin, Siddik

    2013-03-01

    Accidental aspiration of petroleum products in children can also be witnessed in adults working with petroleum products by siphonage or swallowing fire for demonstration purposes. Ten cases admitted to Yuzuncu Yil University Emergency Service due to fuel oil and gasoline aspiration in a three-year period were retrospectively analysed. All cases were males and their average age was determined as 32,4 +/- 7.83 years. Three of the patients aspirated gasoline and 7 fuel oil. Blood gas values in all patients were at normal levels and their average white blood cell values were 16,590. The most frequent symptom for referral to our service was shortness of breath. Infiltration was confirmed in the chest X-ray of 2 patients with aspirated fuel oil and all cases of gasoline aspiration. All patients received methylprednisolone and IV proton-pump inhibitors for treatment. Eight patients were given antibiotics. All victims were discharged from the hospital after recovery. Aspiration of petroleum products which is normally rarely seen is witnessed more frequently in under developed countries. Since the findings determined by screening methods are often nonspecific, history is important for making a diagnosis.

  20. Surfactant therapy for maternal blood aspiration: an unusual cause of neonatal respiratory distress syndrome.

    Science.gov (United States)

    Celik, Istemi Han; Demirel, Gamze; Canpolat, Fuat Emre; Erdeve, Omer; Dilmen, Ugur

    2012-10-01

    Surfactant replacement therapy is the main treatment of neonatal respiratory distress syndrome. However, surfactant therapy has been shown to be effective in the treatment of other diseases causing neonatal respiratory diseases such as pulmonary hemorrhage, meconium aspiration syndrome, pneumonia/sepsis, pulmonary edema or acute lung injury resulting a secondary surfactant deficiency (SSD). Rarely, as like as in the present patient, exogenous blood aspiration such as breast milk or formula aspiration may lead to SSD. Blood in alveolus leads to a significant biochemical and functional disturbance of the surfactant system and inhibits surfactant production. Here, the authors report a preterm infant of 33 wk gestational age with secondary surfactant deficiency due to maternal blood aspiration because of abruptio placentae. She was received two courses of beractant, a natural bovine surfactant, therapy in 24 h. She was extubated on second day and did not require oxygen on 4(th) day. To the authors' knowledge, this is the first reported case of SSD due to maternal blood aspiration treated with surfactant. In conditions such as abruptio placentae, infant should be protected from blood aspiration and if respiratory distress occurs, surfactant inhibition and need for surfactant administration should be considered.

  1. Structural and socio-psychological influences on adolescents' educational aspirations and subsequent academic achievement.

    Science.gov (United States)

    Rothon, Catherine; Arephin, Muna; Klineberg, Emily; Cattell, Vicky; Stansfeld, Stephen

    2011-06-01

    Previous literature indicates that educational aspirations are an important predictor of achievement at school and beyond. This paper examines the factors that are associated with high educational aspirations. It also looks at the relationship between aspirations and achievement at the General Certificate of Secondary Education in a deprived area of London. The results show that educational aspirations are associated with individual characteristics. Girls were more likely than boys to express a wish to remain in education beyond the age of 16. For the most academic route post-16, there were substantial ethnic differences, with minority ethnic groups generally being more likely to state a desire to follow this path. Students who were eligible for free school meals tended to have lower aspirations. Socio-psychological variables were also shown to be of importance, particularly self-esteem and psychological distress. Importantly, educational aspirations had a strong association with actual achievement at age 16, remaining associated even after controlling for a number of other variables, including prior achievement. These findings are discussed in light of previous research and potential intervention strategies.

  2. Percutaneous Aspiration Embolectomy Using Guiding Catheter for the Superior Mesenteric Artery Embolism

    Science.gov (United States)

    Choi, Kyu Sung; Kim, Ji Dae; Min, Sang-Il; Min, Seung-Kee; Jae, Hwan Jun; Chung, Jin Wook

    2015-01-01

    Objective To evaluate the technical feasibility and clinical outcome of percutaneous aspiration embolectomy for embolic occlusion of the superior mesenteric artery (SMA). Materials and Methods Between January 2010 and December 2013, 9 patients with embolic occlusion of the SMA were treated by percutaneous aspiration embolectomy in 2 academic teaching hospitals. The aspiration embolectomy procedure was performed with the 6-Fr and 7-Fr guiding catheter. Thrombolysis was performed with urokinase using a multiple-sidehole infusion catheter. The clinical outcome was investigated retrospectively. Results Superior mesenteric artery occlusion was initially diagnosed by computed tomography (CT) in all patients, and all patients had no obvious evidence of bowel infarction on CT scan. Percutaneous aspiration embolectomy was primarily performed in 6 patients, and thrombolysis was initially performed in 3 patients. In 3 patients who received primary thrombolysis, percutaneous aspiration was undertaken because the emboli were resistant to urokinase. Complete angiographic success was achieved in 6 patients and partial angiographic success was accomplished in 3 patients. One patient underwent bowel resection. One patient died of whole bowel necrosis and sepsis, and 8 patients survived without complications. Conclusion Percutaneous aspiration embolectomy is a useful tool in recanalization of embolic occlusion of the SMA in select patients. PMID:26175572

  3. HER2 expression in fine needle aspirates of lymph nodes detected by preoperative axillary ultrasound in breast cancer patients.

    Directory of Open Access Journals (Sweden)

    Ji Soo Choi

    Full Text Available The purpose of this study was to assess the usefulness of HER2 levels in ultrasonographically guided fine-needle aspiration biopsy (US-FNA aspirates of axillary lymph nodes (ALNs in the determination of lymph node metastasis or the characterization of primary breast cancer, and to correlate the HER2 levels in US-FNA aspirates (FNA-HER2s of metastatic ALNs with the HER2 statuses of corresponding primary breast cancers. An institutional review board approved the study. Between January and October 2010, 164 patients with 167 ALNs examined by US-FNA were included. FNA-HER2s of ALNs were measured by chemiluminescence immunoassay, and they were correlated with cytologic/final diagnoses. Receiver operating characteristics (ROC curve analysis was performed to evaluate the diagnostic ability to differentiate benign and metastatic ALNs. Additionally, FNA-HER2s of metastatic ALNs were correlated with HER2 status and other clinicopathologic variables of the primary breast cancers. Among the 167 ALNs, 138 were metastatic and 29 were benign. The mean FNA-HER2 (6.3 ng/ml of metastatic ALNs was higher than that of benign ALNs. All 29 benign ALNs showed no measurable value of FNA-HER2 (0.0 ng/ml. The area under the ROC curves of FNA-HER2 of ALNs was 0.679 for the diagnosis of ALN metastasis. The FNA-HER2 statuses of 108 metastatic ALNs (79.4% were concordant with the HER2 statuses of the corresponding primary breast cancers. In a subgroup analysis of HER2-positive cancers with ALN metastasis, distant metastasis was significantly associated with FNA-HER2-negativity of metastatic ALNs (P = 0.04. Although FNA-HER2 of ALNs did not improve the diagnostic performance of FNA cytology in preoperative diagnosis of ALN metastasis of overall patients, FNA-HER2-positive metastatic ALNs were significantly associated with HER2-positivity of primary breast cancers. Additionally, FNA-HER2 analysis of ALN may help to develop more personalized treatment protocol for breast

  4. [Investigation of the presence of Mycobacterium tuberculosis in the lymph node aspirates of the suspected tularemia lymphadenitis cases].

    Science.gov (United States)

    Albayrak, Nurhan; Celebi, Bekir; Kavas, Semra; Simşek, Hülya; Kılıç, Selçuk; Sezen, Figen; Arslantürk, Ahmet

    2014-01-01

    Recently reports of cervical tuberculous lymphadenitis and oropharyngeal tularemia which are the most common infectious causes of granulomatous lymphadenitis, have been significantly increased in Turkey. The differentiation of cervical tuberculous lymphadenitis and oropharyngeal tularemia is usually confusing on the basis of clinical and histopathological findings. Thus, in tularemia endemic areas, the patients are more commonly evaluated in terms of tularemia lymphadenitis leaving tuberculosis out. The aim of this study was to investigate the presence of Mycobacterium tuberculosis in cervical lymph node aspirates, obtained from tularemia suspected cases. A total of 105 oropharyngeal tularemia-suspected cases which were found negative for Francisella tularensis by bacteriological (culture), molecular (PCR) and serological (microagglutination) methods, were included in the study. The samples had been previously studied at National Tularemia Reference Laboratory, Turkish Public Health Institution, between 2009-2011. The study samples were evaluated in terms of M.tuberculosis by culture and real-time PCR (rtPCR) methods in the National Tuberculosis Reference Laboratory. Both Lowenstein-Jensen (LJ) medium and liquid-based MGIT (BD, USA) automated culture system were used for mycobacterial culture. Samples that yielded mycobacterial growth were identified as M.tuberculosis by immunochromotographic test (BD, USA). The lymph node aspirates of 65 patients who were F.tularensis PCR negative but antibody positive, were used as the control group. As a result, M.tuberculosis was found to be positive in 9 (8.6%) of 105 tularemia-negative lymph node aspirates, sent to our laboratory from different geographic regions for the investigation of tularemia. Six of the M.tuberculosis positive cases were male and the age range of the patients was 26-85 years. The presence of M.tuberculosis was detected only by culture in two samples, only by rtPCR in five samples and both by culture and

  5. Meconium aspiration syndrome - the experience of a tertiary center

    Directory of Open Access Journals (Sweden)

    M.C. Espinheira

    2011-03-01

    Full Text Available Background: Approximately 5% of infants born with a meconium-stained amniotic fluid (MSAF develop meconium aspiration syndrome (MAS. Aim: The aims of this study were to analyse demographic data, morbidity and mortality associated with MAS and to identify possible risk factors. Methods: Retrospective chart review of newborns with MAS delivered at a tertiary center from January 1st, 1997 to December 31st, 2008. Results: MAS was responsible for 1.4% of all Neonatal Intensive Care Unit (NICU admissions, with a trend towards a decreasing incidence during the duration of the study, especially in the cases of thin meconium. Seventy two newborns were analysed during the study period: 55.6% (n = 40 were of the female gender, 62.5% were delivered by caesarean section, 93% had > 36 weeks of gestational age and 91.2% had a birth weight over 2500 g. Sixty-nine percent had an Apgar score 36 semanas e 91,2% com peso ao nascimento > 2500g. 69% dos recém-nascidos apresentaram Índice de Apgar < 7 no 1.° minuto e 23,6% Índice de Apgar < 7 no 5.° minuto; bradicardia fetal foi observada em 26,4% dos recém-nascidos e taquicardia em 1,4%. A presença de mecónio no líquido amniótico condicionou o desenvolvimento de hipóxia (58,3%, necessidade de ventilação mecânica (43,1%, acidose respiratória e/ou metabólica (30,6%, hipertensão pulmonar (11,1% e encefalopatia hipóxico-isquémica (29,2%. A taxa de mortalidade foi de 2,8%. A presença de mecónio espesso esteve associada a maiores taxas de morbilidade e mortalidade. Conclusão: O número de internamentos por SAM tem vindo a diminuir principalmente devido ao decréscimo das admissões por líquido amniótico tingido de mecónio, enquanto o número de casos de mecónio espesso tem permanecido constante ao longo dos anos. O Índice de Apgar < 7 no 1.° minuto e a presença de sinais de sofrimento fetal durante o trabalho de parto apresentaram relação com a SAM. A morbilidade associada à SAM permanece

  6. Thermal hydraulic performance of naturally aspirated control rod housing assemblies

    International Nuclear Information System (INIS)

    Geiger, G.T.; Randolph, H.W.; Paik, I.K.; Foti, D.J.

    1992-01-01

    Savannah River Site reactors are comprised of heat generating fuel/target assemblies, control rods which regulate reactor power, and heavy water which acts as the coolant and as a moderator. The fuel/target assemblies are cooled by the downflow of heavy water while the control rods are cooled via upflow. Five control rods are grouped with two safety rods in seven-channel assemblies called septifoils. Under normal operating conditions, the reactor power level, radial shape flux and axial power flux are regulated by the positioning of the control rods. The control rods are solid rods of a lithium-aluminum alloy with an thin aluminum outer sheath. Lithium is a good absorber of neutrons and, thus control rod temperatures rise with reactor power. At conditions of sufficiently high reactor power and degraded coolant flow, the control rods could heat sufficiently to cause a metallurigical failure of the sheath leading to molten material coming in contact with water and the possibility of a steam explosion. An accident has been postulated as part of the analysis involving the safety upgrade of Savannah River Site reactors in which the housing is not seated on the pin. Coolant from the upflow pin would not be directed into the housing but, into the moderator space surrounding the housing. Only naturally aspirated cooling due to buoyancy effects would be available to cool the control rods and the coolant mass flow rate would drop significantly from its nominal value. In this study, the mechanisms and limits of cooling heated rods housed in an unseated septifoil are addressed. Experiments were conducted on a shortened, prototypic housing with electrically heated rods to gain an understanding of the phenomena governing the cooling in such a case and develop data which can be used to evaluate predictive models. These experiments are described, their results discussed, and the predictions of current models is presented

  7. High frequency oscillatory ventilation in meconium aspiration syndrome

    Directory of Open Access Journals (Sweden)

    José Nona

    2009-03-01

    Full Text Available Objective: To evaluate and compare the management and associated morbidity in inborn and outborn babies with meconium aspiration syndrome admitted to the Neonatal Intensive Care Unit and ventilated with high frequency oscillatory ventilation. Methods: A retrospective cohort study with a review of clinical data from newborns, admitted to the Neonatal Intensive Care Unit during a six-year period (from 1999 to 2004 and ventilated with early high frequency oscillatory ventilation, first intention in inborns and immediately after Neonatal Intensive Care Unit arrival in outborns. Rresults: In the present study, 27 newborns were included: 12 inborn and 15 outborn infants. Severity criteria were similar in both groups. The pulmonary morbidity associated was severe persistent pulmonary hypertension - 12 (seven outborns, pneumothorax - five (three outborns, interstitial emphysema – two (one outborn and pulmonary hemorrhage – one outborn. Hypoxic-ischemic encephalopathy II-III occurred in six newborns (four outborns. The therapeutic procedures were surfactant administration in 22 newborns (13 outborns, nitric oxide in 12 newborns (7 outborns and magnesium sulphate in four newborns (three outborns. The median length of ventilation was six days (inborn infants: four and half days; outborn infants: ten days and the median length of oxygenation supply was ten days (inborn infants: four and half days; outborn infants: 15 days. The median length of stay was 13 days (inborn infants: 11 days; outborn infants: 16 days. One outborn infant died. Cconclusions: With this ventilation strategy, we have found no significant statistical differences between the two newborn groups, except for the length of oxygenation supply that was longer in the Outborn Group.

  8. Meconium aspiration syndrome - the experience of a tertiary center.

    Science.gov (United States)

    Espinheira, M C; Grilo, M; Rocha, G; Guedes, B; Guimarães, H

    2011-01-01

    Approximately 5 % of infants born with a meconium-stained amniotic fluid (MSAF) develop meconium aspiration syndrome (MAS). The aims of this study were to analyse demographic data, morbidity and mortality associated with MAS and to identify possible risk factors. Retrospective chart review of newborns with MAS delivered at a tertiary centre from January 1st, 1997 to December 31st, 2008. MAS was responsible for 1.4 % of all Neonatal Intensive Care Unit (NICU) admissions, with a trend towards a decreasing incidence during the study duration, especially in the cases of thin meconium. Seventy two newborns were analysed during the study period: 55.6 % (n = 40) were of the female gender, 62.5 % were delivered by caesarean section, 93 % had > 36 weeks of gestational age and 91.2 % had a birth weight over 2500g. Sixty-nine percent had an Apgar score meconium was associated with severe asphyxia and carried a bad prognosis with an increased risk of developing hypoxia (58.3 %), need of mechanical ventilatory support (43.1 %), respiratory and/or metabolic acidosis (30.6 %), pulmonary hypertension (11.1 %) and hypoxic ischemic encephalopathy (29.2 %). The mortality rate was 2.8 %. Thick meconium was associated with higher morbidity and mortality rates. The number of admissions for MAS has been decreasing mostly because of a lower admission rate due to thin meconium; the number of cases with thick meconium has remained constant throughout the years. An Apgar score < 7 at 1 minute and signs of foetal distress during labour were associated with MAS. The MAS related morbidity remains significant.

  9. Single Center Experience with the AngioVac Aspiration System

    Energy Technology Data Exchange (ETDEWEB)

    Salsamendi, Jason, E-mail: jsalsamendi@med.miami.edu; Doshi, Mehul, E-mail: mdoshi@med.miami.edu; Bhatia, Shivank, E-mail: sbhatia1@med.miami.edu [University of Miami Miller School of Medicine/Jackson Memorial Hospital, Department of Vascular and Interventional Radiology (United States); Bordegaray, Matthew, E-mail: matthewbordegaray@gmail.com [University of Miami Miller School of Medicine/Jackson Memorial Hospital, Department Radiology (United States); Arya, Rahul, E-mail: rahul.arya@jhsmiami.org [University of Miami Miller School of Medicine/Jackson Memorial Hospital, Department of Vascular and Interventional Radiology (United States); Morton, Connor, E-mail: cmorton@med.miami.edu [University of Miami Miller School of Medicine (United States); Narayanan, Govindarajan, E-mail: gnarayanan@med.miami.edu [University of Miami Miller School of Medicine/Jackson Memorial Hospital, Department of Vascular and Interventional Radiology (United States)

    2015-08-15

    PurposeThe AngioVac catheter system is a mechanical suction device designed for removal of intravascular material using extracorporeal veno-venous bypass circuit. The purpose of this study is to present the outcomes in patients treated with the AngioVac aspiration system and to discuss its efficacy in different vascular beds.Materials and MethodsA retrospectively review was performed of seven patients treated with AngioVac between October 2013 and December 2014. In 6/7 cases, the AngioVac cannula was inserted percutaneously and the patient was placed on veno-venous bypass. In one of the cases, the cannula was inserted directly into the Fontan circuit after sternotomy and the patient was maintained on cardiopulmonary bypass. Thrombus location included iliocaval (2), SVC (1), pulmonary arteries (1), Fontan circuit and Glenn shunt with pulmonary artery extension (1), right atrium (1), and IVC with renal vein extension (1).ResultsThe majority of thrombus (50–95 %) was removed in 5/7 cases, and partial thrombus removal (<50 %) was confirmed in 2/7 cases. Mean follow-up was 205 days (range 64–403 days). All patients were alive at latest follow-up. Minor complications included three neck hematomas in two total patients. No major complications occurred.ConclusionAngioVac is a useful tool for acute thrombus removal in the large vessels. The setup and substantial cost may limit its application in straightforward cases. More studies are needed to establish the utility of AngioVac in treatment of intravascular and intracardiac material.

  10. Fluoroscopy- vs ultrasound-guided aspiration techniques in the management of periprosthetic joint infection: which is the best?

    Science.gov (United States)

    Randelli, Filippo; Brioschi, Marco; Randelli, Pietro; Ambrogi, Federico; Sdao, Silvana; Aliprandi, Alberto

    2018-01-01

    Fluid samples obtained from an affected joint still play a central role in the diagnosis of periprosthetic joint infection (PJI). It is the only preoperative test able to discover the causative microbiological agent. In the hip, fluid aspiration can be performed through fluoroscopy, ultrasound, or, less commonly, computed tomography. However, there is still a lack of consensus on which method is preferable in terms of efficacy and costbenefit. We, therefore, asked whether (1) the benefits in terms of sensitivity and specificity and (2) the costs were comparable between fluoroscopy- and ultrasound-guided joint aspirations in a suspicious of hip PJI. Between 2013 and 2016, 52 hip aspirations were performed on 49 patients with clinical, radiological, or serological suspicion of PJI, waiting for a revision surgery. The patients were divided in two groups: fluoroscopy- (n = 26) vs ultrasound-guided hip aspiration group (n = 26). These groups were also divided in control and infected patients. The criteria of MusculoSkeletal Infection Society (MSIS) were used, as gold standard, to define PJI. (1) Ultrasound-guided aspiration revealed valid sensitivity (89% vs 60%) and specificity (94% vs 81%) in comparison with fluoroscopic-guided aspiration. (2) The cost analysis was also in favor of ultrasound-guided aspiration (125.30€) than fluoroscopic-guided aspiration (343.58€). We concluded that ultrasound-guided hip aspiration could represent a valid, safe, and less expensive diagnostic alternative to fluoroscopic-guided aspiration in hip PJI.

  11. Differential belongings

    DEFF Research Database (Denmark)

    Oldrup, Helene

    2014-01-01

    This paper explores suburban middle-class residents’ narratives about housing choice, everyday life and belonging in residential areas of Greater Copenhagen, Denmark, to understand how residential processes of social differentiation are constituted. Using Savage et al.’s concepts of discursive...

  12. Big Fish in Little Ponds Aspire More: Mediation and Cross-Cultural Generalizability of School-Average Ability Effects on Self-Concept and Career Aspirations in Science

    Science.gov (United States)

    Nagengast, Benjamin; Marsh, Herbert W.

    2012-01-01

    Being schooled with other high-achieving peers has a detrimental influence on students' self-perceptions: School-average and class-average achievement have a negative effect on academic self-concept and career aspirations--the big-fish-little-pond effect. Individual achievement, on the other hand, predicts academic self-concept and career…

  13. Intratracheal catheter suction removes the same volume of meconium with less impact on desaturation compared with meconium aspirator in meconium aspiration syndrome.

    Science.gov (United States)

    Akazawa, Yohei; Ishida, Takefumi; Baba, Atsushi; Hiroma, Takehiko; Nakamura, Tomohiko

    2010-08-01

    To evaluate the impact of suction technique on the rate of meconium removal, oxygenation, and hemodynamics in an animal experimental model of meconium aspiration syndrome (MAS). MAS was induced in ventilated rabbits using 3.5 ml/kg of 20% human meconium. Tracheal suction with either catheter suction (CS) or meconium aspirator (MA) was performed after meconium instillation. Percentage of meconium collection rate, PaO(2) trends for 2h after tracheal suction, and acute-phase SpO(2) trends were compared between CS and the other three groups, the tube was withdrawn while meconium was aspirated with an MA, then the trachea was reintubated 5, 10 or 15s after suctioning of meconium. Percentage of meconium collection rate and PaO(2) showed no significant differences between groups. The MA group taking 15s for reintubation after meconium suctioning, showed a significantly lower acute-phase SpO(2) than the CS group (Por=90% was also longer in the MA group taking 15s for reintubation than in the CS group (Pmeconium with less impact on desaturation compared with meconium aspiration in an animal model of MAS. Intratracheal CS may be benefit to remove meconium in non-vigorous infants with meconium-stained amniotic fluid at birth. Copyright 2010 Elsevier Ltd. All rights reserved.

  14. Fine needle aspiration cytology of chondroblastoma of the fibula

    Directory of Open Access Journals (Sweden)

    Kamal Malukani

    2014-01-01

    Full Text Available Chondroblastoma is a rare benign cartilaginous tumor typically seen in long bones, especially femur, tibia and proximal humerus. Extracortical soft tissue invasion or metastasis is rarely seen. We report here a unique case of chondroblastoma of the fibula with extracortical soft tissue invasion. Differential diagnosis on cytology is discussed.

  15. Fine-needle aspiration cytology of malignant nerve sheath tumors.

    Science.gov (United States)

    Vendraminelli, R; Cavazzana, A O; Poletti, A; Galligioni, A; Pennelli, N

    1992-01-01

    Precise preoperative diagnosis of three malignant nerve sheath tumors (MNST) was based on their remarkably uniform and highly characteristic cytologic appearance. The differential diagnosis with benign nerve sheath tumors and other spindle cell sarcomas is addressed, and the possibility of achieving confident diagnosis on cytologic material from at least some soft-tissue sarcomas is confirmed.

  16. The Ability of the Eating Assessment Tool-10 to Detect Aspiration in Patients With Neurological Disorders.

    Science.gov (United States)

    Arslan, Selen Serel; Demir, Numan; Kılınç, Hasan E; Karaduman, Aynur A

    2017-10-30

    Dysphagia is common in patients with neurological disorders. There is a need to identify patients at risk early by a useful clinical tool to prevent its serious complications. The study aims to determine the ability of the Turkish version of Eating Assessment Tool-10 (T-EAT-10) to detect aspiration in patients with neurological disorders. Two hundred fifty-nine patients with neurological disorders who had complaints about swallowing difficulty and referred for a swallowing evaluation were included. Oropharyngeal dysphagia was evaluated with the T-EAT-10 and videofluoroscopic swallowing study in the same day. The penetration-aspiration scale (PAS) was used to document the penetration and aspiration severity. The mean age of the patients was 59.72 ± 17.24 years (minimum [min] = 18, maximum [max] = 96), of which 57.1% were male. The mean T-EAT-10 of patients who had aspiration (PAS > 5) was 25.91 ± 10.31 (min = 1, max = 40) and the mean T-EAT-10 of patients who did not have aspiration (PAS EAT-10 score higher than 15 were 2.4 times more likely to aspirate. A linear correlation was found between T-EAT-10 and PAS scores of the patients ( r = 0.416, P EAT-10 higher than 15 in detecting aspiration was 81.0% and the specificity was 58.0%. A T-EAT-10 score of higher than 15 has a positive predictive value of 72.0% and a negative predictive value of 69.0%. The T-EAT-10 can be used to detect unsafe airway protection in neurology clinics to identify and refer dysphagic patients for further evaluation.

  17. Residue influences quality of life independently of penetration and aspiration in head and neck cancer survivors.

    Science.gov (United States)

    Meyer, Tanya K; Pisegna, Jessica M; Krisciunas, Gintas P; Pauloski, Barbara R; Langmore, Susan E

    2017-07-01

    Dysphagia is one of the most significant side effects of the treatment of head and neck cancer. Residue and aspiration are two indicators of dysphagia, but aspiration is historically the only indicator of interest, because it may impact health outcomes. Clinicians have anecdotally used residue as another marker of swallowing dysfunction, but it is understudied. This project investigated the impact of aspiration versus residue on function and quality of life (QoL) in these patients. Observational study. A total of 168 head and neck cancer survivors with moderate to severe dysphagia were enrolled in a randomized clinical trial comparing two swallow therapy interventions. Data at time of entry were used for the current study. A modified barium swallow study was done to compute Penetration-Aspiration Scale (PAS) scores, percentage oral residue, and percentage pharyngeal residue with three bolus consistencies (5 mL thin, nectar, and pudding). The Performance Status Scale (PSS) and the Head Neck Cancer Inventory (HNCI) questionnaires were administered. Data were analyzed to determine associations between aspiration and residue estimates with function and QoL scores. Worsening aspiration and residue estimates were all correlated with decreased scores on the PSS functional scales (r = -0.190 to -0.324, P ≤ .031). However, only increasing residue estimates were significantly related to decreased patient-perceived QoL on the HNCI (r = -.178 to -.194, P < .046). This effect was more pronounced with oral versus pharyngeal residue. In this group of head and neck cancer survivors, penetration/aspiration and residue show independent effects. PAS affects functional status only, but residue affects both functional status and QoL. This study supports that residue should be considered a primary measurement of swallowing function and be a target for identification, treatment, and evaluation of swallowing. 2c. Laryngoscope, 127:1615-1621, 2017. © 2016 The American Laryngological

  18. The Ability of the Eating Assessment Tool-10 to Detect Aspiration in Patients With Neurological Disorders

    Science.gov (United States)

    Arslan, Selen Serel; Demir, Numan; Kılınç, Hasan E; Karaduman, Aynur A

    2017-01-01

    Background/Aims Dysphagia is common in patients with neurological disorders. There is a need to identify patients at risk early by a useful clinical tool to prevent its serious complications. The study aims to determine the ability of the Turkish version of Eating Assessment Tool-10 (T-EAT-10) to detect aspiration in patients with neurological disorders. Methods Two hundred fifty-nine patients with neurological disorders who had complaints about swallowing difficulty and referred for a swallowing evaluation were included. Oropharyngeal dysphagia was evaluated with the T-EAT-10 and videofluoroscopic swallowing study in the same day. The penetration-aspiration scale (PAS) was used to document the penetration and aspiration severity. Results The mean age of the patients was 59.72 ± 17.24 years (minimum [min] = 18, maximum [max] = 96), of which 57.1% were male. The mean T-EAT-10 of patients who had aspiration (PAS > 5) was 25.91 ± 10.31 (min = 1, max = 40) and the mean T-EAT-10 of patients who did not have aspiration (PAS < 6) was 15.70 ± 10.54 (min = 0, max = 40) (P < 0.001). Patients with a T-EAT-10 score higher than 15 were 2.4 times more likely to aspirate. A linear correlation was found between T-EAT-10 and PAS scores of the patients (r = 0.416, P < 0.001). The sensitivity of a T-EAT-10 higher than 15 in detecting aspiration was 81.0% and the specificity was 58.0%. A T-EAT-10 score of higher than 15 has a positive predictive value of 72.0% and a negative predictive value of 69.0%. Conclusion The T-EAT-10 can be used to detect unsafe airway protection in neurology clinics to identify and refer dysphagic patients for further evaluation. PMID:28545185

  19. Massive aspiration past the tracheal tube cuff caused by closed tracheal suction system.

    Science.gov (United States)

    Dave, Mital H; Frotzler, Angela; Madjdpour, Caveh; Koepfer, Nelly; Weiss, Markus

    2011-01-01

    Aspiration past the tracheal tube cuff has been recognized to be a risk factor for the development of ventilator-associated pneumonia (VAP). This study investigated the effect of closed tracheal suctioning on aspiration of fluid past the tracheal tube cuff in an in vitro benchtop model. High-volume low pressure tube cuffs of 7.5 mm internal diameter (ID) were placed in a 22 mm ID artificial trachea connected to a test lung. Positive pressure ventilation (PPV) with 15 cm H₂O peak inspiratory pressure and 5 cm H₂O positive end-expiratory pressure (PEEP) was used. A closed tracheal suction system (CTSS) catheter (size 14Fr) was attached to the tracheal tube and suction was performed for 5, 10, 15, or 20 seconds under 200 or 300 cm H₂O suction pressures. Amount of fluid (mL) aspirated along the tube cuff and the airway pressure changes were recorded for each suction procedure. Fluid aspiration during different suction conditions was compared using Kruskal-Wallis and Mann-Whitney test (Bonferroni correction [α = .01]). During 10, 15, and 20 seconds suction, airway pressure consistently dropped down to -8 to -13 cm H₂O (P aspiration was never observed under PPV + PEEP but occurred always during suctioning. Aspiration along the tube cuff was higher with -300 cm H₂O than with -200 cm H₂O suction pressure (P aspiration of fluid occurs along the tracheal tube cuff during suction with the closed tracheal suction system. © SAGE Publications 2011.

  20. Aspiration in injections: should we continue or abandon the practice? [version 3; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Yasir Sepah

    2017-03-01

    Full Text Available Aspiration during any kind of injection is meant to ensure that the needle tip is at the desired location during this blind procedure. While aspiration appears to be a simple procedure, it has generated a lot of controversy concerning the perceived benefits and indications. Advocates and opponents of aspiration both make logically sound claims. However, due to scarcity of available data, there is no evidence that this procedure is truly beneficial or unwarranted. Keeping in view the huge number of injections given worldwide, it is important that we draw attention to key questions regarding aspiration that, up till now, remain unanswered. In this review, we have attempted to gather and present literature on aspiration both from published and non-published sources in order to provide not only an exhaustive review of the subject, but also a starting point for further studies on more specific areas requiring clarification. A literature review was conducted using the US National Institute of Health’s PubMed service (including Medline, Google Scholar and Scopus. Guidelines provided by the World Health Organization, Safe Injection Global Network, International Council of Nursing, Center for Disease Control, US Federal Drug Agency, UK National Health Services, British Medical Association, Europe Nursing and Midwifery Council, Public Health Agency Canada, Pakistan Medical Association and International Organization of Standardization recommendations 7886 parts 1-4 for sterile hypodermics were reviewed for relevant information. In addition, curricula of several medical/nursing schools from India, Nigeria and Pakistan, the US pharmacopeia Data from the WHO Program for International Drug Monitoring network in regard to adverse events as a result of not aspirating prior to injection delivery were reviewed. Curricula of selected major medical/nursing schools in India, Nigeria and Pakistan, national therapeutic formularies, product inserts of most commonly

  1. Differential discriminator

    International Nuclear Information System (INIS)

    Dukhanov, V.I.; Mazurov, I.B.

    1981-01-01

    A principal flowsheet of a differential discriminator intended for operation in a spectrometric circuit with statistical time distribution of pulses is described. The differential discriminator includes four integrated discriminators and a channel of piled-up signal rejection. The presence of the rejection channel enables the discriminator to operate effectively at loads of 14x10 3 pulse/s. The temperature instability of the discrimination thresholds equals 250 μV/ 0 C. The discrimination level changes within 0.1-5 V, the level shift constitutes 0.5% for the filling ratio of 1:10. The rejection coefficient is not less than 90%. Alpha spectrum of the 228 Th source is presented to evaluate the discriminator operation with the rejector. The rejector provides 50 ns time resolution

  2. Differential topology

    CERN Document Server

    Margalef-Roig, J

    1992-01-01

    ...there are reasons enough to warrant a coherent treatment of the main body of differential topology in the realm of Banach manifolds, which is at the same time correct and complete. This book fills the gap: whenever possible the manifolds treated are Banach manifolds with corners. Corners add to the complications and the authors have carefully fathomed the validity of all main results at corners. Even in finite dimensions some results at corners are more complete and better thought out here than elsewhere in the literature. The proofs are correct and with all details. I see this book as a reliable monograph of a well-defined subject; the possibility to fall back to it adds to the feeling of security when climbing in the more dangerous realms of infinite dimensional differential geometry. Peter W. Michor

  3. Hepatocyte differentiation.

    Science.gov (United States)

    Olsavsky Goyak, Katy M; Laurenzana, Elizabeth M; Omiecinski, Curtis J

    2010-01-01

    Increasingly, research suggests that for certain systems, animal models are insufficient for human toxicology testing. The development of robust, in vitro models of human toxicity is required to decrease our dependence on potentially misleading in vivo animal studies. A critical development in human toxicology testing is the use of human primary hepatocytes to model processes that occur in the intact liver. However, in order to serve as an appropriate model, primary hepatocytes must be maintained in such a way that they persist in their differentiated state. While many hepatocyte culture methods exist, the two-dimensional collagen "sandwich" system combined with a serum-free medium, supplemented with physiological glucocorticoid concentrations, appears to robustly maintain hepatocyte character. Studies in rat and human hepatocytes have shown that when cultured under these conditions, hepatocytes maintain many markers of differentiation including morphology, expression of plasma proteins, hepatic nuclear factors, phase I and II metabolic enzymes. Functionally, these culture conditions also preserve hepatic stress response pathways, such as the SAPK and MAPK pathways, as well as prototypical xenobiotic induction responses. This chapter will briefly review culture methodologies but will primarily focus on hallmark hepatocyte structural, expression and functional markers that characterize the differentiation status of the hepatocyte.

  4. Radiography of the equine thorax and its differential diagnosis relevance

    International Nuclear Information System (INIS)

    Klein, H.J.; Offeney, F.

    1990-01-01

    Commonly chronic obstructive pulmonary disease (COPD) is the cause of dyspnoe or loss of performance in the horse. Tracheobronchoscopy, cytology of tracheobronchial aspirates, interpleural pressure measurement, and arterial blood gas analysis improved diagnosis of equine respiratory disorders. Yet some intrathoraeie diseases, especially chronic pneumonia, are differential diagnosis problems. Radiography of the thorax improves the diagnosis of pneumonia and some other intrathoraeie diseases. The technique of the radiography of the thorax is described and radiographic findings in 166 horses suffering from respiratory diseases are evaluated. Theses horses showed pathologic radiographic findings caused by COPD (n =61), pneumonia (67), pleuritis (12), exercise-induced pulmonary haemorrhage (8), aspiration pneumonia (7), hydrothorax (6), pneumothorax (2), lung abseess (1); mediastinal tumor (1), and diaphragmatie hernia (1) [de

  5. Aspirations, education and inequality in England: insights from the Effective Provision of Pre-school, Primary and Secondary Education Project

    OpenAIRE

    Baker, William; Sammons, Pam; Siraj, Iram; Sylva, Kathy; Melhuish, Edward; Taggart, Brenda

    2014-01-01

    Educational and occupational aspirations have become an important reference point in policy debates about educational inequality. Low aspirations are presented as a major barrier to closing educational attainment gaps and increasing levels of social mobility. Our paper contributes to this on-going debate by presenting data on the educational aspirations of students from the Effective Provision of Pre-School, Primary and Secondary Education Project in England. We analyse factors that help pred...

  6. The Functional Dysphagia Scale Is a Useful Tool for Predicting Aspiration Pneumonia in Patients With Parkinson Disease.

    Science.gov (United States)

    Lee, Jong Hwa; Lee, Kyeong Woo; Kim, Sang Beom; Lee, Sook Joung; Chun, Sang Myung; Jung, Sung Moon

    2016-06-01

    To describe the correlation between the functional dysphagia scale and aspiration pneumonia and which characteristics influence the occurrence of aspiration pneumonia in patients with idiopathic Parkinson disease. Fifty-three patients with idiopathic Parkinson disease were prospectively evaluated in this study. Disease severity and functional status were measured by modified Hoehn and Yahr (H&Y) staging, Schwab and England activities of daily living (S-E ADL) scale and Korean version of Mini-Mental State Examination (K-MMSE). Swallowing function was evaluated by the functional dysphagia scale (FDS) and the penetration-aspiration scale (PAS) based on a videofluoroscopic swallowing study. The patients were followed up for 3 months and divided into two groups according to the occurrence of aspiration pneumonia. The correlation between the variables and aspiration pneumonia was analyzed. Eight patients of the 53 patients were allocated to the aspiration pneumonia group and 45 patients to the non-aspiration pneumonia group. The patients in the aspiration pneumonia group had significantly higher H&Y staging, and scored lower on S-E ADL scale and K-MMSE. The patients in the aspiration pneumonia group had significantly higher scores on FDS and PAS. A multiple logistic regression analysis showed that the S-E ADL scale and the FDS were associated with the occurrence of aspiration pneumonia in the patients with Parkinson disease. Given that the FDS can quantitatively assess the functional problems associated with dysphagia, it can be clinically effective in predicting the occurrence of aspiration pneumonia, and the FDS and the S-E ADL scale could be predictive variables for aspiration pneumonia in patients with Parkinson disease.

  7. A radial basis classifier for the automatic detection of aspiration in children with dysphagia

    Science.gov (United States)

    Lee, Joon; Blain, Stefanie; Casas, Mike; Kenny, Dave; Berall, Glenn; Chau, Tom

    2006-01-01

    Background Silent aspiration or the inhalation of foodstuffs without overt physiological signs presents a serious health issue for children with dysphagia. To date, there are no reliable means of detecting aspiration in the home or community. An assistive technology that performs in these environments could inform caregivers of adverse events and potentially reduce the morbidity and anxiety of the feeding experience for the child and caregiver, respectively. This paper proposes a classifier for automatic classification of aspiration and swallow vibration signals non-invasively recorded on the neck of children with dysphagia. Methods Vibration signals associated with safe swallows and aspirations, both identified via videofluoroscopy, were collected from over 100 children with neurologically-based dysphagia using a single-axis accelerometer. Five potentially discriminatory mathematical features were extracted from the accelerometry signals. All possible combinations of the five features were investigated in the design of radial basis function classifiers. Performance of different classifiers was compared and the best feature sets were identified. Results Optimal feature combinations for two, three and four features resulted in statistically comparable adjusted accuracies with a radial basis classifier. In particular, the feature pairing of dispersion ratio and normality achieved an adjusted accuracy of 79.8 ± 7.3%, a sensitivity of 79.4 ± 11.7% and specificity of 80.3 ± 12.8% for aspiration detection. Addition of a third feature, namely energy, increased adjusted accuracy to 81.3 ± 8.5% but the change was not statistically significant. A closer look at normality and dispersion ratio features suggest leptokurticity and the frequency and magnitude of atypical values as distinguishing characteristics between swallows and aspirations. The achieved accuracies are 30% higher than those reported for bedside cervical auscultation. Conclusion The proposed aspiration

  8. A radial basis classifier for the automatic detection of aspiration in children with dysphagia

    Directory of Open Access Journals (Sweden)

    Blain Stefanie

    2006-07-01

    Full Text Available Abstract Background Silent aspiration or the inhalation of foodstuffs without overt physiological signs presents a serious health issue for children with dysphagia. To date, there are no reliable means of detecting aspiration in the home or community. An assistive technology that performs in these environments could inform caregivers of adverse events and potentially reduce the morbidity and anxiety of the feeding experience for the child and caregiver, respectively. This paper proposes a classifier for automatic classification of aspiration and swallow vibration signals non-invasively recorded on the neck of children with dysphagia. Methods Vibration signals associated with safe swallows and aspirations, both identified via videofluoroscopy, were collected from over 100 children with neurologically-based dysphagia using a single-axis accelerometer. Five potentially discriminatory mathematical features were extracted from the accelerometry signals. All possible combinations of the five features were investigated in the design of radial basis function classifiers. Performance of different classifiers was compared and the best feature sets were identified. Results Optimal feature combinations for two, three and four features resulted in statistically comparable adjusted accuracies with a radial basis classifier. In particular, the feature pairing of dispersion ratio and normality achieved an adjusted accuracy of 79.8 ± 7.3%, a sensitivity of 79.4 ± 11.7% and specificity of 80.3 ± 12.8% for aspiration detection. Addition of a third feature, namely energy, increased adjusted accuracy to 81.3 ± 8.5% but the change was not statistically significant. A closer look at normality and dispersion ratio features suggest leptokurticity and the frequency and magnitude of atypical values as distinguishing characteristics between swallows and aspirations. The achieved accuracies are 30% higher than those reported for bedside cervical auscultation. Conclusion

  9. Endobronchial ultrasound–guided transbronchial needle aspiration in the staging of lung cancer patients

    Directory of Open Access Journals (Sweden)

    Dariusz Dziedzic

    2015-10-01

    Full Text Available Objective: Mediastinoscopy as diagnostic procedure for evaluation of mediastinum in patients with non-small-cell lung cancer has long been considered the reference standard. However, less invasive method has occurred. Endobronchial ultrasound–guided transbronchial needle aspiration came into widespread use and has resulted in controversy as to whether it is a good replacement for mediastinoscopy. We chose to demonstrate the usefulness of endobronchial ultrasound–guided transbronchial needle aspiration in evaluating the mediastinum in patients with non-small-cell lung cancer. Material and methods: Over a 48-month period, 1841 patients underwent endobronchial ultrasound–guided transbronchial needle aspiration at our healthcare centre. In all patients, 2964 biopsies from the lymph node group N2 and 783 from group N1 were taken. The mean short axis of the lymph nodes biopsied was 2.0 (range: 0.6–2.6. The mean number of lymph node stations biopsied per patient was 2.6. Patients with a negative result of endobronchial ultrasound–guided transbronchial needle aspiration underwent mediastinoscopy. All patients with a negative result in endobronchial ultrasound–guided transbronchial needle aspiration and mediastinoscopy underwent surgical resection with lymph node sampling. Results: The metastases to lymph nodes N2/N3 and N1 were found in 1111 (60.3% and 199 (9.3%, respectively. Mediastinoscopy was performed in 730 patients with a positive result in 83 (11.4% patients. In the group of operated patients, metastatic N1 disease was found in 264 (14.1%. In the group of the operated patients, mediastinal involvement of disease (N2 was found in 30 patients (4.5%. The sensitivity, negative predictive value and diagnostic accuracy for hilar lymph node staging for endobronchial ultrasound–guided transbronchial needle aspiration were 57%, 96% and 96%, respectively. The sensitivity, negative predictive value and diagnostic accuracy per patient for

  10. [Endoscopic ultrasound-guided fine needle aspiration cytology in the mediastinum].

    Science.gov (United States)

    Dubravcsik, Zsolt; Serényi, Péter; Madácsy, László; Szepes, Attila

    2013-03-03

    Endoscopic ultrasound and endoscopic ultrasound-guided fine needle aspiration in the posterior mediastinum is technically a relatively simple and safe procedure, and it can provide important information for the further management of patients. To analyze and compare the results of mediastinal endoscopic ultrasound-guided fine needle aspiration with the data available in the literature. The authors retrospectively analyzed their prospective database on mediastinal endoscopic ultrasound-guided fine needle aspiration of 49 patients referred to their endoscopy centre between 1 November 2009 and 1 November 2012. For the fine needle aspiration 22 and 25 G needles were used. Two to six needle passes were performed in each patient. All slides were prepared at the endoscopy unit and analyzed at the cytology laboratory. The authors performed mediastinal endoscopic ultrasound-guided fine needle aspiration for enlarged lymph nodes or suspected mediastinal malignancy in all but 4 patients (2 suspected oesophageal cancers, 1 suspected benign oesophageal stenosis with wall thickening and 1 cardia tumour, all with non-diagnostic endoscopic biopsies). Five patients were excluded from the analysis since fine needle aspiration was not performed in them. Benign lesions were suspected based on the endoscopic ultrasound morphology in 7, and malignant disease in 37 patients. In 3 cases samples obtained by biopsy were not informative for cytological analysis. Cytology confirmed all benign lesions and showed malignancy in 28 cases. Cytology failed to reveal malignancy in 6 patients, although it was suspected based upon endoscopic ultrasound finding. Furthermore, endoscopic ultrasound-guided fine needle aspiration provided the diagnosis in 15 of the 17 patients when bronchoscopy was non-diagnostic. The diagnostic accuracy of the EUS-FNA was the following: sensitivity 82%, specificity 100%, positive predictive value 1.0, negative predictive value 0.54. Only one infectious complication was

  11. Improved microscopical detection of acid-fast bacilli by the modified bleach method in lymphnode aspirates

    Directory of Open Access Journals (Sweden)

    Annam Vamseedhar

    2009-07-01

    Full Text Available Objectives: To improve the smear microscopy for detection of acid-fast bacilli (AFB in fine needle aspiration cytology (FNAC of lymph node using the bleach method and also to compare this with cytological diagnosis and the conventional Ziehl-Neelsen (ZN method. Study Design: In 99 consecutive patients with clinical suspicion of tuberculosis (TB presenting with lymphadenopathy, FNACs were performed. Smears from the aspirates were processed for routine cytology and the conventional ZN method. The remaining material in the needle hub and/or the syringe was used for the bleach method. The significance of the bleach method over the conventional ZN method and cytology was analyzed using the χ2 test. Results: Of 99 aspirates, 93 were studied and the remaining six were excluded from the study due to diagnosis of malignancy in 4.04% (4/6 and inadequate aspiration in 2.02% (2/6. Among the 93 aspirates, 33.33% (31/93 were positive for AFB on conventional ZN method, 41.94% (39/93 were indicative of TB on cytology and the smear positivity increased to 63.44% (59/93 on bleach method. Conclusion: The bleach method is simple, inexpensive and potent disinfectant, also limiting the risk of laboratory-acquired infections. The implementation of the bleach method clearly improves microscopic detection and can be a useful contribution to routine cytology.

  12. Foreign body aspiration and language spoken at home: 10-year review.

    Science.gov (United States)

    Choroomi, S; Curotta, J

    2011-07-01

    To review foreign body aspiration cases encountered over a 10-year period in a tertiary paediatric hospital, and to assess correlation between foreign body type and language spoken at home. Retrospective chart review of all children undergoing direct laryngobronchoscopy for foreign body aspiration over a 10-year period. Age, sex, foreign body type, complications, hospital stay and home language were analysed. At direct laryngobronchoscopy, 132 children had foreign body aspiration (male:female ratio 1.31:1; mean age 32 months (2.67 years)). Mean hospital stay was 2.0 days. Foreign bodies most commonly comprised food matter (53/132; 40.1 per cent), followed by non-food matter (44/132; 33.33 per cent), a negative endoscopy (11/132; 8.33 per cent) and unknown composition (24/132; 18.2 per cent). Most parents spoke English (92/132, 69.7 per cent; vs non-English-speaking 40/132, 30.3 per cent), but non-English-speaking patients had disproportionately more food foreign bodies, and significantly more nut aspirations (p = 0.0065). Results constitute level 2b evidence. Patients from non-English speaking backgrounds had a significantly higher incidence of food (particularly nut) aspiration. Awareness-raising and public education is needed in relevant communities to prevent certain foods, particularly nuts, being given to children too young to chew and swallow them adequately.

  13. Proper aspiration level promotes generous behavior in the spatial prisoner's dilemma game

    Science.gov (United States)

    Rong, Zhi-Hai; Zhao, Qian; Wu, Zhi-Xi; Zhou, Tao; Kong Tse, Chi

    2016-07-01

    Zero-determinant strategies, which can unilaterally define a linear relationship between two individuals' long-term payoff, have drawn much attention to comprehend the emergence of cooperation among individuals with repeated interactions. A subset of zero-determinant strategies, extortion strategy, can let an extortioner's surplus exceed her opponent's by a fixed percentage. On the other hand, the dual generosity strategy can ensure that a complier's payoff is never larger than her opponent's. In the framework of the prisoner's dilemma game driven by payoff aspiration, we investigate in this paper the evolution of generosity strategy, in competition with extortion and unconditional defection strategies. We show that extortioners act as a catalyst to induce more defectors to change to compliers. Such influence will enhance when extortioners become more greedy. At a low aspiration level where individuals are easy to be satisfied with their current payoffs, different strategies can coexist. With the increase of aspiration level, unsatisfied individuals are likely to turn to compliers and build long-term reciprocity with their neighbors. However, at a high aspiration level, individuals are difficult to be satisfied with their payoffs and may randomly change their behaviors. Thus proper aspiration level promotes the emergence of generous behavior in the spatial prisoner's dilemma game.

  14. Ranitidine and sodium citrate as prophylaxis against acid aspiration syndrome in obstetric patients undergoing caesarean section.

    Science.gov (United States)

    Lim, S K; Elegbe, E O

    1992-12-01

    The efficacy of a single oral dose of 0.3M of sodium citrate alone as a prophylaxis against acid aspiration syndrome in obstetric patients undergoing LSCS (elective and emergency) was compared with that of intravenous ranitidine. One group of patients was given 30 ml of 0.3M sodium citrate orally just before the induction of anaesthesia while the other group was given 50mg of ranitidine intravenously together with the 30ml of 0.3M sodium citrate. This was done for both the elective and the emergency groups of patients. There was no significant difference in the mean pH of the gastric aspirate obtained from those given sodium citrate alone and those given sodium citrate and ranitidine in either the elective or the emergency group. However, in the emergency group, those who were given sodium citrate alone tend to have a larger volume of gastric aspiration when compared with those given ranitidine together with the sodium citrate. There were significantly more patients with gastric aspirates of more than 25ml in the emergency group to which sodium citrate alone was given. It would appear that supplementing an intravenous dose of ranitidine with the oral dose of sodium citrate is useful in emergency LSCS as a prophylaxis against acid aspiration syndrome.

  15. Secondary Voice Restoration After Laryngotracheal Separation (LTS) for Dysphagia with Intractable Aspiration.

    Science.gov (United States)

    Bonte, Katrien; Huvenne, Wouter; De Loof, Marie; Deron, Philippe; Viaene, Annick; Duprez, Fréderic; Vermeersch, Hubert

    2015-12-01

    Intractable aspiration is a serious, often life-threatening condition due to its potential impact on pulmonary function. Aspiration requires therapeutic measures, starting with conservative management but often necessitating surgical treatment. The basic surgical principle is to separate the alimentary and respiratory tracts through a variety of procedures which, unfortunately, nearly all result in the loss of phonation, with the exception of total laryngectomy (TL) which includes the placement of an indwelling voice prosthesis. In this study, we present a modified laryngotracheal separation (LTS) technique that, we believe, offers multiple advantages compared to standard TL. After reviewing the medical records of 35 patients with intractable aspiration who have undergone LTS, we describe the surgical technique and present the postoperative result. In a second surgical procedure about two months following LTS, we aimed to achieve voice restoration by placement of an indwelling voice prosthesis. Intractable aspiration was successfully treated in all patients. Placement of an indwelling voice prosthesis during a second operation was successful in 15 patients, representing the largest reported cohort thus far. LTS is a reliable surgical technique to treat intractable aspiration, with restoration of oral intake, thereby improving the general condition and quality of life of these unfortunate patients. Furthermore, voice restoration can be achieved in selected patients, by placement of a voice prosthesis.

  16. Association between pathogens from tracheal aspirate and oral biofilm of patients on mechanical ventilation.

    Science.gov (United States)

    Souza, Luana Carneiro Diniz; Mota, Vanise Barros Rodrigues da; Carvalho, Alícia Valéria Dos Santos Zaranza de; Corrêa, Rita da Graça Carvalhal Frazão; Libério, Silvana Amado; Lopes, Fernanda Ferreira

    2017-06-05

    The aim of this study was to detect possible associations between respiratory pathogens from tracheal aspirate and oral biofilm samples in intubated patients in an intensive care unit (ICU), and to identify the most common respiratory pathogens in oral biofilm, particularly in patients that developed ventilator-associated pneumonia (VAP). Two oral biofilm samples were collected from the tongue of intubated patients (at admission and after 48 hours) and analyzed by culture with the Antibiotic Sensitivity Test. The results from the tongue biofilm samples were compared with the tracheal secretions samples. A total of 59.37% of patients exhibited the same species of pathogens in their tracheal aspirate and oral biofilm, of which 8 (42.1%) developed VAP, 10 (52.63%) did not develop pneumonia and one (5.26%) had aspiration pneumonia. There was a statistically significant association between presence of microorganisms in the tracheal and mouth samples for the following pathogens: Klebsiella pneumoniae, Candida albicans, Pseudomonas aeruginosa, Enterobacter gergoviae, Streptococcus spp and Serratia marcescens (p aspirates of intubated patients can be detected in their oral cavity, especially in those who developed VAP or aspiration pneumonia. Thus, the results indicate that an improved oral care in these patients could decrease ICU pneumonia rates.

  17. Association between pathogens from tracheal aspirate and oral biofilm of patients on mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Luana Carneiro Diniz SOUZA

    2017-06-01

    Full Text Available Abstract The aim of this study was to detect possible associations between respiratory pathogens from tracheal aspirate and oral biofilm samples in intubated patients in an intensive care unit (ICU, and to identify the most common respiratory pathogens in oral biofilm, particularly in patients that developed ventilator-associated pneumonia (VAP. Two oral biofilm samples were collected from the tongue of intubated patients (at admission and after 48 hours and analyzed by culture with the Antibiotic Sensitivity Test. The results from the tongue biofilm samples were compared with the tracheal secretions samples. A total of 59.37% of patients exhibited the same species of pathogens in their tracheal aspirate and oral biofilm, of which 8 (42.1% developed VAP, 10 (52.63% did not develop pneumonia and one (5.26% had aspiration pneumonia. There was a statistically significant association between presence of microorganisms in the tracheal and mouth samples for the following pathogens: Klebsiella pneumoniae, Candida albicans, Pseudomonas aeruginosa, Enterobacter gergoviae, Streptococcus spp and Serratia marcescens (p < 0.05. Pathogens that are present in tracheal aspirates of intubated patients can be detected in their oral cavity, especially in those who developed VAP or aspiration pneumonia. Thus, the results indicate that an improved oral care in these patients could decrease ICU pneumonia rates.

  18. Effect of Aspiration and Mean Gain on the Emergence of Cooperation in Unidirectional Pedestrian Flow

    International Nuclear Information System (INIS)

    Wang Zi-Yang; Zhao Hui; Ma Jian; Qin Yong; Jia Li-Min; Zhu Wei

    2013-01-01

    When more than one pedestrian want to move to the same site, conflicts appear and thus the involved pedestrians play a motion game. In order to describe the emergence of cooperation during the conflict resolving process, an evolutionary cellular automation model is established considering the effect of aspiration and mean gain. In each game, pedestrian may be gentle cooperator or aggressive defector. We propose a set of win-stay-lose-shrift (WSLS) like rules for updating pedestrian's strategy. These rules prescribe that if the mean gain of current strategy between some given steps is larger than aspiration the strategy keeps, otherwise the strategy changes. The simulation results show that a high level aspiration will lead to more cooperation. With the increment of the statistic length, pedestrians will be more rational in decision making. It is also found that when the aspiration level is small enough and the statistic length is large enough all the pedestrian will turn to defectors. We use the prisoner's dilemma model to explain it. At last we discuss the effect of aspiration on fundamental diagram. (interdisciplinary physics and related areas of science and technology)

  19. Towards the ASEAN Community: Assessing the Knowledge, Attitudes, and Aspirations of Thai University Students

    Directory of Open Access Journals (Sweden)

    Pinn Siraprapasiri

    2016-01-01

    Full Text Available This article assesses the knowledge of, attitudes towards, and aspirations for ASEAN among Thai university students, who are set to enter the ASEAN Community labour market and are among those most in touch with ASEAN issues. It uses data obtained from a countrywide survey and focus group discussions to identify variables that affect knowledge, attitudes, and aspirations and to explore the relationships between knowledge, attitudes, and aspirations. The quantitative analysis conducted here uses students’ fields of study, academic performance, and exposure to both ASEAN-related courses and also information and discussions about ASEAN in the mass media and public forums as predictors of their level of knowledge about ASEAN. The paper’s results confirm that positive attitudes towards ASEAN lead to positive aspirations for ASEAN. They also reveal that significant knowledge about ASEAN cannot, in isolation, adequately explain students’ attitudes towards ASEAN and does not always lead to positive attitudes. These findings and those obtained from the focus group discussions suggest that a high level of knowledge and understanding of fellow ASEAN member countries and their people – whether attained through formal or informal education or social interaction – is needed for students to develop positive attitudes and become aspiring members of the ASEAN Community.

  20. What differentiates a differential psychopharmacology?

    OpenAIRE

    Krüger, Hans-Peter

    2010-01-01

    The methodological implications of a differential psychopharmacology are discussed. It is shown that the technique of stratifying subjects with personality scores depends on one basic assumption: the personality score is not affected by the other experimental factors. Two experiments are reported in which pre- and posttest (after the experiment) scores were measured. The pre-post-differences showed themselves to be affected by the medication. It is argued that in psychopharmacological experim...

  1. Differential geometry

    CERN Document Server

    Ciarlet, Philippe G

    2007-01-01

    This book gives the basic notions of differential geometry, such as the metric tensor, the Riemann curvature tensor, the fundamental forms of a surface, covariant derivatives, and the fundamental theorem of surface theory in a selfcontained and accessible manner. Although the field is often considered a classical one, it has recently been rejuvenated, thanks to the manifold applications where it plays an essential role. The book presents some important applications to shells, such as the theory of linearly and nonlinearly elastic shells, the implementation of numerical methods for shells, and

  2. Differential equations

    CERN Document Server

    Tricomi, FG

    2013-01-01

    Based on his extensive experience as an educator, F. G. Tricomi wrote this practical and concise teaching text to offer a clear idea of the problems and methods of the theory of differential equations. The treatment is geared toward advanced undergraduates and graduate students and addresses only questions that can be resolved with rigor and simplicity.Starting with a consideration of the existence and uniqueness theorem, the text advances to the behavior of the characteristics of a first-order equation, boundary problems for second-order linear equations, asymptotic methods, and diff

  3. Differential topology

    CERN Document Server

    Guillemin, Victor

    2010-01-01

    Differential Topology provides an elementary and intuitive introduction to the study of smooth manifolds. In the years since its first publication, Guillemin and Pollack's book has become a standard text on the subject. It is a jewel of mathematical exposition, judiciously picking exactly the right mixture of detail and generality to display the richness within. The text is mostly self-contained, requiring only undergraduate analysis and linear algebra. By relying on a unifying idea-transversality-the authors are able to avoid the use of big machinery or ad hoc techniques to establish the main

  4. Fine-needle aspirate cytology suggesting hepatic lipidosis in four cats with infiltrative hepatic disease.

    Science.gov (United States)

    Willard, M D; Weeks, B R; Johnson, M

    1999-12-01

    Four cats are reported in which cytology smears obtained by ultrasound-guided fine needle aspiration of the liver were interpreted as indicative of hepatic lipidosis. However, histopathology of hepatic tissue samples obtained with Tru-Cut-like needles or wedge biopsy revealed that the cats had inflammatory or neoplastic hepatic disease causing their clinical signs. Fine needle aspiration and cytology may not detect infiltrative lesions, particularly those that are nodular, multifocal, or localised around the portal regions. Fine needle aspirate cytology is a useful diagnostic procedure with many advantages, but care must be taken to avoid diagnosing hepatic lipidosis as the cause of illness when an infiltrative lesion is responsible. Copyright 1999 European Society of Feline Medicine.

  5. [Quality assurance of fine-needle aspiration cytology of the organized mammography screening].

    Science.gov (United States)

    Bak, Mihály; Konyár, Eva; Schneider, Ferenc; Bidlek, Mária; Szabó, Eva; Nyári, Tibor; Godény, Mária; Kásler, Miklós

    2010-08-08

    The National Public Health Program has established the organized mammography screening in Hungary. The aim of our study was to determine the quality assurance of breast aspiration cytology. Cytology results were rated to 5 categories (C1, C2, C3, C4 and C5). All cytology reports were compared with the final histology diagnosis. 1361 women had aspiration cytology diagnosis performed from a total of 47718 mammography non-negative lesions. There were 805 (59.1%) benign and 187 (13.7%) malignant alterations. Sensitivity was 91%, specificity 88%, positive predictive value 96.6% and negative predictive value turned to be 71% (pauditing values of fine needle aspiration cytology in our laboratory meet, or in certain aspects exceed the proposed minimum threshold values.

  6. Sebaceous carcinoma of the eyelid diagnosed on fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Meenu Gill

    2012-01-01

    Full Text Available Sebaceous carcinoma of the ocular adnexa is a malignant neoplasm which has aggressive local behavior and can metastasize to regional lymph nodes and distant organs. It is a malignant neoplasm known to masquerade as other benign and less malignant lesions, resulting in delay in diagnosis and relatively high morbidity and mortality. Aspiration cytological features of this neoplasm have not been well characterized in the literature. We report a case of this tumor diagnosed on fine needle aspiration. Clinically, a diagnosis of chalazion was made and fine needle aspiration cytology (FNAC was performed. Cytological diagnosis of a malignant tumor with closest resemblance to sebaceous carcinoma was suggested which was confirmed on histopathology. Eyelid reconstruction was done after histopathological confirmation of tumor-free margins. The article highlights the role of FNAC in early diagnosis and subsequent appropriate surgical management of eyelid sebaceous gland carcinoma to prevent recurrence and metastasis.

  7. Comparison of gastric aspiration and HIDA scintigraphy in detecting fasting duodenogastric bile reflux

    Energy Technology Data Exchange (ETDEWEB)

    Eriksson, B.; Emaas, S.; Jacobsson, H.; Larsson, S.A

    1988-01-01

    Gastric aspiration and HIDA scintigraphy have been compared to assess duodenogastric bile reflux. Gastric aspiration was performed on two separate occasions with a total examination time of 3 h. The highest 1-h output and the highest concentration of bile acids were recorded. HIDA scintigraphy was carried out for 90 min after an injection of 60 MBq /sup 99m/Tc-dimethyl-iminodiacetic acid (HIDA). Forty-six patients with different gastrointestinal disorders were studied; 24 patients were positive and 13 negative in both tests. Accordingly, the methods agreed in 37 of 46 patients (80.4%). It is conluded that gastric aspiration is as reliable as HIDA scintigraphy to assess fasting bile reflux. 20 refs.

  8. Comparison of gastric aspiration and HIDA scintigraphy in detecting fasting duodenogastric bile reflux

    International Nuclear Information System (INIS)

    Eriksson, B.; Emaas, S.; Jacobsson, H.; Larsson, S.A

    1988-01-01

    Gastric aspiration and HIDA scintigraphy have been compared to assess duodenogastric bile reflux. Gastric aspiration was performed on two separate occasions with a total examination time of 3 h. The highest 1-h output and the highest concentration of bile acids were recorded. HIDA scintigraphy was carried out for 90 min after an injection of 60 MBq 99m Tc-dimethyl-iminodiacetic acid (HIDA). Forty-six patients with different gastrointestinal disorders were studied; 24 patients were positive and 13 negative in both tests. Accordingly, the methods agreed in 37 of 46 patients (80.4%). It is concluded that gastric aspiration is as reliable as HIDA scintigraphy to assess fasting bile reflux

  9. Effectiveness of Toyota process redesign in reducing thyroid gland fine-needle aspiration error.

    Science.gov (United States)

    Raab, Stephen S; Grzybicki, Dana Marie; Sudilovsky, Daniel; Balassanian, Ronald; Janosky, Janine E; Vrbin, Colleen M

    2006-10-01

    Our objective was to determine whether the Toyota Production System process redesign resulted in diagnostic error reduction for patients who underwent cytologic evaluation of thyroid nodules. In this longitudinal, nonconcurrent cohort study, we compared the diagnostic error frequency of a thyroid aspiration service before and after implementation of error reduction initiatives consisting of adoption of a standardized diagnostic terminology scheme and an immediate interpretation service. A total of 2,424 patients underwent aspiration. Following terminology standardization, the false-negative rate decreased from 41.8% to 19.1% (P = .006), the specimen nondiagnostic rate increased from 5.8% to 19.8% (P Toyota process change led to significantly fewer diagnostic errors for patients who underwent thyroid fine-needle aspiration.

  10. A finite element study of micropipette aspiration of single cells: effect of compressibility.

    Science.gov (United States)

    Bidhendi, Amirhossein Jafari; Korhonen, Rami K

    2012-01-01

    Micropipette aspiration (MA) technique has been widely used to measure the viscoelastic properties of different cell types. Cells experience nonlinear large deformations during the aspiration procedure. Neo-Hookean viscohyperelastic (NHVH) incompressible and compressible models were used to simulate the creep behavior of cells in MA, particularly accounting for the effect of compressibility, bulk relaxation, and hardening phenomena under large strain. In order to find optimal material parameters, the models were fitted to the experimental data available for mesenchymal stem cells. Finally, through Neo-Hookean porohyperelastic (NHPH) material model for the cell, the influence of fluid flow on the aspiration length of the cell was studied. Based on the results, we suggest that the compressibility and bulk relaxation/fluid flow play a significant role in the deformation behavior of single cells and should be taken into account in the analysis of the mechanics of cells.

  11. Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors

    Directory of Open Access Journals (Sweden)

    In Hye Song

    2015-03-01

    Full Text Available Background: Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. Methods: We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. Results: Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. Conclusions: We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.

  12. Acute myocardial infarction caused by left atrial myxoma: Role of intracoronary catheter aspiration.

    Science.gov (United States)

    Al-Fakhouri, Ahmad; Janjua, Muhammad; DeGregori, Michele

    2017-01-01

    Acute ST-segment elevation myocardial infarction (STEMI) caused by left atrial myxoma is very rare. Catheter-based approaches or thrombolytic therapy are mostly the first step in the management of STEMI with less time delay. We report a case of acute anterior/lateral STEMI caused by a left atrial myxoma. The patient was successfully treated by intracoronary aspiration with an Export aspiration catheter, with excellent distal coronary flow. Intracoronary catheter aspiration in acute myocardial infarction caused by a left atrial myxoma may help to salvage the infarcting myocardium with less time delay. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. "Diesel siphoner′s lung": Exogenous lipoid pneumonia following hydrocarbon aspiration

    Directory of Open Access Journals (Sweden)

    Kavitha Venkatnarayan

    2014-01-01

    Full Text Available Lipoid pneumonia is an unusual and uncommon form of pneumonia caused by aspiration of fatty substances. Hydrocarbon pneumonitis following aspiration of diesel is a form of exogenous lipoid pneumonia wherein, aspirated diesel reaches the alveoli rapidly without evoking any significant cough, but initiates an intense inflammatory reaction in the pulmonary parenchyma. This is a rarely described clinical scenario, although the practice of diesel siphonage from automobiles is a common practice in developing countries. We herein describe a 40-year-old male patient, in whom the diagnosis of lipoid pneumonia was delayed for a long duration and highlight the importance of taking a detailed occupational exposure history in patients with non-resolving pneumonia to rule out the underlying possibility of this rare clinical entity.

  14. Aspiration Levels and R&D Search in Young Technology-Based Firms

    DEFF Research Database (Denmark)

    Candi, Marina; Saemundsson, Rognvaldur; Sigurjonsson, Olaf

    the same when performance surpasses aspirations. Both positive and negative outlooks reinforce the effects of performance feedback. The combined effect is that the more outcomes and expectations deviate from aspirations the more young technology-based firms invest in R&D search.......Decisions about allocation of resources to research and development (R&D), referred to here as R&D search, are critically important for competitive advantage. Using panel data collected yearly over a period of nine years, this paper re-visits existing theories of backward-looking and forward......-looking decision models for R&D search in the important context of young technology-based firms. Some of the findings confirming existing models, but overall the findings contradict existing models. Not only are young technology-based firms found to increase search when aspirations are not met, but they do...

  15. Aspiration and evaluation of gastric residuals in the neonatal intensive care unit: state of the science.

    Science.gov (United States)

    Parker, Leslie; Torrazza, Roberto Murgas; Li, Yuefeng; Talaga, Elizabeth; Shuster, Jonathan; Neu, Josef

    2015-01-01

    The routine aspiration of gastric residuals (GR) is considered standard care for critically ill infants in the neonatal intensive care unit (NICU). Unfortunately, scant information exists regarding the risks and benefits associated with this common procedure. This article provides the state of the science regarding what is known about the routine aspiration and evaluation of GRs in the NICU focusing on the following issues: (1) the use of GRs for verification of feeding tube placement, (2) GRs as an indicator of gastric contents, (3) GRs as an indicator of feeding intolerance or necrotizing enterocolitis, (4) the association between GR volume and ventilator-associated pneumonia, (5) whether GRs should be discarded or refed, (6) the definition of an abnormal GR, and (7) the potential risks associated with aspiration and evaluation of GRs. Recommendations for further research and practice guidelines are also provided.

  16. Toxic effects of different meconium fractions on lung function: new therapeutic strategies for meconium aspiration syndrome?

    Science.gov (United States)

    Saugstad, O D; Tølløfsrud, P A; Lindenskov, P; Drevon, C A

    2008-12-01

    To review and summarize experimental data examining the effects of different fractions of meconium, and to test the effect of albumin on meconium aspiration both as prophylactic and rescue treatment. Newborn piglets 2 to 5 days of age were made hypoxic and then instilled meconium or fractions of meconium intratracheally. Meconium-added albumin and albumin instilled after meconium were also tested. Lung function and inflammatory cytokines were measured. Both the lipid- and water-soluble fractions induce inflammation in the lungs with elevation of inflammatory cytokines. When meconium was mixed with albumin, the inflammatory effects of meconium were significantly ameliorated. Rescue therapy with intratracheal albumin 5 min after the meconium aspiration syndrome was induced also improved lung function. These results indicate that at least part of the symptoms seen in the meconium aspiration syndrome could be prevented by blocking the active substances of meconium such as bile acids and free fatty acids.

  17. Anti-inflammatory treatment of meconium aspiration syndrome: benefits and risks.

    Science.gov (United States)

    Mokra, Daniela; Mokry, Juraj; Tonhajzerova, Ingrid

    2013-06-01

    Meconium aspiration syndrome (MAS) is a major cause of respiratory insufficiency in the term and post-term newborns. There are several pathomechanisms participating in this disorder, particularly the airway obstruction, surfactant dysfunction, inflammation, lung edema, pulmonary vasoconstriction and bronchoconstriction. Inflammatory changes resulting from meconium aspiration cause severe impairment of lung parenchyma and surfactant, and influence the reactivity of both vascular and airway smooth muscle. Therefore, anti-inflammatory drugs may be of benefit in the management of MAS. This article reviews the pharmacological actions and side effects of various anti-inflammatory drugs used up to now in the experimental models of MAS and in the treatment of newborns with meconium aspiration. Copyright © 2013. Published by Elsevier B.V.

  18. Beneficial effect of combined aspiration and interstitial laser therapy in patients with benign cystic thyroid nodules

    DEFF Research Database (Denmark)

    Døssing, H; Bennedbaek, F N; Hegedüs, L

    2006-01-01

    of the amount of aspirated cyst fluid, thereby calculating the volume of the solid part. Follow-up included ultrasound and determination of thyroid function. Pressure and cosmetic complaints were evaluated on a visual analogue scale. The median initial volume of the cystic nodule decreased from 9.6 ml [6......The aim of this study was to evaluate the effect of combined cyst aspiration and ultrasound-guided interstitial laser photocoagulation (ILP) on recurrence rate and the volume of benign cystic thyroid nodules. 10 euthyroid outpatients with a solitary and cytologically benign partially cystic thyroid...... part. Both pressure symptoms and cosmetic complaints were significantly reduced. The only side effect was mild pain or tenderness for a few days. Our study suggests that complete cyst aspiration and subsequent ultrasound-guided ILP of benign cystic thyroid nodules is a feasible and safe technique...

  19. Meconium aspiration syndrome: a role for fetal systemic inflammation.

    Science.gov (United States)

    Lee, JoonHo; Romero, Roberto; Lee, Kyung A; Kim, Eun Na; Korzeniewski, Steven J; Chaemsaithong, Piya; Yoon, Bo Hyun

    2016-03-01

    Meconium aspiration syndrome (MAS) is a leading cause of morbidity and mortality in term infants. Meconium-stained amniotic fluid (MSAF) occurs in approximately 1 of every 7 pregnancies, but only 5% of neonates exposed to MSAF develop MAS. Why some infants exposed to meconium develop MAS while others do not is a fundamental question. Patients with MSAF have a higher frequency of intraamniotic inflammation/infection than those with clear fluid. We propose that fetal systemic inflammation is a risk factor for the development of MAS in patients with MSAF. We sought to investigate whether intraamniotic inflammation and funisitis, the histopathologic landmark of a fetal inflammatory response, predispose to MAS. A prospective cohort study was conducted from 1995 through 2009. Amniotic fluid (AF) samples (n = 1281) were collected at the time of cesarean delivery from women who delivered singleton newborns at term (gestational age ≥38 weeks). Intraamniotic inflammation was diagnosed if the AF concentration of matrix metalloproteinase-8 was >23 ng/mL. Funisitis was diagnosed by histologic examination if inflammation was present in the umbilical cord. The prevalence of MSAF was 9.2% (118/1281), and 10.2% (12/118) of neonates exposed to MSAF developed MAS. There were no significant differences in the median gestational age or umbilical cord arterial pH at birth between neonates who developed MAS and those who did not (each P > .1). Mothers whose newborns developed MAS had a higher median of AF matrix metalloproteinase-8 (456.8 vs 157.2 ng/mL, P < .05). Newborns exposed to intraamniotic inflammation had a higher rate of MAS than those who were not exposed to intraamniotic inflammation [13.0% (10/77) vs 0% (0/32), P = .03], as did those exposed to funisitis [31.3% (5/16) vs 7.3% (6/82); relative risk, 4.3; 95% confidence interval, 1.5-12.3]. Among the 89 newborns for whom both AF and placental histology were available, MAS was more common in patients with both intraamniotic

  20. Efficacy of knee joint aspiration in patients with acute ACL injury in the emergency department.

    Science.gov (United States)

    Wang, Joon Ho; Lee, Jin Hyuck; Cho, Youngsuk; Shin, Jung Min; Lee, Byung Hoon

    2016-08-01

    To evaluate the influence of joint aspiration on the sensitivity of physical examination for diagnosing acute anterior cruciate ligament (ACL) lesion in the second outpatient-department (OPD) follow-up referred from emergency department (ED). This retrospective study included sixty patients underwent ACL reconstruction with initial visit at ED. They were divided into two groups based on the presence or absence of joint aspiration at ED. All participants were referred to second OPD follow-up within 7-14days after the injury. Clinical manifestation (including visual analogue scale (VAS) for pain, range of motion (ROM), and severity of knee effusion) and physical examination (Lachman test and pivot shift test) were checked in ED and the second OPD follow-up. The group of patients with joint aspiration (G1) showed substantial decreases in mean values of VAS for pain (p=0.005), ROM (p=0.001), and effusion level (pknee joint aspiration. Positive Lachman test was recorded at 76.5% in the second follow-up in G1, which was significantly (p=0.047) higher than that (47.6%) in G2. The percentage of positive pivot shift test was recorded at 76.5% in the second follow-up in G1, which as significantly (pKnee joint aspiration in acute ACL injury with suspected hemarthrosis could be considered as a diagnostic procedure. Joint aspiration in early medical attendance might be able to lower pain scores or raise the sensitivity of physical examination for diagnosing acute ACL injury at follow up visit in orthopedic outpatient department. Retrospective cohort study III. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Pediatric Eating Assessment Tool-10 as an indicator to predict aspiration in children with esophageal atresia.

    Science.gov (United States)

    Soyer, Tutku; Yalcin, Sule; Arslan, Selen Serel; Demir, Numan; Tanyel, Feridun Cahit

    2017-10-01

    Airway aspiration is a common problem in children with esophageal atresia (EA). Pediatric Eating Assessment Tool-10 (pEAT-10) is a self-administered questionnaire to evaluate dysphagia symptoms in children. A prospective study was performed to evaluate the validity of pEAT-10 to predict aspiration in children with EA. Patients with EA were evaluated for age, sex, type of atresia, presence of associated anomalies, type of esophageal repair, time of definitive treatment, and the beginning of oral feeding. Penetration-aspiration score (PAS) was evaluated with videofluoroscopy (VFS) and parents were surveyed for pEAT-10, dysphagia score (DS) and functional oral intake scale (FOIS). PAS scores greater than 7 were considered as risk of aspiration. EAT-10 values greater than 3 were assessed as abnormal. Higher DS scores shows dysphagia whereas higher FOIS shows better feeding abilities. Forty patients were included. Children with PAS greater than 7 were assessed as PAS+ group, and scores less than 7 were constituted as PAS- group. Demographic features and results of surgical treatments showed no difference between groups (p>0.05). The median values of PAS, pEAT-10 and DS scores were significantly higher in PAS+ group when compared to PAS- group (ptool to predict aspiration in children. Patients with higher pEAT-10 scores should undergo detailed evaluation of deglutitive functions and assessment of risks of aspiration to improve safer feeding strategies. Level II (Development of diagnostic criteria in a consecutive series of patients and a universally applied "gold standard"). Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Percutaneous aspiration thrombectomy for acute mesenteric arterial embolism: an experimental study in dogs

    International Nuclear Information System (INIS)

    Ma Yongqiang; Yang Ning; Zhang Xiaofeng; Lu Junliang

    2012-01-01

    Objective: To discuss the safety and feasibility of percutaneous aspiration thrombectomy in treating acute mesenteric arterial embolism. Methods: Acute superior mesenteric arterial embolism model was established in 12 hybrid dogs through injection of autologous blood clot via an arterial sheath. According to the removal time of the embolus (2, 4 and 6 hours), the experimental dogs were randomly divided into three groups with 4 dogs in each group. Percutaneous aspiration thrombectomy by using an 8F arterial sheath was carried out at 2, 4 and 6 hours after embolization procedure for the dogs in 2, 4 and 6 hour groups respectively. The results were analyzed. Results: Percutaneous aspiration of the blood bolt with an 8F arterial sheath was successfully accomplished in all experimental dogs of the three groups. The technical success rate was 100%. The average time for the performance of thrombectomy was (2.48±0.47) min, and the average collected volume of the blood was (41.0±4.2) ml. Angiography performed after aspiration revealed that the main stem of the superior mesenteric artery was reopened in all dogs of each group, and residual embolus was seen in a small number of second vascular branches (less than 4 vessels and not adjacent to each other). No serious complications, such as vascular injuries or intestinal bleeding, occurred during and after the aspiration procedures. Conclusion: For the treatment of acute superior mesenteric artery embolism, percutaneous aspiration thrombectomy with an 8F arterial sheath is safe, effective, economical and technically simple. (authors)

  3. Surgery for Pyogenic Brain Abscess over 30 Years: Evaluation of the Roles of Aspiration and Craniotomy.

    Science.gov (United States)

    Aras, Yavuz; Sabanci, Pulat Akın; Izgi, Nail; Boyali, Osman; Ozturk, Onur; Aydoseli, Aydin; Ali, Achmet; Sencer, Altay; Hepgul, Kemal; Unal, Faruk; Barlas, Orhan

    2016-01-01

    To evaluate the roles of craniotomy and aspiration in the treatment of pyogenic brain abscess throughout 30 years of computerized tomography. A retrospective study of 224 patients who were surgically treated at Istanbul Medical Faculty, Department of Neurosurgery between 1982 and 2012 was undertaken. The records were analyzed for demographic, clinical and radiological findings, surgical interventions (resection, free-hand aspiration and image-guided aspiration), data regarding abscesses (etiological factors, site, size, number, localization and identified microorganism), corticosteroid and antibiotic usage and complications, and the outcomes were reviewed. The male-to-female ratio was 2.2, and the mean age was 26.2±1.25 years. The most common presenting symptom was headache (56.7%), followed by nausea and vomiting (28.5%). Otitis media and mastoiditis were the most common causes of abscess (41.9%), and 44 patients had multiple abscesses. Aerobic gram-positive microorganisms were the most frequently isolated pathogens in culture (51.5%). Primary surgical interventions were as follows: craniotomy and resection (38.8%), free-hand aspiration (49.1%) and image-guided aspiration (12.1%). The aspiration-to-resection ratio was 1.36 (64/47) in the first decade, 2.94 (50/17) in the second decade and 1 (23/23) in the last decade. Age, level of consciousness at the time of admission and potent corticosteroid usage were found to be significantly associated with mortality (p=0.001, p≤0.001 and p=0,038, respectively). The total morbidity and mortality ratios were 4.9% and 9.8%, respectively. Seizures were more common in patients of craniotomy group (p=0.023). Treatment of pyogenic brain abscess remains challenging, despite advances in surgical and imaging technology, and craniotomy retains a significant role in surgical treatment.

  4. Aspiration Pneumonia in Carbon Monoxide Poisoning Patients with Loss of Consciousness: Prevalence, Outcomes, and Risk Factors.

    Science.gov (United States)

    Sohn, Chang Hwan; Huh, Jin Won; Seo, Dong Woo; Oh, Bum Jin; Lim, Kyoung Soo; Kim, Won Young

    2017-12-01

    Aspiration pneumonia is associated with significant morbidity and mortality; however, little is known about aspiration pneumonia in patients with carbon monoxide intoxication, which is the leading cause of poisoning-related death. This study aimed to evaluate the prevalence, clinical impacts, and risk factors for developing aspiration pneumonia in patients with carbon monoxide poisoning with loss of consciousness. A retrospective analysis of a carbon monoxide poisoning registry was performed at our emergency department for the period January 2008 to December 2015. All adult carbon monoxide poisoning patients with loss of consciousness were included. Aspiration pneumonia developed in 103 (19.2%) of 537 patients. It was associated with increased ventilator use (52.4% vs 3.2%), length of hospital stay (median [interquartile range], 3.6 [2.1-5.1] vs 1.3 [0.6-2.1] days), and in-hospital mortality (5.8% vs 0.0%) (all P factors associated with development of aspiration pneumonia; odds ratios were 9.46 (95% confidence interval [CI] 4.92-18.19; P 12,000/mm 3 , the odds ratio increased up to 17.75 (95% CI 10.65-29.59; P pneumonia was 19.2% in carbon monoxide poisoning patients with loss of consciousness and was associated with poor outcomes. Additionally, altered mental status on emergency department arrival, white blood cell count, and increased exposure duration were independently associated with the development of aspiration pneumonia. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Role of Manual Aspiration in Treating Pneumothorax after Computed Tomography-Guided Lung Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Yamagami, T.; Terayama, K.; Yoshimatsu, R.; Matsumoto, T.; Miura, H.; Nishimura, T. (Dept. of Radiology, Graduate School of Medical Science, Kyoto Prefectural Univ. of Medicine, Kyoto (Japan)). e-mail: yamagami@koto.kpu-m.ac.jp

    2009-12-15

    Background: Pneumothorax is the most common complication after computed tomography (CT)-guided lung biopsy. The presence of a pneumothorax per se does not complicate patient management, but an increasing pneumothorax, making chest tube placement necessary, is highly problematic. Purpose: To evaluate the efficacy and limitations of simple aspiration of air from the pleural space to prevent increased pneumothorax and avoid chest tube placement in cases of pneumothorax following CT-guided lung biopsy. Material and Methods: The subjects of our study were 642 consecutive lung lesions in 594 patients for which percutaneous needle lung biopsies were performed using CT guidance. While patients were on the CT scanner table, percutaneous manual aspiration was performed in all patients with a non-small pneumothorax demonstrated on post-biopsy chest CT images. The frequency of pneumothorax, management of each such case, and factors influencing the incidence of worsening pneumothorax that finally required chest tube placement were evaluated. Results: Post-biopsy pneumothorax occurred in 243 of 642 (38%) procedures. Of the 243 cases, 112 were treated with manual aspiration immediately after biopsy. In 210 (86.4%), the pneumothorax had resolved completely on follow-up chest radiographs without chest tube placement. Only 33 patients required chest tube placement. Requirement of chest tube insertion significantly increased in parallel with the degree of pneumothorax as shown on post-biopsy CT images. The rate of chest tube insertion was statistically higher in subjects with values for aspirated air above 543 ml. Conclusion: Percutaneous manual aspiration of biopsy-induced pneumothorax performed immediately after biopsy may prevent worsening of pneumothorax and avoid chest tube placement. The amount of aspirated air can be predictive of the requirement for chest tube placement

  6. Assessment of complications of EUS-guided fine-needle aspiration.

    Science.gov (United States)

    O'Toole, D; Palazzo, L; Arotçarena, R; Dancour, A; Aubert, A; Hammel, P; Amaris, J; Ruszniewski, P

    2001-04-01

    EUS-guided fine-needle aspiration (EUS-FNA) permits both morphologic and cytologic analysis of lesions within or adjacent to the GI tract. Despite increasing use of this technique, the safety and overall complication rates remain poorly defined. During a period of 20 months, 322 consecutive patients underwent EUS-FNA in 2 centers. All procedures were performed with the patients under general anesthesia. All complications (including local complications resulting from endoscopy/aspiration or clinical complications after the procedure) were evaluated. Potential risk factors for the development of complications were also analyzed including site and nature of the lesion, presence of portal hypertension, and number of needle passes. A total of 345 lesions were aspirated in 322 patients. EUS-FNA involved the pancreas in 248 cases. Pancreatic lesions included solid (134) and cystic (114) types, which required a mean of 2.5 and 1.4 needle passes, respectively. Complications were observed in 4 (1.2%) patients after aspiration of pancreatic cystic lesions (acute pancreatitis, n = 3; aspiration pneumonia, n = 1) and all cases of pancreatitis resulted from FNA of lesions in the head/uncinate process. No complications resulted from FNA of solid pancreatic lesions. Complications were not observed after FNA of lymph nodes (n = 62) and one case of aspiration pneumonia was observed after FNA of a stromal tumor. EUS-FNA was performed without complication in 16 patients (5%) with portal hypertension. The number of needle passes was not predictive of complications. Because the overall risk of complications from EUS-FNA was relatively low (1.6%) with no severe or fatal incidents and although the risk appears slightly higher than that for standard EUS alone, the safety of EUS-FNA appears acceptable based on this analysis from an experienced center.

  7. Access to Rehabilitation at Six Months Post Stroke: A Profile from the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) Study.

    Science.gov (United States)

    Hall, Patricia; Williams, David; Hickey, Anne; Brewer, Linda; Mellon, Lisa; Dolan, Eamon; Kelly, Peter J; Shelley, Emer; Horgan, N Frances

    2016-01-01

    Stroke is the third leading cause of death and disability. Few studies have assessed the profile and adequacy of access to rehabilitation services after ischaemic stroke both in the inpatient and community setting. The objectives of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) study were to assess the disability and rehabilitation profile, adherence with rehabilitation recommendations and needs of patients 6 months following hospital admission for stroke. A rehabilitation prescription was completed before hospital discharge for each participant, and adherence to this prescription was assessed at 6 months to determine whether patients received their recommended rehabilitation needs. Two hundred and fifty six patients were recruited to ASPIRE-S. The average age was 69 (SD 12.8). A majority (n = 221, 86%) were referred to the hospital multidisciplinary team, 59% (n = 132) were referred to all services (physiotherapy (PT), occupational therapy (OT), speech and language therapy (SLT)). Fifty-four percent (n = 119) of patients (seen by the multidisciplinary team) were referred for further rehabilitation in the community on discharge. Of these 119 patients, 112 (95%) recalled receiving community rehabilitation services. However, while most (68%) patients were referred for several disciplines (PT, OT, SLT), the most commonly recalled therapy (55%) was from a single discipline. The most commonly recommended frequency of therapy required was on a weekly basis. Sixty-one patients (51%) reported a delay in services, with some still awaiting services at 6 months. Results from this prospective study revealed that a significant number of patients (57%) did not receive the therapy recommended on discharge. Future initiatives should include the development of policies, which support more effective, equitable multidisciplinary rehabilitation for stroke patients in the community. © 2016 S. Karger AG, Basel.

  8. Predictors of the Aspiration Component Success of a Direct Aspiration First Pass Technique (ADAPT) for the Endovascular Treatment of Stroke Reperfusion Strategy in Anterior Circulation Acute Stroke.

    Science.gov (United States)

    Blanc, Raphaël; Redjem, Hocine; Ciccio, Gabriele; Smajda, Stanislas; Desilles, Jean-Philippe; Orng, Eliane; Taylor, Guillaume; Drumez, Elodie; Fahed, Robert; Labreuche, Julien; Mazighi, Mikael; Lapergue, Bertrand; Piotin, Michel

    2017-06-01

    A direct aspiration first pass technique (ADAPT) has been reported to be fast, safe, and effective for the treatment of acute ischemic stroke. The aim of this study is to determine the preoperative factors that affect success of the aspiration component of the technique in ischemic stroke patients with large vessel occlusion in the anterior circulation. We enrolled all 347 consecutive patients with anterior circulation acute ischemic stroke admitted for mechanical thrombectomy at our institution from August 2013 to October 2015 and treated by ADAPT for the endovascular treatment of stroke. Baseline and procedural characteristics, modified thrombolysis in cerebral infarction scores, and 3-month modified Rankin Scale were captured and analyzed. Among the 347 patients (occlusion sites: middle cerebral artery=200, 58%; internal carotid artery Siphon=89, 25%; Tandem=58, 17%), aspiration component led to successful reperfusion (modified thrombolysis in cerebral infarction 2b/3 scores) in 55.6% (193/347 patients), stent retrievers were required in 40%, and a total successful final reperfusion rate of 83% (288/347) was achieved. Overall, procedural complications occurred in 13.3% of patients (48/347). Modified Rankin Scale score of 0 to 2 at 90 days was reported in 45% (144/323). Only 2 factors positively influenced the success of the aspiration component: an isolated middle cerebral artery occlusion ( P stroke onset to clot contact ( P =0.018). In this large retrospective study, ADAPT was shown to be safe and effective for anterior circulation acute ischemic stroke with a final successful reperfusion achieved in 83%. The site of arterial occlusion and delay of the procedure were predictors for reperfusion. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02523261, NCT02678169, and NCT02466893. © 2017 American Heart Association, Inc.

  9. A Rare Cause of Dyspnea in Elderly Patients: Foreign Body Aspiration

    Directory of Open Access Journals (Sweden)

    Sevdegül Karadas

    2012-10-01

    Full Text Available Foreign body aspiration is frequently seen at childhood age group whereas various facilitator factors can be observed in adults particularly in the elderly group. In this study a 78 year-old male case who swallowed his dental prothesis and had a foreign substance detected in his chest X-ray was presented. In the cases that have nonspesific complaints such as incipient chest pain and difficulty in breathing and have no known underlying lung disease, foreign body aspiration must be suspected.

  10. Design of a new air flow velocity sensor for aspirating high sensitivity smoke detectors

    OpenAIRE

    Córdoba Galera, Andrés

    2015-01-01

    Aspirating detectors use the high sensitivity sensing given by laser technology to detect smoke in the early stages of a fire ignition. To do this, the air is aspirated through pipe conducts to be sampled and analyzed. This air is inserted into a smoke sensor cavity, where a laser emitter and photoreceptor quantify smoke particles present in the air sampled. To assure that the system is working according to the initial conditions during all its life, it is required to have an accurate air-flo...

  11. Engineering, safety, and economic evaluations of ASPIRE [Advanced Safe Pool Immersed REactor

    International Nuclear Information System (INIS)

    Sze, D.K.; Gordon, J.; Piet, S.; Cheng, E.T.; Klein, A.

    1988-02-01

    A preconceptual design of a tokamak fusion reactor concept called ASPIRE (Advanced Safe Pool Immersed REactor) has been developed. This concept provides many of the attractive features that are needed to enhance the capability of fusion to become the power generation technology for the 21st century. Specifically, these features are: inherent safety, low pressure, environmental compatibility, moderate unit size, high availability, high thermal efficiency, simplicity, low radioactive inventory, Class C radioactive waste disposal, and low cost of electricity. We have based ASPIRE on a second stability tokamak. However, the concept is equally applicable to a first stability tokamak or to most other magnetic fusion systems

  12. Novel balloon-and-aspiration method for cerebral venous sinus thrombosis: dental-floss technique.

    Science.gov (United States)

    Matsuda, Yoshikazu; Okada, Hideo; Chung, Joonho; Webster Crowley, R; Lopes, Demetrius K

    2017-04-01

    Cerebral venous sinus thrombosis is sometimes fatal. The standard treatment for sinus thrombosis is anticoagulation, but endovascular intervention must be considered when medical treatment fails. Mechanical thrombectomy is usually required when a large clot burden exits. Unfortunately, in sinus thrombosis attributable to a clot burden larger than that in an intracranial artery, the conventional technique used for intraarterial acute stroke intervention with a stent retriever and/or aspiration is not very effective. The authors describe here their endovascular approach to mechanical thrombectomy for sinus thrombosis using aspiration combined with angioplasty balloon support.

  13. EUS – Fine- Needle Aspiration Biopsy (FNAB in the Diagnosis of Pancreatic Adenocarcinoma: A Review

    Directory of Open Access Journals (Sweden)

    Kalogeraki Alexandra

    2016-03-01

    Full Text Available Solid masses of the pancreas represent a variety of benign and malignant neoplasms of the exocrine and endocrine tissues of the pancreas. A tissue diagnosis is often required to direct therapy in the face of uncertain diagnosis or if the patient is not a surgical candidate either due to advanced disease or comorbidities. Endoscopic ultrasound (EUS is a relatively new technology that employs endoscopy and high-frequency ultrasound (US. EUS involves imaging of the pancreatic head and the uncinate from the duodenum and imaging of the body and tail from the stomach. It has been shown to be a highly sensitive method for the detection of pancreatic masses. It is superior to extracorporeal US and computed tomographic (CT scans, especially when the pancreatic tumor is smaller than 2-3 cm. Although EUS is highly sensitive in detecting pancreatic solid masses, its ability to differentiate between inflammatory masses and malignant disease is limited. Endoscopic retrograde cholangiopancreatography (ERCP brushing, CT-guided biopsies, and transabdominal ultrasound (US have been the standard nonsurgical methods for obtaining a tissue diagnosis of pancreatic lesions, but a substantial false-negative rate has been reported. Transabdominal US-guided fine-needle aspiration biopsy (US-FNAB has been used for tissue diagnosis in patients with suspected pancreatic carcinoma. It has been shown to be highly specific, with no false-positive diagnoses. With the advent of curvilinear echoendoscopes, transgastric and transduodenal EUS-FNAB of the pancreas have become a reality EUS with FNAB has revolutionized the ability to diagnose and stage cancers of the gastrointestinal tract and assess the pancreas. Gastrointestinal cancers can be looked at with EUS and their depth of penetration into the intestinal wall can be determined. Any suspicious appearing lymph nodes can be biopsied using EUS/FNAB. The pancreas is another organ that is well visualized with EUS. Abnormalities

  14. Fine-needle aspiration biopsy of lymphoproliferative disorders--interpretations based on morphologic criteria alone: results from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology.

    Science.gov (United States)

    Young, Nancy A; Moriarty, Ann T; Haja, Jennifer C; Wilbur, David C

    2006-12-01

    Diagnosis of lymphoproliferative disorders is one of the most challenging tasks faced by the cytologist. The initial cytomorphologic evaluation of lymphoproliferative lesions directs the choice of ancillary studies that ultimately lead to a diagnosis based on the World Health Organization classification system using a composite of clinical, morphologic, immunophenotypic, and molecular features. To evaluate the ability of participating laboratories in the College of American Pathologists Interlaboratory Comparison Program in Non-Gynecologic Cytopathology to appropriately categorize lymphoproliferative lesions based solely on cytomorphologic criteria. Laboratory responses for lymph node aspirates were examined. All responses were based on review of glass slides without ancillary immunologic or molecular data available. The benchmarking data provided for each specific diagnosis were analyzed, with a focus on the performance for evaluation of lymphoproliferative lesions. Based on morphology alone, responses for lymph node aspirates in the Non-Gynecologic Cytopathology program were correct to the exact reference diagnosis for 87.1% of Hodgkin lymphoma. Non-Hodgkin lymphoma was identified in 69.5% of the large cell non-Hodgkin lymphoma cases, of which 66.8% were correctly classified as large cell type. Non-Hodgkin lymphoma was identified in 68.1% of non-Hodgkin lymphoma, other than large cell cases, and of these, 94.7% were identified as other than large cell type. The spectrum of specific responses was consistent for lymphoproliferative lesions, with a reasonable differential diagnosis based on cytomorphology alone, which, in practice, facilitates the appropriate choice of immunophenotypic markers and other ancillary studies.

  15. Not all forms of dialect contact are the same: Effects of regional media, travel, and social contacts on the perception of Spanish aspirated-/s/

    Directory of Open Access Journals (Sweden)

    Lauren B. Schmidt

    2015-05-01

    Full Text Available Previous work has found that speakers who move to a new dialect region may come to adopt features of the second dialect. This study investigates whether other types of dialect exposure – those present without ever leaving one’s home dialectal region – similarly result in differences in language use. An identification task and a dialect contact questionnaire were administered to two Spanish-speaking dialect groups in Latin America to determine the effect of different types of dialect contact on the perceptual categorization of the regionally and socially variable feature of syllable-final /s/-aspiration (e.g., fresco [fɾeh.ko], ‘fresh’. Short-term travel and exposure to Media from /s/-weakening regions were not found to play a role in identification of aspirated-/s/. However, the regional background of reported social contacts (i.e., the social network was a significant factor in how the regional variant was identified. Findings highlight the importance of live social interaction in language contact and change.

  16. Pancreatic metastases from ocular malignant melanoma: the use of endoscopic ultrasound-guided fine-needle aspiration to establish a definitive cytologic diagnosis: a case report.

    Science.gov (United States)

    De Moura, Diogo Turiani Hourneaux; Chacon, Danielle Azevedo; Tanigawa, Ryan; Coronel, Martin; Cheng, Spencer; Artifon, Éverson L A; Jukemura, José; De Moura, Eduardo Guimarães Hourneaux

    2016-12-01

    When encountering solid pancreatic lesions, nonpancreatic primary metastases are rare and differentiating a metastasis from a primary neoplastic lesion is challenging. The clinical presentation and radiologic features can be similar and the possibility of a pancreatic metastasis should be considered when the patient refers to a history of a different primary cancer. Endoscopic ultrasound offers a key anatomical advantage in accessing the pancreas and endoscopic ultrasound-guided fine-needle aspiration has become the gold standard method for diagnosing pancreatic lesions. A 58-year-old white Hispanic woman with a history of uveal malignant melanoma, presented with abdominal pain and jaundice. On admission, laboratory tests were performed (her total bilirubin was 6.37 mg/dL with a direct fraction of 5.30 mg/dL). Cross-sectional, abdominal computed tomography with contrast, showed a low-attenuating lesion localized in the pancreatic head (measuring 4 × 3 cm) and a thinner section of the distal bile duct suspicious for compression. Our patient was scheduled for an endoscopic ultrasound-guided fine-needle aspiration to establish a diagnosis. Endoscopic ultrasound showed a solid, hypoechoic, well-defined lesion with regular contours (measuring 3.17 × 2.61 cm), localized between the head and neck of the pancreas. Endoscopic ultrasound-guided fine-needle aspiration was performed with a 22G needle and cytology confirmed the diagnosis of metastatic melanoma. Our patient subsequently underwent right orbital exenteration, followed by duodenopancreatectomy without complications. At the moment our patient is receiving adjuvant chemotherapy at an outside oncology clinic. To the best of our knowledge, this is a very rare presentation of an ocular malignant melanoma with an isolated pancreatic metastasis causing symptomatic biliary obstruction. Endoscopic ultrasound-guided fine-needle aspiration has proven to be the best method to diagnose solid pancreatic lesions. In

  17. Pancreatic metastases from ocular malignant melanoma: the use of endoscopic ultrasound-guided fine-needle aspiration to establish a definitive cytologic diagnosis: a case report

    Directory of Open Access Journals (Sweden)

    Diogo Turiani Hourneaux De Moura

    2016-12-01

    Full Text Available Abstract Background When encountering solid pancreatic lesions, nonpancreatic primary metastases are rare and differentiating a metastasis from a primary neoplastic lesion is challenging. The clinical presentation and radiologic features can be similar and the possibility of a pancreatic metastasis should be considered when the patient refers to a history of a different primary cancer. Endoscopic ultrasound offers a key anatomical advantage in accessing the pancreas and endoscopic ultrasound-guided fine-needle aspiration has become the gold standard method for diagnosing pancreatic lesions. Case presentation A 58-year-old white Hispanic woman with a history of uveal malignant melanoma, presented with abdominal pain and jaundice. On admission, laboratory tests were performed (her total bilirubin was 6.37 mg/dL with a direct fraction of 5.30 mg/dL. Cross-sectional, abdominal computed tomography with contrast, showed a low-attenuating lesion localized in the pancreatic head (measuring 4 × 3 cm and a thinner section of the distal bile duct suspicious for compression. Our patient was scheduled for an endoscopic ultrasound-guided fine-needle aspiration to establish a diagnosis. Endoscopic ultrasound showed a solid, hypoechoic, well-defined lesion with regular contours (measuring 3.17 × 2.61 cm, localized between the head and neck of the pancreas. Endoscopic ultrasound-guided fine-needle aspiration was performed with a 22G needle and cytology confirmed the diagnosis of metastatic melanoma. Our patient subsequently underwent right orbital exenteration, followed by duodenopancreatectomy without complications. At the moment our patient is receiving adjuvant chemotherapy at an outside oncology clinic. Conclusions To the best of our knowledge, this is a very rare presentation of an ocular malignant melanoma with an isolated pancreatic metastasis causing symptomatic biliary obstruction. Endoscopic ultrasound-guided fine-needle aspiration has

  18. Everything that wheezes… Late presentation of an aspirated foreign body as a cause of near fatal respiratory distress

    Directory of Open Access Journals (Sweden)

    L. Hindle*

    2013-12-01

    Discussion: This case illustrates the difficulty doctors may have when there is delayed presentation or unwitnessed aspiration of a foreign body. History, clinical symptoms and the X-ray findings may provide clues but are not diagnostic. In cases where a FB aspiration is suspected, bronchoscopy is both diagnostic and potentially curative.

  19. Pathways to Achievement: Career and Educational Aspirations and Expectations of Latina/o Immigrant Parents and Early Adolescents

    Science.gov (United States)

    Chavira, Gabriela; Cooper, Catherine R.; Vasquez-Salgado, Yolanda

    2016-01-01

    Drawing on sociocultural and related theories, 4 questions examined career and educational aspirations and expectations among 24 immigrant Latina/o early adolescents and their parents as predictors of students' grades. First, adolescents' career aspirations and expectations were correlated, and both parents and adolescents held educational…

  20. Intermittent At-Home Suctioning of Esophageal Content for Prevention of Recurrent Aspiration Pneumonia in 4 Dogs with Megaesophagus.

    Science.gov (United States)

    Manning, K; Birkenheuer, A J; Briley, J; Montgomery, S A; Harris, J; Vanone, S L; Gookin, J L

    2016-09-01

    Megaesophagus carries a poor to guarded prognosis due to death from aspiration pneumonia. Options for medical management of regurgitation are limited to strategic oral or gastrostomy tube feeding. To describe the use and efficacy of intermittent esophageal suctioning to prevent regurgitation and associated episodes of aspiration pneumonia in dogs with megaesophagus. Four dogs with acquired idiopathic megaesophagus and recurrent aspiration pneumonia. Retrospective review of medical records of dogs with megaesophagus in which intermittent suctioning of esophageal content was employed for management of recurrent aspiration pneumonia. Intermittent suctioning of the esophagus was initiated in 4 dogs after failure of strict gastrostomy tube feeding failed to prevent regurgitation and repeated episodes of aspiration pneumonia. Suctioning was accomplished by esophagostomy tube in 3 dogs and per os in 1 dog. After initiation of esophageal suctioning, dogs survived for a median of 13.5 additional months (range, 10-30 months) during which time 2 dogs had no additional episodes of aspiration pneumonia and 2 dogs had infrequent episodes of pneumonia, but aspiration was suspected to be a contributing factor in their death. Complications included clogging of the esophagostomy tube, esophagostomy site infections, and esophagitis. Use of intermittent esophageal suctioning in dogs with megaesophagus that continue to regurgitate despite gastrostomy tube feedings can reduce or abolish clinical episodes of aspiration pneumonia. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  1. The Ability of the 10-Item Eating Assessment Tool (EAT-10) to Predict Aspiration Risk in Persons With Dysphagia.

    Science.gov (United States)

    Cheney, Diane M; Siddiqui, M Tausif; Litts, Juliana K; Kuhn, Maggie A; Belafsky, Peter C

    2015-05-01

    Dysphagia is common and costly. The ability of patient symptoms to predict objective swallowing dysfunction is uncertain. This study aimed to evaluate the ability of the Eating Assessment Tool (EAT-10) to screen for aspiration risk in patients with dysphagia. Data from individuals with dysphagia undergoing a videofluoroscopic swallow study between January 2012 and July 2013 were abstracted from a clinical database. Data included the EAT-10, Penetration Aspiration Scale (PAS), total pharyngeal transit (TPT) time, and underlying diagnoses. Bivariate linear correlation analysis, sensitivity, specificity, and predictive values were calculated. The mean age of the entire cohort (N=360) was 64.40 (±14.75) years. Forty-six percent were female. The mean EAT-10 was 16.08 (±10.25) for nonaspirators and 23.16 (±10.88) for aspirators (PEAT-10 score and the PAS (r=0.273, PEAT-10>15 in predicting aspiration were 71% and 53%, respectively. Subjective dysphagia symptoms as documented with the EAT-10 can predict aspiration risk. A linear correlation exists between the EAT-10 and aspiration events (PAS) and aspiration risk (TPT time). Persons with an EAT-10>15 are 2.2 times more likely to aspirate (95% confidence interval, 1.3907-3.6245). The sensitivity of an EAT-10>15 is 71%. © The Author(s) 2014.

  2. Extraction of challenging intracoronary thrombi: multi-device strategies using guide catheters, distal vascular protection devices and aspiration catheters.

    Science.gov (United States)

    Pornratanarangsi, Suwatchai; El-Jack, Seif S; Webster, Mark W I; McNab, Duncan; Stewart, James T; Ormiston, John A; Ruygrok, Peter N

    2008-09-01

    Patients with large intracoronary thrombi represent a difficult management problem for the interventional cardiologist. We report 10 cases of challenging thrombi treated percutaneously using varying combinations of deep guide catheter engagement, guide aspiration, dedicated catheter aspiration and withdrawal of a distal filter vascular protection device. These cases demonstrate interventional options which may be considered for such patients.

  3. Drivers of entrepreneurial aspirations at the country level: The role of start-up motivations and social security

    NARCIS (Netherlands)

    Hessels, J.; van Gelderen, M.W.; Thurik, A.R.

    2008-01-01

    This paper investigates whether various start-up motivations and a country's level of social security can explain the prevalence of entrepreneurial aspirations. For entrepreneurial aspirations and motivations we use country-level data from the Global Entrepreneurship Monitor (GEM) for the year 2005.

  4. Social Capital and Educational Aspiration of Students: Does Family Social Capital Affect More Compared to School Social Capital?

    Science.gov (United States)

    Shahidul, S. M.; Karim, A. H. M. Zehadul; Mustari, S.

    2015-01-01

    Resources from multiple social contexts influence students' educational aspiration. In the field of social capital a neglected issue is how students obtain social capital from varying contexts and which contexts benefit them more to shape their future educational plan which consequently affects their level of aspiration. In this study, we aim to…

  5. Capital, Agency, Family and the Diaspora: An Exploration of Boys' Aspirations towards Higher Education in Urban Jamaica

    Science.gov (United States)

    Stockfelt, Shawanda

    2015-01-01

    The paper discusses factors impacting on boys' educational aspirations at two case-study schools in urban Jamaica. It focuses on boys' experience of their educational environment in relation to social, cultural and economic factors, which shapes the nature of their aspirations towards higher education. The study utilised Bourdieu's notion of…

  6. A Statistical Profile of the Differences between Undergraduate Women in Guam and Japan: Their Status Aspirations and Occupational Ethics.

    Science.gov (United States)

    Inoue, Yukiko

    This study sought to better understand the academic and social aspirations of undergraduate women in Guam and Japan. A survey question examined whether significant differences existed between Guamanian and Japanese undergraduate women in status aspirations and occupational ethics and in their life course selection. The questionnaire's five…

  7. Care and the Influence of Student-Adult Stakeholder Interactions on Young Black Men's College Aspirations

    Science.gov (United States)

    Warren, Chezare A.; Bonilla, Christian

    2018-01-01

    Students' college aspirations precede any decision they may make to apply and enroll in college. College aspirations broadly refer to the formal development of specific plans made by a young person to position themselves to enroll in a four-year college or university after high school. Regular, ongoing interaction with college-educated adults is…

  8. Employability and Students' Part-Time Work in the UK: Does Self-Efficacy and Career Aspiration Matter?

    Science.gov (United States)

    Gbadamosi, Gbolahan; Evans, Carl; Richardson, Mark; Ridolfo, Mark

    2015-01-01

    Amid a growing focus on graduate employability, this study examines the relationship between students' part-time work, career aspirations and self-efficacy, in a survey of 357 UK students from two post-92 universities. The results suggest a positive and significant relationship between part-time work and career aspiration. Students who work…

  9. Tuberculous brain abscess and subdural empyema in an immunocompetent child: Significance of AFB staining in aspirated pus

    Directory of Open Access Journals (Sweden)

    B Vijayakumar

    2012-01-01

    Full Text Available Tuberculous brain abscess and subdural empyema are extremely rare manifestations of central nervous system tuberculosis. Here, we report a case of an 11-year-old immunocompetent child who developed temporal lobe abscess and subdural empyema following chronic otitis media. A right temporal craniotomy was performed and the abscess was excised. The Ziehl Nielsen staining of the aspirated pus from the temporal lobe abscess yielded acid fast bacilli. Prompt administration of antituberculous treatment resulted in complete recovery of the child. Even though the subdural abscess was not drained, we presume that to be of tubercular aetiology. Ours is probably the first case of brain abscess and subdural empyema due to Mycobacterium tuberculosis reported in the same child. This case is being reported because of its rarity and to stress the importance of routine staining for tubercle bacilli in all cases of brain abscess, especially in endemic areas, as it is difficult to differentiate tuberculous from pyogenic abscess clinically as well as histopathologically.

  10. A Rare Presentation of a Morel-Lavallee Lesion of the Lower Leg Successfully Treated With Ultrasound-Guided Aspiration.

    Science.gov (United States)

    Falconi, Audrey; Crellin, Holly; Tagawa, Chelsea

    2017-07-21

    A Morel-Lavallee lesion (MLL) is a relatively rare condition that is caused by a traumatic shearing force. This force leads to a closed degloving injury of the subcutaneous tissue and fascia that creates a potential space that can fill with lymph, blood, and necrotic fat. The MLLs are traditionally seen after high impact trauma and typically located at the greater trochanter and pelvis, although recent reports have found them to be located at the knee, thigh, and lower leg. The MLLs typically present as swelling at the site of injury, which can be difficult to differentiate from several other diagnoses. This case report discusses an MLL in the lower extremity that occurred during a rugby game. A lack of familiarity with MLLs often leads to delayed diagnosis and treatment. The diagnosis was eventually made with an magnetic resonance imaging, and the lesion was successfully treated with ultrasound-guided aspiration and compression. The athlete was able to return to play without recurrence of the lesion.

  11. Quantification of bone marrow plasma cell infiltration in multiple myeloma: usefulness of bone marrow aspirate clot with CD138 immunohistochemistry.

    Science.gov (United States)

    Matsue, Kosei; Matsue, Yuya; Kumata, Kaoru; Usui, Yoshiaki; Suehara, Yasuhito; Fukumoto, Kota; Fujisawa, Manabu; Narita, Kentaro; Takeuchi, Masami

    2017-09-01

    Accurate quantification of plasma cells (PCs) in bone marrow (BM) is critical for diagnosis and assessment of treatment response in patients with multiple myeloma (MM). We compared the % of BM PC quantified by 250 cell differential count on May-Giemsa-stained BM smears, by counting 500 - 2500 cells in 2 - 5 representative microscopy fields in CD138-immunostained BM clot and biopsy sections, and CD38/CD45/CD138 gated BM PCs on flow cytometry (FCM) in 150 sets of BM samples from 120 patients. Percentages of PC were significantly correlated between BM biopsy and clot, and between smear and FCM (r = 0.96, 0.93, respectively). However, quantification by smear and FCM significantly underestimated the PC compared to biopsy or clot, and the degree of underestimation increased with blood dilution. FCM consistently showed lower % of PC compared to aspirate smears. Fifty-nine of 103 patients with M-protein level smoldering MM when reassessed using CD138-stained biopsy/clot sections. Among the 72 patients with sMM diagnosed by BM biopsy and/clot, three patients (4.2%) had extensive BM infiltration of PC (≥ 60%) and required treatment. Our data clearly showed the necessity of CD138 immunostaining of BM biopsy/clot specimens for correct diagnosis of MM and related disorders. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  12. Endobronchial ultrasound-guided transbronchial needle aspiration of thyroid: Report of two cases and systematic review of literature

    Directory of Open Access Journals (Sweden)

    Karan Madan

    2016-01-01

    Full Text Available Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA is a minimally invasive and safe technique for a sampling of mediastinal lesions. Indications for EBUS-TBNA have gradually expanded since its introduction. The usual approach to cytological sampling of the thyroid gland is percutaneous ultrasound-guided fine needle aspiration (US-FNA performed under local anesthesia. US-FNA may be risky or not feasible in intrathoracic/substernal thyroid location. Feasibility of aspirating thyroid lesions with EBUS-TBNA has been occasionally reported. We report two patients wherein EBUS-TBNA was utilized for thyroid lesion aspiration and definitive diagnosis. We highlight the utility and safety of EBUS-TBNA in the evaluation of intrathoracic thyroid lesions wherein image-guided percutaneous aspiration may be risky/sometimes impossible to perform. A systematic review of literature has also been performed summarizing and discussing the issues pertaining to EBUS-TBNA of the thyroid gland.

  13. Endobronchial ultrasound-guided transbronchial needle aspiration of thyroid: Report of two cases and systematic review of literature

    Science.gov (United States)

    Madan, Karan; Mittal, Saurabh; Hadda, Vijay; Jain, Deepali; Mohan, Anant; Guleria, Randeep

    2016-01-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive and safe technique for a sampling of mediastinal lesions. Indications for EBUS-TBNA have gradually expanded since its introduction. The usual approach to cytological sampling of the thyroid gland is percutaneous ultrasound-guided fine needle aspiration (US-FNA) performed under local anesthesia. US-FNA may be risky or not feasible in intrathoracic/substernal thyroid location. Feasibility of aspirating thyroid lesions with EBUS-TBNA has been occasionally reported. We report two patients wherein EBUS-TBNA was utilized for thyroid lesion aspiration and definitive diagnosis. We highlight the utility and safety of EBUS-TBNA in the evaluation of intrathoracic thyroid lesions wherein image-guided percutaneous aspiration may be risky/sometimes impossible to perform. A systematic review of literature has also been performed summarizing and discussing the issues pertaining to EBUS-TBNA of the thyroid gland. PMID:27891005

  14. Impact of consumption aspirations and brand knowledge on customer decision making: Evidence form fast food industry of Pakistan

    Directory of Open Access Journals (Sweden)

    Shaheer Ellahi

    2012-10-01

    Full Text Available The purpose of this research is to find out the impact of consumption aspirations and brand knowledge on customer purchase decisions. Data was collected through a questionnaire from 168 customers of fast food sector of Pakistan. Results show that there is a positive association between consumption aspirations, brand knowledge and customer decision making. The Results of the study show that there is a significant association between consumption aspirations, brand knowledge and customer decision making. The fast food sector can get higher level of customer satisfaction and a higher number of customer base and market share through a higher level of brand knowledge and consumption aspiration of the customer. The results of the study show that there is a positive association between consumption aspirations, brand knowledge and customer decision making in the fast food sector of Pakistan.

  15. The value of oropharyngoesophageal scintigraphy in the management of aspiration into the tracheobronchial tree in neurological patients.

    Science.gov (United States)

    Grosso, M; Fattori, B; Volterrani, D; Chondrogiannis, S; Boni, G; Nacci, A; Marzola, M C; Rubello, D

    2015-01-01

    Dysphagia and bolus aspiration are two of the most frequent and invalidating symptoms of various neurological diseases. Swallowing disorders often lead to tracheobronchial aspiration with consequent pneumonia episodes. Aspiration pneumonia per se constitutes the most frequent cause of death in these patients, with mortality rate ranging from 20% to 62%. Oropharyngoesophageal scintigraphy (OPES) permits functional quantitative assessment of the different stages of swallowing, together with the detection and quantitative measurement of bolus aspiration. In this work, we analyzed the role of OPES in patients with different neurological conditions to evaluate swallowing and to detect and quantify bolus aspiration. We enrolled 43 neurological patients (25 women and 18 men, mean age 67.3±12.4 yr) complaining of dysphagia with suspected inhalation. All patients underwent OPES with (99m)Tc-nanocolloid using a liquid bolus first, followed by a semi-solid bolus. We evaluated the following parameters: Oral, Pharyngeal and Esophageal Transit Time, Oro-Pharyngeal Retention Index, Esophageal Emptying Rate, and Aspiration Rate (% AR). OPES detected some airway aspiration in 26/43 patients. 19 patients had tracheal aspiration (with a mean 18.1% AR) and the remaining 7 patients had bilateral broncho-pulmonary aspiration (mean 44.9% AR). OPES is a feasible, repeatable and noninvasive method that allows quantitative assessment of bolus aspiration into the tracheobronchial tract, thus representing a useful and accurate tool to guide the most appropriate treatment and to monitor response to therapy in neurological patients with dysphagia. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  16. Cost-Effectiveness Analysis of Interventions to Reduce Risk of Aspiration in Elderly Cancer Survivors Residing in Skilled Nursing Facilities.

    Science.gov (United States)

    Mantravadi, S

    2017-04-01

    Aspiration can occur in patients of any age group, but it can be prevented. The primary population at risk is made up of survivors of cancer because of their increased risk of mucositis, mucosal atrophy, and dysphagia associated with chemotherapy, radiotherapy, and the disease process itself. The rate of incidence of aspiration cannot be quantified, because minor cases of aspiration often go unreported. Sequelae ensuing from aspirations can include pneumonia, end-stage kidney disease, dialysis, and death. Analyses of cost, decision-tree modeling, and cost effectiveness were performed to compare a hypothetical, interventional model based on best practices with usual (standard) care. A societal perspective was used as the economic view point. Direct costs, caregiver time, and market values for wages were estimated for the 2 interventions. Effectiveness values for the cost-effectiveness and decision-tree analyses were obtained from the literature. The incremental-cost-effectiveness ratio was calculated and used to compare the intervention with usual care. The interventional method was more costly but more effective than usual care. A sensitivity analysis considered the uncertainty of event probability (aspiration vs no aspiration). The interventional protocol for aspiration reduction continued to be more cost effective than usual care. Aspiration takes a financial toll on all facets of health care, including on nurses, skilled nursing facilities, patients, their families, and insurers, among others. Implementing guidelines that describe best practices for aspiration appears to be a cost-effective strategy for reducing aspirations among cancer survivors - especially elderly patients - who live in skilled nursing facilities.

  17. Rapid on-site evaluation of axillary fine-needle aspiration cytology in breast cancer.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2012-06-01

    Axillary ultrasonography (AUS) and fine-needle aspiration cytology (FNAC) can establish axillary lymph node status before surgery, although this technique is hampered by poor adequacy rates. To achieve consistently high rates of FNAC adequacy, rapid on-site evaluation (ROSE) of FNAC samples was introduced.

  18. Beyond the Big Five: the role of extrinsic life aspirations in compulsive buying.

    Science.gov (United States)

    Otero-López, José M; Villardefrancos Pol, Estíbaliz; Castro Bolaño, Cristina

    2017-11-01

    The integration of units of differing natures which are found in different parts of some multilevel personality models is one of the most thought-provoking paths in contemporary research. In the field of compulsive buying, little is known about the interrelationships between the comparative and stable units such as personality traits (basic tendencies or Level I units) and goals (a kind of middle-level unit) which are more related to motivational processes and intentions governing people’s behavior. Self-reporting measures of compulsive buying, Big Five personality traits, and extrinsic life aspirations were administered to a general population sample consisting of 2,159 participants aged 15 to 65 (48.1% males; Mage= 35.4, SD= 13.24). Our results confirmed statistically significant associations with compulsive buying for the traits as well as the extrinsic goals. Furthermore, an important relationship between both levels in personality – traits vs . extrinsic life aspirations – was found. Finally, extrinsic life aspirations (specially, image, popularity, and conformity) contribute to the potentiation of the prediction of compulsive buying beyond the Five Factor Model. Current findings emphasize the advisability of considering both levels in personality, traits and middle-level units like life aspirations, not only in the prediction of compulsive buying, but also as potential targets for preventive and treatment programs.

  19. The quality of specimens obtained by fine-needle aspiration biopsy ...

    African Journals Online (AJOL)

    Questionnaires were completed prior to the training session and after the subsequent six-month period, to determine the subjective assessment of the clinicians' perceived value of the training on their aspiration technique. Results: Five of the clinicians had never received training in FNAB technique. The adequacy of the ...

  20. Academic performance, educational aspiration and birth outcomes among adolescent mothers: a national longitudinal study.

    Science.gov (United States)

    Xie, Yiqiong; Harville, Emily Wheeler; Madkour, Aubrey Spriggs

    2014-01-15

    Maternal educational attainment has been associated with birth outcomes among adult mothers. However, limited research explores whether academic performance and educational aspiration influence birth outcomes among adolescent mothers. Data from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) were used. Adolescent girls whose first pregnancy occurred after Wave I, during their adolescence, and ended with a singleton live birth were included. Adolescents' grade point average (GPA), experience of ever skipping a grade and ever repeating a grade, and their aspiration to attend college were examined as predictors of birth outcomes (birthweight and gestational age; n = 763). Univariate statistics, bivariate analyses and multivariable models were run stratified on race using survey procedures. Among Black adolescents, those who ever skipped a grade had higher offspring's birthweight. Among non-Black adolescents, ever skipping a grade and higher educational aspiration were associated with higher offspring's birthweight; ever skipping a grade was also associated with higher gestational age. GPA was not statistically significantly associated with either birth outcome. The addition of smoking during pregnancy and prenatal care visit into the multivariable models did not change these associations. Some indicators of higher academic performance and aspiration are associated with better birth outcomes among adolescents. Investing in improving educational opportunities may improve birth outcomes among teenage mothers.