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Sample records for syndrome evaluation wise

  1. Combining psychosocial data to improve prediction of cardiovascular disease risk factors and events:: The NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study

    Science.gov (United States)

    Whittaker, Kerry S.; Krantz, David S.; Rutledge, Thomas; Johnson, B. Delia; Wawrzyniak, Andrew J.; Bittner, Vera; Eastwood, Jo-Ann; Eteiba, Wafia; Cornell, Carol E.; Pepine, Carl J.; Vido, Diane A.; Handberg, Eileen; Merz, C. Noel Bairey

    2012-01-01

    Background There is overlap among psychosocial variables associated with cardiovascular disease (CVD), and utility of combining psychosocial variables as risk markers for understanding CVD is largely unknown. Methods Women (n=493) in the NHLBI Women's Ischemia Syndrome Evaluation (WISE) Study were evaluated. The predictive value for CVD events was determined for multivariate combination of Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Social Network Index (SNI), and Cook-Medley hostility (Ho) scales. Principal components analysis of psychosocial scales revealed composite psychosocial risk markers, and their relationships to CVD events and risk factors were assessed. Results In a multivariate model, the block of SNI, Hostile Affect, STAI and BDI predicted CVD events (χ2[6]=27.8, ppsychosocial variables. Multivariate combination of psychosocial risk markers predicts CVD events; derived psychosocial factors were associated with CVD risk factors but not events. Measuring common and unique variance among psychosocial variables may be useful for understanding and predicting CVD. PMID:22434916

  2. Adverse Outcomes Among Women Presenting with Signs and Symptoms of Ischemia and No Obstructive Coronary Artery Disease: Findings from the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation (WISE) Angiographic Core Laboratory

    Science.gov (United States)

    Sharaf, Barry; Wood, Todd; Shaw, Leslee; Johnson, B. Delia; Kelsey, Sheryl; Anderson, R. David; Pepine, Carl J.; Merz, Noel Bairey

    2013-01-01

    Background Women presenting with signs and symptoms of myocardial ischemia frequently have no or non-obstructive coronary artery disease (CAD). Objective To investigate associations between angiographic measures and longer-term clinical outcomes among women with signs and symptoms of ischemia referred for coronary angiography. Methods Prospective cohort analysis of women referred for coronary angiography and enrolled in the National Heart, Lung, and Blood Institute-sponsored Women’s Ischemia Syndrome Evaluation (WISE). An angiographic severity score was prospectively developed, assigning points for any stenosis weighted by stenosis severity, location and collaterals, and then tested for prediction for adverse outcome in 917 women over a median 9.3 years. Setting Referral centers. Patients Women, with signs and/or symptoms of myocardial ischemia, referred for coronary angiography were consecutively consented and enrolled in a prospective study. Main Outcome Measures First occurrence of cardiovascular death or non-fatal myocardial infarction. Hospitalization for angina was a secondary outcome. Results Cardiovascular death or myocardial infarction at 10 years occurred in 6.7%, 12.8% and 25.9% of women with no, non-obstructive, and obstructive CAD (p50. The optimal threshold in the WISE severity score classifications for predicting cardiovascular mortality was >10 (e.g. 5.0–10 vs. 10.1–89), with both a sensitivity and specificity of 0.64 and an area under the curve of 0.64 (p=0.02, 95% CI = 0.59, 0.68). Conclusions Among women with signs and symptoms of ischemia, non-obstructive CAD is common, and associated with adverse outcomes over the longer-term. The new WISE angiographic score appears to be useful for risk prediction in this population. PMID:23816032

  3. Brachial artery constriction during brachial artery reactivity testing predicts major adverse clinical outcomes in women with suspected myocardial ischemia: results from the NHLBI-sponsored women's ischemia Syndrome Evaluation (WISE Study.

    Directory of Open Access Journals (Sweden)

    Tara L Sedlak

    Full Text Available Limited brachial artery (BA flow-mediated dilation during brachial artery reactivity testing (BART has been linked to increased cardiovascular risk. We report on the phenomenon of BA constriction (BAC following hyperemia.To determine whether BAC predicts adverse CV outcomes and/or mortality in the women's ischemic Syndrome Evaluation Study (WISE. Further, as a secondary objective we sought to determine the risk factors associated with BAC.We performed BART on 377 women with chest pain referred for coronary angiography and followed for a median of 9.5 years. Forearm ischemia was induced with 4 minutes occlusion by a cuff placed distal to the BA and inflated to 40mm Hg > systolic pressure. BAC was defined as >4.8% artery constriction following release of the cuff. The main outcome was major adverse events (MACE including all-cause mortality, non-fatal MI, non-fatal stroke, or hospitalization for heart failure.BA diameter change ranged from -20.6% to +44.9%, and 41 (11% women experienced BAC. Obstructive CAD and traditional CAD risk factors were not predictive of BAC. Overall, 39% of women with BAC experienced MACE vs. 22% without BAC (p=0.004. In multivariate Cox proportional hazards regression, BAC was a significant independent predictor of MACE (p=0.018 when adjusting for obstructive CAD and traditional risk factors.BAC predicts almost double the risk for major adverse events compared to patients without BAC. This risk was not accounted for by CAD or traditional risk factors. The novel risk marker of BAC requires further investigation in women.

  4. Timing of Hormone Therapy, Type of Menopause, and Coronary Disease in Women: Data from the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation (WISE)

    Science.gov (United States)

    Shufelt, Chrisandra; Johnson, B. Delia; Berga, Sarah L.; Braunstein, Glenn D.; Reis, Steven E.; Bittner, Vera; Yang, YuChing; Pepine, Carl J.; Sharaf, Barry L.; Sopko, George; Kelsey, Sheryl F.; Merz, C. Noel Bairey

    2011-01-01

    Objective To assess the relationship of timing of hormone therapy (HT) use with angiographic coronary artery disease (CAD) and cardiovascular disease (CVD) events in women with natural versus surgical menopause. Methods We studied 654 postmenopausal women undergoing coronary angiography for evaluation of suspected ischemia. Timing and type of menopause, HT use, and quantitative angiographic evaluations were obtained at baseline, and the women were followed for a median of 6 years for CVD events. Results Ever users of HT had a significantly lower prevalence of obstructive CAD compared to never users (age-adjusted OR=0.41 [0.28, 0.60]). Naturally menopausal women initiating HT at age menopause group (HR [95%CI] = 0.60[0.41, 0.88], p=0.009) but became non-significant when adjusting for presence or severity of obstructive CAD. Conclusions Using quantitative measurements of timing and type of menopause and HT use, earlier initiation of HT was associated with less angiographic CAD in women with natural but not surgical menopause. Our data suggest that the effect of HT use on reduced cardiovascular event rates is mediated by the presence or absence of angiographic obstructive atherosclerosis. PMID:21532511

  5. Anginal symptoms, coronary artery disease, and adverse outcomes in Black and White women: the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE) study.

    Science.gov (United States)

    Eastwood, Jo-Ann; Johnson, B Delia; Rutledge, Thomas; Bittner, Vera; Whittaker, Kerry S; Krantz, David S; Cornell, Carol E; Eteiba, Wafia; Handberg, Eileen; Vido, Diane; Bairey Merz, C Noel

    2013-09-01

    Black women are less likely to be evaluated and treated for anginal symptoms, despite a higher premature cardiac mortality rate compared to white women. Our objective was to compare angina symptoms in black versus white women regarding (1) angina symptoms characterization; (2) relationship with obstructive coronary artery disease (CAD); and (3) relationship with subsequent mortality. A cohort of 466 women (69 black and 397 white) undergoing coronary angiography for suspected ischemia and without prior history of CAD completed symptom checklists. Four symptom clusters (CHEST, UPPER, STOMACH, and TYPICAL TRIGGERS) were derived by factor analysis. All angiograms were analyzed by core lab. Mortality data over 10 years were obtained from National Death Index. (1) Black women had lower mean CHEST cluster scores (0.60±0.30 vs. 0.73±30, p=0.002), but higher STOMACH scores (0.41±0.25 vs. 0.30±0.25, p=0.011) than white women. (2) Prevalence and severity of CAD did not differ in black and white women and was not predicted by symptom cluster scores. (3) All-cause mortality rates were 24.9% in blacks versus 14.5% in whites, p=0.007; and cardiovascular mortality 22.5% vs.8.8%, p=0.001. Symptom clusters were not predictive of adverse events in white women. However, black women with a low TYPICAL score had significantly higher mortality compared to those with a high TYPICAL score (43% vs. 10%, p=0.006). Among women undergoing coronary angiography, black women report fewer chest-related and more stomach-related symptoms, regardless of presence or severity of CAD, and these racial symptom presentation differences are linked with the more adverse prognosis observed in the black women. Atypical symptom presentation may be a barrier to appropriate and timely diagnosis and treatment and contribute to poorer outcomes for black women.

  6. Adverse outcomes among women presenting with signs and symptoms of ischemia and no obstructive coronary artery disease: findings from the National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation (WISE) angiographic core laboratory.

    Science.gov (United States)

    Sharaf, Barry; Wood, Todd; Shaw, Leslee; Johnson, B Delia; Kelsey, Sheryl; Anderson, R David; Pepine, Carl J; Bairey Merz, C Noel

    2013-07-01

    Women presenting with signs and symptoms of myocardial ischemia frequently have no or nonobstructive coronary artery disease (CAD). This study aimed to investigate the associations between angiographic measures and longer-term clinical outcomes among women with signs and symptoms of ischemia referred for coronary angiography. A prospective cohort analysis of women referred for coronary angiography and enrolled in the National Heart, Lung, and Blood Institute-sponsored WISE was performed. An angiographic severity score was prospectively developed, assigning points for any stenosis weighted by stenosis severity, location, and collaterals and was then tested for prediction for adverse outcome in 917 women, over a median of 9.3 years. The study was conducted in referral centers. Women with signs and/or symptoms of myocardial ischemia referred for coronary angiography were consecutively consented and enrolled in a prospective study. Main outcomes included first occurrence of cardiovascular death or nonfatal myocardial infarction. Hospitalization for angina was a secondary outcome. Cardiovascular death or myocardial infarction at 10 years occurred in 6.7%, 12.8%, and 25.9% of women with no, nonobstructive, and obstructive CAD (P 50. The optimal threshold in the WISE severity score classifications for predicting cardiovascular mortality was >10 (eg, 5.0-10 vs 10.1-89), with both a sensitivity and specificity of 0.64 and an area under the curve of 0.64 (P = .02, 95% CI 0.59-0.68). Among women with signs and symptoms of ischemia, nonobstructive CAD is common and associated with adverse outcomes over the longer term. The new WISE angiographic score appears to be useful for risk prediction in this population. Copyright © 2013 Mosby, Inc. All rights reserved.

  7. Imaging studies in patients with spinal pain: Practice audit evaluation of Choosing Wisely Canada recommendations.

    Science.gov (United States)

    Ferrari, Robert

    2016-03-01

    To evaluate an a priori threshold for advanced imaging in patients with spinal pain. Patients with spinal pain in any region for 6 to 52 weeks were assessed to determine if radiologic studies beyond x-ray scans were indicated, including magnetic resonance imaging (MRI), computed tomography (CT), and radionuclide bone scans. An a priori threshold was set before MRI, CT, or bone scans would be considered. Those who did not have MRI, CT, or bone scans ordered were followed for at least 1 year to determine if any of them went on to be diagnosed with a more serious spinal disorder (eg, infection, fracture, spondylitis, tumour, neurologic compression). Four large primary care clinics in Edmonton, Alta. A total of 1003 consecutively presenting patients with symptoms suspected to be related to the spine (for a duration of generally 6 to 52 weeks) who had not already undergone advanced imaging and did not have a diagnosis of nonbenign back pain. Number of cases of nonbenign spinal disorder in participants who underwent advanced imaging and participants who did not undergo advanced imaging (ie, did not have any red flags). There were 399 women (39.8%) and 604 men (60.2%). The mean (SD) age of the group was 47.2 (14.6) years. The mean (SD) duration of symptoms was 15.1 (8.6) weeks. Of the 1003 participants, 110 met an a priori threshold for undergoing at least 1 of MRI, CT, or bone scan. In these 110 participants, there were newly diagnosed cases of radiculopathy (n = 12), including a case of cauda equina syndrome; spondyloarthropathy (n = 6); occult fracture (n = 2); solitary metastasis (n = 1); epidural lipomatosis (n = 1); osteomyelitis (n = 1), and retroperitoneal hematoma (n = 1), each of which was considered likely to be the cause of the patient's spinal symptoms. The remaining 893 participants were followed for at least 1 year and none showed evidence of a nonbenign cause of his or her spinal pain. In the evaluation of nonspecific spinal pain and symptoms, setting and

  8. Choosing Wisely Canada Students and Trainees Advocating for Resource Stewardship (STARS) campaign: a descriptive evaluation.

    Science.gov (United States)

    Cardone, Franco; Cheung, Daphne; Han, Angela; Born, Karen B; Alexander, Lisa; Levinson, Wendy; Wong, Brian M

    2017-12-19

    Resource stewardship is being increasingly recognized as an essential competency for physicians, but medical schools are just beginning to integrate this into education. We describe the evaluation of Choosing Wisely Canada's Students and Trainees Advocating for Resource Stewardship (STARS) campaign, a student-led campaign to advance resource stewardship education in medical schools across Canada. We evaluated the campaign 6 months after its launch, in November 2015. STARS students were administered a telephone survey eliciting a description of the initiatives that they had implemented or planned to implement at their schools to promote resource stewardship, and exploring their perceptions of facilitators of and barriers to successful implementation of their initiatives. We used a mixed-methods approach to analyze and summarize the data. Twenty-seven (82%) of the 33 eligible students representing all 17 medical schools responded. In 14 schools (82%), students led various local activities (e.g., interest groups, campaign weeks) to raise awareness about resource stewardship among medical students and faculty. Students contributed to curriculum change (both planned and implemented) at 10 schools (59%). Thematic analysis revealed key program characteristics that facilitated success (e.g., pan-Canadian student network, local faculty champion) as well as barriers to implementing change (e.g., complex processes to change curriculum, hierarchical nature of medical school). This student-led campaign, with support from local faculty and Choosing Wisely Canada staff, led to awareness-building activities and early curricula change at medical schools across Canada. Future plans will build on the initial momentum created by the STARS campaign to sustain and spread local initiatives. Copyright 2017, Joule Inc. or its licensors.

  9. Evaluation of the Wise Guys Male Responsibility Curriculum: Participant-Control Comparisons

    Science.gov (United States)

    Gruchow, Harvey William; Brown, Roger K.

    2011-01-01

    Background: Although males are often the initiators of teen sexual activity, pregnancy prevention programs generally target females. To address this deficiency, the Wise Guys Male Responsibility Curriculum was developed to be delivered to adolescent males in weekly classroom sessions. Methods: Seventh grade participants (n = 124) in the Wise Guys…

  10. D-WISE: Diabetes Web-Centric Information and Support Environment: conceptual specification and proposed evaluation.

    Science.gov (United States)

    Abidi, Samina; Vallis, Michael; Raza Abidi, Syed Sibte; Piccinini-Vallis, Helena; Imran, Syed Ali

    2014-06-01

    To develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management. The above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management. We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision

  11. Burn Wise

    Science.gov (United States)

    Burn Wise is a partnership program of the U.S. Environmental Protection Agency that emphasizes the importance of burning the right wood, the right way, in the right appliance to protect your home, health, and the air we breathe.

  12. Evaluation of users' satisfaction on pedestrian facilities using pair-wise comparison approach

    International Nuclear Information System (INIS)

    Zainol, R; Ahmad, F; Nordin, N A; Aripin, A W M

    2014-01-01

    Global climate change issues demand people of the world to change the way they live today. Thus, current cities need to be redeveloped towards less use of carbon in their day to day operations. Pedestrianized environment is one of the approaches used in reducing carbon foot print in cities. Heritage cities are the first to be looked into since they were built in the era in which motorized vehicles were minimal. Therefore, the research explores users' satisfaction on assessment of physical attributes of pedestrianization in Melaka Historical City, a UNESCO World Heritage Site. It aims to examine users' satisfaction on pedestrian facilities provided within the study area using pair wise questionnaire comparison approach. A survey of 200 respondents using random sampling was conducted in six different sites namely Jonker Street, Church Street, Kota Street, Goldsmith Street, Merdeka Street to Taming Sari Tower and Merdeka Street to River Cruise terminal. The survey consists of an assessment tool based on a nine-point scale of users' satisfaction level of pathway properties, zebra pedestrian crossing, street furniture, personal safety, adjacent to traffic flow, aesthetic and amenities. Analytical hierarchical process (AHP) was used to avoid any biasness in analyzing the data collected. Findings show that Merdeka Street to Taming Sari Tower as the street that scores the highest satisfaction level that fulfils all the required needs of a pedestrianized environment. Similar assessment elements can be used to evaluate existing streets in other cities and these criteria should also be used in planning for future cities

  13. Choosing Wisely

    Directory of Open Access Journals (Sweden)

    Emilie Chan

    2017-02-01

    Full Text Available Purpose of review: The purpose of this review is to contribute to the Choosing Wisely Canada campaign and develop a list of 5 items for nephrology health care professionals and patients to re-evaluate based on evidence that they are overused or misused. Sources of information: A working group was formed from the Canadian Society of Nephrology (CSN Clinical Practice Guidelines Committee. This working group sequentially used a multistage Delphi method, a survey of CSN members, a modified Delphi process, and a comprehensive literature review to determine 10 candidate items representing potentially ineffective care in nephrology. An in-person vote by CSN members at their Annual General Meeting was used to rank each item based on their relevance to and potential impact on patients with kidney disease to derive the final 5 items on the list. Key messages: One hundred thirty-four of 609 (22% CSN members responded to the survey, from which the CSN working group identified 10 candidate-misused items. Sixty-five CSN members voted on the ranking of these items. The top 5 recommendations selected for the final list were (1 do not initiate erythropoiesis-stimulating agents in patients with chronic kidney disease (CKD with hemoglobin levels greater than or equal to 100 g/L without symptoms of anemia; (2 do not prescribe nonsteroidal anti-inflammatory drugs for individuals with hypertension or heart failure or CKD of all causes, including diabetes; (3 do not prescribe angiotensin-converting-enzyme inhibitors in combination with angiotensin II receptor blockers for the treatment of hypertension, diabetic nephropathy or heart failure; (4 do not initiate chronic dialysis without ensuring a shared decision-making process between patients, their families, and their nephrology health care team; and (5 do not initiate dialysis in outpatients with CKD category G5-ND in the absence of clinical indications. Limitations: A low survey response rate of both community and

  14. Wise Choices

    DEFF Research Database (Denmark)

    Linder, Stefan; Lyngsie, Jacob; Foss, Nicolai Juul

    2015-01-01

    as managerial criteria. Given that such evaluation takes considerable time, energy, attention, and skill on the part of employees, we propose that firms need to establish a fit between the thoroughness of opportunity appraisal and their reward as well as performance evaluation practices. Evidence from a double......Firms need to invest their scarce resources into the most promising new business opportunities (e.g., new engineering technologies). Yet, the literature on strategic entrepreneurship pays little attention to how, and how thoroughly, firms appraise potential opportunities based on technical as well...

  15. Working with Evaluation Stakeholders: A Rationale, Step-Wise Approach and Toolkit

    Science.gov (United States)

    Bryson, John M.; Patton, Michael Quinn; Bowman, Ruth A.

    2011-01-01

    In the broad field of evaluation, the importance of stakeholders is often acknowledged and different categories of stakeholders are identified. Far less frequent is careful attention to analysis of stakeholders' interests, needs, concerns, power, priorities, and perspectives and subsequent application of that knowledge to the design of…

  16. Community-wise evaluation of rice beer prepared by some ethnic tribes of Tripura

    OpenAIRE

    Ghosh, Sushanta; Rahaman, Lovely; Kaipeng, David Lalvohbika; Deb, Dipankar; Nath, Nandita; Tribedi, Prosun; Sharma, Bipin Kumar

    2016-01-01

    Tripura is inhabited by many indigenous communities having unique ethno-socio-cultural lifestyle with age-old rice beer brewing techniques using wild herbs and local rice varieties popularly known as chuwak or zu. The present study is focused on comparative evaluation of brewing methods and nutritional aspects of rice beer among Debbarma, Jamatia, Koloi, and Molsom tribes of Tripura. Sample ingredients and plant species are properly identified before reporting. Rice beer is also prepared in l...

  17. Educational Materials - Burn Wise

    Science.gov (United States)

    Burn Wise outreach material. Burn Wise is a partnership program of that emphasizes the importance of burning the right wood, the right way, in the right wood-burning appliance to protect your home, health, and the air we breathe.

  18. Community-wise evaluation of rice beer prepared by some ethnic tribes of Tripura

    Directory of Open Access Journals (Sweden)

    Sushanta Ghosh

    2016-12-01

    Full Text Available Tripura is inhabited by many indigenous communities having unique ethno-socio-cultural lifestyle with age-old rice beer brewing techniques using wild herbs and local rice varieties popularly known as chuwak or zu. The present study is focused on comparative evaluation of brewing methods and nutritional aspects of rice beer among Debbarma, Jamatia, Koloi, and Molsom tribes of Tripura. Sample ingredients and plant species are properly identified before reporting. Rice beer is also prepared in laboratory conditions for comparative studies of qualitative and quantitative aspects. Thirteen different plant species are used by these four tribes for preparation of starter cultures using soaked rice flour. Markhamia stipulate (Wall. Seem. is common to all communities for starter cake preparation. Litsea monopetala (Roxb. Pers. is used by all three communities except Jamatia. The use of Ananus comosus Mill. is common among Debbarma and Jamatia tribes, whereas that of Artocarpus heterophyllus Lam. is common among Molsom and Koloi tribes. However, Aporusa diocia (Roxb. Muell., Combretum indicum (L. DeFilipps., and Citrus sinensis (L. Osbeck. are used only by Debbarma tribe for unique tangy flavor. The physicochemical properties of rice beer varied within tribes for its moisture content, carbohydrate content, reducing sugar, and alcohol percentage. The concentration of alcohol increases with aging and prolonged fermentation. The plants reported here are also reported for having nutritional and medicinal benefits for the metabolic stability in humans, which make the process more prospective for commercialization if a standard for maintaining a quality and associated risk can be determined.

  19. Implementation of a self-management support approach (WISE) across a health system: a process evaluation explaining what did and did not work for organisations, clinicians and patients.

    Science.gov (United States)

    Kennedy, Anne; Rogers, Anne; Chew-Graham, Carolyn; Blakeman, Thomas; Bowen, Robert; Gardner, Caroline; Lee, Victoria; Morris, Rebecca; Protheroe, Joanne

    2014-10-21

    Implementation of long-term condition management interventions rests on the notion of whole systems re-design, where incorporating wider elements of health care systems are integral to embedding effective and integrated solutions. However, most self-management support (SMS) evaluations still focus on particular elements or outcomes of a sub-system. A randomised controlled trial of a SMS intervention (WISE-Whole System Informing Self-management Engagement) implemented in primary care showed no effect on patient-level outcomes. This paper reports on a parallel process evaluation to ascertain influences affecting WISE implementation at patient, clinical and organisational levels. Normalisation Process Theory (NPT) provided a sensitising background and analytical framework. A multi-method approach using surveys and interviews with organisational stakeholders, practice staff and trial participants about impact of training and use of tools developed for WISE. Analysis was sensitised by NPT (coherence, cognitive participation, collective action and reflective monitoring). The aim was to identify what worked and what did not work for who and in what context. Interviews with organisation stakeholders emphasised top-down initiation of WISE by managers who supported innovation in self-management. Staff from 31 practices indicated engagement with training but patchy adoption of WISE tools; SMS was neither prioritised by practices nor fitted with a biomedically focussed ethos, so little effort was invested in WISE techniques. Interviews with 24 patients indicated no awareness of any changes following the training of practice staff; furthermore, they did not view primary care as an appropriate place for SMS. The results contribute to understanding why SMS is not routinely adopted and implemented in primary care. WISE was not embedded because of the perceived lack of relevance and fit to the ethos and existing work. Enacting SMS within primary care practice was not viewed as a

  20. Evaluation of a computerized cognitive behavioural therapy programme, MindWise (2.0), for adults with mild-to-moderate depression and anxiety.

    Science.gov (United States)

    Collins, Sarah; Byrne, Michael; Hawe, James; O'Reilly, Gary

    2017-12-02

    To investigate the acceptability and utility of a newly developed computerized cognitive behavioural therapy (cCBT) programme, MindWise (2.0), for adults attending Irish primary care psychology services. Adult primary care psychology service users across four rural locations in Ireland were invited to participate in this study. A total of 60 service users participated in the MindWise (2.0) treatment group and compared to 22 people in a comparison waiting list control group. Participants completed pre- and post-intervention outcome measures of anxiety, depression, and work/social functioning. At post-intervention, 25 of 60 people in the MindWise (2.0) condition had fully completed the programme and 19 of 22 people in the waiting list condition provided time 2 data. Relative to those in the control group, the MindWise (2.0) participants reported significantly reduced symptoms of anxiety and no change in depression or work/social functioning. The newly developed cCBT programme, MindWise (2.0), resulted in significant improvements on a measure of anxiety and may address some barriers to accessing more traditional face-to-face mental health services for adults in a primary care setting. Further programme development and related research appears both warranted and needed to lower programme drop-out, establish if gains in anxiety management are maintained over time, and support people in a primary care context with depression. There is a growing evidence base that computerized self-help programmes can assist in a stepped-care approach to adult mental health service provision. These programmes require further development to address issues such as high dropout, the development of equally effective transdiagnostic content, and greater effectiveness in the country of origin. This study evaluated the acceptability and utility of a brief online CBT programme for adults referred due to anxiety or low mood to primary care psychology services in the national health service in

  1. Using Dietary Supplements Wisely

    Science.gov (United States)

    ... U V W X Y Z Using Dietary Supplements Wisely Share: On This Page Key Points About ... help ensure coordinated and safe care. About Dietary Supplements Dietary supplements were defined in a law passed ...

  2. Burn Wise - Partners

    Science.gov (United States)

    Within this site you will find information for consumers to make informed decisions about what it means to burn wise. And partners will learn about how they can work with EPA to bring cleaner-burning appliances to market.

  3. Comparison of PET/CT and whole-mount histopathology sections of the human prostate: a new strategy for voxel-wise evaluation.

    Science.gov (United States)

    Schiller, F; Fechter, T; Zamboglou, C; Chirindel, A; Salman, N; Jilg, C A; Drendel, V; Werner, M; Meyer, P T; Grosu, A-L; Mix, M

    2017-08-17

    Implementation of PET/CT in diagnosis of primary prostate cancer (PCa) requires a profound knowledge about the tracer, preferably from a quantitative evaluation. Direct visual comparison of PET/CT slices to whole prostate sections is hampered by considerable uncertainties from imperfect coregistration and fundamentally different image modalities. In the current study, we present a novel method for advanced voxel-wise comparison of histopathology from excised prostates to pre-surgical PET. Resected prostates from eight patients who underwent PSMA-PET/CT were scanned (ex vivo CT) and thoroughly pathologically prepared. In vivo and ex vivo CT including histopathology were coregistered with three different methods (manual, semi-/automatic). Spatial overlap after CT-based registration was evaluated with dice similarity (DSC). Furthermore, we constructed 3D cancer distribution models from histopathologic information in various slices. Subsequent smoothing reflected the intrinsically limited spatial resolution of PSMA-PET. The resulting histoPET models were used for quantitative analysis of spatial histopathology-PET pattern agreement focusing on p values and coefficients of determination (R 2 ). We examined additional rigid mutual information (MI) coregistration directly based on PSMA-PET and histoPET. Mean DSC for the three different methods (ManReg, ScalFactReg, and DefReg) were 0.79 ± 0.06, 0.82 ± 0.04, and 0.90 ± 0.02, respectively, while quantification of PET-histopathology pattern agreement after CT-based registration revealed R 2 45.7, 43.2, and 41.3% on average with p histopathological preparation allowed sophisticated quantitative analyses showing highly significant correlations between histopathology and (PSMA-)PET. We recommend manual CT-based coregistration followed by a PET-based MI algorithm to overcome limitations of purely CT-based coregistrations for meaningful voxel-wise comparisons between PET and histopathology.

  4. A Point-Wise Quantification of Asymmetry Using Deformation Fields

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur; Lanche, Stephanie; Darvann, Tron Andre

    2007-01-01

    of the resulting displacement vectors on the left and right side of the symmetry plane, gives a point-wise measure of asymmetry. The asymmetry measure was applied to the study of Crouzon syndrome using Micro CT scans of genetically modified mice. Crouzon syndrome is characterised by the premature fusion of cranial...... sutures, which gives rise to a highly asymmetric growth. Quantification and localisation of this asymmetry is of high value with respect to surgery planning and treatment evaluation. Using the proposed method, asymmetry was calculated in each point of the surface of Crouzon mice and wild-type mice...... (controls). Asymmetry appeared in similar regions for the two groups but the Crouzon mice were found significantly more asymmetric. The localisation ability of the method was in good agreement with ratings from a clinical expert. Validating the quantification ability is a less trivial task due to the lack...

  5. Astro-WISE information system

    NARCIS (Netherlands)

    Valentijn, E. A.; Belikov, A. N.; Kleijn, G. A. Verdoes; Williams, O.R.; Radziwill, NM; Chiozzi, G

    2012-01-01

    Astro-WISE is the first information system in astronomy which covers all aspects of data processing, storage and visualization. We show the various concepts behind the Astro-WISE, their realization and use, migration of Astro-WISE to other astronomical and non-astronomical information systems.

  6. Recommendations for a step‐wise comparative approach to the evaluation of new screening tests for colorectal cancer

    Science.gov (United States)

    Senore, Carlo; Mandel, Jack S.; Allison, James E.; Atkin, Wendy S.; Benamouzig, Robert; Bossuyt, Patrick M. M.; Silva, Mahinda De; Guittet, Lydia; Halloran, Stephen P.; Haug, Ulrike; Hoff, Geir; Itzkowitz, Steven H.; Leja, Marcis; Levin, Bernard; Meijer, Gerrit A.; O'Morain, Colm A.; Parry, Susan; Rabeneck, Linda; Rozen, Paul; Saito, Hiroshi; Schoen, Robert E.; Seaman, Helen E.; Steele, Robert J. C.; Sung, Joseph J. Y.; Winawer, Sidney J.

    2016-01-01

    BACKGROUND New screening tests for colorectal cancer continue to emerge, but the evidence needed to justify their adoption in screening programs remains uncertain. METHODS A review of the literature and a consensus approach by experts was undertaken to provide practical guidance on how to compare new screening tests with proven screening tests. RESULTS Findings and recommendations from the review included the following: Adoption of a new screening test requires evidence of effectiveness relative to a proven comparator test. Clinical accuracy supported by programmatic population evaluation in the screening context on an intention‐to‐screen basis, including acceptability, is essential. Cancer‐specific mortality is not essential as an endpoint provided that the mortality benefit of the comparator has been demonstrated and that the biologic basis of detection is similar. Effectiveness of the guaiac‐based fecal occult blood test provides the minimum standard to be achieved by a new test. A 4‐phase evaluation is recommended. An initial retrospective evaluation in cancer cases and controls (Phase 1) is followed by a prospective evaluation of performance across the continuum of neoplastic lesions (Phase 2). Phase 3 follows the demonstration of adequate accuracy in these 2 prescreening phases and addresses programmatic outcomes at 1 screening round on an intention‐to‐screen basis. Phase 4 involves more comprehensive evaluation of ongoing screening over multiple rounds. Key information is provided from the following parameters: the test positivity rate in a screening population, the true‐positive and false‐positive rates, and the number needed to colonoscope to detect a target lesion. CONCLUSIONS New screening tests can be evaluated efficiently by this stepwise comparative approach. Cancer 2016;122:826–39. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. PMID:26828588

  7. The wise leader.

    Science.gov (United States)

    Nonaka, Ikujiro; Takeuchi, Hirotaka

    2011-05-01

    In an era of increasing discontinuity, wise leadership has nearly vanished. Many leaders find it difficult to reinvent their corporations rapidly enough to cope with new technologies, demographic shifts, and consumption trends. They can't develop truly global organizations that operate effortlessly across borders. And they find it tough to ensure that their people adhere to values and ethics. The authors assert that leaders must acquire practical wisdom, or what Aristotle called phronesis: experiential knowledge that enables people to make ethically sound judgments. Wise leaders demonstrate six abilities: (i) They make decisions on the basis of what is good for the organization and for society. (2) They quickly grasp the essence of a situation and fathom the nature and meaning of people, things, and events. (3) They provide contexts in which executives and employees can interact to create new meaning. (4) They employ metaphors and stories to convert their experience into tacit knowledge that others can use. (5) They exert political power to bring people together and spur them to act. (6) They use apprenticeship and mentoring to cultivate practical wisdom in orders.

  8. Evaluation of patients with acute vestibular syndrome.

    Science.gov (United States)

    Thabet, Elsaeid

    2008-03-01

    Acute vestibular syndrome is characterized by a rapid unilateral injury to either peripheral or central vestibular structures. It consists of severe vertigo, nausea and vomiting, spontaneous nystagmus, and postural instability. In many cases, a peripheral etiology is considered although it may be due to an underlying serious central pathology. The present study was designed to investigate the feasibility of differentiating the cause of acute vestibular syndrome in such patients using clinical, audiovestibular and radiologic tools. We performed a case series study of patients complaining of acute vertigo at a university referring center for hearing and balance disorders. Thirty patients with history of acute vertigo within 3 days onset with no history of previous otological or neurological disorders. Eighteen patients were due to acute peripheral vestibular lesion, 1 due to psychiatric illness under antidepressant drugs and 11 were of central vestibular lesion. The most important step in the diagnosis of acute vertigo is a thorough and detailed history. The common error of carrying out investigations in place of a detailed history is to be avoided. The clinical evaluation has the highest sensitivity and specificity in differentiating central from peripheral vestibular lesions.

  9. Acute respiratory distress syndrome: evaluation and management.

    Science.gov (United States)

    Cortés, I; Peñuelas, O; Esteban, A

    2012-03-01

    Acute respiratory distress syndrome (ARDS) is a life-threatening condition that affects patients admitted in the Intensive Care Units (ICUs) under mechanical ventilation. ARDS is a process of non-hydrostatic pulmonary edema and hypoxemia associated with a variety of conditions, resulting in a direct (e.g., pneumonia) or indirect (e.g., sepsis) lung injury and is associated with a significant morbidity and mortality. A large body of clinical and basic research has focused in ventilatory strategies and novel pharmacological therapies but, nowadays, treatment is mainly supportive. Mechanical ventilation is the hallmark of the management of these patients. In the last decades, the recognition that mechanical ventilation can contribute to harming the lung has changed the goals of this therapy and has driven research to focus in ventilatory strategies that mitigate lung injury. This review emphasizes clinical aspects in the evaluation and management of ARDS in the ICUs and updates the latest advances in these therapies.

  10. The Performance of Step-Wise Group Screening Designs

    Directory of Open Access Journals (Sweden)

    M.M. Manene

    2005-06-01

    Full Text Available In this paper we evaluate the performance of step-wise group screening designs in which group-factors contain an equal number of factors in the initial step.  A usual assumption in group screening designs is that the directions of possible effects are known a-priori. In practice, however, this assumption is unreasonable. We shall examine step-wise group screening designs without errors in observations when this assumption is relaxed. We shall consider cancellations of effects within group-factors. The performance of step-wise group-screening designs shall then be compared with the performance of multistage group screening designs.

  11. WISE and the Dusty Universe

    Science.gov (United States)

    Benford, Dominic J.

    2010-01-01

    The Wide-field Infrared Survey is a medium class Explorer mission that was launched onl4Dec 2009. WISE should detect hundreds of millions of stars and galaxies, including millions of ULIRGS and QSOs; hundreds of thousands of asteroids; and hundreds of cold brown dwarfs. The telescope cover was ejected on 29 Dec 2009 and the all-sky survey started on 14 Jan 2010. WISE takes more the 7000 framesets per day, with each frameset covering 0.6 square degrees in four bands centered at 3.4, 4.6, 12 and 22 microns. WISE is well-suited to the discovery of brown dwarfs, ultraluminous infrared galaxies, and near-Earth objects. With an angular resolution of 6 arcsecouds at 12 microns, a 5(sigma) point-source sensitivity of around 1 mJy at 12 microns and 6 mJy at 22 microns, and coverage of over 99% of the sky, WISE also provides a powerful database for the study of the dusty ISM in our own galaxy. A preliminary release of WISE data will be made available to the community 6 months after the end of the cryogenic survey, or about May 2011. The final data release will be 11 months later, about April 2012.

  12. Collaborative learning with PeerWise

    Directory of Open Access Journals (Sweden)

    Denis Duret

    2018-01-01

    Full Text Available Building effective and supportive communities of practice in an asynchronous environment can enable students to learn from each other at their own convenient times without the need to meeting for discussing concepts. In an undergraduate course with a large amount of content to learn, working collaboratively to answer practice exam questions can help encourage deeper learning and understanding. This project examined whether exam performance can be positively influenced by online collaboration during revision and suggests that the quality of an individual’s contribution has a direct effect on his/her subsequent exam performance. We compared two student cohorts’ exam marks from their previous 3 years of exams with how they performed in Year 4 after using PeerWise (an online repository of multiple-choice questions that are created, answered, rated and discussed by students. In addition, we looked at the quantity and quality of their contribution in PeerWise to evaluate how this affected their fourth year exam performance. We confirmed that exam performance is improved by authoring questions in PeerWise, but found it is further enhanced by replying to, and commenting on, others’ posts as well.

  13. Wise Creativity and Creative Wisdom

    DEFF Research Database (Denmark)

    Knoop, Hans Henrik

    2008-01-01

    This important new volume from Anna Craft, Howard Gardner and Guy Claxton focuses on the need to educate students for "wise creativity" - the ability to expand their perspectives and exercise their talents responsibly within their school communicaty and in the real world.......This important new volume from Anna Craft, Howard Gardner and Guy Claxton focuses on the need to educate students for "wise creativity" - the ability to expand their perspectives and exercise their talents responsibly within their school communicaty and in the real world....

  14. The evaluation of immediate behavioural outcomes of the syndromic ...

    African Journals Online (AJOL)

    The evaluation of immediate behavioural outcomes of the syndromic case management approach for the treatement of patients with sexually transmitted infections at PHC centres of South Africa: Knowledge, attitudes, beliefs and sexual behaviour.

  15. Alport Syndrome

    Science.gov (United States)

    ... signs and symptoms may differ, based on age, gender and inherited type of Alport syndrome. For example, ... prevention and treatment of kidney disease. The Better Business Bureau Wise Giving Alliance Charity Seal provides the ...

  16. [Evaluation of the primary caregiver syndrome when caring for elderly adults with immobility syndrome].

    Science.gov (United States)

    Morales-Cariño, Elizabeth María; Jiménez-Herrera, Blanca L; Serrano-Miranda, Tirzo A

    2012-01-01

    Caregiver syndrome may develop in caregivers of elderly adults. To evaluate the repercussions of the immobility syndrome present in elderly adults on their primary caregivers as well as to determine the clinical and socio-demographic characteristics of the elderly adult and caregiver. The study population included patients over 65 recruited in the Geriatric Rehabilitation Department, with the diagnosis of immobility syndrome and that required a primary caregiver. A questionnaire including socio-demographic variables was applied to all patients and caregivers, and the Zarit scale was also applied to caregivers in order to determine the presence of caregiver syndrome. Analysis was performed with descriptive statistical methods; Student's t test and Fisher's test were used for comparisons between strata. 75 patients and their caregivers were evaluated; patient average age was 75.9 years and 85.3% were female. 50.7% (38 cases) had mild immobility. The average caregiver's age was 50.6%, 70.7% were female and 57.3% were the patient's daughter. Caregiver syndrome was detected in 60% of them: 57.7% had mild symptoms and in 42.2%, symptoms were moderate to severe. No statistically significant association was established between the development of caregiver syndrome and the degree of patient immobility. Caregivers of patients with immobility syndrome are at high risk of developing caregiver syndrome, thus underscoring the need to include primary caregiver support programs.

  17. Burn Wise Educational Materials for Businesses

    Science.gov (United States)

    Burn Wise outreach material. Burn Wise is a partnership program of that emphasizes the importance of burning the right wood, the right way, in the right wood-burning appliance to protect your home, health, and the air we breathe.

  18. The data zoo in Astro-WISE

    NARCIS (Netherlands)

    Kleijn, Gijs A. Verdoes; Belikov, Andrey N.; McFarland, John P.

    In this paper we describe the way the Astro-WISE information system (or simply Astro-WISE) supports the data from a wide range of instruments and combines multiple surveys and their catalogues. Astro-WISE allows ingesting of data from any optical instrument, survey or catalogue, processing of this

  19. [Choosing Wisely in medical education].

    Science.gov (United States)

    Goldmann, Milena; Middeke, Angelina-Charline; Schuelper, Nikolai; Dehl, Terese; Raupach, Tobias

    2017-12-01

    Choosing Wisely recommendations address situations where physicians will have to make decisions about further diagnostic and therapeutic steps. Undergraduate medical education needs to equip students with the foundations on which clinical reasoning skills can be acquired and fostered throughout their clinical career. Teaching these skills usually involves patients (e.g., bedside teaching, electives, clinical attachments) but it can also be delivered in the format of formalised small-group, case-based learning. Case-based key feature tests have been developed to facilitate the assessment of learning outcomes related to clinical reasoning. Repeated testing with key feature cases yields better medium-term retention than repeatedly studying the same material (without questions). The project 'Choosing Wisely in medical education', which was funded by the German Association for Internal Medicine, involves the creation of key feature cases with reference to the German set of Choosing Wisely recommendations. This article presents the results of the first pilot study using these new cases. Copyright © 2017. Published by Elsevier GmbH.

  20. Radiological evaluation of the chronic venous stasis syndrome

    International Nuclear Information System (INIS)

    Train, J.S.; Schanzer, H.; Peirce, E.C. II; Dan, S.J.; Mitty, H.A.

    1987-01-01

    Chronic venous stasis is an extremely complex clinical syndrome of pain and changes in the skin that can involve the superficial, deep, and perforating veins. This syndrome is commonly referred to as the postphlebitic syndrome, implying that thrombophlebitis is its sole etiology. To test this hypothesis, the authors performed ascending venography on 51 limbs of patients with the chromic venous stasis syndrome and demonstrated that 32 had no radiological evidence of recent or old thrombophlebitis. Instead, they had normal-appearing veins, suggesting primary incompetence of the deep and/or perforating venous valves rather than thrombophlebitis as the etiology. Since various operations have recently been proposed to correct or bypass malfunctioning valves, precise demonstration of pathological change is required to choose the appropriate procedure and to evaluate results. Descending venograms were combined with the ascending studies in 42 limbs for this purpose. In addition to outlining the abnormalities responsible for chronic venous stasis syndrome in individual cases, interesting conclusions regarding the syndrome itself were reached

  1. Hair cortisol in the evaluation of Cushing syndrome.

    Science.gov (United States)

    Hodes, Aaron; Lodish, Maya B; Tirosh, Amit; Meyer, Jerrold; Belyavskaya, Elena; Lyssikatos, Charalampos; Rosenberg, Kendra; Demidowich, Andrew; Swan, Jeremy; Jonas, Nichole; Stratakis, Constantine A; Zilbermint, Mihail

    2017-04-01

    Hair cortisol evaluation has been used to help detect patients with suspected Cushing syndrome. Our goal was to correlate segmental hair cortisol with biochemical testing in patients with Cushing syndrome and controls. This study was a prospective analysis of hair cortisol in confirmed Cushing syndrome cases over 16 months. Thirty-six subjects (26.5 ± 18.9 years, 75% female, and 75% Caucasian) were analyzed by diurnal serum cortisol, 24 h urinary free cortisol corrected for body surface area (UFC/BSA), and 24 h urinary 17-hydroxysteroids corrected for creatinine (17OHS/Cr). Thirty patients were diagnosed with Cushing syndrome, and six were defined as controls. 3-cm hair samples nearest to the scalp, cut into 1-cm segments (proximal, medial, and distal), were analyzed for cortisol by enzyme immunoassay and measured as pmol cortisol/g dry hair. Hair cortisol levels were compared with laboratory testing done within previous 2 months of the evaluation. Proximal hair cortisol was higher in Cushing syndrome patients (266.6 ± 738.4 pmol/g) than control patients (38.9 ± 25.3 pmol/g) (p = 0.003). Proximal hair cortisol was highest of all segments in 25/36 (69%) patients. Among all subjects, proximal hair cortisol was strongly correlated with UFC/BSA (r = 0.5, p = 0.005), midnight serum cortisol (r = 0.4, p = 0.03), and 17OHS/Cr, which trended towards significance (r = 0.3, p = 0.06). Among the three examined hair segments, proximal hair contained the highest cortisol levels and correlated the most with the initial biochemical tests for Cushing syndrome in our study. Further studies are needed to validate proximal hair cortisol in the diagnostic workup for Cushing syndrome.

  2. Pain evaluation during gynaecological surveillance in women with Lynch syndrome

    NARCIS (Netherlands)

    Helder-Woolderink, Jorien; de Bock, Geertruida; Hollema, Harry; van Oven, Magda; Mourits, Marian

    To evaluate perceived pain during repetitive annual endometrial sampling at gynaecologic surveillance in asymptomatic women with Lynch syndrome (LS) over time and in addition to symptomatic women without LS, undergoing single endometrial sampling. In this prospective study, 52 women with LS or first

  3. Dairy Wise, A Whole-Farm Dairy Model

    NARCIS (Netherlands)

    Schils, R.L.M.; Haan, de M.H.A.; Hemmer, J.G.A.; Pol, van den A.; Boer, de J.A.; Evers, A.G.; Holshof, G.; Middelkoop, van J.C.; Zom, R.L.G.

    2007-01-01

    A whole-farm dairy model was developed and evaluated. The DairyWise model is an empirical model that simulated technical, environmental, and financial processes on a dairy farm. The central component is the FeedSupply model that balanced the herd requirements, as generated by the DairyHerd model,

  4. Impact of HealthWise South Africa on Polydrug Use and High-Risk Sexual Behavior

    Science.gov (United States)

    Tibbits, Melissa K.; Smith, Edward A.; Caldwell, Linda L.; Flisher, Alan J.

    2011-01-01

    This study was designed to evaluate the efficacy of the HealthWise South Africa HIV and substance abuse prevention program at impacting adolescents' polydrug use and sexual risk behaviors. HealthWise is a school-based intervention designed to promote social-emotional skills, increase knowledge and refusal skills relevant to substance use and…

  5. Evaluation of Marfan syndrome: MR imaging versus CT

    International Nuclear Information System (INIS)

    Soulen, R.L.; Fishman, E.K.; Pyeritz, R.E.; Gott, V.L.; Zerhouni, E.A.

    1986-01-01

    Twenty-five patients with Marfan, syndrome underwent both CT and MR imaging. MR imaging were interpreted in blinded fashion and then compared with CT scans MR imaging was found to be equivalent to CT in the detection of aortic, dural, and hip abnormalities in patients not operated on. MR imaging was superior to CT in the evaluation of postoperative patients because the artifact produced by Bjork-Shirley or St. Jude valves precludes adequate evaluation of the aortic root on CT while producing only a small inferior field distortion (a ''pseudo-ventricular septal defect'') on MR imaging. The absence of radiation exposure is another major advantage of MR imaging in this relatively young population requiring serial studies. The authors conclude that MR imaging is the modality of choice for the evaluation and follow-up of patients with Marfan syndrome and offers an appropriate means of screening their kindred

  6. Prognostic evaluation of Guillain-Barre' syndrome

    International Nuclear Information System (INIS)

    Shah, F.U.; Saeed, A.M.; Badsha, M.; Tariq, M.

    2001-01-01

    Objective: To study the mortality morbidity and the role of specific therapy in guillain-bare' syndrome (GBS). Design: This was a prospective study. Place and Duration of Study: This study was conducted in the department of Neurology, PIMS, Islamabad from January, 1999 to September, 2000. Subjects and Methods: Forty-eight patients with acute symmetrical flaccid motor weakness, which developed with-in a period of four weeks, were included. These patients were assessed at admission discharge and after 2 and 6 months according to the modified Rankin Scale Scope. Patients with sensory level and those having marked and persistent asymmetry of neurological signs were excluded from the study. Results: The modified disability score (DS) n the patients at admission was 2.-5 in 2,11,19 and 16 patients respectively. Respiratory failure was present in 16 patient. Six patients expired. After 2 months, 19 recovered, 10 were lost and diability was present in 13 patients. After 6 months, 20 recovered and 5 were disabled. Specific treatment was given to 23 patients, plasmaphaeresis was done in 10 patients, gammaglobulin given to 4 patients and both in 9 patients. In plasmaphaeresis group at admission DS was 4, 5 and 7 in 3 patients respectively. Three patients expired. At 2 months, 2 recovered, 3 disable while 2 patient were lost, at 6 months 2 recovered, 1 disable while 4 were lost. Similarly, in gammaglobulin group DS was 4 and 5 in 3 and 1 patient at admission. At 2 months, 3 recovered and 1 was disable. In the combined group, admission DS was 4 in 1 and 5 in the 8 patients. At 2 months, 3 recovered, 5 disabled and 1 patient was lost. At 6 months, 3 recovered and 1 patient was lost. At 6 months, 3 recovered and 2 patients were disabled. In the non-specific treatment group, DS was 2 and 3 in 2 and 11 patients at admission. At 2 months, 9 recovered and 3 were disabled while 1 was lost. At 6 months, 11 patients recovered and 2 were disabled. In the control group, at admission, DS

  7. Water-wise Landscaping: Practical Turfgrass Areas

    OpenAIRE

    Kopp, Kelly; Johnson, Paul

    2011-01-01

    Of the seven guiding principles of water-wise landscaping (a.k.a. Xeriscaping™), the most controversial involves the use of turfgrass in the landscape. At times it has seemed that water-wise landscaping might not allow for the use of turfgrasses at all.

  8. Step-Wise Migration : Evidence from Indonesia

    NARCIS (Netherlands)

    Pardede, Elda; McCann, Philip; Venhorst, Viktor

    2016-01-01

    The objective of this paper is to study multiple internal migration trajectories in Indonesia, with special attention to step-wise migration. Step-wise migration involves moves with smaller steps from village to nearby small town, to larger town, and then to big cities rather than a direct move from

  9. WISE TECHNOLOGY FOR HANDLING BIG DATA FEDERATIONS

    NARCIS (Netherlands)

    Valentijn, E; Begeman, Kornelis; Belikov, Andrey; Boxhoorn, Danny; Verdoes Kleijn, Gijs; McFarland, John; Vriend, Willem-Jan; Williams, Owen; Soille, P.; Marchetti, P.G.

    2014-01-01

    The effective use of Big Data in current and future scientific missions requires intelligent data handling systems which are able to interface the user to complicated distributed data collections. We review the WISE Concept of Scientific Information Systems and the WISE solutions for the storage and

  10. Group-wise partial least square regression

    NARCIS (Netherlands)

    Camacho, José; Saccenti, Edoardo

    2018-01-01

    This paper introduces the group-wise partial least squares (GPLS) regression. GPLS is a new sparse PLS technique where the sparsity structure is defined in terms of groups of correlated variables, similarly to what is done in the related group-wise principal component analysis. These groups are

  11. The Astro-WISE datacentric information system

    NARCIS (Netherlands)

    Begeman, K.; Belikov, A. N.; Boxhoorn, D. R.; Valentijn, E. A.

    In this paper we present the various concepts behind the Astro-WISE Information System. The concepts form a blueprint for general scientific information systems (WISE) which can satisfy a wide and challenging range of requirements for the data dissemination, storage and processing for various fields

  12. Climate wise case study compendium: Report 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    This case study compendium is one of several Climate Wise tools available to help interested companies identify cost-effective options. Climate Wise, a private-public partnership program, is a key Federal initiative to return greenhouse gas emissions to 1990 levels by 2000.

  13. Shoulder impingement syndrome : evaluation of the causes with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yong Ho; Song, In Sup; Chung, Hun Young; Yoon, Sang Jin; Kim, Yang Soo; Shim, Hyung Jin; Choi, Young Hee; Lee, Jong Beum; Lee, Yong Chul; Kim, Kun Sang [Chungang Univ. College of Medicine, Seoul (Korea, Republic of); Choi, Yun Sun [Eulji Hospital, College of Medicine, Seoul (Korea, Republic of)

    1999-12-01

    Various mechanical causes which induce shoulder impingement syndrome have been identified with the help of MRI. The aim of this study is to evaluate the incidence of such causes. A total of 54 patients with clinically confirmed shoulder impingement syndrome and a normal control group(n=20) without symptoms were included. We evaluated the incidence of hook shaped acromion, low lying acromion, downward slope of the acromion, subacromial spur, acromioclavicular joint hypertrophy, coracoacromial ligament hypertrophy, high cuff muscle bulk, and os acromiale. Among the 54 patients, the following conditions were present: acromioclavicular joint hypertrophy(n=36), coracoacromial ligament hypertrophy(n=20), subacromial spur(n=18), downward sloping of the acromion(n=16), hook shaped acromion(n=11), relatively high cuff muscle bulk(n=6), low lying acromion relative to the clavicle(n=3), and os acromiale(n=1). In the normal control group there were nine cases of acromioclavicular joint hypertrophy, nine of coracoacromial ligament hypertrophy, nine of downward sloping acromion, and three of low lying acromion, but hook shaped acromion, high cuff muscle bulk, and os acromiale were not found. Among 54 patients, the syndrome was due to five simultancous causes in one patient, four causes in two, three causes in 12, two causes in 22, and one cause in 17. Hook shaped acromion and subacromial spur are the statistically significant causes of shoulder impingement syndrome. In 69% of patients, the condition was due to more than one cause.

  14. Shoulder impingement syndrome : evaluation of the causes with MRI

    International Nuclear Information System (INIS)

    Choi, Yong Ho; Song, In Sup; Chung, Hun Young; Yoon, Sang Jin; Kim, Yang Soo; Shim, Hyung Jin; Choi, Young Hee; Lee, Jong Beum; Lee, Yong Chul; Kim, Kun Sang; Choi, Yun Sun

    1999-01-01

    Various mechanical causes which induce shoulder impingement syndrome have been identified with the help of MRI. The aim of this study is to evaluate the incidence of such causes. A total of 54 patients with clinically confirmed shoulder impingement syndrome and a normal control group(n=20) without symptoms were included. We evaluated the incidence of hook shaped acromion, low lying acromion, downward slope of the acromion, subacromial spur, acromioclavicular joint hypertrophy, coracoacromial ligament hypertrophy, high cuff muscle bulk, and os acromiale. Among the 54 patients, the following conditions were present: acromioclavicular joint hypertrophy(n=36), coracoacromial ligament hypertrophy(n=20), subacromial spur(n=18), downward sloping of the acromion(n=16), hook shaped acromion(n=11), relatively high cuff muscle bulk(n=6), low lying acromion relative to the clavicle(n=3), and os acromiale(n=1). In the normal control group there were nine cases of acromioclavicular joint hypertrophy, nine of coracoacromial ligament hypertrophy, nine of downward sloping acromion, and three of low lying acromion, but hook shaped acromion, high cuff muscle bulk, and os acromiale were not found. Among 54 patients, the syndrome was due to five simultancous causes in one patient, four causes in two, three causes in 12, two causes in 22, and one cause in 17. Hook shaped acromion and subacromial spur are the statistically significant causes of shoulder impingement syndrome. In 69% of patients, the condition was due to more than one cause

  15. WISE PHOTOMETRY FOR 400 MILLION SDSS SOURCES

    International Nuclear Information System (INIS)

    Lang, Dustin; Hogg, David W.; Schlegel, David J.

    2016-01-01

    We present photometry of images from the Wide-Field Infrared Survey Explorer (WISE) of over 400 million sources detected by the Sloan Digital Sky Survey (SDSS). We use a “forced photometry” technique, using measured SDSS source positions, star–galaxy classification, and galaxy profiles to define the sources whose fluxes are to be measured in the WISE images. We perform photometry with The Tractor image modeling code, working on our “unWISE” coaddds and taking account of the WISE point-spread function and a noise model. The result is a measurement of the flux of each SDSS source in each WISE band. Many sources have little flux in the WISE bands, so often the measurements we report are consistent with zero given our uncertainties. However, for many sources we get 3σ or 4σ measurements; these sources would not be reported by the “official” WISE pipeline and will not appear in the WISE catalog, yet they can be highly informative for some scientific questions. In addition, these small-signal measurements can be used in stacking analyses at the catalog level. The forced photometry approach has the advantage that we measure a consistent set of sources between SDSS and WISE, taking advantage of the resolution and depth of the SDSS images to interpret the WISE images; objects that are resolved in SDSS but blended together in WISE still have accurate measurements in our photometry. Our results, and the code used to produce them, are publicly available at http://unwise.me

  16. Spondylocarpotarsal synostosis syndrome: MRI evaluation of vertebral and disk malformation

    Energy Technology Data Exchange (ETDEWEB)

    Breitling, Magnus; Rabin, Michael [University of Saskatchewan, Department of Medical Imaging, Saskatoon, Saskatchewan (Canada); Lemire, Edmond G. [University of Saskatchewan, Division of Medical Genetics, Department of Pediatrics, Saskatoon (Canada)

    2006-08-15

    Spondylocarpotarsal synostosis syndrome (SSS) is a rare autosomal recessive condition characterized primarily by vertebral malsegmentation, carpal/tarsal coalition, and a dysmorphic appearance. Differentiating SSS from other congenital scoliosis syndromes requires evaluation of the vertebrae, ribs, soft tissues, and spinal cord. The enhanced resolution over plain radiographs seen with MRI allows more detailed assessment of vertebral malformation and surrounding anatomy. Diagnosis of the underlying cause of congenital scoliosis might be enhanced using this technology. We report on a 12-year-old girl of unaffected parents with SSS who was evaluated with MRI sequences of the spine to show various types of malsegmentation. Additionally, there is the new finding of fusion of teeth, with developmental failure of a canine incisor. (orig.)

  17. Cauda equina syndrome in the dog: radiographic evaluation

    International Nuclear Information System (INIS)

    Morgan, J.P.; Bailey, C.S.

    1990-01-01

    Dogs with clinical signs typical of cauda equina syndrome require careful evaluation to determine the cause of the disease as this strongly influences choice of treatment. Possible aetiologies include congenital or developmental, inflammatory, traumatic, neoplastic, and degenerative lesions that may involve vertebrae, vertebral joints, intervertebral discs, spinal cord, spinal nerves, or meninges. It must be determined whether clinical signs are due to musculoskeletal or neurological disease before performing special radiographic procedures. Non-contrast radiography permits false-positive diagnosis of obvious degenerative changes involving the L-S disc that may be without clinical signs or permits a false-negative diagnosis due to the failure to appreciate soft tissue lesions not seen radiographically. Special radiographic techniques are recommended and include: (1) stress radiography, (2) discography, and (3) epidural myelography. Evaluation of the results of these studies assists in determining the cause of the cauda equina syndrome and the type of therapy required

  18. The Italian Society of Internal Medicine choosing wisely campaign.

    Science.gov (United States)

    Montano, Nicola; Costantino, Giorgio; Casazza, Giovanni; Sbrojavacca, Rodolfo; Lenti, Marco Vincenzo; Falsetti, Lorenzo; Guzzo, Annasanta; Majo, Raffaele; Perticone, Francesco; Corazza, Gino Roberto

    2016-12-01

    Appropriateness is one of the critical aspects of medicine. For this reason, the Italian Society of Internal Medicine (SIMI) decided to adhere to the Choosing Wisely Campaign. A bottom-up approach was chosen. All the recommendations published in the US and Canadian Choosing Wisely campaign have been screened, and an e-mail was sent to all the SIMI members for new suggestions. The thirty interventions that were judged as the highest priority by a committee were sent to all the SIMI members for voting. The first procedures selected were then revised, and constituted the five points of the SIMI choosing wisely campaign. The identified procedures were: (1) avoid prescribing bed rest unless an acceptable indication exists. Promote early mobilization; (2) Do not perform a D-dimer test without a precise indication; (3) Do not prescribe long term intravenous antibiotic therapy in the absence of symptoms; (4) Do not indefinitely prescribe proton pump inhibitors in the absence of specific indications; (5) Do not place, or leave in place, peripherally inserted central catheters for patient's or provider's convenience. Four of these points were not present in any other campaign, while one, the fifth, was already present. The bottom-up approach of the SIMI "Choosing Wisely" campaign favored the identification of different priorities compared to other campaigns. Future studies should now evaluate if the application of these "not-to-do" recommendations will be associated with an improvement of clinical outcome and a subsequent direct and indirect health care cost reduction.

  19. Evaluation of Ashwagandha in alcohol withdrawal syndrome

    Directory of Open Access Journals (Sweden)

    Ruby B

    2012-10-01

    Full Text Available Objective: To evaluate the effect of Ashwagandha (ASW in attenuation of alcohol withdrawal in ethanol withdrawal mice model. Methods: Alcohol dependence was induced in mice by the oral, once-daily administration of 10% v/v ethanol (2 g/kg for one week. Once the animals were withdrawn from alcohol, the efficacy of ASW (200mg/kg and 500mg/kg in comparison with diazepam (1 mg/kg in the attenuation of withdrawal was studied using, pentylenetetrazole (PTZ kindling test for seizure threshold, forced swim test (FST for depression and locomotor activity (LCA in open field test (OFT. 6 hours after the last ethanol administration, seizure threshold was measured in all the groups by administering the convulsant drug, PTZ with a subconvulsive dose of 30 mg/kg i.p. In FST, mice were forced to swim and the total duration of immobility (seconds was measured during the last 4 min of a single 6-min test session. In OFT, number of crossings of the lines marked on the floor was recorded for a period of 5 min. Results: Compared to ethanol group, ASW (500 mg/Kg has suppressed the PTZ kindling seizures in ethanol withdrawal animals [0% convulsion], FST has shown decreased immobility time and OFT has exhibited increase in the number of line crossing activity by mice which may be the consequence of anxiolytic activity of ASW similar to that of diazepam. Conclusions: The present study provides satisfactory evidence to use ASW as a safe and reliable alternative to diazepam in alcohol withdrawal conditions.

  20. Global Soil Profile Data (ISRIC-WISE)

    Data.gov (United States)

    National Aeronautics and Space Administration — The ISRIC-WISE International soil profile data set consists of a homogenized, global set of 1,125 soil profiles for use by global modelers. These profiles provided...

  1. Constructing a WISE High Resolution Galaxy Atlas

    Science.gov (United States)

    Jarrett, T. H.; Masci, F.; Tsai, C. W.; Petty, S.; Cluver, M.; Assef, Roberto J.; Benford, D.; Blain, A.; Bridge, C.; Donoso, E.; hide

    2012-01-01

    After eight months of continuous observations, the Wide-field Infrared Survey Explorer (WISE) mapped the entire sky at 3.4 micron, 4.6 micron, 12 micron, and 22 micron. We have begun a dedicated WISE High Resolution Galaxy Atlas project to fully characterize large, nearby galaxies and produce a legacy image atlas and source catalog. Here we summarize the deconvolution techniques used to significantly improve the spatial resolution of WISE imaging, specifically designed to study the internal anatomy of nearby galaxies. As a case study, we present results for the galaxy NGC 1566, comparing the WISE enhanced-resolution image processing to that of Spitzer, Galaxy Evolution Explorer, and ground-based imaging. This is the first paper in a two-part series; results for a larger sample of nearby galaxies are presented in the second paper.

  2. The Evaluation of Diastolic Hypertention in Sleep Overlap Syndrome

    Directory of Open Access Journals (Sweden)

    Fariba Rezaeetalab

    2015-01-01

    Full Text Available Introduction: The overlap syndrome, consisting ofobstructive sleep apnea hypopnea syndrome (OSAHS and chronic obstructvie pulmonary disease (COPD is a major problem in COPD patients. OSHAS corresponds to the likelihood of systemic hypertension.The present study was aimed to evaluate the association between apnea-hypopnea index and diastolic blood presssure (DBP in overlap  patients. Materials and Methods: We conducted a cross-sectional study involving overnight polysomnography after measurment of resting diastolic blood pressure (DBP in patients with overlap syndrome in Sleep Laboartory of Imam Reza Hospital, Mashhad, Iran from October 2011 to December 2012. Participants were divided into four subgroups regarding to their Apnea-Hypopnea Index (AHI (AHI 30.Descriptive statistics included age, body mass index (BMI, OSA, Apnea-Hypopnea Index (AHI, DBP, and neck circumference. Results: Sixty participants ranged between from 46 to 82 years old were entered into this study. There was statistically significant difference in mean DBP among different AHI subgroups (80±0.50, 95±0.60, and 105±0.65, respectively (p

  3. Advanced and standardized evaluation of neurovascular compression syndromes

    Science.gov (United States)

    Hastreiter, Peter; Vega Higuera, Fernando; Tomandl, Bernd; Fahlbusch, Rudolf; Naraghi, Ramin

    2004-05-01

    Caused by a contact between vascular structures and the root entry or exit zone of cranial nerves neurovascular compression syndromes are combined with different neurological diseases (trigeminal neurolagia, hemifacial spasm, vertigo, glossopharyngeal neuralgia) and show a relation with essential arterial hypertension. As presented previously, the semi-automatic segmentation and 3D visualization of strongly T2 weighted MR volumes has proven to be an effective strategy for a better spatial understanding prior to operative microvascular decompression. After explicit segmentation of coarse structures, the tiny target nerves and vessels contained in the area of cerebrospinal fluid are segmented implicitly using direct volume rendering. However, based on this strategy the delineation of vessels in the vicinity of the brainstem and those at the border of the segmented CSF subvolume are critical. Therefore, we suggest registration with MR angiography and introduce consecutive fusion after semi-automatic labeling of the vascular information. Additionally, we present an approach of automatic 3D visualization and video generation based on predefined flight paths. Thereby, a standardized evaluation of the fused image data is supported and the visualization results are optimally prepared for intraoperative application. Overall, our new strategy contributes to a significantly improved 3D representation and evaluation of vascular compression syndromes. Its value for diagnosis and surgery is demonstrated with various clinical examples.

  4. Psychosocial Factors Versus Single Predictors: A Factor Analytic Approach to Cardiovascular Outcomes in The Women’s Ischemia Syndrome Evaluation (WISE) Study

    Science.gov (United States)

    2010-02-18

    later than men (Bello & Mosca, 2004). Also, for women 6 taking oral contraceptives , smoking significantly increases their risk of developing CVD...and risk among users of oral contraceptives who smoke. Am J Obstet Gynecol, 180(6 Pt 2), S349-356. Chaput, L. A., Adams, S. H., Simon, J. A...AND  CORONARY  ARTERY  DISEASE ............................................................... 8   DEPRESSION  AND  CORONARY  ARTERY

  5. GridWise Standards Mapping Overview

    Energy Technology Data Exchange (ETDEWEB)

    Bosquet, Mia L.

    2004-04-01

    ''GridWise'' is a concept of how advanced communications, information and controls technology can transform the nation's energy system--across the spectrum of large scale, central generation to common consumer appliances and equipment--into a collaborative network, rich in the exchange of decision making information and an abundance of market-based opportunities (Widergren and Bosquet 2003) accompanying the electric transmission and distribution system fully into the information and telecommunication age. This report summarizes a broad review of standards efforts which are related to GridWise--those which could ultimately contribute significantly to advancements toward the GridWise vision, or those which represent today's current technological basis upon which this vision must build.

  6. Stage wise modeling of liquid-extraction column (RDC)

    International Nuclear Information System (INIS)

    Bastani, B.

    2004-01-01

    Stage wise forward mixing model considering coalescence and re dispersion of drops was used to predict the performance of Rotating Disk Liquid Extraction Contactors. Experimental data previously obtained in two RDC columns of 7-62 cm diameter, 73.6 cm height and 21.9 cm diameter,150 cm height were used to evaluate the model predications. Drops-side mass transfer coefficients were predicted applying Hand los-baron drop model and onley's model was used to predict velocities. According to the results obtained the followings could be concluded: (1) If the height of coalescence and re dispersion i.e.:h=h p Q p / Q could be estimated, the stage wise forward mixing with coalescence and re dispersion model will predict the column height and efficiency with the acceptable accuracy, (2) The stage wise modeling predictions are highly dependent on the number of stages used when the number of stages is less than 10 and (3) Application of continuous phase mass transfer axial dispersion coefficients (k c and E c ) obtained from the solute concentration profile along the column height will predict the column performance more accurately than the Calder bank and moo-young (for K c ) and Kumar-Heartland (for E c ) correlations

  7. Ultrasound evaluation of metabolic syndrome patients with hepatosteatosis

    Directory of Open Access Journals (Sweden)

    Mehmet Emin Demir

    2013-01-01

    Full Text Available Objective: The exact incidence of hepatosteatosis in patients with metabolic syndrome (MetS is unknown; also there is no valid, simple and inexpensive method to evaluate and follow-up for patients with MetS. In our study, we aimed to demonstrate the frequency of hepatosteatosis, and whether demonstrate presence and degree of steatosis using liver ultrasonography may provide additional benefit for evaluating and following-up in MetS patients with non-alcoholic fatty liver disease. Methods: One hundred and twelve patients with MetS were included to the study. Patients divided into three groups; control group (n= 36 consisted of patients without hepatosteatosis, group 1 (n=43 consisted of patients with grade 1 hepatosteatosis. Finally, group 2 (n= 33 consisted of patients with grade 2 hepatosteatosis. The relationship between the presence and degree of the hepatosteatosis and MetS parameters were analyzed.Results: The incidence of hepatosteatosis was found 69.4% in patients with MetS. There were significantly differences in HOMA-IR, AST, ALT and GGT levels among control group and group 1 (p0.05 for all. Besides, there were significantly differences in waist circumferences, fasting insulin, HOMA-IR, GGT, uric acid, CRP levels among group 1 and 2 (p<0.05 for all.Conclusion: Our study indicates that MetS related parameters; especially insulin resistance, were significantly different in patients with hepatosteatosis compared to patients without hepatosteatosis. Because of the different measurment of waist circumferences among groups, we recommend to use liver ultrasonography and waist circumference together to evaluate and follow-up for MetS patients with hepatosteatosis. J Clin Exp Invest 2013; 4 (2: 153-158Key words: Fatty Liver, metabolic syndrome X, ultrasonography

  8. Evaluation of Gastroesophageal Reflux in Anesthetized Dogs with Brachycephalic Syndrome.

    Science.gov (United States)

    Shaver, Stephanie L; Barbur, Laura A; Jimenez, David A; Brainard, Benjamin M; Cornell, Karen K; Radlinsky, MaryAnn G; Schmiedt, Chad W

    Brachycephalic airway syndrome may predispose to gastroesophageal reflux (GER) because of the high negative intrathoracic pressures required to overcome conformational partial upper airway obstruction. To investigate this, 20 dogs presenting for elective correction of brachycephalic airway syndrome (cases) and 20 non-brachycephalic dogs (controls) undergoing other elective surgeries were prospectively enrolled. Dogs underwent a standardized anesthetic protocol, and esophageal pH was monitored. Signalment, body weight, historical gastrointestinal and respiratory disease, complete blood count, serum biochemical values, radiographic findings, and anesthetic and surgical time were compared between cases and controls, and dogs that did and did not have basic (pH > 7.5), acidic (pH dogs were evaluated, dogs with GER had increased creatinine (P = .01), % positive for esophageal fluid on radiographs (P = .05), and body weight (P = .04) compared to those without GER. GER was common in both cases and controls, and cases had lower esophageal pH; however, greater numbers are required to determine if a true difference exists in % GER.

  9. Evaluation of the anterior chamber angle in pseudoexfoliation syndrome.

    Science.gov (United States)

    Iwanejko, Małgorzata; Turno-Kręcicka, Anna; Tomczyk-Socha, Martyna; Kaczorowski, Kamil; Grzybowski, Andrzej; Misiuk-Hojło, Marta

    2017-08-01

    Pseudoexfoliation syndrome (PEX) is the most frequently identifiable cause of secondary open-angle glaucoma, known as pseudoexfoliation glaucoma. The exact pathophysiology and etiology of PEX and associated glaucoma remains obscure. The purpose of this study was to determine the differences in the morphology of the anterior chamber angle in people with pseudoexfoliation syndrome and pseudoexfoliation glaucoma compared to a control group. We also evaluated the correlation between intraocular pressure (IOP) and pigmentation of the angle with the amount of exfoliated material in the anterior segment. The study group was composed of 155 eyes from 103 patients aged between 43 and 86 years. Each patient underwent a complete ophthalmological examination. Some difference was found in intraocular pressure between the PEX group and the control group and between the pseudoexfoliation glaucoma group and the control group, but no significant difference was found between the 2 study groups. There was a significant difference in the incidence of some degree of pigmentation in the anterior chamber angle and no difference in the widths of the angle between each group. A significant positive relationship was observed between intraocular pressure and the degree of pigmentation of the anterior chamber angle in both the PEX group and the pseudoexfoliation glaucoma group. The results of this study indicate that the amount of pigmentation and exfoliation material in the anterior segment significantly correlates with the level of IOP and possibly with the degree of trabecular dysfunction. It seems that for clear identification of PEX and pseudoexfoliation glaucoma factors, clinical assessment appears to be insufficient.

  10. [Evaluation of ear acupressure on painful shoulder syndrome: case study].

    Science.gov (United States)

    Zanelatto, Ana Paula

    2013-01-01

    The Painful Shoulder Syndrome (PSS) is defined as pain and functional limitation resulting from impairment of static and dynamic structures of the shoulder, such as ligaments, capsule and muscles. It is one of the most common and disabling of the musculoskeletal system in the general population with prevalence estimated between 15-25%. This study aimed to evaluate the results of auricular acupressure when used as therapy in the treatment of chronic pain secondary to SOD, and the analgesic effect and therapeutic satisfactory and the estimated time of treatment. To obtain the objective was to perform a case study was to intervene with auricular acupressure beads and crystals as an indicator of the outcome questionnaire Penn Shoulder Score (PSS - Brazil). Data were analyzed qualitatively and quantitatively. We conclude that auriculotherapy is an important therapeutic technique, because the study showed an improvement in the total score of the PSS - Brazil at 34.3%.

  11. SunWise[R] Meteorologist Tool Kit

    Science.gov (United States)

    US Environmental Protection Agency, 2007

    2007-01-01

    The SunWise Program is designed to help meteorologists raise sun safety awareness by addressing the science of the sun, the risk of overexposure to its ultraviolet (UV) radiation, and what students and their families can do to protect themselves from overexposure. This Tool Kit has been designed for use all over the United States and its…

  12. THE MASSIVE DISTANT CLUSTERS OF WISE SURVEY: THE FIRST DISTANT GALAXY CLUSTER DISCOVERED BY WISE

    Energy Technology Data Exchange (ETDEWEB)

    Gettings, Daniel P.; Gonzalez, Anthony H.; Mancone, Conor [Department of Astronomy, University of Florida, 211 Bryant Space Center, Gainesville, FL 32611 (United States); Stanford, S. Adam [Institute of Geophysics and Planetary Physics, Lawrence Livermore National Laboratory, Livermore, CA 94550 (United States); Eisenhardt, Peter R. M.; Stern, Daniel [Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 (United States); Brodwin, Mark [Department of Physics and Astronomy, University of Missouri, 5110 Rockhill Road, Kansas City, MO 64110 (United States); Zeimann, Gregory R. [Department of Physics, University of California, One Shields Avenue, Davis, CA 95616 (United States); Masci, Frank J. [Infrared Processing and Analysis Center, California Institute of Technology 100-22, Pasadena, CA 91125 (United States); Papovich, Casey [George P. and Cynthia Woods Mitchell Institute for Fundamental Physics and Astronomy, and Department of Physics and Astronomy, Texas A and M University, College Station, TX, 77843-4242 (United States); Tanaka, Ichi [Subaru Telescope, National Astronomical Observatory of Japan, 650 North A' ohoku Place, Hilo, HI 96720 (United States); Wright, Edward L. [UCLA Astronomy, P.O. Box 951547, Los Angeles, CA 90095-1547 (United States)

    2012-11-01

    We present spectroscopic confirmation of a z = 0.99 galaxy cluster discovered using data from the Wide-field Infrared Survey Explorer (WISE). This is the first z {approx} 1 cluster candidate from the Massive Distant Clusters of WISE Survey to be confirmed. It was selected as an overdensity of probable z {approx}> 1 sources using a combination of WISE and Sloan Digital Sky Survey DR8 photometric catalogs. Deeper follow-up imaging data from Subaru and WIYN reveal the cluster to be a rich system of galaxies, and multi-object spectroscopic observations from Keck confirm five cluster members at z = 0.99. The detection and confirmation of this cluster represents a first step toward constructing a uniformly selected sample of distant, high-mass galaxy clusters over the full extragalactic sky using WISE data.

  13. The Massive Distant Clusters of WISE Survey: The First Distant Galaxy Cluster Discovered by WISE

    Science.gov (United States)

    Gettings, Daniel P.; Gonzalez, Anthony H.; Stanford, S. Adam; Eisenhardt, Peter R. M.; Brodwin, Mark; Mancone, Conor; Stern, Daniel; Zeimann, Gregory R.; Masci, Frank J.; Papovich, Casey; Tanaka, Ichi; Wright, Edward L.

    2012-11-01

    We present spectroscopic confirmation of a z = 0.99 galaxy cluster discovered using data from the Wide-field Infrared Survey Explorer (WISE). This is the first z ~ 1 cluster candidate from the Massive Distant Clusters of WISE Survey to be confirmed. It was selected as an overdensity of probable z >~ 1 sources using a combination of WISE and Sloan Digital Sky Survey DR8 photometric catalogs. Deeper follow-up imaging data from Subaru and WIYN reveal the cluster to be a rich system of galaxies, and multi-object spectroscopic observations from Keck confirm five cluster members at z = 0.99. The detection and confirmation of this cluster represents a first step toward constructing a uniformly selected sample of distant, high-mass galaxy clusters over the full extragalactic sky using WISE data.

  14. THE MASSIVE DISTANT CLUSTERS OF WISE SURVEY: THE FIRST DISTANT GALAXY CLUSTER DISCOVERED BY WISE

    International Nuclear Information System (INIS)

    Gettings, Daniel P.; Gonzalez, Anthony H.; Mancone, Conor; Stanford, S. Adam; Eisenhardt, Peter R. M.; Stern, Daniel; Brodwin, Mark; Zeimann, Gregory R.; Masci, Frank J.; Papovich, Casey; Tanaka, Ichi; Wright, Edward L.

    2012-01-01

    We present spectroscopic confirmation of a z = 0.99 galaxy cluster discovered using data from the Wide-field Infrared Survey Explorer (WISE). This is the first z ∼ 1 cluster candidate from the Massive Distant Clusters of WISE Survey to be confirmed. It was selected as an overdensity of probable z ∼> 1 sources using a combination of WISE and Sloan Digital Sky Survey DR8 photometric catalogs. Deeper follow-up imaging data from Subaru and WIYN reveal the cluster to be a rich system of galaxies, and multi-object spectroscopic observations from Keck confirm five cluster members at z = 0.99. The detection and confirmation of this cluster represents a first step toward constructing a uniformly selected sample of distant, high-mass galaxy clusters over the full extragalactic sky using WISE data.

  15. [Serial clinical and echocardiographic evaluation in children with Marfan syndrome].

    Science.gov (United States)

    Lopez, Victor Manuel Oporto; Perez, Ana Beatriz Alvarez; Moisés, Valdir Ambrósio; Gomes, Lourdes; Pedreira, Patricia da Silveira; Silva, Célia C; Campos Filho, Orlando; Carvalho, Antônio Carlos C

    2005-11-01

    To describe the clinical cardiac manifestations and temporal evolution of Marfan syndrome in children; to estimate the incidence of annuloaortic ectasia and mitral valve prolapse; and to evaluate tolerability and efficacy of beta-blockers in these patients. During one year, 21 children with Marfan syndrome underwent serial clinical and echocardiographic examinations. Echocardiograms assessed: the presence of mitral valve prolapse, aortic root diameter, mitral and aortic valves regurgitation, and aortic enlargement during beta-blocker therapy. Eleven patients had two measurements of the aortic root taken one year apart. The children were asymptomatic throughout the study. Mitral prolapse was found in 11 (52%) children. Annuloaortic ectasia occurred in 16 (76%) patients and found to be mild in 42.8%, moderate in 9.5%, and severe in 23.8%. One of these patients underwent aortic valve replacement and repair of the ascending aorta by the Bentall-De Bono technique, with good results. Heart rate decreased by 13.6% (from 85 to 73 bpm; p < 0.009) with the use of beta-blockers; however, aortic root diameter increased by 1.4 mm/year (p < 0.02). One child could not be given beta-blockers due to bronchial asthma, and no significant side effects were observed in the remaining children, including one who also had bronchial asthma. The children remained asymptomatic throughout the study, the use of beta-blockers led to a significant decrease in heart rate, and no significant adverse effects were observed. Contrary to the literature, incidence of annuloaortic ectasia was high among the study population, greater than that of mitral valve prolapse, even during beta-blocker therapy.

  16. Evaluation of metabolic syndrome in adults of Talca city, Chile

    Directory of Open Access Journals (Sweden)

    Moore-Carrasco Rodrigo

    2008-05-01

    Full Text Available Abstract Objective- Insulin resistance (IR is an important risk factor for type 2 Diabetes Mellitus (DM2 and cardiovascular disease (CVD. Metabolic Syndrome (MS is a clustering of metabolic alterations associated to IR; however, there is no international consensus for defining its diagnosis. Our objective was to evaluate the prevalence and characteristics of MS identified by the ATP III and IDF criteria in adults from Talca city. Research and methods- We studied 1007 individuals, aged 18–74, and residents from Talca. MS subjects were defined according to ATP III (three altered factors and IDF criteria (patients with waist circumference >80/90 cm (W/M and two others altered factors. Results- The prevalence of metabolic syndrome according to the IDF and ATP III criteria was 36.4% and 29.5%, respectively after adjustment for age and sex. The agreement for both criteria was 89%. The prevalence in men was higher than in women for both MS definitions, although not significant. MS probability increased with age, and the highest risk was in the 57–68 age group (ATP-MS and 53–72 age group (IDF-MS. Hypertension, high triglycerides and abdominal obesity are the most frequent alterations in MS. Conclusion- MS prevalence in adults was higher when diagnosed with IDF than with ATP criterion; in both, age is directly related with the MS presence. The MS subjects showed higher levels of blood pressure, waist circumference and plasma triglycerides. Considering our results, it is worrisome that one third of our population has a high risk of developing DM2 and CVD in the future.

  17. Sustainable Materials Management (SMM) WasteWise Data

    Data.gov (United States)

    U.S. Environmental Protection Agency — EPA’s WasteWise encourages organizations and businesses to achieve sustainability in their practices and reduce select industrial wastes. WasteWise is part of EPA’s...

  18. Evaluation of the temporal bone malformations by HRCT in 17 patients with Treacher Collins Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Chihara, Yasuhiro [Kanto Medical Center NTT EC, Tokyo (Japan); Takegoshi, Hideki [Saitama Medical School, Moroyama (Japan); Kaga, Kimitaka [Tokyo Univ. (Japan). Faculty of Medicine

    2003-05-01

    Patients with Treacher Collins Syndrome have severe middle ear malformations. We have studied high-resolution computed tomography (HRCT) of seventeen patients with Treacher Collins Syndrome by using Jahrsdoerfer's grading system. Four patients underwent canalplasty. The appearance of the auricle (which we evaluated by using Marx's grading system) was correlated with the development of the middle ear in patients with Treacher Collins Syndrome. The four cases who underwent canalplasty were using a canal type hearing aid. (author)

  19. Invited Commentary: Evaluation of Horner Syndrome in the MRI Era.

    Science.gov (United States)

    Kawasaki, Aki

    2018-03-01

    This Invited Commentary discusses the following article: BACKGROUND:: To identify the etiologies of adult Horner syndrome (HS) in the MRI era using a targeted evaluation approach and to assess the value and yield of targeted imaging. A retrospective chart review was performed of 200 adult outpatients with HS, confirmed with cocaine eyedrop testing. Patients were divided into subgroups based on the presence or absence of symptoms and those who did or did not receive additional testing with hydroxyamphetamine drops. Imaging was obtained based on pharmacologic localization and/or clinical evaluation. The etiology of HS and the yield of imaging were determined in all subgroups. Imaging showed causative lesions in 24 of 179 (12.84%) imaged patients with HS, and 13 (69.0%) were determined "idiopathic." Of the patients who underwent testing with hydroxyamphetamine drops (132 patients), 86 had a postganglionic localization with an imaging yield of 8.1%, and 46 had preganglionic cause with an imaging yield of 21.7%. Fifty-three patients (26.5%) never noticed ptosis/anisocoria before examination, and the imaging yield in this subgroup was 2.8%. Eighteen of the 200 patients (9.0%) had serious pathology, including carotid artery dissection, brain, or neck mass, and 6 of these (31.6%) had acute symptoms and/or pain. HS is most often idiopathic with serious pathology being relatively infrequent. When determining etiology, the absence of symptoms is not predictive of the pathology. However, acute onset of symptoms and/or pain are possible indicators for serious pathology. Localizing the lesion using hydroxyamphetamine drops whenever obtainable and available is still an efficient way to target imaging evaluation.

  20. Evaluation and management of superior canal dehiscence syndrome

    NARCIS (Netherlands)

    Niesten, M.E.F.

    2014-01-01

    Superior canal dehiscence (SCD) syndrome is a rare disorder involving the inner ear that was first described by Lloyd Minor in 1998. Patients with SCD syndrome can present with a range of auditory and/or vestibular signs and symptoms that are associated with a bony defect of one or both superior

  1. Foetal alcohol syndrome: an osteometric evaluation in the wistar rat ...

    African Journals Online (AJOL)

    Background: Foetal alcohol syndrome had been reported as a common feature in the off – springs of alcoholic mothers; and craniofacial and limb bones anomalies are usually some of the cardinal features of foetal alcohol syndrome (FAS). Methods: These features were osteometrically assessed in the cranial and limb ...

  2. Extremely Variable Quasars from CRTS and WISE

    Science.gov (United States)

    Stern, Daniel

    2017-08-01

    I will present deep dives on a few examples of highly variable quasars identified from the Catalina Real-Time Transient Survey (CRTS) and WISE/NEOWISE. In particular, I will focus on a CRTS-identified iron low-ionization broad absorption line (FeLoBAL) quasar which, over the past decade, has transformed into a more typical BAL quasar (Stern et al. 2017) and a WISE-identified quasar that has shut off in the past decade (Stern et al., in prep.). I will focus on what we learn about the physics of these systems from the multiwavelength imaging and spectroscopy. Given the pace of discovery, additional interesting examples are expected to be discovered before the conference.

  3. Aortopathies in Turner syndrome -- new strategies for evaluation and treatment.

    Science.gov (United States)

    Kriksciuniene, Ruta; Ostrauskas, Rytas; Zilaitiene, Birute

    2015-01-01

    Turner syndrome is a rare genetic disorder which impairs women's growth, reproductive function, cardiovascular development and other functions. This syndrome has been proposed as an independent risk marker for cardiovascular disease. Despite this, life-threatening cardiovascular outcomes affecting young women are dismissed because of incomplete follow up. During assessment due to their smaller stature, it should be noted that, although the ascending aorta diameter is normal in absolute terms, after indexation for body size, patients with Turner syndrome may have a dilated aorta.Based on recent guidelines and the latest studies, there is new evidence on the use of magnetic resonance imaging in diagnosing aortic lesions. New management possibilities of aortopathies have also been discussed. This approach should optimise medical care for women with Turner syndrome, but many areas of uncertainty still remain in the diagnosis and management of this syndrome, and new prospective studies are needed.

  4. THE MOST LUMINOUS GALAXIES DISCOVERED BY WISE

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, Chao-Wei; Eisenhardt, Peter R. M.; Stern, Daniel; Moustakas, Leonidas A. [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Dr., Pasadena, CA 91109 (United States); Wu, Jingwen; Wright, Edward L. [Department of Physics and Astronomy, UCLA, Los Angeles, CA 90095-1547 (United States); Assef, Roberto J. [Núcleo de Astronomía de la Facultad deIngeniería, Universidad Diego Portales, Av. Ejército Libertador 441, Santiago (Chile); Blain, Andrew W. [Department of Physics and Astronomy, University of Leicester, 1 University Road, Leicester, LE1 7RH (United Kingdom); Bridge, Carrie R.; Sayers, Jack [Division of Physics, Math, and Astronomy, California Institute of Technology, Pasadena, CA 91125 (United States); Benford, Dominic J.; Leisawitz, David T. [NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States); Cutri, Roc M.; Masci, Frank J.; Yan, Lin [Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, CA 91125 (United States); Griffith, Roger L. [Department of Astronomy and Astrophysics, The Pennsylvania State University, 525 Davey Lab, University Park, PA 16802 (United States); Jarrett, Thomas H. [Astronomy Department, University of Cape Town, Private Bag X3, Rondebosch 7701 (South Africa); Lonsdale, Carol J. [National Radio Astronomy Observatory, 520 Edgemont Road, Charlottesville, VA 22903 (United States); Petty, Sara M. [Department of Physics, Virginia Tech, Blacksburg, VA 24061 (United States); Stanford, S. Adam, E-mail: Chao-Wei.Tsai@jpl.nasa.gov [Department of Physics, University of California Davis, One Shields Avenue, Davis, CA 95616 (United States); and others

    2015-06-01

    We present 20 Wide-field Infrared Survey Explorer (WISE)-selected galaxies with bolometric luminosities L{sub bol} > 10{sup 14} L{sub ☉}, including five with infrared luminosities L{sub IR} ≡ L{sub (rest} {sub 8–1000} {sub μm)} > 10{sup 14} L{sub ☉}. These “extremely luminous infrared galaxies,” or ELIRGs, were discovered using the “W1W2-dropout” selection criteria which requires marginal or non-detections at 3.4 and 4.6 μm (W1 and W2, respectively) but strong detections at 12 and 22 μm in the WISE survey. Their spectral energy distributions are dominated by emission at rest-frame 4–10 μm, suggesting that hot dust with T{sub d} ∼ 450 K is responsible for the high luminosities. These galaxies are likely powered by highly obscured active galactic nuclei (AGNs), and there is no evidence suggesting these systems are beamed or lensed. We compare this WISE-selected sample with 116 optically selected quasars that reach the same L{sub bol} level, corresponding to the most luminous unobscured quasars in the literature. We find that the rest-frame 5.8 and 7.8 μm luminosities of the WISE-selected ELIRGs can be 30%–80% higher than that of the unobscured quasars. The existence of AGNs with L{sub bol} > 10{sup 14} L{sub ☉} at z > 3 suggests that these supermassive black holes are born with large mass, or have very rapid mass assembly. For black hole seed masses ∼10{sup 3} M{sub ☉}, either sustained super-Eddington accretion is needed, or the radiative efficiency must be <15%, implying a black hole with slow spin, possibly due to chaotic accretion.

  5. WISE - User Guide and Implementation Notes

    CERN Document Server

    Hagen, P

    2008-01-01

    The goal of WISE is to prepare as accurately as possible the description of the LHC magnetic and geometric properties for use by the MAD-X model of the machine. WISE is designed to take into account the best estimate of uncertainties. The reason being that magnetic and geometric measurements have error bars associated with them, like calibration and resolution. Therefore WISE produces a number of instances of the most likely LHC machine that may be used to predict ranges of beam parameters. Magnetic and geometric data are downloaded from the different databases, missing information is completed, and uncertainties are added. This report contains a short section on how using the code and a detailed description of how data relative to magnetic and geometric imperfections, and slot allocation are prepared. The code is built as a transparent box, thus allowing inspection of all the information acquired during the production and test of the LHC magnets. The user interface offers a range of options that allow testin...

  6. 'Choosing Wisely' culture among Brazilian cardiologists.

    Science.gov (United States)

    Correia, Luis C L; Barcellos, Guilherme B; Calixto, Vitor; Volschan, André; Barreto-Filho, José A S; Lopes, Renato D; Rassi, Anis; Levinson, Wendy; de Paola, Angelo A V

    2018-03-01

    (i) To describe how aligned the 'Choosing Wisely' concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians' preference for avoiding wasteful care. Cross-sectional study. Brazilian Society of Cardiology. Cardiologists who agree to fill a web questionary. A task force of 12 Brazilian cardiologists prepared a list of 13 'do not do' recommendations, which were made available on the Brazilian Society of Cardiology website for affiliates to assign a supported score of 1 to 10 to each recommendation. Score average for supporting recommendations. Of 14 579 Brazilian cardiologists, 621 (4.3%) answered the questionnaire. The top recommendation was 'do not perform routine percutaneous coronary intervention in asymptomatic individuals' (mean score = 8.0 ± 2.9) while the one with the lowest support was 'do not use an intra-aortic balloon pump in infarction with cardiogenic shock' (5.8 ± 3.2). None of the 13 recommendations presented a mean grade >9 (strong support); 7 recommendations averaged 7-8 (moderate support) followed by 6 recommendations with an average of 5-7 (modest support). Multivariate analysis independently identified predictors of the score attributed to the top recommendation; being an interventionist and time since graduation were both negatively associated with support. (i) The support of Brazilian cardiologists for the 'Choosing Wisely' concept is modest to moderate, and (ii) older generations and enthusiasm towards the procedure one performs may be factors against the 'Choosing Wisely' philosophy.

  7. Choosing Wisely - An international and multimorbid perspective.

    Science.gov (United States)

    Battegay, Edouard J; Cheetham, Marcus

    2017-12-01

    Some medical diagnostic and therapeutic interventions are non-beneficial or even harmful. The Choosing Wisely campaign has encouraged the generation of "top five" lists of unnecessary low-value services in different specialist areas. In the USA alone, where the campaign was launched, these lists include a total of 450 evidence-based recommendations. Medical scientific societies in further countries such as Canada, Australia, New Zealand, England, Switzerland and Germany have since initiated Choosing Wisely campaigns. Besides implementing top five lists, these aim to change attitudes, expectations and practices in the culture of medicine. The field of internal medicine has initiated change in Switzerland (Swiss Society of General Internal Medicine: Smarter Medicine) and Germany (German Society of Internal Medicine: Klug entscheiden). Formulating Choosing Wisely principles in managing complex patients with multiple concurrent acute or chronic diseases, i. e., multimorbidity (MM), will present a particular challenge. Research is needed to determine the primary sources of overuse in specific combinations of diseases (i. e., MM clusters) and spearhead corresponding recommendations. National Choosing Widely campaigns may serve as a forerunner to a more global initiative. Copyright © 2017. Published by Elsevier GmbH.

  8. Tics and Tourette syndrome: clinical evaluation of 44 cases

    Directory of Open Access Journals (Sweden)

    Teive Hélio A.G.

    2001-01-01

    Full Text Available We evaluated 44 patients with tics and Tourette's syndrome (TS emphasising the age of onset of symptoms, sex, classification and localization of tics, associated symptoms and signs and comorbidities. Thirty-three patients (75.2% had TS defined criteria whereas 10 (22.7% had chronic motor and/or vocal tics. Simple motor tics were found in 43 cases (97.7%, mainly affecting the eyes (43.2%, mouth (43.2%, face (34.1%. Simple vocal tics occurred in 33 (75%. Coprolalia was found in just 6 cases (13.6% and copropraxia in just 2 (4.5%. Obsessive compulsive disorder and/or symptoms were found in 26 cases (59.1% and attention deficit in 17 (38.6%. Eighteen patients (40.9% had other disorders, such as alcoholism, tabagism, drug abuse, affective disorders, anxiety, sleep and learning disorders. The data obtained are similar to those found by other authors. We highlight the low frequency of coprolalia, as well as the associated neuropsychiatric disorders.

  9. Pathophysiology, Evaluation, and Management of Edema in Childhood Nephrotic Syndrome.

    Science.gov (United States)

    Ellis, Demetrius

    2015-01-01

    Generalized edema is a major presenting clinical feature of children with nephrotic syndrome (NS) exemplified by such primary conditions as minimal change disease (MCD). In these children with classical NS and marked proteinuria and hypoalbuminemia, the ensuing tendency to hypovolemia triggers compensatory physiological mechanisms, which enhance renal sodium (Na(+)) and water retention; this is known as the "underfill hypothesis." Edema can also occur in secondary forms of NS and several other glomerulonephritides, in which the degree of proteinuria and hypoalbuminemia, are variable. In contrast to MCD, in these latter conditions, the predominant mechanism of edema formation is "primary" or "pathophysiological," Na(+) and water retention; this is known as the "overfill hypothesis." A major clinical challenge in children with these disorders is to distinguish the predominant mechanism of edema formation, identify other potential contributing factors, and prevent the deleterious effects of diuretic regimens in those with unsuspected reduced effective circulatory volume (i.e., underfill). This article reviews the Starling forces that become altered in NS so as to tip the balance of fluid movement in favor of edema formation. An understanding of these pathomechanisms then serves to formulate a more rational approach to prevention, evaluation, and management of such edema.

  10. Acute Coronary Syndrome: Emergency Department Evaluation and Management.

    Science.gov (United States)

    Veauthier, Brian; Sievers, Karlynn; Hornecker, Jaime

    2015-10-01

    Patients with chest pain who present to emergency departments have a significantly higher incidence of acute coronary syndrome (ACS) than patients with chest pain presenting to outpatient settings, so emergency department clinicians should have a lower threshold for considering ACS as an etiology. Evaluating patients with suspected ACS in the emergency department involves obtaining a history, physical examination, electrocardiograms (ECGs), and cardiac troponin measurements in conjunction with risk calculators. These parameters cannot be used individually because, for example, a normal ECG result does not exclude ACS and troponin levels can be elevated in many conditions. All patients with suspected ACS should receive aspirin, if not contraindicated, as soon as possible. Those with an ST-segment elevation myocardial infarction (STEMI) or those without STEMI who are in unstable condition should be triaged to undergo reperfusion therapy, typically via percutaneous coronary intervention (PCI), within 120 minutes of first medical contact. If that time limit cannot be met because the patient must be transferred to a PCI-capable facility, fibrinolytic therapy should be initiated within 30 minutes of presentation if STEMI is present. (Fibrinolytic therapy is contraindicated for myocardial infarction without STEMI.) Patients also should receive nitroglycerin to relieve angina and beta blockers if not contraindicated. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  11. Pathophysiology, Evaluation, and Management of Edema in Childhood Nephrotic Syndrome

    Science.gov (United States)

    Ellis, Demetrius

    2016-01-01

    Generalized edema is a major presenting clinical feature of children with nephrotic syndrome (NS) exemplified by such primary conditions as minimal change disease (MCD). In these children with classical NS and marked proteinuria and hypoalbuminemia, the ensuing tendency to hypovolemia triggers compensatory physiological mechanisms, which enhance renal sodium (Na+) and water retention; this is known as the “underfill hypothesis.” Edema can also occur in secondary forms of NS and several other glomerulonephritides, in which the degree of proteinuria and hypoalbuminemia, are variable. In contrast to MCD, in these latter conditions, the predominant mechanism of edema formation is “primary” or “pathophysiological,” Na+ and water retention; this is known as the “overfill hypothesis.” A major clinical challenge in children with these disorders is to distinguish the predominant mechanism of edema formation, identify other potential contributing factors, and prevent the deleterious effects of diuretic regimens in those with unsuspected reduced effective circulatory volume (i.e., underfill). This article reviews the Starling forces that become altered in NS so as to tip the balance of fluid movement in favor of edema formation. An understanding of these pathomechanisms then serves to formulate a more rational approach to prevention, evaluation, and management of such edema. PMID:26793696

  12. Pathophysiology, Evaluation and Management of Edema in Childhood Nephrotic Syndrome

    Directory of Open Access Journals (Sweden)

    Demetrius eEllis

    2016-01-01

    Full Text Available Generalized edema is a major presenting clinical feature of children with nephrotic syndrome (NS exemplified by such primary conditions as minimal change disease (MCD. In these children with classical NS and marked proteinuria and hypoalbuminemia, the ensuing tendency to hypovolemia triggers compensatory physiologic mechanisms which enhance renal sodium (Na+ and water retention; this is known as the underfill hypothesis. Edema can also occur in secondary forms of NS and several other glomerulonephritides, in which the degree of proteinuria and hypoalbuminemia, are variable. In contrast to MCD, in these latter conditions the predominant mechanism of edema formation is primary or pathophysiologic, Na+ and water retention; this is known as the overfill hypothesis. A major clinical challenge in children with these disorders is to distinguish the predominant mechanism of edema formation, identify other potential contributing factors, and prevent the deleterious effects of diuretic regimens in those with unsuspected reduced effective circulatory volume (i.e., underfill. This article reviews the Starling forces that become altered in NS so as to tip the balance of fluid movement in favor of edema formation. An understanding of these pathomechanisms then serves to formulate a more rational approach to prevention, evaluation and management of such edema

  13. Smith-Magenis syndrome: clinical evaluation in seven Brazilian patients.

    Science.gov (United States)

    Gamba, B F; Vieira, G H; Souza, D H; Monteiro, F F; Lorenzini, J J; Carvalho, D R; Morreti-Ferreira, D

    2011-10-31

    Smith-Magenis syndrome (SMS) is a complex congenital anomaly characterized by craniofacial anomalies, neurological and behavioral disorders. SMS is caused by a deletion in region 17p11.2, which includes the RAI1 gene (90% of cases), or by point mutation in the RAI1 gene (10% of cases). Laboratory diagnosis is through cytogenetic analysis by GTG banding and molecular cytogenetic analysis by FISH. We carried out an active search for patients in Associations of Parents and Friends of Exceptional Children (APAE) of São Paulo and genetic centers in Brazil. Forty-eight patients were screened for mental retardation, craniofacial abnormalities and stereotyped behavior with a diagnosis of SMS. In seven of them, chromosome banding at high resolution demonstrated chromosome 17p11.2 deletions, confirmed by FISH. We also made a meta-analysis of 165 cases reported between 1982 and 2010 to compare with the clinical data of our sample. We demonstrated differences between the frequencies of clinical signs among the cases reported and seven Brazilian cases of this study, such as dental anomalies, strabismus, ear infections, deep hoarse voice, hearing loss, and cardiac defects. Although the gold standard for diagnosis of SMS is FISH, we found that the GTG banding technique developed to evaluate chromosome 17 can be used for the SMS diagnosis in areas where the FISH technique is not available.

  14. Yield and Costs of Evaluating Children with Cyclic Vomiting Syndrome.

    Science.gov (United States)

    Lucia-Casadonte, Chantal; Whaley, Kaitlin; Chogle, Ashish

    2018-01-25

    Cyclic vomiting syndrome (CVS) clinical guidelines recommend an algorithm of basic testing for standard patients, and more targeted testing, including laboratory and imaging studies, in the presence of specific red flags. The cost effectiveness of this screening of children with suspected CVS is lacking. To determine if screening studies in CVS patients results in diagnostic change, and to estimate their healthcare cost. Charts of patients (1-18 years) with suspected CVS were retrospectively reviewed at a single center. Results and cost of laboratory and imaging studies were analyzed. 503 charts were reviewed from electronic medical records with the ICD9 code 536.2 or search terms "CVS, cyclic vomiting, persistent emesis/vomiting, hyperemesis, or intractable/ periodic vomiting". Of these, 165 (33%) had a diagnosis of CVS and 135 (82%) children (mean age 7.7 ± 4.3; 73 (54%) females) met CVS criteria based on NASPGHAN diagnostic criteria. Of those meeting CVS criteria, 6 (4%) had a change in management based on the CVS screening evaluation. The mean cost of screening per patient that met CVS criteria was $6,125.02 USD and the estimated total cost for all patients who met CVS criteria was $826,877.88 USD. The screening metabolic labs, pelvic ultrasound, MRI, and upper endoscopy resulted in a diagnosis change in few patients screened for CVS. Most children who met criteria for CVS did not benefit from screening evaluation as results did not change clinical diagnosis or management, and were associated with higher cost.

  15. Cardiac evaluation in children with Prader-Willi syndrome.

    NARCIS (Netherlands)

    Marcus, K.A.; Alfen-van der Velden, J. van; Otten, B.J.; Weijers, G.; Yntema, H.G.; Korte, C.L. de; Kapusta, L.

    2012-01-01

    AIM: To assess cardiac anatomy and myocardial systolic function in children with Prader-Willi syndrome (PWS). METHODS: Physical examination, electrocardiographic (ECG) recordings and transthoracic echocardiograms including two-dimensional speckle tracking echocardiography (2DSTE) were performed and

  16. Respiratory Disturbances in Rett Syndrome: Don't Forget to Evaluate Upper Airway Obstruction

    NARCIS (Netherlands)

    Hagebeuk, Eveline E. O.; Bijlmer, Rob P. G. M.; Koelman, Johannes H. T. M.; Poll-The, Bwee Tien

    2012-01-01

    Rett syndrome is characterized by loss of motor and social functions, development of stereotypic hand movements, seizures, and breathing disturbances. This study evaluates the presence of overnight respiratory disturbances. Polysomnography in combination with a questionnaire (the Sleep Disturbance

  17. Evaluation of three different measurement methods for dural ectasia in Marfan syndrome

    International Nuclear Information System (INIS)

    Weigang, E.; Ghanem, N.; Chang, X.-C.; Richter, H.; Frydrychowicz, A.; Szabo, G.; Dudeck, O.; Knirsch, W.; Samson, P. von; Langer, M.; Beyersdorf, F.

    2006-01-01

    Aim: Dural ectasia is a major diagnostic criterion for Marfan syndrome using the Ghent nosology. Our aim was to evaluate the efficacy of three different radiological methods previously proposed for the assessment of dural sac diameter in Marfan syndrome. Methods: Marfan syndrome was diagnosed in our study using the Ghent criteria, disregarding dural ectasia as a criterion. Three proposed radiological methods were applied to measure dural sac diameter, examined for 41 patients (18 patients with and 23 without Marfan syndrome) by computed tomography or magnetic resonance imaging. Results: Using Oosterhof's method, 94% of the patients with and 44% of the patients without Marfan syndrome fulfilled the criteria of dural ectasia. According to Villeirs, dural ectasia was diagnosed in 18% of the patients with and in none of the patients without Marfan syndrome. With Ahn's method, dural ectasia was found in 72% of the patients with and in 44% of the patients without Marfan syndrome. In only two patients with Marfan syndrome was dural ectasia diagnosed by all three methods. Conclusion: Our results reveal overt discrepancy between the three methods of assessing dural ectasia. Considering the key role played by dural ectasia in reinforcing the diagnosis of Marfan syndrome according to the Ghent nosology, a standardized and reliable method should be sought

  18. Evaluation of three different measurement methods for dural ectasia in Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Weigang, E.; Ghanem, N.; Chang, X.-C.; Richter, H.; Frydrychowicz, A.; Szabo, G.; Dudeck, O.; Knirsch, W.; Samson, P. von; Langer, M.; Beyersdorf, F

    2006-11-15

    Aim: Dural ectasia is a major diagnostic criterion for Marfan syndrome using the Ghent nosology. Our aim was to evaluate the efficacy of three different radiological methods previously proposed for the assessment of dural sac diameter in Marfan syndrome. Methods: Marfan syndrome was diagnosed in our study using the Ghent criteria, disregarding dural ectasia as a criterion. Three proposed radiological methods were applied to measure dural sac diameter, examined for 41 patients (18 patients with and 23 without Marfan syndrome) by computed tomography or magnetic resonance imaging. Results: Using Oosterhof's method, 94% of the patients with and 44% of the patients without Marfan syndrome fulfilled the criteria of dural ectasia. According to Villeirs, dural ectasia was diagnosed in 18% of the patients with and in none of the patients without Marfan syndrome. With Ahn's method, dural ectasia was found in 72% of the patients with and in 44% of the patients without Marfan syndrome. In only two patients with Marfan syndrome was dural ectasia diagnosed by all three methods. Conclusion: Our results reveal overt discrepancy between the three methods of assessing dural ectasia. Considering the key role played by dural ectasia in reinforcing the diagnosis of Marfan syndrome according to the Ghent nosology, a standardized and reliable method should be sought.

  19. Outcome of genetic evaluation of patients with kidney cancer referred for suspected hereditary cancer syndromes.

    Science.gov (United States)

    Stratton, Kelly L; Alanee, Shaheen; Glogowski, Emily A; Schrader, Kasmintan A; Rau-Murthy, Rohini; Klein, Robert; Russo, Paul; Coleman, Jonathan; Offit, Kenneth

    2016-05-01

    To analyze patients with kidney cancer referred for evaluation at a high-volume genetics service at a comprehensive cancer center and identify factors associated with positive tests for hereditary cancer syndromes. A retrospective review of patients referred to the Clinical Genetics Service at Memorial Sloan-Kettering Cancer Center was performed, and patients with a personal history of kidney cancer were identified. Patient and disease characteristics were reviewed. In all, 4 variables including age at diagnosis of kidney tumor, presence of syndromic manifestations, family history of kidney cancer, and number of primary malignancies were evaluated for association with positive test results in 2 groups: patients tested for renal cell carcinoma syndromes and Lynch syndrome. Guidance for genetic testing strategy in patients with kidney cancer is provided. Between 1999 and 2012, 120 patients with a history of kidney cancer were evaluated by the Clinical Genetics Service. The mean age at kidney cancer diagnosis was 52 years (interquartile range: 42-63), with 57% being women. A family history of kidney cancer was reported by 39 patients (33%). Time between diagnosis of first cancer and genetic consultation was 5 years in the remaining 23%. Overall, 95 patients were tested for genetic abnormalities with 27 (28%) testing positive. Testing for renal cell carcinoma (RCC)-related syndromes was performed on 43 patients, with 13 testing positive (30%). Lynch syndrome testing was positive in 9 patients (32%) after 28 were tested. In RCC-associated syndromes, young age of diagnosis was associated with positive test results. Conversely, syndromic manifestations and increasing number of primary malignancies were associated with positive Lynch testing. The discovery of inherited kidney cancer syndromes has provided a unique opportunity to identify patients at increased risk for cancer. Factors associated with positive genetic testing are unique to different syndromes. These data

  20. Genetic evaluation of the serotonergic system in chronic fatigue syndrome.

    Science.gov (United States)

    Smith, Alicia K; Dimulescu, Irina; Falkenberg, Virginia R; Narasimhan, Supraja; Heim, Christine; Vernon, Suzanne D; Rajeevan, Mangalathu S

    2008-02-01

    Chronic fatigue syndrome (CFS) is a debilitating disorder of unknown etiology with no known lesions, diagnostic markers or therapeutic intervention. The pathophysiology of CFS remains elusive, although abnormalities in the central nervous system (CNS) have been implicated, particularly hyperactivity of the serotonergic (5-hydroxytryptamine; 5-HT) system and hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis. Since alterations in 5-HT signaling can lead to physiologic and behavioral changes, a genetic evaluation of the 5-HT system was undertaken to identify serotonergic markers associated with CFS and potential mechanisms for CNS abnormality. A total of 77 polymorphisms in genes related to serotonin synthesis (TPH2), signaling (HTR1A, HTR1E, HTR2A, HTR2B, HTR2C, HTR3A, HTR3B, HTR4, HTR5A, HTR6, and HTR7), transport (SLC6A4), and catabolism (MAOA) were examined in 137 clinically evaluated subjects (40 CFS, 55 with insufficient fatigue, and 42 non-fatigued, NF, controls) derived from a population-based CFS surveillance study in Wichita, Kansas. Of the polymorphisms examined, three markers (-1438G/A, C102T, and rs1923884) all located in the 5-HT receptor subtype HTR2A were associated with CFS when compared to NF controls. Additionally, consistent associations were observed between HTR2A variants and quantitative measures of disability and fatigue in all subjects. The most compelling of these associations was with the A allele of -1438G/A (rs6311) which is suggested to have increased promoter activity in functional studies. Further, in silico analysis revealed that the -1438 A allele creates a consensus binding site for Th1/E47, a transcription factor implicated in the development of the nervous system. Electrophoretic mobility shift assay supports allele-specific binding of E47 to the A allele but not the G allele at this locus. These data indicate that sequence variation in HTR2A, potentially resulting in its enhanced activity, may be involved in the

  1. Evaluation of a support worker role, within a nurse delegation and supervision model, for provision of medicines support for older people living at home: the Workforce Innovation for Safe and Effective (WISE) Medicines Care study.

    Science.gov (United States)

    Lee, Cik Yin; Beanland, Christine; Goeman, Dianne; Johnson, Ann; Thorn, Juliet; Koch, Susan; Elliott, Rohan A

    2015-10-06

    Support with managing medicines at home is a common reason for older people to receive community nursing services. With population ageing and projected nurse shortages, reliance on nurses may not be sustainable. We developed and tested a new workforce model: 'Workforce Innovation for Safe and Effective (WISE) Medicines Care', which enabled nurses to delegate medicines support home visits for low-risk clients to support workers (known as community care aides [CCAs]). Primary study aims were to assess whether the model increased the number of medicines support home visits conducted by CCAs, explore nurses', CCAs' and consumers' experiences with the CCAs' expanded role, and identify enablers and barriers to delegation of medicines support. A prospective before-after mixed-methods study was conducted within a community nursing service that employed a small number of CCAs. The CCAs' main role prior to the WISE Medicines Care model was personal care, with a very limited role in medicines support. CCAs received training in medicines support, and nurses received training in assessment, delegation and supervision. Home visit data over two three-month periods were compared. Focus groups and interviews were conducted with purposive samples of nurses (n = 27), CCAs (n = 7) and consumers (n = 28). Medicines support visits by CCAs increased from 43/16,863 (0.25 %) to 714/21,552 (3.3 %) (p delegating to CCAs sometimes eliminated the need for duplicate nurse and CCA visits (for people requiring personal care plus medicines support) and enabled them to visit people with more complex needs. CCAs enjoyed their expanded role and were accepted by clients and/or carers. Nurses and CCAs reported effective communication when medicine-related problems occurred. No medication incidents involving CCAs were reported. Barriers to implementation included the limited number of CCAs employed in the organisation and reluctance from some nurses to delegate medicines support to CCAs

  2. Syndrome-wise diagnosis status of sexually transmitted infection ...

    African Journals Online (AJOL)

    recognition of STDs as a major public health problem, stigma and discrimination associated with the STDs, lack of interdepartmental coordination for studies, poor attendance of STD patients at the public clinics and academic institutions, and availability of limited diagnostic facilities, among others. This in-depth clinical ...

  3. ROLE OF MRI IN EVALUATION OF MRKH SYNDROME

    Directory of Open Access Journals (Sweden)

    Lalitha Kumari

    2015-11-01

    Full Text Available : MRKH Syndrome is one of diverse spectrum of congenital mullerian duct anamolies ranging from complete absence to hypoplasia of uterus and upper 2/3rd of vagina owing to their embryological origin. This is the second most common cause of primary amennorhoea in young females who shows normal development of secondary sexual characters and endocrine profile with essential normal female phenotype & genotype (46 XX. Our study is to emphasis the role of MRI in diagnosis of this syndrome non-invasively without exposure to radiation. The excellent soft tissue anatomical details by MRI provides the diagnosis with accuracy along with information of adjacent viscera and other associated systemic anamolies.

  4. Painful bladder syndrome/interstitial cystitis: Aetiology, evaluation and management

    Directory of Open Access Journals (Sweden)

    William Rourke

    2014-06-01

    Full Text Available Interstitial cystitis or bladder pain syndrome (BPS is often a chronic debilitating condition characterised by predominantly storage symptoms and associated frequently with pelvic pain that varies with bladder filling. The aetiology is uncertain as the condition occurs in the absence of a urinary tract infection or other obvious pathology. Resulting discomfort may vary and ranges from abdominal tenderness to intense bladder spasms. Diagnosis and management of this syndrome may be difficult and is often made by its typical cystoscopic features. This review discusses the diagnosis and management of interstitial cystitis according to the current available best evidence and advises a multimodal approach in its management.

  5. [Guidelines for wise utilization of knee imaging].

    Science.gov (United States)

    Finestone, Aharon S; Eshed, Iris; Freedman, Yehuda; Beer, Yiftah; Bar-Sever, Zvi; Kots, Yavvgeni; Adar, Eliyahu; Mann, Gideon

    2012-02-01

    The knee is a complex structure afflicted with diverse pathologies. Correct management of knee complaints demands wise utilization of imaging modalities, considering their accuracy in the specific clinical situation, the patient's safety and availability and financial issues. Some of these considerations are universal, while others are local, depending on medical and insurance systems. There is controversy and unclearness regarding the best imaging modality in different clinical situations. To develop clinical guidelines for utilizing knee imaging. Leading physicians in specialties associated with knee disease and imaging were invited to participate in a panel on the guidelines. Controversies were settled in the main panel or in sub-panels. The panel agreed on the principles in choosing from the various modalities, primarily medical accuracy, followed by patient safety, availability and cost. There was agreement that the physician is responsible to choose the most appropriate diagnostic tool, consulting, when necessary, on the advantages, limitations and risks of the various imaging modalities. A comprehensive table was compiled with the importance of the different imaging modalities in various clinical situations. For the first time, Israeli guidelines on wise utilization of knee imaging are presented. They take into consideration the clinical situations and also availability and financial issues specific to Israel. These guidelines will serve physicians of several disciplines and medical insurers to improve patient management efficiently.

  6. Evaluation of acute compartment syndrome of extremities in ...

    African Journals Online (AJOL)

    The aim of this study was to analyze the clinical signs of diagnosis, treatment and followup of the pediatric population presenting with acute compartment syndrome in the emergency room at an Institutional Level II trauma center. The study is a prospective case series. Thirty-two samples were selected from Institutional ...

  7. Infantile Short Bowel Syndrome: short and long term evaluation

    NARCIS (Netherlands)

    J.F. Olieman (Joanne)

    2009-01-01

    textabstractInfantile short bowel syndrome is a condition which is characterized by malabsorption of nutrients, as a result of congenital intestinal shortening or massive small bowel resection. Survival rates have improved over the years, but morbidity remains high and clinical management of these

  8. Evaluation of acute compartment syndrome of extremities in ...

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    necrotic tissue in the histological examination. In our study, we also observed patchy necrosis of muscle fibers with perifascicular oedema3. We observed ischemic contractures in about 18.7% of our cases. In a series of 24 children with acute compartment syndrome, chronic contractures were reported only in 4.2% cases3.

  9. Evaluation Of Irritable Bowel Syndrome Symptoms Amongst Warsaw University Students

    OpenAIRE

    Niemyjska Sylwia; Ukleja Anna; Ławiński Michał

    2015-01-01

    Irritable bowel syndrome (IBS) belongs to functional gastrointestinal disorders and is characterized by abdominal pain and change in stool consistency and/or bowel habits. Etiological factors include gastrointestinal peristalsis disturbances, visceral hypersensitivity, chronic inflammation of the mucous membrane, dysbacteremia, intestinal infections, psychosomatic and nutritional factors. Gastrointestinal motility disturbances in case of IBS are manifested by the inhibition of the intestinal ...

  10. The evaluation of immediate behavioural outcomes of the syndromic ...

    African Journals Online (AJOL)

    Enrique

    syndromic case management approach for the treatment of patients with sexually transmitted infections at PHC centres in. South Africa: Knowledge, attitudes, beliefs and sexual behaviour. L C Simbayi,A Strebel, M Andipatin, C Potgieter, K Ratele, N Shabalala,T Shefer,T Wilson. ABSTRACT. This study aimed to determine ...

  11. Scintigraphic and Endoscopic Evaluation of Radiation-induced Acute Gastrointestinal Syndrome in Micro-pig Model

    International Nuclear Information System (INIS)

    Lee, Seung-Sook; Kim, Kyung-Min; Kim, Jin; Jang, Won-Suk; Lee, Jung-Eun; Kim, Noo-Ri; Lee, Sun-Joo; Kim, Mi-Sook; Ji, Young-Hoon; Cheon, Gi-Jeong; Lim, Sang-Moo

    2007-01-01

    Micro-pig model can be served as a proper substitute for humans in studying acute radiation syndrome following radiation-exposure accidents, especially showing similar clinico-pathologic response of hematopoietic and gastrointestinal (GI) syndrome to human. Among acute GI syndrome induced by radiation, GI motility disturbance has not been studied, however, it would be important in a viewpoint of affecting infectious progression from GI tract. Here, we employed scintigraphy of GI transit time and sequential endoscopic examination and tissue sampling in micropigs followed by abdominal radiation exposure. The specific aims of this study are to evaluate objective evidence of GI motility disturbance by scintigraphic evaluation and to find corresponding clinicoapthologic changes in radiation-induced acute GI syndrome

  12. WISE Observations of Comets, Centaurs, & Scattered Disk Objects

    Science.gov (United States)

    Bauer, J.; Walker, R.; Mainzer, A.; Masiero, J.; Grav, T.; Cutri, R.; Dailey, J.; McMillan, R.; Lisse, C. M.; Fernandez, Y. R.; hide

    2011-01-01

    The Wide-Field Infrared Survey Explorer (WISE) was luanched on December 14, 2009. WISE imaged more than 99% of the sky in the mid-infrared for a 9-month mission lifetome. In addition to its primary goals of detecting the most luminous infrared galaxies and the nearest brown dwarfs, WISE, detected over 155500 of solar system bodies, 33700 of which were previously unknown. Most of the new objects were main Belt asteriods, and particular emphasis was on the discovery of Near Earth Asteoids. Hundreds of Jupiter Trojans have been imaged by WISE as well. However a substantial number of Centaurs, Scattered Disc Objects (SDOs), & cometary objects, were observed and discovered.

  13. Evaluation of effectiveness of orlistat in complexed obesity treatment in teenagers with metabolic syndrome

    OpenAIRE

    G A Mel'nichenko; V A Peterkova; L V Savel'eva; N A Zubkova

    2011-01-01

    An open, comparative, randomized study of orlistat in the combined treatment of obesity in adolescents with metabolic syndrome (IIIb phase) was held. Objective: to evaluate the efficacy and safety of the orlistat in adolescents 12-17 years with high risk of cardiovascular disease and type 2 diabetes. The study included 60 adolescents with obesity and metabolic syndrome. The main group (n=30) followed a hypocaloric diet and aerobic exercises and took orlistat 120 mg 3 times daily with...

  14. Moving Target Photometry Using WISE and NEOWISE

    Science.gov (United States)

    Wright, Edward L.

    2015-01-01

    WISE band 1 observations have a significant noise contribution from confusion. The image subtraction done on W0855-0714 by Wright et al. (2014) shows that this noise source can be eliminated for sources that move by much more than the beamsize. This paper describes an analysis that includes a pattern of celestially fixed flux plus a source moving with a known trajectory. This technique allows the confusion noise to be modeled with nuisance parameters and removed even for sources that have not moved by many beamwidths. However, the detector noise is magnified if the motion is too small. Examples of the method applied to fast moving Y dwarfs and slow moving planets will be shown.

  15. AN INDIVIDUALIZED APPROACH TO THE EVALUATION OF CUSHING SYNDROME.

    Science.gov (United States)

    Sharma, Susmeeta T

    2017-06-01

    Cushing syndrome (CS) is caused by chronic exposure to excess glucocorticoids. Early recognition and treatment of hypercortisolemia can lead to decreased morbidity and mortality. The diagnosis of CS and thereafter, establishing the cause can often be difficult, especially in patients with mild and cyclic hypercortisolism. Surgical excision of the cause of excess glucocorticoids is the optimal treatment for CS. Medical therapy (steroidogenesis inhibitors, medications that decrease adrenocorticotropic hormone [ACTH] levels or glucocorticoid antagonists) and pituitary radiotherapy may be needed as adjunctive treatment modalities in patients with residual, recurrent or metastatic disease, in preparation for surgery, or when surgery is contraindicated. A multidisciplinary team approach, individualized treatment plan and long-term follow-up are important for optimal management of hypercortisolemia and the comorbidities associated with CS. ACTH = adrenocorticotropic hormone; BIPSS = bilateral inferior petrosal sinus sampling; CBG = corticosteroid-binding globulin; CD = Cushing disease; CRH = corticotropin-releasing hormone; CS = Cushing syndrome; Dex = dexamethasone; DST = dexamethasone suppression test; EAS = ectopic ACTH syndrome; FDA = U.S. Food & Drug Administration; HDDST = high-dose DST; IPS/P = inferior petrosal sinus to peripheral; MRI = magnetic resonance imaging; NET = neuroendocrine tumor; PET = positron emission tomography; UFC = urinary free cortisol.

  16. Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial

    NARCIS (Netherlands)

    Voorn, Eric L.; Koopman, Fieke S.; Brehm, Merel A.; Beelen, Anita; de Haan, Arnold; Gerrits, Karin H. L.; Nollet, Frans

    2016-01-01

    To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS) on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function. A process evaluation using data from an RCT. Forty-four severely fatigued

  17. Impact of screening for metabolic syndrome on the evaluation of obese living kidney donors.

    Science.gov (United States)

    Marcusa, Daniel P; Schaubel, Douglas E; Woodside, Kenneth J; Sung, Randall S

    2018-01-01

    We report our experience with metabolic syndrome screening for obese living kidney donor candidates to mitigate the long-term risk of CKD. We retrospectively reviewed 814 obese (BMI≥30) and 993 nonobese living kidney donor evaluations over 12 years. Using logistic regression, we explored interactions between social/clinical variables and candidate acceptance before and after policy implementation. Obese donor candidate acceptance decreased after metabolic syndrome screening began (56.3%, 46.3%, p metabolic syndrome, there was no significant change in how age, sex, race, or BMI affected a donor candidate's probability of acceptance. Metabolic syndrome screening is a simple stratification tool for centers with liberal absolute BMI cut-offs to exclude potentially higher-risk obese candidates. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Evaluation of insulin sensitivity status in polycystic ovarian syndrome

    Directory of Open Access Journals (Sweden)

    Wilma Delphine Silvia C

    2011-03-01

    Full Text Available Objective: To identify the risk arising from polycystic ovarian syndrome (PCOS which would help the clinician to make early interventions. Methods: Fasting and postprandial serum glucose and serum insulin levels were estimated in 26 cases of PCOS and 26 healthy women were selected as controls. Calculation of quantitative insulin sensitivity check index (QUICKI in all the subjects was utilized to analyze its sensitivity and reliability. Also body mass index and waist circumference in all these subjects were measured as obesity plays a key role in the pathogenesis of PCOS. Results: Hyperglycemia was observed in 11% of the cases and hyperinsulinemia was a consistent feature in 46% of the patients. The postprandial insulin levels in cases were statistically significant (P=0.006. Sensitivity to insulin as indicated by QUICKI in the postprandial state was less in cases than in controls (P=0.13. The BMI was markedly raised in 15% and moderately raised in about 38% of the cases (P=0.024. Waist circumference was significantly raised in about 61% of the cases (>80 cm (P<0.001. Conclusions: Our study indicates that QUICKI, BMI and waist circumference are simple, quick and may act as early markers in identifying the risks of developing metabolic syndrome. Obesity, being a consistent finding in most cases suggested its key role in the pathogenesis of PCOS.

  19. Med Wise: A theory-based program to improve older adults' communication with pharmacists about their medicines.

    Science.gov (United States)

    Martin, B A; Chewning, B A; Margolis, A R; Wilson, D A; Renken, J

    2016-01-01

    The health and economic toll of medication errors by older adults is well documented. Poor communication and medication coordination problems increase the likelihood of adverse drug events (ADEs). Older adults have difficulty communicating with health care professionals, including pharmacists. As such, the theory-based Med Wise program was designed. Building on the Self-efficacy Framework and the Chronic Care Model, this program was tested with community-dwelling older adults. This study and its resultant paper: (1) describe the theory-based design of the Med Wise program; (2) describe the collaboration of multiple community partners to develop a sustainable model for implementing Med Wise; and (3) present findings from the Med Wise course evaluation. Med Wise was designed to be a sustainable, skill-based educational and behavior change program consisting of two, 2-h interactive classes to enhance participants' medication communication skills and self-efficacy. To explore the potential to disseminate Med Wise throughout the state, a partnership was formed between the pharmacy team and the statewide Aging & Disability Resource Centers (ADRCs), as well as the Community-Academic Aging Research Network (CAARN). Over 30 lay volunteer leaders in 8 Wisconsin (U.S. State) counties were trained, and they delivered Med Wise through ADRC community centers. The CAARN staff evaluated the fidelity of the course delivery by leaders. To evaluate Med Wise, a quasi-experimental design using pre/post surveys assessed knowledge, worry and self-efficacy. A telephone follow-up three months later assessed self-efficacy and translation of medication management skills and behaviors. Med Wise programs were presented to 198 community-dwelling older adults while maintaining program fidelity. This evaluation found significant increases in older adults' knowledge about pharmacists' roles and responsibilities, likelihood of talking with a pharmacist about medication concerns, and self

  20. DTI analysis in patients with primary open-angle glaucoma: impact of registration on Voxel-Wise statistics.

    Science.gov (United States)

    Schmidt, Manuel A; Mennecke, Angelika; Michelson, Georg; Doerfler, Arnd; Engelhorn, Tobias

    2014-01-01

    Tract-based spatial statistics (TBSS) has been used to assess the integrity of the visual pathway in glaucoma patients. TBSS uses the subjects' FA data to create a mean FA skeleton of white matter tracts before running voxel-wise cross-subject statistics. We compared four different approaches of registration of FA maps to create the skeleton and evaluated alignment and subsequently the impact of the chosen registration on voxel-wise statistics. Our study comprised 69 subjects, i.e. 46 patients with primary open angle glaucoma (POAG) and a healthy, age-matched control group of 23 subjects. Mean FA skeletons were created using the following registration approaches: registration to a standard template (T), registration to the group mean (GM), registration to a group-wise atlas (GW) and registration to the most typical subject (N). Subsequently, maps of standard deviation of the 4D images were created to assess the alignment. Voxel-wise statistics for each registration approach were performed. We found distinct differences in voxel-wise statistics depending on the chosen registration approach. Best alignment results were achieved by registration to a study specific template, i.e. to the group mean (GM) or to a group-wise atlas (GW). Overall alignment did not differ between these two approaches. However, voxel-wise statistics showed clusters of significantly decreased FA values in the T and GM approach, which were not significant after GW registration. These voxels of significantly decreased FA values after T and GM registration did not represent white matter tracts and correlated with higher standard deviation in FA maps across subjects, thus implying registration errors, especially in the optic radiation. Registration to a study-specific template, i.e. to the group mean or a group-wise atlas seems to be the method of choice in TBSS-analysis of glaucoma patients as it shows better alignment of the optic radiation and helps to rule out registration errors due to

  1. Evaluation of uric acid levels, thyroid function, and anthropometric parameters in Japanese children with Down syndrome.

    Science.gov (United States)

    Niegawa, Tomomi; Takitani, Kimitaka; Takaya, Ryuzo; Ishiro, Manabu; Kuroyanagi, Yuichi; Okasora, Keisuke; Minami, Yukako; Matsuda, Takuya; Tamai, Hiroshi

    2017-09-01

    Down syndrome, caused by trisomy 21, is characterized by congenital abnormalities as well as mental retardation. From the neonatal stage through adolescence, patients with Down syndrome often have several complications. Thus, it is important to attain knowledge of the prevalence of these comorbidities in children with Down syndrome. We, therefore, evaluated the biochemical data, thyroid function, and anthropometric parameters, and analyzed the association among them in Japanese children and early adolescents with Down syndrome. There was no difference in the prevalence of obesity and overweight between boys and girls. The level of uric acid was higher in boys than in girls. Moreover, the prevalence of hyperuricemia was also higher in boys than in girls (approximately 32% and 10%, respectively). The prevalence of subclinical hypothyroidism in children with Down syndrome was approximately 20%, with no significant sex differences. The levels of uric acid and dehydroepiandrosterone-sulfate were positively associated with age, while the levels of thyroid-stimulating hormone and free thyroxine had a negative association with age. Overall, children with Down syndrome, exhibit a higher incidence of hyperuricemia. Therefore, uric acid levels, as well as thyroid function, from childhood to early adulthood should be monitored in this patient cohort.

  2. Vaginal discharge: aetiological agents and evaluation of syndromic management in Lagos.

    Science.gov (United States)

    Onyekonwu, C L; Olumide, Y M; Oresanya, F A; Onyekonwu, G C

    2011-01-01

    The WHO introduced the syndromic management to help in the control of STIs in resource-poor settings. This needs to be adapted to local settings taking into consideration the prevalence of the various organisms causing STIs. This has given rise to a need to validate the algorithm. The study aimed to correlate the syndromic management treatment algorithm for vaginal discharge with the aetiological diagnosis based on laboratory investigations. Specifically, the sensitivity, specificity and positive predictive values of the syndromic management against a gold standard laboratory diagnosis were evaluated. A total of 195 consecutive patients presenting to the study sites with vaginal discharge were enrolled in the study. Information on sociodemographic data was obtained with the aid of questionnaires. Samples were taken and examined for candida, trichomonas, bacterial vaginosis (BV), chlamydia and gonorrheal infections, after speculum and vaginal examinations. The sensitivity and positive predictive values (PPV) of the syndromic management in detecting vaginal infections performed better than corresponding values for cervicitis. The algorithm for cervicitis improved on addition of speculum examination (36% and 32.1% for sensitivity and PPV respectively). The study shows that the syndromic diagnosis for vaginal discharge fares better for vaginitis, especially with addition of speculum examination. The application of syndromic diagnosis for cervicitis resulted in omission of patients who had evidence of cervical infections by bacteriologic examination.

  3. [Evaluation on methodological problems in reports concerning quantitative analysis of syndrome differentiation of diabetes mellitus].

    Science.gov (United States)

    Chen, Bi-Cang; Wu, Qiu-Ying; Xiang, Cheng-Bin; Zhou, Yi; Guo, Ling-Xiang; Zhao, Neng-Jiang; Yang, Shu-Yu

    2006-01-01

    To evaluate the quality of reports published in recent 10 years in China about quantitative analysis of syndrome differentiation for diabetes mellitus (DM) in order to explore the methodological problems in these reports and find possible solutions. The main medical literature databases in China were searched. Thirty-one articles were included and evaluated by the principles of clinical epidemiology. There were many mistakes and deficiencies in these articles, such as clinical trial designs, diagnosis criteria for DM, standards of syndrome differentiation of DM, case inclusive and exclusive criteria, sample size and estimation, data comparability and statistical methods. It is necessary and important to improve the quality of reports concerning quantitative analysis of syndrome differentiation of DM in light of the principles of clinical epidemiology.

  4. Nonthyroidal illness syndrome: evaluation of thyroid function in sick patients.

    Science.gov (United States)

    Langton, Joanne E; Brent, Gregory A

    2002-03-01

    Altered thyroid function tests as a consequence of illness have been recognized for many years, yet the cause and clinical implications remains uncertain. The routine testing of thyroid function in hospitalized patients should be discouraged, as the results are less predictive of primary thyroid disease than in ambulatory patients. Clinicians should be aware of the methods used for thyroid function testing, as the effect of illness on thyroid function varies among the different tests. The most commonly used free T4 assays likely are influenced significantly by nonthyroidal illness. Advances in understanding the basic mechanisms of thyroid hormone metabolism and thyroid hormone action have given insights into the changes in thyroid function tests as a consequence of nonthyroidal illness. In the future, thyroid hormone receptor isoform-specific agonists and antagonists may allow for more specific treatment of select patients with nonthyroidal illness syndrome.

  5. A generalized slab-wise framework for parallel transmit multiband RF pulse design.

    Science.gov (United States)

    Wu, Xiaoping; Schmitter, Sebastian; Auerbach, Edward J; Uğurbil, Kâmil; Van de Moortele, Pierre-François

    2016-04-01

    We propose a new slab-wise framework to design parallel transmit multiband pulses for volumetric simultaneous multislice imaging with a large field of view along the slice direction (FOVs). The slab-wise framework divides FOVs into a few contiguous slabs and optimizes pulses for each slab. Effects of relevant design parameters including slab number and transmit B1 (B1+) mapping slice placement were investigated for human brain imaging by designing pulses with global or local SAR control based on electromagnetic simulations of a 7T head RF array. Pulse design using in vivo B1+ maps was demonstrated and evaluated with Bloch simulations. RF performance with respect to SAR reduction or B1+ homogenization across the entire human brain improved with increasing slabs; however, this improvement was nonlinear and leveled off at ∼12 slabs when the slab thickness reduced to ∼12 mm. The impact of using different slice placements for B1+ mapping was small. Compared with slice-wise approaches where each of the many imaging slices requires both B1+ mapping and pulse optimization, the proposed slab-wise design framework attained comparable RF performance while drastically reducing the number of required pulses; therefore, it can be used to increase time efficiency for B1+ mapping, pulse calculation, and sequence preparation. © 2015 Wiley Periodicals, Inc.

  6. The Evaluation of a Personal Narrative Language Intervention for School-Age Children with Down Syndrome

    Science.gov (United States)

    Finestack, Lizbeth; O'Brien, Katy H.; Hyppa-Martin, Jolene; Lyrek, Kristen A.

    2017-01-01

    The purpose of this study was to evaluate the feasibility of an intervention focused on improving personal narrative skills of school-age children with Down syndrome (DS) using an approach involving visual supports. Four females with DS, ages 10 through 15 years, participated in this multiple baseline across participants single-subject…

  7. Preliminary early evaluation of radiation acute syndrome severity in an animal model

    International Nuclear Information System (INIS)

    Gimenez, J.C.; Nasazzi, N.B.; Taja, M.R.; Nagle, C.; Dubner, D.; Di Rizzio, C.

    1992-01-01

    To improve the knowledge of Radiation Acute Syndrome radiopathological picture, whole body x-rays irradiation at 2Gy of a primate (Cebus apella paraguayanus) used as model has been performed. Early evaluations of clinical symptoms and dose and damage biological indicators have shown that this primate has given out similar responses to those of man. (author)

  8. Evaluation of a Behavioral Treatment Package to Reduce Sleep Problems in Children with Angelman Syndrome

    Science.gov (United States)

    Allen, Keith D.; Kuhn, Brett R.; DeHaai, Kristi A.; Wallace, Dustin P.

    2013-01-01

    The purpose of this investigation was to evaluate the effectiveness of a behavioral treatment package to reduce chronic sleep problems in children with Angelman Syndrome. Participants were five children, 2-11 years-of-age. Parents maintained sleep diaries to record sleep and disruptive nighttime behaviors. Actigraphy was added to provide…

  9. Ultrasonographic evaluation of liver volume and the metabolic syndrome in obese women.

    Science.gov (United States)

    Santini, F; Giannetti, M; Mazzeo, S; Fierabracci, P; Scartabelli, G; Marsili, A; Valeriano, R; Pucci, A; Anselmino, M; Zampa, V; Vitti, P; Pinchera, A

    2007-02-01

    Non-alcoholic fatty liver disease is a common finding in obese subjects, and increasing evidence has been provided suggesting that it represents the hepatic component of the metabolic syndrome. The aim of this study was to evaluate whether the extent of liver enlargement is related to the severity of the metabolic syndrome in obese women. The relationship between ultrasound- measured hepatic left lobe volume (HLLV) and various features of the metabolic syndrome was evaluated in 85 obese women. The mean+/-SD value of HLLV in obese women was 431+/-214 ml (range 46-1019 ml) while it was 187+/-31 ml (range 143-258 ml) in lean subjects. In a multiple logistic regression analysis, ultrasound-measured intra-abdominal fat was the only anthropometric measure independently associated with HLLV. A strong positive association was found between HLLV and serum liver enzymes, triglycerides, glucose, insulin, uric acid, C reactive protein, systolic and diastolic blood pressure, while a negative correlation was observed between HLLV and HDL cholesterol. The values of HLLV corresponding to the cut-off values of various risk factors for the diagnosis of the metabolic syndrome were calculated, yielding a mean value of 465 ml. In conclusion, ultrasound measurement of HLLV represents a simple, reliable and low-cost tool for the evaluation of liver involvement in the metabolic syndrome. The strong association between liver enlargement and various cardiovascular risk factors associated with insulin resistance supports the role of liver steatosis as an important link among the many facets of the metabolic syndrome in human obesity.

  10. Prognosis, with evaluation of general biochemistry, of liver disease in lymphoedema cholestasis syndrome 1 (LCS1/Aagenaes syndrome).

    Science.gov (United States)

    Drivdal, Monica; Trydal, Torleif; Hagve, Tor-Arne; Bergstad, Ingunn; Aagenaes, Oystein

    2006-04-01

    To investigate the prognosis of liver disease in Aagenaes syndrome (lymphoedema cholestasis syndrome 1 (LCS1)), which is an autosomal recessive inherited syndrome consisting of neonatal cholestasis with intermittent cholestatic episodes in childhood into adulthood and development of lymphoedema. Forty Norwegian patients are known to have this condition, 25 of whom are alive. A clinical description of the liver disease is supplied with a case-control study. In this paper we review the course of the liver disease in the Norwegian cohort of patients and present results from a case-control study in the patients above 10 years of age. The case-control study was performed on 15 patients without clinical cholestasis (itching and sometimes jaundice) at the time of the study. An evaluation of 11 patients above 15 years of age without chronic biochemical cholestasis (increased alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) and/or serum bile acids) was also carried out. For each patient one randomly identified control person was included (15 in one study, 11 in the other). Cirrhosis with either transplantation or death in infancy or early childhood occurred in six patients; slowly developing cirrhosis occurred in three patients. Two patients may be in the process of developing cirrhosis. Significantly increased ALP and GGT levels were found in patients with normal liver biochemistry in the preceding years when compared with the case control group. Additionally, albumin was found to be lower in older patients. Compared with that for other types of hereditary neonatal cholestasis, patients with LCS1 have a relatively good prognosis. More than 50% can expect a normal life span.

  11. Evaluation of 2-stage Treatment for Cervical Dorsal Rami Entrapment Syndrome: A Randomized, Controlled Trial.

    Science.gov (United States)

    Li, Qi; Wang, Jing-Wu; Zeng, Bing-Fang; Cai, Yi-Ming; Zhang, Chang-Qing

    2017-09-01

    To evaluate the effectiveness of a 2-stage nonoperative treatment for patients with cervical dorsal rami entrapment syndrome. The study included 66 patients diagnosed with cervical dorsal rami entrapment syndrome randomized to an experimental group (n=33) and control group (n=33). The experimental group was treated with additional diagnostic block if regular 2 weeks medication was not effective. The control group only received nonsteroidal anti-inflammatory drugs for 2 weeks. A visual analog scale (VAS) and pain treatment satisfaction scale (PTSS) were used to assess pain. Muscle power in the upper limbs was also assessed. The registration number of this study is ChiCTR-IIR-15007565. The VAS scores of the experimental group were significantly lower at 2, 4, and 6 months after treatment compared with baseline and the VAS scores of the control group (all Prami entrapment syndrome.

  12. Evaluation of drug treatment in irritable bowel syndrome

    Science.gov (United States)

    Talley, Nicholas J

    2003-01-01

    The irritable bowel syndrome (IBS) remains a therapeutic challenge in part because of the limited understanding of the pathophysiology. The placebo response rate varies in randomized controlled trials from 20 to 70%, and can persist for up to at least 1 year. It is contentious whether dietary fibre and bulking agents relieve the symptoms of IBS; constipation probably improves. Anticholinergic and antispasmodic agents are of questionable benefit in IBS despite positive meta-analyses of poor quality trials. A meta-analysis concluded that the tricyclic antidepressants were superior to placebo in IBS, although the individual trial results were variable. Selective serotonin reuptake inhibitors are of uncertain benefit. Laxatives are used for constipation but probably poorly control the IBS symptom complex. Loperamide is superior to placebo in improvement of diarrhoea but not abdominal pain in IBS. Tegaserod is a well- tolerated aminoguanidine indole derivative of serotonin that is a partial 5HT4–receptor agonist with prokinetic properties; a therapeutic gain over placebo of 5% to 15% has been observed in constipation-predominant IBS in females. Alosetron is a 5HT3-receptor antagonist that is efficacious in females with diarrhoea-predominant IBS, with a 12% to 17% therapeutic gain; the risk of ischaemic colitis is 1 in 350, with very severe constipation occurring in about 1 in 1000. Optimizing study design remains a challenge in IBS. New visceral analgesic and motility modifying agents, as well as anti-inflammatory agents are in trials, and hopefully additional efficacious therapeutic options for patients with IBS will soon emerge. PMID:12968980

  13. Data Reports for Retrospective Case Study in Wise County, Texas

    Science.gov (United States)

    Data reports from sampling events collected in wise county, texas as part of EPA's Study of the Potential Impacts of Hydraulic Fracturing for Oil and Gas on Drinking Water Resources, retrospective case study.

  14. Evaluation of cardiovascular anomalies in patients with asymptomatic turner syndrome using multidetector computed tomography.

    Science.gov (United States)

    Lee, Sun Hee; Jung, Ji Mi; Song, Min Seob; Choi, Seok jin; Chung, Woo Yeong

    2013-08-01

    Turner syndrome is well known to be associated with significant cardiovascular abnormalities. This paper studied the incidence of cardiovascular abnormalities in asymptomatic adolescent patients with Turner syndrome using multidetector computed tomography (MDCT) instead of echocardiography. Twenty subjects diagnosed with Turner syndrome who had no cardiac symptoms were included. Blood pressure and electrocardiography (ECG) was checked. Cardiovascular abnormalities were checked by MDCT. According to the ECG results, 11 had a prolonged QTc interval, 5 had a posterior fascicular block, 3 had a ventricular conduction disorder. MDCT revealed vascular abnormalities in 13 patients (65%). Three patients had an aberrant right subclavian artery, 2 had dilatation of left subclavian artery, and others had an aortic root dilatation, aortic diverticulum, and abnormal left vertebral artery. As for venous abnormalities, 3 patients had partial anomalous pulmonary venous return and 2 had a persistent left superior vena cava. This study found cardiovascular abnormalities in 65% of asymptomatic Turner syndrome patients using MDCT. Even though, there are no cardiac symptoms in Turner syndrome patients, a complete evaluation of the heart with echocardiography or MDCT at transition period to adults must be performed.

  15. Resiliency and the subjective evaluation of health in mothers of children with Asperger’s syndrome

    Directory of Open Access Journals (Sweden)

    Arleta Kasprzak

    2014-02-01

    Full Text Available Background Parents caring for children with developmental disorders are exposed to much higher levels of stress than parents of typically developing children. It has also been proved that parents of children with developmental disorders experience mental health deterioration, a sense of guilt, physical weakness, fatigue and exhaustion. Resiliency conditions cognitive and emotional flexibility, and enables an individual to adjust their own behavior to particular circumstances. The present study aims to verify whether there is a relationship between resiliency and the subjective evaluation of health under stress in a group of mothers of children with Asperger’s syndrome. Participants and procedure The three measures used in the study were The Polish Resiliency Assessment Scale, The Subjective Evaluation of Health Scale, and a personal questionnaire. A group of 31 mothers of children with Asperger’s syndrome and a group of 31 mothers whose children were not chronically ill and developed typically were examined. Results Mothers of children with Asperger’s syndrome have similar levels of resiliency and its contributing factors compared to mothers with healthy children. However, when compared to mothers of healthy children, mothers of children with Asperger’s syndrome show a more negative subjective evaluation of health. Moreover, we found that some resiliency factors (The ability to tolerate failures and view life as a challenge, and Optimism in life and the ability to focus in adversity correlate positively only in the group of mothers of children with Asperger’s syndrome. Conclusions Findings obtained in the study allow us to consider resiliency along with having a healthy child, as a factor contributing to a positive evaluation of health.

  16. The etiology of idiopathic carpal tunnel syndrome. Evaluation from the viewpoint of magnetic resonance imaging

    International Nuclear Information System (INIS)

    Ikeda, Jun

    2003-01-01

    The etiology of idiopathic carpal tunnel syndrome has not been clarified. A cross sectional area of carpal tunnel, flexor tendons, median nerve, and thickness of transverse carpal ligament were evaluated by MRI. Twenty-six patients who were electrophysiologically diagnosed with idiopathic carpal tunnel syndrome were tested by MRI. All patients were females; the mean age was sixty-four years old. The cross sectional area of carpal tunnel, the median nerve area, the area of the flexor tendons and its synovium in carpal tunnel, and thickness of the transverse carpal ligament were calculated. The following are of a seuere type carpal tunnel syndrome: Mean area of the flexor tendons and its synovium in carpal tunnel, 110.5±25.5 mm 2 (control group; 79.3±13.8 mm 2 ); ratio of flexor tendons and its synovium area to carpal tunnel area, 51.6±8.8% (control; 40.5±2.3%); and thickness of the transverse carpal ligament, 3.3±0.4 mm (control; 2.4±0.4 mm). These mean areas in severe carpal tunnel syndrome were significantly greater than those in mild type (p<0.05 or p<0.01). From the viewpoint of this result, it is possible that tenosynovitis is strongly to the etiology of idiopathic carpal tunnel syndrome. In other words, synovium edema causes chronic high pressure environment in carpal tunnel. Moreover, we classified these MRI findings into the following subgroups: enlargement of cross sectional area of flexor tendon and its synovia (n=8; 25.8%), thickened transverse carpal ligament (n=11; 35.5%), and combined type (n=7; 22.6%). This classification by MRI imaging was related to a clinical course and electro-physiologic severity. The present study suggests that to evaluate the cross sectional, area of an MRI image is useful for diagnosis and cure of idiopathic carpal tunnel syndrome. (author)

  17. Evaluation of Kinesiophobia and Its Correlations with Pain and Fatigue in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome Hypermobility Type

    Directory of Open Access Journals (Sweden)

    Claudia Celletti

    2013-01-01

    Full Text Available Ehlers-Danlos syndrome hypermobility type a. k. a. joint hypermobility syndrome (JHS/EDS-HT is a hereditary musculoskeletal disorder associating generalized joint hypermobility with chronic pain. Anecdotal reports suggest a prominent role for kinesiophobia in disease manifestations, but no study has systematically addressed this point. Objective. To investigate the impact of kinesiophobia and its relationship with pain, fatigue, and quality of life in JHS/EDS-HT. Design. Cross-sectional study. Subjects/Patients. 42 patients (40 female and 2 male with JHS/EDS-HT diagnosis following standardized diagnostic criteria were selected. Methods. Disease features were analyzed by means of specific questionnaires and scales evaluating kinesiophobia, pain, fatigue, and quality of life. The relationships among variables were investigated using the Spearman bivariate analysis. Results. Kinesiophobia resulted predominantly in the patients’ sample. The values of kinesiophobia did not correlate with intensity of pain, quality of life, and (or the single component of fatigue. A strong correlation was discovered between kinesiophobia and general severity of fatigue. Conclusions. In JHS/EDS-HT, the onset of pain-avoiding strategies is related to the presence of pain but not to its intensity. The clear-cut correlation between kinesiophobia and severity of fatigue suggests a direct link between musculoskeletal pain and fatigue. In JHS/EDS-HT, the underlying mechanism is likely to be facilitated by primary disease characteristics, including hypotonia.

  18. Sustainable Materials Management (SMM) WasteWise Data

    Science.gov (United States)

    EPA??s WasteWise encourages organizations and businesses to achieve sustainability in their practices and reduce select industrial wastes. WasteWise is part of EPA??s sustainable materials management efforts, which promote the use and reuse of materials more productively over their entire lifecycles. All U.S. businesses, governments and nonprofit organizations can join WasteWise as a partner, endorser or both. Current participants range from small local governments and nonprofit organizations to large multinational corporations. Partners demonstrate how they reduce waste, practice environmental stewardship and incorporate sustainable materials management into their waste-handling processes. Endorsers promote enrollment in WasteWise as part of a comprehensive approach to help their stakeholders realize the economic benefits to reducing waste. WasteWise helps organizations reduce their impact on global climate change through waste reduction. Every stage of a product's life cycle??extraction, manufacturing, distribution, use and disposal??indirectly or directly contributes to the concentration of greenhouse gases (GHGs) in the atmosphere and affects the global climate. WasteWise is part of EPA's larger SMM program (https://www.epa.gov/smm). Sustainable Materials Management (SMM) is a systemic approach to using and reusing materials more productively over their entire lifecycles. It represents a change in how our society thinks about the use of natural resources

  19. Evaluation of Patients with Painful Bladder Syndrome/Interstitial Cystitis

    Directory of Open Access Journals (Sweden)

    Jean Jacques Wyndaele

    2005-01-01

    Full Text Available This review looks into the evaluation of patients with interstitial cystitis (IC. Interstitial cystitis is not easy to define. There is a lot of activity in this domain and a great international effort is made to get to a generally accepted definition and standardised protocols for diagnosis and treatment. We have not reached this point so far.

  20. Impact of Antibiotic Shortage on H. Pylori Treatment: A Step-Wise Approach for Pharmacist Management

    Directory of Open Access Journals (Sweden)

    Michelle M. Lamb

    2013-01-01

    Full Text Available The current drug shortage crisis involving multiple oral antibiotics has significantly impacted preferred therapeutic options for treatment of H.pylori infection. Pharmacists may help alleviate the impact of this shortage through a proposed step-wise approach which includes proper inventory management, verification of indication, evaluation of regimen, therapeutic monitoring, and communication with patients and providers regarding alternative therapy or symptomatic relief.   Type: Original Research

  1. Impact of Antibiotic Shortage on H. Pylori Treatment: A Step-Wise Approach for Pharmacist Management

    Directory of Open Access Journals (Sweden)

    Ann Lloyd, Pharm.D., BCPS

    2013-01-01

    Full Text Available The current drug shortage crisis involving multiple oral antibiotics has significantly impacted preferred therapeutic options for treatment of H.pylori infection. Pharmacists may help alleviate the impact of this shortage through a proposed step-wise approach which includes proper inventory management, verification of indication, evaluation of regimen, therapeutic monitoring, and communication with patients and providers regarding alternative therapy or symptomatic relief.

  2. Evaluation of children with steroid-sensitive nephrotic syndrome in terms of allergies.

    Science.gov (United States)

    Yılmaz, Dilek; Yenigün, Ayşe; Sönmez, Ferah; Kurt Ömürlü, İmran

    2015-04-01

    The etiology of minimal-change disease is not fully known, it is believed to be mediated by the immune system. Minimal-change disease also reported as having association with atopy. In this study, atopy history, the levels of serum IgE, and skin prick test in children with steroid-sensitive nephrotic syndrome were investigated. A group of 30 children (mean age 7.7 ± 2.2 years, 56.6% male) diagnosed with steroid-sensitive nephrotic syndrome were included in the study. Serum immunoglobulin E levels and eosinophil counts were evaluated in children with steroid-sensitive nephrotic syndrome both in relapse and remission. Skin prick test was performed in remission. Of the 30 children investigated, 11 (36.7%) had a history of atopy. The median serum total IgE levels in nephrotic children in relapse, with (445 IU/mL) and without atopy (310 IU/mL) were significantly higher than those in remission (respectively, 200 IU/mL, p = 0.021, and 42 IU/mL, p = 0.001). The skin prick tests for all the allergens were evaluated as negative in all the patients. It was thought that increased IgE may reflect the activation of immune mechanism following various stimuli rather than a direct association with atopy in children with steroid-sensitive nephrotic syndrome.

  3. The Usefulness of the Preoperative Magnetic Resonance Imaging Findings in the Evaluation of Tarsal Tunnel Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hyun Jin; Lee, Sheen Woo; Jeong, Yu Mi; Choi, Hye Young; Kim, Hyung Sik [Dept. of Radiology, Gil Hospital, Gacheon University College of Medicine, Incheon (Korea, Republic of); Park, Hong Gi; Kwak, Ji Hoon [Dept. of Orthopedic Surgery, Gil Hospital, Gacheon University College of Medicine, Incheon (Korea, Republic of)

    2012-02-15

    The purpose of this study was to access the diverse conditions that lead to the clinical manifestations of tarsal tunnel syndrome and evaluate the usefulness of magnetic resonance imaging (MRI) in preoperative evaluation. Thirty-three patients who underwent ankle MRI and surgery under the impression of tarsal tunnel syndrome were retrospectively analyzed. The findings on ankle MRI were categorized into space occupying lesions within the tarsal tunnel, space occupying lesions of the tunnel wall, and non-space occupying lesions. Associated plantar muscle atrophy was also evaluated. Medical records were reviewed for correlation of nerve conduction velocity (NCV) and surgical findings. There were 21 space occupying lesions of the tarsal tunnel, and eight lesions of tarsal tunnel wall. There were three cases with accessory muscle, three with tarsal coalition, five with ganglion cysts, one neurogenic tumor, five flexor retinaculum hypertrophy, three varicose veins, and nine with tenosynovitis of the posterior tibialis, flexor digitorum longus, or flexor hallucis longus tendon. One patient was found to have a deltoid ligament sprain. Of the 32, eight patients experienced fatty atrophic change within any one of the foot muscles. NCV was positive in 79% of the MRI-positive lesions. MRI provides detailed information on ankle anatomy, which includes that of tarsal tunnel and beyond. Pathologic conditions that cause or mimic tarsal tunnel syndrome are well demonstrated. MRI can enhance surgical planning by indicating the extent of decompression required, and help with further patient management. Patients with tarsal tunnel syndrome can greatly benefit from preoperative MRI. However, it should be noted that not all cases with tarsal tunnel syndrome have MRI-demonstrable causes.

  4. The Usefulness of the Preoperative Magnetic Resonance Imaging Findings in the Evaluation of Tarsal Tunnel Syndrome

    International Nuclear Information System (INIS)

    Jung, Hyun Jin; Lee, Sheen Woo; Jeong, Yu Mi; Choi, Hye Young; Kim, Hyung Sik; Park, Hong Gi; Kwak, Ji Hoon

    2012-01-01

    The purpose of this study was to access the diverse conditions that lead to the clinical manifestations of tarsal tunnel syndrome and evaluate the usefulness of magnetic resonance imaging (MRI) in preoperative evaluation. Thirty-three patients who underwent ankle MRI and surgery under the impression of tarsal tunnel syndrome were retrospectively analyzed. The findings on ankle MRI were categorized into space occupying lesions within the tarsal tunnel, space occupying lesions of the tunnel wall, and non-space occupying lesions. Associated plantar muscle atrophy was also evaluated. Medical records were reviewed for correlation of nerve conduction velocity (NCV) and surgical findings. There were 21 space occupying lesions of the tarsal tunnel, and eight lesions of tarsal tunnel wall. There were three cases with accessory muscle, three with tarsal coalition, five with ganglion cysts, one neurogenic tumor, five flexor retinaculum hypertrophy, three varicose veins, and nine with tenosynovitis of the posterior tibialis, flexor digitorum longus, or flexor hallucis longus tendon. One patient was found to have a deltoid ligament sprain. Of the 32, eight patients experienced fatty atrophic change within any one of the foot muscles. NCV was positive in 79% of the MRI-positive lesions. MRI provides detailed information on ankle anatomy, which includes that of tarsal tunnel and beyond. Pathologic conditions that cause or mimic tarsal tunnel syndrome are well demonstrated. MRI can enhance surgical planning by indicating the extent of decompression required, and help with further patient management. Patients with tarsal tunnel syndrome can greatly benefit from preoperative MRI. However, it should be noted that not all cases with tarsal tunnel syndrome have MRI-demonstrable causes.

  5. Student Teachers' Evaluations of Slides of Children with Down Syndrome: Impact of Facial Plastic Surgery, Labelling and Factual Knowledge.

    Science.gov (United States)

    Elkabetz, R.; And Others

    1990-01-01

    This study examined the impact of facial plastic surgery, labeling (mentally retarded, normal, Down's syndrome), and level of knowledge of Down's syndrome on 127 student teachers' evaluations of slides of persons with such characteristics. Although there was no overall significant main effect for the pre-post operation condition, there was a…

  6. CLINICAL-EVALUATION OF PAIN TREATMENT WITH ELECTROSTIMULATION - A STUDY OF TENS IN PATIENTS WITH DIFFERENT PAIN SYNDROMES

    NARCIS (Netherlands)

    MEYLER, WJ; DEJONGSTE, MJL; ROLF, CAM

    Objective: We evaluated the clinical efficacy and the unwanted side effects of transcutaneous electrical nerve stimulation (TENS) in a consecutive group of patients with intractable pain due to different pain syndromes. Methods: Two hundred eleven patients with different pain syndromes, coded

  7. Choosing Wisely: Opportunities for Improving Value in Cancer Care Delivery?

    Science.gov (United States)

    Rocque, Gabrielle B; Williams, Courtney P; Jackson, Bradford E; Wallace, Audrey S; Halilova, Karina I; Kenzik, Kelly M; Partridge, Edward E; Pisu, Maria

    2017-01-01

    Patients, providers, and payers are striving to identify where value in cancer care can be increased. As part of the Choosing Wisely (CW) campaign, ASCO and the American Society for Therapeutic Radiology and Oncology have recommended against specific, yet commonly performed, treatments and procedures. We conducted a retrospective analysis of Medicare claims data to examine concordance with CW recommendations across 12 cancer centers in the southeastern United States. Variability for each measure was evaluated on the basis of patient characteristics and site of care. Hierarchical linear modeling was used to examine differences in average costs per patient by concordance status. Potential cost savings were estimated on the basis of a potential 95% adherence rate and average cost difference. The analysis included 37,686 patients with cancer with Fee-for-Service Medicare insurance. Concordance varied by CW recommendation from 39% to 94%. Patient characteristics were similar for patients receiving concordant and nonconcordant care. Significant variability was noted across centers for all recommendations, with as much as an 89% difference. Nonconcordance was associated with higher costs for every measure. If concordance were to increase to 95% for all measures, we would estimate a $19 million difference in total cost of care per quarter. These results demonstrate ample room for reduction of low-value care and corresponding costs associated with the CW recommendations. Because variability in concordance was driven primarily by site of care, rather than by patient factors, continued education about these low-value services is needed to improve the value of cancer care.

  8. DEVELOPMENT OF A GAME FOR THE EVALUATION OF OPERATIVE STRUCTURE IN TEENAGERS WITH DOWN SYNDROME

    Directory of Open Access Journals (Sweden)

    Flávio Cezar Amate

    2014-05-01

    Full Text Available When an individual presents some type of mental deficiency, there is a tendency to expose him to innumerous evaluations, repeating them several times in a short period so as to verify his development. In some cases, the evaluation is tiring and could lead to the desistance of the person evaluated and to the   exhaustion of the appraiser. In this article a computational game was developed in Flash for teenagers with the Down Syndrome that demonstrate light or moderate mental deficiency to evaluate cognitive seriation functions and classes inclusion based on the Jean Piaget theory. The game is set up in a kitchen where the individual  to be evaluated  helps the principal character in achieving tasks. After the termination of the activities a report is made with the  analysis  of the operative structures  demonstrated. To evaluate the efficiency of the game, the subjects went through the evaluation of the operative tests and then played the game. Two pilot tests were made and applied to 13 teenagers with the Down Syndrome. The analysis showed that the method minimizes subjectivity and manipulation of the material needing less time making the report as the  game is produced immediately. There was a bigger interest because the game contextualizes the tests even when the individual had verbal difficulty  the evaluation access was possible through the game which didn´t occur when applied in the real tests

  9. Choosing Wisely: How To Fulfill The Promise In The Next 5 Years.

    Science.gov (United States)

    Kerr, Eve A; Kullgren, Jeffrey T; Saini, Sameer D

    2017-11-01

    Low-value care-the use of unnecessary and potentially harmful health care services-accounted for roughly $200 billion in wasteful spending in the United States in 2011. In 2012 the ABIM Foundation and Consumer Reports launched the Choosing Wisely® campaign, inspired by the idea that professional societies and health care providers should take the lead in defining and motivating efforts to reduce the use of low-value care. But decreases in that use have been slow in coming. We discuss the campaign's significant accomplishments in the past five years and summarize the work that is needed to fulfill the promise of Choosing Wisely. We focus on innovations in three main areas: identifying high-priority clinical targets, developing theory-based interventions, and evaluating interventions in ways that are clinically meaningful.

  10. Fluorescent in situ hybridization for evaluation of Prader-Willi and Angelman syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Wenger, S.L.; Cummins, J.H. [Univ. of Pittsburgh, PA (United States)

    1995-07-17

    We have found fluorescence in situ hybridization (FISH) results more reliavle than high resolution chromosome analysis for the diagnosis of Prader-Willi (PWS) or Angelman syndromes (AS). Specifically, we have found success in the detection of 15q11q13 deletions among 55 cases. Our study suggests that FISH analysis using PWS/AS probes can facilitate diagnostic evaluation of these cases for deletions. 2 refs., 1 tab.

  11. On Pixel-Wise Explanations for Non-Linear Classifier Decisions by Layer-Wise Relevance Propagation.

    Directory of Open Access Journals (Sweden)

    Sebastian Bach

    Full Text Available Understanding and interpreting classification decisions of automated image classification systems is of high value in many applications, as it allows to verify the reasoning of the system and provides additional information to the human expert. Although machine learning methods are solving very successfully a plethora of tasks, they have in most cases the disadvantage of acting as a black box, not providing any information about what made them arrive at a particular decision. This work proposes a general solution to the problem of understanding classification decisions by pixel-wise decomposition of nonlinear classifiers. We introduce a methodology that allows to visualize the contributions of single pixels to predictions for kernel-based classifiers over Bag of Words features and for multilayered neural networks. These pixel contributions can be visualized as heatmaps and are provided to a human expert who can intuitively not only verify the validity of the classification decision, but also focus further analysis on regions of potential interest. We evaluate our method for classifiers trained on PASCAL VOC 2009 images, synthetic image data containing geometric shapes, the MNIST handwritten digits data set and for the pre-trained ImageNet model available as part of the Caffe open source package.

  12. Evaluating CHARGE syndrome in congenital hypogonadotropic hypogonadism patients harboring CHD7 variants.

    Science.gov (United States)

    Xu, Cheng; Cassatella, Daniele; van der Sloot, Almer M; Quinton, Richard; Hauschild, Michael; De Geyter, Christian; Flück, Christa; Feller, Katrin; Bartholdi, Deborah; Nemeth, Attila; Halperin, Irene; Pekic Djurdjevic, Sandra; Maeder, Philippe; Papadakis, Georgios; Dwyer, Andrew A; Marino, Laura; Favre, Lucie; Pignatelli, Duarte; Niederländer, Nicolas J; Acierno, James; Pitteloud, Nelly

    2017-11-16

    PurposeCongenital hypogonadotropic hypogonadism (CHH), a rare genetic disease caused by gonadotropin-releasing hormone deficiency, can also be part of complex syndromes (e.g., CHARGE syndrome). CHD7 mutations were reported in 60% of patients with CHARGE syndrome, and in 6% of CHH patients. However, the definition of CHD7 mutations was variable, and the associated CHARGE signs in CHH were not systematically examined.MethodsRare sequencing variants (RSVs) in CHD7 were identified through exome sequencing in 116 CHH probands, and were interpreted according to American College of Medical Genetics and Genomics guidelines. Detailed phenotyping was performed in CHH probands who were positive for CHD7 RSVs, and genotype-phenotype correlations were evaluated.ResultsOf the CHH probands, 16% (18/116) were found to harbor heterozygous CHD7 RSVs, and detailed phenotyping was performed in 17 of them. Of CHH patients with pathogenic or likely pathogenic CHD7 variants, 80% (4/5) were found to exhibit multiple CHARGE features, and 3 of these patients were reclassified as having CHARGE syndrome. In contrast, only 8% (1/12) of CHH patients with nonpathogenic CHD7 variants exhibited multiple CHARGE features (P = 0.01).ConclusionPathogenic or likely pathogenic CHD7 variants rarely cause isolated CHH. Therefore a detailed clinical investigation is indicated to clarify the diagnosis (CHH versus CHARGE) and to optimize clinical management.Genetics in Medicine advance online publication, 16 November 2017; doi:10.1038/gim.2017.197.

  13. [Evaluating the relation of premenstrual syndrome and primary dysmenorrhea in women diagnosed with fibromyalgia].

    Science.gov (United States)

    Terzi, Rabia; Terzi, Hasan; Kale, Ahmet

    2015-01-01

    In this study, we aimed to investigate the presence of premenstrual syndrome (PMS), primary dysmenorrhea (PD) and depression among women with fibromyalgia (FM) and healthy females and to determine possible factors related with PMS and PD in FM. The present study was conducted on 98 female patients diagnosed with FM and 102 age and sex-matched healthy controls. All patients were evaluated for premenstrual syndrome (PMS) and primary dysmenorrhea (PD). Premenstrual syndrome was assessed among the patients for the presence of one or more affective or somatic symptoms within the five days preceding menses. The diagnosis of primary dysmenorrhea was defined as having abdominal pain or lower back pain lasting at least two days during a menstrual period. Dysmenorrhea was assessed via visual analog scale. Dysmenorrhea was rated via Multidimensional Scoring System. The Hamilton depression scale was applied to all patients. Primary dysmenorrhea was established in 41% of FM patients and 28% of the control group. A statistically significant difference was found in PD between the two groups (p=0.03). PMS was established in 42% of the FM patients and 25% of the control group. A statistically significant difference was found in PMS between the two groups (p=0.03). There is an increased frequency of premenstrual syndrome and dysmenorrhea in FM patients. The patients with high symptom severity scores and high depression scores among the FM patients are at risk of PMS and PD. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  14. Evaluation of surgical treatment of carpal tunnel syndrome using local anesthesia

    Directory of Open Access Journals (Sweden)

    Marco Felipe Francisco Honorato Barros

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the results and complications from surgical treatment of carpal tunnel syndrome by means of an open route, using a local anesthesia technique comprising use of a solution of lidocaine, epinephrine and sodium bicarbonate. MATERIAL AND METHODS: This was a cohort study conducted through evaluating the medical files of 16 patients who underwent open surgery to treat carpal tunnel syndrome, with use of local anesthesia consisting of 20 mL of 1% lidocaine, adrenaline at 1:100,000 and 2 mL of sodium bicarbonate. The DASH scores before the operation and six months after the operation were evaluated. Comparisons were made regarding the intensity of pain at the time of applying the anesthetic and during the surgical procedure, and in relation to other types of procedure. RESULTS: The DASH score improved from 65.17 to 16.53 six months after the operation (p < 0.01. In relation to the anesthesia, 75% of the patients reported that this technique was better than or the same as venous puncture and 81% reported that it was better than a dental procedure. Intraoperative pain occurred in two cases. There were no occurrences of ischemia. CONCLUSION: Use of local anesthesia for surgically treating carpal tunnel syndrome is effective for performing the procedure and for the final result.

  15. Evaluation of bone and mineral metabolism in primary corticosteroid-sensitive pediatric nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Miguel Liern

    2017-04-01

    Full Text Available Introduction: Steroid treatment for corticosteroid-sensitive nephrotic syndrome (CSNS could cause bone and mineral metabolism alterations, preventable with calcium and Vitamin D. Objectives: We carried out a preliminary retrospective study along 36 months with the following objectives. 1 To evaluate the relationship between Cumulative Corticosteroid Doses (CCD and 25-0 Vitamin D serum concentration and with Bone Mineral Content (BMC; 2 To evaluate the relationship between CCD and Bone Mineral Densitomety (BMD. Methods: We included patients between 2 and 12 years of age with corticosteroid sensitive primary nephrotic syndrome (CSNS (first episode, relapsing nephrotic syndrome, corticosteroid dependent nephrotic syndrome normotensive, eutrophic and FG>:90ml/min/1.73 m2, who were divided into three groups: GROUP A: =3 or 4 relapses/year, GROUP C: CSNS, we measured: a Quarterly: calcemia, phosphatemia, alkaline phosphatase; b half-yearly: 25-OH cholecalcipherol levels, CCD; c annually BMD in children >6 years (score Z and BMC, bone age, PTHi. Results: We evaluated 29 patients, average age: 4.4 years. The BMD was performed on 11 patients and there were no significant differences among the groups (p=0.08. No significant differences were seen between chronologic age and average bone age (p=0.3. Change in 25-OH cholecalcipherol levels due to the increase of ergocalcipherol dose was significant (T:32.4 Q:<0.001. There were significant correlation in the three groups, between Vitamin D dose and Vitamin D serum levels (Pearson correlation R=0.9, between CCD and 25 OH cholecalcipherol dose: (Pearson correlation R=0.62 and between CCD and BMC (Pearson correlation R=0.44. Finally, in these three groups the average increase of vitamin D was: 1833IU. Conclusions: We found a relationship between CCD and hypovitaminosis D, which could be corrected increasing Vitamin D dose.

  16. Clinical, pathological, and genetic evaluations of Chinese patient with otodental syndrome and multiple complex odontoma

    Science.gov (United States)

    Liu, Anqi; Wu, Meiling; Guo, Xiaohe; Guo, Hao; Zhou, Zhifei; Wei, Kewen; Xuan, Kun

    2017-01-01

    Abstract Otodental syndrome is a rare autosomal-dominant disease characterized by globodontia, associated with sensorineural, high-frequency hearing loss. Here, we describe the clinical, pathological, and genetic evaluations of a 9-year-old girl with otodental syndrome and multiple complex odontoma. The patient presented with a draining sinus tract in her left cheek, globodontia, and hearing loss. The odontomas which caused the cutaneous sinus tracts were extracted because of the odontogenic infection. The extracted odontoma and primary tooth was studied by micro-CT and further observed histopathologically. The micro-CT findings revealed that the primary tooth had three crowns with two separated pulp chambers, and their root canals were partially fused. The histological findings showed abnormal morphologies of odontoblasts and dentin, hyperplasia of enamel, and malformation of odontogenic epithelium. Furthermore, DNA sequencing and analyze of deafness associated gene GJB2, GJB3, and PDS had not revealed any SNP or mutation; but exon 3 of the causative gene FGF3 could not be amplified, which may be associated with the microdeletion at chromosome 11q13.3. Three month after surgery, the patient was found to be asymptomatic and even the evidence of the extra-oral sinus had disappeared. The dental abnormality of otodental syndrome included congenital missing teeth, globodontia, and multiple complex odontoma. Globodontia exhibited characteristic features of fusion teeth. In addition, gene FGF3 haploinsufficiency was likely to be the cause of otodental syndrome. The report provides some new information in the field of otodental syndrome, which would make dentists more familiar with this disease. PMID:28151902

  17. Evaluation of ten prognostic factors affecting the outcome of West syndrome.

    Science.gov (United States)

    Yilmaz, Sanem; Tekgul, Hasan; Serdaroglu, Gul; Akcay, Ayfer; Gokben, Sarenur

    2016-12-01

    The aim of this study is to assess the seizure and developmental outcome and to determine the prognostic factors affecting the outcome of West syndrome in an etiologically well-defined large cohort. Demographic features, treatment modalities, etiology, seizure and developmental outcome of 216 cases with West syndrome were recorded retrospectively. Ten prognostic factors possibly affecting the outcome of West syndrome including (1) gender, (2) age at the onset (3) presence of seizures prior to spasms, (4) presence of asymmetric spasm, (5) presence of abnormal neurological signs, (6) treatment lag, (7) etiology, (8) drug chosen as the initial treatment, (9) response to initial treatment regardless of the kind, (10) development of other seizure types after spasms were evaluated in terms of seizure and developmental outcome. Twelve percent of the cases were developmentally normal at the end of 2-year follow-up. Ongoing seizures requiring antiepileptic drug medication at the last follow-up were noted in 90 % of the cases. Hypoxia (29 %), metabolic disorders (11 %), infectious diseases (9 %) and cerebral developmental disorders (8 %) were the most frequent etiological factors. Five of the ten prognostic factors (presence of seizures prior to spasms, presence of abnormal neurological signs, response to initial treatment regardless of the kind, etiology and development of other seizure types after spasms) were found to be statistically significant prognostic factors predicting the outcome. In conclusion, West syndrome is still a catastrophic epileptic encephalopathy. Preventable causes still constitute a substantial portion of the etiological causes of West syndrome. Therefore, the prevention of avoidable causes is at least as important as the treatment.

  18. Evaluation of Gilles de la Tourette syndrome with [99mTc] HMPAO Brain SPECT

    International Nuclear Information System (INIS)

    Carreira, LCTF; Santos, A. O; Juarez, B. A; Leite, H. A; Lima, M. C. L; Ramos, C. D; Camargo, E. E

    2002-01-01

    Gilles de la Tourette syndrome (GLTS) is a disorder characterized by tics and several behavioral disturbances. Although GLTS is a relatively common disorder, little is known about its pathophysiology. Previous studies with SPECT and PET were performed in a small number of patients and have shown some discordant data. The aim of this study is to evaluate brain perfusion abnormalities in patients with GLTS and to correlate them with the clinical manifestations of the syndrome. Twenty-eight patients were submitted to brain [99mTc]-HMPAO SPECT. 82 percent of the patients had abnormal studies. The most frequent finding was perfusion abnormalities in the thalami in 16 patients (57 percent) and 85 percent of patients with hyperperfusion of one or both thalami had complex motor tics. This investigation has demonstrated that brain perfusion SPECT is able to identify cortical perfusion abnormalities, associated with clinical symptoms in patients with GLTS. These abnormalities involve the pre-frontal-striatal-thalamic-cortical pathways (Au)

  19. New mouse model for inducing and evaluating unilateral vestibular deafferentation syndrome.

    Science.gov (United States)

    Cassel, R; Bordiga, P; Pericat, D; Hautefort, C; Tighilet, B; Chabbert, C

    2018-01-01

    Unilateral vestibular deafferentation syndrome (uVDS) holds a particular place in the vestibular pathology domain. Due to its suddenness, the violence of its symptoms that often result in emergency hospitalization, and its associated original neurophysiological properties, this syndrome is a major source of questioning for the otoneurology community. Also, its putative pathogenic causes remain to be determined. There is currently a strong medical need for the development of targeted and effective countermeasures to improve the therapeutic management of uVDS. The present study reports the development of a new mouse model for inducing and evaluating uVDS. Both the method for generating controlled excitotoxic-type peripheral vestibular damages, through transtympanic administration of the glutamate receptors agonist kainate (TTK), and the procedure for evaluating the ensuing clinical signs are detailed. Through extensive analysis of the clinical symptoms characteristics, this new animal model provides the opportunity to better follow the temporal evolution of various uVDS specific symptoms, while better appreciating the different phases that composed this syndrome. The uVDS evoked in the TTK mouse model displays two main phases distinguishable by their kinetics and amplitudes. Several parameters of the altered vestibular behaviour mimic those observed in the human syndrome. This new murine model brings concrete information about how uVDS develops and how it affects global behaviour. In addition, it opens new opportunity to decipher the etiopathological substrate of this pathology by authorizing the use of genetically modified mouse models. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Age-wise and gender-wise prevalence of oral habits in 7–16-year-old school children of Mewar ethnicity, India

    Directory of Open Access Journals (Sweden)

    Pradeep Vishnoi

    2017-01-01

    Full Text Available Objectives: The study aimed to check the age- and gender-wise prevalence of oral habits in the children of 7–16-year-old Indian children. Materials and Methods: A cross-sectional survey involving 1029 (661 males and 368 females children of age 7–16 years was done to record the presence or absence of the oral habits with the aid of the anamnestic questionnaire. The recorded oral habits were tongue thrusting, thumb or digit sucking, mouth breathing, bruxism, lip biting or lip sucking, and nail biting. The collected data were subjected to Pearson's Chi-square statistical analysis to know the overall difference in the prevalence rate of different oral habits and to evaluate the gender- and age-wise difference in the prevalence of oral habits. Results: Oral habits were present in 594 participants (57.73%. The highest prevalence rate was registered for tongue thrusting habit (28.8%, which was followed by nail biting (201/19.5% and thumb sucking (128/12.4%, mouth breathing (109/10.6%, lip biting (85/8.3%, and bruxism (29/2.8%. The male participants showed a greater prevalence rate for the oral habits than the female participants (58.55% vs. 56.25%. There was a significant difference in the age-wise prevalence of oral habits with older children showing greater prevalence of oral habits than the younger ones. Conclusion: The prevalence of oral habits in the current group of children is high. It warrants the need for the community-based educational preventive and interceptive programs to spread the awareness regarding the deleterious effects of these oral habits.

  1. A WISE Survey of Star Formation in Nearby Molecular Clouds

    Science.gov (United States)

    Huard, Tracy

    During the last decade, sensitive mid-infrared observations obtained by the Spitzer Space Telescope significantly increased the known population of Young Stellar Objects (YSOs) associated with nearby molecular clouds. With such a census, recent studies have derived efficiencies of the star formation rates in the different environments. Given the small Spitzer coverage of these molecular clouds, relative to their large extended regions, these YSO populations may represent a limited view of star formation in these regions. We propose to take advantage of mid-infrared observations from the recent WISE mission, which provides an all-sky view and therefore full coverage of the nearby molecular clouds, to assess the degree to which their currently known YSO populations may be under-representative of the extended, more complete populations. We will extend and apply the well established classification method, developed by Spitzer Legacy teams, to archived WISE observations in order to identify and assemble a more complete census of YSOs associated with nearby clouds. Large-scale, high angular resolution extinction maps covering the full extent of these clouds will also be constructed in a uniform manner to enable cross-comparison studies of star formation rates in these different environments. Finally, we plan to provide enhanced WISE data products to the community through the Infrared Processing and Analysis Center, which will promote a diversity of studies by a wider group of investigators, facilitate star-formation studies across different environments, and help ensure the legacy of WISE data.

  2. Meeting Wise: Making the Most of Collaborative Time for Educators

    Science.gov (United States)

    Boudett, Kathryn Parker; City, Elizabeth A.

    2014-01-01

    This book, by two editors of "Data Wise: A Step-by-Step Guide to Using Assessment Results to Improve Teaching and Learning," attempts to bring about a fundamental shift in how educators think about the meetings we attend. They make the case that these gatherings are potentially the most important venue where adult and organizational…

  3. Bit-Wise Arithmetic Coding For Compression Of Data

    Science.gov (United States)

    Kiely, Aaron

    1996-01-01

    Bit-wise arithmetic coding is data-compression scheme intended especially for use with uniformly quantized data from source with Gaussian, Laplacian, or similar probability distribution function. Code words of fixed length, and bits treated as being independent. Scheme serves as means of progressive transmission or of overcoming buffer-overflow or rate constraint limitations sometimes arising when data compression used.

  4. Wise reasoning in the face of everyday life challenges

    NARCIS (Netherlands)

    Grossmann, Igor; Gerlach, Tanja M.; Denissen, J.J.A.

    2016-01-01

    How stable vs. dynamic is wisdom in daily life? We conducted a daily diary study of wise reasoning (WR) by recording people's reflections on daily challenges in terms of three facets: intellectual humility, self-transcendence, and consideration of others' perspectives/compromise. We observed

  5. On the joint entropy of d-wise-independent variables

    Czech Academy of Sciences Publication Activity Database

    Gavinsky, Dmitry; Pudlák, Pavel

    2016-01-01

    Roč. 57, č. 3 (2016), s. 333-343 ISSN 0010-2628 R&D Projects: GA ČR GBP202/12/G061 Institutional support: RVO:67985840 Keywords : d-wise-independent variable s * entropy * lower bound Subject RIV: BA - General Mathematics http://hdl.handle.net/10338.dmlcz/145838

  6. Localized Multiple Kernel Learning Via Sample-Wise Alternating Optimization.

    Science.gov (United States)

    Han, Yina; Yang, Kunde; Ma, Yuanliang; Liu, Guizhong

    2014-01-01

    Our objective is to train support vector machines (SVM)-based localized multiple kernel learning (LMKL), using the alternating optimization between the standard SVM solvers with the local combination of base kernels and the sample-specific kernel weights. The advantage of alternating optimization developed from the state-of-the-art MKL is the SVM-tied overall complexity and the simultaneous optimization on both the kernel weights and the classifier. Unfortunately, in LMKL, the sample-specific character makes the updating of kernel weights a difficult quadratic nonconvex problem. In this paper, starting from a new primal-dual equivalence, the canonical objective on which state-of-the-art methods are based is first decomposed into an ensemble of objectives corresponding to each sample, namely, sample-wise objectives. Then, the associated sample-wise alternating optimization method is conducted, in which the localized kernel weights can be independently obtained by solving their exclusive sample-wise objectives, either linear programming (for l1-norm) or with closed-form solutions (for lp-norm). At test time, the learnt kernel weights for the training data are deployed based on the nearest-neighbor rule. Hence, to guarantee their generality among the test part, we introduce the neighborhood information and incorporate it into the empirical loss when deriving the sample-wise objectives. Extensive experiments on four benchmark machine learning datasets and two real-world computer vision datasets demonstrate the effectiveness and efficiency of the proposed algorithm.

  7. CLASSICS Are we Utilizing our Water Resources Wisely?

    Indian Academy of Sciences (India)

    IAS Admin

    side, especially the question of wise utilization of our soil and water resources. The problem. 'I can foretell the ... continues to remain as the largest sick industry. The craze for big dams and ..... contracted time of human life, had strained with all the reachings and gropings of a vivacious mind to extend the dominion of their ...

  8. WISE technology: A scientific information system for astronomy and beyond

    NARCIS (Netherlands)

    Belikov, A.; Boxhoorn, D.; Begeman, K.; Valentijn, E.; Vriend, W.-j.; Williams, O. R.

    2015-01-01

    The data processing of a number of current astronomical projects require an intelligent data handling system which can satisfy the requirements both from users processing the data and users exploring the result. We present the WISE Concept of Scientific Information Systems which has been used in a

  9. On the joint entropy of d-wise-independent variables

    Czech Academy of Sciences Publication Activity Database

    Gavinsky, Dmitry; Pudlák, Pavel

    2016-01-01

    Roč. 57, č. 3 (2016), s. 333-343 ISSN 0010-2628 R&D Projects: GA ČR GBP202/12/G061 Institutional support: RVO:67985840 Keywords : d-wise-independent variables * entropy * lower bound Subject RIV: BA - General Mathematics http://hdl.handle.net/10338.dmlcz/145838

  10. Role of Imaging and Cytogenetics in Evaluation of DiGeorge Syndrome - A Rare Entity in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Rajoo Ramachandran

    2015-01-01

    Full Text Available DiGeorge syndrome is a congenital genetic disorder that affects the endocrine system, mainly the thymus and parathyroid glands. The syndrome produces different symptoms, which vary in severity and character between patients. It manifests with craniofacial dysmorphism and defects in the heart, parathyroid, and thymus. Patients can present with a palatal deformity and nasal speech. This rare entity is caused mainly due to deletion of chromosome 22q11.2. Radiographic evaluation of DiGeorge syndrome is necessary to define aberrant anatomy, evaluate central nervous system, craniofacial abnormalities, musculoskeletal system, and cardiothoracic contents. It also helps in planning surgical procedures and surgical reconstructions. We report a case of DiGeorge syndrome in a 4-month-old neonate and discuss the clinical, imaging, and cytogenetic findings that helped in the diagnosis of this rare entity.

  11. Electromyographic evaluation of the lower limbs of patients with Down syndrome in hippotherapy

    Directory of Open Access Journals (Sweden)

    Mariane Fernandes Ribeiro

    2017-05-01

    Full Text Available Hippotherapy is a therapeutic method that uses the horse’s movement to achieve functional results in practitioners with Down syndrome (DS, who present motor and neurophysiological changes that affect the musculoskeletal system. Evaluating the motor behavior related to the control and the improvement of muscle activation in practitioners with Down syndrome subjected to hippotherapy. 10 practitioners were divided into two groups: Down Group (DG – practitioners with DS, and Healthy Group (HG – practitioners with no physical impairment. The muscles gluteus medius, tensor fasciae latae, rectus femoris, vastus medialis, vastus lateralis, biceps femoris, tibialis anterior and gastrocnemius were evaluated by electromyography using gross RMS values, which correspond to muscle activation; the evaluations were performed on the 1st and 10th hippotherapy sessions (frequency: once a week, and after 2 months interval without treatment, they were performed on the 1st and 10th hippotherapy sessions (frequency: twice a week. It was noted that activation of the studied muscles increased with the passing of sessions, regardless the weekly frequency of attendance; however, the period without treatment resulted in reduction of this effect. Practitioners with DS presented satisfactory changes in muscle activation pattern, in learning and in motor behavior during hippotherapy sessions.

  12. The First Hyper-Luminous Infrared Galaxy Discovered by WISE

    Science.gov (United States)

    Eisenhardt, Peter R.; Wu, Jingwen; Tsai, Chao-Wei; Assef, Roberto; Benford, Dominic; Blain, Andrew; Bridge, Carrie; Condon, J. J.; Cushing, Michael C.; Cutri, Roc; hide

    2012-01-01

    We report the discovery by the Wide-field Infrared Survey Explorer of the z = 2.452 source WISEJ181417.29+341224.9, the first hyperluminous source found in the WISE survey. WISE 1814+3412 is also the prototype for an all-sky sample of approximately 1000 extremely luminous "W1W2-dropouts" (sources faint or undetected by WISE at 3.4 and 4.6 micrometers and well detected at 12 or 22 micrometers). The WISE data and a 350 micrometers detection give a minimum bolometric luminosity of 3.7 x 10(exp 13) solar luminosity, with approximately 10(exp 14) solar luminosity plausible. Followup images reveal four nearby sources: a QSO and two Lyman Break Galaxies (LBGs) at z = 2.45, and an M dwarf star. The brighter LBG dominates the bolometric emission. Gravitational lensing is unlikely given the source locations and their different spectra and colors. The dominant LBG spectrum indicates a star formation rate approximately 300 solar mass yr(exp -1), accounting for less than or equal to 10 percent of the bolometric luminosity. Strong 22 micrometer emission relative to 350 micrometer implies that warm dust contributes significantly to the luminosity, while cooler dust normally associated with starbursts is constrained by an upper limit at 1.1 mm. Radio emission is approximately 10? above the far-infrared/radio correlation, indicating an active galactic nucleus is present. An obscured AGN combined with starburst and evolved stellar components can account for the observations. If the black hole mass follows the local MBH-bulge mass relation, the implied Eddington ratio is approximately greater than 4. WISE 1814+3412 may be a heavily obscured object where the peak AGN activity occurred prior to the peak era of star formation.

  13. [Application of shear wave elastography in the evaluation of neck-shoulder myofascial pain syndrome].

    Science.gov (United States)

    Guo, Ling; Zhang, Chen; Zhang, Ding-ding; Gao, Jing-hua; Liu, Guang-hui; Wang, Shang-quan

    2016-02-01

    To study clinical value of shear wave elastography (SWE) in the evaluation of neck-shoulder myofascial pain syndrome. From December 2013 to July 2014,30 patients diagnosed as neck-shoulder myofascial pain syndrome were in the treatment group,including 17 males and 13 females, with an average age of (44 ± 3) years old. Thirty healthy people were in the control group, including 22 males and 8 females, with a mean age of (37 ± 5) years old. The patients in the treatment group were treated with manipulation, once every other day, total 7 times. The SWE was used to detect tension part of trapezius muscle of patients in the treatment group before and after treatment, as well as to detect muscle belly at the descending part of trapezius muscle in the control group. The tissue elasticity and Yang's modulus value were recorded and compared. The tissue elasticity chart of patients in the treatment group before treatment was mainly greenish blue with the score of 3.70 ± 1.53, and the Yang's modulus was (43.4 ± 15.6) kPa. The tissue elasticity figure after treatment was mainly blue with the score of 2.40 ± 0.87, and the Yang's modulus was (29.0 ± 5.9) kPa. Whereas in the control group, the tissue elasticity figure was mainly blue with the score of 1.60 ± 0.72, and the Yang's modulus was (24.0 ± 7.6) kPa. These were statistical differences between the two groups (P = 0.000). SWE can be used as an evaluation method of manipulation treatment for neck-shoulder myofascial pain syndrome, which is an objective and sensitive detection method.

  14. Evaluation of Asperger Syndrome in Youth Presenting to a Gender Dysphoria Clinic.

    Science.gov (United States)

    Shumer, Daniel E; Reisner, Sari L; Edwards-Leeper, Laura; Tishelman, Amy

    2016-10-01

    There is evolving evidence that children and adolescents with gender dysphoria have higher-than-expected rates of autism spectrum disorder (ASD), yet clinical data on ASD among youth with gender dysphoria remain limited, particularly in North America. This report aims to fill this gap. We conducted a retrospective review of patient chart data from 39 consecutive youth ages 8 to 20 years (mean age 15.8 years, natal male: n = 22, natal female: n = 17) presenting for evaluation at a multidisciplinary gender clinic in a large U.S. pediatric hospital from 2007 to 2011 to evaluate the prevalence of ASD in this patient population. Overall, 23.1% of patients (9/39) presenting with gender dysphoria had possible, likely, or very likely Asperger syndrome as measured by the Asperger Syndrome Diagnostic Scale (ASDS). These findings are consistent with growing evidence supporting increased prevalence of ASD in gender dysphoric children. To guide provision of optimal clinical care and therapeutic intervention, routine assessment of ASD is recommended in youth presenting for gender dysphoria.

  15. Evaluation of the Endothelial Cell Density and the Central Corneal Thickness in Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma

    Directory of Open Access Journals (Sweden)

    Bożydar T. Tomaszewski

    2014-01-01

    Full Text Available Purpose. Evaluation of central corneal thickness (CCT and endothelial cell density (ECD in patients with senile cataract and coexisting pseudoexfoliation (PEX syndrome with glaucoma (PEXG and without glaucoma using specular microscopy. Participants and Methods. The study included 122 patients (217 eyes. In this group of patients we identified 133 eyes with PEX syndrome (65 with glaucoma, 68 without glaucoma and 84 eyes without PEX syndrome. ECD and CCT were measured in each eye by specular microscopy. Results. ECD in eyes with PEX syndrome without glaucoma (2297 ± 359 cell/mm2 and in eyes with PEXG (2241 ± 363 cell/mm2 was lower than in the control group (2503 ± 262 cell/mm2 (P<0.001. CCT in eyes with PEXG (508.2 ± 32.6 μm was thinner than in eyes with PEX syndrome without glaucoma (529.7 ± 30.3 μm and control group (527.7 ± 29.4 μm (P<0.001. Conclusions. This research shows that in eyes with PEX syndrome, both with and without glaucoma, ECD was statistically significantly lower than in the control group. In patients with PEXG, CCT was statistically significantly thinner than in the PEX syndrome and control group.

  16. Differential Diagnosis Tool for Parkinsonian Syndrome Using Multiple Structural Brain Measures

    Directory of Open Access Journals (Sweden)

    Miho Ota

    2013-01-01

    Full Text Available Clinical differentiation of parkinsonian syndromes such as the Parkinson variant of multiple system atrophy (MSA-P and cerebellar subtype (MSA-C from Parkinson's disease is difficult in the early stage of the disease. To identify the correlative pattern of brain changes for differentiating parkinsonian syndromes, we applied discriminant analysis techniques by magnetic resonance imaging (MRI. T1-weighted volume data and diffusion tensor images were obtained by MRI in eighteen patients with MSA-C, 12 patients with MSA-P, 21 patients with Parkinson’s disease, and 21 healthy controls. They were evaluated using voxel-based morphometry and tract-based spatial statistics, respectively. Discriminant functions derived by step wise methods resulted in correct classification rates of 0.89. When differentiating these diseases with the use of three independent variables together, the correct classification rate was the same as that obtained with step wise methods. These findings support the view that each parkinsonian syndrome has structural deviations in multiple brain areas and that a combination of structural brain measures can help to distinguish parkinsonian syndromes.

  17. A WISE VIEW OF STAR FORMATION IN LOCAL GALAXY CLUSTERS

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Sun Mi; Gonzalez, Anthony H. [Department of Astronomy, University of Florida, Gainesville, FL 32611-2055 (United States); Eisenhardt, Peter R.; Stern, Daniel [Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 (United States); Stanford, Spencer A. [Department of Physics, University of California, Davis, CA 95616 (United States); Brodwin, Mark [Harvard-Smithsonian Center for Astrophysics, Cambridge, MA 02138 (United States); Jarrett, Thomas, E-mail: schung@astro.ufl.edu [Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, CA 91125 (United States)

    2011-12-10

    We present results from a systematic study of star formation in local galaxy clusters using 22 {mu}m data from the Wide-field Infrared Survey Explorer (WISE). The 69 systems in our sample are drawn from the Cluster Infall Regions Survey, and all have robust mass determinations. The all-sky WISE data enable us to quantify the amount of star formation, as traced by 22 {mu}m, as a function of radius well beyond R{sub 200}, and investigate the dependence of total star formation rate upon cluster mass. We find that the fraction of star-forming galaxies increases with cluster radius but remains below the field value even at 3R{sub 200}. We also find that there is no strong correlation between the mass-normalized total specific star formation rate and cluster mass, indicating that the mass of the host cluster does not strongly influence the total star formation rate of cluster members.

  18. Melanin fluorescence spectra by step-wise three photon excitation

    Science.gov (United States)

    Lai, Zhenhua; Kerimo, Josef; DiMarzio, Charles A.

    2012-03-01

    Melanin is the characteristic chromophore of human skin with various potential biological functions. Kerimo discovered enhanced melanin fluorescence by stepwise three-photon excitation in 2011. In this article, step-wise three-photon excited fluorescence (STPEF) spectrum between 450 nm -700 nm of melanin is reported. The melanin STPEF spectrum exhibited an exponential increase with wavelength. However, there was a probability of about 33% that another kind of step-wise multi-photon excited fluorescence (SMPEF) that peaks at 525 nm, shown by previous research, could also be generated using the same process. Using an excitation source at 920 nm as opposed to 830 nm increased the potential for generating SMPEF peaks at 525 nm. The SMPEF spectrum peaks at 525 nm photo-bleached faster than STPEF spectrum.

  19. Space-Wise approach for airborne gravity data modelling

    Science.gov (United States)

    Sampietro, D.; Capponi, M.; Mansi, A. H.; Gatti, A.; Marchetti, P.; Sansò, F.

    2017-05-01

    Regional gravity field modelling by means of remove-compute-restore procedure is nowadays widely applied in different contexts: it is the most used technique for regional gravimetric geoid determination, and it is also used in exploration geophysics to predict grids of gravity anomalies (Bouguer, free-air, isostatic, etc.), which are useful to understand and map geological structures in a specific region. Considering this last application, due to the required accuracy and resolution, airborne gravity observations are usually adopted. However, due to the relatively high acquisition velocity, presence of atmospheric turbulence, aircraft vibration, instrumental drift, etc., airborne data are usually contaminated by a very high observation error. For this reason, a proper procedure to filter the raw observations in both the low and high frequencies should be applied to recover valuable information. In this work, a software to filter and grid raw airborne observations is presented: the proposed solution consists in a combination of an along-track Wiener filter and a classical Least Squares Collocation technique. Basically, the proposed procedure is an adaptation to airborne gravimetry of the Space-Wise approach, developed by Politecnico di Milano to process data coming from the ESA satellite mission GOCE. Among the main differences with respect to the satellite application of this approach, there is the fact that, while in processing GOCE data the stochastic characteristics of the observation error can be considered a-priori well known, in airborne gravimetry, due to the complex environment in which the observations are acquired, these characteristics are unknown and should be retrieved from the dataset itself. The presented solution is suited for airborne data analysis in order to be able to quickly filter and grid gravity observations in an easy way. Some innovative theoretical aspects focusing in particular on the theoretical covariance modelling are presented too

  20. Evaluation of the patients diagnosed with Stevens Johnson syndrome and toxic epidermal necrolysis: a single center experience.

    Science.gov (United States)

    Çekiç, Şükrü; Canıtez, Yakup; Sapan, Nihat

    2016-09-01

    Stevens Johnson syndrome and toxic epidermal necrolysis are severe acute mucocutaneous diseases. In this study, we evaluated the clinical aspects of Steven Johnson syndrome, toxic epidermal necrolysis and Stevens-Johnson syndrome/toxic epidermal necrolysis overlap patients who admitted to our clinics in the last five years. Eleven patients diagnosed as Stevens-Johnson syndrome, toxic epidermal necrolysis and Stevens-Johnson syndrome/toxic epidermal necrolysis overlap in Department of Pediatric Allergy in Uludağ University School of Medicine were included in this study. Clinical findings, laboratory tests and response to treatments were evaluated via electronic files. Two of the patients had Stevens-Johnson syndrome, four had Stevens-Johnson syndrome/toxic epidermal necrolysis overlap, and five had toxic epidermal necrolysis. The median period for drug usage was 10 days (2-44 days). Herpes simpleks virus IgM antibody was detected two patients. The median healing time was 38 days 26-94 days). Maculopapular eruptions and oral mucositis were seen in all patients. Vesicul or bullae, epidermal detachment and ocular involvement in 10 of patients. Wound care, H1 antihistamine and methyl prednisolon were used in all patients, intravenous immunoglobulin were used in 7 patients and cyclosporine in 1 patient. Sequel lesions developed in 2 of the patients and there was no death. Anticonvulsants, antibiotics and non steroid anti-inflammatory drugs play a major role in the etiology of Stevens-Johnson syndrome and toxic epidermal necrolysis. Anticonvulsants are associated with severe disease. The patients with proper wound care and treatment with immunosuppressive drugs can be recovered without or with minimal sequelae.

  1. Evaluation of the relationship between pelvic fracture and abdominal compartment syndrome in traumatic patients

    Directory of Open Access Journals (Sweden)

    Sheikhi Rahim Ali

    2013-01-01

    Full Text Available Introduction: An increase in abdominal pressure can lead to so-called intra-abdominal compartment syndrome (ACS. Multiple factors such as an increase in retroperitoneal volume due to pancreatitis, bleeding and edema as a result of pelvic fracture can lead to compartment syndrome. Prevention is better than cure in compartment syndrome. By measuring the intra-abdominal pressure (IAP through the bladder, a quick and accurate assessment of abdominal pressure is achieved. Therefore, this study aimed to evaluate the relationship between pelvic fracture and ACS in traumatic patients. Materials and Methods: This research was a descriptive-analytical study conducted on 100 patients referring to the Shiraz Nemazee Hospital in 2010. IAP was monitored every 4 h in patients suspected to be at high risk for ACS, e.g., those undergoing severe abdominal trauma and pelvic fracture. The IAP was measured via the urinary bladder using the procedure described by Kron et al. Data collected were analyzed using SPSS software. Results: The findings showed that ACS occurred in 28 of 100 patients. With regard to the associated injuries with abdominal trauma, 19% of all patients and 46/42% of the patients with ACS had pelvic fracture. Chi-square test revealed a significant relationship between pelvic fracture and incidence rate of ACS ( P < 0.001. Conclusions: According to the collected data, pelvic fracture due to a trauma can be one of the important causes of an increase in IAP and ACS. In this lethal condition, prevention is better than cure. Therefore, serial measurement of IAP through the bladder in high-risk patients (those with pelvic fracture by trauma is recommended to the nurses to diagnose this condition and to decrease the incidence of mortality.

  2. An evaluation of the metabolic syndrome in the HyperGEN study

    Directory of Open Access Journals (Sweden)

    Lewis Cora E

    2005-01-01

    Full Text Available Abstract Background In 2001 the National Cholesterol Education Program (NCEP provided a categorical definition for metabolic syndrome (c-MetS. We studied the extent to which two ethnic groups, Blacks and Whites were affected by c-MetS. The groups were members of the Hypertension Genetic Epidemiology Network (HyperGEN, a part of the Family Blood Pressure Program, supported by the NHLBI. Although the c-MetS definition is of special interest in particular to the clinicians, the quantitative latent traits of the metabolic syndrome (MetS are also important in order to gain further understanding of its etiology. In this study, quantitative evaluation of the MetS latent traits (q-MetS was based on the statistical multivariate method factor analysis (FA. Results The prevalence of the c-MetS was 34% in Blacks and 39% in Whites. c-MetS showed predominance of obesity, hypertension, and dyslipidemia. Three and four factor domains were identified through FA, classified as "Obesity," "Blood pressure," "Lipids," and "Central obesity." They explained approximately 60% of the variance in the 11 original variables. Two factors classified as "Obesity" and "Central Obesity" overlapped when FA was performed without rotation. All four factors in FA with Varimax rotation were consistent between Blacks and Whites, between genders and also after excluding type 2 diabetes (T2D participants. Fasting insulin (INS associated mainly with obesity and lipids factors. Conclusions MetS in the HyperGEN study has a compound phenotype with separate domains for obesity, blood pressure, and lipids. Obesity and its relationship to lipids and insulin is clearly the dominant factor in MetS. Linkage analysis on factor scores for components of MetS, in familial studies such as HyperGEN, can assist in understanding the genetic pathways for MetS and their interactions with the environment, as a first step in identifying the underlying pathophysiological causes of this syndrome.

  3. Sheehan's syndrome in Xinjiang: Clinical characteristics and laboratory evaluation of 97 patients.

    Science.gov (United States)

    Du, Guo-li; Liu, Zhong-hua; Chen, Min; Ma, Rui; Jiang, Sheng; Shayiti, Miriguli; Zhu, Jun; Yusufu, Aibibai

    2015-01-01

    To evaluate the clinical and hormonal characteristics of patients with Sheehan's syndrome in Xinjiang, China. 97 cases diagnosed as Sheehan's syndrome in our hospital from 1999 to 2013 were retrospectively reviewed. The medical history, physical examination findings and hormonal profiles were documented and analyzed. The mean age at diagnosis was 43.7±12.4 years, with a mean diagnostic delay of 9.1±9.5 years (range, 1 month-35 years). 10 of our patients (10.3%) had a home birth. 96 of our patients (99.0%) had a history of obstetric hemorrhage. The most common clinical presentation included amenorrhea (80/97, 82.5%), agalactia (2/97, 74.2%) and loss of axillary or pubic hair (83/97, 85.6%). Seventy two of our patients (74.2%) failed to lactate and 80 of our patients (82.5%) failed to resume menstruation. Hypothalamic dysfunction included the hypothalamic-pituitary-gonadal axis (HPG) (LH deficiency: 77/83 patients, 92.8%; FSH deficiency: 73/83 patients, 88%; E2 deficiency: 62 of 82 patients,75.6%), the hypothalamic-pituitary-thyroid (HPT) axis (TSH deficiency: 77/93 patients, 82.8%, TT3 deficiency: 70/ 87 patients, 80.5%, TT4 deficiency: 72/87 patients, 82.8%) and the hypothalamus-pituitary-adrenal (HPA) axis (ACTH deficiency: 19/37 patients, 51.4%, cortisol deficiency: 49/64, 76.6%). Sheehan's syndrome is still common in Xinjiang, especially in rural areas. Long diagnosis delay in most of the patients indicates that women might be lacking correct diagnosis and treatment. Physicians need to be aware of the most important clues for diagnosis such as lack of lactation in the postpartum period and failure to resume menstruation.

  4. Exploring the Universe with WISE and Cloud Computing

    Science.gov (United States)

    Benford, Dominic J.

    2011-01-01

    WISE is a recently-completed astronomical survey mission that has imaged the entire sky in four infrared wavelength bands. The large quantity of science images returned consists of 2,776,922 individual snapshots in various locations in each band which, along with ancillary data, totals around 110TB of raw, uncompressed data. Making the most use of this data requires advanced computing resources. I will discuss some initial attempts in the use of cloud computing to make this large problem tractable.

  5. WISE: The Wide-field Infrared Survey Explorer

    Science.gov (United States)

    Eisenhardt, Peter R.; Wright, E. L.; Benford, D.; Blain, A.; Cohen, M.; Cutri, R.; Gautier, T. N.; Jarrett, T.; Kirkpatrick, J. D.; Leisawitz, D.; Lonsdale, C.; Mainzer, A.; Mather, J.; McLean, I.; McMillan, R.; Mendez, B.; Padgett, D.; Ressler, M.; Skrutskie, M.; Stanford, S. A.; Walker, R.

    2009-01-01

    WISE will map the entire sky at 3.3, 4.7, 12 and 23 microns with sensitivities of 0.12, 0.16. 0.65, and 2.6 mJy. WISE will find the most luminous galaxies in the universe, the closest stars to the Sun, and detect most main belt asteroids larger than 3 km. WISE will be placed into a Sun-synchronous polar orbit on a Delta 7320-10 rocket, rotating at a constant rate while a scan mirror freezes the line of sight during each exposure, covering the sky in 6 months following a one month checkout. Orbit to orbit overlap provides 8 or more exposures at each location. The instrument, provided by the Space Dynamics Laboratory, includes an all-reflective aluminum telescope with a 40 cm primary built by SSG-Tinsley, a solid hydrogen cryostat built by Lockheed-Martin's Advanced Technology Center, and 1024x1024 pixel Si:As and HgCdTe arrays built by DRS and Teledyne. Dichroic beamsplitters allow simultaneous images in the four bands over a 47'x47' field of view with 5" resolution to be obtained every 11 seconds. Ball Aerospace is providing the spacecraft, including a 500W fixed solar array, Li-ion battery, two star trackers, reaction wheels, and torque rods. The 50 GB per day of images are losslessly compressed, stored in flash memory, and downlinked at 100 Mbps four times per day using a fixed antenna and TDRSS satellites. The Infrared Processing and Analysis Center will process the data and deliver the image atlas and source catalog, with a preliminary release 6 months after the survey, and a final release 2 years after the survey. JPL manages the project for UCLA PI Ned Wright, and conducts mission operations. Education and Public Outreach is provided by UC Berkeley's Space Science Laboratory. WISE hardware is presently being integrated and tested, with launch scheduled in November 2009.

  6. Thermophysical modeling of main-belt asteroids from WISE data

    Science.gov (United States)

    Hanuš, J.; Delbó, M.; Durech, J.; Alí-Lagoa, V.

    2014-07-01

    We determine asteroid physical parameters such as size, surface roughness, albedo, and thermal inertia by applying the implementation of the thermophysical model (TPM) of Lagerros (1996; 1997; 1998) to the thermal data obtained by the NASA WISE satellite. We present thermophysical parameters for ˜150 asteroids, which gives us so far the largest sample of asteroids with determined values of thermal inertia. On several individual cases, we discuss the reliability of our determinations and limitations of the TPM method we use. As initial shapes, we adopt convex shape models from the DAMIT database (Durech et al., 2010) and present new determinations based on combined dense and sparse-in-time disk-integrated photometry and the lightcurve inversion method (Kaasalainen & Torppa 2001; Kaasalainen et al., 2001). We use thermal data from the WISE filters W3 and W4, as well as the data observed by the IRAS satellite. However, due to the intriguing accuracy of the fluxes and larger amount of measurements, the WISE data are significantly more important and dominate the modeling. The WISE data are processed the same way as in Alí-Lagoa et al. (2014) for asteroid (341 843) 2008 EV_5. We show the main results of the study of derived thermophysical parameters within the whole population of MBAs and within several asteroid families with the main focus on the thermal inertia. The thermal inertia increases with decreasing size (as previously shown by Delbó et al., 2007), but a large range of thermal inertia values is observed within the similar size ranges between D˜10-100 km. Surprisingly, we derived very low (<10 J m^{-2} s^{-1/2} K^{-1}) thermal inertias for many asteroids (˜20) with various sizes. The range of thermal inertia values is large even within a few asteroid families.

  7. The Perihelion Emission of Comet C/2010 L5 ( WISE )

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, E. A.; Bauer, J. M.; Stevenson, R.; Mainzer, A. K.; Masiero, J.; Sonnett, S. [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States); Fernandez, Y. R. [University of Central Florida, 4000 Central Florida Boulevard, Orlando, FL 32816 (United States); Grav, T. [Planetary Science Institute, 1700 East Fort Lowell, Suite 106, Tucson, AZ 85719-2395 (United States); Nugent, C. [Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, CA 91125 (United States)

    2017-03-20

    The only Halley-type comet discovered by the Wide-Field Infrared Survey Explorer ( WISE ), C/2010 L5 ( WISE ), was imaged three times by WISE , and it showed a significant dust tail during the second and third visits (2010 June and July, respectively). We present here an analysis of the data collected by WISE , putting estimates on the comet’s size, dust production rate, gas production (CO+CO{sub 2}) rate, and active fraction. We also present a detailed description of a novel tail-fitting technique that allows the commonly used syndyne–synchrone models to be used analytically, thereby giving more robust results. We find that C/2010 L5's dust tail was likely formed by strong emission, likely in the form of an outburst, occurring when the comet was within a few days of perihelion. Analyses of the June and July data independently agree on this result. The two separate epochs of dust tail analysis independently suggest a strong emission event close to perihelion. The average size of the dust particles in the dust tail increased between the epochs, suggesting that the dust was primarily released in a short period of time, and the smaller dust particles were quickly swept away by solar radiation pressure, leaving the larger particles behind. The difference in CO{sub 2} and dust production rates measured in 2010 June and July is not consistent with “normal” steady-state gas production from a comet at these heliocentric distances, suggesting that much of the detected CO{sub 2} and dust was produced in an episodic event. Together, these conclusions suggest that C/2010 L5 experienced a significant outburst event when the comet was close to perihelion.

  8. Algorithms for Generalized Cluster-wise Linear Regression

    OpenAIRE

    Park, Young Woong; Jiang, Yan; Klabjan, Diego; Williams, Loren

    2016-01-01

    Cluster-wise linear regression (CLR), a clustering problem intertwined with regression, is to find clusters of entities such that the overall sum of squared errors from regressions performed over these clusters is minimized, where each cluster may have different variances. We generalize the CLR problem by allowing each entity to have more than one observation, and refer to it as generalized CLR. We propose an exact mathematical programming based approach relying on column generation, a column...

  9. [The MMPI-2 test in the evaluation of the mobbing syndrome].

    Science.gov (United States)

    Pappone, P; Santalucia, L; Del Castello, E; De Maino, V; Garofalo, E; Cappelluccio, R; Feola, D; Ruberto, M; Liotti, F

    2007-01-01

    MMPI-2 test is widely used in psychodiagnostic evaluation as well as in the evaluation of psychic pathologies related to psychosocial adversative events in working activities. A more efficacious use of MMPI-2 test in the working context can be achieved by the individuation of indexes able to facilitate the evaluation of mobbing syndrome. This work is based on the analysis of 150 cases (39.7% women and 60.7% men, 30 to 60 years of age), evaluated through an accurate examination of working history and a series of clinic conversations, followed by psychodiagnostic evaluation. The average of T-scores on the clinical scale, the content scale, the PK addition scale and the validation scale were calculated from tests. Pathologic high T-scores on the scales Hs, D. Hy e Pa were found in subjects having positive mobbing anamnesis. These results strongly indicate the presence of clinical specificities in workers exposed to working harassments, and that these specificities can be efficaciously evidenced by the MMPI-2 test.

  10. Instance-Wise Denoising Autoencoder for High Dimensional Data

    Directory of Open Access Journals (Sweden)

    Lin Chen

    2016-01-01

    Full Text Available Denoising Autoencoder (DAE is one of the most popular fashions that has reported significant success in recent neural network research. To be specific, DAE randomly corrupts some features of the data to zero as to utilize the cooccurrence information while avoiding overfitting. However, existing DAE approaches do not fare well on sparse and high dimensional data. In this paper, we present a Denoising Autoencoder labeled here as Instance-Wise Denoising Autoencoder (IDA, which is designed to work with high dimensional and sparse data by utilizing the instance-wise cooccurrence relation instead of the feature-wise one. IDA works ahead based on the following corruption rule: if an instance vector of nonzero feature is selected, it is forced to become a zero vector. To avoid serious information loss in the event that too many instances are discarded, an ensemble of multiple independent autoencoders built on different corrupted versions of the data is considered. Extensive experimental results on high dimensional and sparse text data show the superiority of IDA in efficiency and effectiveness. IDA is also experimented on the heterogenous transfer learning setting and cross-modal retrieval to study its generality on heterogeneous feature representation.

  11. Slope Stability Analysis Using Slice-Wise Factor of Safety

    Directory of Open Access Journals (Sweden)

    Yu Zhao

    2014-01-01

    Full Text Available The concept of slice-wise factor of safety is introduced to investigate the state of both the whole slope and each slice. The assumption that the interslice force ratio is the same between any two slices is made and the eccentric moment of slice weight is also taken into account. Then four variables equations are formulated based on the equilibrium of forces and moment and the assumption of interslice forces, and then the slice-wise factor of safety along the slip surface can be obtained. The active and passive sections of the slope can be determined based on the distribution of factor of safety. The factor of safety of the whole slope is also defined as the ratio of the sum of antisliding force to the sum of sliding force on the slip surface. Two examples with different slip surface shapes are analysed to demonstrate the usage of the proposed method. The slice-wise factor of safety enables us to determine the sliding mechanism and pattern of a slope. The reliability is verified by comparing the overall factor of safety with that calculated by conventional methods.

  12. The evaluation of disphagic syndrome, in patients with previously acquired brain damages.

    Science.gov (United States)

    Bartuli, F N; Luciani, F; Marino, S; Bramanti, E; Cecchetti, F; Arcuri, C

    2010-04-01

    Recently clinical studies have proved without doubts that in patients affect by neurological diseases, like stroke, parkinsonism syndromes and others neurodegenerative pathologies, there is a very elevated incidence of swallowing disorders even severe. The disease can show up in a full blown way, with clinical evident signs like suffocation or frequent and sudden cough, at the moment in which the patient tries to feed or to drink; or it can appear in a less clear way, through an unable protection of the low airway and with possible pathologies ab ingestis. The first signals are represented by frequent resulting of cough reflex at nutrition or hydratation. Important is to assess the validity of this reflection, monitoring the amount of food reflux in the mouth after swallowing, which then could be perceived like foreign body and be aspired. The main diagnostic tests are the pHmetry in 24h, ultrasound, esophagography, videofluoroscopy, endoscopic examination and scintigraphy. Through the FEES (Fiberoptic Endoscopic Evaluation of Swallowing) we can then identify the time of swallowing deficit. Early diagnosis of Dysphagia Syndrome is important to improve living condition and survival of patients.

  13. Evaluation of renal resistive index in cirrhotic patients for predicting the hepatirenal syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Seung Yon; Kim, Hyae young; Yi, Sun Young [Ewha WoMans Univ. Mokdong Hospital, Seoul (Korea, Republic of)

    1996-04-01

    To evaluate the usefulness of renal resistive index(RI) in patients with liver cirrhosis as an indicator for predicting hepatorenal syndrome. Renal RIs of thirty cirrhotic patients were analyzed using the gray-scale and Doppler ultrasonograms. As a control group, eight normal subjects were included. Renal RIs were measured at three sites of interlobar or arcuate arteries of both kidneys. The patients were divided into three groups (A, B, or C) according to the Child-Turcotte-Pugh classification and their serum BUN and creatinine levels were compared. We determined whether RIs of normal controls differed from those of cirrhotic patients or whether RIs of cirrhotic patients correlated with the Child-Turcotte-Pugh classification or BUN and creatinine levels. Mean RIs(0.63 {+-}0.33) of normal subjects were statistically different from those(0.67 {+-} 0.05) of cirrhotic patients(P=0.009). RIs of group A(n=6), B(n=9) and C(n=15) were 0.65 {+-} 0.03, 0.65 {+-} 0.04 and 0.70 {+-} 0.04, respectively. The ANOVA test revealed statistically significant differences between the three groups(F ratio=4.472, P=0.021). RIs did not correlate with BUN or creatinine levels. RI could be used as an index for predicting hepatorenal syndrome before the renal function becomes impaired.

  14. Evaluation of long-term neurodevelopment in twin-twin transfusion syndrome after laser therapy.

    Science.gov (United States)

    Sananès, Nicolas; Gabriele, Victor; Weingertner, Anne Sophie; Ruano, Rodrigo; Sanz-Cortes, Magdalena; Gaudineau, Adrien; Langer, Bruno; Nisand, Israël; Akladios, Chérif Youssef; Favre, Romain

    2016-12-01

    The primary objective of our study was to evaluate the long-term neurodevelopment outcome after laser surgery for twin-twin transfusion syndrome (TTTS). The secondary objective was to identify perinatal prognostic factors associated with neurodevelopmental impairment. This was a single-center cohort prospective study carried out in pregnancies complicated by TTTS and treated by laser. Neurodevleopmental assesment included the administration of Ages and Stages Questionnaires® (ASQ), for the infants between 2 and 5 years of age. A total of 187 patients underwent a laser for TTTS between 2004 and 2013. Significant brain lesions were detected in eight (2.9%) cases by ultrasound and/or magnetic resonance imaging including intraventricular hemorrhage, periventricular leukomalacia, and porencephaly. Questionnaires were administered to 126 children (50.4%) at 24 months or older at the moment of testing. There were 13.5% of those infants who had an abnormal ASQ (established as one area or more scoring < 2 SD) at 3.6 years ±1.3 follow-up. There was a higher rate of abnormal ASQ among the infants with a birth weight below the fifth percentile (p = 0.036). Twin-twin transfusion syndrome is associated with a risk of abnormal neurological development, even in case of laser surgery. Further studies are necessary to identify the risk factors for neurological impairment. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  15. Tc-99m-MDP scintigraphy in the evaluation of epidermal nevus syndrome

    International Nuclear Information System (INIS)

    Barbosa, M.N.S.; Cunha, M.O.; Severiche, A.F.A.; Ramos, C.D.; Etchebehere, E.C.S.C.; Belangero, W.; Camargo, E.E.

    1997-01-01

    Full text: Epidermal nevus syndrome has been described as a congenital neurocutaneous disorder in which epidermal nevi are associated with malformations of other organs, commonly the skeleton and central nervous system. Ocular, cardiac, and genitourinary system abnormalities, as well as other skin lesions, may also be seen. A 19 year old patient with epidermal nevus syndrome, presenting congenital facial epidermal nevi and bone deformity of the lower limbs (shortening of the left leg, left thigh varum, bilateral genu valgum, and multiple pathological fractures), as referred to the nuclear medicine laboratory to evaluate involvement of other sites of the skeleton. Whole body bone scintigraphy performed with MDP-Tc-99m showed multiple small focal areas of increased uptake in the skeleton, mainly in the upper and lower limbs, posterior ribs, right acetabulum, right sacroiliac joint, and right greater trochanter, interpreted as pathological fractures at different stages of remodeling. The range of skeletal findings in this condition is quite diverse. Many of these findings can be attributed to local tissue overgrowth with deformities and advanced bone age, associate with pathological fractures

  16. Magnetic Resonance Evaluation of Müllerian Remnants in Mayer-Rokitansky-Küster-Hauser Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Roh-Eul; Cho, Jeong Yeon; Kim, Sang Youn; Kim, Seung Hyup [Department of Radiology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of)

    2013-07-01

    To analyze magnetic resonance imaging (MRI) findings of Müllerian remnants in young females clinically suspected of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome in a primary amenorrhea workup. Fifteen young females underwent multiplanar T2- and transverse T1-weighted MRI at either a 1.5T or 3.0T MR imager. Two gynecologic radiologists reached consensus decisions for the evaluation of Müllerian remnants, vagina, ovaries, and associated findings. All cases had bilateral uterine buds in the pelvic cavity, with unilateral cavitation in two cases. The buds had an average long-axis diameter of 2.64 ± 0.65 cm. In all cases, bilateral buds were connected with fibrous band-like structures. In 13 cases, the band-like structures converged at the midline or a paramedian triangular soft tissue lying above the bladder dome. The lower one-third of the vagina was identified in 14 cases. Fourteen cases showed bilateral normal ovaries near the uterine buds. One unilateral pelvic kidney, one unilateral renal agenesis, one mild scoliosis, and three lumbar sacralization cases were found as associated findings. Typical Müllerian remnants in MRKH syndrome consist of bilateral uterine buds connected by the fibrous band-like structures, which converge at the midline triangular soft tissue lying above the bladder dome.

  17. Magnetic Resonance Evaluation of Müllerian Remnants in Mayer-Rokitansky-Küster-Hauser Syndrome

    International Nuclear Information System (INIS)

    Yoo, Roh-Eul; Cho, Jeong Yeon; Kim, Sang Youn; Kim, Seung Hyup

    2013-01-01

    To analyze magnetic resonance imaging (MRI) findings of Müllerian remnants in young females clinically suspected of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome in a primary amenorrhea workup. Fifteen young females underwent multiplanar T2- and transverse T1-weighted MRI at either a 1.5T or 3.0T MR imager. Two gynecologic radiologists reached consensus decisions for the evaluation of Müllerian remnants, vagina, ovaries, and associated findings. All cases had bilateral uterine buds in the pelvic cavity, with unilateral cavitation in two cases. The buds had an average long-axis diameter of 2.64 ± 0.65 cm. In all cases, bilateral buds were connected with fibrous band-like structures. In 13 cases, the band-like structures converged at the midline or a paramedian triangular soft tissue lying above the bladder dome. The lower one-third of the vagina was identified in 14 cases. Fourteen cases showed bilateral normal ovaries near the uterine buds. One unilateral pelvic kidney, one unilateral renal agenesis, one mild scoliosis, and three lumbar sacralization cases were found as associated findings. Typical Müllerian remnants in MRKH syndrome consist of bilateral uterine buds connected by the fibrous band-like structures, which converge at the midline triangular soft tissue lying above the bladder dome

  18. [Evaluation of selected socioeconomic factors in patients with acute ethanol intoxication and alcohol withdrawal syndrome].

    Science.gov (United States)

    Lukasik-Głębocka, Magdalena; Sommerfeld, Karina

    2014-01-01

    Ethanol is commonly overused psychoactive substance in Poland and all around the world. It causes addiction, which occurs as a result of its chronic administration. One of the main symptoms of addiction is hunger due to psychoactive substance that prevents interruption of its adoption and contributes to relapse drinking. Acute poisoning with ethyl alcohol and alcohol withdrawal syndrome are diseases causing a potential danger to life. The prevalence of use and abuse of alcoholic beverages is a potential risk, causing health problems, including permanent damage of the central and peripheral nervous system and socio-economic problems. The aim of this study is to analyze certain aspects of the socio-economic situation of the patients hospitalized in the Department of Toxicology in Raszeja City Hospital in Poznan due to acute ethanol intoxication or alcohol withdrawal syndrome in 2010. 299 patients history was evaluated, among which 161 were treated for acute intoxication with ethanol and 138 due to alcohol withdrawal syndrome. Objects of interest were elements of subjective tests including: marital status of patients, their education and professional activity and the problem of homelessness. The study group consisted of 299 patients in age from 16 to 77 years, hospitalized in the Department of Toxicology in Raszeja City Hospital in Poznan due to acute ethanol intoxication or alcohol withdrawal syndrome. It was found that the largest group consisted of patients remaining married (42.81%) and unmarried (30.43%). Alcohol abuse affects people of all levels of education. In the present study, most patients had a vocational education (37.79%) and medium (23.08%). Patients were analyzed in terms of economic activity, among which about 40% were unemployed. In the whole group more than 10% of those were homeless. Ethyl alcohol intoxication and alcohol withdrawal represents a significant hazard. As a result of reliance, patients lose control of alcohol consumption and they

  19. Evaluation of Swallowing Functions in Patients with Sjögren's Syndrome.

    Science.gov (United States)

    Eyigör, Sibel; Sezgin, Baha; Karabulut, Gonca; Öztürk, Kerem; Göde, Sercan; Kirazlı, Tayfun

    2017-04-01

    Patients with Sjögren's syndrome (SS) manifest symptoms such as dry eyes, dry mouth, and dysphagia. This study aims to evaluate the swallowing functions of the patients with SS. 69 patients with SS (65 females, 4 males) and 40 healthy individuals (33 females, 7 males) were included as study and control groups, respectively. Mean ages were 52.86 and 48.25 years for study and control groups, respectively. Swallowing functions were evaluated by fiberoptic endoscopic evaluation of swallowing (FEES). All the patients underwent FEES and were given 3, 5, and 10 ml water, yogurt, and fish-shaped crackers twice, respectively. The presence of bolus control, residue, penetration, and aspiration were evaluated. Additionally, certain types of foods triggering the dysphagia, any difficulties in bolus control, need to clean the throat, sensation of having a lump in the throat, sensation of choking, and xerostomia were included in the questionnaire. The MD Anderson Dysphagia Inventory and the Beck Depression Inventory were administered to patients. Considering the presence of residue with yogurt and fish cracker, there was a significant difference between groups (P  0.05). Regarding the MD Anderson Dysphagia Inventory, the average scores were 48.18 ± 13.21 and 87.6 ± 10.67 for study and control groups, respectively, and a statistically significant difference was detected (P quality of life in patients with SS.

  20. Evaluation of the relationship between self-reported physical activity and metabolic syndrome and its components in apparently healthy women.

    Science.gov (United States)

    Suárez-Ortegón, Milton Fabián; Arbeláez, Alejandra; Mosquera, Mildrey; Ramírez-Vélez, Robinson; Aguilar-De Plata, Cecilia

    2014-01-01

    The metabolic syndrome, a set of metabolic anomalies that include insulin resistance, central obesity, dyslipidemia, hypertension and inflammation, is an important tool to explore factors associated to cardiometabolic disease. The aim of this study was to evaluate the relationship of the levels of self-reported physical activity and the International Physical Activity Questionnaire items and the metabolic syndrome and the variables related to cardiovascular risk in 89 women. The short version of International Physical Activity Questionnaire was applied to classify participating subjects into three categories: insufficient, sufficient and very active physical activity. The metabolic syndrome was assessed according to the International Diabetes Federation criteria. Biochemical and anthropometrical parameters were measured . Twenty-two participants (23%) presented metabolic syndrome and 66 women (74.2%) were classified in the insufficient physical activity category. No association was found between insufficient physical activity and metabolic syndrome . Inverse correlations were found among the days and minutes per week of physical activity of moderate-intensity, waist circumference ( r =-0.327, and r =-0.313, pphysical activity was found in the study participants, but this was not associated with metabolic syndrome . Moderate but not vigorous physical activity items from the International Physical Activity Questionnaire correlated inversely with anthropometrical markers related to cardiovascular risk.

  1. Stabilization of activated fragments by shell-wise construction of an embedding environment.

    Science.gov (United States)

    Krausbeck, Florian; Sobez, Jan-Grimo; Reiher, Markus

    2017-05-30

    An activated fragment which is structurally unstable when considered isolated can be stabilized through binding to a suitable molecular environment; for instance, to a transition-metal fragment. The metal fragment may be designed in a shell-wise build-up of a surrounding molecular environment. However, adding more and more atoms in a consecutive fashion soon leads to a combinatorial explosion of structures, which is unfeasible to handle without automation. Here, we present a fully automated and parallelized framework that constructs such an embedding environment atom-wise. Molecular realizations of such an environment are constructed based on simple heuristic rules intended to screen a sufficiently large portion of the possible compound space and are then subsequently optimized by electronic structure methods. (Constrained-optimized) structures are then evaluated with respect to a scoring function, for which we choose here the concept of gradient-driven molecule construction. This concept searches for structure modifications that reduce the forces on all atoms. We develop and analyze our approach at the example of CO 2 activation by reproducing a known compound and mapping out possible alternative structures and their effect on the stabilization of a (bent) CO 2 ligand. For all generated structures, the nuclear gradient on the activated fragment and its coordination energy are evaluated to steer the design process. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  2. Unusual Horner's syndrome in recurrent breast cancer: Evaluating using {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Hyun; Kim, Tae Sung; Kim, Seok Ki [Dept. of Nuclear Medicine, National Cancer Center, Goyang (Korea, Republic of)

    2017-03-15

    {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a widely used imaging modality in the initial diagnosis of cancer, treatment response evaluation and detection of recurrence. Herein, we present the case of a 39-year-old female who presented right ptosis on the follow-up of breast cancer after surgery. Clinicians suspected Horner's syndrome, and the patient underwent FDG PET/CT for the evaluation of recurrence that could cause Horner's syndrome. FDG PET/CT demonstrated a focal hypermetabolic lesion in the right cervicothoracic junction area, corresponding to the preganglionic cervical sympathetic trunk. A subsequent needle biopsy was done, and the lesion was confirmed as metastatic ductal carcinoma. In this case, we could detect the exact location of the recurring lesion that caused Horner's syndrome using FDG PET/CT.

  3. Evaluation of autonomic nervous system function in children with overactive bladder syndrome.

    Science.gov (United States)

    Demir, Aysegul Dogan; Gursoy, Azize Esra; Goknar, Nilufer; Uzuner, Selcuk; Ozkaya, Emin; Erenberk, Ufuk; Vehapoglu, Aysel; Dundaroz, Mehmet Rusen; Oktem, Faruk

    2017-03-01

    We aimed to evaluate the autonomic nervous system activity in children with overactive bladder (OAB) syndrome. Included in the study were 40 children with overactive bladder and 28 healthy controls. Autonomic tests were performed on all participants, including heart rate interval variation (RRIV), heart rate response to valsalva maneuver, and sympathetic skin response (SSR). Mean valsalva rates in the overactive bladder and control groups were 1.53 ± 0.29 and 1.30 ± 0.18, respectively, a statistically significant difference (P  0.05). This study demonstrated a parasympathetic hyperactivity in children with OAB, results suggesting a dysfunction in their autonomic nervous systems. Neurourol. Urodynam. 36:673-676, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. Cushing's Syndrome in a Morbidly Obese Patient Undergoing Evaluation before Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Livia Borsoi

    2014-06-01

    Full Text Available Objective: Cushing's syndrome (CS is extremely rare in morbidly obese patients. To date, no occurrences in obese patients with BMI above 60 kg/m2 have been reported in the literature. Case Report: This case report describes a patient who was admitted to the ward of the Clinical Division of Endocrinology and Metabolism of the Medical University of Vienna in preparation for bariatric surgery. The patient was a 49-year-old female who showed morbid obesity (BMI 61.6 kg/m2, hypertension, and substituted hypothyroidism. Preoperative work-up revealed CS due to an adrenal adenoma. Therefore, the patient underwent unilateral adrenalectomy followed by bariatric surgery 6 months later. Conclusion: Since undiagnosed CS might result in severe perioperative complications in a population already at increased risk, this case report underlines the importance of careful endocrine evaluation of morbidly obese patients. After all, even rare endocrine causes should be excluded.

  5. Process evaluation of a pilot evidence-based Polycystic Ovary Syndrome clinic in the Torres Strait.

    Science.gov (United States)

    Boyle, Jacqueline; Hollands, Grace; Beck, Sarah; Hampel, Gaynor; Wapau, Hylda; Arnot, Marissa; Browne, Louise; Teede, Helena J; Moran, Lisa J

    2017-06-01

    Polycystic ovary syndrome (PCOS) is a chronic endocrine syndrome in reproductive-aged women which is very common among Aboriginal and Torres Strait Islander women. The objective of this study was to conduct a process evaluation of a pilot clinic on Thursday Island which aimed to provide a comprehensive evidence-based service for women with PCOS throughout the Torres Strait. Mixed-method evaluation at 12 months comprising a medical record audit, semi-structured interviews and focus group discussions. Primary care. Audit of n = 11 clinics (n = 36 women), qualitative semi-structured interviews with n = 8 clinicians and focus group discussions with n = 8 women. (i) Fidelity to evidence-based guidelines, (ii) barriers and enablers to women using the service, (iii) the ability to meet the needs of women and the community. The clinic was largely successful in providing evidence-based care with up to 78% of women receiving recommended cardiometabolic screening, 100% emotional screening and 89% lifestyle management despite the remoteness of the clinic and limited financial and human resources. Health care providers report sustainability of the clinic will be dependent on factors including staffing, administrative support and inclusion of Aboriginal and Torres Strait Islander health workers. While the clinic has been largely successful there are areas identified for potential improvement and to facilitate sustainability which should be considered before up-scaling this model to a national level. These include systems, administrative and staffing support, engaging with other community services to facilitate lifestyle changes and ongoing engagement and upskilling of Aboriginal and Torres Strait Islander health care providers. © 2016 National Rural Health Alliance Inc.

  6. Usher's Syndrome Type II: A Comparative Study of Genetic Mutations and Vestibular System Evaluation.

    Science.gov (United States)

    Magliulo, Giuseppe; Iannella, Giannicola; Gagliardi, Silvia; Iozzo, Nicola; Plateroti, Rocco; Mariottini, Alessandro; Torricelli, Francesca

    2017-11-01

    Objective Usher's syndrome type II (USH2) is characterized by moderate to profound congenital hearing loss, later onset of retinitis pigmentosa, and normal vestibular function. Recently, a study investigating the vestibular function of USH2 patients demonstrated a pathologic response to vestibular tests. In this cross-sectional study we performed vestibular tests of a group patients with genetic diagnosis of USH2 syndrome to demonstrate if vestibular damage is present in USH2 patients. Study Design Cross-sectional study. Setting Tertiary referral center. Subjects and Methods Mutated genes of 7 patients with a clinical diagnosis of USH2 were evaluated. Vestibular function was investigated by audiometry, Fitzgerald-Hallpike caloric vestibular testing, cervical vestibular evoked myogenic potentials (C-VEMPs), ocular vestibular evoked myogenic potentials (O-VEMPs), and video head impulse test (v-HIT). Results Genetic tests confirmed the USH2 diagnosis in 5 of 7 patients examined, with 1 patient reporting a unique mutation on genetic tests. Four (80%) of the 5 patients with a genetic diagnosis of USH2 showed pathological O-VEMPs. Two patients (40%) reported bilateral absent or abnormal values of C-VEMPs. The superior semicircular canal presented a significant deficit in 2 (40%) patients. The same 2 cases showed a pathologic response of the v-HIT of the horizontal semicircular canal. Finally, the posterior semicircular canal presented a significant deficit in 4 (40.0%) patients. Conclusion A vestibular evaluation with vestibular evoked myogenic potentials and v-HIT seems to identify latent damage to the vestibular receptors of USH2 patients.

  7. Migraine in Gulf War Illness and Chronic Fatigue Syndrome: Prevalence, potential mechanisms, and evaluation

    Directory of Open Access Journals (Sweden)

    Rakib eRayhan

    2013-07-01

    Full Text Available Objective: To assess the prevalence of headache subtypes in Gulf War Illness and Chronic Fatigue Syndrome compared to controls. Background: Migraines are reported in Chronic Fatigue Syndrome (CFS. Approximately, 25% of the military personnel who served in the 1990-1991 Persian Gulf War have developed Gulf War Illness (GWI. Symptoms in GWI share considerable overlap with CFS, including headache complaints. The type and prevalence of headaches in GWI have not been adequately assessed.Methods: 50 GWI, 39 CFS and 45 controls were examined. Participants had structured headache evaluations based on the 2004 International Headache Society criteria. All subjects had history and physical examinations, measurements of systemic hyperalgesia (dolorimetry, assessments for exclusionary indicators, fatigue and symptom related questionnaires. Results: Migraines were detected in 64% of GWI (odds ratio, 11.6, [±95% CI, 4.1 to 32.5] and 82% of CFS subjects (odds ratio, 22.5, [±95% CI, 7.8 to 64.8] compared to only 13% of controls. There was a predominance of females in the CFS compared to GWI and controls. However, gender did not influence migraine status (x2= 2.7; P = 0.101. Measures of fatigue, pain, and other ancillary criteria were comparable between GWI and CFS subjects with and without headache. Conclusion: Results validate previous findings of migraine in CFS and confirms similar increased prevalence in GWI compared to controls. This suggests GWI and CFS subjects share pathophysiological mechanisms that underlie migraine attacks and contribute to the extensive overlap of symptom constructs and disease pathophysiology. The high migraine prevalence warrants the inclusion of a structured headache evaluation that coincides with clinical assessments of GWI and CFS diagnosis.

  8. The Glass Is Half Full: Evidence for Efficacy of Alcohol-Wise at One University But Not the Other

    OpenAIRE

    CROOM, KATHERINE; STAIANO-COICO, LISA; LESSER, MARTIN L.; LEWIS, DEBORAH K.; REYNA, VALERIE F.; MARCHELL, TIMOTHY C.; FRANK, JEREMY; IVES, STEPHANIE

    2015-01-01

    This research extends the growing literature about online alcohol prevention programs for first-year college students. Two independent randomized control studies, conducted at separate universities, evaluated the short-term effectiveness of Alcohol-Wise, an online alcohol prevention program not previously studied. It was hypothesized the prevention program would increase alcohol knowledge and reduce alcohol consumption, including high-risk alcohol-related behaviors, among first-year college s...

  9. [Scales for evaluation of mortality of patients with trauma and adult respiratory distress syndrome].

    Science.gov (United States)

    Hernández-Gutiérrez, P; Grifé-Coromina, A; de la Garza-Estrada, V A

    1997-01-01

    To compare different scores and scales used to evaluate mortality in patients with trauma and adult respiratory distress syndrome (ARDS). The clinical charts of 80 adult patients, 70 men and 10 women, who were admitted during the period from January Ist, 1990, to December 31st, 1993, to the Hospital Guillermo Barroso C., Cruz Roja Mexicana in Mexico City with trauma and ARDS, were revised. The following data were evaluated: sex, age, injury-producing mechanisms, associated morbid conditions (shock, multiple blood transfusions, long bone fracture, pulmonary contusion and sepsis), ARDS diagnostic criteria, systemic failure, multiple organ failure, injury severity score. Acute Physiology and Chronic Health Evaluation Scoring System, time elapsed to ARDS diagnosis, period of tracheal intubation and stay at the intensive care unit. Of the 80 patients, 26 died (32.5%), 2 women and 24 men. Injury-producing mechanisms were: running over (31.3%), car accidents (27.5%), gunshot wounds (15%), stab wounds (13.7%) multiple contusions (7.5%) and falls (5%). A highly significant relationship was found between all scores and scales investigated and mortality. In pulmonary contusion and gastrointestinal failure correlation was doubtful; period of tracheal intubation and stay at the intensive care unit showed no correlation to mortality. Adult patients with trauma who develop ARDS showed high probability of death if additional clinical data of shock and consolidation in three or four quadrants of thorax X-rays are present, among other factors.

  10. Efficacy of high frequency ultrasound in postoperative evaluation of carpal tunnel syndrome treatment

    Directory of Open Access Journals (Sweden)

    Katarzyna Kapuścińska

    2016-03-01

    Full Text Available Carpal tunnel syndrome (CTS is the most common entrapment neuropathy and a frequent cause of sick leave because of work-related hand overload. The main treatment is operation. Aim: The aim of the study is to assess the usefulness of high frequency ultrasound in the postoperative evaluation of CTS treatment efficacy. Material and methods: Sixty-two patients (50 women and 12 men aged 28–70, mean age 55.2 underwent surgical treatment of CTS. Ultrasound examinations of the wrist in all carpal tunnel sufferers were performed 3 months after the procedure with the use of a high frequency broadband linear array transducer (6–18 MHz, using 18 MHz band of MyLab 70/Esaote. On the basis of the collected data, the author has performed multiple analyses to confirm the usefulness of ultrasound imaging for postoperative evaluation of CTS treatment efficacy. Results: Among all 62 patients, 3 months after surgical median nerve decompression: in 40 patients, CTS symptoms subsided completely, and sonographic evaluation did not show median nerve entrapment signs; in 9 patients, CTS symptoms persisted or exacerbated, and ultrasound proved nerve compression revealing preserved flexor retinaculum fibers; in 13 patients, scar tissue symptoms occurred, and in 5 of them CTS did not subside completely (although ultrasound showed no signs of compression. Conclusions: Ultrasound imaging with the use of a high frequency transducer is a valuable diagnostic tool for postoperative assessment of CTS treatment efficacy.

  11. Parametric Response Mapping as an Indicator of Bronchiolitis Obliterans Syndrome after Hematopoietic Stem Cell Transplantation

    NARCIS (Netherlands)

    Galban, Craig J.; Boes, Jennifer L.; Bule, Maria; Kitko, Carrie L.; Couriel, Daniel R.; Johnson, Timothy D.; Lama, Vihba; Telenga, Eef D.; van den Berge, Maarten; Rehemtulla, Alnawaz; Kazerooni, Ella A.; Ponkowski, Michael J.; Ross, Brian D.; Yanik, Gregory A.

    2014-01-01

    The management of bronchiolitis obliterans syndrome (BOS) after hematopoietic cell transplantation presents many challenges, both diagnostically and therapeutically. We developed a computed tomography (CT) voxel-wise methodology termed parametric response mapping (PRM) that quantifies normal

  12. Description of SODAR data storage. WISE project WP2

    International Nuclear Information System (INIS)

    Barhorst, S.A.M.; Verhoef, J.P.; Van der Werff, P.A.; Eecen, P.J.

    2003-10-01

    The partners in the WISE project are investigating whether application of the SODAR (sonic detection and ranging) measurement technique in wind energy experimental work is feasible as a replacement for cup anemometers and wind direction sensors mounted on tall meteorological masts both from the view of accuracy and cost. In Work Package 2 (WP2) of the WISE project extensive controlled experiments with the SODAR have been performed. For example, SODAR measurements have been compared with measurements from nearby masts and different brands of SODARs have been compared. Part of the work package was the creation of a database to gather the measured SODAR data. The database was created by ECN in order to enable further analysis by the partners in the project. The database structure that has been defined by ECN is described in full detail. The database is based on SQL (structured query language), and care is taken that data that is unchanged during a measurement period is only stored once. The logic behind the structure is described and the relations between the various tables are described. Up to now the description of the database is limited to include SODAR data measured close to a meteorological mast. Power measurements from wind turbines are not yet included. However, the database can easily be extended to include these data. The data measured by means of the ECN SODAR have completely been re-processed. A new directory structure was defined which is accessible from both the Unix (Linux) and the Microsoft Windows platform. The processed and validated data have been stored in a database to make retrieval of specific data sets possible. The database is also accessible from the Windows platform. The defined format is available for the WISE project, so that the database containing data from all partners can be created

  13. SUBMILLIMETER FOLLOW-UP OF WISE-SELECTED HYPERLUMINOUS GALAXIES

    Energy Technology Data Exchange (ETDEWEB)

    Wu Jingwen; Eisenhardt, Peter R. M.; Stern, Daniel; Assef, Roberto [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States); Tsai, Chao-Wei; Cutri, Roc; Griffith, Roger; Jarrett, Thomas [Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, CA 91125 (United States); Sayers, Jack; Bridge, Carrie [Division of Physics, Math and Astronomy, California Institute of Technology, Pasadena, CA 91125 (United States); Benford, Dominic [NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States); Blain, Andrew [Department of Physics and Astronomy, University of Leicester, LE1 7RH Leicester (United Kingdom); Petty, Sara; Lake, Sean [Department of Physics and Astronomy, University of California Los Angeles, Los Angeles, CA 90095 (United States); Bussmann, Shane [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, MS78, Cambridge, MA 02138 (United States); Comerford, Julia M.; Evans, Neal J. II [Department of Astronomy, University of Texas, Austin, TX 78731 (United States); Lonsdale, Carol [National Radio Astronomy Observatory, 520 Edgemont Road, Charlottesville, VA 22903 (United States); Rho, Jeonghee [SETI Institute, 189 BERNARDO Avenue, Mountain View, CA 94043 (United States); Stanford, S. Adam, E-mail: jingwen.wu@jpl.nasa.gov [Department of Physics, University of California Davis, One Shields Avenue, Davis, CA 95616 (United States); and others

    2012-09-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare ({approx}1000 all-sky) population of galaxies at high redshift (peaks at z = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 {mu}m, yet are clearly detected at 12 and 22 {mu}m. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (z > 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 {mu}m, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 {mu}m, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature. We estimate their dust temperatures to be 60-120 K using a single-temperature model. Their infrared luminosities are well over 10{sup 13} L{sub Sun }. These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe. We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

  14. Submillimeter Follow-Up of WISE-Selected Hyperluminous Galaxies

    Science.gov (United States)

    Wu, Jingwen; Tsai, Chao-Wei; Sayers, Jack; Benford, Dominic; Bridge, Carrie; Blain, Andrew; Eisenhardt, Peter R.; Stern, Daniel; Petty, Sara; Assef, Roberto; hide

    2012-01-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare (approx.1000 all-sky) population of galaxies at high redshift (peaks at z = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 microns, yet are clearly detected at 12 and 22 microns. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (z > 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 microns, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 microns, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature.We estimate their dust temperatures to be 60 C120 K using a single-temperature model. Their infrared luminosities are well over 10(exp 13) Stellar Luminosity. These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe.We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

  15. WISE-Selected Red and Obscured Quasars in Stripe 82

    Science.gov (United States)

    Glikman, Eilat; Lacy, M.; Urrutia, T.; Urry, C. M.

    2013-01-01

    We identified a sample of 120 dust-reddened quasars identified by matching radio sources detected at 1.4 GHz in the Faint Images of the Radio Sky at Twenty Centimeters (FIRST) survey with the near-infrared Two Micron All Sky Survey (2MASS) catalog and color-selecting red sources. We interpret this population of objects as a tansitional phase in merger-driven quasar/galaxy co-evolution where these reddened quasars are shedding their dusty environment prior to becoming a “normal” blue quasar. When correcting for extinction, we find that red quasars make up ~15%-20% of the luminous quasar population. The radio requirement was intended to avoid contamination from stars, but restricts our sample to radio-detected objects. With the release of the Wide-Field Infrared Survey Explorer (WISE) we can now select all red quasars regardless of their radio propoerties, using infrared colors. We present a pilot survey for heavily obscured luminous quasars using infrared selection from WISE colors in the SDSS Stripe 82. We concentrated on objects with both bright WISE 22 micron fluxes and 2MASS magnitudes that lack spectra in SDSS to identify the brightest (mostly high luminosity) sources that complement the fainter objects in Spitzer-selected samples. Our relatively liberal color selection produced a candidate list of 12 sources. We obtained near-infrared spectra for all using SpeX on IRTF and have spectroscopically confirmed at least five obscured and reddened quasars. We explore the nature of the dusty quasar population and how it depends on redshift, luminosity and radio-loudness.

  16. SUBMILLIMETER FOLLOW-UP OF WISE-SELECTED HYPERLUMINOUS GALAXIES

    International Nuclear Information System (INIS)

    Wu Jingwen; Eisenhardt, Peter R. M.; Stern, Daniel; Assef, Roberto; Tsai, Chao-Wei; Cutri, Roc; Griffith, Roger; Jarrett, Thomas; Sayers, Jack; Bridge, Carrie; Benford, Dominic; Blain, Andrew; Petty, Sara; Lake, Sean; Bussmann, Shane; Comerford, Julia M.; Evans, Neal J. II; Lonsdale, Carol; Rho, Jeonghee; Stanford, S. Adam

    2012-01-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare (∼1000 all-sky) population of galaxies at high redshift (peaks at z = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 μm, yet are clearly detected at 12 and 22 μm. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (z > 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 μm, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 μm, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature. We estimate their dust temperatures to be 60-120 K using a single-temperature model. Their infrared luminosities are well over 10 13 L ☉ . These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe. We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

  17. a Wise Census of the Perseus OB2 Association

    Science.gov (United States)

    Azimlu, Mohaddesseh; Muench, August; Martinez-Galarza, Rafael

    2013-07-01

    We have performed a WISE based survey to identify young stellar objects throughout a large 12 by 12 degree area around the Perseus OB2 association (Per OB2) and the spatially co-located Perseus molecular cloud. While this region contains several well studied, active star forming regions and many massive and intermediate mass stars, comprehensive knowledge about the population of low mass stars in the association is lacking. Understanding age, mass and spatial extent of the low mass association members is particularly important because Per OB2, is the second closest OB association to the Sun with an age of less than 15 Myr. We constructed a panchromatic census of this region using WISE, Spitzer and all other optical/infrared all sky surveys this region. If available, we folded in X-ray data that can help to confirm the young but diskless members and to distinguish young sources from background extragalactic objects. We used this panchromatic census to construct spectral energy distributions (SEDs) of about 1 million 2MASS and more than 1.5 million WISE point sources to look for signatures of disk infrared excess emission as a means to identify young stars. We present a detailed analysis of our careful matching of multiple all sky catalogs, our filtering of the merged source catalog for high quality SEDs, basic characterization of these SEDs, and our analysis of low mass population we identified. The overall aim of this project is to characterize the spatial and mass distribution of the objects in this region. This research funded by the National Aeronautics and Space Administration Grant NNX08AJ66G to the Smithsonian Astrophysical Observatory.

  18. Converting point-wise nuclear cross sections to pole representation using regularized vector fitting

    Science.gov (United States)

    Peng, Xingjie; Ducru, Pablo; Liu, Shichang; Forget, Benoit; Liang, Jingang; Smith, Kord

    2018-03-01

    Direct Doppler broadening of nuclear cross sections in Monte Carlo codes has been widely sought for coupled reactor simulations. One recent approach proposed analytical broadening using a pole representation of the commonly used resonance models and the introduction of a local windowing scheme to improve performance (Hwang, 1987; Forget et al., 2014; Josey et al., 2015, 2016). This pole representation has been achieved in the past by converting resonance parameters in the evaluation nuclear data library into poles and residues. However, cross sections of some isotopes are only provided as point-wise data in ENDF/B-VII.1 library. To convert these isotopes to pole representation, a recent approach has been proposed using the relaxed vector fitting (RVF) algorithm (Gustavsen and Semlyen, 1999; Gustavsen, 2006; Liu et al., 2018). This approach however needs to specify ahead of time the number of poles. This article addresses this issue by adding a poles and residues filtering step to the RVF procedure. This regularized VF (ReV-Fit) algorithm is shown to efficiently converge the poles close to the physical ones, eliminating most of the superfluous poles, and thus enabling the conversion of point-wise nuclear cross sections.

  19. Report of the Wises Committee; Rapport du Comite des Sages

    Energy Technology Data Exchange (ETDEWEB)

    Castillon, P.; Lesggy, M.; Morin, E.

    2003-09-01

    This report on the energy theme, calls in experts in different areas such economics, technologies, regulations, fiscality, geopolitics, regional, european and international approaches. Because of numerous constraints, interactions in the energy subject, the Wises Committee has wished to tackle in priority the subject under a point of view less technical, by insisting on the necessary sudden awareness of the public about stakes in the energy field, on the necessity to implement actions for energy efficiency without waiting for the crisis situations that will come from excess of energy consumption. (N.C.)

  20. Ichthyosis prematurity syndrome: clinical evaluation of 17 families with a rare disorder of lipid metabolism.

    Science.gov (United States)

    Khnykin, Denis; Rønnevig, Jørgen; Johnsson, Margareta; Sitek, Jan C; Blaas, Harm-Gerd K; Hausser, Ingrid; Johansen, Finn-Eirik; Jahnsen, Frode L

    2012-04-01

    Ichthyosis prematurity syndrome (IPS) is classified as a syndromic congenital ichthyosis based on the presence of skin changes at birth, ultrastructural abnormalities in the epidermis, and extracutaneous manifestations. Recently, mutations in the fatty acid transporter protein 4 gene have been identified in patients with IPS. We sought to perform a detailed clinical evaluation of patients with IPS identified in Norway. Clinical examination and follow-up of all patients (n = 23) and light and electron microscopic examination of skin biopsy specimens were performed. IPS was characterized prenatally by ultrasound findings of polyhydramnios, separation of membranes, echogenic amniotic fluid, and clear chorionic fluid. All patients were born prematurely with sometimes life-threatening neonatal asphyxia; this was likely caused by aspiration of corneocyte-containing amniotic fluid as postmortem examination of lung tissue in two patients revealed keratin debris filling the bronchial tree and alveoli. The skin appeared erythrodermic, swollen, and covered by a greasy, thick vernix caseosa-like "scale" at birth, and evolved rapidly to a mild chronic ichthyosis. Many patients subsequently had chronic, severe pruritus. Histopathologic and ultrastructural examination of skin biopsy specimens showed hyperkeratosis, acanthosis, dermal inflammation, and characteristic aggregates of curved lamellar structures in the upper epidermis. Peripheral blood eosinophilia was invariably present and most patients had increased serum immunoglobulin E levels. Over 70% of the patients had a history of respiratory allergy and/or food allergy. The study included only 23 patients because of the rarity of the disease. IPS is characterized by defined genetic mutations, typical ultrastructural skin abnormalities, and distinct prenatal and postnatal clinical features. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  1. Surgical evaluation of magnetic resonance imaging findings in piriformis muscle syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Pecina, Hrvoje Ivan; Boric, Igor [Clinical Hospital ' ' Sestre Milosrdnice' ' , Department of Radiology, Zagreb (Croatia); Smoljanovic, Tomislav; Pecina, Marko [University of Zagreb, Department of Orthopedic Surgery, School of Medicine, Zagreb (Croatia); Duvancic, Davor [Outpatients Clinic and Clinic for Diagnostic Procedures, Zagreb (Croatia)

    2008-11-15

    The objective of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of the piriformis muscle syndrome (PMS). In ten patients, seven female and three male, with a long history of clinical symptoms of the PMS, an MRI was performed as the last preoperative diagnostic tool. All patients were imaged using 2T MR system (Elscint, Haifa, Israel). Axial and coronal spin-echo, fast spin-echo (FSE), and fat-suppressed FSE-weighted images were made through the pelvic region with 3-mm section thickness and a 0.5-mm gap to show the whole piriformis muscle and the course of sciatic nerve on its way out of the pelvis. A routine examination also included axial fast spin-echo T2, three-dimensional gradient echo. In seven cases, an MRI abnormality for the PMS was found. In two women, the MRI demonstrated a bigastric appearance of the piriformis muscle with a tendinous portion between the muscle heads and the course of the common peroneal nerve through the muscle between the tendinous portions of the muscle. In one female patient, the common peroneal nerve passed through the hypertrophied piriformis muscle. In four patients, the MRI showed a hypertrophied aspect of the piriformis muscle and an anteriorly displaced sciatic nerve. All MRI findings were confirmed surgically. In three patients, no apparent abnormalities could be observed, but after a surgical treatment, i.e., a tenotomy of the piriformis muscle and neurolysis of the sciatic nerve, all symptoms disappeared. In piriformis muscle syndrome, MRI may demonstrate signal abnormalities of the sciatic nerve as well as its relationship with the normal and abnormal piriformis muscle. (orig.)

  2. Evaluation of some physical and motoric characteristics of athletes with down syndrome

    Directory of Open Access Journals (Sweden)

    Ilkım Mehmet

    2017-01-01

    Full Text Available The aim of this study was to evaluate some physical and motoric characteristics of Down’s syndrome athletes. The sample of the study consists of 60 athletes (n=30 experimetal group and n=30 control group who are in the Malatya Sessiz Adımlar Sports Club, aged between 13 and 15. Athletes in the experimental group were subjected to a training program to improve the balance and flexibility of 2 hours of 3 days a week for 8 weeks. The athletes, in the control group continued their usual training programs. Before and after the 8-week training program that is applicated for the athletes in the experimental group, the balance and flexibility performances of the athletes in both the experimental and control groups were determined. It was used the flamingo balance test to determine the balance performance of the athletes; was used Sit & Reach test to determine flexibility performance. In favor of the athletes who are in experimental group a statistically significant difference (p0.05 obtained between pre-test and post-test results that is applicated to determine the flexibility performance. It was also found that there was no relationship (p>0.05 between the BMI values of the athletes and their balance and flexibility performances. In the study, it was found that the training program for 8 week training to improve balance and flexibility that was applied to dealing with athleticism 13–15 age group athletes with down syndrome improved the athletes’ balance performance but did not contribute to the their improvement of flexibility performances.

  3. A new cognitive evaluation battery for Down syndrome and its relevance for clinical trials

    Directory of Open Access Journals (Sweden)

    Susana ede Sola

    2015-06-01

    Full Text Available The recent prospect of pharmaceutical interventions for cognitive impairment of Down syndrome(DS has boosted a number of clinical trials in this population. However, running the trials has raised some methodological challenges and questioned the prevailing methodology used to evaluate cognitive functioning of DS individuals. This is usually achieved by comparing DS individuals to matched healthy controls of the same mental age. We propose a new tool, the TESDAD Battery that uses comparison with age-matched typically developed adults. This is an advantageous method for probing the clinical efficacy of DS therapies, allowing the interpretation and prediction of functional outcomes in clinical trials. In our DS population the TESDAD battery permitted a quantitative assessment of cognitive defects, which indicated language dysfunction and deficits in executive function, as the most important contributors to other cognitive and adaptive behavior outcomes as predictors of functional change in DS. Concretely, auditory comprehension and functional academics showed the highest potential as end-point measures of therapeutic intervention for clinical trials: the former as a cognitive key target for therapeutic intervention, and the latter as a primary functional outcome measure of clinical efficacy. Our results also emphasize the need to explore the modulating effects of IQ, gender and age on cognitive enhancing treatments. Noticeably, women performed significantly better than men of the same age and IQ in most cognitive tests, with the most consistent differences occurring in memory and executive functioning and negative trends rarely emerged on quality of life linked to the effect of age after adjusting for IQ and gender. In sum, the TESDAD battery is a useful neurocognitive tool for probing the clinical efficacy of experimental therapies in interventional studies in the DS population suggesting that age-matched controls are advantageous for determining

  4. Strong correlation of elastin deletions, detected by FISH, with Williams syndrome: Evaluation of 235 patients

    Energy Technology Data Exchange (ETDEWEB)

    Lowery, M.C.; Brothman, L.J.; Leonard, C.O. [Univ. of Utah Health Sciences Center, Salt Lake City, UT (United States)] [and others

    1995-07-01

    Williams syndrome (WS) is generally characterized by mental deficiency, gregarious personality, dysmorphic facies, supravalvular aortic stenosis, and idiopathic infantile hypercalcemia. Patients with WS show allelic loss of elastin (ELN), exhibiting a submicroscopic deletion, at 7q11.23, detectable by FISH. Hemizygosity is likely the cause of vascular abnormalities in WS patients. A series of 235 patients was studied, and molecular cytogenetic deletions were seen in 96% of patients with classic WS. Patients included 195 solicited through the Williams Syndrome Association (WSA), plus 40 clinical cytogenetics cases referred by primary-care physicians. Photographs and medical records of most WSA subjects were reviewed, and patients were identified as {open_quotes}classic{open_quotes} (n = 114) or{open_quotes}uncertain{close_quotes} (n = 39). An additional 42 WSA patients were evaluated without clinical information. FISH was performed with biotinylated ELN cosmids on metaphase cells from immortalized lymphoblastoid lines from WSA patients and after high-resolution banding analysis on clinical referral patients. An alpha-satellite probe for chromosome 7 was included in hybridizations, as an internal control. Ninety-six percent of the patients with classic WS showed a deletion in one ELN allele; four of these did not show a deletion. Of the uncertain WS patients, only 3 of 39 showed a deletion. Of the 42 who were not classified phenotypically, because of lack of clinical information, 25 patients (60%) showed a deletion. Thirty-eight percent (15/40) of clinical cytogenetics cases showed an ELN deletion and no cytogenetic deletion by banded analysis. These results support the usefulness of FISH for the detection of elastin deletions as an initial diagnostic assay for WS. 14 refs., 2 figs., 4 tabs.

  5. Evaluation of the ability of standardized supports to improve public health response to syndromic surveillance for respiratory diseases in Canada

    Directory of Open Access Journals (Sweden)

    Laura A. Rivera

    2017-02-01

    Full Text Available Abstract Background Despite widespread implementation of syndromic surveillance systems within public health agencies, previous studies of the implementation and use of these systems have indicated that the functions and responses taken in response to syndromic surveillance data vary widely according to local context and preferences. The objective of the Syndromic Surveillance Evaluation Study was to develop and implement standardized supports in local public health agencies in Ontario, Canada, and evaluate the ability of these supports to affect actions taken as part of public health communicable disease control programs. Methods Local public health agencies (LPHA in Ontario, which used syndromic surveillance based on emergency department visits for respiratory disease, were recruited and randomly allocated to the study intervention or control group. The intervention group health agencies received standardized supports in terms of a standardized aberrant event detection algorithm and a response protocol dictating steps to investigate and assess the public health significance of syndromic surveillance alerts. The control group continued with their pre-existing syndromic surveillance infrastructure and processes. Outcomes were assessed using logbooks, which collected quantitative and qualitative information about alerts received, investigation steps taken, and public health responses. The study was conducted prospectively for 15 months (October 2013 to February 2015. Results Fifteen LPHAs participated in the study (n = 9 intervention group, n = 6 control group. A total of 1,969 syndromic surveillance alerts were received by all LPHAs. Variations in the types and amount of responses varied by LPHA, in particularly differences were noted by the size of the health unit. Smaller health units had more challenges to both detect and mount a response to any alerts. LPHAs in the control group were more likely to declare alerts to have public

  6. A deep WISE search for very late type objects and the discovery of two halo/thick-disk T dwarfs: WISE 0013+0634 and WISE 0833+0052

    OpenAIRE

    Pinfield, D. J.; Gomes, J.; Day-Jones, A. C.; Leggett, S. K.; Gromadzki, M.; Burningham, B.; Ruiz, M. T.; Kurtev, R.; Cattermole, T.; Cardoso, C.; Lodieu, N.; Faherty, J.; Littlefair, S.; Smart, R.; Irwin, M.

    2013-01-01

    A method is defined for identifying late-T and Y dwarfs in WISE down to low values of signal-to-noise. This requires a WISE detection only in the W2-band and uses the statistical properties of the WISE multiframe measurements and profile fit photometry to reject contamination resulting from non-point-like objects, variables and moving sources. To trace our desired parameter space, we use a control sample of isolated non-moving non-variable point sources from the Sloan Digital Sky Survey (SDSS...

  7. Smith-Magenis Syndrome and Social Security Administration's Compassionate Allowances Initiative: An Evaluative Review of the Literature.

    Science.gov (United States)

    Burke, Shanna L; Maramaldi, Peter

    2016-08-01

    The Social Security Administration (SSA) launched the Compassionate Allowances List (CAL) in 2008. This created a mechanism for expediting review and delivery of disability benefits, while decreasing application backlog. This study hypothesized that developmental disorders, such as Smith-Magenis syndrome, may meet criterion for inclusion. An evaluative review of the literature was undertaken to determine if the expedited review criterion was met. Ten databases were searched and articles meeting pre-defined criteria were coded according to the SSA definition of disability to determine if severity indices screen in or screen out certain severity levels or exclude Smith-Magenis syndrome entirely in relation to the CAL program. It was strongly recommended that Smith-Magenis syndrome receive consideration for inclusion in the CAL.

  8. Can't Curb the Urge to Move? Living with Restless Legs Syndrome

    Science.gov (United States)

    ... Sleep? Wise Choices Recognizing Restless Legs Restless legs syndrome brings all 4 of these characteristics: A strong urge to move your legs, often with unpleasant feelings like tingling, burning or throbbing in the legs. Symptoms that get better ... Legs Syndrome Fact Sheet What Is Restless Legs Syndrome? Brain ...

  9. Handwritten Devanagari Character Recognition Using Layer-Wise Training of Deep Convolutional Neural Networks and Adaptive Gradient Methods

    Directory of Open Access Journals (Sweden)

    Mahesh Jangid

    2018-02-01

    Full Text Available Handwritten character recognition is currently getting the attention of researchers because of possible applications in assisting technology for blind and visually impaired users, human–robot interaction, automatic data entry for business documents, etc. In this work, we propose a technique to recognize handwritten Devanagari characters using deep convolutional neural networks (DCNN which are one of the recent techniques adopted from the deep learning community. We experimented the ISIDCHAR database provided by (Information Sharing Index ISI, Kolkata and V2DMDCHAR database with six different architectures of DCNN to evaluate the performance and also investigate the use of six recently developed adaptive gradient methods. A layer-wise technique of DCNN has been employed that helped to achieve the highest recognition accuracy and also get a faster convergence rate. The results of layer-wise-trained DCNN are favorable in comparison with those achieved by a shallow technique of handcrafted features and standard DCNN.

  10. Evaluation of brain metabolite in patients with complex regional pain syndrome by MR spectroscopy

    International Nuclear Information System (INIS)

    Iwashita, Narihito; Fukui, Mikio; Nitta, Kazuhito; Anzawa, Noriyuki; Tomie, Hisashi; Nakanishi, Miho; Matsumoto, Tomikichi; Nosaka, Shuichi

    2010-01-01

    Recently brain imaging studies have shown that patients with chronic pain have an altered cortical processing of nociceptive inputs. We evaluated brain metabolites in patients with complex regional pain syndrome (CRPS) using MR spectroscopy. Absolute concentrations of N-acetylaspartate (NAA) and choline (Cho) were measured in anterior cingulate (ACC) and prefrontal cortices (PFC) of patients and volunteers as matched control. Psychological aspects of patients were also evaluated with Hospital Anxiety and Depression (HAD) scale, in addition to the intensity of pain by visual analog scale. In the ACC, CRPS patients had a significant decrease of NAA and a significant increase of Cho compared to the control. Furthermore, patients with anxiety scored by HAD scale had reduced NAA concentration in ACC compared to the patients without anxiety. In the PFC, there was a reduction of NAA in the patients compared with that in control. No correlation was observed between intensity of pain and these metabolites. These results suggest that metabolite changes in ACC and PFC could reflect the pathogenesis of CRPS. (author)

  11. Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial.

    Science.gov (United States)

    Voorn, Eric L; Koopman, Fieke S; Brehm, Merel A; Beelen, Anita; de Haan, Arnold; Gerrits, Karin H L; Nollet, Frans

    2016-01-01

    To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS) on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function. A process evaluation using data from an RCT. Forty-four severely fatigued individuals with PPS were randomized to exercise therapy (n = 22) or usual care (n = 22). Participants in the exercise group were instructed to exercise 3 times weekly for 4 months on a bicycle ergometer (60-70% heart rate reserve). The attendance rate was high (median 89%). None of the participants trained within the target heart rate range during >75% of the designated time. Instead, participants exercised at lower intensities, though still around the anaerobic threshold (AT) most of the time. Muscle function did not improve in the exercise group. Our results suggest that severely fatigued individuals with PPS cannot adhere to a high intensity aerobic exercise program on a cycle ergometer. Despite exercise intensities around the AT, lower extremity muscle function nor cardiorespiratory fitness improved. Improving the aerobic capacity in PPS is difficult through exercise primarily focusing on the lower extremities, and may require a more individualized approach, including the use of other large muscle groups instead. Netherlands National Trial Register NTR1371.

  12. Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Eric L Voorn

    Full Text Available To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function.A process evaluation using data from an RCT.Forty-four severely fatigued individuals with PPS were randomized to exercise therapy (n = 22 or usual care (n = 22.Participants in the exercise group were instructed to exercise 3 times weekly for 4 months on a bicycle ergometer (60-70% heart rate reserve.The attendance rate was high (median 89%. None of the participants trained within the target heart rate range during >75% of the designated time. Instead, participants exercised at lower intensities, though still around the anaerobic threshold (AT most of the time. Muscle function did not improve in the exercise group.Our results suggest that severely fatigued individuals with PPS cannot adhere to a high intensity aerobic exercise program on a cycle ergometer. Despite exercise intensities around the AT, lower extremity muscle function nor cardiorespiratory fitness improved. Improving the aerobic capacity in PPS is difficult through exercise primarily focusing on the lower extremities, and may require a more individualized approach, including the use of other large muscle groups instead.Netherlands National Trial Register NTR1371.

  13. Evaluation of the mechanical and chemical control of dental biofilm in patients with Down syndrome.

    Science.gov (United States)

    Teitelbaum, Ana P; Pochapski, Márcia T; Jansen, Jocélia L; Sabbagh-Haddad, Aida; Santos, Fábio A; Czlusniak, Gislaine D

    2009-10-01

    To evaluate the mechanical and chemical control of dental biofilm in patients with Down syndrome, using different experimental dentifrices. Forty institutionalized children between ages 7 and 13 years in the mixed dentition phase participated in this study. An experimental cross-over, blind clinical trial was used, having the following protocols: fluoridated dentifrice (protocol G1); fluoridated dentifrice + chlorhexidine (protocol G2); fluoridated dentifrice + chlorhexidine + plaque-disclosing agent (protocol G3); and fluoridated dentifrice + plaque-disclosing agent (protocol G4). Each experimental stage lasted 10 days with a 15-day washout. The evaluated parameters were Plaque Index and gingival bleeding. The initial clinical conditions between each stage were similar. Statistical differences were observed (P plaque-disclosing agent, irrespective of their association with chlorhexidine, produced a greater reduction in the final plaque index. As for gingival bleeding, the dentifrice containing erythrosine and the one containing chlorhexidine produced similar results. The dentifrice containing an association of chlorhexidine and erythrosine gave the best results. With the methodology employed, it was possible to conclude that the combination of drugs (chlorhexidine, fluorine and erythrosine) within one dentifrice can be useful in controlling dental biofilm and in the reduction of gingival bleeding.

  14. Physical activity and nutrition program for adults with metabolic syndrome: Process evaluation.

    Science.gov (United States)

    Tran, Van Dinh; Jancey, Jonine; Lee, Andy; James, Anthony; Howat, Peter; Thi Phuong Mai, Le

    2017-04-01

    The Vietnam Physical Activity and Nutrition (VPAN) program aimed to improve physical activity and nutrition for adults aged 50-65 years with Metabolic Syndrome in Vietnam. The VPAN program consisted of a range of resources and strategies, including an information booklet, resistance band, face-to-face education sessions, and walking groups. This process evaluation assessed the participation, fidelity, satisfaction, and reasons for completing and not-completing the VPAN. Data were collected by mixed-methods from a sample of 214 intervention participants. Quantitative data were collected via surveys (n=163); qualitative data via face-to-face exit interviews with intervention program completers (n=10) and non-completers (n=10), and brief post education session discussions. Most participants (87%-96%) reported the program resources and strategies useful, assisting them to increase their physical activity level and improving their diet. The education sessions were the most preferred strategy (97%) with high attendance (>78% of participants). The main reasons for withdrawal were work commitments and being too busy. The evaluation indicated that the program reached and engaged the majority of participants throughout the six-month intervention. The combination of printed resources and face-to-face intervention components was a suitable approach to support lifestyle behavioural change in the Vietnamese population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Evaluating the Risk of Metabolic Syndrome Based on an Artificial Intelligence Model

    OpenAIRE

    Chen, Hui; Xiong, Shenghua; Ren, Xuan

    2014-01-01

    Metabolic syndrome is worldwide public health problem and is a serious threat to people's health and lives. Understanding the relationship between metabolic syndrome and the physical symptoms is a difficult and challenging task, and few studies have been performed in this field. It is important to classify adults who are at high risk of metabolic syndrome without having to use a biochemical index and, likewise, it is important to develop technology that has a high economic rate of return to s...

  16. Clinical Evaluation of Percutaneous Vertebroplasty in a Patient with Paraplegia and Immobilization Syndrome: A Case Report

    OpenAIRE

    Masala, Salvatore; Calabria, Eros; Nezzo, Marco; De Vivo, Dominique; Neroni, Luca; Simonetti, Giovanni

    2013-01-01

    We will discuss a potential role of percutaneous vertebroplasty (PVP) in the management of a patient with immobilization syndrome due to paraplegia and vertebral osteoporotic fractures. While PVP is commonly used for the treatment of osteoporotic thoracolumbar vertebral compression fractures, its role in vertebral stabilization in patient with immobilization syndrome has not been reported in the literature. A 73-year-old woman affected by immobilization syndrome due to paraplegia and vertebra...

  17. Evaluation of natural language processing from emergency department computerized medical records for intra-hospital syndromic surveillance

    Directory of Open Access Journals (Sweden)

    Pagliaroli Véronique

    2011-07-01

    Full Text Available Abstract Background The identification of patients who pose an epidemic hazard when they are admitted to a health facility plays a role in preventing the risk of hospital acquired infection. An automated clinical decision support system to detect suspected cases, based on the principle of syndromic surveillance, is being developed at the University of Lyon's Hôpital de la Croix-Rousse. This tool will analyse structured data and narrative reports from computerized emergency department (ED medical records. The first step consists of developing an application (UrgIndex which automatically extracts and encodes information found in narrative reports. The purpose of the present article is to describe and evaluate this natural language processing system. Methods Narrative reports have to be pre-processed before utilizing the French-language medical multi-terminology indexer (ECMT for standardized encoding. UrgIndex identifies and excludes syntagmas containing a negation and replaces non-standard terms (abbreviations, acronyms, spelling errors.... Then, the phrases are sent to the ECMT through an Internet connection. The indexer's reply, based on Extensible Markup Language, returns codes and literals corresponding to the concepts found in phrases. UrgIndex filters codes corresponding to suspected infections. Recall is defined as the number of relevant processed medical concepts divided by the number of concepts evaluated (coded manually by the medical epidemiologist. Precision is defined as the number of relevant processed concepts divided by the number of concepts proposed by UrgIndex. Recall and precision were assessed for respiratory and cutaneous syndromes. Results Evaluation of 1,674 processed medical concepts contained in 100 ED medical records (50 for respiratory syndromes and 50 for cutaneous syndromes showed an overall recall of 85.8% (95% CI: 84.1-87.3. Recall varied from 84.5% for respiratory syndromes to 87.0% for cutaneous syndromes. The

  18. Evaluation of Retinal Changes Using Optical Coherence Tomography in a Pediatric Case of Susac Syndrome

    Directory of Open Access Journals (Sweden)

    Mehmet Kola

    2017-01-01

    Full Text Available Susac syndrome is a rare occlusive vasculopathy affecting the retina, inner ear and brain. The cause is unknown, although it generally affects young women. This syndrome can be difficult to diagnose because its signs can only be revealed by detailed examination. These signs are not always concomitant, but may appear at different times. This report describes a pediatric case who was diagnosed with Susac syndrome when retinal lesions were identified in the inactive period with the help of optical coherence tomography (OCT. The purpose of this case report is to emphasize the importance of OCT in clarifying undefined retinal changes in Susac syndrome.

  19. THE WISE CATALOG OF GALACTIC H II REGIONS

    International Nuclear Information System (INIS)

    Anderson, L. D.; Cunningham, V.; Johnstone, B. M.; Armentrout, W. P.; Bania, T. M.; Balser, Dana S.; Wenger, T. V.

    2014-01-01

    Using data from the all-sky Wide-Field Infrared Survey Explorer (WISE) satellite, we made a catalog of over 8000 Galactic H II regions and H II region candidates by searching for their characteristic mid-infrared (MIR) morphology. WISE has sufficient sensitivity to detect the MIR emission from H II regions located anywhere in the Galactic disk. We believe this is the most complete catalog yet of regions forming massive stars in the Milky Way. Of the ∼8000 cataloged sources, ∼1500 have measured radio recombination line (RRL) or Hα emission, and are thus known to be H II regions. This sample improves on previous efforts by resolving H II region complexes into multiple sources and by removing duplicate entries. There are ∼2500 candidate H II regions in the catalog that are spatially coincident with radio continuum emission. Our group's previous RRL studies show that ∼95% of such targets are H II regions. We find that ∼500 of these candidates are also positionally associated with known H II region complexes, so the probability of their being bona fide H II regions is even higher. At the sensitivity limits of existing surveys, ∼4000 catalog sources show no radio continuum emission. Using data from the literature, we find distances for ∼1500 catalog sources, and molecular velocities for ∼1500H II region candidates

  20. A WISE survey of circumstellar disks in Taurus

    International Nuclear Information System (INIS)

    Esplin, T. L.; Luhman, K. L.; Mamajek, E. E.

    2014-01-01

    We have compiled photometry at 3.4, 4.6, 12, and 22 μm from the all-sky survey performed by the Wide-field Infrared Survey Explorer (WISE) for all known members of the Taurus complex of dark clouds. Using these data and photometry from the Spitzer Space Telescope, we have identified members with infrared excess emission from circumstellar disks and have estimated the evolutionary stages of the detected disks, which include 31 new full disks and 16 new candidate transitional, evolved, evolved transitional, and debris disks. We have also used the WISE All-Sky Source Catalog to search for new disk-bearing members of Taurus based on their red infrared colors. Through optical and near-infrared spectroscopy, we have confirmed 26 new members with spectral types of M1-M7. The census of disk-bearing stars in Taurus should now be largely complete for spectral types earlier than ∼M8 (M ≳ 0.03 M ☉ ).

  1. A WISE survey of circumstellar disks in Taurus

    Energy Technology Data Exchange (ETDEWEB)

    Esplin, T. L.; Luhman, K. L. [Department of Astronomy and Astrophysics, The Pennsylvania State University, University Park, PA 16802 (United States); Mamajek, E. E., E-mail: taran.esplin@psu.edu [Department of Physics and Astronomy, The University of Rochester, Rochester, NY 14627 (United States)

    2014-04-01

    We have compiled photometry at 3.4, 4.6, 12, and 22 μm from the all-sky survey performed by the Wide-field Infrared Survey Explorer (WISE) for all known members of the Taurus complex of dark clouds. Using these data and photometry from the Spitzer Space Telescope, we have identified members with infrared excess emission from circumstellar disks and have estimated the evolutionary stages of the detected disks, which include 31 new full disks and 16 new candidate transitional, evolved, evolved transitional, and debris disks. We have also used the WISE All-Sky Source Catalog to search for new disk-bearing members of Taurus based on their red infrared colors. Through optical and near-infrared spectroscopy, we have confirmed 26 new members with spectral types of M1-M7. The census of disk-bearing stars in Taurus should now be largely complete for spectral types earlier than ∼M8 (M ≳ 0.03 M {sub ☉}).

  2. WISE/NEOWISE OBSERVATIONS OF THE JOVIAN TROJANS: PRELIMINARY RESULTS

    International Nuclear Information System (INIS)

    Grav, T.; Mainzer, A. K.; Bauer, J.; Masiero, J.; Eisenhardt, P. R. M.; Blauvelt, E.; DeBaun, E.; Elsbury, D.; Gautier, T. IV; Gomillion, S.; Hand, E.; Wilkins, A.; Spahr, T.; McMillan, R. S.; Walker, R.; Cutri, R.; Wright, E.

    2011-01-01

    We present the preliminary analysis of over 1739 known and 349 candidate Jovian Trojans observed by the NEOWISE component of the Wide-field Infrared Survey Explorer (WISE). With this survey the available diameters, albedos, and beaming parameters for the Jovian Trojans have been increased by more than an order of magnitude compared to previous surveys. We find that the Jovian Trojan population is very homogenous for sizes larger than ∼10 km (close to the detection limit of WISE for these objects). The observed sample consists almost exclusively of low albedo objects, having a mean albedo value of 0.07 ± 0.03. The beaming parameter was also derived for a large fraction of the observed sample, and it is also very homogenous with an observed mean value of 0.88 ± 0.13. Preliminary debiasing of the survey shows that our observed sample is consistent with the leading cloud containing more objects than the trailing cloud. We estimate the fraction to be N(leading)/N(trailing) ∼ 1.4 ± 0.2, lower than the 1.6 ± 0.1 value derived by Szabó et al.

  3. Screening with Papanicolaou tests in Alberta: Are we Choosing Wisely?

    Science.gov (United States)

    Symonds, Christopher J; Chen, Wenxin; Rose, Marianne Sarah; Cooke, Lara J

    2018-01-01

    To describe the prevalence and geographic distribution of cervical cancer screening, as well as the age groups of those undergoing screening, in Alberta, and to determine if screening practices conform to current guidelines and follow Choosing Wisely Canada recommendations. Descriptive study using data from the Alberta Ministry of Health Analytics and Performance Reporting Branch. Alberta. Women who had 1 or more Papanicolaou tests between 2011 and 2013. Number of women aged 15 to 20 and those aged 70 and older who had 1 or more Pap tests in a 3-year period; year-to-year trends in screening rates for women in these 2 age groups; trends in screening rates in various geographic regions (ie, cities and zones) in Alberta; and the discipline of clinicians who ordered the Pap tests. Between 2011 and 2013, 805 632 women in the province of Alberta had 1 or more Pap tests for cervical cancer screening. Overall, 25 511 (17.5%) women aged 15 to 20 and 16 818 (10.3%) aged 70 and older were screened contrary to most existing guidelines. Screening rates varied markedly in different geographic regions of the province. Most Pap tests were ordered by family physicians or general practitioners. Within the geographic regions of Alberta, provincial, national, and international guidelines for screening with Pap tests are inconsistently followed. This strongly echoes the need for clinicians and patients to consider the Choosing Wisely Canada recommendations and current guidelines for cervical cancer screening. Copyright© the College of Family Physicians of Canada.

  4. Clinical and diagnostic methods for evaluation of sharp foreign body syndrome in buffaloes

    Directory of Open Access Journals (Sweden)

    Nasr-Eldin M. Aref

    2013-06-01

    Full Text Available Aim: The present study was designed to evaluate clinically and under laboratory condition the sharp foreign body syndrome (SFBS in buffaloes with special emphasis on the diagnostic value of radiography, ultrasonography and blood gases and acidbase balance. Materials and Methods: 196 buffaloes with a history of anorexia, reduction of milk production and no response to previous medical treatment were included in the present study. These animals were subjected to clinical and radiographical examinations. Positive cases for SFBS were further evaluated by sonography, hemato-biochemical and blood gas and acid base balance analysis.Results: Out of 196 admitted cases, 49 (25% cases were confirmed as SFBS by clinical and radiographical examination. Positive cases were subsequently divided into two main categories (complicated and non complicated according to radiographical and sonographical findings. SFBS with no complication was diagnosed in 16 cases while 33 cases showed various degrees of complication including reticular adhesion (abdominal and diaphragmatic, n= 23, diaphragmatic hernia (n = 6 and traumatic pericarditis (n = 4. Leukocytosis, hyperprotenemia and increased activity of AST and ALT were of additional values in the diagnosis of SFBS. A consistent finding of primary metabolic alkalosis was recorded in all cases except one with advanced traumatic pericarditis that showed metabolic acidosis. Conclusion: While there is no substitution for clinical examination, using of ultrasonography and radiography simultaneously are essential for proper evaluation and differentiation between various sequelae of SFBS in buffaloes. Radiography is an efficient tool for visualization of metallic foreign body while ultrasonography is an excellent device in assessing fibrinous deposits. Hemato-biochemical and blood gases and acid base balance are of additional values in discriminating between various outcomes of SFBS.

  5. Evaluation of Presumably Disease Causing SCN1A Variants in a Cohort of Common Epilepsy Syndromes.

    Science.gov (United States)

    Lal, Dennis; Reinthaler, Eva M; Dejanovic, Borislav; May, Patrick; Thiele, Holger; Lehesjoki, Anna-Elina; Schwarz, Günter; Riesch, Erik; Ikram, M Arfan; van Duijn, Cornelia M; Uitterlinden, Andre G; Hofman, Albert; Steinböck, Hannelore; Gruber-Sedlmayr, Ursula; Neophytou, Birgit; Zara, Federico; Hahn, Andreas; Gormley, Padhraig; Becker, Felicitas; Weber, Yvonne G; Cilio, Maria Roberta; Kunz, Wolfram S; Krause, Roland; Zimprich, Fritz; Lemke, Johannes R; Nürnberg, Peter; Sander, Thomas; Lerche, Holger; Neubauer, Bernd A

    2016-01-01

    The SCN1A gene, coding for the voltage-gated Na+ channel alpha subunit NaV1.1, is the clinically most relevant epilepsy gene. With the advent of high-throughput next-generation sequencing, clinical laboratories are generating an ever-increasing catalogue of SCN1A variants. Variants are more likely to be classified as pathogenic if they have already been identified previously in a patient with epilepsy. Here, we critically re-evaluate the pathogenicity of this class of variants in a cohort of patients with common epilepsy syndromes and subsequently ask whether a significant fraction of benign variants have been misclassified as pathogenic. We screened a discovery cohort of 448 patients with a broad range of common genetic epilepsies and 734 controls for previously reported SCN1A mutations that were assumed to be disease causing. We re-evaluated the evidence for pathogenicity of the identified variants using in silico predictions, segregation, original reports, available functional data and assessment of allele frequencies in healthy individuals as well as in a follow up cohort of 777 patients. We identified 8 known missense mutations, previously reported as pathogenic, in a total of 17 unrelated epilepsy patients (17/448; 3.80%). Our re-evaluation indicates that 7 out of these 8 variants (p.R27T; p.R28C; p.R542Q; p.R604H; p.T1250M; p.E1308D; p.R1928G; NP_001159435.1) are not pathogenic. Only the p.T1174S mutation may be considered as a genetic risk factor for epilepsy of small effect size based on the enrichment in patients (P = 6.60 x 10-4; OR = 0.32, fishers exact test), previous functional studies but incomplete penetrance. Thus, incorporation of previous studies in genetic counseling of SCN1A sequencing results is challenging and may produce incorrect conclusions.

  6. Fragile X syndrome: panoramic radiographic evaluation of dental anomalies, dental mineralization stage, and mandibular angle

    Directory of Open Access Journals (Sweden)

    Aida Sabbagh-Haddad

    Full Text Available ABSTRACT Fragile X syndrome (FXS is a disorder linked to the chromosome X long arm (Xq27.3, which is identified by a constriction named fragile site. It determines various changes, such as behavioral or emotional problems, learning difficulties, and intellectual disabilities. Craniofacial abnormalities such as elongated and narrow face, prominent forehead, broad nose, large and prominent ear pavilions, strabismus, and myopia are frequent characteristics. Regarding the oral aspects, deep and high-arched palate, mandibular prognathism, and malocclusion are also observed. Objective: The purpose of this study was to evaluate the dental radiographic characteristics as described in 40 records of patients with panoramic radiography. Material and Methods: The patients were in the range of 6–17 years old, and were divided into two groups (20 subjects who were compatible with the normality standard and 20 individuals diagnosed with the FXS, which were matched for gender and age. Analysis of the panoramic radiographic examination involved the evaluation of dental mineralization stage, mandibular angle size, and presence of dental anomalies in both deciduous and permanent dentitions. Results: The results of radiographic evaluation demonstrated that the chronology of tooth eruption of all third and second lower molars is anticipated in individuals with FXS (p<0.05. In this group, supernumerary deciduous teeth (2.83%, giroversion of permanent teeth (2.31%, and partial anodontia (1.82% were the most frequent dental anomalies. In addition, an increase was observed in the mandibular angle size in the FXS group (p<0.05. Conclusion: We conclude that knowledge of dental radiographic changes is of great importance for dental surgeons to plan the treatment of these individuals.

  7. Renal function evaluation in an adult female with cat-eye syndrome.

    Science.gov (United States)

    Bellinghieri, G; Triolo, O; Stella, N C; Gemelli, M; Musolino, R; Monardo, P; Savica, V

    1994-01-01

    Cat-eye syndrome is a rare congenital anomaly involving the kidney. It is rarely reported in literature, while renal function has never been studied up to now. Shown here are the morphofunctional renal alterations observed in a female patient affected by cat-eye syndrome.

  8. Diagnostic Strategies for Early Lynch Syndrome Detection: From Molecular Testing to Economic Evaluation

    NARCIS (Netherlands)

    C.H.M. Leenen (Celine)

    2015-01-01

    markdownabstract__Abstract__ Lynch syndrome (LS) is an autosomal dominant inherited syndrome that predisposes to multiple malignancies, in particular colorectal cancer (CRC) and endometrial cancer (EC). The lifetime risk of developing CRC for a LS mutation carrier is 25 to 70%, while women

  9. EVALUATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS WITH OBSTRUCTIVE SLEEP APNOEA - OVERLAP SYNDROME

    Directory of Open Access Journals (Sweden)

    Vaddadi Sailendra

    2016-09-01

    Full Text Available BACKGROUND The drop in oxygen saturation during sleep is more than during exercise and patients of COPD who spend more time in sleeping. Significant sleep desaturation and the sleep disturbances are greater in overlap syndrome than in OSA alone. The present study is conducted in Gayathri Vidya Parishad Institute of Healthcare and Medical Technology, Visakhapatnam, AP, India, to find the prevalence of obstructive sleep apnoea in the patients with COPD. AIMS The present study was a cross-sectional study prospectively carried out with an aim to evaluate the breathing disorders during sleep in patients with COPD and to correlate these disorders with the stage of the disease. SETTINGS AND DESIGN The study Cohort was constituted by patients of COPD registered into Chest OPD or admitted in Indoor units of Gayathri Vidya Parishad Institute of Healthcare and Medical Technology, Visakhapatnam, AP, India, from July 2014 to May 2016. A total of thirty six consecutive COPD patients who consented to be enrolled into the study were classified into Mild, Moderate and Severe stages based on the Indian Guidelines for the management of COPD. METHODS AND MATERIAL Spirometric evaluation and bronchial reversibility testing was conducted in all the patients. Arterial Blood Gas Analysis was done using ABL3 arterial blood gas analyser (Radiometer, Copenhagen. POLYSOMNOGRAPHY Patients were hooked to Compumedics ProFusion Polysomnographic Machine (Compumedics Private Limited 2001, USA, by standard gold cups/electrodes. Thereafter, the patients were subjected to a full night sleep study (Overnight polysomnography. The electrode and sensor connection system utilises E-series EEG/PSG system in order to record the PSG study. The impedance of electrodes was checked and set to <10. A total of 20 leads were utilised for the study. The various parameters monitored included Electroencephalogram (EEG, Electro-oculogram (EOG, Electrocardiogram (ECG, chin and leg Electromyogram (EMG

  10. Low complexity symbol-wise beamforming for MIMO-OFDM systems

    KAUST Repository

    Lee, Hyun Ho

    2011-12-01

    In this paper, we consider a low complexity symbol-wise beamforming for MIMO-OFDM systems. We propose a non-iterative algorithm for the symbol-wise beamforming, which can provide the performance approaching that of the conventional symbol-wise beamforming based on the iterative algorithm. We demonstrate that our proposed scheme can reduce the computational complexity significantly. From our simulation results, it is evident that our proposed scheme leads to a negligible performance loss compared to the conventional symbol-wise beamforming regardless of spatial correlation or presence of co-channel interference. © 2011 IEEE.

  11. Comparison of high resolution chromosome banding and fluorescence in situ hybridization (FISH) for the laboratory evaluation of Prader-Willi syndrome and Angelman syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Delach, J.A.; Rosengren, S.S.; Kaplan, L.; Greenstein, R.M.; Cassidy, S.B.; Benn, P.A.

    1994-08-01

    The development of probes containing segments of DNA from chromosome region 15q11-q13 provides the opportunity to confirm the diagnosis of Prader-Willi syndrome (PWS) and Angelman syndrome (AS) by fluorescence in situ hybridization (FISH). We have evaluated FISH studies and high resolution chromosome banding studies in 14 patients referred to confirm or rule out AS. In four patients (three from the PWS category and 1 from the AS group) chromosome analysis suggested that a deletion was present but FISH failed to confirm the finding. In one AS group patient, FISH identified a deletion not detectable by high resolution banding. Review of the clinical findings in the discrepant cases suggested that FISH results were correct and high resolution findings were erroneous. Studies with a chromosome 15 alpha satellite probe (D15Z) on both normal and abnormal individuals suggested that incorrect interpretation of chromosome banding may occasionally be attributable to alpha satellite polymorphism but other variation of 15q11-q13 chromosome bands also contributes to misinterpretation. We conclude that patients who have been reported to have a cytogenetic deletion of 15q11-q13 and who have clinical findings inconsistent with PWS and AS should be re-evaluated by molecular genetic techniques. 31 refs., 3 figs., 2 tabs.

  12. The role of transcranial magnetic stimulation in evaluation of motor cortex excitability in Rett syndrome.

    Science.gov (United States)

    Krajnc, Natalija; Zidar, Janez

    2016-07-01

    Rett syndrome (RTT) is a frequent neurodevelopmental disorder confirmed by clinical criteria and supported by the methyl-CpG-binding protein 2 gene (MECP2) mutation. A short central motor conduction time (CMCT) was reported in transcranial magnetic stimulation (TMS) studies performed in RTT. This was attributed to hyperexcitability of the motor cortex and/or spinal motor neurons, but was not studied further. We performed TMS in RTT to evaluate motor cortex excitability by determining the cortical motor threshold (CMT) and motor cortex inhibition by the cortical silent period (CSP) besides measuring CMCT. Single-pulse TMS was performed in 17 Rett patients, diagnosed by clinical criteria and MECP2 mutation testing, and the same number of healthy controls. The outcome measures were compared between RTT groups with different antiepileptic drugs (AED) and those with and without the MECP2 mutation. CMCT was shorter, but we found elevated CMT and shorter CSP, which suggests decreased excitatory and inhibitory motor cortical function. The outcome was independent of AED and the presence or absence of the MECP2 mutation. Decreased excitatory and inhibitory motor cortical function could explain the short CMCT, with higher stimulus intensities needed to excite pyramidal neurons. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  13. A quantitative evaluation of erythropoiesis in myelodysplastic syndromes using multiparameter flow cytometry

    DEFF Research Database (Denmark)

    Jensen, I M; Hokland, M; Hokland, P

    1993-01-01

    By staining human bone marrow cells with a monoclonal antibody reacting with erythroid precursor cells (AS-E1) and propidium iodide, we have evaluated the proliferative capacity of erythropoiesis in patients with myelodysplastic syndromes (MDS) using flow cytometry. Comparing 36 patients (13 RA....../RAS, 13 RAEB, 10 RAEB-t) with 7 normal controls, significant differences in both the percentage of AS-E1+ cells and the fraction of AS-E1+ cells in the S or S-G2M-phase between the four groups were found. Since neither the percentage of AS-E1+ cells nor their fraction in S or S-G2M alone was found...... to characterize their proliferative activity, we introduced the proliferative fractions of the erythroid cell, i.e. the number of the AS-E1+ cells in S or S-G2M related to all bone marrow cells in S or S-G2M. Applying these parameters, we found significantly increased proliferative AS-E1 fractions in the RA...

  14. Clumsiness in fine motor tasks: evidence from the quantitative drawing evaluation of children with Down Syndrome.

    Science.gov (United States)

    Vimercati, S L; Galli, M; Stella, G; Caiazzo, G; Ancillao, A; Albertini, G

    2015-03-01

    Drawing tests are commonly used for the clinical evaluation of cognitive capabilities in children with learning disabilities. We analysed quantitatively the drawings of children with Down Syndrome (DS) and of healthy, mental age-matched controls to characterise the features of fine motor skills in DS during a drawing task, with particular attention to clumsiness, a well-known feature of DS gross movements. Twenty-three children with DS and 13 controls hand-copied the figures of a circle, a cross and a square on a sheet. An optoelectronic system allowed the acquisition of the three-dimensional track of the drawing. The participants' posture and upper limb movements were analysed as well. Results showed that the participants with DS tended to draw faster but with less accuracy than controls. While clumsiness in gross movements manifests mainly as slow, less efficient movements, it manifests as high velocity and inaccurate movements in fine motor tasks such as drawing. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  15. Evaluation of protective effect of Aegle marmelos Corr. in an animal model of chronic fatigue syndrome.

    Science.gov (United States)

    Lalremruta, Vanphawng; Prasanna, Gurunath S

    2012-05-01

    To evaluate ethanolic extract of leaves of Aegle marmelos in an experimental animal model of chronic fatigue syndrome for potential therapeutic benefit. Age/weight-matched female Wistar albino rats were grouped into five groups. (Group I- V) (n = 8). Group I served as naïve control and II served as stress control. Except for group I animals, other group animals were subjected to forced swimming every day for 15 minutes to induce a state of chronic fatigue and simultaneously treated with ethanolic extract of Aegle marmelos (EEAM) 150 and 250 mg/kg b.w. and Imipramine (20 mg.kg b.w.), respectively. Duration of immobility, anxiety level and locomotor activity were assessed on day 1, 7, 14 and 21 followed by biochemical estimation of oxidative biomarkers at the end of the study. Treatment with EEAM (150 and 250 mg/kg b.w.) resulted in a statistically significant and dose dependent reduction (P immobility, reduction in anxiety and increase in locomotor activity. Dose dependent and significant reduction in LPO level and increase in CAT and SOD was observed in extract treated animals. The results are suggestive of potential protective effect of A. marmelos against experimentally induced CFS.

  16. Development of a clinical tool and patient questionnaire for evaluation of patellofemoral pain syndrome patients.

    Science.gov (United States)

    Harrison, E; Magee, D; Quinney, H

    1996-07-01

    To develop an evaluation tool for patellofemoral pain syndrome (PFPS) patients. Exploratory, descriptive content validation study. Convenience sample, three groups of clinicians: 15 sports physical therapists, 9 sports medicine physicians, and 10 physical therapists and physicians with limited experience with PFPS. Selection based on specialization qualifications and experience with PFPS patients. DESCRIPTION OF TESTS: Content validation questionnaire to determine importance of clinical outcomes in determining change in PFPS patients. Using 10-cm visual analogue scales, reviewers rated the importance of five domains and rated the importance of twenty-one clinical tests; using a categorical scale, determined appropriateness and clarity of potential patient questionnaire items. Correlation values indicated significant correlation (p limitations (r = 0.068) and activity and functional limitations (r = 0.67), indicating that functional limitation may not be a unique component, but is integrated with pain and activity. A set of five pain questions, twelve function questions and six activity questions was developed. No statistical differences (p report questionnaire items and clinical tests.

  17. Anthropometric and intellectual evaluation of individuals with Prader-Willi syndrome.

    Science.gov (United States)

    Shu, San-Ging; Chien, Shu; Wu, Yen-Ching; Tsai, Pei-Ling; Yih, Joung-Kun

    2007-06-01

    Prader-Willi syndrome (PWS) is a rare, multifaceted genetic disorder resulting from the absence of normally active paternally expressed genes from the 15q11-q13 chromosome region. Due to a lack of anthropometric and intellectual data in Taiwan, we attempted these evaluations. Twenty patients (14 males/6 females) aged 7-23 years with molecularly confirmed PWS were enrolled with parental consent. Their mean height standard deviation score (SDS) was -1.26 +/- 1.89 (from -4.3 to +2.16); mean weight SDS was +1.77 +/- 2.00 (from -0.44 to +5.89); mean body mass index SDS was +3.84 +/- 10.54 (from -0.08 to +10.48); and mean body fat tissue SDS was 39.4 +/- 10.54% (14.7-57.8%) by an InBody 3.0 analyzer. All were hypogonadal. Nine of them had once been given growth hormone therapy, and were taller and slimmer than the rest. Their intelligence tests showed full intelligence quotient = 52.0 +/- 7.6; verbal intelligence quotient = 55.9 +/- 8.77; performance intelligence quotient = 53.2 +/- 9.0. Chronic health status revealed that diabetes was prevalent among the older population. Their IQ was in the range of those with moderate retardation.

  18. Anthropometric and Intellectual Evaluation of Individuals with Prader-Willi Syndrome

    Directory of Open Access Journals (Sweden)

    San-Ging Shu

    2007-01-01

    Full Text Available Prader-Willi syndrome (PWS is a rare, multifaceted genetic disorder resulting from the absence of normally active paternally expressed genes from the 15q11-q13 chromosome region. Due to a lack of anthropometric and intellectual data in Taiwan, we attempted these evaluations. Twenty patients (14 males/6 females aged 7–23 years with molecularly confirmed PWS were enrolled with parental consent. Their mean height standard deviation score (SDS was −1.26 ± 1.89 (from −4.3 to +2.16; mean weight SDS was +1.77 ± 2.00 (from −0.44 to +5.89; mean body mass index SDS was +3.84 ± 10.54 (from −0.08 to +10.48; and mean body fat tissue SDS was 39.4 ± 10.54% (14.7-57.8% by an InBody 3.0 analyzer. All were hypogonadal. Nine of them had once been given growth hormone therapy, and were taller and slimmer than the rest. Their in telligence tests showed full intelligence quotient = 52.0 ± 7.6; verbal intelligence quotient = 55.9 ± 8.77; performance intelligence quotient = 53.2 ± 9.0. Chronic health status revealed that diabetes was prevalent among the older population. Their IQ was in the range of those with moderate retardation.

  19. Evaluating compliance to a low glycaemic index (GI) diet in women with polycystic ovary syndrome (PCOS).

    Science.gov (United States)

    Egan, Nicola; Read, Anna; Riley, Paddy; Atiomo, William

    2011-03-08

    A low Glycaemic Index (GI) diet may decrease some long-term health risks in Polycystic Ovary Syndrome (PCOS) such as endometrial cancer. This study was performed to assess compliance to a low GI diet in women with PCOS. Food diaries prospectively collected over 6 months from women on a low GI diet or healthy eating diet were analysed retrospectively. The women were recruited for a pilot randomised control trial investigating whether a low GI diet decreased the risk of Endometrial Cancer. Nine women with PCOS completed 33 food diaries (17 from women on a low GI diet and 16 from women on a healthy eating diet) recording 3023 food items (low GI group:n = 1457; healthy eating group:n = 1566). Data was analysed using Foster-Powell international values inserted into an SPSS database as no scientifically valid established nutrition software was found. The main outcome measures were mean item GI and Glyacemic Load (GL), mean meal GL, percentage high GI foods and mean weight loss. Women allocated the low GI diet had a statistically significant lower GI of food items (33.67 vs 36.91, p PCOS on a low GI diet consumed food items with a significantly lower mean GI and GL compared to the healthy eating diet group. Longer term compliance needs evaluation in subsequent studies to ascertain that this translates to reduced long term health risks. ISRCTN: ISRCTN86420258.

  20. Evaluating compliance to a low glycaemic index (GI diet in women with polycystic ovary syndrome (PCOS

    Directory of Open Access Journals (Sweden)

    Atiomo William

    2011-03-01

    Full Text Available Abstract Background A low Glycaemic Index (GI diet may decrease some long-term health risks in Polycystic Ovary Syndrome (PCOS such as endometrial cancer. This study was performed to assess compliance to a low GI diet in women with PCOS. Food diaries prospectively collected over 6 months from women on a low GI diet or healthy eating diet were analysed retrospectively. The women were recruited for a pilot randomised control trial investigating whether a low GI diet decreased the risk of Endometrial Cancer. Nine women with PCOS completed 33 food diaries (17 from women on a low GI diet and 16 from women on a healthy eating diet recording 3023 food items (low GI group:n = 1457; healthy eating group:n = 1566. Data was analysed using Foster-Powell international values inserted into an SPSS database as no scientifically valid established nutrition software was found. The main outcome measures were mean item GI and Glyacemic Load (GL, mean meal GL, percentage high GI foods and mean weight loss. Findings Women allocated the low GI diet had a statistically significant lower GI of food items (33.67 vs 36.91, p Conclusion Women with PCOS on a low GI diet consumed food items with a significantly lower mean GI and GL compared to the healthy eating diet group. Longer term compliance needs evaluation in subsequent studies to ascertain that this translates to reduced long term health risks. Trial Registration ISRCTN: ISRCTN86420258

  1. Evaluation of laser therapy and routine treatment modalities in the management of myofascial pain dysfunction syndrome

    Directory of Open Access Journals (Sweden)

    Smriti B Jagdhari

    2015-01-01

    Full Text Available Objective: To evaluate the efficacy of laser as a monotherapy and in combination with exercise therapy in comparison to only exercise in the treatment of Myofascial Pain Dysfunction Syndrome (MPDS or Temporomandibular Myofascial Pain. Materials and Methods: A total of 60 patients with MPDS were included in the study and were randomly divided into three groups: exercise, laser, and the combination of both (exercise and laser. Results: Significant reduction in pain at rest and pain on movement was observed with all three types of treatment modalities. Pain reduction was more in those patients who received combination of exercise and laser therapy. Similarly, decrease in the muscle tenderness was more when combination of exercise and laser therapy was used. Conclusion: The ideal therapy should be fast, cheap, and have a long-term effect. Laser (Helium Neon as monotherapy or in combination with exercise had shown promising results and can be used as an effective treatment modality for the treatment of MPDS.

  2. Evaluation of anterior segment parameters in patients with pseudoexfoliation syndrome using Scheimpflug imaging

    Directory of Open Access Journals (Sweden)

    Alime Gunes

    2016-06-01

    Full Text Available ABSTRACT Purpose: To evaluate anterior segment parameters in patients with pseudoexfoliation syndrome (PXS using Scheimpflug imaging. Methods: Forty-three PXS patients and 43 healthy control subjects were included in this cross-sectional study. All participants underwent a detailed ophthalmologic examination. Anterior segment parameters were measured using a Scheimpflug system. Results: Considering the PXS and control groups, the mean corneal thicknesses at the apex point (536 ± 31 and 560 ± 31 µm, respectively, p=0.001, at the center of the pupil (534 ± 31 and 558 ± 33 µm, respectively, p=0.001, and at the thinnest point (528 ± 30 and 546 ± 27 µm, respectively, p=0.005 were significantly thinner in PXS patients. Visual acuity was significantly lower (0.52 ± 0.37 versus 0.88 ± 0.23, p<0.001 and axial length was significantly longer (23.9 ± 0.70 mm versus 23.2 ± 0.90 mm, p=0.001 in the PXS eyes than in the control eyes. There were no statistically significant differences in the mean values of keratometry, anterior chamber angle, anterior chamber depth, corneal volume, and anterior chamber volume between the PXS and control eyes. Conclusions: The patients with PXS had thinner corneas, worse visual acuity, and longer axial length compared with those in the healthy controls.

  3. Small Decline In Low-Value Back Imaging Associated With The 'Choosing Wisely' Campaign, 2012-14.

    Science.gov (United States)

    Hong, Arthur S; Ross-Degnan, Dennis; Zhang, Fang; Wharam, J Frank

    2017-04-01

    Choosing Wisely was launched by the American Board of Internal Medicine in April 2012 as a patient- and clinician-targeted campaign to reduce potentially unnecessary "low-value" medical services. The campaign's impact on low- and high-value care beyond its first year is unknown; furthermore, it is unknown whether some patients such as members of consumer-directed health plans and people residing in different US regions have responded more than others. To evaluate the impact of Choosing Wisely, we used commercial insurance claims to track changes in the use of low-value imaging (x-ray, computed tomography, and magnetic resonance imaging) for back pain before and after the campaign began, a period running from 2010 to 2014. We selected back pain imaging because it is a prominent target of Choosing Wisely, which considers it low value except in a minority of cases, because of its relatively high out-of-pocket expense, and the large volume of low back pain visits nationally. We found only a 4 percent relative reduction in low-value back imaging 2.5 years after the start of the campaign and some differences in regional trends, but no differences associated with enrollment in consumer-directed health plans. Our findings highlight the ongoing challenge of reducing unnecessary medical care, even when patients have "skin in the game" under consumer-directed health plans. Project HOPE—The People-to-People Health Foundation, Inc.

  4. A 3D Two-node and One-node HCMFD Algorithm for Pin-wise Reactor Analysis

    International Nuclear Information System (INIS)

    Kim, Jaeha; Kim, Yonghee

    2016-01-01

    To maximize the parallel computational efficiency, an iterative local-global strategy is adopted in the HCMFD algorithm. The global eigenvalue problem is solved by one-node CMFD, and the local fixed-source problems are solved by two-node CMFD based on the pin-wise nodal solutions. In such local-global scheme, the computational cost is mostly concentrated in solving the local problems while they can be solved in parallel so that a parallel computing can effectively be applied. Previously, the feasibility of the HCMFD algorithm was evaluated only in a 2-D scheme. In this paper, the 3D HCMFD algorithm with some possible variations in treating the axial direction is introduced. The HCMFD algorithm was successfully extended to a 3-D core analysis without any numerical instability even though the axial mesh size in local problems is quite different from the x-y node size. We have shown that 3D pin-wise core analysis can be done very effectively with the HCMFD framework. Additionally, it was demonstrated that parallel efficiency of the new 3D HCMFD scheme can be quite high on a simple OpenMP parallel architecture. It is concluded that the 3D HCMFD will enable an efficient pin-wise 3D core analysis

  5. Evaluation of oral sugar test response for detection of equine metabolic syndrome in obese Crioulo horses.

    Science.gov (United States)

    Cantarelli, C; Dau, S L; Stefanello, S; Azevedo, M S; De Bastiani, G R; Palma, H E; Brass, K E; De La Côrte, F D

    2018-04-01

    Owing to the high prevalence of obesity in Crioulo horses, information allowing early diagnosis of equine metabolic syndrome (EMS) and prevention of the associated laminitis is of great value. The aim of this study was to evaluate the occurrence of EMS and the response to an oral sugar test (OST) in obese Crioulo horses. Twenty-two Crioulo horses were allocated into 3 groups according to their body condition score (BCS out of 9) and presence or absence of laminitis as follows: CON (6/22), BCS laminitis. A complete clinical history was obtained, followed by a physical examination, morphometric measurements, radiographic evaluation of front feet, and ultrasonography measurements of subcutaneous body fat. For the OST, animals were fasted overnight, and blood samples were collected for glucose and insulin concentration before and after sugar administration. Morphometric and metabolic differences (P < 0.05) were observed between CON animals and obese ones, with horses from the LAM group presenting the highest morphometric measurements and insulin plasma concentrations. A delayed peak glucose response for OST was observed in the majority of obese animals, indicating that sampling between 60 and 90 min after sugar administration without glycemic curve follow-up, as previously used for hyperinsulinism detection, can be inadequate. The observed delay in the return to glucose baseline levels, combined with high insulin levels, supports the diagnosis of insulin dysregulation. These results indicate that there are clear obesity-related differences in the glucose and insulin responses of Crioulo horses to an OST. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Evaluation of oral iron treatment in pediatric restless legs syndrome (RLS).

    Science.gov (United States)

    Mohri, Ikuko; Kato-Nishimura, Kumi; Kagitani-Shimono, Kuriko; Kimura-Ohba, Shihoko; Ozono, Keiichi; Tachibana, Naoko; Taniike, Masako

    2012-04-01

    We conducted a retrospective chart review of children with restless legs syndrome (RLS) to evaluate the efficacy of oral iron treatment, which was administered open-label during the course of clinical care. In addition, we provided detailed clinical information about RLS in this pediatric cohort. The study included 30 consecutive Japanese children with RLS who visited the Pediatric Sleep Clinic at Osaka University Hospital, and consisted of 17 boys and 13 girls, aged 2-14 years (mean ± SD, 6.5 ± 2.8). All-night polysomnography was performed in 18 patients and serum ferritin levels were measured in all the patients. After the diagnosis of RLS, iron was administered at doses between 1.6 and 7.8 mg/kg/day (3.2 ± 1.3). Serum ferritin was re-evaluated 3-6 months after iron treatment, or when RLS symptoms had disappeared. The patient age at onset of RLS symptoms ranged from six months to 13 years (4.3 ± 3.6). A positive family history was recognized in 19 children (63.3%). Serum ferritin levels before therapy were 9-62 ng/ml (26.6 ± 12.8) and oral iron supplementation was reported to be highly effective in 17 children, effective in 10, and ineffective in three. The serum ferritin level at follow-up was 23-182 ng/ml (83.5 ± 49.8). The onset of treatment effect was within approximately three months. Iron treatment could be effective in Japanese pediatric RLS. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. Neural correlates of taste and pleasantness evaluation in the metabolic syndrome.

    Science.gov (United States)

    Green, Erin; Jacobson, Aaron; Haase, Lori; Murphy, Claire

    2015-09-16

    Metabolic syndrome (MetS) is a constellation of cardiometabolic abnormalities that commonly occur together and increase risk for cardiovascular disease and type II diabetes. Having MetS, especially during middle-age, increases the risk for dementia in later life. Abdominal obesity is a central feature of MetS; therefore, increased efforts to prevent obesity and identify predictors of weight gain are of extreme importance. Altered processing of food reward in the brain of obese individuals has been suggested to be a possible mechanism related to overeating. We scanned fifteen healthy middle-aged controls (aged 44-54) and sixteen middle-aged adults with MetS after a fast (hungry) and after a preload (sated), while they rated the pleasantness of sucrose (sweet) and caffeine (bitter) solutions. Data were analyzed using voxelwise linear mixed-effects modeling, and a region of interest analysis to examine associations between hypothalamic activation to sweet taste and BMI during hunger and satiety. The results indicate that middle-aged individuals with MetS respond with significantly less brain activation than controls without MetS during pleasantness evaluation of sweet and bitter tastes in regions involved in sensory and higher-level taste processing. Participants with higher BMI had greater hypothalamic response during pleasantness evaluation of sucrose in the sated condition. Importantly, this study is the first to document differential brain circuitry in middle-aged adults with MetS, a population at risk for poor physical and cognitive outcomes. Future research aimed at better understanding relationships among MetS, obesity, and brain function is warranted to better conceptualize and develop interventions for overeating in these disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Evaluation of Meibomian Gland Dysfunction in Polycystic Ovary Syndrome and Obesity.

    Science.gov (United States)

    Baser, Gonen; Yildiz, Nurdan; Calan, Mehmet

    2017-05-01

    Purpose/Aim of the study: The purpose of this study was to evaluate the interaction between Polycystic ovary syndrome (PCOS) and Meibomian gland dysfunction (MGD) and obesity, to reveal whether there is a correlation between the testosterone levels and body-mass index (BMI) levels and the dry-eye complaints of these patients. The study included 92 patients with PCOS and 52 healthy patients from March 2013 to March 2014. All patients underwent a physical examination, pelvic ultrasound, and clinical and biochemical tests, including free testosterone levels to confirm the diagnosis of PCOS. The BMIs of all subjects were recorded. In addition, the presence of posterior blepharitis, as an indicator of MGD, was recorded. All patients underwent the dry-eye tests including Schirmer 1 and tear film break-up time (BUT). Complaints of dry-eye of the patients were evaluated with the ocular surface disease index (OSDI) questionnaire. The scores of both groups were compared. The presence of MGD was 72.82% in the PCOS group and 61.53% in the control group. There was no correlation between the testosterone levels and study parameters in both groups. BUT levels negatively correlated with BMI in subjects without PCOS (r = -0.520, p = 0.001), whereas positively correlated with MGD and OSDI scores (r = 0.610, p = 0.632; p = 0.001, p = 0.001; respectively). Tear film instability due to MGD is common in PCOS and in subjects with high BMI. The MGD in PCOS patients is independent of the BMI.

  9. Acute Transient Vestibular Syndrome: Prevalence of Stroke and Efficacy of Bedside Evaluation.

    Science.gov (United States)

    Choi, Jae-Hwan; Park, Min-Gyu; Choi, Seo Young; Park, Kyung-Pil; Baik, Seung Kug; Kim, Ji-Soo; Choi, Kwang-Dong

    2017-03-01

    The aim of this study was to determine the prevalence of stroke and efficacy of bedside evaluation in diagnosing stroke in acute transient vestibular syndrome (ATVS). We performed a prospective, single-center, observational study that had consecutively recruited 86 patients presenting with ATVS to the emergency department of Pusan National University Yangsan Hospital from January to December 2014. All patients received a constructed evaluation, including HINTS plus (head impulse, nystagmus patterns, test of skew, and finger rubbing) and brain magnetic resonance imagings. Patients without an obvious cause further received perfusion-weighted imaging. Multivariable logistic regression was used to determine clinical parameters to identify stroke in ATVS. The prevalence of stroke was 27% in ATVS. HINTS plus could not be applied to the majority of patients because of the resolution of the vestibular symptoms, and magnetic resonance imagings were falsely negative in 43% of confirmed strokes. Ten patients (12%) showed unilateral cerebellar hypoperfusion on perfusion-weighted imaging without an infarction on diffusion-weighted imaging, and 8 of them had a focal stenosis or hypoplasia of the corresponding vertebral artery. The higher risk of stroke in ATVS was found in association with craniocervical pain (odds ratio, 9.6; 95% confidence interval, 2.0-45.2) and focal neurological symptoms/signs (odds ratio, 15.2; 95% confidence interval, 2.5-93.8). Bedside examination and routine magnetic resonance imagings have a limitation in diagnosing strokes presenting with ATVS, and perfusion imaging may help to identify strokes in ATVS of unknown cause. Associated craniocervical pain and focal neurological symptoms/signs are the useful clues for strokes in ATVS. © 2017 American Heart Association, Inc.

  10. Study of clinical parameters and laboratory evaluation of metabolic syndrome in adolescents

    Directory of Open Access Journals (Sweden)

    Ayesha Imran

    2015-01-01

    Full Text Available Introduction: Worldwide incidence of obesity is rising. Genetic predisposition, urbanization, sedentary lifestyle, television watching, food habits, and lack of exercise are contributing factors. They result in obesity-related morbidity like metabolic syndrome, stroke in young, coronary artery disease, and diabetes. Materials and Methods: A cross-sectional study was undertaken among 1000 adolescents of both genders, aged 12-19 years in three schools of Pimpri, Pune, after obtaining approval from Institutional Ethical Committee. The criterion used to diagnose metabolic syndrome was International Diabetes Federation definition. The Chi-square test was used to explore the association between metabolic syndrome and various predictors. A P value of 0.05 was accepted as the level of statistical significance. Results: In the study sample, the prevalence of metabolic syndrome was 16/1000. Females were more likely to have metabolic syndrome (male:female = 7:9. Factors associated were body mass index (BMI, waist-hip ratio (WHR, birth weight, skin fold thickness, body fat percentage, faulty dietary habits, and sedentary lifestyles (P < 0.05. Among all, the components of metabolic syndrome, raised triglyceride (75%, and fasting blood sugar level (75% were more prevalent than high-density lipoprotein-cholesterol (44% and hypertension (37.5%. Conclusion: Metabolic syndrome was found to be more prevalent in females of age group 16-19 years, among the obese population, associated with birth weight, BMI, and WHR.

  11. Evaluation of obstructive sleep apnea-hypopnea syndrome (OSAHS using measurement instruments such as scales and mathematical formulas

    Directory of Open Access Journals (Sweden)

    Franklin Escobar-Córdoba

    2017-08-01

    Full Text Available The psychometry of obstructive sleep apnea-hypopnea syndrome (OSAHS can be obtained through various methods of evaluation such as clinical interviews, scales, sleep questionnaires, self-reports and psychophysiological records. The gold test for the diagnosis of this disease is still polysomnography, which can be expensive and poses difficulties to access the study. Due to the high morbidity and mortality associated with this syndrome, instruments are needed to allow the rapid identification of individuals who may be at risk. In consequence, different tools have been developed to detect patients at risk, such as the Berlin Questionnaire, the STOP-Bang and the Epworth Sleepiness Scale. Considering the scope and limitations of these tools is important to choose the correct instrument depending on what needs to be evaluated.

  12. On the non-convergence of energy intensities: evidence from a pair-wise econometric approach

    International Nuclear Information System (INIS)

    Le Pen, Yannick; Sevi, Benoit

    2008-01-01

    This paper evaluates convergence of energy intensities for a group of 97 countries in the period 1971-2003. Convergence is tested using a recent method proposed by Pesaran (2007) [M.H. Pesaran. A pair- wise approach to testing for output and growth convergence. Journal of Econometrics 138, 312-355.] based on the stochastic convergence criterion. Main advantages of this method are that results do not depend on a benchmark against which convergence is assessed, and that it is more robust. Applications of several unit-root tests as well as a stationarity test uniformly reject the global convergence hypothesis. Locally, for Middle- East, OECD and Europe sub-groups, non-convergence is less strongly rejected. The introduction of possible structural breaks in the analysis only marginally provides more support to the convergence hypothesis. (authors)

  13. The dipole anisotropy of AllWISE galaxies

    Science.gov (United States)

    Rameez, M.; Mohayaee, R.; Sarkar, S.; Colin, J.

    2018-03-01

    We determine the dipole in the WISE galaxy catalogue. After reducing star contamination to reduces but stabilises at ˜0.012, corresponding to a velocity >1000 km/s if it is solely of kinematic origin. However, previous studies have shown that only ˜70% of the velocity of the Local Group as inferred from the CMB dipole is due to sources at z 240 km/s extending to z > 0.03) that we do. We construct mock catalogues in the neighbourhood of such peculiar observers in order to mimic our final galaxy selection and quantify the residual clustering dipole. After subtracting this the remaining dipole is 0.0048 ± 0.0022, corresponding to a velocity of 420 ± 213 km/s which is consistent with the CMB. However the sources (at z > 0.03) of such a large clustering dipole remain to be identified.

  14. Evaluation du coût médical direct de il prise en charge du syndrome ...

    African Journals Online (AJOL)

    Evaluation du coût médical direct de il prise en charge du syndrome drépanocytaire majeur de l'enfant à Ouagadougou. S.O. Ouédraogo/Yugbaré, J Tiendrébéogo, D Belemsaga, F Koueta, H Savadogo, L Dao, S Kaboret, M Kam, P Ouédraogo, L Kam, D Yé, J Simporé ...

  15. Evaluating the utility of syndromic case management for three sexually transmitted infections in women visiting hospitals in Delhi, India

    OpenAIRE

    Sonkar, Subash Chandra; Wasnik, Kirti; Kumar, Anita; Sharma, Vineeta; Mittal, Pratima; Mishra, Prashant Kumar; Bharadwaj, Mausumi; Saluja, Daman

    2017-01-01

    Utility of syndromic case management (SCM) in women visiting obstetrics & gynecology department needs to be evaluated as it is subjective and imperfect. Consequently, antibiotic resistance has accelerated along with increased risk of infection to the partners. To understand the effectiveness and/or inadequacies of SCM, 11000 women were recruited and examined by clinicians for infection by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Bacterial vaginosis (...

  16. PROTOCOL FOR THE EVALUATION AND FUNCTIONAL RE-EDUCATION OF THE LUMBARSACRAL PAIN SYNDROME WITH A MUSCULAR-LIGAMENT CAUSE

    OpenAIRE

    Călina Mirela-Lucia; Rusu Ligia; Elena Taina Avramescu; Denisa Enescu-Bieru; Eugenia Rosulescu; Dragomir Mihai

    2009-01-01

    The current paper aims to evaluate the lumbar-sacral algo-functional syndromes with a muscular-ligament cause and to establish a staged program for its functional recovery which would also prevent reoccurrences and/ or complications, these being relatively frequent and with important functional implications [1]. These ailments,specific to patients who are at an active age have a particular social impact, important morbidity and can be easily mistaken for more serious lumbar-sacral ailments, t...

  17. Outcome reporting across randomised trials and observational studies evaluating treatments for Twin-Twin Transfusion Syndrome: a systematic review.

    Science.gov (United States)

    Perry, Helen; Duffy, James M N; Umadia, Ogochukwu; Khalil, Asma

    2018-04-01

    Twin-Twin Transfusion syndrome is associated with significant mortality and morbidity. Potential treatments require robust evaluation. The aim of this study was to evaluate outcome reporting across observational studies and randomised controlled trials assessing treatments for twin-twin transfusion syndrome (TTTS). Cochrane Central Register of Controlled Trials, EMBASE and Medline were searched from inception to August 2016. Observational studies and randomised controlled trials reporting outcomes following a treatment for TTTS in monochorionic-diamniotic twin pregnancies and monochorionic-triamniotic or dichorionic-triamniotic triplet pregnancies were included. We systematically extracted and categorised outcome reporting. Six randomised trials and 94 observational studies, reporting data from 20,071 maternal participants and 3,199 children, were included. Six different treatments were evaluated. Included studies reported sixty-two different outcomes, including 10 fetal, 28 neonatal, 6 early childhood and 18 maternal outcomes. The outcomes were inconsistently reported across trials. For example, when considering offspring mortality, 31 studies (31%) reported live birth, 31 studies (31%) reported intrauterine death, 49 studies (49%) reported neonatal mortality, and 17 studies (17%) reported perinatal mortality. Four studies (4%) reported respiratory distress syndrome. Only 19 (19%) of studies were designed for long-term follow-up and 11 of these studies (11%) reported cerebral palsy. Most studies evaluating treatments for TTTS, have often neglected to report clinically important outcomes, especially neonatal morbidity outcomes. Most studies are not designed for long-term follow-up. The development of a core outcome set could help standardised outcome collection and reporting in Twin-Twin Transfusion syndrome studies. This article is protected by copyright. All rights reserved.

  18. Principles for the wise use of computers by children.

    Science.gov (United States)

    Straker, L; Pollock, C; Maslen, B

    2009-11-01

    Computer use by children at home and school is now common in many countries. Child computer exposure varies with the type of computer technology available and the child's age, gender and social group. This paper reviews the current exposure data and the evidence for positive and negative effects of computer use by children. Potential positive effects of computer use by children include enhanced cognitive development and school achievement, reduced barriers to social interaction, enhanced fine motor skills and visual processing and effective rehabilitation. Potential negative effects include threats to child safety, inappropriate content, exposure to violence, bullying, Internet 'addiction', displacement of moderate/vigorous physical activity, exposure to junk food advertising, sleep displacement, vision problems and musculoskeletal problems. The case for child specific evidence-based guidelines for wise use of computers is presented based on children using computers differently to adults, being physically, cognitively and socially different to adults, being in a state of change and development and the potential to impact on later adult risk. Progress towards child-specific guidelines is reported. Finally, a set of guideline principles is presented as the basis for more detailed guidelines on the physical, cognitive and social impact of computer use by children. The principles cover computer literacy, technology safety, child safety and privacy and appropriate social, cognitive and physical development. The majority of children in affluent communities now have substantial exposure to computers. This is likely to have significant effects on child physical, cognitive and social development. Ergonomics can provide and promote guidelines for wise use of computers by children and by doing so promote the positive effects and reduce the negative effects of computer-child, and subsequent computer-adult, interaction.

  19. Investment in Watershed Services projects: the ClimateWIse project

    Science.gov (United States)

    Brauman, K. A.; Ponette-González, A.; Bremer, L.; Hamel, P.; Floerke, M.; Rocha, H.; Schneider, C.

    2016-12-01

    Millions of people depend on water supplied from páramo grasslands and Andean and Atlantic forests in montane tropical South America. It is thus critical to ensure clean, secure water through climate-resilient source water protection. Through a multidisciplinary, multi-institutional, and multi-country (U.S., Germany, Brazil) partnership, our newly funded project `ClimateWIse' will collaborate with a network of Investment in Watershed Services (IWS) projects to assess the effects of land use and climate change on water resources in this region. In IWS projects, downstream water users support upstream land stewards in undertaking source watershed protection activities. These projects are often sited at high-elevations in data-poor regions, and there is little evidence of their immediate or long-term impact on water quantity or quality. In recent years, many IWS projects have initiated formal monitoring programs. One key goal of ClimateWIse is to compile and analyze this IWS monitoring data, focusing on three sites in Brazil and three in Peru, Ecuador, and Colombia. Using preliminary data from three IWS programs in Brazil - Extrema, Camboriu, and Guandu - we demonstrate how the monitoring design of IWS programs can be combined with regional-scale weather and land use data to quantify land-use change and climate change impacts on water resources in this region. The challenges of ongoing data cleaning and assimilation will be discussed, as will the challenges of comparing data from programs where different types of monitoring programs have been implemented.

  20. Measuring global oil trade dependencies: An application of the point-wise mutual information method

    International Nuclear Information System (INIS)

    Kharrazi, Ali; Fath, Brian D.

    2016-01-01

    Oil trade is one of the most vital networks in the global economy. In this paper, we analyze the 1998–2012 oil trade networks using the point-wise mutual information (PMI) method and determine the pairwise trade preferences and dependencies. Using examples of the USA's trade partners, this research demonstrates the usefulness of the PMI method as an additional methodological tool to evaluate the outcomes from countries' decisions to engage in preferred trading partners. A positive PMI value indicates trade preference where trade is larger than would be expected. For example, in 2012 the USA imported 2,548.7 kbpd despite an expected 358.5 kbpd of oil from Canada. Conversely, a negative PMI value indicates trade dis-preference where the amount of trade is smaller than what would be expected. For example, the 15-year average of annual PMI between Saudi Arabia and the U.S.A. is −0.130 and between Russia and the USA −1.596. We reflect the three primary reasons of discrepancies between actual and neutral model trade can be related to position, price, and politics. The PMI can quantify the political success or failure of trade preferences and can more accurately account temporal variation of interdependencies. - Highlights: • We analyzed global oil trade networks using the point-wise mutual information method. • We identified position, price, & politics as drivers of oil trade preference. • The PMI method is useful in research on complex trade networks and dependency theory. • A time-series analysis of PMI can track dependencies & evaluate policy decisions.

  1. Evaluating the use of cell phone messaging for community Ebola syndromic surveillance in high risked settings in Southern Sierra Leone.

    Science.gov (United States)

    Jia, Kangbai; Mohamed, Koroma

    2015-09-01

    Most underdeveloped countries do not meet core disease outbreak surveillance because of the lack of human resources, laboratory and infrastructural facilities. The use of cell phone technology for disease outbreak syndromic surveillance is a new phenomenon in Sierra Leone despite its successes in other developing countries like Sri Lanka. In this study we set to evaluate the effectiveness of using cell phone technology for Ebola hemorrhagic fever syndromic surveillance in a high risked community in Sierra Leone. This study evaluated the effectiveness of using cell phone messaging (text and calls) for community Ebola hemorrhagic fever syndromic surveillance in high risked community in southern Sierra Leone. All cell phone syndromic surveillance data used for this study was reported as cell phone alert messages-texts and voice calls; by the Moyamba District Health Management Team for both Ebola hemorrhagic fever suspect and mortalities. We conducted a longitudinal data analysis of the monthly cumulative confirmed Ebola hemorrhagic fever cases and mortalities collected by both the traditional sentinel and community cell phone syndromic surveillance from August 2014 to October 2014. A total of 129 and 49 Ebola hemorrhagic fever suspect and confirmed cases respectively were recorded using the community Ebola syndromic surveillance cell phone alert system by the Moyamba District Health Management Team in October 2014. The average number of Ebola hemorrhagic fever suspects and confirmed cases for October 2014 were 4.16 (Std.dev 3.76) and 1.58 (Std.dev 1.43) respectively. Thirty-four percent (n=76) of the community Ebola syndromic surveillance cell phone alerts that were followed-up within 24 hours reported Ebola hemorrhagic fever suspect cases while 65.92% (n=147) reported mortality. Our study suggests some form of underreporting by the traditional sentinel Ebola hemorrhagic fever disease surveillance system in Moyamba District southern Sierra Leone for August

  2. Evaluation of the scratch collapse test for the diagnosis of carpal tunnel syndrome

    NARCIS (Netherlands)

    Makanji, H. S.; Becker, S. J. E.; Mudgal, C. S.; Jupiter, J. B.; Ring, D.

    2014-01-01

    This prospective study measured and compared the diagnostic performance characteristics of various clinical signs and physical examination manoeuvres for carpal tunnel syndrome (CTS), including the scratch collapse test. Eighty-eight adult patients that were prescribed electrophysiological testing

  3. Current concepts in the pathophysiology, evaluation, and diagnosis of compartment syndrome

    Science.gov (United States)

    Hargens, A. R.; Mubarak, S. J.

    1998-01-01

    This article reviews present knowledge of the pathophysiology and diagnosis of acute compartment syndromes. Recent results using compression of legs in normal volunteers provide objective data concerning local pressure thresholds for neuromuscular dysfunction in the anterior compartment. Results with this model indicate that a progression of neuromuscular deficits occurs when IMP increases to within 35 to 40 mm Hg of diastolic blood pressure. These findings provide useful information on the diagnosis and compression thresholds for acute compartment syndromes. Time factors are also important, however, and usually are incompletely known in most cases of acute compartment syndrome. Although the slit catheter is a very good technique for monitoring IMP during rest, these catheters and their associated extracorporeal transducer systems are not ideal. Recently developed miniature transducer-tipped catheters and, perhaps, future development of noninvasive techniques may provide accurate recordings of IMP in patients with acute compartment syndromes.

  4. Irritable bowel syndrome and other gastrointestinal disorders: evaluating self-medication in an Asian community setting.

    Science.gov (United States)

    Kua, Chong-Han; Ng, Siow-Tian; Lhode, Reshma; Kowalski, Stefan; Gwee, Kok-Ann

    2012-08-01

    Gastrointestinal disorders frequently present symptoms which are often self-treated. To record demographic profile of patients visiting community pharmacies for self-treatment with medications for gastrointestinal disorders, the number of these patients who fulfilled irritable bowel syndrome diagnostic criteria, and to judge the appropriateness of their treatment requests. Singapore community pharmacies. The multicentre study was conducted using ROME III adapted criteria on adults above 18 years who have self-selected medicinal products for treatment of irritable bowel syndrome or gastrointestinal symptoms in the community pharmacy. Among those seeking self-medication, 36.8 % fulfilled criteria for irritable bowel syndrome, with irritable bowel syndrome-mixed (16.3 %) being the most prevalent subtype. For patients not fulfilling criteria for irritable bowel syndrome diagnosis, rates for other functional gastrointestinal disorders were constipation (20.5 %), dyspepsia (16.3 %), gastroesophageal reflux disease (12.1 %), diarrhoea (8.9 %), bloating (4.2 %), and heartburn (3.2 %). There were more females with gastrointestinal complaints. Overall, 21.6 % of the total participants had recently sought medical attention for their gastrointestinal complaint. 20 % of patients selected inappropriate medication for their gastrointestinal complaints, and the antacids class had the highest incidence of inappropriate medication use. Possible co-existing relationships were seen between gastroesophageal reflux disease with dyspepsia, irritable bowel syndrome with gastroesophageal reflux disease, irritable bowel syndrome with dyspepsia, and diarrhoea with constipation. Patients who fulfilled criteria for irritable bowel syndrome had a high tendency to self-treat their gastrointestinal symptoms. Constipation complaints were also common. Around one in five patients self-medicated gastrointestinal symptoms inappropriately, with antacids being the most common.

  5. Evaluation of signalment, clinical, and laboratory variables as prognostic indicators in dogs with acute abdominal syndrome

    OpenAIRE

    SIMEONOVA, Galina; DINEV, Dinko; CHAPRAZOV, Tzvetan; ROYDEV, Rumen

    2013-01-01

    The aim of the study was to identify predictors of mortality and to propose a new severity scoring system in dogs with acute abdominal syndrome. A retrospective study was carried out on 58 dogs presented with acute abdominal syndrome with American Society of Anesthesiologists grades III-IV and treated surgically by exploratory laparotomy. Medical records were reviewed and information regarding dog signalment, history, clinical, and laboratory data; surgical findings; and outcome was collected...

  6. The hematopoietic syndrome induced by an accidental radiation: evaluation and treatments; Le syndrome h atopoietique induit par une irradiation accidentelle: evaluation et traitements possibles

    Energy Technology Data Exchange (ETDEWEB)

    Bertho, J.M. [Institut de Radioprotection et de Surete Nucleaire (IRSN/DRPH/SRBE), Lab. de Therapie Cellulaire et de Radioprotection Accidentelle 92 - Fontenay-aux-Roses (France)

    2006-04-15

    The accidental radiation-induced hematopoietic syndrome remains difficult to treat, mainly due to the heterogeneity of irradiation. As a result, there always remains an area of active hematopoiesis that was partly protected from irradiation. The choice of a therapeutic strategy must be based upon the estimate of radiation damage to the bone marrow. This can be achieved by the use of biological indicators of radiation dose or damage such as the follow up of Flt3 ligand concentration in the blood. The possible therapeutic strategies remain limited, either stem cell transplantation or supportive care. A new approach based upon autologous cell therapy was proposed and the results highlighted new insight about the radiation-induced multiple organ disease syndrome. Other recent results from our lab suggested that among the possible therapeutic strategies, the stimulation of residual hematopoiesis by the mean of cytokines such as G-CSF is one of the most interesting strategies. These new data highlight the notion of residual hematopoiesis but also the fact that regulation mechanisms of residual hematopoiesis are not well understood. (author)

  7. Carpal tunnel syndrome: An evaluation clinical and sociodemographic characteristics of 350 patients

    Directory of Open Access Journals (Sweden)

    Nermin Tanık

    2014-09-01

    Full Text Available Objective: This study aimed to define the sociodemographic and clinical characteristics of patients with carpaltunnel syndrome. Methods: The study comprised 350 patients diagnosed with carpal tunnel syndrome. Exclusion criteria were cervical radiculopathy, brachial plexopathy, thoracic outlet syndrome, polyneuropathy, pregnancy and a history of upper extremity trauma. The sociodemographic characteristics of the patients and the clinical characteristics of the carpal tunnel syndrome were recorded. Results: Of the total 350 patients, 86.2% were female, mean age was 52.5 years, 69.7% were obese, bilateral involvement was determined in 72.9% and the duration of symptoms was 3.0±0.9 years. 98.3% of the patients were married, 79.1% were housewives, 80.6% had a moderate income level, 59.6% were educated to primary school level and the most common ccompanying disease was diabetes at a rate of 26.9%. Conclusion: The study results showed that in Central Anatolia, carpal tunnel syndrome was seen in middleaged, obese, married housewives of moderate income and a low educational level. Generally, there was no accompanying disease, bilateral involvement was high and the disease was determined to have become chronic. With the detailed examination of the ociodemographic data of carpal tunnel syndrome patients, a good definition of a profile specific to this society will contribute to the treatment process.

  8. Evaluation of Presumably Disease Causing SCN1A Variants in a Cohort of Common Epilepsy Syndromes.

    Directory of Open Access Journals (Sweden)

    Dennis Lal

    Full Text Available The SCN1A gene, coding for the voltage-gated Na+ channel alpha subunit NaV1.1, is the clinically most relevant epilepsy gene. With the advent of high-throughput next-generation sequencing, clinical laboratories are generating an ever-increasing catalogue of SCN1A variants. Variants are more likely to be classified as pathogenic if they have already been identified previously in a patient with epilepsy. Here, we critically re-evaluate the pathogenicity of this class of variants in a cohort of patients with common epilepsy syndromes and subsequently ask whether a significant fraction of benign variants have been misclassified as pathogenic.We screened a discovery cohort of 448 patients with a broad range of common genetic epilepsies and 734 controls for previously reported SCN1A mutations that were assumed to be disease causing. We re-evaluated the evidence for pathogenicity of the identified variants using in silico predictions, segregation, original reports, available functional data and assessment of allele frequencies in healthy individuals as well as in a follow up cohort of 777 patients.We identified 8 known missense mutations, previously reported as pathogenic, in a total of 17 unrelated epilepsy patients (17/448; 3.80%. Our re-evaluation indicates that 7 out of these 8 variants (p.R27T; p.R28C; p.R542Q; p.R604H; p.T1250M; p.E1308D; p.R1928G; NP_001159435.1 are not pathogenic. Only the p.T1174S mutation may be considered as a genetic risk factor for epilepsy of small effect size based on the enrichment in patients (P = 6.60 x 10-4; OR = 0.32, fishers exact test, previous functional studies but incomplete penetrance. Thus, incorporation of previous studies in genetic counseling of SCN1A sequencing results is challenging and may produce incorrect conclusions.

  9. A Closer Look at Chinese EFL Learners' Test-Wiseness Strategies in Reading Test

    Science.gov (United States)

    Haiyan, Miao; Rilong, Liu

    2016-01-01

    This paper reports on an investigation into the relationship of test-takers' use of test-wiseness strategies to Chinese EFL learners' reading test performance. A test-wiseness questionnaire was administered immediately after the final achievement test to probe into how learners thought while completing the reading section of the test. It was found…

  10. WISE Science: Web-based Inquiry in the Classroom. Technology, Education--Connections

    Science.gov (United States)

    Slotta, James D.; Linn, Marcia C.

    2009-01-01

    This book shares the lessons learned by a large community of educational researchers and science teachers as they designed, developed, and investigated a new technology-enhanced learning environment known as WISE: The Web-Based Inquiry Science Environment. WISE offers a collection of free, customizable curriculum projects on topics central to the…

  11. Safari 2000 derived soil properties, 0.5-deg (ISRIC-WISE)

    NARCIS (Netherlands)

    Batjes, N.H.

    2014-01-01

    The data set consists of a southern Africa subset of the ISRIC-WISE global data set of derived soil properties. The World Inventory of Soil Emission Potentials (WISE) database currently contains data for over 4300 soil profiles collected mostly between 1950 and 1995. This database has been used to

  12. Stimulation of Work Integration Social Enterprises (WISES) and Combatting Social Exclusion at the Local Level

    NARCIS (Netherlands)

    Boesveldt, N.F.

    2016-01-01

    WISES are social enterprises that work with people marginalized from the regular labour market, including people with severe handicaps, with disabilities and those who suffer addiction and homelessness. WISES offer an alternative to regular social programs: they breach social exclusion and stimulate

  13. ISRIC-WISE - Global Soil Profile Data (ver. 3.1)

    NARCIS (Netherlands)

    Batjes, N.H.

    2009-01-01

    Version 3.1 of the ISRIC-WISE database (WISE3) was compiled from a wide range of soil profile data collected by many soil professionals worldwide. All profiles have been harmonized with respect to the original Legend (1974) and Revised Legend (1988) of FAO-Unesco. Thereby, the primary soil data ─

  14. Fingerponds: seasonal integrated aquaculture in East African freshwater wetlands : exploring their potential for wise use strategies

    NARCIS (Netherlands)

    Kipkemboi, J.

    2006-01-01

    This study was stimulated by the need for an integrated approach in wetland wise use. Sustainable management is critical for long-term ecosystem health and people's livelihoods. The potential for smallholder integrated agriculture-aquaculture as one of the possible wetland wise use strategies was

  15. Evaluation of Tourette's syndrome by 99Tcm-TRODAT-1 SPECT imaging

    International Nuclear Information System (INIS)

    Dong Feng; Liu Hong; Meng Zhaowei; Tan Jian; Zhang Benshu

    2011-01-01

    Objective: To observe dopamine transporter (DAT) binding capacity using 99 Tc m -TRODAT-1 in drug-naive patients with Tourette's syndrome (TS) on SPECT imaging, and explore possible correlations between 99 Tc m -TRODAT-1 uptake ratio and TS patient's age, disease duration, and tic severity. Methods: Eighteen drug-naive TS patients, male 14, female 4, as well as 8 age- and gender-matched healthy subjects were recruited. Brain SPECT imaging was performed 2. 5 h after intravenous injection of 11.1 - 14.8 MBq/kg 99 Tc m -TRODAT-1. ROI was drawn on the striatum including its sub-regions of caudate and putamen, with cerebellum as the background. Striatum/cerebellum ratio was calculated. Comparisons of the ratios between TS patients and controls were carried out by independent-sample t-test. Pearson correlation analysis was performed between DAT uptake ratios of striatum and patients' age, disease duration, tic severity. Results: Compared with the control, higher symmetrically striatum uptake of 99 Tc m -TRODAT-1 in TS patients was observed (2.17±0.23 vs 1.87±0.24, t=2.957, P 0.05)and tic severity(r=0.345, P>0.05) scores were not significantly correlated with specific uptake ratios measured in the striatum. But there was significant negative correlation between disease duration and the specific uptake ratios (r=-0.483, P 99 Tc m -TRODAT-1 SPECT imaging may play an adjuvant role for initial evaluation of untreated TS. (authors)

  16. Evaluation of Women with Myofascial Abdominal Syndrome Based on Traditional Chinese Medicine

    Directory of Open Access Journals (Sweden)

    Andréia Mitidieri

    2015-12-01

    Full Text Available Objectives: This study used semiology based on traditional Chinese medicine (TCM to investigate vital energy (Qi behavior in women with abdominal myofascial pain syndrome (AMPS. Methods: Fifty women diagnosed with chronic pelvic pain (CPP secondary to AMPS were evaluated by using a questionnaire based on the theories of “yin-yang,” “zang-fu”, and “five elements”. We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs; onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine, menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Results: Patients were between 22 and 56 years old, and most were married (78%, possessed a elementary school (66%, and had one or two children (76%. The mean body mass index and body fat were 26.86 kg/ cm2 (range: 17.7 — 39.0 and 32.4% (range: 10.7 — 45.7, respectively. A large majority of women (96% exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. Conclusion: The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the

  17. Do published guidelines for evaluation of Irritable Bowel Syndrome reflect practice?

    Directory of Open Access Journals (Sweden)

    Bertram Susan L

    2001-10-01

    Full Text Available Abstract Background The only US guidelines listed in the National Guideline Warehouse for the diagnosis of Irritable Bowel Syndrome (IBS are the expert opinion guidelines published by The American Gastroenterology Association. Although the listed target audience of these guidelines includes family physicians and general internists, the care recommended in the guidelines has not been compared to actual primary care practice. This study was designed to compare expert opinion guidelines with the actual primary care provided and to assess outcomes in the 3 years following the IBS diagnosis. Methods This is a retrospective medical record review study using a random sample of incident IBS cases from all Olmsted County, Minnesota providers diagnosed between January 1, 1993 and December 31, 1995. Data was collected on all care and testing provided to the subjects as well as 3-year outcomes related to the IBS diagnosis. Results Of the 149 IBS patients, 99 were women and the mean age was 47.6 years. No patient had all of the diagnostic tests recommended in the guidelines. 42% had the basic blood tests of CBC and a chemistry panel. Sedimentation rate (2% and serum thyroxine level (3% were uncommon. Colon imaging studies were done in 41% including 74% of those over the age of 50. In the 3 years following the diagnosis, only one person had a change in diagnosis and no diagnoses of gastro-intestinal malignancies were made in the cohort. Conclusions Primary care practice based diagnostic evaluations for IBS differ significantly from the specialty expert opinion-based guidelines. Implementation of the specialty guidelines in primary care practice would increase utilization with apparent limited improvement in diagnostic outcomes.

  18. Evaluation of Women with Myofascial Abdominal Syndrome Based on Traditional Chinese Medicine.

    Science.gov (United States)

    Mitidieri, Andréia; Gurian, Maria Beatriz; Silva, Ana Paula; Tawasha, Kalil; Poli-Neto, Omero; Nogueira, Antônio; Reis, Francisco; Rosa-E-Silva, Júlio

    2015-12-01

    This study used semiology based on traditional Chinese medicine (TCM) to investigate vital energy (Qi) behavior in women with abdominal myofascial pain syndrome (AMPS). Fifty women diagnosed with chronic pelvic pain (CPP) secondary to AMPS were evaluated by using a questionnaire based on the theories of "yin-yang," "zang-fu", and "five elements". We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs); onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine), menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Patients were between 22 and 56 years old, and most were married (78%), possessed a elementary school (66%), and had one or two children (76%). The mean body mass index and body fat were 26.86 kg/ cm2 (range: 17.7 - 39.0) and 32.4% (range: 10.7 - 45.7), respectively. A large majority of women (96%) exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the pelvic floor and abdominal region.

  19. Evaluation of endoscopic hemostasis in upper gastrointestinal bleeding related to Mallory-Weiss syndrome.

    Science.gov (United States)

    Chung, I K; Kim, E J; Hwang, K Y; Kim, I H; Kim, H S; Park, S H; Lee, M H; Kim, S J

    2002-06-01

    The endoscopic hemostatic method has been introduced as a safe and effective mechanical approach to hemostasis for upper gastrointestinal bleeding related to Mallory-Weiss syndrome (MWS). However, the indications for when to use endoscopic treatment are debatable because many patients need only medical observation. The study was designed to evaluate the necessity and efficacy of endoscopic hemostasis in upper gastrointestinal bleeding related to MWS. From July 1994 to May 2000, we conducted a clinical trial in 76 patients who were found by endoscopy to have active bleeding (I, spurting; II, oozing), protruding visible vessels (III), and/or adherent clots (IV). Two study periods can be differentiated: in the first 3 years endoscopic treatment (n = 30) was prospectively analyzed and in the final 3 years medical treatment (n = 46) was analyzed in both cases to compare the outcome in MWS bleeding II-IV. In the first study period, in addition, endoscopic treatment was randomised to an injection method, using a mixture of hypertonic saline and epinephrine (HSE) (n = 14) and a hemoclipping or band ligation method (n = 16). Rebleeding was observed in four of 14 patients who had received endoscopic hemostasis with HSE injection and one of 46 patients who had been managed with medical treatment. No rebleeding was found following hemoclipping or band ligation. While all rebleeding was in bleeding stigmata of the I (1) and II (4) grades, there was no rebleeding in protruding visible vessels (III) or in adherent clots (IV), regardless of treatment methods. Our results suggested that endoscopic hemostasis is not necessary in patients without active bleeding stigmata, and the mechanical hemostatic method is more effective than HSE injection in patients with active bleeding stigmata.

  20. DASH (disabilities of the arm, shoulder, and hand) evaluation of QOL for carpal tunnel syndrome

    International Nuclear Information System (INIS)

    Morita, Akimasa; Kawamoto, Masataka; Fujisawa, Kouzou; Tsujii, Masaya; Hirata, Hitoshi

    2006-01-01

    The questionnaire on the disabilities of the arm, shoulder, and hand is a region-specific, self-administered outcome instrument that is developed as a measure of self-rate upper extremity disability and symptoms. Last year, the Japanese version of disabilities of the arm, shoulder and hand (DASH) was cross-culturally adapted. The main purpose of this study is to analyze the relationship between DASH and clinical assessment (findings of MRI and electrodiagnostic parameters). The subjects comprised 41 patients (6 males and 35 females) with carpal tunnel syndrome (CTS), except for cases with other upper extremity disorders. These subjects prospectively completed DASH 1 (disability module), DASH 2 (symptom module), and DASH (disability and symptom module) before the release of the open carpal tunnel. The patients were divided into 3 groups based on the symptom duration (A: shorter than 3 months, B: 4-11 months, C: longer than 12 months). All patients were preoperatively assessed with regard to sensory conduction velocity (SCV) and compound muscle action potential (CMAP). In addition, all patients underwent MRI in order to evaluate the flexor tenosynovial swelling represented by palmar bowing of the flexor retinaculum (PBFR). The relationships were estimated using the Spearman rank score, unpaired t tests, and Bonferroni tests. DASH 2 scores indicated greater responsiveness than DASH 1, which reflected the character of CTS. DASH 1 scores were higher in patients who were affected in their dominant hand than in those whose nondominant hand was affected. The DASH scores decreased significantly in groups A and B, with the exception of C. However, DASH did not show any correlation either with the parameters, age, or MRI assessment. DASH can be used for the research of preoperative outcomes related to CTS. It also has the advantage of being useful in assessing and comparing the outcome for various other hand disorders. (author)

  1. Evaluation of QTc in Rett syndrome: Correlation with age, severity, and genotype.

    Science.gov (United States)

    Crosson, Jane; Srivastava, Siddharth; Bibat, Genila M; Gupta, Siddharth; Kantipuly, Aditi; Smith-Hicks, Constance; Myers, Scott M; Sanyal, Abanti; Yenokyan, Gayane; Brenner, Joel; Naidu, Sakkubai R

    2017-06-01

    Rett syndrome (RTT) is caused by MECP2 mutations, resulting in various neurological symptoms. Prolonged corrected QT interval (QTc) is also reported and is a speculated cause of sudden death in RTT. The purpose of this study was to correlate QTc in RTT patients with age, clinical severity, and genotype. 100 RTT patients (98 females, 2 males) with MECP2 mutations underwent baseline neurological evaluation (KKI-RTT Severity Scale) and QTc measurement (standard 12 lead electrocardiogram) as part of our prospective natural history study. Mean QTc of the cohort was 422.6 msec, which did not exceed the normal values for age. 7/100 patients (7%) had QTc prolongation (>450 msec). There was a trend for increasing QTc with age and clinical severity (P = 0.09). No patients with R106C, R106W, R133C, R168*, R270*, R294*, R306C, R306H, and R306P mutations demonstrated QTc prolongation. There was a relatively high proportion of QTc prolongation in patients with R255* mutations (2/8, 25%) and large deletions (1/4, 25%). The overall presence of QTc prolongation did not correlate with mutation category (P = 0.52). Our findings demonstrate that in RTT, the prevalence of QTc prolongation is lower than previously reported. Hence, all RTT patients warrant baseline ECG; if QTc is prolonged, then cardiac followup is warranted. If initial QTc is normal, then annual ECGs, particularly in younger patients, may not be necessary. However, larger sample sizes are needed to solidify the association between QTc and age and clinical severity. The biological and clinical significance of mild QTc prolongation above the normative data remains undetermined. © 2017 Wiley Periodicals, Inc.

  2. Evaluation of psycho-motor development in children with West syndrome

    Directory of Open Access Journals (Sweden)

    Nikolić Dimitrije

    2012-01-01

    Full Text Available Introduction. West Syndrome (WS is age-related epileptic encephalopathy characterised by a triad of symptoms: specific seizure type, pathognomonic electroencephalographic (EEG pattern - hypsarrhythmia and delay and/or regression in psychomotor development (PMD. Aetiologically, it occurs in three forms: symptomatic, cryptogenic and idiopathic. Objective. Estimation of PMD in children with WS according to aetiology. Methods. The observed group consisted of 65 children. Age range was between 6 and 30 months. The patients were divided into three groups according to aetiology. All patients underwent psychological examination with Brunet-Lesine test, as well as PMD evaluation based on achieved developmental milestones for the corresponding age. Results. Statistically significant better values in the Human Developmental Index (HDI had patients with idiopathic compared to other forms of WS, at testing after 12 months (93.0±8.1 vs. 46.8±6.1 vs. 45.6±3.8, as well as after 24 months (93.9±7.7 vs. 51.9±5.5 vs. 50.9±4.4. The best values of HDI after 24 months had patients with improvement in PMD with the average of 66.2±4.4, which was statistically significant compared to those with unchanged PMD (41.5±5.3 and with further regression in PMD (28.3±4.4. Significant correlation was obtained between PMD after 12 and 24 months (r=0.477, as well as a considerable improvement in HDI from the 12th to 24th month (49.4±4.0 vs. 53.7±3.9. Conclusion. The patients with idiopathic WS accomplished the best PMD. Improvement in PMD after 12 and 24 months of treatment was associated with improved HDI. Improvement in PMD was observed in all patients after 2 years of follow-up.

  3. Clinical, pathological, and genetic evaluations of Chinese patient with otodental syndrome and multiple complex odontoma: Case report.

    Science.gov (United States)

    Liu, Anqi; Wu, Meiling; Guo, Xiaohe; Guo, Hao; Zhou, Zhifei; Wei, Kewen; Xuan, Kun

    2017-02-01

    Otodental syndrome is a rare autosomal-dominant disease characterized by globodontia, associated with sensorineural, high-frequency hearing loss. Here, we describe the clinical, pathological, and genetic evaluations of a 9-year-old girl with otodental syndrome and multiple complex odontoma.The patient presented with a draining sinus tract in her left cheek, globodontia, and hearing loss. The odontomas which caused the cutaneous sinus tracts were extracted because of the odontogenic infection. The extracted odontoma and primary tooth was studied by micro-CT and further observed histopathologically. The micro-CT findings revealed that the primary tooth had three crowns with two separated pulp chambers, and their root canals were partially fused. The histological findings showed abnormal morphologies of odontoblasts and dentin, hyperplasia of enamel, and malformation of odontogenic epithelium. Furthermore, DNA sequencing and analyze of deafness associated gene GJB2, GJB3, and PDS had not revealed any SNP or mutation; but exon 3 of the causative gene FGF3 could not be amplified, which may be associated with the microdeletion at chromosome 11q13.3. Three month after surgery, the patient was found to be asymptomatic and even the evidence of the extra-oral sinus had disappeared.The dental abnormality of otodental syndrome included congenital missing teeth, globodontia, and multiple complex odontoma. Globodontia exhibited characteristic features of fusion teeth. In addition, gene FGF3 haploinsufficiency was likely to be the cause of otodental syndrome. The report provides some new information in the field of otodental syndrome, which would make dentists more familiar with this disease.

  4. Evaluation Of Clinical Course, Rirsk Factors For Relapse And Long-Term Outcome Of Children With Primary Nephrotic Syndrome

    Directory of Open Access Journals (Sweden)

    Ataei N

    2003-09-01

    Full Text Available The nephrotic syndrome is the most common chronic renal disease of childhood."nMaterials and Methods: In this study the clinical course, risk factors for relapse and the predictors of long-term outcome of 502 patients (median age 5 yearswith primary nephrotic syndrome were followed for an average of 60 months (3.5 to 240 months from 1981 to 2000."nResults: Among the 502 patients 5 (1% achieved spontaneous remission and 313 children were initial responder. One hundred eighty four patients received at least 1 kidney biopsy (78 prior and 106 after initiation of treatment. Of 104 children with frequently relapsing steroid sensitive and steroid dependent nephrotic syndrome, levamisole induced prolong remission in 33 ( 31.7% of patients. Cyclophosphamid and cyclosporine A induced prolong remission in 49 (50% of 98 and 28 (41.3% of 68 patients respectively. At the time of the final clinical evaluation, 73 patients (14.5% were on remission; 301 (59.9% had relapsing; 43 (8.6% had persistent nephrotic syndrome; 33 (6.6% of patients evolving to end-stage renal disease (ESRD and 6 (1.2% of them with chronic renal failure died (infection and cardio respiratory were the cause of death in 5 and 1 patient respectively. Young age (1-5 y at onset of disease and atopy were identified as an independent risk factors for relapse (P0.05. Patients with steroid dependent nephrotic syndrome (SDNS or MCNS had better response to cyclophosphamide or cyclosporin than children with steroid resistance nephrotic syndrome (SRNS or FSGS (P0.05. Persistent proteinuria, hypertension, microscopic or macroscopic hematuia, glucosuria were associated with progression to chronic renal failure (PO.05."nConclusion: Steroid dependency and histopathology of MCNS in patients with nephrotic syndrome were significantly associated with good long-term prognosis. In contrast persistent proteinuria, histopatholoy of FSGS, hypertension, macroscopic or microscopic hematuria, and glucosoria were

  5. Modelling airborne gravity data by means of adapted Space-Wise approach

    Science.gov (United States)

    Sampietro, Daniele; Capponi, Martina; Hamdi Mansi, Ahmed; Gatti, Andrea

    2017-04-01

    Regional gravity field modelling by means of remove - restore procedure is nowadays widely applied to predict grids of gravity anomalies (Bouguer, free-air, isostatic, etc.) in gravimetric geoid determination as well as in exploration geophysics. Considering this last application, due to the required accuracy and resolution, airborne gravity observations are generally adopted. However due to the relatively high acquisition velocity, presence of atmospheric turbulence, aircraft vibration, instrumental drift, etc. airborne data are contaminated by a very high observation error. For this reason, a proper procedure to filter the raw observations both in the low and high frequency should be applied to recover valuable information. In this work, a procedure to predict a grid or a set of filtered along track gravity anomalies, by merging GGM and airborne dataset, is presented. The proposed algorithm, like the Space-Wise approach developed by Politecnico di Milano in the framework of GOCE data analysis, is based on a combination of along track Wiener filter and Least Squares Collocation adjustment and properly considers the different altitudes of the gravity observations. Among the main differences with respect to the satellite application of the Space-Wise approach there is the fact that, while in processing GOCE data the stochastic characteristics of the observation error can be considered a-priori well known, in airborne gravimetry, due to the complex environment in which the observations are acquired, these characteristics are unknown and should be retrieved from the dataset itself. Some innovative theoretical aspects focusing in particular on the theoretical covariance modelling are presented too. In the end, the goodness of the procedure is evaluated by means of a test on real data recovering the gravitational signal with a predicted accuracy of about 0.25 mGal.

  6. Plane-wise sensitivity based inhomogeneous excitation fields for magnetorelaxometry imaging of magnetic nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Baumgarten, Daniel, E-mail: daniel.baumgarten@tu-ilmenau.de [Institute of Biomedical Engineering and Informatics, Technische Universität Ilmenau, 98693 Ilmenau (Germany); IJN-UTM Cardiovascular Engineering Centre, Universiti Teknologi Malaysia, 81310 UTM Skudai, Johor Bahru (Malaysia); Braune, Friedemann [Institute of Biomedical Engineering and Informatics, Technische Universität Ilmenau, 98693 Ilmenau (Germany); Supriyanto, Eko [IJN-UTM Cardiovascular Engineering Centre, Universiti Teknologi Malaysia, 81310 UTM Skudai, Johor Bahru (Malaysia); Haueisen, Jens [Institute of Biomedical Engineering and Informatics, Technische Universität Ilmenau, 98693 Ilmenau (Germany)

    2015-04-15

    Promising biomedical applications of magnetic nanoparticles share the need for a quantitative knowledge of their in vivo distribution. From multichannel magnetorelaxometry measurements with sequential activation of inhomogeneous excitation fields, the distribution can be quantitatively determined. In first studies, single excitation coils were consecutively activated. We aim at further advancing this imaging technology by suitable activation patterns involving multiple excitation coils. In this work, we propose the estimation of these patterns based on the spatial sensitivity in order to reduce the number of required measurements. The sensitivity of a voxel carrying magnetic nanoparticles is determined by its position relative to the sensors and the excitation field. Whereas the position is fixed within a given setup, the excitation is controlled by the currents in the coils. The currents required for a defined target sensitivity are estimated by solving an inverse problem. In our work, two target sensitivity paradigms are presented: (a) plane-wise activation, where only one plane with high sensitivities is sought and moved through the source space and (b) plane-wise non-activation, where all voxels except for one plane should receive high sensitivity. Our approach is investigated in simulation studies using a setup with a cubic region of interest and a planar sensor array. The imaging quality of both activation paradigms is evaluated. Our results demonstrate the principal applicability of this spatial sensitivity based approach for defining inhomogeneous activation patterns. The obtained patterns allow for a similar imaging quality using a lower number of activation sequences compared to the conventional single coil activation.

  7. TERLIPRESSIN VERSUS NORADRENALINE FOR HEPATORENAL SYNDROME. Economic evaluation under the perspective of the Brazilian Public Health System

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    Ângelo Zambam de MATTOS

    Full Text Available ABSTRACT Background - Terlipressin and noradrenaline are the best studied treatments for hepatorenal syndrome, and there is no evidence of superiority of one over the other regarding to efficacy. While the former drug is more costly, the latter requires admission into an intensive care unit. Objective - The aim of this study was to perform an economic evaluation, comparing treatments for hepatorenal syndrome with terlipressin and noradrenaline. Methods - For the economic evaluation, a cost-minimization analysis was performed. Direct medical costs of the two treatment strategies were compared under the perspective of the Brazilian Public Health System as the third-party payer. A probabilistic sensitivity analysis was performed. Results - The costs of treatments with terlipressin or noradrenaline were 287.77 and 2,960.45 International Dollars (Int$ respectively. Treatment using terlipressin would save Int$2,672.68 for the Public Health System for each hospital admission related to hepatorenal syndrome. In the probabilistic sensitivity analysis, it was verified that the cost of the treatment with noradrenaline could vary between Int$2,326.53 and Int$3,644.16, while costs related to the treatment using terlipressin are not variable. Conclusion - The treatment strategy using terlipressin was more economical than that using noradrenaline under the perspective of the Brazilian Public Health System as the third-party payer.

  8. Evaluation of the influence of clinical symptoms on the quality of life in individuals with Williams-Beuren Syndrome

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    Andrea Parolin Jackowski

    2017-03-01

    Full Text Available Introduction: Williams-Beuren Syndrome (WBS results from a deletion in the chromosome 7q11.23. Psychiatric symptoms, such as Generalized Anxiety Disorder (GAD, Attention Deficit Hyperactivity Disorder (ADHD, and others, have been described in this syndrome. Objective: The main purpose of this study was to identify related clinical symptoms in individuals with WBS and the impact of this disorder in their quality of life. Method: The study sample included 42 individuals aged 11 to 16 years divided into two groups: a study group composed of 20 individuals with WBS and a control group comprising 22 individuals with typical development. The following instruments were used in this evaluation: Brazilian Criterion of Economic Classification (CCEB, to estimate the purchasing power of urban households; Strengths & Difficulties Questionnaire (SDQ, to provide a useful measure of psychopathology applied to children and youth aged 4-17 years; and Quality of Life Evaluation Scale (AUQEI, to assess the feeling of well-being according to the opinion of the child and adolescent. Results: The results suggest that adolescents with WBS have a good quality of life despite presenting greater possibilities of psychiatric symptoms. These results are valid considering that quality of life is measured from the opinion of the assessed individual. Conclusion: We hypothesized that adolescents with WBS can present a distortion of reality regarding the positive/optimistic factor, possibly based on some characteristics of the syndrome such as being always cheerful and smiling, which are factors associated with intellectual disability.

  9. PROTOCOL FOR THE EVALUATION AND FUNCTIONAL RE-EDUCATION OF THE LUMBARSACRAL PAIN SYNDROME WITH A MUSCULAR-LIGAMENT CAUSE

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    Călina Mirela-Lucia

    2009-03-01

    Full Text Available The current paper aims to evaluate the lumbar-sacral algo-functional syndromes with a muscular-ligament cause and to establish a staged program for its functional recovery which would also prevent reoccurrences and/ or complications, these being relatively frequent and with important functional implications [1]. These ailments,specific to patients who are at an active age have a particular social impact, important morbidity and can be easily mistaken for more serious lumbar-sacral ailments, thus leading to disproportionately serious, but inefficient for thereal cause, treatments [4].The study was made over a period of 6 months, on 18 patients with lumbar-sacral syndrome with a muscularligament cause, diagnosed as a result of clinical and paraclinic evaluation, an alternative etiology of the syndrome being excluded. The patients were integrated into a functional re-education programme which included drug therapy (anti-inflammatory +/- relaxant medication, physically-kinetically supported (thermal-kinetic-massage therapy, staged into 2 weeks, one and 3-6 months intervals, respectively. The results obtained emphasise the improvement in the clinical parameters form one stage to the other, in the third stage of the programme reaching asemi-complete (over 90% recovery of the affected areas, compared to the initial stages.

  10. Angiographic and hemodynamic evaluation of the mesoatrial shunt in patients with Budd-Chiari syndrome and inferior vena caval obstruction

    International Nuclear Information System (INIS)

    Redmond, P.L.; Kadir, S.; Cameron, J.L.; Kaufman, S.L.; White, R.I. Jr.

    1986-01-01

    Obstruction of the inferior vena cava (IVC) is not uncommon in patients with the Budd-Chiari syndrome. The caval obstruction may be due to thrombus or compression by an enlarged caudate lobe. Conventional portosystemic shunts are not possible in the presence of an obstructed IVC; the mesoatrial shunt is indicated in these patients. Between 1973 and 1986, the authors studied 13 patients (ten female, three male) with Budd-Chiari syndrome and IVC obstruction in whom mesoatrial shunts were subsequently constructed. Polycythemia rubra vera was the most common predisposing condition. Preoperative evaluation included US, scintigraphy, CT, and angiography (hepatic arteriography, hepatic venography and pressure measurements, inferior vena cavography, arterial portography). Postoperatively shunts were assessed angiographically and hemodynamically, and several patients underwent CT. The shunts were catheterized via a brachial or femoral venous approach, which allowed pressures along the shunt from the superior mesenteric vein to the right atrium to be measured. The mesoatrial shunt is a relatively new procedure which is indicated in patients with the Budd-Chiari syndrome complicated by IVC obstruction. Shunt patency may be demonstrated arteriographically or with CT, but hemodynamic evaluation with measurement of pressure gradients is required to assess shunt function

  11. Evaluation of bone mineral density and osteonecrosis in the recovered severe acute respiratory syndrome patients

    International Nuclear Information System (INIS)

    Shang Wei; Yu Wei; Lin Qiang; Li Taisheng; Fan Hongwei; Tian Junping; Meng Wei

    2005-01-01

    Objective: To evaluate the bone mineral density (BMD) and osteonecrosis in the recovered patients with severe acute respiratory syndrome (SARS). Methods: Sixty-four patients with SARS were recruited in the study. There were 19 males with mean age 37 years (26-57 years) and 45 females with mean age 39 years (21-67 years) who divided into ten year cohorts for the analysis. BMD measurements were obtained by dual X-ray absorptiometry (DXA) at the sites of both lumbar spine (L2-4) and hip (neck, Ward's triangle, greater trochanter) which compared with those of the control groups. In addition to BMD measurements, hip MRI examinations were performed on 55 patients among the 64 patients for evaluating the osteonecrosis during an average of 10-12 months follow up after discharged from hospital. The BMD were also compared between the patients with osteonecrosis and without osteonecrosis. Results: BMD results of the 19 male SARS patients were not different from those of the normal reference, except that the 40-49 age-group at the site of L2-4 whose BMD was significantly higher than that of the normal group (P=0.016). For the 45 female recovered SARS patients, the BMD at femur neck of 20-29 age-group and greater trochanter of 40-49 age-group were significantly higher than those of normal reference respectively (P=0.0013, P=0.041). Besides that there were no significant BMD differences between any other age-groups when comparison with each site, although the BMD results of the female group were slightly higher than those of the normal reference in general. Osteonecrosis of the femur was diagnosed by MRI in 6 of the 55 patients. Although BMD results in the patients with osteonecrosis were slightly lower than those patients without osteonecrosis for each site, the difference was not statistically significant (P>0.05). Conclusion: Therapy with glucocorticoids in short period may not influence the BMD results in the recovered SARS patients within this near 10-12 months follow up

  12. Evaluation of latent links between irritable bowel syndrome and sleep quality

    Science.gov (United States)

    Bellini, Massimo; Gemignani, Angelo; Gambaccini, Dario; Toti, Simona; Menicucci, Danilo; Stasi, Cristina; Costa, Francesco; Mumolo, Maria Gloria; Ricchiuti, Angelo; Bedini, Remo; de Bortoli, Nicola; Marchi, Santino

    2011-01-01

    AIM: To examine the links between quality of sleep and the severity of intestinal symptoms in irritable bowel syndrome (IBS). METHODS: One hundred and forty-two outpatients (110 female, 32 male) who met the Rome III criteria for IBS with no psychiatric comorbidity were consecutively enrolled in this study. Data on age, body mass index (BMI), and a set of life-habit variables were recorded, and IBS symptoms and sleep quality were evaluated using the questionnaires IBS Symptom Severity Score (IBS-SSS) and Pittsburgh Sleep Quality Index (PSQI). The association between severity of IBS and sleep disturbances was evaluated by comparing the global IBS-SSS and PSQI score (Pearson’s correlation and Fisher’s exact test) and then analyzing the individual items of the IBS-SSS and PSQI questionnaires by a unitary bowel-sleep model based on item response theory (IRT). RESULTS: IBS-SSS ranged from mild to severe (120-470). The global PSQI score ranged from 1 to 17 (median 5), and 60 patients were found to be poor sleepers (PSQI > 5). The correlation between the global IBS-SSS and PSQI score indicated a weak association (r = 0.2 and 95% CI: -0.03 to 0.35, P < 0.05), which becomes stronger using our unitary model. Indeed, the IBS and sleep disturbances severities, estimated as latent variables, resulted significantly high intra-subject correlation (posterior mean of r = 0.45 and 95% CI: 0.17 to 0.70, P < 0.05). Moreover, the correlations between patient features (age, sex, BMI, daily coffee and alcohol intake) and IBS and sleep disturbances were also analyzed through our unitary model. Age was a significant regressor, with patients ≤ 50 years old showing more severe bowel disturbances (posterior mean = -0.38, P < 0.05) and less severe sleep disturbances (posterior mean = 0.49, P < 0.05) than older patients. Higher daily coffee intake was correlated with a lower severity of bowel disturbances (posterior mean = -0.31, P < 0.05). Sex (female) and daily alcohol intake (modest

  13. Evaluating the Risk of Metabolic Syndrome Based on an Artificial Intelligence Model

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    Hui Chen

    2014-01-01

    Full Text Available Metabolic syndrome is worldwide public health problem and is a serious threat to people's health and lives. Understanding the relationship between metabolic syndrome and the physical symptoms is a difficult and challenging task, and few studies have been performed in this field. It is important to classify adults who are at high risk of metabolic syndrome without having to use a biochemical index and, likewise, it is important to develop technology that has a high economic rate of return to simplify the complexity of this detection. In this paper, an artificial intelligence model was developed to identify adults at risk of metabolic syndrome based on physical signs; this artificial intelligence model achieved more powerful capacity for classification compared to the PCLR (principal component logistic regression model. A case study was performed based on the physical signs data, without using a biochemical index, that was collected from the staff of Lanzhou Grid Company in Gansu province of China. The results show that the developed artificial intelligence model is an effective classification system for identifying individuals at high risk of metabolic syndrome.

  14. A WISE View of Almost Dark ALFALFA Galaxies

    Science.gov (United States)

    Pérez, Jonathan; Arrieta, A.; Pantoja, C.; Lebron, M. E.; Leisman, L.; Koopmann, R. A.; Haynes, M. P.

    2014-01-01

    Dark galaxies are galaxies that have few stars and are made mostly of dense gas. These objects are expected to be difficult to detect with optical telescopes. Dark galaxies are thought to exist possibly associated to tidal interactions between galaxies, or they might represent an early stage in the process of galaxy formation. The prototype for dark galaxies is the southwestern component of HI 1225+01 (Chengalur et al. 1995, AJ 109, 2415) with an HI mass of 8*10^8M⊙ circular velocity ~34 km/s. The Arecibo Legacy Fast ALFA extragalactic survey (ALFALFA) is a blind HI survey completed in 2012. One of the scientific objectives of ALFALFA was the possible detection of HI tidal remnants (Giovanelli et al. 2005, AJ 130, 2598). Less than 2% of the total extragalactic population of the α.40 Source Catalog from ALFALFA are classified as dark HI sources (Haynes et al. 2011, AJ. 142,170). As part of our participation of the Undergraduate ALFALFA Team we present an analysis of the infrared data from WISE of a sample of the most extreme high M_HI/ almost dark galaxies being studied by the ALFALFA team. Some of these objects have no detectable optical emission in SDSS images, while others may be associated with very faint, low luminosity stellar counterparts. For HI 1225+01, Matsuoka et al (2012, AJ 144,159) obtained an R band image of the NE clump of this object, and also found emission in the Spitzer IRAC bands of 3.6μm and 4.5μm among others. No emission was found In the SW component. We present our findings of the emission at 3.4, 4.6 and 12μm from WISE of a region centered on the almost dark galaxies. This research has made use of the NASA/IPAC Infrared Science Archive, which is operated by the Jet Propulsion Laboratory, California Institute of Technology, under contract with the National Aeronautics and Space Administration. We gratefully acknowledge the support from the NSF grant AST-1211005 for this project.

  15. Clinical Evaluation of Percutaneous Vertebroplasty in a Patient with Paraplegia and Immobilization Syndrome: A Case Report

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    Salvatore Masala

    2013-01-01

    Full Text Available We will discuss a potential role of percutaneous vertebroplasty (PVP in the management of a patient with immobilization syndrome due to paraplegia and vertebral osteoporotic fractures. While PVP is commonly used for the treatment of osteoporotic thoracolumbar vertebral compression fractures, its role in vertebral stabilization in patient with immobilization syndrome has not been reported in the literature. A 73-year-old woman affected by immobilization syndrome due to paraplegia and vertebral osteoporotic fractures was treated with PVP of vertebrae D12, L1, and L4. After PVP, the patient did not need any antalgic therapy, and there was a significant improvement regarding mobilization, performance of physiological functions, daily management of personal care, and treatment of decubitus ulcers, increasing life quality and psychological well-being.

  16. Clinical evaluation of percutaneous vertebroplasty in a patient with paraplegia and immobilization syndrome: a case report.

    Science.gov (United States)

    Masala, Salvatore; Calabria, Eros; Nezzo, Marco; De Vivo, Dominique; Neroni, Luca; Simonetti, Giovanni

    2013-01-01

    We will discuss a potential role of percutaneous vertebroplasty (PVP) in the management of a patient with immobilization syndrome due to paraplegia and vertebral osteoporotic fractures. While PVP is commonly used for the treatment of osteoporotic thoracolumbar vertebral compression fractures, its role in vertebral stabilization in patient with immobilization syndrome has not been reported in the literature. A 73-year-old woman affected by immobilization syndrome due to paraplegia and vertebral osteoporotic fractures was treated with PVP of vertebrae D12, L1, and L4. After PVP, the patient did not need any antalgic therapy, and there was a significant improvement regarding mobilization, performance of physiological functions, daily management of personal care, and treatment of decubitus ulcers, increasing life quality and psychological well-being.

  17. A systematic review and economic evaluation of diagnostic strategies for Lynch syndrome.

    Science.gov (United States)

    Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

    2014-09-01

    Lynch syndrome (LS) is an inherited autosomal dominant disorder characterised by an increased risk of colorectal cancer (CRC) and other cancers, and caused by mutations in the deoxyribonucleic acid (DNA) mismatch repair genes. To evaluate the accuracy and cost-effectiveness of strategies to identify LS in newly diagnosed early-onset CRC patients (aged strategies for individuals in whom LS is identified. Systematic reviews were conducted of the test accuracy of microsatellite instability (MSI) testing or immunohistochemistry (IHC) in individuals with CRC at risk of LS, and of economic evidence relating to diagnostic strategies for LS. Reviews were carried out in April 2012 (test accuracy); and in February 2012, repeated in February 2013 (economic evaluations). Databases searched included MEDLINE (1946 to April week 3, 2012), EMBASE (1980 to week 17, 2012) and Web of Science (inception to 30 April 2012), and risk of bias for test accuracy was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) quality appraisal tool. A de novo economic model of diagnostic strategies for LS was developed. Inconsistencies in study designs precluded pooling of diagnostic test accuracy results from a previous systematic review and nine subsequent primary studies. These were of mixed quality, with significant methodological concerns identified for most. IHC and MSI can both play a part in diagnosing LS but neither is gold standard. No UK studies evaluated the cost-effectiveness of diagnosing and managing LS, although studies from other countries generally found some strategies to be cost-effective compared with no testing. The de novo model demonstrated that all strategies were cost-effective compared with no testing at a threshold of £20,000 per quality-adjusted life-year (QALY), with the most cost-effective strategy utilising MSI and BRAF testing [incremental cost-effectiveness ratio (ICER) = £5491 per QALY]. The maximum health benefit to the

  18. Clinical evaluation and surgical decision making for patients with lumbar discogenic pain and facet syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Tessitore, Enrico, E-mail: enrico.tessitore@hcuge.ch [Neurosurgical Unit, Geneva University Hospitals, Faculty of Medicine, University of Geneva (Switzerland); Molliqaj, Granit, E-mail: granitmolliqaj@gmail.com [Neurosurgical Unit, Geneva University Hospitals, Faculty of Medicine, University of Geneva (Switzerland); Schatlo, Bawarjan, E-mail: schatlo@gmail.com [Department of Neurosurgery, Georg-August University, University of Medicine Gottingen, 37075 Gottingen (Germany); Schaller, Karl, E-mail: karl.schaller@hcuge.ch [Neurosurgical Unit, Geneva University Hospitals, Faculty of Medicine, University of Geneva (Switzerland)

    2015-05-15

    In industrialized countries, more than two thirds of the population suffers from low back pain (LBP) in their lifetime. LBP associated with lumbar disc herniation, stenosis, and instability is a well-known and documented entity. On the other hand, the lumbar discogenic pain and facet syndrome are difficult to be clearly identified, and they are not always detectable by imaging. This article describes the causes of these painful syndromes, which are typically without radicular component, explains the modern diagnostic procedures, and provides guidelines for surgical decision making.

  19. Research and development needs in a step-wise process for the nuclear waste programme in Sweden

    International Nuclear Information System (INIS)

    Ström, A.; Andersson, J.; Ekeroth, E.; Hedin, A.; Pers, K.

    2016-01-01

    Concluding remarks: • The SKB RD&D Programme 2016 − contains an overview of all the measures that may be necessary for treatment and final disposal of nuclear waste from Swedish nuclear reactors and SKB's facilities; − clarifies how research and technology development are justified and evaluated in a step-wise procedure on the basis of the measures planned; − presents a strategic plan for the research and development necessary to establish and implement future activities; − Published as SKB TR 16-15 in December 2016

  20. Colors of Dwarf Ellipticals from GALEX to WISE

    Science.gov (United States)

    Schombert, James M.

    2018-02-01

    Multicolor photometry is presented for a sample of 60 dwarf ellipticals (dE’s) selected by morphology. The sample uses data from GALEX, SDSS, and WISE to investigate the colors in the NUV, ugri, and W1 (3.4 μm) filters. We confirm the blueward shift in the color–magnitude relation (CMR) for dE’s, compared to the CMR for bright ellipticals, as seen in previous studies. However, we find that the deviation in color across the UV to near-IR for dE’s is a strong signal of a younger age for dE’s, one that indicates decreasing mean age with lower stellar mass. Lower mass dE’s are found to have mean ages of 4 Gyr and mean [Fe/H] values of ‑1.2. Age and metallicity increase tothe most massive dE’s, with mean ages similar to normal ellipticals (12 Gyr) and their lowest metallicities ([Fe/H] = ‑0.3). Deduced initial star formation rates for dE’s, combined with their current metallicities and central stellar densities, suggest a connection between field low surface brightness (LSB) dwarfs and cluster dE’s, where the cluster environment halts star formation for dE’s, triggering a separate evolutionary path.

  1. Morphological appearance manifolds for group-wise morphometric analysis.

    Science.gov (United States)

    Lian, Nai-Xiang; Davatzikos, Christos

    2011-12-01

    Computational anatomy quantifies anatomical shape based on diffeomorphic transformations of a template. However, different templates warping algorithms, regularization parameters, or templates, lead to different representations of the same exact anatomy, raising a uniqueness issue: variations of these parameters are confounding factors as they give rise to non-unique representations. Recently, it has been shown that learning the equivalence class derived from the multitude of representations of a given anatomy can lead to improved and more stable morphological descriptors. Herein, we follow that approach, by approximating this equivalence class of morphological descriptors by a (nonlinear) morphological appearance manifold fitting to the data via a locally linear model. Our approach parallels work in the computer vision field, in which variations lighting, pose and other parameters lead to image appearance manifolds representing the exact same figure in different ways. The proposed framework is then used for group-wise registration and statistical analysis of biomedical images, by employing a minimum variance criterion to perform manifold-constrained optimization, i.e. to traverse each individual's morphological appearance manifold until group variance is minimal. The hypothesis is that this process is likely to reduce aforementioned confounding effects and potentially lead to morphological representations reflecting purely biological variations, instead of variations introduced by modeling assumptions and parameter settings. Copyright © 2011 Elsevier B.V. All rights reserved.

  2. Evaluation of the radiological criteria to diagnose large vestibular aqueduct syndrome.

    Science.gov (United States)

    El-Badry, Mohamed M; Osman, Nasr M; Mohamed, Haytham Mamdouh; Rafaat, Fatma M

    2016-02-01

    The main objective of the current work is to increase the sensitivity of the radiological diagnosis of the large vestibular aqueduct syndrome (LVAS). The specific aims were to compare between the two famous criteria to diagnose large vestibular aqueduct (LVA), (i.e., Valvassori and Cincinnati), to correlate between vestibular aqueduct (VA) measurements in the axial view and those in 45° oblique reformate in children with LVAS, and to define radiological criteria to diagnose LVA in the 45° oblique reformate. The study group included 61 children with LVAS according to Cincinnati criteria (greater than 0.9mm at the midpoint or greater than 1.9mm at the operculum in the axial view). All participants were subjected to full Audiological evaluation and CT scanning in axial plane. The axial data were then transferred to workstation for post-processing with 3D reformatting software (Baxara 3D) in order to obtain the 45° oblique reformates. VA measurements were done at 4 points: midpoint and operculum in both the axial plane and the 45° oblique reformate. Only 81% of ears of children with LVAS (99 ears) fit Valvassori criterion (i.e., larger than 1.5mm at midpoint), while 19% (23 ears) of them were missed. There were statistically significant correlations among the diameters of the VA in the axial view (both in the midpoint and operculum) and their counterparts in the 45° oblique reformate. Values equal to or greater than 1.2mm in the midpoint and 1.3mm in the operculum are proposed to be the criteria to diagnose LVA in the 45° oblique reformate. Finally, no significant correlations were found between the degree of hearing loss and VA diameters at the axial or 45° oblique reformate. Cincinnati criteria are more sensitive than Valvassori criterin in the diagnosis of LVAS. We recommend the application of Cincinnati criteria instead of Valvassori criteria in order not miss cases with LVAS. Measurement of VA in the 45° oblique reformate is a reliable method to diagnose

  3. Evaluation of prakṛti and quality-of-life in patients with irritable bowel syndrome

    Science.gov (United States)

    Shirolkar, Sudatta G.; Tripathi, Raakhi K.; Rege, Nirmala N.

    2015-01-01

    Objective: To evaluate the prakṛti of irritable bowel syndrome (IBS) patients and its association with IBS subtypes and quality-of-life (QOL). Methodology: IBS patients with the consistent subtype in the last 6 months were recruited. Prakṛti assessment with a 24-item questionnaire was performed and depending on the scores the patients were categorized into vāta predominant, pitta predominant, and kapha predominant prakṛti. QOL was assessed with prevalidated disease-specific 34-item questionnaire scored on a 0–100 scale. Results: Of 50 IBS patients enrolled, with mean age of 43.5 ± 12.8 years, and male: female as 43:7, 22 patients were of vāta and pitta predominant prakṛti each while six patients had kapha predominant prakṛti. IBS-C was diagnosed in 24 patients, IBS-D in 21, and IBS-M in five patients. In vāta predominant group, IBS-C was found in 13 patients, IBS-D in 8, and IBS-M in 1. In pitta predominant group, IBS-D was found in 13, IBS-C in 6, and IBS-M in 3. In kapha predominant group, IBS-C was found in 5 patients and IBS-M in 1. The median QOL in IBS-C group was 48.897, IBS-D was 38.97, and IBS-M was 66.911. The median QOL score 52.205, 42.27, and 55.51 in vāta, pitta, and kapha predominant group, respectively. Conclusion: Majority of the vāta predominant patients had developed IBS-C, pitta predominant patients had developed IBS-D. QOL was better in pitta predominant individuals of all IBS-disease subtypes. With this, we find that prakṛti examination in IBS helps in detecting the proneness of developing an IBS subtype and predicting their QOL accordingly. PMID:26283806

  4. Do female patients with nonpathological vaginal discharge need the same evaluation as for Dhat syndrome in males?

    Science.gov (United States)

    Grover, Sandeep; Avasthi, Ajit; Gupta, Sunil; Hazari, Nandita; Malhotra, Nidhi

    2016-01-01

    The aim of this study was to evaluate the concept of female Dhat syndrome characterized by the complaint of nonpathological vaginal discharge in association with somatic, anxiety, and depressive symptoms. A total of 26 female subjects with nonpathological vaginal discharge along with depressive and somatic complaints were assessed on a self-rated questionnaire modified from Comprehensive Questionnaire for Assessment of Dhat Syndrome designed for males. They were also assessed for psychiatric comorbidity as per ICD-10. All female subjects received an ICD-10 psychiatric diagnosis, with somatoform/dissociative disorder (57.7%) being the most common. The mean age of onset of vaginal discharge was 24.6 (standard deviation - 7.0) years, noted every day or for 2-3 times per week by more than two-third of the participants. Two-fifth (61.5%) of the women described it as a milky discharge. The most common reason reported for passage of vaginal discharge was that of urinary infection or problems of urinary tract infections (42.3%) followed by vaginal infection/disease (34.6%). More than half (53.8%) of the subjects considered vaginal discharge to be responsible for weakness in the body, weakness in stamina and thinness of physique, while slightly more than two-third (69.2%) of them reported bodily weakness and sleep disturbances. Overall the clinical picture in females was similar to male patients with Dhat syndrome on most of the account. Subgroup of patients with vaginal discharge attribute their somatic and mental symptoms to the passage of whitish vaginal discharge and are distressed due to the same. The clinical picture is similar to Dhat syndrome in males. There is a need to recognize female variant of Dhat syndrome as a culture-bound syndrome. Identification of the same may help in managing this subgroup of patients seeking help from the gynecologists for their nonpathological vaginal discharge or from mental health professionals for their symptoms of common mental

  5. The Weight Influenced Self-Esteem Questionnaire (WISE-Q): factor structure and psychometric properties.

    Science.gov (United States)

    Trottier, Kathryn; McFarlane, Traci; Olmsted, Marion P; McCabe, Randi E

    2013-01-01

    Weight-based self-esteem (WBSE) is hypothesized to be the core cognitive feature of eating disorders. The Weight Influenced Self-Esteem Questionnaire (WISE-Q) was designed to measure the influence of a negatively perceived body image on multiple dimensions of self-esteem, which we believe to be one aspect of WBSE. Study 1 sought to determine the factor structure of the WISE-Q as well as to examine the reliability and concurrent validity of WISE-Q scores among eating disorder and undergraduate student participants. In Study 2, validity was further investigated by examining changes in WISE-Q scores with treatment. The WISE-Q has two factors representing generalized and expected WBSE. Evidence of internal and test-retest reliability was found. Also, the pattern of correlations between WISE-Q scores and other constructs was in line with predictions. As expected, WISE-Q scores improved with treatment yet remained high. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. OpWise: Operons aid the identification of differentially expressed genes in bacterial microarray experiments

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    Arkin Adam P

    2006-01-01

    Full Text Available Abstract Background Differentially expressed genes are typically identified by analyzing the variation between replicate measurements. These procedures implicitly assume that there are no systematic errors in the data even though several sources of systematic error are known. Results OpWise estimates the amount of systematic error in bacterial microarray data by assuming that genes in the same operon have matching expression patterns. OpWise then performs a Bayesian analysis of a linear model to estimate significance. In simulations, OpWise corrects for systematic error and is robust to deviations from its assumptions. In several bacterial data sets, significant amounts of systematic error are present, and replicate-based approaches overstate the confidence of the changers dramatically, while OpWise does not. Finally, OpWise can identify additional changers by assigning genes higher confidence if they are consistent with other genes in the same operon. Conclusion Although microarray data can contain large amounts of systematic error, operons provide an external standard and allow for reasonable estimates of significance. OpWise is available at http://microbesonline.org/OpWise.

  7. Evaluation of the association between chronic periodontitis and acute coronary syndrome: A case control study

    Directory of Open Access Journals (Sweden)

    Amitha Ramesh

    2013-01-01

    Full Text Available Background: The periodontal tissues mount an immune inflammatory response to bacteria and their products and the systemic challenge with these agents also induce a major vascular response. Although many studies have found a correlation between chronic periodontitis and cardiovascular diseases, the role of infection in acute coronary syndrome is disputed. The aim of this study is to investigate whether there is an association between chronic periodontitis and acute coronary syndrome. Materials and Methods: A total of 30 patients, ages ranging from 30 -80. 15 patients from A. B. Shetty Memorial Institute of Dental Sciences and 15 patients admitted to Coronary Care Unit of Justice K. S. Hegde Charitable Hospital Deralakatte Mangalore were included in the study. Variables age more than 40 and gender were also analyzed. Results: Of the 30 patients analyzed in this study, periodontitis was recognized in 11 patients of the acute coronary syndrome group and 10 patients in the healthy group. Fisher′s exact test yielded a p value of 0.4539 with an odds ratio of 0.727(95% confidence interval 0.151 to 3.493. Conclusion: No significant association was found between periodontal disease and acute coronary syndrome. Periodontitis may contribute to cardiovascular disease and stroke in susceptible subjects. Properly powered longitudinal case control and intervention trials are needed to identify how periodontitis and periodontal interventions may have an impact on cardiovascular diseases.

  8. Brain metabolite alterations in Eisenmenger syndrome: Evaluation with MR proton spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Dokumacı, Dilek Şen, E-mail: dileksendokumaci@yahoo.com [Harran University School of Medicine, Department of Radiology, Sanliurfa (Turkey); Doğan, Ferit [Children Hospital, Department of Radiology, Sanliurfa (Turkey); Yıldırım, Ali [Children Hospital, Department of Pediatric Cardiology, Sanliurfa (Turkey); Boyacı, Fatıma Nurefşan; Bozdoğan, Erol [Harran University School of Medicine, Department of Radiology, Sanliurfa (Turkey); Koca, Bülent [Harran University School of Medicine, Department of Pediatric Cardiology, Sanliurfa (Turkey)

    2017-01-15

    Objective: Eisenmenger syndrome (ES) is a life-threatening disease characterized by pulmonary hypertension and cyanosis in patients with congenital heart diseases. The aim of this study was to determine the brain metabolite changes in Eisenmenger syndrome compared with a control group using MR proton spectroscopy. Methods and Materials: The study included 10 children (3 male, 7 female) with congenital heart diseases and a diagnosis of Eisenmenger syndrome. The control group consisted of 10 healthy volunteer children. All were examined with a 1.5 T MRI scanner and single voxel spectroscopy was performed to obtain spectra from three different regions; left frontal subcortical white matter, left lentiform nucleus and left thalamus. Peak integral values obtained from the spectra were used as quantitative data. Results: The ages of the children with ES were between 5 and 16 years, and between 5 and 15 years in the control group. Periventricular white matter hyperintensities were observed in 3 patients. On MR spectroscopy study, significantly lower levels of Choline metabolite (Cho) were detected in the frontal subcortical region and thalamus regions of the patients compared with the control group. There was no statistically significant difference between the levels of other metabolites (NAA, Cr, mI and Glx). In the lentiform nucleus, although the average value of Cho in ES patients was lower than that of the control group, it was not statistically significant. Conclusion: Cho metabolite was determined to have an important role in brain metabolism in Eisenmenger syndrome patients. Oral Cho treatment may help to extend survival.

  9. Parental Alienation Syndrome vs. Parental Alienation: Which Diagnosis Should Evaluators Use in Child-Custody Disputes?

    Science.gov (United States)

    Gardner, Richard A.

    2002-01-01

    The purpose of this article is to elucidate the sources of controversy between the use of the terms Parental Alienation Syndrome and Parental Alienation and to delineate the advantages and disadvantages of using either term in the context of child-custody disputes. It concludes that families are best served when the more specific term, Parental…

  10. McCune-Albright syndrome: evaluation of craniofacial involvement through magnetic resonance images

    International Nuclear Information System (INIS)

    Poma, A.; Baganz, M.; Gutierrez, G.

    1999-01-01

    We report the case of a male teenager with the classical clinical picture of McCune-Albright syndrome, with precocious puberty, cafe-au-lait spots, polyostotic fibrous dysplasia and gigantism. Magnetic resonance images are described and a review of the perspective literature is also presented. (authors)

  11. Brain metabolite alterations in Eisenmenger syndrome: Evaluation with MR proton spectroscopy

    International Nuclear Information System (INIS)

    Dokumacı, Dilek Şen; Doğan, Ferit; Yıldırım, Ali; Boyacı, Fatıma Nurefşan; Bozdoğan, Erol; Koca, Bülent

    2017-01-01

    Objective: Eisenmenger syndrome (ES) is a life-threatening disease characterized by pulmonary hypertension and cyanosis in patients with congenital heart diseases. The aim of this study was to determine the brain metabolite changes in Eisenmenger syndrome compared with a control group using MR proton spectroscopy. Methods and Materials: The study included 10 children (3 male, 7 female) with congenital heart diseases and a diagnosis of Eisenmenger syndrome. The control group consisted of 10 healthy volunteer children. All were examined with a 1.5 T MRI scanner and single voxel spectroscopy was performed to obtain spectra from three different regions; left frontal subcortical white matter, left lentiform nucleus and left thalamus. Peak integral values obtained from the spectra were used as quantitative data. Results: The ages of the children with ES were between 5 and 16 years, and between 5 and 15 years in the control group. Periventricular white matter hyperintensities were observed in 3 patients. On MR spectroscopy study, significantly lower levels of Choline metabolite (Cho) were detected in the frontal subcortical region and thalamus regions of the patients compared with the control group. There was no statistically significant difference between the levels of other metabolites (NAA, Cr, mI and Glx). In the lentiform nucleus, although the average value of Cho in ES patients was lower than that of the control group, it was not statistically significant. Conclusion: Cho metabolite was determined to have an important role in brain metabolism in Eisenmenger syndrome patients. Oral Cho treatment may help to extend survival.

  12. Study to Evaluate Targeted Management and Syndromic Management in Women Presenting with Abnormal Vaginal Discharge.

    Science.gov (United States)

    Meena, Veena; Bansal, Charu Lata

    2016-10-01

    Vaginal discharge is a commonest complaint among women in reproductive age group. Infective vaginal discharge can be broadly categorized into vaginitis or mucopurulent cervicitis. Vaginitis is predominantly caused by bacterial vaginosis, vaginal candidiasis, vaginal trichomoniasis, etc. Mucopurulent cervicitis is due to chlamydia or gonococcal infection. The targeted management is based on identification of causative organism and targeting the therapy against it, while syndromic management is based on high risk factors's presence. To study the effect of targeted management as compared to syndromic management in achieving a complete cure for abnormal vaginal discharge and to study the microbial flora of women presenting with abnormal vaginal discharge. The study is a randomized control trial conducted at tertiary health care on 200 women who presented with abnormal vaginal discharge, distributed in two groups A and B each consisted of 100 women. Group A underwent laboratory investigations, and treatment was started as soon as reports were available. Group B was given syndromic management based on high risk factors's presence. Both groups were followed up after 2 weeks. The prevalence of various organisms in vaginal discharge was candidiasis 39 %, bacterial vaginosis 28 %, trichomoniasis 5 %, N. gonorrhoeae 5 % and chlamydia 2 % among the 100 women in group A. Response to treatment for vaginitis was 76.3 % in group A, whereas it was 41 % in group B. With cervicitis, 71.4 % women responded to treatment in targeted group as compared to 54 % in syndromic management group. There is a potential disadvantage of syndromic management because of its total reliability on a subjective clinical assessment.

  13. Comparison of Nicolaides' risk evaluation for Down's syndrome with a novel software: an analysis of 1,463 cases.

    Science.gov (United States)

    Schmidt, Peter; Staboulidou, Ismini; Soergel, Philipp; Wüstemann, Max; Hillemanns, Peter; Scharf, Alexander

    2007-06-01

    The individual risk assessment of fetal Down's syndrome based on measurement of nuchal translucency (NT) according to Nicolaides, optionally complemented by the determination of PAPP-A and free beta HCG has progressively supplanted other search strategies for fetal aneuploidies. It could be shown that this diagnostic strategy equally detects other numeric aneuploidies at a comparable rate. A positive test result is also predictive for the presence of a fetal malformation. In this field, several computer programs are available for clinical use. The objective of our study was to re-evaluate the first consecutive 1463 NT-risk calculations determined by Nicolaides' method and to compare the risk calculation to the JOY software (NT-risk calculation module, JOY Patient Database) introduced in 2002. At the Department of Obstetrics and Gynecology, Hannover Medical School, 1463 consecutive complete data sets comprising first trimester screening performed between May 2, 2000 and June 26, 2003 and corresponding fetal outcome were analysed using risk assessment based on the Nicolaides method (PIA Fetal Database NT-Module) and compared with the risk evaluation as determined by the JOY software (JOY Patient Database NT module). A risk exceeding 1:300 was considered to indicate the need for further invasive testing. In a first step, only cytogenetically detectable chromosomal aberrations were analysed. Then, a second evaluation including fetal malformations was performed. Among the 1463 cases, 1445 (98.77%) fetuses revealed to be cytogenetically healthy. Both softwares showed identical detection rates at the genetic and somatic level:13 cases of Down-Syndrome (0.89%), 2 cases of trisomy 18 (0.14%), one case of triploidy, one Turner-Syndrome, one Klinefelter-Syndrome (0.07% each) were detected. A positive test result was found in 15 cases ending in a spontaneous abortion, intrauterine death or peripartum death (1.03%) and in 22 cases of fetal malformation (1.50%). At the level of

  14. Evaluation of Metabolic Syndrome in Patients with Chronic Low Back Pain: Using the Fourth Korea National Health and Nutrition Examination Survey Data

    OpenAIRE

    Ha, Jae Yong

    2011-01-01

    The aim of this study was to investigate the frequency of the metabolic syndrome in patients with chronic lower back pain in Korea and to evaluate the differences in clinical characteristics in chronic lower back pain patients with and without metabolic syndrome. This was a cross-sectional study using data from the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) 2008. The sample consisted of 1085 participants with chronic lower back pain. The diagnosis of metabolic ...

  15. Multitracer CMB delensing maps from Planck and WISE data

    Science.gov (United States)

    Yu, Byeonghee; Hill, J. Colin; Sherwin, Blake D.

    2017-12-01

    Delensing, the removal of the limiting lensing B -mode background, is crucial for the success of future cosmic microwave background (CMB) surveys in constraining inflationary gravitational waves (IGWs). In recent work, delensing with large-scale structure tracers has emerged as a promising method both for improving constraints on IGWs and for testing delensing methods for future use. However, the delensing fractions (i.e., the fraction of the lensing-B mode power removed) achieved by recent efforts have been only 20%-30%. In this work, we provide a detailed characterization of a full-sky, dust-cleaned cosmic infrared background (CIB) map for delensing and construct a further-improved delensing template by adding additional tracers to increase delensing performance. In particular, we build a multitracer delensing template by combining the dust-cleaned Planck CIB map with a reconstructed CMB lensing map from Planck and a galaxy number density map from the Wide-field Infrared Survey Explorer (WISE) satellite. For this combination, we calculate the relevant weightings by fitting smooth templates to measurements of all the cross-spectra and autospectra of these maps. On a large fraction of the sky (fsky=0.43 ), we demonstrate that our maps are capable of providing a delensing factor of 43 ±1 % ; using a more restrictive mask (fsky=0.11 ), the delensing factor reaches 48 ±1 % . For low-noise surveys, our delensing maps, which cover much of the sky, can thus improve constraints on the tensor-to-scalar ratio (r ) by nearly a factor of 2. The delensing tracer maps are made publicly available, and we encourage their use in ongoing and upcoming B -mode surveys.

  16. WISE TF: A MID-INFRARED, 3.4 μm EXTENSION OF THE TULLY-FISHER RELATION USING WISE PHOTOMETRY

    International Nuclear Information System (INIS)

    Lagattuta, David J.; Mould, Jeremy R.; Staveley-Smith, Lister; Hong Tao; Springob, Christopher M.; Masters, Karen L.; Koribalski, Bärbel S.; Jones, D. Heath

    2013-01-01

    We present a mid-infrared Tully-Fisher (TF) relation using photometry from the 3.4 μm W1 band of the Wide-field Infrared Survey Explorer (WISE) satellite. The WISE TF relation is formed from 568 galaxies taken from the all-sky 2MASS Tully-Fisher (2MTF) galaxy catalog, spanning a range of environments including field, group, and cluster galaxies. This constitutes the largest mid-infrared TF relation constructed to date. After applying a number of corrections to galaxy magnitudes and line widths, we measure a master TF relation given by M corr = –22.24 – 10.05[log (W corr ) – 2.5], with an average dispersion of σ WISE = 0.686 mag. There is some tension between WISE TF and a preliminary 3.6 μm relation, which has a shallower slope and almost no intrinsic dispersion. However, our results agree well with a more recent relation constructed from a large sample of cluster galaxies. We additionally compare WISE TF to the near-infrared 2MTF template relations, finding a good agreement between the TF parameters and total dispersions of WISE TF and the 2MTF K-band template. This fact, coupled with typical galaxy colors of (K – W1) ∼ 0, suggests that these two bands are tracing similar stellar populations, including the older, centrally-located stars in the galactic bulge which can (for galaxies with a prominent bulge) dominate the light profile.

  17. Building Community and Fostering Success in STEM Through the Women in Science & Engineering (WiSE) Program at the University of Nevada, Reno

    Science.gov (United States)

    Langus, T. C.; Tempel, R. N.

    2017-12-01

    The Women in Science & Engineering (WiSE) program at the University of Nevada, Reno (UNR) aims to recruit and retain a diverse population of women in STEM fields. During the WiSE Program's 10 years in service, we have primarily functioned as a resource for 364 young women to expand their pre-professional network by building valuable relationships with like-minded women. More recently, we have introduced key changes to better benefit our WiSE scholars, establishing a new residence hall, the Living Learning Community (LLC). The introduction of the LLC, resident assistants, and academic mentors helped to provide support to a diverse culture of women with varying thoughts, values, attitudes, and identities. To evaluate the progress of our program, demographic data was statistically analyzed using SPSS to identify correlations between math preparation, performance in foundational courses, average time to graduation, and retention in STEM majors. Initial programmatic assessment indicates that students participating in WiSE are provided a more well-rounded experience while pursuing higher education. We have maintained a 90% retention rate of females graduating with bachelor's degrees in STEM disciplines (n=187), with many graduates completing advanced masters and doctoral degrees and seamlessly entering into post-graduate internships, professional, and industry careers. The success of the WiSE program is attributed to a focused initiative in fostering supportive classroom environments through common course enrollment, professional development, and engaging women in their community through service learning. As a continued focus, we aim to increase the inclusivity and representation of women at UNR in underrepresented fields such as physics, math, and the geosciences. Further program improvements will be based on ongoing research, including a qualitative approach to explore how providing gender equitable resources influences the persistence of women in STEM.

  18. Medication use among pediatric patients with chronic musculoskeletal pain syndromes at initial pain clinic evaluation.

    Science.gov (United States)

    W Guite, Jessica; Sherry, David D; Jarvis, Esther W; O Lewen, Margaret; Khan, Sarosh; Wickham Kraemer, Francis

    2018-01-01

    To characterize medication use by adolescents with chronic musculoskeletal pain syndromes before an initial multidisciplinary clinic visit. A cross-sectional sample of 120 adolescents and parents reported on standardized assessment measures, with medication use data extracted from the medical chart and categorized. On average, 3.2 medications were reported; 70% used more than one pain-specific medication including opioids (17%), nonopioids (31%), psychotropics/neuropathics (45%) and other medications (13%). Adolescents with complex regional pain syndrome consistently reported greatest use of opioid, psychotropic/neuropathic and other pain medications. A regression model explained 17% of the variance in pain medication use. Nonpain medication use and disability contributed unique variance - pain duration and intensity did not. Greater attention to factors contributing to prescriptive practices, medication use and long-term outcomes is warranted.

  19. Evaluation of systems for reducing the transmission of Porcine reproductive and respiratory syndrome virus by aerosol

    OpenAIRE

    Dee, Scott A.; Batista, Laura; Deen, John; Pijoan, Carlos

    2006-01-01

    The purpose of this study was to compare 3 methods for the reduction of aerosol transmission of Porcine reproductive and respiratory syndrome virus (PRRSV): high-efficiency particulate air (HEPA) filtration, low-cost filtration, and ultraviolet light (UV) irradiation. The HEPA-filtration system involved a pre-filter screen, a bag filter (EU8 rating), and a HEPA filter (EU13 rating). The low-cost-filtration system contained mosquito netting (pre-filter), a fiberglass furnace filter, and an ele...

  20. The evaluation of disphagic syndrome, in patients with previously acquired brain damages

    OpenAIRE

    BARTULI, F. N.; LUCIANI, F.; MARINO, S.; BRAMANTI, E.; CECCHETTI, F.; ARCURI, C.

    2010-01-01

    Recently clinical studies have proved without doubts that in patients affect by neurological diseases, like stroke, parkinsonism syndromes and others neurodegenerative pathologies, there is a very elevated incidence of swallowing disorders even severe. The disease can show up in a full blown way, with clinical evident signs like suffocation or frequent and sudden cough, at the moment in which the patient tries to feed or to drink; or it can appear in a less clear way, through an unable protec...

  1. Evaluating compliance to a low glycaemic index (GI) diet in women with polycystic ovary syndrome (PCOS)

    OpenAIRE

    Egan, Nicola; Read, Anna; Riley, Paddy; Atiomo, William

    2011-01-01

    Abstract Background A low Glycaemic Index (GI) diet may decrease some long-term health risks in Polycystic Ovary Syndrome (PCOS) such as endometrial cancer. This study was performed to assess compliance to a low GI diet in women with PCOS. Food diaries prospectively collected over 6 months from women on a low GI diet or healthy eating diet were analysed retrospectively. The women were recruited for a pilot randomised control trial investigating whether a low GI diet decreased the risk of Endo...

  2. Interstitial cystitis/painful bladder syndrome: diagnostic evaluation and therapeutic response in a private urogynecology unit.

    Science.gov (United States)

    Flores-Carreras, Oscar; González-Ruiz, Maria Isabel; Martínez-Espinoza, Claudia J; Monroy-Rodríguez, Fabiola; Zaragoza-Torres, Rocio M

    2015-12-01

    Interstitial cystitis/painful bladder syndrome (IC/PBS) is a spectrum of pelvic, bladder or urethral pain, as well as irritative voiding symptoms. The term interstitial cystitis (IC) is reserved for patients with typical cystoscopic features. Diagnosis and management of this syndrome may be difficult. The aim of this study was to describe endoscopic features and our experience on the treatment of this syndrome in Urodifem de Occidente S.C., a private urogynecology unit. Observational, retrospective analytic study of 25 treated patients from 33 with diagnosis of IC/PBS between January 2001 and March 2015. The diagnosis was done by clinical, cystoscopic and urodynamic approach. Treatment was based on bladder instillation of dymetilsulfoxido (DMSO), dexamethasone and heparin. Oral pentosan polysulphate was prescribed for at least 1 year. Cystoscopic findings showed petechial hemorrhages in 32%, Hunner's lesions in 28%, glomerulations in 28% and bladder pain in absence of lesions in 12%. The basic treatment included one instillation once a week for 6 weeks, twice a month for 2 months and four monthly instillations. Three cases had complete remission of their symptoms, 21 had significant improvement and we have only one failure. We recommend the combined use of DMSO instillation and pentosan polysulphate (PPS) in cases of IC/PBS.

  3. Global Data Set of Derived Soil Properties, 0.5-Degree Grid (ISRIC-WISE)

    Data.gov (United States)

    National Aeronautics and Space Administration — The World Inventory of Soil Emission Potentials (WISE) database was used to generate a series of uniform data sets of derived soil properties for each of the 106...

  4. Using the thoughts on teen parenting survey to determine the impact of Wise Guys.

    Science.gov (United States)

    Herrman, Judith W; Moore, Christopher C; Sims, Regina

    2013-04-01

    The purpose of this project was to determine if the Wise Guys program influences young men's perceptions of the impact a teen birth would have on their lives in the areas of relationships, vocation, and personal life. The Wise Guys program was implemented with 70 adolescent males. The Thoughts on Teen Parenting Survey was used to determine participants' perceptions of the costs and rewards associated with teen parenting. Data, analyzed using paired t-tests, demonstrated that Wise Guys was effective in reinforcing less positive perceptions of teen parenting. Wise Guys offers an important strategy to impact young men's perceptions about the teen parenting experience and provides one means to promote responsible sexual behavior in teen men. © 2012, Wiley Periodicals, Inc.

  5. The Astro-Wise system: a federated information accumulator for astronomy

    NARCIS (Netherlands)

    Valentijn, Edwin A.; Verdoes Kleijn, Gijs

    2007-01-01

    The Astro-Wise consortium has designed a new paradigm, ‘Awe‘, and implemented a fully scalable and distributed information system to overcome the huge information avalanche in wide-field astronomical imaging Surveys.

  6. LBA Regional Derived Soil Properties, 0.5-Deg (ISRIC-WISE)

    Data.gov (United States)

    National Aeronautics and Space Administration — The data set consists of a subset of the ISRIC-WISE global data set of derived soil properties for the study area of the Large Scale Biosphere-Atmosphere Experiment...

  7. LBA Regional Derived Soil Properties, 0.5-Deg (ISRIC-WISE)

    Data.gov (United States)

    National Aeronautics and Space Administration — ABSTRACT: The data set consists of a subset of the ISRIC-WISE global data set of derived soil properties for the study area of the Large Scale Biosphere-Atmosphere...

  8. Battle-Wise: Seeking Time-Information Superiority in Networked Warfare

    National Research Council Canada - National Science Library

    Gompert, David C; Lachow, Irving; Perkins, Justin; Smith, Raymond C; Wells, Linton

    2006-01-01

    .... This is not so in the 21st century. Taking the information revolution as a starting point, Battle-Wise argues that only by strengthening the relationship between information technology and brain matter will the U.S...

  9. Prospective, randomized evaluation of endoscopic versus open carpal tunnel release in bilateral carpal tunnel syndrome: an interim analysis.

    Science.gov (United States)

    Michelotti, Brett; Romanowsky, Diane; Hauck, Randy M

    2014-12-01

    Most randomized trials have shown similar results with endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR); however, there are studies suggesting less postoperative pain, faster improvement in grip and pinch strength, and earlier return to work with the endoscopic technique. The goal of this study was to prospectively examine subjective and functional outcomes, satisfaction, and complications after both ECTR and OCTR in the opposite hands of the same patient, serving as their own control. This was a prospective, randomized study in which patients underwent surgery for bilateral carpal tunnel syndrome. The first carpal tunnel release was performed on the most symptomatic hand-determined by the patient. Operative approach was randomly assigned and, approximately 1 month later, the alternative technique was performed on the contralateral side. Demographic data were obtained, and functional outcomes were recorded preoperatively and postoperatively, including pain score, 2-point discrimination, Semmes-Weinstein monofilament testing, thenar strength, and overall grip strength. The carpal tunnel syndrome-functional status score and carpal tunnel syndrome-symptom severity score were recorded before surgery and at 2, 4, 8, 12, and 24 weeks postoperatively. Overall satisfaction with each technique was recorded at the conclusion of the study. Currently, 25 subjects have completed final visit testing. There were no differences in pain score, 2-point discrimination, Semmes-Weinstein monofilament testing, thenar strength, or overall grip strength at any of the postoperative time points. Carpal tunnel syndrome-symptom severity score and carpal tunnel syndrome-functional status score were not significantly different between groups at any of the evaluations. Overall satisfaction, where patients recorded a number from 0 to 100, was significantly greater in the ECTR group (95.95 vs 91.60, P = 0.04). There were no complications with either technique. This

  10. EVALUATION OF OCULAR PROFILE OF PATIENTS WITH PSEUDOEXFOLIATION SYNDROME IN A TERTIARY EYE CARE CENTER IN WEST BENGAL

    Directory of Open Access Journals (Sweden)

    Nirmal Kumar Sasmal

    2017-07-01

    Full Text Available BACKGROUND Pseudoexfoliation Syndrome (PEX is characterized by the deposition of a distinctive fibrillar material on the lens capsule, pupillary margin, iris, ciliary body and subconjunctival tissue and has also been identified in other parts of the body. PEX occurs worldwide and prevalence rates vary from 10 to 20% of the general population over the age of 60 years. Heightened awareness of this condition and its associated clinical signs are important in the detection and management of glaucoma, and preoperative determination of those patients at increased risk for surgical complications. The aim of the study was to evaluate the ocular profile of patients with Pseudoexfoliation Syndrome in a tertiary eye care centre in West Bengal and to assess surgical complications which may arise from Pseudoexfoliation Syndrome. MATERIALS AND METHODS This is institution based cross sectional study, conducted at the Regional Institute of Ophthalmology (RIO OPD over a period of 1.5 years starting from February 2014 to July 2015. Fifty patients with the age between 20-80 years, attending RIO, OPD and diagnosed as having Pseudoexfoliation Syndrome were included in our study. Patients with other causes of secondary glaucoma and Fuchs Heterochromic Uveitis were excluded from our study RESULTS In our study we found results similar to other studies with respect to age distribution of pseudo exfoliation patients. Higher incidence was found in age group of patients more than 55 years. The PEX patients in our study had10.0%, 4.0%, 3.0% and 2.0% of pseudoexfoliation glaucoma (PXG, primary open angle glaucoma (POAG, primary angle closure glaucoma(PACG and normal tension glaucoma (NTG respectively. 81% eyes were non-glaucomatous. The mean IOP (mean ± s.d. of the patients was 17.48 ± 2.58 mmHg with range 14 - 23 mmHg and the median was 17 mmHg. Surgical complication was observed in 22.22% of the cases, but this was not further analysed since very few patients (9 patients

  11. Efficient space-time sampling with pixel-wise coded exposure for high-speed imaging.

    Science.gov (United States)

    Liu, Dengyu; Gu, Jinwei; Hitomi, Yasunobu; Gupta, Mohit; Mitsunaga, Tomoo; Nayar, Shree K

    2014-02-01

    Cameras face a fundamental trade-off between spatial and temporal resolution. Digital still cameras can capture images with high spatial resolution, but most high-speed video cameras have relatively low spatial resolution. It is hard to overcome this trade-off without incurring a significant increase in hardware costs. In this paper, we propose techniques for sampling, representing, and reconstructing the space-time volume to overcome this trade-off. Our approach has two important distinctions compared to previous works: 1) We achieve sparse representation of videos by learning an overcomplete dictionary on video patches, and 2) we adhere to practical hardware constraints on sampling schemes imposed by architectures of current image sensors, which means that our sampling function can be implemented on CMOS image sensors with modified control units in the future. We evaluate components of our approach, sampling function and sparse representation, by comparing them to several existing approaches. We also implement a prototype imaging system with pixel-wise coded exposure control using a liquid crystal on silicon device. System characteristics such as field of view and modulation transfer function are evaluated for our imaging system. Both simulations and experiments on a wide range of scenes show that our method can effectively reconstruct a video from a single coded image while maintaining high spatial resolution.

  12. An Equivalent Layer-Wise Approach for the Free Vibration Analysis of Thick and Thin Laminated and Sandwich Shells

    Directory of Open Access Journals (Sweden)

    Francesco Tornabene

    2016-12-01

    Full Text Available The main purpose of the paper is to present an innovative higher-order structural theory to accurately evaluate the natural frequencies of laminated composite shells. A new kinematic model is developed starting from the theoretical framework given by a unified formulation. The kinematic expansion is taken as a free parameter, and the three-dimensional displacement field is described by using alternatively the Legendre or Lagrange polynomials, following the key points of the most typical Layer-wise (LW approaches. The structure is considered as a unique body and all the geometric and mechanical properties are evaluated on the shell middle surface, following the idea of the well-known Equivalent Single Layer (ESL models. For this purpose, the name Equivalent Layer-Wise (ELW is introduced to define the present approach. The governing equations are solved numerically by means of the Generalized Differential Quadrature (GDQ method and the solutions are compared with the results available in the literature or obtained through a commercial finite element program. Due to the generality of the current method, several boundary conditions and various mechanical and geometric configurations are considered. Finally, it should be underlined that different doubly-curved surfaces may be considered following the mathematical framework given by the differential geometry.

  13. Development and evaluation of an E-health system to care for patients with bladder pain syndrome/interstitial cystitis.

    Science.gov (United States)

    Lee, Ming-Huei; Wu, Huei-Ching; Lin, Jen-Yung; Tan, Tan-Hsu; Chan, Po-Chou; Chen, Yung-Fu

    2014-04-01

    Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease that highly degrades the quality of life for patients. In the present study, Internet intervention was used to care for bladder pain syndrome/interstitial cystitis patients to alleviate their pain and bothering symptoms. Healthcare education was carried out through the Internet by asking the patients, who were randomly divided into study (40 patients) and control (40 patients) groups, to check possible sensitive foods, habits, and behaviors weekly to remind and consolidate important rules for promoting quality of life. The symptom flares consultation through short message service with the Internet used to elevate healthcare efficiency was undertaken. Questionnaires, including Short Form 36 health survey, O'Leary-Sant symptom and problem indices, as well as visual analog scales pain and urgency scales, were used to evaluate quality of life and disease severity improvements before and after information and communication technology intervention. The outcome was evaluated at week 8. The quality of life of both the control and study groups was significantly improved. The quality of life and visual analog scales for the patients in the study group with information and communication technology intervention showed a much greater improvement compared with the patients in the control group (P interstitial cystitis patients through intervention of Internet healthcare education and short message service for the consolidation of healthy behavior and lifestyle in the 8-week follow up. © 2014 The Japanese Urological Association.

  14. Productivity Enhancement of Solar Still with PV Powered Heating Coil and Chamber Step-Wise Basin

    Directory of Open Access Journals (Sweden)

    Salah Abdallah

    2018-03-01

    Full Text Available There is a strong need to improve the productivity of single slope solar still. PV generator powered electrical heater and chamber step-wise design were introduced to the conventional solar still. An experimental study was performed to investigate the effect of adding the above mentioned modifications on the output parameters of the modified solar still. The inclusion of PV-powered heating coil and chamber step-wise design enhanced the productivity of distiller by up to 1098%.

  15. Serotonin syndrome

    Science.gov (United States)

    Hyperserotonemia; Serotonergic syndrome; Serotonin toxicity; SSRI - serotonin syndrome; MAO - serotonin syndrome ... brain area. For example, you can develop this syndrome if you take migraine medicines called triptans together ...

  16. Nutritional support in the tertiary care of patients affected by chronic renal insufficiency: report of a step-wise, personalized, pragmatic approach

    OpenAIRE

    Cupisti, Adamasco; D?Alessandro, Claudia; Di Iorio, Biagio; Bottai, Anna; Zullo, Claudia; Giannese, Domenico; Barsotti, Massimiliano; Egidi, Maria Francesca

    2016-01-01

    Background Dietary treatment is helpful in CKD patients, but nutritional interventions are scarcely implemented. The main concern of the renal diets is its feasibility with regards to daily clinical practice especially in the elderly and co-morbid patients. This study aimed to evaluate the effects of a pragmatic, step-wise, personalized nutritional support in the management of CKD patients on tertiary care. Methods This is a case-control study. It included 823 prevalent out-patients affected ...

  17. Amniotic band syndrome with sacral agenesis and umbilical cord entrapment: A case report emphasizing the value of evaluation of umbilical cord.

    Science.gov (United States)

    Gupta, Kanika; Venkatesan, Bhuvaneswari; Chandra, Tushar; Rajeswari, Kathiah; Devi, Thangammal Kandasamy Renuka

    2015-03-01

    Amniotic band syndrome is a rare congenital disorder caused by entrapment of fetal parts by fibrous amniotic bands in utero. The congenital anomalies seen in this syndrome vary widely and defects may be isolated or multiple and do not follow a specific pattern. Asymmetric distribution of defects is the hallmark of this syndrome. The diagnosis is difficult to make on ultrasound and relies on identification of amniotic bands. We report a case of amniotic band syndrome with sacral agenesis diagnosed on routine antenatal ultrasound scan in the second offspring of a recently diagnosed diabetic mother. The associated features were entrapment of umbilical cord, caudal adhesions and lower limb anomalies. Medical termination of pregnancy was done and all the fetal anomalies as well as umbilical cord abnormalities were confirmed. The importance of meticulous scanning to evaluate for amniotic bands and the umbilical cord in addition to the fetal structures is emphasized.

  18. Evaluation of Visual Evoked Potentials in Patient with Angelmans Syndrome - Case Report

    Directory of Open Access Journals (Sweden)

    Tatjana Knezevic

    2013-06-01

    Full Text Available Background: Angelman syndrome (AS is a genetic disorder with varying degrees of neurological impairment. It is often associated with ocular involvement. Case Report: We present a child diagnosed with AS who had a deletion on the short arm of chromosome 15. The child seemed to be happy, with developmental delay, speech problem, and altering strabismus. To assess the potential presence and degree of damage in the visual pathway, we recorded monocular flash visual evoked potentials (VEPs. Our results revealed the presence of severe central afferent dysfunction in both optical pathways. Conclusion: VEPs can be used in patients with AS and visual disturbances to assess the integrity of the visual system.

  19. Comparative evaluation of the influence of diabetic retinopathy progression factors on indices of lipid metabolism in metabolic syndrome

    Directory of Open Access Journals (Sweden)

    L.Yu. Pуlуpenko

    2017-11-01

    Full Text Available Background. The search and study of new risk factors for the development and progression of diabetic retinopathy (DRP and their modifying influence on the components of metabolic syndrome in type 2 diabetes mellitus (T2DM remain relevant. The purpose was to conduct a comparative evaluation of the impact of certain DRP development factors on indices of lipid metabolism in metabolic syndrome. Materials and methods. The research was carried out in 64 patients (95 eyes with T2DM, metabolic syndrome and DRP (males and females, average age 61.55 ± 2.37 years, average duration of diabetes 11.23 ± 2.11 years, average level of HbA1c 9.89 ± 0.78 %, average body mass index 34.55 ± 3.75 kg/m2, who were divided into 3 groups depending on the stage of DRP. Results. Results had showed that the following factors have modifying influence on the level of total cholesterol in the blood of patients with T2DM and DRP: age of patients (under 60 years, duration of diabetes (less than 10 years, decompensation of carbohydrates metabolism — for the 3rd stage of DRP, features of therapy for T2DM (oral hypoglycemic drugs — for the 2nd stage of DRP; on the level of low-density lipoprotein cholesterol: younger age of patients, decompensation of diabetes — for the 3rd stage of DRP, features of hypoglycemic therapy (insulin therapy, shorter duration of diabetes — for the 2nd stage of DRP; on the level of triglycerides: age of patients (under 60 years, duration of diabetes (less than 10 years and insulin therapy — for the 1st and 3rd stages of DRP. Conclusions. It is concluded that features of hypoglycemic therapy can be a new modifying factor for the risk of DRP progression.

  20. Interstage evaluation of homograft-valved right ventricle to pulmonary artery conduits for palliation of hypoplastic left heart syndrome.

    Science.gov (United States)

    Sandeep, Nefthi; Punn, Rajesh; Balasubramanian, Sowmya; Smith, Shea N; Reinhartz, Olaf; Zhang, Yulin; Wright, Gail E; Peng, Lynn F; Wise-Faberowski, Lisa; Hanley, Frank L; McElhinney, Doff B

    2018-04-01

    Palliation of hypoplastic left heart syndrome with a standard nonvalved right ventricle to pulmonary artery conduit results in an inefficient circulation in part due to diastolic regurgitation. A composite right ventricle pulmonary artery conduit with a homograft valve has a hypothetical advantage of reducing regurgitation, but may differ in the propensity for stenosis because of valve remodeling. This retrospective cohort study included 130 patients with hypoplastic left heart syndrome who underwent a modified stage 1 procedure with a right ventricle to pulmonary artery conduit from 2002 to 2015. A composite valved conduit (cryopreserved homograft valve anastomosed to a polytetrafluoroethylene tube) was placed in 100 patients (47 aortic, 32 pulmonary, 13 femoral/saphenous vein, 8 unknown), and a nonvalved conduit was used in 30 patients. Echocardiographic functional parameters were evaluated before and after stage 1 palliation and before the bidirectional Glenn procedure, and interstage interventions were assessed. On competing risk analysis, survival over time was better in the valved conduit group (P = .040), but this difference was no longer significant after adjustment for surgical era. There was no significant difference between groups in the cumulative incidence of bidirectional Glenn completion (P = .15). Patients with a valved conduit underwent more interventions for conduit obstruction in the interstage period, but this difference did not reach significance (P = .16). There were no differences between groups in echocardiographic parameters of right ventricle function at baseline or pre-Glenn. In this cohort of patients with hypoplastic left heart syndrome, inclusion of a valved right ventricle to pulmonary artery conduit was not associated with any difference in survival on adjusted analysis and did not confer an identifiable benefit on right ventricle function. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier

  1. Plasma free amino acid profiles evaluate risk of metabolic syndrome, diabetes, dyslipidemia, and hypertension in a large Asian population.

    Science.gov (United States)

    Yamaguchi, Natsu; Mahbub, M H; Takahashi, Hidekazu; Hase, Ryosuke; Ishimaru, Yasutaka; Sunagawa, Hiroshi; Amano, Hiroki; Kobayashi-Miura, Mikiko; Kanda, Hideyuki; Fujita, Yasuyuki; Yamamoto, Hiroshi; Yamamoto, Mai; Kikuchi, Shinya; Ikeda, Atsuko; Takasu, Mariko; Kageyama, Naoko; Nakamura, Mina; Tanabe, Tsuyoshi

    2017-04-07

    Recently, the association of plasma free amino acid (PFAA) profile and lifestyle-related diseases has been reported. However, few studies have been reported in large Asian populations, about the usefulness of PFAAs for evaluating disease risks. We examined the ability of PFAA profiles to evaluate lifestyle-related diseases in so far the largest Asian population. We examined plasma concentrations of 19 amino acids in 8589 Japanese subjects, and determined the association with variables associated with obesity, blood glucose, lipid, and blood pressure. We also evaluated the PFAA indexes that reflect visceral fat obesity and insulin resistance. The contribution of single PFAA level and relevant PFAA indexes was also examined in the risk assessment of lifestyle-related diseases. Of the 19 amino acids, branched-chain amino acids and aromatic amino acids showed association with obesity and lipid variables. The PFAA index related to visceral fat obesity showed relatively higher correlation with variables than that of any PFAA. In the evaluation of lifestyle-related disease risks, the odds ratios of the PFAA index related to visceral fat obesity or insulin resistance with the diseases were higher than most of those of individual amino acid levels even after adjusting for potential confounding factors. The association pattern of the indexes and PFAA with each lifestyle-related disease was distinct. We confirmed the usefulness of PFAA profiles and indexes as markers for evaluating the risks of lifestyle-related diseases, including diabetes mellitus, metabolic syndrome, dyslipidemia, and hypertension in a large Asian population.

  2. Multiobjective Level-Wise Scientific Workflow Optimization in IaaS Public Cloud Environment

    Directory of Open Access Journals (Sweden)

    Phyo Thandar Thant

    2017-01-01

    Full Text Available Cloud computing in the field of scientific applications such as scientific big data processing and big data analytics has become popular because of its service oriented model that provides a pool of abstracted, virtualized, dynamically scalable computing resources and services on demand over the Internet. However, resource selection to make the right choice of instances for a certain application of interest is a challenging problem for researchers. In addition, providing services with optimal performance at the lowest financial resource deployment cost based on users’ resource selection is quite challenging for cloud service providers. Consequently, it is necessary to develop an optimization system that can provide benefits to both users and service providers. In this paper, we conduct scientific workflow optimization on three perspectives: makespan minimization, virtual machine deployment cost minimization, and virtual machine failure minimization in the cloud infrastructure in a level-wise manner. Further, balanced task assignment to the virtual machine instances at each level of the workflow is also considered. Finally, system efficiency verification is conducted through evaluation of the results with different multiobjective optimization algorithms such as SPEA2 and NSGA-II.

  3. [Re-evaluation of classification of myelodysplastic syndromes with low percentage bone marrow blasts].

    Science.gov (United States)

    Yu, Ming-Hua; Xu, Ze-Feng; Li, Lin; Nie, Ling; Liu, Liang; Zhang, Yue; Qin, Tie-Jun; Hao, Yu-Shu; Xiao, Zhi-Jian

    2009-01-01

    To apply the WHO criteria and the minimal diagnostic criteria to the classification of myelodysplastic syndromes (MDS) with low percentage (MDS patients with less than 0.050 BM blasts diagnosed between 1988 and 2005 according to FAB criteria were retrospectively reclassified with WHO criteria (2001) and minimal diagnostic criteria. According to the WHO criteria, 5 patients were diagnosed as refractory anemia (RA), 7 as refractory anemia with ringed sideroblasts (RARS), 76 as refractory cytopenia with multilineage dysplasia (RCMD), 9 as RCMD-RS, 35 as MDS-unclassified (MDS-U), 3 as 5q - syndromes, and the rest 75 patients could not be classified suitably. Among the latter 75 patients 16 BM smears showed dysplasia in more than 2 cell lineage but only unilineage cytopenia in peripheral blood (PB). Nine of them were reclassified as RCMD after followed up for more than half a year. Forty-four BM smears showed erythroid dysplasia only, but bicytopenia or pancytopenia in PB. Twenty-seven of them were classified as RCMD after follow-up. Fifteen BM smears not showed dysplasia in any myeloid lineage were reclassified as MDS (5 patients), HS-MDS (5 patients) and idiopathic cytopenia of uncertain significance (ICUS) (5 patients) according to the MDS minimal diagnostic criteria. According to WHO criteria (2001), RA is the least diagnosis in MDS. The minimal diagnostic criteria for MDS classification of patients not fulfilled the standard criteria of MDS.

  4. Radiological evaluation of acromial characteristic using supraspinatus outlet view in shoulder impingement syndrome

    Directory of Open Access Journals (Sweden)

    Marcel Prasetyo

    2007-09-01

    Full Text Available Purpose of this study was to find the association between shoulder impingement syndrome (SIS and morphological characteristics of acromion (acromial tilt angle, type of acromion, subacromial osteophyte. Supraspinatus outlet view was performed using fluoroscopy. There were 40 SIS patients and 40 individuals with no shoulder pain examined and measured for their acromial tilt angle, type of acromion (according to Bigliani’s classification and Park’s criteria and for the presence of subacromial osteophyte. Average acromial tilt angle was 34.1° (SD 7.6 for SIS group and 32.1° (SD 7.7 for control group. Type II acromion was found more frequent in both groups (85% and 95%. The association between SIS and acromial tilt angle or between SIS and type of acromion were statistically insignificant (p=0.241 and p=0.221. Subacromial osteophyte was found in 52.5% of SIS group compare to 12.5% among the control group, and the association with SIS was statistically significant (p=0.0003. Subacromial osteophyte was found to have significant association with SIS. Such association was not found in acromial tilt angle and type of acromion. (Med J Indones 2007; 16:176-80 Keywords: shoulder impingement syndrome, acromion, supraspinatus

  5. Evaluation of functional characteristics of preactivated thiolated chitosan as potential therapeutic agent for dry mouth syndrome.

    Science.gov (United States)

    Laffleur, Flavia; Fischer, Alexander; Schmutzler, Matthias; Hintzen, Fabian; Bernkop-Schnürch, Andreas

    2015-07-01

    The objective of this study was to investigate preactivated thiomers for their potential in the treatment of dry mouth syndrome. Chitosan-thioglycolic-mercaptonicotinamide conjugates (chitosan-TGA-MNA) were synthesized by the oxidative S-S coupling of chitosan-thioglycolic acid (chitosan-TGA) with 6-mercaptonicotinamide (MNA). Test disks were compressed out of unmodified chitosan, chitosan-TGA (thiomers) and chitosan-TGA-MNA conjugates to investigate cohesive properties, cytotoxicity assays and mucoadhesion studies. Immobilizing the MNA achieved higher swelling and cohesive properties of chitosan-TGA-MNA conjugates compared to unmodified chitosan. Rotating cylinder studies displayed a 3.1-fold improvement of mucoadhesiveness of chitosan-TGA-MNA conjugates compared to thiolated polymers. Findings in tensile strength were in good agreement with rotating cylinder ones. Furthermore, preactivated thiomers exhibit higher stability. All conjugates were found non-toxic against Caco-2 cells. Preactivated thiolated chitosan could be a promising system for the treatment of dry mouth syndrome where mucosa requires lubrication and mucoadhesiveness. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  6. Caudal duplication syndrome: imaging evaluation of a rare entity in an adult patient

    Directory of Open Access Journals (Sweden)

    Tianshen Hu, BS

    2016-03-01

    Full Text Available Several theories have been put forth to explain the complex yet symmetrical malformations and the myriad of clinical presentations of caudal duplication syndrome. Hereby, reported case is a 28-year-old female, gravida 2 para 2, with congenital caudal malformation who has undergone partial reconstructive surgeries in infancy to connect her 2 colons. She presented with recurrent left lower abdominal pain associated with nausea, vomiting, and subsequent feculent anal discharge. Imaging reveals duplication of the urinary bladder, urethra, and colon with with cloacal malformations and fistulae from the left-sided cloaca, uterus didelphys with separate cervices and vaginal canals, right-sided aortic arch and descending thoracic aorta, and dysraphic midline sacrococcygeal defect. Hydronephrosis of the left kidney with left hydroureter and inflammation of one of the colons were suspected to be the cause of the patient’s acute complaints. She improved symptomatically over the course of her hospitalization stay with conservative treatments. The management for this syndrome is individualized and may include surgical intervention to fuse or excise the duplicated organs.

  7. Choosing wisely in headache medicine: the American Headache Society's list of five things physicians and patients should question.

    Science.gov (United States)

    Loder, Elizabeth; Weizenbaum, Emma; Frishberg, Benjamin; Silberstein, Stephen

    2013-01-01

    In an effort to draw attention to tests and procedures associated with low-value care in headache medicine, the American Headache Society (AHS) joined the Choosing Wisely initiative of the American Board of Internal Medicine Foundation. The AHS president appointed an ad hoc "Choosing Wisely" task force of the AHS. The committee surveyed AHS members to develop a candidate list of items for the AHS "Top 5" list of low-value care in headache medicine. Through a process of literature review and consensus, the final list of five items was chosen. Draft recommendations went through several rounds of revision and a process of outside review. The AHS Board of Directors approved the final list of "Five Things." The five recommendations approved by the AHS Board of Directors are: (1) don't perform neuroimaging studies in patients with stable headaches that meet criteria for migraine; (2) don't perform computed tomography imaging for headache when magnetic resonance imaging is available, except in emergency settings; (3) don't recommend surgical deactivation of migraine trigger points outside of a clinical trial; (4) don't prescribe opioid- or butalbital-containing medications as a first-line treatment for recurrent headache disorders; and (5) don't recommend prolonged or frequent use of over-the-counter pain medications for headache. We recommend that headache medicine specialists and other physicians who evaluate and treat headache disorders should use this list when discussing care with patients. © 2013 American Headache Society.

  8. Domain Decomposition strategy for pin-wise full-core Monte Carlo depletion calculation with the reactor Monte Carlo Code

    Energy Technology Data Exchange (ETDEWEB)

    Liang, Jingang; Wang, Kan; Qiu, Yishu [Dept. of Engineering Physics, LiuQing Building, Tsinghua University, Beijing (China); Chai, Xiao Ming; Qiang, Sheng Long [Science and Technology on Reactor System Design Technology Laboratory, Nuclear Power Institute of China, Chengdu (China)

    2016-06-15

    Because of prohibitive data storage requirements in large-scale simulations, the memory problem is an obstacle for Monte Carlo (MC) codes in accomplishing pin-wise three-dimensional (3D) full-core calculations, particularly for whole-core depletion analyses. Various kinds of data are evaluated and quantificational total memory requirements are analyzed based on the Reactor Monte Carlo (RMC) code, showing that tally data, material data, and isotope densities in depletion are three major parts of memory storage. The domain decomposition method is investigated as a means of saving memory, by dividing spatial geometry into domains that are simulated separately by parallel processors. For the validity of particle tracking during transport simulations, particles need to be communicated between domains. In consideration of efficiency, an asynchronous particle communication algorithm is designed and implemented. Furthermore, we couple the domain decomposition method with MC burnup process, under a strategy of utilizing consistent domain partition in both transport and depletion modules. A numerical test of 3D full-core burnup calculations is carried out, indicating that the RMC code, with the domain decomposition method, is capable of pin-wise full-core burnup calculations with millions of depletion regions.

  9. Evaluation of C-reactive protein, haptoglobin and cardiac troponin 1 levels in brachycephalic dogs with upper airway obstructive syndrome.

    Science.gov (United States)

    Planellas, Marta; Cuenca, Rafaela; Tabar, Maria-Dolores; Bertolani, Coralie; Poncet, Cyrill; Closa, Josep M; Lorente, Juan; Cerón, Jose J; Pastor, Josep

    2012-08-31

    Brachycephalic dogs have unique upper respiratory anatomy with abnormal breathing patterns similar to those in humans with obstructive sleep apnea syndrome (OSAS). The objective of this study was to evaluate the correlation between anatomical components, clinical signs and several biomarkers, used to determine systemic inflammation and myocardial damage (C-reactive protein, CRP; Haptoglobin, Hp; cardiac troponin I, cTnI), in dogs with brachycephalic upper airway obstructive syndrome (BAOS). Fifty brachycephalic dogs were included in the study and the following information was studied: signalment, clinical signs, thoracic radiographs, blood work, ECG, components of BAOS, and CRP, Hp and cTnI levels. A high proportion of dogs with BAOS (88%) had gastrointestinal signs. The prevalence of anatomic components of BAOS was: elongated soft palate (100%), stenotic nares (96%), everted laryngeal saccules (32%) and tracheal hypoplasia (29.1%). Increased serum levels of biomarkers were found in a variable proportion of dogs: 14% (7/50) had values of CRP > 20 mg/L, 22.9% (11/48) had values of Hp > 3 g/L and 47.8% (22/46) had levels of cTnI > 0.05 ng/dl. Dogs with everted laryngeal saccules had more severe respiratory signs (pdogs with BAOS that can be detected by cTnI concentration.

  10. Contribution of facet joints to chronic low back pain in postlumbar laminectomy syndrome: a controlled comparative prevalence evaluation.

    Science.gov (United States)

    Manchikanti, L; Pampati, V; Baha, A G; Fellows, B; Damron, K S; Barnhill, R C

    2001-04-01

    Postlumbar laminectomy syndrome, or pain following operative procedures of the lumbar spine, is increasingly a common entity in modern medicine. Multiple causes proposed for recurrence of pain after lumbar laminectomy are: epidural fibrosis, recurrent disc herniation, instability, and facet joints. Even though the prevalence of persistent low back pain secondary to the involvement of lumbosacral facet joints has been described in controlled studies from 15% to 45%, the prevalence of facet joint mediated pain in postlumbar laminectomy syndrome has not been studied. This prospective, randomized, controlled comparative evaluation was performed to determine the prevalence of facet joint mediated pain in persistent low back pain in postlumbar laminectomy patients with a comparative non-surgical group. One hundred patients with fifty patients in each group were randomly assigned with group I consisting of fifty patients without history of previous surgery and group II consisting of fifty patients with history of previous surgery. Results showed that the prevalence of facet joint mediated pain in non-surgical patients was 44% compared to 32% in post surgical patients determined by comparative controlled local anesthetic blocks utilizing lidocaine and bupivacaine. This study also showed a false positive rate of 36% in non-surgical group and 24% in post-surgical group. In conclusion, this study shows that facet joint mediated symptomatology in chronic low back pain is prevalent, both in non-surgical as well as post-surgical patients even though prevalence was somewhat higher in the non-surgical group compared to post-surgical group.

  11. Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the US Multi-Society Task Force on colorectal cancer.

    Science.gov (United States)

    Giardiello, Francis M; Allen, John I; Axilbund, Jennifer E; Boland, C Richard; Burke, Carol A; Burt, Randall W; Church, James M; Dominitz, Jason A; Johnson, David A; Kaltenbach, Tonya; Levin, Theodore R; Lieberman, David A; Robertson, Douglas J; Syngal, Sapna; Rex, Douglas K

    2014-08-01

    The Multi-Society Task Force, in collaboration with invited experts, developed guidelines to assist health care providers with the appropriate provision of genetic testing and management of patients at risk for and affected with Lynch syndrome as follows: Figure 1 provides a colorectal cancer risk assessment tool to screen individuals in the office or endoscopy setting; Figure 2 illustrates a strategy for universal screening for Lynch syndrome by tumor testing of patients diagnosed with colorectal cancer; Figures 3-6 provide algorithms for genetic evaluation of affected and at-risk family members of pedigrees with Lynch syndrome; Table 10 provides guidelines for screening at-risk and affected persons with Lynch syndrome; and Table 12 lists the guidelines for the management of patients with Lynch syndrome. A detailed explanation of Lynch syndrome and the methodology utilized to derive these guidelines, as well as an explanation of, and supporting literature for, these guidelines are provided. Copyright © 2014 American Gastroenterological Association, American College of Gastroenterology, the American Society of Colon and Rectal Surgeons, and the American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  12. In vivo Evaluation of Patellar Tendon Stiffness in Individuals with Patellofemoral Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Hsin-Yi Liu

    2008-01-01

    Full Text Available The objective of this study was to utilise an ultrasonic technique to assess the effect of patellofemoral pain syndrome (PFPS on the mechanical properties of the patellar tendon. Seven subjects with PFPS and seven matched control subjects volunteered to participate in this study. Subjects were asked to perform isometric maximal voluntary contractions of the knee extensors while their knee extension torque was monitored and the displacement of the patellar tendon was recorded with an ultrasonic system. Our results showed significantly lower tendon stiffness (by ∼30% in the PFPS subjects. Although tendon secant modulus was lower by 34% in the PFPS subjects, the difference was not statistically significant. Therefore, we conclude that the ultrasonic technique was able to detect a decrease in the structural stiffness of the patellar tendon associated with PFPS. The decrease in tendon stiffness was moderately correlated with the length of symptoms in these individuals.

  13. Successful Management of Pregnancy Complicated by Klippel-Trenaunay Syndrome Using MR Angiography-Based Evaluation

    Directory of Open Access Journals (Sweden)

    Reiko Tanaka

    2011-01-01

    Full Text Available Klippel-Trenaunay syndrome (KTS is a rare congenital disease, and extensive cutaneous hemangiomas and abnormal venous vessels are characteristic. In our case, to manage her pregnancy with KTS, whole-body MRA was performed before delivery. A 29-year-old woman was referred at 28 weeks because of prominent vulvovaginal varicosities due to KTS. At 35 weeks, hypertrophy and multiple venous varicosities of her leg as well as massive vulvovaginal varicosities became prominent with a normal coagulation profile. Systematic MRAs revealed hemangiomas and varicosities in the right leg, the lower abdomen, and the pubic region, while no obvious AVM was detected around the bronchial tube and spine. We decided to deliver her baby by cesarean section at 37 weeks under general anesthesia, and a healthy baby was delivered. No blood transfusion was required. Prophylaxis against thrombosis was performed after the operation. She was discharged with her baby. Her vulvovaginal varicosities shrunk considerably one month later.

  14. Beals Syndrome

    Science.gov (United States)

    ... the syndrome. How does Beals syndrome compare with Marfan syndrome? People with Beals syndrome have many of the ... bone) and aortic enlargement problems as people with Marfan syndrome, and treatments for these problems are the same. ...

  15. Data Processing, Distribution and Product Characteristics for the WISE Preliminary Data Release

    Science.gov (United States)

    Cutri, Roc M.; IPAC/WISE Science Data Center Team

    2011-01-01

    The Wide-Field Infrared Survey Explorer (WISE) began its digital imaging survey of the sky in the 3.4, 4.6, 12 and 22 micron bands in January 2010. WISE completed its first complete sky coverage in July and will continue to survey until its cryogens are exhausted later this year. A preliminary Image Atlas in the four WISE bands and a corresponding Source Catalog containing accurate positions and mid-infrared photometry that cover the first 55% of the sky surveyed will be released in April 2011. The Infrared Processing and Analysis Center, California Institute of Technology is the WISE Science Data Center (WSDC) and is responsible for processing, archiving and distribution of WISE science data products. We describe the processing system that converts the raw science and engineering data into calibrated Atlas Images and Source Catalog entries, validates and archives these products, and enables access to them by the community. We also describe the general properties of the Preliminary Release data products including areal coverage, image and catalog formats and access modes.

  16. Social class and wise reasoning about interpersonal conflicts across regions, persons and situations.

    Science.gov (United States)

    Brienza, Justin P; Grossmann, Igor

    2017-12-20

    We propose that class is inversely related to a propensity for using wise reasoning (recognizing limits of their knowledge, consider world in flux and change, acknowledges and integrate different perspectives) in interpersonal situations, contrary to established class advantage in abstract cognition. Two studies-an online survey from regions differing in economic affluence ( n = 2 145) and a representative in-lab study with stratified sampling of adults from working and middle-class backgrounds ( n = 299)-tested this proposition, indicating that higher social class consistently related to lower levels of wise reasoning across different levels of analysis, including regional and individual differences, and subjective construal of specific situations. The results held across personal and standardized hypothetical situations, across self-reported and observed wise reasoning, and when controlling for fluid and crystallized cognitive abilities. Consistent with an ecological framework, class differences in wise reasoning were specific to interpersonal (versus societal) conflicts. These findings suggest that higher social class weighs individuals down by providing the ecological constraints that undermine wise reasoning about interpersonal affairs. © 2017 The Authors.

  17. Evaluation of clinical characteristics of Kawasaki syndrome and risk factors for coronary artery abnormalities among children in Denmark.

    Science.gov (United States)

    Patel, Amy; Holman, Robert C; Callinan, Laura S; Sreenivasan, Nandini; Schonberger, Lawrence B; Fischer, Thea K; Belay, Ermias D

    2013-04-01

    To examine clinical characteristics, treatment and outcome of Kawasaki syndrome patients in Denmark. A retrospective chart review of hospitalization records for children Kawasaki syndrome discharge diagnosis identified through the Danish National Patient Registry during 1994 through June 2008 was conducted. A total of 284 cases Kawasaki syndrome (n = 279) and atypical Kawasaki syndrome (n = 5); 70.4% were Kawasaki syndrome patients were diagnosed with coronary artery abnormalities. Not receiving intravenous immunoglobulin treatment before the 10th day of illness, young age and male sex were significantly associated with the development of coronary artery abnormalities. In Denmark, more than one in 10 children with Kawasaki syndrome develop coronary artery abnormalities. Physicians should increase their index of suspicion for early diagnosis and treatment of Kawasaki syndrome among patients susceptible to increased risk of coronary artery abnormalities, particularly in infants who may have a more atypical presentation of the illness. ©2012 The Author(s)/Acta Paediatrica ©2013 Foundation Acta Paediatrica.

  18. Gorlin syndrome

    African Journals Online (AJOL)

    develop medulloblastomas and are treated with radiation, it is mandatory that they be monitored for the development of BCCs in the radiation field. Management of a patient or family with this syndrome should include genetic counselling and neurological evaluations to detect medulloblastoma until the age of 7, after which ...

  19. LEGO[R] Therapy and the Social Use of Language Programme: An Evaluation of Two Social Skills Interventions for Children with High Functioning Autism and Asperger Syndrome

    Science.gov (United States)

    Owens, Gina; Granader, Yael; Humphrey, Ayla; Baron-Cohen, Simon

    2008-01-01

    LEGO[R] therapy and the Social Use of Language Programme (SULP) were evaluated as social skills interventions for 6-11 year olds with high functioning autism and Asperger Syndrome. Children were matched on CA, IQ, and autistic symptoms before being randomly assigned to LEGO or SULP. Therapy occurred for 1 h/week over 18 weeks. A no-intervention…

  20. Evaluation of SCORTEN on a Cohort of Patients With Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Included in the RegiSCAR Study

    NARCIS (Netherlands)

    Sekula, Peggy; Liss, Yvonne; Davidovici, Batya; Dunant, Ariane; Roujeau, Jean-Claude; Kardaun, Sylvia; Naldi, Luigi; Schumacher, Martin; Mockenhaupt, Maja

    2011-01-01

    The purpose of this study was to evaluate the severity-of-illness score called SCORTEN with respect to its predictive ability and by using data obtained in the RegiSCAR study, the most comprehensive European registry of patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis

  1. Retrospective Evaluation of Two Fast-track Strategies to Rule Out Acute Coronary Syndrome in a Real-life Chest Pain Population

    DEFF Research Database (Denmark)

    Schønemann-Lund, Martin; Schoos, Mikkel Malby; Iversen, Kasper

    2015-01-01

    BACKGROUND: The European Society of Cardiology (ESC) guideline on non-ST-elevation acute coronary syndrome (N-STE ACS) proposed a new ACS rule-out protocol. OBJECTIVES: To evaluate this new tool, which uses diagnostic levels of high-sensitivity troponin T (hs-TnT; > 14 ng/L) in a slightly modified...

  2. Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome: An Observational Study.

    Science.gov (United States)

    Seyahi, Emire; Cakmak, Osman Serdal; Tutar, Burcin; Arslan, Caner; Dikici, Atilla Suleyman; Sut, Necdet; Kantarci, Fatih; Tuzun, Hasan; Melikoglu, Melike; Yazici, Hasan

    2015-11-01

    Vascular involvement can be seen in up to 40% of patients with Behcet syndrome (BS), the lower-extremity vein thrombosis (LEVT) being the most common type. The aim of the current study was to compare venous Doppler findings and clinical features between BS patients with LEVT and control patients diagnosed as having LEVT due to other causes.All consecutive 78 patients (71 men, 7 women; mean age 38.6 ± 10.3 years) with LEVT due to BS and 50 control patients (29 men, 21 women; mean age 42.0 ± 12.5 years) who had LEVT due to other causes, or idiopathic, were studied with the help of a Doppler ultrasonography after a detailed clinical examination. Patterns of venous disease were identified by cluster analyses. Clinical features of chronic venous disease were assessed using 2 classification systems. Venous claudication was also assessed.Patients with BS were more likely to be men, had significantly earlier age of onset of thrombosis, and were treated mainly with immunosuppressives and less frequently with anticoagulants. Furthermore, they had significantly more bilateral involvement, less complete recanalization, and more frequent collateral formation. While control patients had a disorganized pattern of venous involvement, BS patients had a contiguous and symmetric pattern, involving all deep and superficial veins of the lower extremities, with less affinity for crural veins. Clinical assessment, as measured by the 2 classification systems, also indicated a more severe disease among the BS patients. In line, 51% of the BS patients suffered from severe post-thrombotic syndrome (PTS) and 32% from venous claudication, whereas these were present in 8% and 12%, respectively, among the controls. Among BS patients, a longer duration of thrombosis, bilateral femoral vein involvement, and using no anticoagulation along with immunosuppressive treatment when first diagnosed were found to be associated independently with severe PTS.Lower-extremity vein thrombosis

  3. Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome

    Science.gov (United States)

    Seyahi, Emire; Cakmak, Osman Serdal; Tutar, Burcin; Arslan, Caner; Dikici, Atilla Suleyman; Sut, Necdet; Kantarci, Fatih; Tuzun, Hasan; Melikoglu, Melike; Yazici, Hasan

    2015-01-01

    Abstract Vascular involvement can be seen in up to 40% of patients with Behcet syndrome (BS), the lower-extremity vein thrombosis (LEVT) being the most common type. The aim of the current study was to compare venous Doppler findings and clinical features between BS patients with LEVT and control patients diagnosed as having LEVT due to other causes. All consecutive 78 patients (71 men, 7 women; mean age 38.6 ± 10.3 years) with LEVT due to BS and 50 control patients (29 men, 21 women; mean age 42.0 ± 12.5 years) who had LEVT due to other causes, or idiopathic, were studied with the help of a Doppler ultrasonography after a detailed clinical examination. Patterns of venous disease were identified by cluster analyses. Clinical features of chronic venous disease were assessed using 2 classification systems. Venous claudication was also assessed. Patients with BS were more likely to be men, had significantly earlier age of onset of thrombosis, and were treated mainly with immunosuppressives and less frequently with anticoagulants. Furthermore, they had significantly more bilateral involvement, less complete recanalization, and more frequent collateral formation. While control patients had a disorganized pattern of venous involvement, BS patients had a contiguous and symmetric pattern, involving all deep and superficial veins of the lower extremities, with less affinity for crural veins. Clinical assessment, as measured by the 2 classification systems, also indicated a more severe disease among the BS patients. In line, 51% of the BS patients suffered from severe post-thrombotic syndrome (PTS) and 32% from venous claudication, whereas these were present in 8% and 12%, respectively, among the controls. Among BS patients, a longer duration of thrombosis, bilateral femoral vein involvement, and using no anticoagulation along with immunosuppressive treatment when first diagnosed were found to be associated independently with severe PTS. Lower-extremity vein

  4. The Choosing Wisely Initiative: A critical analysis with a special focus on primary care.

    Science.gov (United States)

    Horvath, Karl; Siebenhofer, Andrea

    2017-12-01

    The Choosing Wisely initiative (CWI), a campaign led by the American Board of Internal Medicine (ABIM) Foundation, promotes doctor-patient communication and reducing waste in healthcare. At present, many of the top 5 lists from the Choosing Wisely Initiative appear to be primarily eminence-based and influenced by self-interest. The implementation of recommendations from these lists may mean taking a step backwards to the time before evidence-based medicine. On the other hand, despite all the challenges that the Choosing Wisely initiatives are currently facing, it is difficult to deny that they also hold great potential in terms of making healthcare systems more efficient and beneficial to patients. The aim of the ongoing work in Germany and Austria is to create conditions that are necessary if CW initiatives are to evolve into a model tool that will help introduce the principles of evidence-based medicine into daily practice. Copyright © 2017. Published by Elsevier GmbH.

  5. Wireless Positioning Based on a Segment-Wise Linear Approach for Modeling the Target Trajectory

    DEFF Research Database (Denmark)

    Figueiras, Joao; Pedersen, Troels; Schwefel, Hans-Peter

    2008-01-01

    Positioning solutions in infrastructure-based wireless networks generally operate by exploiting the channel information of the links between the Wireless Devices and fixed networking Access Points. The major challenge of such solutions is the modeling of both the noise properties of the channel...... measurements and the user mobility patterns. One class of typical human being movement patterns is the segment-wise linear approach, which is studied in this paper. Current tracking solutions, such as the Constant Velocity model, hardly handle such segment-wise linear patterns. In this paper we propose...... a segment-wise linear model, called the Drifting Points model. The model results in an increased performance when compared with traditional solutions....

  6. Target and (Astro-)WISE technologies Data federations and its applications

    Science.gov (United States)

    Valentijn, E. A.; Begeman, K.; Belikov, A.; Boxhoorn, D. R.; Brinchmann, J.; McFarland, J.; Holties, H.; Kuijken, K. H.; Kleijn, G. Verdoes; Vriend, W.-J.; Williams, O. R.; Roerdink, J. B. T. M.; Schomaker, L. R. B.; Swertz, M. A.; Tsyganov, A.; van Dijk, G. J. W.

    2017-06-01

    After its first implementation in 2003 the Astro-WISE technology has been rolled out in several European countries and is used for the production of the KiDS survey data. In the multi-disciplinary Target initiative this technology, nicknamed WISE technology, has been further applied to a large number of projects. Here, we highlight the data handling of other astronomical applications, such as VLT-MUSE and LOFAR, together with some non-astronomical applications such as the medical projects Lifelines and GLIMPS; the MONK handwritten text recognition system; and business applications, by amongst others, the Target Holding. We describe some of the most important lessons learned and describe the application of the data-centric WISE type of approach to the Science Ground Segment of the Euclid satellite.

  7. Towards a Full-sky, High-resolution Dust Extinction Map with WISE and Planck

    Science.gov (United States)

    Meisner, Aaron M.; Finkbeiner, D. P.

    2014-01-01

    We have recently completed a custom processing of the entire WISE 12 micron All-sky imaging data set. The result is a full-sky map of diffuse, mid-infrared Galactic dust emission with angular resolution of 15 arcseconds, and with contaminating artifacts such as compact sources removed. At the same time, the 2013 Planck HFI maps represent a complementary data set in the far-infrared, with zero-point relatively immune to zodiacal contamination and angular resolution superior to previous full-sky data sets at similar frequencies. Taken together, these WISE and Planck data products present an opportunity to improve upon the SFD (1998) dust extinction map, by virtue of enhanced angular resolution and potentially better-controlled systematics on large scales. We describe our continuing efforts to construct and test high-resolution dust extinction and temperature maps based on our custom WISE processing and Planck HFI data.

  8. Towards a Full-sky Map of Galactic 12 Micron Dust Emission with WISE

    Science.gov (United States)

    Meisner, Aaron; Finkbeiner, D. P.

    2013-01-01

    We describe our custom processing of the entire Wide-field Infrared Survey Explorer (WISE) 12 micron imaging data set, aimed at creating a high-resolution, full-sky map of diffuse emission from Galactic dust that is free of compact sources and all other contaminating artifacts. The principal distinctions between our resulting co-added images and the WISE Atlas stacks are our removal of compact sources, including their associated electronic and optical artifacts, and our preservation of spatial modes larger than ~1.5 degrees. We present sample mosaics which illustrate our progress and the imperfections that remain to be addressed. When combined appropriately with other mid and far-infrared data sets, we expect our WISE 12 micron map to form the basis for a full-sky dust extinction map with angular resolution approximately 10 times better than that of SFD (1998).

  9. Fourier analysis of cell-wise Block-Jacobi splitting in two-dimensional geometry

    International Nuclear Information System (INIS)

    Rosa, M.; Warsa, J. S.; Kelley, T. M.

    2009-01-01

    A Fourier analysis is conducted in two-dimensional (2D) geometry for the discrete ordinates (S N ) approximation of the neutron transport problem solved with Richardson iteration (Source Iteration) using the cell-wise Block-Jacobi (BJ) algorithm. The results of the Fourier analysis show that convergence of cell-wise BJ can degrade, leading to a spectral radius equal to 1, in problems containing optically thin cells. For problems containing cells that are optically thick, instead, the spectral radius tends to 0. Hence, in the optically thick-cell regime, cell-wise BJ is rapidly convergent even for problems that are scattering dominated, with a scattering ratio c close to 1. (authors)

  10. Public awareness and misunderstanding about DrinkWise Australia: a cross-sectional survey of Australian adults.

    Science.gov (United States)

    Brennan, Emily; Wakefield, Melanie A; Durkin, Sarah J; Jernigan, David H; Dixon, Helen G; Pettigrew, Simone

    2017-08-01

    DrinkWise Australia is an alcohol industry Social Aspects/Public Relations Organisation (SAPRO). We assessed the Australian public's awareness of DrinkWise, beliefs about its funding source, and associations between funding beliefs and perceptions of DrinkWise. A total of 467 adult weekly drinkers completed an online cross-sectional survey in February 2016. Half the sample had heard of DrinkWise (48.6%); of these, the proportion aware that DrinkWise is industry funded (37.0%) was much smaller than the proportion believing it receives government funding (84.1%). Respondents who incorrectly believed DrinkWise receives government funding were more likely to hold a favourable perception of the organisation's credibility, trustworthiness and respectability than those who did not believe it receives government funding (75.9% vs. 58.3%; p=0.032). The drinking population is vulnerable to believing that alcohol industry public relations organisations such as DrinkWise are government funded, which in turn is associated with more favourable perceptions of the organisation's credibility, trustworthiness, and respectability. Implications for public health: Favourable perceptions of DrinkWise may enhance the industry's ability to delay or dilute potentially effective alcohol control policies. Future research should investigate whether educating the public about DrinkWise's alcohol industry funding alters the public's perception of how credible, trustworthy and respectable the organisation is. © 2017 The Authors.

  11. The Evaluation of Pulmonary Function Tests in Patients with Polycystic Ovary Syndrome

    Directory of Open Access Journals (Sweden)

    Davood Attaran

    2013-10-01

    Full Text Available Introduction: Recently a relation between female sex hormones and severity of asthma symptoms has been proposed. As a common endocrine dysfunction, polycystic ovary syndrome (PCOS could significantly influence the level of sex hormones in PCOS patients. Regarding the possible role of sex hormones in airway physiology, the present study was conducted to survey the effects of PCOS on pulmonary function test parameters. Materials and Methods: In this cross-sectional study 30 recently diagnosed patients with PCOS without history of pulmonary disease were enrolled and 20 healthy women were considered as the control group according to their age, weight, and height. The patients and the controls underwent body plethysmography to measure pulmonary function tests. Results: The mean age of the patients and the controls were 29.43±7.8 and 30.0±7.6 years respectively. There were no statistically significant differences in all pulmonary function test parameters between the patients and the controls (p>0.05. After dividing the patients into 2 groups based on their body mass index (BMI, BMIConclusion: Our results showed that pulmonary function test parameters are not different in PCOS patients comparing to healthy women. Only the deleterious effects of high BMI on pulmonary function can be occurred in these patients.

  12. Efficacy evaluation of clonazepam for symptom remission in burning mouth syndrome: a meta-analysis.

    Science.gov (United States)

    Cui, Y; Xu, H; Chen, F M; Liu, J L; Jiang, L; Zhou, Y; Chen, Q M

    2016-09-01

    Clonazepam has been used in the treatment of burning mouth syndrome (BMS) for several decades. We conducted a meta-analysis to investigate the efficacy of clonazepam in the treatment of BMS. We conducted a search of the PubMed, MEDLINE, EMBASE, Web of Science (TS), and the Cochrane Library databases for relevant studies that met our eligibility criteria (up to September 22, 2015). Statistical analyses were conducted using RevMan 5.2 and STATA 11.0 software. Three randomized controlled trials (RCTs) and two high-quality case-control studies involving 195 BMS patients were selected for this study. Our results show that clonazepam can reduce the oral pain sensation in patients with BMS (WMD: -3.72, 95% CI: -4.57, -2.86; P 10 weeks) application (WMD: -4.50, 95% CI: -4.98, -4.03; P clonazepam were confirmed to be effective. Clonazepam is effective in inducing symptom remission in patients with BMS. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. A metabonomic evaluation of the monocrotaline-induced sinusoidal obstruction syndrome (SOS) in rats

    Energy Technology Data Exchange (ETDEWEB)

    Conotte, R.; Colet, J.-M., E-mail: jean-marie.colet@umons.ac.be

    2014-04-15

    The main curative treatment of colorectal cancer remains the surgery. However, when metastases are suspected, surgery is followed by a preventive chemotherapy using oxaliplatin which, unfortunately, may cause liver sinusoidal obstruction syndrome (SOS). Such hepatic damage is barely detected during or after chemotherapy due to a lack of effective diagnostic procedures, but liver biopsy. The primary objective of the present study was to identify potential early diagnosis biomarkers of SOS using a metabonomic approach. SOS was induced in rats by monocrotaline, a prototypical toxic substance. {sup 1}H NMR spectroscopy analysis of urine samples collected from rats treated with monocrotaline showed significant metabolic changes as compared to controls. During a first phase, cellular protective mechanisms such as an increased synthesis of GSH (reduced taurine) and the recruitment of cell osmolytes in the liver (betaine) were seen. In the second phase, the disturbance of the urea cycle (increased ornithine and urea reduction) leading to the depletion of NO, the alteration in the GSH synthesis (increased creatine and GSH precursors (glutamate, dimethylglycine and sarcosine)), and the liver necrosis (decrease taurine and increase creatine) all indicate the development of SOS. - Highlights: • Urine metabonomic profiles of SOS have been identified. • Urine osmoprotectants and anti-oxidants indicated an initial liver protection. • Liver necrosis was demonstrated by increased urine levels of taurine and creatine. • NO depletion was suggested by changes in ornithine and urea.

  14. Development and evaluation of a pH-dependent sustained release tablet for irritable bowel syndrome

    Science.gov (United States)

    Zhang, Shuang-Qing; Chen, Guo-Hua; Rahman, Ziyaur; Thumma, Sridhar; Li, San-Ming; Repka, Michael A.

    2017-01-01

    The overall objective of this study was to develop a pH-dependent sustained release tablet formulation of a model drug, tegaserod maleate, which is a poorly water soluble and acid labile drug in gastric milieu. The formulation’s goal was to allow the dosage form to pass through the stomach intact, start disintegrating in the upper small intestine and slowly release the active in a controlled manner. Partition coefficient, contact angle and drug-excipient compatibility were investigated as part of the preformulation studies. A pH-dependent sustained release tablet was prepared using a combination of Eudragit® L100 and Eudragit® S100. The effects of solubilizer, disintegrant, binder, coating polymer concentration, pore former and plasticizer on the drug release rate were determined. The results demonstrated that approximately 90% of the drug was released in a sustained release manner in the pH 6.8 phosphate buffer within 12 h while no drug was detected when subjected to drug release studies in 0.1 mol/L hydrochloric acid for 2 h. The drug release mechanism involved stress points and/or pore formation in the coated film. The coated tablets were stable at 40 °C/75% RH for 3 months. These results highlighted the feasibility of this coated tablet system containing tegaserod maleate, which may contribute to the successful treatment of irritable bowel syndrome. PMID:19031287

  15. A short neuropsychological evaluation of patients with primary Sjögren's syndrome

    Directory of Open Access Journals (Sweden)

    Dóra-Neide Rodrigues

    2014-01-01

    Full Text Available Objective: To investigate cognitive deficits in patients with primary Sjögren’s syndrome (PSS. Method: Eighteen patients with PSS, aged between 25 and 61 years, were subjected to a short neuropsychological battery and compared with 18 patients with multiple sclerosis and 18 healthy controls. Results: The analysis of variance (ANOVA revealed that the clinical groups had significantly worse performance than the control group on the Rey Auditory Verbal Learning Test 3; (F 2,53 =3.500, p=0.038 and 7 (F 2,53 =5.068, p=0.010. The clinical groups had elevated levels of depression on the Beck Depression Inventory (BDI; (p=0.003. The analysis of the data from the Trail Making Test B-A revealed a significant difference between the clinical and control groups (p=0.023. The analysis of covariance with BDI score as a covariate, did not change the outcome. Conclusion: Our study revealed cognitive deficits in patients with PSS detectable by a short neuropsychological battery.

  16. Evaluation of insulin resistance in idiopathic hirsutism compared with polycystic ovary syndrome patients and healthy individuals.

    Science.gov (United States)

    Bonakdaran, Shokoufeh; Kiafar, Bita; Barazandeh Ahmadabadi, Fatemeh

    2016-02-01

    Hirsutism is defined as the excessive male-pattern growth of hair in women. Hirsutism is often idiopathic or the consequence of polycystic ovary syndrome (PCOS). Insulin resistance is common in PCOS (especially in obese patients) but the association between insulin resistance and idiopathic hirsutism (IH) is not clear. The aim of this study was to investigate the rate of insulin resistance in IH, compared with healthy individuals and patients with PCOS. The study included three groups, patients with idiopathic hirsutism, PCOS and healthy women. Each group included 30 non-obese women. Fasting blood sugar (FBS), insulin level and insulin resistance (estimated by the homeostasis model assessment [HOMA-IRIR]) were compared in the three groups. There was a significant difference between the age of the women with IH compared with two other groups. There were no significant difference in levels of serum insulin (P = 0.49, HOMA-IR (P = 0.47) and prevalence of insulin resistance (P = 0.07) in the three groups. The age-adjusted prevalence of insulin resistance was similar in the three groups. Insulin resistance was no more frequent in IH patients than in healthy control groups. © 2014 The Australasian College of Dermatologists.

  17. Impact of cusp inclinations on dental fractures in cracked tooth syndrome model and relevant risk evaluation.

    Science.gov (United States)

    Xie, Nina; Wang, Penglai; Wu, Cui; Song, Wenting; Wang, Wen; Liu, Zongxiang

    2017-12-01

    We explored the impact of cusp inclinations on dental fractures in cracked tooth syndrome model and formulated corresponding risk scale. Forty maxillary premolars were randomized into four groups for cusp inclination measurements by digital radiovisiography (RVG). For cracked tooth models, buccal and palatal cusp inclinations were achieved by grinding in groups I (59°-50°), II (64°-55°) and III (69°-60°), with group IV as blank control. All groups underwent compression loading test, with fracture levels recorded for statistical analysis. The fracture modes included a majority of crown root fractures and a minority of crown fractures in groups I and II, exclusive crown root fractures in group III, and exclusive crown fractures in group IV. Overall, palatal fractures were predominant versus buccal fractures, with exclusive palatal fractures in group IV, and oblique fractures were overwhelming versus the scanty vertical fractures. Fracture risk classification: grade III was prevalent in groups I and II, grade IV in group III, and grades I and II in group IV only. The fracture risk scores in groups III and IV had significant statistical differences versus groups I and II (P0.05). Cracked teeth are more vulnerable to complex fractures, with increment of cusp inclinations contributable to complex fracture modes, involving deep roots and high risk scores.

  18. Turner Syndrome

    Directory of Open Access Journals (Sweden)

    Ramachandran Sudarshan

    2012-08-01

    Full Text Available Turner syndrome is a genetic disorder that affects mostly females. Affected females have characteristic features such as short stature, premature ovarian failure, and several other features. Oral manifestations of this condition are not much discussed in the literature. But reported literature includes teeth, palate, periodontal and salivary changes. So the aim of this review is to illustrate the general manifestations, and especially the oral manifestations of Turner syndrome and evaluate their possible management. [Archives Medical Review Journal 2012; 21(4.000: 246-252

  19. FULL-DEPTH COADDS OF THE WISE AND FIRST-YEAR NEOWISE-REACTIVATION IMAGES

    Energy Technology Data Exchange (ETDEWEB)

    Meisner, Aaron M. [Berkeley Center for Cosmological Physics, Berkeley, CA 94720 (United States); Lang, Dustin [Department of Astronomy and Astrophysics and Dunlap Institute, University of Toronto, Toronto, ON M5S 3H4 (Canada); Schlegel, David J. [Lawrence Berkeley National Laboratory, Berkeley, CA, 94720 (United States)

    2017-01-01

    The Near Earth Object Wide-field Infrared Survey Explorer (NEOWISE) Reactivation mission released data from its first full year of observations in 2015. This data set includes ∼2.5 million exposures in each of W1 and W2, effectively doubling the amount of WISE imaging available at 3.4 μ m and 4.6 μ m relative to the AllWISE release. We have created the first ever full-sky set of coadds combining all publicly available W1 and W2 exposures from both the AllWISE and NEOWISE-Reactivation (NEOWISER) mission phases. We employ an adaptation of the unWISE image coaddition framework, which preserves the native WISE angular resolution and is optimized for forced photometry. By incorporating two additional scans of the entire sky, we not only improve the W1/W2 depths, but also largely eliminate time-dependent artifacts such as off-axis scattered moonlight. We anticipate that our new coadds will have a broad range of applications, including target selection for upcoming spectroscopic cosmology surveys, identification of distant/massive galaxy clusters, and discovery of high-redshift quasars. In particular, our full-depth AllWISE+NEOWISER coadds will be an important input for the Dark Energy Spectroscopic Instrument selection of luminous red galaxy and quasar targets. Our full-depth W1/W2 coadds are already in use within the DECam Legacy Survey (DECaLS) and Mayall z-band Legacy Survey (MzLS) reduction pipelines. Much more work still remains in order to fully leverage NEOWISER imaging for astrophysical applications beyond the solar system.

  20. Isgur-Wise function in a QCD-inspired potential model with WKB approximation

    International Nuclear Information System (INIS)

    Hazarika, Bhaskar Jyoti; Choudhury, D.K.

    2017-01-01

    We use Wentzel-Kramers-Brillouin (WKB) approximation for calculating the slope and curvature of Isgur-Wise function in a QCD-inspired potential model. This work is an extension of the approximation methods to the QCD-inspired potential model. The approach hints at an effective range of distance for calculating the slope and curvature of Isgur-Wise function. Comparison is also made with those of Dalgarno method and variationally improved perturbation theory (VIPT) as well as other models to show the advantages of using WKB approximation. (author)

  1. SuperWiseNet - a unique network platform to leverage student entrepreneurship projects

    DEFF Research Database (Denmark)

    Gertsen, Frank; Høgsaa, Asger; Tollestrup, Christian H. T.

    2016-01-01

    The area of interests is the development of a potentially new complementary industry-university component, which has been labelled ‘SuperWiseNet’ for the context of academic entrepreneurial programs. The SuperWiseNet is a network-based platform for interaction between students of entrepreneurship...... and an experience-enriched forum consisting of teachers, industry experts, entrepreneurs and specialty consultants. The interaction unfolds as a series of workshops facilitating the progression of the student teams’ four months project work. The students of concern are enrolled in the international Entrepreneurial...

  2. The Superomedial Pedicle Wise-Pattern Breast Reduction: Reproducible, Reliable, and Resilient.

    Science.gov (United States)

    Brown, Rodger H; Siy, Richard; Khan, Khurrum; Izaddoost, Shayan

    2015-05-01

    The combination of the superomedial pedicle with the traditional Wise-pattern skin resection has gained increasing popularity for its versatility and ability to achieve significant reduction of breast parenchyma and skin envelope with improved contour and lasting results. Here the authors review the pertinent anatomy and discuss their surgical technique and its benefits. In addition, a retrospective chart review of 80 patients (151 breasts) who underwent superomedial pedicle Wise-pattern breast reduction between 2010 and 2014 was performed. Mean specimen weights and complication rates, including seroma, delayed wound healing, nipple loss, infection, and reoperation were calculated for the cohort.

  3. Structural integration of separation and reaction systems: I. Integration of stage-wise processes

    Directory of Open Access Journals (Sweden)

    Mitrović Milan

    2002-01-01

    Full Text Available The structural integration of separation processes, using multifunctional equipment, has been studied on four stage-wise liquid-liquid separations extraction, absorption, distillation, adsorption and on some combinations of these processes. It was shown for stage - wise processes that the ultimate aim of equipment integration is 3-way integration (by components by steps and by stages and that membrane multiphase contactors present concerning the equipment optimal solutions in many cases. First, by using partially integrated equipment and, later by developing fully integrated systems it was experimentally confirmed that structural 3-way integration produces much higher degrees of component separations and component enrichments in compact and safe equipment.

  4. Photon absorption in step-wise multi-photon activation fluorescence (SMPAF) of Sepia melanin

    Science.gov (United States)

    Lai, Zhenhua; Kerimo, Josef; DiMarzio, Charles

    2013-02-01

    Previous research has shown that melanin goes through a step-wise three-photon absorption process when the fluorescence is activated with high laser intensity. We have conducted further research using even higher laser intensity for the activation, and have shown the possibility of observing power dependence other than third-order. This article discusses the possible energy states of Sepia melanin by studying the power dependence curves of the step-wise multi-photon activated fluorescence signal. Three different excitation channels are activated. Possible reasons causing the three channels are discussed.

  5. Battle-Wise: Seeking Time-Information Superiority in Networked Warfare

    Science.gov (United States)

    2006-07-01

    it best about learning from mistakes in life: “There is no wisdom in the second kick of a mule .” Although he did not have 21st-century warfare in...part of our military leadership—can we expect to avoid the “second kick of a mule .” xii BATTLE-WISE PREFACE xiii xiii Preface This book is an inquiry...recruiting meth - ods. Depending on work experience before joining the military, it may be possible actually to identify battle-wise traits in recruits. For

  6. Evaluation of C-reactive protein, Haptoglobin and cardiac troponin 1 levels in brachycephalic dogs with upper airway obstructive syndrome

    Directory of Open Access Journals (Sweden)

    Planellas Marta

    2012-08-01

    Full Text Available Abstract Background Brachycephalic dogs have unique upper respiratory anatomy with abnormal breathing patterns similar to those in humans with obstructive sleep apnea syndrome (OSAS. The objective of this study was to evaluate the correlation between anatomical components, clinical signs and several biomarkers, used to determine systemic inflammation and myocardial damage (C-reactive protein, CRP; Haptoglobin, Hp; cardiac troponin I, cTnI, in dogs with brachycephalic upper airway obstructive syndrome (BAOS. Results Fifty brachycephalic dogs were included in the study and the following information was studied: signalment, clinical signs, thoracic radiographs, blood work, ECG, components of BAOS, and CRP, Hp and cTnI levels. A high proportion of dogs with BAOS (88% had gastrointestinal signs. The prevalence of anatomic components of BAOS was: elongated soft palate (100%, stenotic nares (96%, everted laryngeal saccules (32% and tracheal hypoplasia (29.1%. Increased serum levels of biomarkers were found in a variable proportion of dogs: 14% (7/50 had values of CRP > 20 mg/L, 22.9% (11/48 had values of Hp > 3 g/L and 47.8% (22/46 had levels of cTnI > 0.05 ng/dl. Dogs with everted laryngeal saccules had more severe respiratory signs (p Conclusions According to the low percentage of patients with elevated levels of CRP and Hp, BAOS does not seem to cause an evident systemic inflammatory status. Some degree of myocardial damage may occur in dogs with BAOS that can be detected by cTnI concentration.

  7. The Glass Is Half Full: Evidence for Efficacy of Alcohol-Wise at One University But Not the Other

    Science.gov (United States)

    CROOM, KATHERINE; STAIANO-COICO, LISA; LESSER, MARTIN L.; LEWIS, DEBORAH K.; REYNA, VALERIE F.; MARCHELL, TIMOTHY C.; FRANK, JEREMY; IVES, STEPHANIE

    2017-01-01

    This research extends the growing literature about online alcohol prevention programs for first-year college students. Two independent randomized control studies, conducted at separate universities, evaluated the short-term effectiveness of Alcohol-Wise, an online alcohol prevention program not previously studied. It was hypothesized the prevention program would increase alcohol knowledge and reduce alcohol consumption, including high-risk alcohol-related behaviors, among first-year college students. At both universities, the intervention significantly increased alcohol-related knowledge. At one university, the prevention program also significantly reduced alcohol consumption and high-risk drinking behaviors, such as playing drinking games, heavy drinking, and extreme ritualistic alcohol consumption. Implications for the use of online alcohol prevention programs and student affairs are discussed. PMID:25909233

  8. Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls

    DEFF Research Database (Denmark)

    Glintborg, Dorte; Andersen, Marianne; Hagen, Claus

    2006-01-01

    OBJECTIVE: Polycystic ovary syndrome (PCOS) patients are abdominally obese and are at increased risk of developing the metabolic syndrome. Low adiponectin and ghrelin levels in PCOS patients could be caused by insulin resistance as well as high testosterone levels. DESIGN: Adiponectin and ghrelin......: Obese hirsute PCOS patients demonstrated significantly lower adiponectin levels than weight-matched controls suggesting a very high risk for the metabolic syndrome. Furthermore, ghrelin levels were decreased in hirsute PCOS patients and showed a significant, negative correlation with testosterone...... levels were evaluated in 51 hirsute PCOS patients referred to the outpatient clinic of an academic, tertiary care medical centre and in 63 weight-matched female controls. Relationships between adiponectin, ghrelin, leptin, body composition, testosterone and insulin were examined. METHODS: Measurements...

  9. Evaluating daytime alertness in individuals with Restless Legs Syndrome (RLS) compared to sleep restricted controls.

    Science.gov (United States)

    Gamaldo, Charlene; Benbrook, Amy R; Allen, Richard P; Oguntimein, Oluwamurewa; Earley, Christopher J

    2009-01-01

    Restless Legs Syndrome (RLS) is a common sensorimotor disorder often associated with significant chronic sleep loss. Previous studies looking at the effects of sleep loss on daytime function in RLS individuals, using subjective reporting techniques have yielded mixed results. In this study we used more objective measures of alertness and compared RLS subjects who are off treatments and chronically sleep restricted to chronic sleep-restricted controls. The final sample consisted of 20 RLS subjects (10 male and 10 female) and 13 sleep-restricted controls (seven male and six female). Thirteen controls underwent a 14-day chronic partial sleep-restriction protocol in order to closely match the degree of chronic sleep loss reportedly experienced by untreated RLS patients. On the final day of the protocol each subject performed a morning and evening Suggested Immobilization Test (SIT) which served as a modified Maintenance of Wakefulness Test (MWT). RLS and control groups were compared for differences in alertness as measured objectively by the sleep latency on the morning and evening SITs. The RLS subjects had a longer sleep latency on the morning and evening SIT than controls (t=3.80, p=0.001, U=31.0, pRLS individuals still demonstrated a higher degree of objective alertness (p=0.023, p=0.006, Fisher's exact test). RLS subjects, despite having, if anything, greater sleep loss, displayed greater sustained alertness than sleep-restricted controls. Thus, the heightened degree of alertness demonstrated by RLS patients may be in contrast to the perceived impairment in mood, vigor, and vigilance commonly reported in previous studies.

  10. Evaluation of depression and quality of life in patients with obstructive sleep apnea syndrome.

    Science.gov (United States)

    Yosunkaya, S; Kutlu, R; Cihan, F G

    2016-01-01

    Sleep fragmentation, repetitive hypoxemia during sleep, excessive sleepiness during the day, lack of concentration, memory loss, depression, decreased libido, and impotence are the characteristics of obstructive sleep apnea syndrome (OSAS) that may impair quality of life (QOL). This study aimed to investigate the QOL and factors that may affect QOL in people with different OSAS severity and without sleep apnea. This was an analytical cross-sectional study. Polysomnography was performed on 200 people. Those detected as having nonapnea and mild-moderate-severe OSAS were administered the Epworth sleepiness scale, Beck Depression Inventory, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale. According to the apnea-hypopnea index, 36 people (18.0%) were in the nonapnea-hypopnea group, 28 (14.0%) in the mild OSAS group, 63 (31.5%) in the moderate OSAS group, and 73 people (36.5%) were in the severe OSAS group. Depression was present in 31 people (15.5%) who participated in the study. The nonapnea-hypopnea group comprised 12.9% of those with depression, mild OSAS group comprised 16.1%, moderate OSAS group comprised 22.6%, and severe OSAS group had 48.4% of the depressed subjects. Beck depression scores showed a significant positive correlation with the Epworth scale (tsleep duration, increased arousal index, and a high ratio of sleep duration with oxygen saturation below 90% to the duration of the entire sleep period increase daytime sleepiness and depressive symptoms in those with OSAS; thus, disrupting general health and QOL.

  11. Evaluation of posture and pain in persons with benign joint hypermobility syndrome.

    Science.gov (United States)

    Booshanam, Divya S; Cherian, Binu; Joseph, Charles Premkumar A R; Mathew, John; Thomas, Raji

    2011-12-01

    The objective of the present study is to compare and quantify the postural differences and joint pain distribution between subjects with benign joint hypermobility syndrome (BJHS) and the normal population. This observational, non-randomized, and controlled study was conducted at Rheumatology and Physical Medicine and Rehabilitation Medicine Departments of a tertiary care teaching hospital. Subjects comprise 35 persons with diagnosis of BJHS, and the control group was matched for age and sex. Reedco's Posture score (RPS) and visual analogue scale (VAS) were the outcome measures. The subjects were assessed for pain in ten major joints and rated on a VAS. A standard posture assessment was conducted using the Reedco's Posture score. The same procedure was executed for an age- and sex-matched control group. Mean RPS for the BJHS group was 55.29 ± 8.15 and for the normal group it was 67 ± 11.94. The most common postural deviances in subjects with BJHS were identified in the following areas of head, hip (Sagittal plane), upper back, trunk, and lower back (Coronal plane). Intensity of pain was found to be more in BJHS persons than that of the normal persons, and the knee joints were the most affected. The present study compared and quantified the postural abnormalities and the pain in BJHS persons. The need for postural re-education and specific assessment and training for the most affected joints are discussed. There is a significant difference in posture between subjects with BJHS and the normal population. BJHS persons need special attention to their posture re-education during physiotherapy sessions to reduce long-term detrimental effects on the musculoskeletal system.

  12. Ultrasound Evaluation of Patients with Moderate and Severe Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Ali Moghtaderi

    2012-01-01

    Full Text Available The objective of this study is to determine cut-off points for the crosssectional areas of the median nerve proximal and distal to carpal tunnel in moderate and severe Carpal Tunnel Syndrome (CTS and compare the results of our study with those available in the literature. Forty-three patients with upper limb pain other than CTS and 36 patients with idiopathic CTS enrolled into the study. The diagnosis and categorization of CTS were based on electrophysiologic criteria of the American Academy of Neurology. Median nerve cross-sectional areas were measured. Arithmetic mean values and standard deviation of each variable were measured. Student t-test and chi-squared test were applied to compare continuous and dichotomous variables between CTS and non-CTS control groups. Ultimately the diagnostic performances of the test characteristics including sensitivity, specificity, positive and negative predictive values were measured. Mean cross-sectional area of the nerve is higher in moderate than severe CTS proximal and distal to carpal tunnel. We accepted cut-off points of 11.5 mm2 and 13.5 mm2 for cross-sectional areas of the proximal and distal portions of carpal canal respectively. The sensitivity, specificity, positive and negative predictive values for the proximal inlet are 83%, 90.7%, 65.5% and 55.7%; and for the distal outlet are 36.1%, 93%, 81.2% and 63.4% respectively. We suggest that ultrasound is a good diagnostic modality for patients referred to tertiary care centers which categorized as moderate CTS.

  13. Evaluating Burning Mouth Syndrome as a Comorbidity of Atypical Odontalgia: The Impact on Pain Experiences.

    Science.gov (United States)

    Tu, Trang T H; Miura, Anna; Shinohara, Yukiko; Mikuzuki, Lou; Kawasaki, Kaoru; Sugawara, Shiori; Suga, Takayuki; Watanabe, Takeshi; Watanabe, Motoko; Umezaki, Yojiro; Yoshikawa, Tatsuya; Motomura, Haruhiko; Takenoshita, Miho; Toyofuku, Akira

    2017-10-03

    This study aimed (1) to investigate the differences in clinical characteristics of patients between 2 groups, those who have atypical odontalgia (AO) only and those who have AO with burning mouth syndrome (BMS), and (2) to assess the influence of psychiatric comorbidity factors on patients' experiences. Medical records and psychiatric referral forms of patients visiting the Psychosomatic Dentistry Clinic of Tokyo Medical and Dental University between 2013 and 2016 were reviewed. The final sample included 2 groups of 355 patients: those who have AO only (n = 272) and those who have AO with BMS (AO-BMS; n = 83). Clinicodemographic variables (gender, age, comorbid psychiatric disorders, and history of headache or sleep disturbances) and pain variables (duration of illness, pain intensity, and severity of accompanying depression) were collected. Initial pain assessment was done using the Short-Form McGill Pain Questionnaire, and depressive state was determined using the Zung Self-Rating Depression Scale. The average age, female ratio, and sleep disturbance prevalence in the AO-only group were significantly lower than those in AO-BMS group. AO-BMS patients rated overall pain score and present pain intensity significantly higher than did the AO-only patients (P = 0.033 and P = 0.034, respectively), emphasizing sharp (P = 0.049), hot-burning (P = 0.000), and splitting (P = 0.003) characteristics of pain. Patients having comorbid psychiatric disorders had a higher proportion of sleep disturbance in both groups and a higher proportion of depressive state in the AO-only group. AO-BMS patients have different epidemiological characteristics, sleep quality, and pain experiences compared to AO-only patients. The presence of psychiatric comorbidities in both groups may exacerbate sleep quality. We suggest that BMS as a comorbid oral disorder in AO patients contributes to a more intensively painful experience. © 2017 The Authors. Pain Practice published by Wiley Periodicals, Inc

  14. Evaluation of unilateral versus bilateral ovarian drilling in clomiphene citrate resistant cases of polycystic ovarian syndrome.

    Science.gov (United States)

    Roy, K K; Baruah, Jinee; Moda, Nidhi; Kumar, Sunesh

    2009-10-01

    Laparoscopic ovarian drilling (LOD) has been put forward as the treatment of choice in women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS), with tubo-ovarian adhesion formation as the major disadvantage. Our study proposed to compare the efficacy of laparoscopic unilateral ovarian drilling with bilateral ovarian drilling in terms of ovulation and pregnancy rate with the expected advantage of decreasing postoperative adhesion rate and change in fimbiro ovarian relationship with unilateral drilling. This prospective randomized study included 44 patients with anovulatory infertility due to PCOS. Twenty-two patients underwent unilateral ovarian drilling in group-I and 22 patients underwent bilateral ovarian drilling in group-II between June 2005 and June 2007. The number of drilling site in each ovary was limited to five. The clinical and biochemical response, ovulation and pregnancy rates over a follow-up period of 1 year were compared. Tubo-ovarian adhesion rate was compared during cesarean section or during repeat laparoscopy. There was no statistical difference between the two groups in terms of clinical and biochemical response, ovulation rate and pregnancy rate. Postoperatively, tubo-ovarian adhesions could be assessed in 36.3% of the patients and no adhesions were found in a single case in either group. Unilateral drilling cauterization of ovary is equally efficacious as bilateral drilling in inducing ovulation and achieving pregnancy. Unilateral ovarian drilling may be a suitable option in clomiphene citrate resistant infertility patient of PCOS which can replace bilateral ovarian drilling with the potential advantage of decreasing the chances of adhesion formation.

  15. The hand in Smith-Magenis syndrome (deletion 17p11.2): evaluation by metacarpophalangeal pattern profile analysis

    International Nuclear Information System (INIS)

    Schlesinger, Alan E.; Potocki, Lorraine; Poznanski, Andrew K.; Lupski, James R.

    2003-01-01

    Brachydactyly has been described on physical examination in patients with Smith-Magenis syndrome (SMS). Metacarpophalangeal pattern profile analysis (MCPPPA), a method of graphic depiction of the relative size of the bones of the hand, has been used to objectively evaluate radiographs of the hand in patients with SMS in two small series: a single case and a study of four patients. This technique has confirmed brachydactyly and has suggested conflicting MCPPPA results. The purpose of our study was to evaluate the hand by MCPPPA in a large series of patients with SMS.Patients and methods We measured the bones of the hand and performed MCPPPA in 29 confirmed cases of SMS. Our results in 29 patients demonstrated a different MCPPPA in patients with SMS than previously reported. The analysis confirmed brachydactyly and the previously described trend of more pronounced shortening of the distal bones relative to the more proximal bones, but also demonstrated a previously undescribed pattern: relative enlargement of the proximal phalanx of the thumb and middle phalanx of the fifth finger. However, statistical analysis suggested that the pattern was not highly characteristic. MCPPPA of 29 patients with SMS demonstrates a pattern different than previously reported, but not highly characteristic. (orig.)

  16. Prevalence and severity of hepatopulmonary syndrome and its influence on survival in cirrhotic patients evaluated for liver transplantation.

    Science.gov (United States)

    Pascasio, J M; Grilo, I; López-Pardo, F J; Ortega-Ruiz, F; Tirado, J L; Sousa, J M; Rodriguez-Puras, M J; Ferrer, M T; Sayago, M; Gómez-Bravo, M A; Grilo, A

    2014-06-01

    The prevalence of hepatopulmonary syndrome (HPS) and its influence on survival before and after liver transplantation (LT) remain controversial. Additionally, the chronology of post-LT reversibility is unclear. This study prospectively analyzed 316 patients with cirrhosis who were evaluated for LT in 2002-2007; 177 underwent LT at a single reference hospital. HPS was defined by a partial pressure of arterial oxygen (PaO2 ) position and positive contrast echocardiography. The prevalence of HPS was 25.6% (81/316 patients), and most patients (92.6%) had mild or moderate HPS. High Child-Pugh scores and the presence of ascites were independently associated with HPS. Patients with and without HPS did not significantly differ in LT waiting list survival (mean 34.6 months vs. 41.6 months, respectively; log-rank, p = 0.13) or post-LT survival (mean 45 months vs. 47.6 months, respectively; log-rank, p = 0.62). HPS was reversed in all cases within 1 year after LT. One-fourth of the patients with cirrhosis who were evaluated for LT had HPS (mostly mild to moderate); the presence of HPS did not affect LT waiting list survival. HPS was always reversed after LT, and patient prognosis did not worsen. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

  17. Technical report: an ePRO patient reported outcome program for the evaluation of patients with irritable bowel syndrome.

    Science.gov (United States)

    Gerson, C D; Gerson, M-J

    2014-02-01

    Patient reported outcome (PRO) is an important healthcare concept that describes patient's participation in their care by self-evaluation, usually in the form of questionnaires. This report describes an unique computerized technique, electronic PRO (ePRO), for following the progress of patients with irritable bowel syndrome (IBS). Patients first completed a series of questionnaires, including questions about their illness history, symptom severity, and, in this application, psychological and relationship issues. The symptom severity and psychological questionnaires were then completed at intervals by the patients on their own computers. The ePRO was constructed to allow scores to be automatically summed and placed on a time-line graph for review at the time of the next office visit. Of the 32 patients who completed the initial set of questionnaires, 20 maintained participation in the program for a 6-month period. Of those 20 patients, median number of submissions was 7.0; median interval between questionnaire submissions was 3.0 weeks, whereas median interval between office visits was 5.9 weeks. On average, questionnaire completion took less than 5 min and was positively experienced by the patients. The ePRO program proved to be technically feasible, clinically useful, and positively experienced by the patients. It provides a focus on a collaborative conversation between physician and patient. It has significant potential as a technique for evaluating outcome in response to various therapies. © 2013 John Wiley & Sons Ltd.

  18. The hand in Smith-Magenis syndrome (deletion 17p11.2): evaluation by metacarpophalangeal pattern profile analysis

    Energy Technology Data Exchange (ETDEWEB)

    Schlesinger, Alan E. [Department of Diagnostic Imaging, Texas Children' s Hospital, 6621 Fannin Street, MC2-2521, Houston, TX 77030 (United States); Potocki, Lorraine [Department of Molecular and Human Genetics, Baylor College of Medicine and Texas Children' s Hospital, 6621 Fannin Street, CC-1560, Houston, TX 77030 (United States); Poznanski, Andrew K. [Department of Radiology, Children' s Memorial Hospital and Northwestern University School of Medicine, 2300 Children' s Plaza, Chicago, IL 60614 (United States); Lupski, James R. [Department of Molecular and Human Genetics, Baylor College of Medicine and Texas Children' s Hospital, 1 Baylor Plaza, Room 604B, Houston, TX 77030 (United States)

    2003-03-01

    Brachydactyly has been described on physical examination in patients with Smith-Magenis syndrome (SMS). Metacarpophalangeal pattern profile analysis (MCPPPA), a method of graphic depiction of the relative size of the bones of the hand, has been used to objectively evaluate radiographs of the hand in patients with SMS in two small series: a single case and a study of four patients. This technique has confirmed brachydactyly and has suggested conflicting MCPPPA results. The purpose of our study was to evaluate the hand by MCPPPA in a large series of patients with SMS.Patients and methods We measured the bones of the hand and performed MCPPPA in 29 confirmed cases of SMS. Our results in 29 patients demonstrated a different MCPPPA in patients with SMS than previously reported. The analysis confirmed brachydactyly and the previously described trend of more pronounced shortening of the distal bones relative to the more proximal bones, but also demonstrated a previously undescribed pattern: relative enlargement of the proximal phalanx of the thumb and middle phalanx of the fifth finger. However, statistical analysis suggested that the pattern was not highly characteristic. MCPPPA of 29 patients with SMS demonstrates a pattern different than previously reported, but not highly characteristic. (orig.)

  19. The Evaluation and Management of Toxic Shock Syndrome in the Emergency Department: A Review of the Literature.

    Science.gov (United States)

    Gottlieb, Michael; Long, Brit; Koyfman, Alex

    2018-01-20

    Toxic shock syndrome (TSS) is a severe, toxin-mediated illness that can mimic several other diseases and is lethal if not recognized and treated appropriately. This review provides an emergency medicine evidence-based summary of the current evaluation and treatment of TSS. The most common etiologic agents are Staphylococcus aureus and Streptococcus pyogenes. Sources of TSS include postsurgical wounds, postpartum, postabortion, burns, soft tissue injuries, pharyngitis, and focal infections. Symptoms are due to toxin production and infection focus. Early symptoms include fever, chills, malaise, rash, vomiting, diarrhea, and hypotension. Diffuse erythema and desquamation may occur later in the disease course. Laboratory assessment may demonstrate anemia, thrombocytopenia, elevated liver enzymes, and abnormal coagulation studies. Diagnostic criteria are available to facilitate the diagnosis, but they should not be relied on for definitive diagnosis. Rather, specific situations should trigger consideration of this disease process. Treatment involves intravenous fluids, source control, and antibiotics. Antibiotics should include a penicillinase-resistant penicillin, cephalosporin, or vancomycin (in methicillin-resistant S. aureus prevalent areas) along with either clindamycin or linezolid. TSS is a potentially deadly disease requiring prompt recognition and treatment. Focused history, physical examination, and laboratory testing are important for the diagnosis and management of this disease. Understanding the evaluation and treatment of TSS can assist providers with effectively managing these patients. Published by Elsevier Inc.

  20. Piriformis muscle syndrome. A cross-sectional imaging study in 116 patients and evaluation of therapeutic outcome

    International Nuclear Information System (INIS)

    Vassalou, Evangelia E.; Katonis, Pavlos; Karantanas, Apostolos H.

    2018-01-01

    To increase the clinical awareness of piriformis muscle syndrome (PMs) by reporting cross-sectional imaging findings, the clinical impact of imaging studies and treatment outcome. Within a 10-year-period, 116 patients referred for radiological evaluation of clinically suspected PMs, with excluded lumbar pathology related to symptomatology, were prospectively studied with MRI and/or computed tomography (CT). Piriformis muscle (PM), sciatic nerve (SN), piriformis region and sacroiliac joints were evaluated. PMs was categorised into primary/secondary, according to a reported classification system. Treatment decisions were recorded. Outcome was categorised using a 3-point-scale. Seventy-four patients (63.8%) exhibited pathologies related to PMs. Primary causes were detected in 12 and secondary in 62 patients. PM enlargement was found in 45.9% of patients, abnormal PM signal intensity/density in 40.5% and sciatic neuritis in 25.7%. Space-occupying lesions represented the most common related pathology. Treatment proved effective in 5/8 patients with primary and 34/51 patients with secondary PMs. In 34 patients, imaging revealed an unknown underlying medical condition and altered treatment planning. Secondary PMs aetiologies appear to prevail. In suspected PMs, PM enlargement represented the most common imaging finding and space-occupying lesions the leading cause. Imaging had the potential to alter treatment decisions. (orig.)

  1. A sneaky surgical emergency: Acute compartment syndrome. Retrospective analysis of 66 closed claims, medico-legal pitfalls and damages evaluation.

    Science.gov (United States)

    Marchesi, M; Marchesi, A; Calori, G M; Cireni, L V; Sileo, G; Merzagora, I; Zoia, R; Vaienti, L; Morini, O

    2014-12-01

    Acute compartment syndrome (ACS) is a clinical condition with potentially dramatic consequences, therefore, it is important to recognise and treat it early. Good management of ACS minimises or avoids the sequelae associated with a late diagnosis, and may also reduce the risk of malpractice claims. The aim of this article was to evaluate different errors ascribed to the surgeon and to identify how the damage was evaluated. A total of 66 completed and closed ACS cases were selected. The following were analysed for each case: clinical management before and after diagnosis of ACS, imputed errors, professional fault, damage evaluation and quantification. Particular attention was paid to distinguishing between impairment because of primary injury and iatrogenic impairment. Statistical analyses were performed using Fisher's exact test and Pearson's correlation. The most common presenting symptom was pain. Delay in the diagnosis, and hence delay in decompression, was common in the study. A total of 48 out of 66 cases resolved with the verdict of iatrogenic damage, which varied from 12% to 75% of global capability of the person. A total of $394,780 out of $574,680 (average payment) derived from a medical error. ACS is a clinical emergency that requires continuous clinical surveillance from both medical and nursing staff. The related damage should be evaluated in two parts: damage deriving from the trauma, so that it is considered inevitable and independent from the surgeon's conduct, and damage deriving from a surgeon's error, which is eligible for an indemnity payment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. [Evaluation on Efficacy and Safety of Jinying Capsule in Treatment of Pelvic Inflammatory Disease Patients with Accumulated Damp-heat Syndrome].

    Science.gov (United States)

    Li, Qin; Chen, Chun-yan; Suo, Yu-ping; Huang, Min; Huang, Xian-hua

    2015-12-01

    To evaluate the efficacy and safety of Jinying Capsule (JC) in treating pelvic inflammatory disease patients with accumulated damp-heat syndrome (ADHS). Totally 328 patients were recruited in a prospective, positive drug parallel controlled, and multi-center clinical trial. Of them 213 patients in the treatment group took JC (0.5 g per capsule), 4 capsules each time, 3 times per day, while 115 patients in the control group took Kangfuyan Capsule (KC, 0.4 g per capsule), 3 capsules each time, twice per day. The course of treatment was 4 weeks for all. Scores of Chinese medical syndromes, visual analogue scale (VAS) of the lower abdominal pain, and European quality of life-five dimension scale (EQ-5D) were observed before treatment and after 4 weeks of treatment. There were 204 patients in the treatment group and 109 in the control group who completed this trial. The total effective rate of Chinese medical syndrome was 89.71% (183/204 cases) in the treatment group and 76.15% (83/109 cases) in the control group (P 0.05). No adverse reaction occurred in the two groups. JC was superior to KC in improving Chinese medical syndrome and quality of life of pelvic inflammatory disease patients with accumulated damp-heat syndrome.

  3. Lean Management to support Choosing Wisely in healthcare: the first evidence from a systematic literature review.

    Science.gov (United States)

    Crema, Maria; Verbano, Chiara

    2017-11-01

    Choosing Wisely (CW) is an emergent approach to identify and reduce unnecessary care, such as tests and treatments that do not add value for patients and may even cause harm. The purpose of this paper is to investigate whether and how Lean Healthcare Management (LHM) can support CW objectives, focusing on customer needs and on waste elimination. A systematic literature review has been performed in Scopus, PubMed and Web of Science. Peer reviewed articles published in English language have been selected. Papers were considered if they regarded LHM and its possible support for achieving CW objectives. Data extraction. The links between the LHM purposes of adoption and the pursued CW objectives were investigated. Moreover, LHM tools, practices and interventions to support CW were grasped. Sixteen articles were included in the analysis. Links between the identified LHM purposes of adoption and CW objectives were discovered: through process understanding, optimization, evaluation and control, LHM contributes to the reduction of overuses in healthcare, but also to the delivery of a more effective and evidence-based care (EBC). Moreover, it provides an objective approach useful for choosing the most cost-effective solution among different alternatives. Results highlight how LHM, and with which tools and practices, can be adopted to enhance the healthcare appropriateness pursued by CW, paving the way for interesting future research about this emerging topic. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  4. Evaluation of Tourette's syndrome by 99mTc-TRODAT-1 SPECT/CT imaging

    International Nuclear Information System (INIS)

    Liu Hong; Dong Feng; Meng Zhaowei; Zhang Benshu; Tan Jian; Wang Yu

    2010-01-01

    Clinical evidence indicates that the Tourette's syndrome (TS) is associated with hyperactivity of the dopaminergic system; however, imaging studies of dopamine transporter (DAT) in TS patients remain controversial. In this study, we aimed to study DAT binding capacities in a relatively larger sample of drug-naive patients with TS in comparison with controlled subjects by 99m -Tc-TRODAT-1 single photon emission computed tomography (SPECT)/CT imaging. We also aimed to look for any possible correlations between DAT and age, disease duration or tic severity of TS, which have not been thoroughly investigated in previous studies. We tried to provide more evidence for the understanding of the physiopathological mechanism of TS from the molecular imaging perspective. Eighteen drug-naive patients with TS and 8 age- and gender-matched healthy subjects were recruited. Severity of TS was measured with Yale Global Tic Severity Scale. Brain SPECT/CT was performed 2.5 h after injection of 99m Tc-TRODAT-1. Regions of interest were drawn on the striatum including its sub-regions of caudate and putamen. The cerebellum was used as the reference region. DAT uptake ratio was calculated by subtracting the mean counts per pixel in the cerebellum from the mean counts per pixel in the striatum, caudate or putamen and by dividing the result by the mean counts per pixel in the cerebellum. Comparisons of DAT uptake ratios between TS patients and controls, and comparisons in bilateral striatum and sub-regions in TS patients were carried out. Correlation analysis between DAT uptake ratios and clinical data were also conducted. TS patients showed significantly higher uptake of 99m Tc-TRODAT-1 in bilateral striatum in comparison with the controls. There was no group-specific preferential lateralization in striatal uptake. DAT uptake ratios were not correlated with age and tic severity scores, but significant negative correlation with disease duration was found. High level of DAT was demonstrated

  5. A further evaluation of the cognitive deficits associated with restless legs syndrome (RLS).

    Science.gov (United States)

    Gamaldo, Charlene E; Benbrook, Amy R; Allen, Richard P; Oguntimein, Oluwamurewa; Earley, Christopher J

    2008-07-01

    Restless legs syndrome (RLS) is a common sensorimotor disorder that peaks in severity during the night and comes on with rest. As a result, this condition often results in significant chronic sleep loss, especially for those with severe disease. Chronic partial sleep restriction has been associated with conditions such as depression, anxiety, chronic pain, and decline in cognitive function. Furthermore, studies have found that RLS patients suffer from these conditions more than their unaffected peers. Thus, the morbidity rate associated with RLS has often been attributed to the chronic sleep loss that frequently accompanies this condition. However, no study has specifically compared RLS sufferers to otherwise normal sleep-restricted controls in order to assess disease morbidity independent of its sleep deprivation effects. In this study, we compared the cognitive function of RLS patients who were off treatment to sleep-restricted control subjects. A novel chronic partial sleep-restriction protocol that utilized a 14-day combined inpatient and outpatient design was implemented in order to test the differences in cognitive functioning between RLS patients and sleep-restricted controls. The brief cognitive battery included instruments assessing general intelligence and global executive function in order to control for baseline cognitive function between the groups, and then the effects of sleep loss were assessed using prefrontal lobe-specific tasks. The final sample consisted of 16 RLS (11 male and 5 female) and 13 sleep-restricted control subjects (7 male and 6 female). In order to examine the differences in cognitive functioning between sleep-restricted controls and RLS subjects, independent samples t-tests were conducted. RLS subjects performed significantly better on both the Letter Fluency (t=2.13, pRLS subjects performed better than the sleep-restricted controls on two tasks that are particularly sensitive to sleep loss. Although previous studies suggest that

  6. The Evaluation of Digital Rectal Examination for Assessment of Anal Tone in Suspected Cauda Equina Syndrome.

    Science.gov (United States)

    Sherlock, Katrina Eve; Turner, William; Elsayed, Sherief; Bagouri, M; Baha, L; Boszczyk, Bronek M; McNally, Donal

    2015-08-01

    Seventy-five doctors completed a questionnaire documenting their grade, specialty, and experience in performing digital rectal examination (DRE). A model anus, using a pressure transducer surrounding an artificial canal, was assembled and calibrated. Participants performed 4 DREs on the model (with a break between attempts) and predicted tone as "reduced" or "normal" (35 and 60 mm Hg, respectively), followed by a "squeeze" test. Thirty health care assistants partook as a control group with no training in DRE. Our main objective was to investigate the validity of digital rectal examination (DRE) for assessment of anal tone. Cauda equina syndrome represents the constellation of symptoms and signs resulting from compression of lumbrosacral nerve routes. Combined with subjective neurological findings, a reduction in anal tone is an important sign, deeming further imaging necessary. DRE is an invasive procedure used to assess anal tone despite debated accuracy. A total of 75 doctors from various specialties were asked to fill in a questionnaire detailing their grade, age, and area of expertise. In addition, information was gathered with regard to prior training in performing DRE to assess anal tone and the importance placed on any findings. Thirty hospital health care assistants (HCAs) were used as a control group. HCAs were selected as a control group because they receive no training on the technique and would never be required to perform it in their clinical practice. A model anus was assembled using a modified pediatric sphygmomanometer cuff to act as a sphincter. The cuff could be inflated to simulate a full range of anal tone. The cuff was incorporated into an artificial anal canal, which was, in turn, placed into a model buttock created from plaster of Paris. The apparatus was calibrated across a range of pressures. In each attempt, 60%, 61%, 63%, and 67% of doctors correctly identified the anal tone, respectively (average accuracy: 64%). HCAs had an identical

  7. AN EVALUATION OF THE REARFOOT POSTURE IN INDIVIDUALS WITH PATELLOFEMORAL PAIN SYNDROME

    Directory of Open Access Journals (Sweden)

    Wendy Gilleard

    2004-11-01

    Full Text Available Structural abnormalities of the foot may cause abnormal subtalar joint compensatory motion in order to attain normal function of the lower extremity during gait although studies have not been conclusive. Current conflict in the literature may be related to the differing measures focused on the varying protocols and also the absence of a control group in some studies. This study investigated the rearfoot posture including Subtalar Joint Neutral Position (STJN and Relaxed Calcaneal Standing (RCS measurements in patellofemoral pain syndrome (PFPS and healthy subjects. The angle of STJN during non-weight bearing position and the two dimensional (2D rearfoot RCS posture was measured using a goniometer in 14 healthy females and 13 females with PFPS. The RCS posture was also measured three dimensionally (3D by attaching external markers to a tibia shell and the calcaneus and videoing with a four-camera three-dimensional motion analysis system. A one way ANOVA was used to assess the differences between the groups. The 2D and 3D RCS were significantly different between the groups (p ¡Ü 0.001 with mean -0.23¡ã ¡À 1.35¡ã , 2.52¡ã ¡À 3.11¡ã for the control group and 2.35¡ã ¡À 1.4¡ã, 7.02¡ã ¡À 3.33¡ã for the clinical group respectively. STJN showed a slight rearfoot varus (although significant p = 0.04 in PFPS (-2.20¡ã ¡À 1.51¡ã compared to the control group (-1.00¡ã ¡À 1.36¡ã. Negative values indicated inversion and positive values indicated eversion. The 2D and 3D RCS showed a significantly more everted posture of the rearfoot for the PFPS group. Subtalar joint varus may contribute to the increased eversion during relaxed standing in the PFPS group. Rearfoot measurements may be an important addition to other clinical measurements taken to explore the underlying aetiology of subjects with PFPS.

  8. Investing Wisely in Information Technology: Asking the Right Questions.

    Science.gov (United States)

    Breivik, Patricia Senn

    1993-01-01

    College administrators are offered a series of questions to ask in evaluating the appropriateness of information technology for their campuses. Issues addressed include defining institutional goals and the role of information technology in them, determining the most effective organization of information resources and technology, and allocation of…

  9. Syndrome dimensions and the Child Behavior Checklist and the Teacher Report Form: A critical empirical evaluation

    NARCIS (Netherlands)

    Hartman, C.A.; Hox, J.; Auerbach, J.; Erol, N.; Fonseca, A.C.; Mellenbergh, G.J.; Novik, T.S.; Oosterlaan, J.; Roussos, A.C.; Shalev, R.S.; Zilber, N.; Sergeant, J.A.

    1999-01-01

    The construct representation of the cross-informant model of the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF) was evaluated using confirmatory factor analysis. Samples were collected in seven different countries. The results are based on 13,226 parent ratings and 8893 teacher

  10. Evaluation of Right Ventricle Function in Children With Primary Nephrotic Syndrome

    Directory of Open Access Journals (Sweden)

    Qiang Qin

    2010-06-01

    Conclusion: Right ventricle function was impaired in children with PNS. The characteristics were unrelated to blood pressure and IGF-1, but may be correlated with TNF-α and disease duration. Further studies are needed to evaluate the etiology and clinical implications of this abnormality.

  11. The Astro-WISE approach to quality control for astronomical data

    NARCIS (Netherlands)

    Mc Farland, John; Helmich, Ewout M.; Valentijn, Edwin A.

    We present a novel approach to quality control during the processing of astronomical data. Quality control in the Astro-WISE Information System is integral to all aspects of data handing and provides transparent access to quality estimators for all stages of data reduction from the raw image to the

  12. OPTICAL SPECTROSCOPIC SURVEY OF HIGH-LATITUDE WISE-SELECTED SOURCES

    Energy Technology Data Exchange (ETDEWEB)

    Lake, S. E.; Wright, E. L.; Petty, S. [Physics and Astronomy Department, University of California, Los Angeles, CA 90095-1547 (United States); Assef, R. J.; Stern, D. [Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 (United States); Jarrett, T. H.; Tsai, C.-W. [Infrared Processing and Analysis Center (IPAC), California Institute of Technology, Pasadena, CA 91125 (United States); Stanford, S. A., E-mail: lake@physics.ucla.edu [Department of Physics, University of California, Davis, CA 95616 (United States)

    2012-01-15

    We report on the results of an optical spectroscopic survey at high Galactic latitude (|b| {>=} 30 Degree-Sign ) of a sample of WISE-selected targets, grouped by WISE W1 ({lambda}{sub eff} = 3.4 {mu}m) flux, which we use to characterize the sources WISE detected. We observed 762 targets in 10 disjoint fields centered on ultraluminous infrared galaxy candidates using DEIMOS on Keck II. We find 0.30 {+-} 0.02 galaxies arcmin{sup -2} with a median redshift of z = 0.33 {+-} 0.01 for the sample with W1 {>=} 120 {mu}Jy. The foreground stellar densities in our survey range from 0.23 {+-} 0.07 arcmin{sup -2} to 1.1 {+-} 0.1 arcmin{sup -2} for the same sample. We obtained spectra that produced science grade redshifts for {>=}90% of our targets for sources with W1 flux {>=}120 {mu}Jy that also had an i-band flux {approx}> 18 {mu}Jy. We used this for targeting very preliminary data reductions available to the team in 2010 August. Our results therefore present a conservative estimate of what is possible to achieve using WISE's Preliminary Data Release for the study of field galaxies.

  13. IRAC Imaging of Clusters from the Massive Distant Clusters of WISE Survey

    Science.gov (United States)

    Gonzalez, Anthony; Gettings, Daniel; Brodwin, Mark; Stanford, Adam; Eisenhardt, Peter; Stern, Daniel; Zeimann, Greg; Wylezalek, Dominika

    2012-12-01

    The Massive Distant Clusters of WISE Survey (MaDCoWS) is a comprehensive search of the full extragalactic sky designed to detect and characterize the massive galaxy cluster population at 0.90.9 galaxies and identify clusters as overdensities of super-L* galaxies at these redshifts. Within the WISE-SDSS overlap region, which is the focus of this proposal, our team has identified approximately 4000 massive galaxy clusters, with follow-up optical imaging and spectroscopy demonstrating the success of our approach. We propose with Spitzer to obtain IRAC imaging of the 200 highest significance detections within the WISE-SDSS overlap region, which requires only 37.9 hrs. These data will be used to identify the most exciting, massive systems for detailed multiwavelength analysis, to calibrate WISE-based mass proxies for the full cluster survey, and to conduct a statistical analysis of the evolution of cluster galaxy properties as a function of cluster mass at this epoch. MaDCoWS provides the first all-sky sample of massive clusters at this epoch, and the results from this program with enhance the legacy value of the survey.

  14. Electrophysiological correlates of block-wise strategic adaptations to consciously and unconsciously triggered conflict

    NARCIS (Netherlands)

    Jiang, J.; van Gaal, S.; Bailey, K.; Chen, A.; Zhang, Q.

    2013-01-01

    The role of consciousness in conflict adaptation has been a topic of much debate. The purpose of the current study was to investigate the neural correlates of block-wise conflict adaptations elicited by conscious and unconscious conflicting stimuli in a meta-contrast masked priming task. Event-related

  15. The dipole anisotropy of WISE × SuperCOSMOS number counts

    Science.gov (United States)

    Bengaly, C. A. P.; Novaes, C. P.; Xavier, H. S.; Bilicki, M.; Bernui, A.; Alcaniz, J. S.

    2018-01-01

    We probe the isotropy of the Universe with the largest all-sky photometric redshift dataset currently available, namely WISE × SuperCOSMOS. We search for dipole anisotropy of galaxy number counts in multiple redshift shells within the 0.10 origin of the latter discrepancy is unclear, and improved data may be needed to explain it.

  16. Infrared excesses in stars with and without planets using revised WISE photometry

    Science.gov (United States)

    Maldonado, Raul F.; Chavez, Miguel; Bertone, Emanuele; Cruz-Saenz de Miera, Fernando

    2017-11-01

    We present an analysis on the potential prevalence of mid-infrared excesses in stars with and without planetary companions. Based on an extended data base of stars detected with the Wide Infrared Survey Explorer (WISE) satellite, we studied two stellar samples: one with 236 planet hosts and another with 986 objects for which planets have been searched, but not found. We determined the presence of an excess over the photosphere by comparing the observed flux ratio at 22 and 12 μm (f22/f12) with the corresponding synthetic value, derived from results of classical model photospheres. We found a detection rate of 0.85 per cent at 22 μm (two excesses) in the sample of stars with planets and 0.1 per cent (1 detection) for the stars without planets. The difference of the detection rate between the two samples is not statistically significant, a result that is independent of the different approaches found in the literature to define an excess in the wavelength range covered by WISE observations. As an additional result, we found that the WISE fluxes required a normalization procedure to make them compatible with synthetic data, probably pointing out a revision of the WISE data calibration.

  17. Global data set of derived soil properties, 0.5-degree grid (ISRIC-WISE)

    NARCIS (Netherlands)

    Batjes, N.H.

    2014-01-01

    The World Inventory of Soil Emission Potentials (WISE) database currently contains data for over 4300 soil profiles collected mostly between 1950 and 1995. This database has been used to generate a series of uniform data sets of derived soil properties for each of the 106 soil units considered in

  18. LBA Regional Derived Soil Properties, 0.5-Deg (ISRIC-WISE)

    NARCIS (Netherlands)

    Batjes, N.H.

    2014-01-01

    The data set consists of a subset of the ISRIC-WISE global data set of derived soil properties for the study area of the Large Scale Biosphere-Atmosphere Experiment in Amazonia (LBA) in South America (i.e., longitude 85 to 30 degrees W, latitude 25 degrees S to 10 degrees N).The World Inventory of

  19. Deep Full-sky Coadds from Three Years of WISE and NEOWISE Observations

    Science.gov (United States)

    Meisner, A. M.; Lang, D.; Schlegel, D. J.

    2017-10-01

    We have reprocessed over 100 terabytes of single-exposure Wide-field Infrared Survey Explorer (WISE)/NEOWISE images to create the deepest ever full-sky maps at 3-5 microns. We include all publicly available W1 and W2 imaging—a total of ˜8 million exposures in each band—from ˜37 months of observations spanning 2010 January to 2015 December. Our coadds preserve the native WISE resolution and typically incorporate ˜3× more input frames than those of the AllWISE Atlas stacks. Our coadds are designed to enable deep forced photometry, in particular for the Dark Energy Camera Legacy Survey (DECaLS) and Mayall z-Band Legacy Survey (MzLS), both of which are being used to select targets for the Dark Energy Spectroscopic Instrument. We describe newly introduced processing steps aimed at leveraging added redundancy to remove artifacts, with the intent of facilitating uniform target selection and searches for rare/exotic objects (e.g., high-redshift quasars and distant galaxy clusters). Forced photometry depths achieved with these coadds extend 0.56 (0.46) magnitudes deeper in W1 (W2) than is possible with only pre-hibernation WISE imaging.

  20. Public Libraries--A Wise Investment: A Return on Investment Study of Colorado Public Libraries

    Science.gov (United States)

    Steffen, Nicolle; Lietzau, Zeth; Lance, Keith Curry; Rybin, Amanda; Molliconi, Carla

    2009-01-01

    Public libraries deliver many benefits to their patrons, but understanding these benefits in terms of dollars-and-cents is difficult. In an effort to quantify the return on investment to taxpayers for monies invested in public libraries, the Library Research Service (LRS) initiated the study, "Public Libraries -- A Wise Investment: A Return…

  1. Batwing versus Wise pattern mammoplasty for upper pole breast tumours: a detailed comparison of cosmetic outcome.

    Science.gov (United States)

    Hashem, Tarek; Farahat, Ahmed

    2017-03-14

    The aim of this study is to compare the results of batwing mammoplasty and Wise pattern mammoplasty in the surgical management of upper pole breast tumours. This is a retrospective observational study including 126 breast cancer patients who presented between 2009 and 2015 to the National Cancer Institute of Cairo University in Egypt. All patients were candidates for breast conservation, with upper pole tumours, which was defined as tumours between 3 and 9 o'clock. Patients were categorized into two groups. Group A (64) included patients who underwent inferiorly based therapeutic mammoplasty, while group B (62) was designated for patients who had batwing mammoplasty. The results of both groups were compared and analyzed. Wise pattern mammoplasty group had statistically significant higher complication rate. The overall aesthetic result of Wise pattern technique was superior to batwing mammoplasty. However, batwing mammoplasty showed a statistically significant higher rate of patient satisfaction. Both techniques are valid options for upper pole breast tumours. Wise pattern therapeutic mammoplasty remains aesthetically superior; however, batwing mammoplasty is an easy, simple technique with acceptable results to patients.

  2. WISE Infrared Properties of Fermi AGNs JJ Qiu1, JS Zhang1,∗ & Q ...

    Indian Academy of Sciences (India)

    Abstract. The infrared properties of Fermi AGNs were investigated using the survey data of the Wide-field Infrared Survey Explorer (WISE). The results showed: (1) BL Lacs tend to be brighter than FSRQs at. 3.4μm. However, with increase of wavelength, FSRQs tend to be brighter than BL Lacs. (2) FSRQs colours are redder ...

  3. Isgur–Wise function in a QCD-inspired potential model with WKB ...

    Indian Academy of Sciences (India)

    2017-02-28

    Feb 28, 2017 ... DOI 10.1007/s12043-016-1357-9. Isgur–Wise function in a QCD-inspired potential model with WKB approximation. BHASKAR JYOTI HAZARIKA1,∗ and D K CHOUDHURY1,2. 1Centre for Theoretical Studies, Pandu College, Guwahati 781 012, India. 2Physics Academy of North East, Gauhati University, ...

  4. Wise Humanising Creativity: Changing How We Create in a Virtual Learning Environment

    Science.gov (United States)

    Chappell, Kerry; Walsh, Chris; Wren, Heather; Kenny, Karen; Schmoelz, Alexander; Stouraitis, Elias

    2017-01-01

    This article interrogates how a particular conception of creativity: "wise humanising creativity" (WHC) is manifest within a virtual learning environment (VLE) with children and young people. It reports on the outcomes of C[superscript 2]Learn, a three-year European Commission funded project which introduced innovative digital gaming…

  5. Integration of the MUSE Software Pipeline into the Astro-WISE System

    NARCIS (Netherlands)

    Pizagno, J.; Streicher, O.; Vriend, W.-J.; Ballester, P.; Egret, D.; Lorente, N.P.F.

    We discuss the current state of integrating the Mutli Unit Spectroscopic Explorer (hereafter: MUSE) software pipeline (Weilbacher et al. 2006) into the Astro-WISE system (Valentijn et al. 2007a; Vriend et al. 2012). MUSE is a future integral-field spectrograph for the VLT, consisting of 24 Integral

  6. Role of supply chain management in the wise use of wood resources

    African Journals Online (AJOL)

    One of the cornerstones of sustainable forestry is the wise use of wood resources to achieve maximum value or benefit for society, while not jeopardizing the future. At the same time forest companies must compete on an international scale, otherwise they themselves risk becoming non-sustainable. Supply chain ...

  7. Making and Being Made: Wise Humanising Creativity in Interdisciplinary Early Years Arts Education

    Science.gov (United States)

    Chappell, Kerry Anne; Pender, Tamsin; Swinford, Elizabeth; Ford, Katherine

    2016-01-01

    This paper focuses on how wise humanising creativity (WHC) is manifested within early years interdisciplinary arts education. It draws on Arts Council-funded participatory research by Devon Carousel Project and University of Exeter's Graduate School of Education. It is grounded in previous AHRC-funded research, which conceptualised WHC in the face…

  8. Bridging the Divide: A Case Study Investigating Digitally-Wise Teacher Perceptions of Middle School Cyberbullying

    Science.gov (United States)

    Graves, Tiffany Nicole

    2013-01-01

    The purpose of this qualitative case study was to explore the perceptions of middle school, technologically proficient, or digitally-wise teachers, regarding how they defined, prevented, recognized, and handled incidences of cyberbullying in four middle schools located in Southern Virginia. Data was collected using an open-ended questionnaire,…

  9. Step wise approach of gout in the rheumatology ward of Point-G ...

    African Journals Online (AJOL)

    Step wise approach of gout in the rheumatology ward of Point-G University Teaching Hospital of Bamako, Mali. ... Obesity, high blood pressure, diuretics intake, and kidney failure were observed in 83%, 76%, 64% and 37%, respectively. Clinical manifestations of gout were located in joints (100%), in skin (4 cases of tophus) ...

  10. Deep Full-sky Coadds from Three Years of WISE and NEOWISE Observations

    Energy Technology Data Exchange (ETDEWEB)

    Meisner, A. M. [Berkeley Center for Cosmological Physics, New Campbell Hall 341, University of California, Berkeley, CA 94720 (United States); Lang, D. [Department of Astronomy and Astrophysics and Dunlap Institute, University of Toronto, Toronto, ON M5S 3H4 (Canada); Schlegel, D. J., E-mail: ameisner@lbl.gov [Lawrence Berkeley National Laboratory, Berkeley, CA, 94720 (United States)

    2017-10-01

    We have reprocessed over 100 terabytes of single-exposure Wide-field Infrared Survey Explorer ( WISE )/NEOWISE images to create the deepest ever full-sky maps at 3–5 microns. We include all publicly available W1 and W2 imaging—a total of ∼8 million exposures in each band—from ∼37 months of observations spanning 2010 January to 2015 December. Our coadds preserve the native WISE resolution and typically incorporate ∼3× more input frames than those of the AllWISE Atlas stacks. Our coadds are designed to enable deep forced photometry, in particular for the Dark Energy Camera Legacy Survey (DECaLS) and Mayall z-Band Legacy Survey (MzLS), both of which are being used to select targets for the Dark Energy Spectroscopic Instrument. We describe newly introduced processing steps aimed at leveraging added redundancy to remove artifacts, with the intent of facilitating uniform target selection and searches for rare/exotic objects (e.g., high-redshift quasars and distant galaxy clusters). Forced photometry depths achieved with these coadds extend 0.56 (0.46) magnitudes deeper in W1 (W2) than is possible with only pre-hibernation WISE imaging.

  11. Deep Full-sky Coadds from Three Years of WISE and NEOWISE Observations

    International Nuclear Information System (INIS)

    Meisner, A. M.; Lang, D.; Schlegel, D. J.

    2017-01-01

    We have reprocessed over 100 terabytes of single-exposure Wide-field Infrared Survey Explorer ( WISE )/NEOWISE images to create the deepest ever full-sky maps at 3–5 microns. We include all publicly available W1 and W2 imaging—a total of ∼8 million exposures in each band—from ∼37 months of observations spanning 2010 January to 2015 December. Our coadds preserve the native WISE resolution and typically incorporate ∼3× more input frames than those of the AllWISE Atlas stacks. Our coadds are designed to enable deep forced photometry, in particular for the Dark Energy Camera Legacy Survey (DECaLS) and Mayall z-Band Legacy Survey (MzLS), both of which are being used to select targets for the Dark Energy Spectroscopic Instrument. We describe newly introduced processing steps aimed at leveraging added redundancy to remove artifacts, with the intent of facilitating uniform target selection and searches for rare/exotic objects (e.g., high-redshift quasars and distant galaxy clusters). Forced photometry depths achieved with these coadds extend 0.56 (0.46) magnitudes deeper in W1 (W2) than is possible with only pre-hibernation WISE imaging.

  12. Searching for Planet Nine and Other Nearby Worlds with WISE and NEOWISE

    Science.gov (United States)

    Meisner, Aaron Michael; Bromley, Benjamin; Nugent, Peter; Schlegel, David; Kenyon, Scott; Schlafly, Eddie; Dawson, Kyle; Anderson, Teddy

    2018-01-01

    Launched nearly eight years ago, NASA's WISE satellite continues to collect millions of infrared images at 3-5 microns as part of its asteroid-hunting NEOWISE mission. We have repurposed these NEOWISE exposures for science beyond the main belt by generating a novel full-sky set of time-resolved coadded images. This reprocessing allows for moving object searches reaching ~1.3 magnitudes fainter than previous studies while also providing a factor of ten increase in time baseline. This creates an exciting opportunity for motion-based discovery of very cold and faint objects which may have thus far eluded detection despite residing close to the Sun. We present the results of our latest WISE/NEOWISE search for 'Planet Nine', a giant planet hypothesized to orbit the Sun at hundreds of astronomical units. Our search incorporates over four years of WISE W1 observations spanning a seven year time period, and covers more than 75% of the sky. Variants of the WISE/NEOWISE Planet Nine search methodology we have developed should enable motion-based discoveries of large numbers of cold, faint brown dwarfs, especially those which are not detectable with Gaia.

  13. Sustainable, efficient, and equitable water use: the three pillars under wise freshwater allocation

    NARCIS (Netherlands)

    Hoekstra, Arjen Ysbert

    2014-01-01

    There are many river basins in the world where human water footprint needs to be reduced substantially. This article proposes three pillars under wise freshwater allocation: water footprint caps per river basin, water footprint benchmarks per product, and fair water footprint shares per community.

  14. Multi-atlas segmentation with particle-based group-wise image registration.

    Science.gov (United States)

    Lee, Joohwi; Lyu, Ilwoo; Styner, Martin

    2014-03-21

    We propose a novel multi-atlas segmentation method that employs a group-wise image registration method for the brain segmentation on rodent magnetic resonance (MR) images. The core element of the proposed segmentation is the use of a particle-guided image registration method that extends the concept of particle correspondence into the volumetric image domain. The registration method performs a group-wise image registration that simultaneously registers a set of images toward the space defined by the average of particles. The particle-guided image registration method is robust with low signal-to-noise ratio images as well as differing sizes and shapes observed in the developing rodent brain. Also, the use of an implicit common reference frame can prevent potential bias induced by the use of a single template in the segmentation process. We show that the use of a particle guided-image registration method can be naturally extended to a novel multi-atlas segmentation method and improves the registration method to explicitly use the provided template labels as an additional constraint. In the experiment, we show that our segmentation algorithm provides more accuracy with multi-atlas label fusion and stability against pair-wise image registration. The comparison with previous group-wise registration method is provided as well.

  15. QCD sum rule calculation of the Isgur-Wise form factor

    International Nuclear Information System (INIS)

    Radyushkin, A.V.

    1991-01-01

    Within the QCD sum rule approach, we develop a formalism that enables one to calculate the form factors of the heavy-light mesons in the m Q → ∞ limit. It is shown that the behavior of the universal Isgur-Wise form factor is determined by the quark propagation function in imaginary time. (orig.)

  16. [An evaluation of HLA class 2 alleles and anti-islet antibodies as evidence for non-autoimmune diabetes in Wolfram syndrome].

    Science.gov (United States)

    Zmysłowska, Agnieszka; Borowiec, Maciej; Antosik, Karolina; Wyka, Krystyna; Cieślik-Heinrich, Agnieszka; Klich, Izabela; Młynarski, Wojciech

    2010-01-01

    A clinical criterion of the Wolfram syndrome is the coexistence of diabetes and optic atrophy recognized before the age of 15. Diabetes present in Wolfram syndrome is a result of the selective β cell loss and failed insulin secretion which is probably associated with non-autoimmune pathogenesis. The aim of the study was an evaluation of HLA subtypes and presence of β-cell autoantibodies in patients with molecularly confirmed Wolfram syndrome. 9 patients with Wolfram syndrome aged 10-24 years were examined. We also studied 218 patients with type 1 diabetes as a reference group. A control group of 176 healthy individuals was included in the study. Besides the clinical assessment the HLA typing by PCR-SSO was performed. Islet cell antibodies (ICA), antibodies to glutamic acid decarboxylase (GADA), thyrosine phosphatase antibodies (IA2A) and insulin antibodies (IAA) were also detected. In all nine patients the coexistence of diabetes with optic atrophy was observed and in 8/9 individuals additional symptoms were recognized. In patients with Wolfram syndrome a significantly lower age of diagnosis of diabetes (Me=5.0 years) than in type 1 diabetic children (Me=10.4; p=0.002) was observed. Studies of HLA subtypes demonstrated an increased prevalence of HLA-DQw1, DRB1⋅03 and/or 04 and DR2. A comparison of the frequency of the HLA alleles in patients with Wolfram syndrome with type 1 diabetic children showed a more frequent presence of the DRB1⋅1501 (p=0.03; OR=13.28 (2.44-72.12)) and DQB1⋅06 (p=0.016; OR=10.15 (2.49-41.35)) alleles in patients with Wolfram syndrome. Polish patients with Wolfram syndrome have a different profile of the HLA antigens with the presence of DR2, DQw1 and DRB3/4 allele and are negative for diabetes-related autoantibodies, which may confirm non-autoimmune β-cell destruction in this syndrome.

  17. Evaluation of Potential Modifiers of the Cardiac Phenotype in the 22q11.2 Deletion Syndrome

    Science.gov (United States)

    Goldmuntz, Elizabeth; Driscoll, Deborah A.; Emanuel, Beverly S.; McDonald-McGinn, Donna; Mei, Minghua; Zackai, Elaine; Mitchell, Laura E.

    2010-01-01

    BACKGROUND The phenotype associated with deletion of the 22q11.2 chromosomal region is highly variable, yet little is known about the source of this variability. Cardiovascular anomalies, including tetralogy of Fallot, truncus arteriosus, interrupted aortic arch type B, perimembranous ventricular septal defects, and aortic arch anomalies, occur in approximately 75% of individuals with a 22q11.2 deletion. METHODS Data from 343 subjects enrolled in a study of the 22q11.2 deletion syndrome were used to evaluate potential modifiers of the cardiac phenotype in this disorder. Subjects with and without cardiac malformations, and subjects with and without aortic arch anomalies were compared with respect to sex and race. In addition, in the subset of subjects from whom a DNA sample was available, genotypes for variants of four genes that are involved in the folate-homocysteine metabolic pathway and that have been implicated as risk factors for other birth defects were compared. Five variants in four genes were genotyped by heteroduplex or restriction digest assays. The chi-square or Fisher’s exact test was used to evaluate the association between the cardiac phenotype and each potential modifier. RESULTS The cardiac phenotype observed in individuals with a 22q11.2 deletion was not significantly associated with either sex or race. The genetic variants that were evaluated also did not appear to be associated with the cardiovascular phenotype. CONCLUSIONS Variation in the cardiac phenotype observed between individuals with a 22q11.2 deletion does not appear to be related to sex, race, or five sequence variants in four folate-related genes that are located outside of the 22q11.2 region. PMID:18770859

  18. Single TCR-Vβ2 evaluation discloses the circulating T cell clone in Sezary syndrome: one family fits all!

    Science.gov (United States)

    Scala, Enrico; Abeni, Damiano; Pomponi, Debora; Russo, Nicoletta; Russo, Giandomenico; Narducci, Maria Grazia

    2015-08-01

    Sézary Syndrome (SS/L-CTCL) is a rare but aggressive variant of cutaneous T cell lymphoma (CTCL), characterized by erythroderma, lymphadenopathy, and the presence of a circulating memory CD4(+) T cell malignant clone with a skin homing behavior, lacking CD26 and CD49d and over-expressing CD60. The availability of a panel of monoclonal antibodies recognizing distinct TCR-Vβ families, allows to typify the clone by flow cytometry in about 70 % of cases. The TCR-Vβ repertoire of 533 individuals, comprising 308 patients affected by CTCL, 50 healthy donors, and subjects affected by various non-neoplastic dermatological affections was evaluated by flow cytometry. Statistical analyses were performed using the SPSS statistical software package for Microsoft Windows (SPSS, version 21, Chicago, IL). TCR-Vβ2 levels below 5.4 % or above 39.5 %, within total CD4(+) T cells, showed the best balance between sensitivity (98.1 %) and specificity (96 %) to identify the presence of a clone in the peripheral blood of patients affected by SS. Based on this observation, a "two-step" procedure in the detection of the malignant T cell clone in CTCLs is herein suggested. TCR-Vβ2 assessment in all cases (first step). In the case of TCR-Vβ2 levels above 39.5 %, the presence of a clonal expansion of this family is suggested, deserving further confirmation by means of T cell gene rearrangement evaluation. In patients having a TCR-Vβ2 reactivity below 5.4 % (second step), the entire TCR-Vβ repertoire should be evaluated to typify the expanded clone. In conclusion, the single TCR-Vβ2 expression check, instead of the entire repertoire assessment, represents an easy and cost-effective method for the recognition of CTCL aggressive leukemic variant.

  19. The Waste Wise Schools Program: Evidence of Educational, Environmental, Social and Economic Outcomes at the School and Community Level

    Science.gov (United States)

    Armstrong, Patricia; Sharpley, Brian; Malcolm, Stephen

    2004-01-01

    The Waste Wise Schools Program was established by EcoRecycle Victoria to implement waste and litter education in Victorian schools. It is now operating in over 900 schools in Victoria and 300 schools in other Australian states / territories. This paper provides detailed case studies of two active schools in the Waste Wise Schools Program and…

  20. Evaluation of the impact of the urinary symptoms on quality of life of patients with painful bladder syndrome/chronic pelvic pain and radiation cystitis: EURCIS study.

    Science.gov (United States)

    Rapariz-González, M; Castro-Díaz, D; Mejía-Rendón, D

    2014-05-01

    To evaluate the impact of urinary symptoms of Painful Bladder/Pelvic Pain Syndrome and Radiation Cystitis (PBCPPS) on the Quality of Life, and self-esteem of the patient. An observational, multicenter, epidemiological and cross-sectional study was performed on patients with Painful Bladder/Chronic Pelvic Pain Syndrome and Radiation Cystitis. Data was recorded on severity of urinary symptoms and QoL impairment using the PUF Score. The patients evaluated the QoL deterioration grade through the King's Health Questionnaire (KHQ), and the level of their anxiety and self-esteem with the Goldberg's Anxiety Scale (GAS) and Rosenberg's Self-Esteem Scale (RSES), respectively. Post-hoc comparisons were performed between the results of the KHQ of this study and a sample of patients with urinary incontinence (UI). Results on RSES were analyzed with data from the general population and from patients with erectile dysfunction. A total of 530 cases, mostly female patients, who had been diagnosed with PBCPPS, were analyzed. High levels of deterioration in QoL were described: KHQ scores were significantly higher when compared with patients with UI (PBladder Syndrome/Chronic Pelvic Pain Syndrome and Radiation Cystitis present high levels of anxiety, and significant reductions in both quality of life and self-esteem. Especially for men, this affectation is similar to that caused by erectile dysfunction. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  1. Fanconi syndrome

    Science.gov (United States)

    De Toni-Fanconi syndrome ... Fanconi syndrome can be caused by faulty genes, or it may result later in life due to kidney damage. Sometimes the cause of Fanconi syndrome is unknown. Common causes of Fanconi syndrome in ...

  2. Duane Syndrome

    Science.gov (United States)

    ... Frequently Asked Questions Español Condiciones Chinese Conditions Duane Syndrome En Español Read in Chinese What is Duane Syndrome? Duane syndrome, also called Duane retraction syndrome (DRS), ...

  3. Hunter Syndrome

    Science.gov (United States)

    ... in girls. There's no cure for Hunter syndrome. Treatment of Hunter syndrome involves management of symptoms and complications. Symptoms Hunter syndrome is one type of a group of inherited metabolic disorders called mucopolysaccharidoses (MPSs), and Hunter syndrome is ...

  4. Using Pair Wise Rankings in the Assessment of Adaptive Aiding

    Science.gov (United States)

    2017-02-22

    Evaluation of Physiologically-Based Artificial Neural Network Models to Detect Operator Workload in Remotely Piloted Aircraft Operations (Report No...research, artificial neural network (ANN) models have been used in an attempt to model cognitive workload (Hoepf et al., 2016). These models can be used...currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 22-02-17 2. REPORT TYPE

  5. 75 FR 13765 - Draft Guidance for Industry on Irritable Bowel Syndrome-Clinical Evaluation of Products for...

    Science.gov (United States)

    2010-03-23

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Irritable Bowel Syndrome... and symptom assessment for IBS with diarrhea (IBS-D) and IBS with constipation (IBS-C): The evolution... irritable bowel syndrome. It does not create or confer any rights for or on any person and does not operate...

  6. Central sensitization syndrome and the initial evaluation of a patient with fibromyalgia: a review.

    Science.gov (United States)

    Fleming, Kevin C; Volcheck, Mary M

    2015-04-01

    In both primary care and consultative practices, patients presenting with fibromyalgia (FM) often have other medically unexplained somatic symptoms and are ultimately diagnosed as having central sensitization (CS). Central sensitization encompasses many disorders where the central nervous system amplifies sensory input across many organ systems and results in myriad symptoms. A pragmatic approach to evaluate FM and related symptoms, including a focused review of medical records, interviewing techniques, and observations, is offered here, giving valuable tools for identifying and addressing the most relevant symptoms. At the time of the clinical evaluation, early consideration of CS may improve the efficiency of the visit, reduce excessive testing, and help in discerning between typical and atypical cases so as to avoid an inaccurate diagnosis. Discussion of pain and neurophysiology and sensitization often proves helpful.

  7. Central Sensitization Syndrome and the Initial Evaluation of a Patient with Fibromyalgia: A Review

    Directory of Open Access Journals (Sweden)

    Kevin C. Fleming

    2015-04-01

    Full Text Available In both primary care and consultative practices, patients presenting with fibromyalgia (FM often have other medically unexplained somatic symptoms and are ultimately diagnosed as having central sensitization (CS. Central sensitization encompasses many disorders where the central nervous system amplifies sensory input across many organ systems and results in myriad symptoms. A pragmatic approach to evaluate FM and related symptoms, including a focused review of medical records, interviewing techniques, and observations, is offered here, giving valuable tools for identifying and addressing the most relevant symptoms. At the time of the clinical evaluation, early consideration of CS may improve the efficiency of the visit, reduce excessive testing, and help in discerning between typical and atypical cases so as to avoid an inaccurate diagnosis. Discussion of pain and neurophysiology and sensitization often proves helpful.

  8. Fragile X syndrome: panoramic radiographic evaluation of dental anomalies, dental mineralization stage, and mandibular angle.

    Science.gov (United States)

    Sabbagh-Haddad, Aida; Haddad, Denise Sabbagh; Michel-Crosato, Edgard; Arita, Emiko Saito

    2016-01-01

    The purpose of this study was to evaluate the dental radiographic characteristics as described in 40 records of patients with panoramic radiography. The patients were in the range of 6-17 years old, and were divided into two groups (20 subjects who were compatible with the normality standard and 20 individuals diagnosed with the FXS), which were matched for gender and age. Analysis of the panoramic radiographic examination involved the evaluation of dental mineralization stage, mandibular angle size, and presence of dental anomalies in both deciduous and permanent dentitions. The results of radiographic evaluation demonstrated that the chronology of tooth eruption of all third and second lower molars is anticipated in individuals with FXS (p<0.05). In this group, supernumerary deciduous teeth (2.83%), giroversion of permanent teeth (2.31%), and partial anodontia (1.82%) were the most frequent dental anomalies. In addition, an increase was observed in the mandibular angle size in the FXS group (p<0.05). We conclude that knowledge of dental radiographic changes is of great importance for dental surgeons to plan the treatment of these individuals.

  9. Prognosis of Cyclic Vomiting Syndrome

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2016-03-01

    Full Text Available Investigators from Teikyo University School of Medicine, Tokyo, Japan, evaluated the clinical features, prognosis, and prophylaxis of cyclic vomiting syndrome and the relationship between the syndrome and levels of adrenocorticotropic/antidiuretic hormones (ACTH/ADH.

  10. Pixel-wise estimation of noise statistics on iterative CT reconstruction from a single scan.

    Science.gov (United States)

    Wang, Tonghe; Zhu, Lei

    2017-07-01

    As iterative CT reconstruction continues to advance, the spatial distribution of noise standard deviation (STD) and accurate noise power spectrum (NPS) on the reconstructed CT images become important for method evaluation as well as optimization of algorithm parameters. Using a single CT scan, we propose a practical method for pixel-wise calculation of noise statistics on an iteratively reconstructed CT image, which enables accurate calculation of noise STD for each pixel and NPS. We first derive the noise propagation from measured projections to an iteratively reconstructed CT image provided that the projection noise is known. We then show that the model of noise propagation remains approximately unchanged for extra simulated noise added on the measured projections. To compute the noise STD map and the NPS map on an iteratively reconstructed CT image from a single scan, we first iteratively reconstruct the CT image from the measured projections using an existing reconstruction algorithm. The same measured projections are added by different sets (a total of 32 sets in our implementation) of projection noise simulated from an estimated projection noise model, and are then used to iteratively reconstruct different CT images. The calculations of the noise STD map and the NPS map are finally performed on the entire stack of these different reconstruction images. We evaluate our method on an anthropomorphic head phantom, and demonstrate the clinical utility on a set of head and neck patient CT data, using two iterative CT reconstruction algorithms: the penalized weighted least-square (PWLS) algorithm and the total-variation (TV) regularization. In the head phantom case, repeated scans are acquired to generate the ground truths of noise STD and NPS maps. Using only one single scan, the proposed method accurately calculates the noise STD maps with a root-mean-square error (RMSE) of less than 5HU. In the NPS map estimation, we compare the result of our proposed method with

  11. ["Deciding wisely together" - an initiative of the Association of the Scientific Medical Societies in Germany: Mission, methodology and application].

    Science.gov (United States)

    Nothacker, Monika; Kreienberg, Rolf; Kopp, Ina B

    2017-12-01

    The question of how to improve healthcare quality and the need for patient empowerment and shared decision-making has been the subject of political and scientific debate for years. In addition to various quality initiatives, "top lists" summarizing selected recommendations to increase awareness of overuse, spread by means of public campaigns, has become popular on the international level - known as the "Choosing Wisely" initiative. However, the trustworthiness of "top lists", their impact on patient-relevant outcomes, their role in and integration into the context of the various pre-existing approaches to improve healthcare quality and the effects of neglecting under- and misuse are not clear. On the other hand, "top lists" may provide new opportunities to improve awareness and dissemination of carefully selected recommendations based on high-quality guidelines. Therefore, the Association of Scientific Medical Societies in Germany (AWMF) has established an ad hoc commission to design a system-specific initiative. The commission has the task to clarify goals, methods of development and concepts for implementation and evaluation, to address concerns and to build upon specific existing resources - e. g., the established quality management system for guidelines in Germany. The key goals defined by the commission include the systematization of the dialogue between healthcare practitioners and patients and the promotion of ethically founded decision-making as an answer to an increasing economic orientation of the healthcare system. To ensure the methodological quality of specific recommendations, the commission has developed a manual. To the best of our knowledge, this manual is the first detailed method paper aiming to guide developers of "Choosing Wisely" recommendations. More than 20 German medical scientific societies have already addressed the subject of "top lists". Copyright © 2017. Published by Elsevier GmbH.

  12. Evaluation of Cardiovascular System in Fibromyalgia Syndrome: Tissue Doppler Echocardiographic Investigation

    Directory of Open Access Journals (Sweden)

    Selma YAZICI

    2010-05-01

    Full Text Available Aim: We aim to investigate besides the cardiac structures and functions by both conventionalmethods and Tissue Doppler Echocardiography (TDE which is a new and useful method inpatients with Fibromyalgia (FM. Additionally, we evaluated QT parameters (QT maximum,QT minimum and QT dispertion with the use of electrocardiography in order to measure theautonomic dysfunction which is a possible mechanism in the pathogenesis of the disease. Methods: The study was performed on 42 patients (mean age 41 years, 38 female and 38completely healthy subjects (35 female, mean age of 42 years who were admitted to the sameclinic were collected as the control group. All the individuals were undergone a completephysical examination, electrocardiography (recordings were displayed at 50 mm/s speed andechocardiography evaluation (both conventional methods and TDE.Results: Analysis of electrocardiographic recordings revealed mildly increased mean QTdispertion in the patient group, but this difference was statistically insignificant. Analysis ofconventional echocardiographic parameters revealed similar results between the patient groupand the control cases. However, an important finding of this study is that significant diastolicdysfunction was found in the patient group which was recorded with the TDE technique. Emwave velocity and Em/Am ratios were significantly lower in patients with FM compared withcontrols (p<0.005, p<0.01, respectively. Sm and Am waves velocities were similar in bothgroups. Conclusion: In this study, significant left ventricular diastolic dysfunction which was detectedby TDE technique can partly explain several symptoms such as fatigue and dyspnea in FM. Inaddition, fully cardiac evaluation of patients with FM might be obtained supporting findingsthe autonomic dysfunction theory in fibromyalgia pathogenesis.

  13. A Prospective Evaluation of Duplex Ultrasound for Thoracic Outlet Syndrome in High-Performance Musicians Playing Bowed String Instruments

    Science.gov (United States)

    Adam, Garret; Wang, Kevin; Demaree, Christopher J; Jiang, Jenny S; Cheung, Mathew; Bechara, Carlos F; Lin, Peter H

    2018-01-25

    Thoracic outlet syndrome (TOS) is a neurovascular condition involving the upper extremity, which is known to occur in individuals who perform chronic repetitive upper extremity activities. We prospectively evaluate the incidence of TOS in high-performance musicians who played bowed string musicians. Sixty-four high-performance string instrument musicians from orchestras and professional musical bands were included in the study. Fifty-two healthy volunteers formed an age-matched control group. Bilateral upper extremity duplex scanning for subclavian vessel compression was performed in all subjects. Provocative maneuvers including Elevated Arm Stress Test (EAST) and Upper Limb Tension Test (ULTT) were performed. Abnormal ultrasound finding is defined by greater than 50% subclavian vessel compression with arm abduction, diminished venous waveforms, or arterial photoplethysmography (PPG) tracing with arm abduction. Bowed string instruments performed by musicians in our study included violin (41%), viola (33%), and cello (27%). Positive EAST or ULTT test in the musician group and control group were 44%, and 3%, respectively ( p = 0.03). Abnormal ultrasound scan with vascular compression was detected in 69% of musicians, in contrast to 15% of control subjects ( p = 0.03). TOS is a common phenomenon among high-performance bowed string instrumentalists. Musicians who perform bowed string instruments should be aware of this condition and its associated musculoskeletal symptoms.

  14. An ergonomics study on the evaluation of carpal tunnel syndrome among Chikan embroidery workers of West Bengal, India.

    Science.gov (United States)

    Gangopadhyay, Somnath; Chakrabarty, Sabarni; Sarkar, Krishnendu; Dev, Samrat; Das, Tamal; Banerjee, Sunetra

    2015-01-01

    Chikan embroidery is a popular handicraft in India that involves hand-intensive stitching while seated in a static posture with the upper back curved and the head bent over the fabric. Women perform most Chikan embroidery. The aim of this study was to analyze the repetitive nature of this work among female Chikan embroiderers by measuring the prevalence of upper extremity discomfort and carpal tunnel syndrome (CTS). The Nordic musculoskeletal questionnaire was used to analyze the extent of upper extremity pain symptomology. The repetitive nature of Chikan embroidery work was evaluated using the Assessment of Repetitive Tasks of the upper limbs tool (ART). Motor nerve conduction studies of median and ulnar nerves were performed with embroidery workers and a control group to determine the risk of CTS. Among embroidery workers, the prevalence of wrist pain was 68% and forearm pain was 60%. The embroiderers also commonly reported Tingling and numbness in the hands and fingertips. The ART analysis found that Chikan embroidery is a highly repetitive task and nerve conduction studies showed that the embroidery workers were more likely to experience CTS than women in the control group. Chikan embroidery is a hand-intensive occupation involving repetitive use of hands and wrists and this study population is at risk of experiencing CTS. Future research should explore the potential benefits of ergonomics measures including incorporating breaks, stretching exercises, and the use of wrist splints to reduce repetitive strain and the probability of developing CTS.

  15. Evaluating the utility of syndromic case management for three sexually transmitted infections in women visiting hospitals in Delhi, India.

    Science.gov (United States)

    Sonkar, Subash Chandra; Wasnik, Kirti; Kumar, Anita; Sharma, Vineeta; Mittal, Pratima; Mishra, Prashant Kumar; Bharadwaj, Mausumi; Saluja, Daman

    2017-05-03

    Utility of syndromic case management (SCM) in women visiting obstetrics & gynecology department needs to be evaluated as it is subjective and imperfect. Consequently, antibiotic resistance has accelerated along with increased risk of infection to the partners. To understand the effectiveness and/or inadequacies of SCM, 11000 women were recruited and examined by clinicians for infection by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Bacterial vaginosis (BV) and others. Amongst these patients, 1797 (16.3%) reported vaginal discharge (VD). Other symptoms included: vaginitis (97%), cervicitis (75%), genital ulcers (60%), abnormal vaginal discharge (55%) and lower abdominal pain (48%). The patients were treated for single or co-infections using pre-packed National Aids Control Program III STI/RTI Kits. However, based on PCR diagnostics, 1453/1797 (81%) subjects were uninfected for NG/TV/CT. Amongst 344 (19%) infected patients, 257 (75%) carried infection with single pathogen (TV/NG/CT) while 87/344 (25%) were co-infected with multiple pathogens. Prevalence of TV, NG & CT was 4%, 7% and 8% respectively. Co-infection with CT + NG was highest, 51% (44/87), whereas, co-infection with CT + TV was 21% and NG + TV was 18% while co-infection with all three pathogens was 1.3%. We conclude that SCM is imprecise and successful intervention requires accurate and confirmatory diagnostic approach.

  16. Self-regulation evaluation of therapeutic yoga and walking for patients with irritable bowel syndrome: a pilot study.

    Science.gov (United States)

    Shahabi, Leila; Naliboff, Bruce D; Shapiro, David

    2016-01-01

    With limited efficacy of medications for symptom relief, non-medication treatments may play an important role in the treatment of irritable bowel syndrome (IBS), the most common functional gastrointestinal (GI) disorder. This study aimed to evaluate the efficacy of two self-regulation strategies for symptom relief and mood management in IBS patients. Thirty-five adult participants meeting ROME III criteria for IBS were enrolled, 27 of the 35 participants (77%) completed treatment and pre- and post-treatment visits (89% women, 11% men; M (SD) age = 36 (13)), and 20 of the 27 (74%) completed a 6-month follow-up. Participants were randomly assigned to 16 biweekly group sessions of Iyengar yoga or a walking program. Results indicated a significant group by time interaction on negative affect with the walking treatment showing improvement from pre- to post-treatment when compared to yoga (p IBS severity. Exploratory analyses of secondary outcomes examined change separately for each treatment condition. From pre- to post-treatment, yoga showed significant decreases in IBS severity measures (p IBS patients, though maintenance of a self-regulated walking program may be more feasible and therefore more effective long term.

  17. An ergonomics study on the evaluation of carpal tunnel syndrome among Chikan embroidery workers of West Bengal, India

    Science.gov (United States)

    Gangopadhyay, Somnath; Chakrabarty, Sabarni; Sarkar, Krishnendu; Dev, Samrat; Das, Tamal; Banerjee, Sunetra

    2015-01-01

    Background: Chikan embroidery is a popular handicraft in India that involves hand-intensive stitching while seated in a static posture with the upper back curved and the head bent over the fabric. Women perform most Chikan embroidery. Objectives: The aim of this study was to analyze the repetitive nature of this work among female Chikan embroiderers by measuring the prevalence of upper extremity discomfort and carpal tunnel syndrome (CTS). Methods: The Nordic musculoskeletal questionnaire was used to analyze the extent of upper extremity pain symptomology. The repetitive nature of Chikan embroidery work was evaluated using the Assessment of Repetitive Tasks of the upper limbs tool (ART). Motor nerve conduction studies of median and ulnar nerves were performed with embroidery workers and a control group to determine the risk of CTS. Results: Among embroidery workers, the prevalence of wrist pain was 68% and forearm pain was 60%. The embroiderers also commonly reported Tingling and numbness in the hands and fingertips. The ART analysis found that Chikan embroidery is a highly repetitive task and nerve conduction studies showed that the embroidery workers were more likely to experience CTS than women in the control group. Conclusions: Chikan embroidery is a hand-intensive occupation involving repetitive use of hands and wrists and this study population is at risk of experiencing CTS. Future research should explore the potential benefits of ergonomics measures including incorporating breaks, stretching exercises, and the use of wrist splints to reduce repetitive strain and the probability of developing CTS. PMID:25658674

  18. Role of 64-slice cardiac computed tomography in the evaluation of patients with non-ST-elevation acute coronary syndrome.

    Science.gov (United States)

    Romagnoli, A; Martuscelli, E; Sperandio, M; Arganini, C; De Angelis, B; Acampora, V; Patrei, A; Bazzocchi, G; Romeo, F; Simonetti, G

    2010-04-01

    This study was done to evaluate the feasibility, sensitivity and specificity of 64-slice computed tomography (CT) in identifying haemodynamically significant (>50%) coronary artery stenoses in patients with suspected acute coronary syndrome (ACS) by correlating the CT findings with the clinical event and data provided by conventional coronary angiography (CCA). Sixty-four patients (38 men and 26 women; mean age 65 years; range+/-10 years) presenting to our hospital's emergency department with a clinical suspicion of ACS were studied with 64-slice CT followed by CCA within 24 h of arrival. Two patients (3.1%) were excluded from the analysis due to artefacts. Per-patient analysis in the remaining 62 patients identified 24 cases (38.7%) of negative CT findings (no stenoses or stenoses 50%, seven overestimated vessels (3.7%) due to extensive calcifications, three vessels (1.6%) with underestimated stenosis and 98 vessels (52.6%) without stenosis. Sensitivity and specificity were 95.3% and 93.3%, respectively. In this type of emergency, coronary CT angiography could lead to considerably lower healthcare costs by identifying patients without coronary disease and allowing immediate discharge without any need for further diagnostic procedures.

  19. [Evaluation of low level laser and interferential current in the therapy of complex regional pain syndrome by infrared thermographic camera].

    Science.gov (United States)

    Kocić, Mirjana; Lazović, Milica; Dimitrijević, Irena; Mancić, Dragan; Stanković, Anita

    2010-09-01

    BACKGROUND/AIM; Complex regional pain syndrom type I (CRPS I) is characterised by continuous regional pain, disproportional according to duration and intensity and to the sort of trauma or other lesion it was caused by. The aim of the study was to evaluate and compare, by using thermovison, the effects of low level laser therapy and therapy with interferential current in treatment of CRPS I. The prospective randomized controlled clinical study included 45 patients with unilateral CRPS 1, after a fracture of the distal end of the radius, of the tibia and/or the fibula, treated in the Clinical Centre in Nis from 2004 to 2007. The group A consisted of 20 patients treated by low level laser therapy and kinesy-therapy, while the patients in the group B (n = 25) were treated by interferential current and kinesy-therapy. The regions of interest were filmed by a thermovision camera on both sides, before and after the 20 therapeutic procedures had been applied. Afterwards, the quantitative analysis and the comparing of thermograms taken before and after the applied therapy were performed. There was statistically significant decrease of the mean maximum temperature difference between the injured and the contralateral extremity after the therapy in comparison to the status before the therapy, with the patients of the group A (p interferential current therapy.

  20. Fuellish trends and wise choices : options for the future

    International Nuclear Information System (INIS)

    1992-01-01

    It is pointed out that India has no coherent energy policy. The demand for energy is always growing. If the present business as usual (BAU) approach is continued, the energy demand in the year 2009-10 will be about 600 mtoe (million tonnes of oil equivalent) as against the present level of 200 mtoe. This demand in the BAU approach will be met by oil import and exploitation of coal reserves. The rising import bills will put a heavy strain on the country's foreign exchange position. The Tata Energy Research Institute has developed Energy Economy Simulation and Evaluation (TEESE) model to evaluate energy policies within a quantitative framework. Using this model, low and high energy conservation scenarios for India in the year 2009-10 are presented. If as suggested in these scenarios, energy conservation measures are taken, operational efficiency of power stations is improved, renewable sources of energy are used on an increasing scale to generate power and cogeneration technology is used, future development based on increased energy consumption as predicted by TEESE can be sustained. It is pointed out that for this achievement, necessary investments for alternative energy sources should be forthcoming. (M.G.B.)

  1. Lessons learned from the Syrian sarin attack: evaluation of a clinical syndrome through social media.

    Science.gov (United States)

    Rosman, Yossi; Eisenkraft, Arik; Milk, Nadav; Shiyovich, Arthur; Ophir, Nimrod; Shrot, Shai; Kreiss, Yitshak; Kassirer, Michael

    2014-05-06

    On the night of 21 August 2013, sarin was dispersed in the eastern outskirts of Damascus, killing 1400 civilians and severely affecting thousands more. This article aims to delineate the clinical presentation and management of a mass casualty event caused by a nerve agent as shown in the social media. Authors searched YouTube for videos uploaded of this attack and identified 210 videos. Of these, 67 met inclusion criteria and were evaluated in the final analysis.These videos displayed 130 casualties; 119 (91.5%) of which were defined as moderately injured or worse. The most common clinical signs were dyspnea (53.0%), diaphoresis (48.5%), and loss of consciousness (40.7%). Important findings included a severe shortage of supporting measures and lack of antidotal autoinjectors. Decontamination, documented in 25% of the videos, was done in an inefficient manner. Protective gear was not noticed, except for sporadic use of latex gloves and surgical masks.This is believed to be the first time that social media was used to evaluate clinical data and management protocols to better prepare against future possible events.

  2. Magnetic resonance evaluation of cerebral toxoplasmosis in patients with the acquired immunodeficiency syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Batra, A; Tripathi, R.P.; Gorthi, S.P. [Inst. of Nuclear Medicine and Allied Sciences, Delhi (India). NMR Research Center

    2004-04-01

    PURPOSE: To evaluate and delineate the characteristics of cerebral toxoplasmosis lesions using a combination of magnetic resonance (MR) spectroscopy, diffusion, and perfusion studies. MATERIAL AND METHODS: A total of 8 patients with 23 lesions were evaluated on a 1.5-T MR system. Diffusion-weighted imaging (DWI) was performed with three 'b' values of 50, 500, and 1000 s/mm2, and the apparent diffusion coefficient maps were calculated. The diffusion-weighted appearances and the T2-weighted MR appearances of the lesions were compared. MR spectroscopy was performed using the point-resolved single-voxel technique with two TE values of 135 ms and 270 ms. Perfusion studies were carried out using the dynamic contrast-enhanced technique, and the relative cerebral blood volume maps were qualitatively and quantitatively analyzed. RESULTS: DWI revealed the majority of the lesions as having increased diffusion within their necrotic centers, with the ADC ranging from 0.5 to 3.01 (mean {+-} SD: 1.49 {+-} 0.7). All the lesions revealed a predominant lipid peak on MR spectroscopy and were extremely hypovascular on perfusion MR studies. CONCLUSION: MR diffusion, spectroscopy, and perfusion studies help in characterizing toxoplasmosis lesions and, in most cases, can be used in combination to help establish the diagnosis of toxoplasmosis.

  3. Magnetic resonance evaluation of cerebral toxoplasmosis in patients with the acquired immunodeficiency syndrome

    International Nuclear Information System (INIS)

    Batra, A; Tripathi, R.P.; Gorthi, S.P.

    2004-01-01

    PURPOSE: To evaluate and delineate the characteristics of cerebral toxoplasmosis lesions using a combination of magnetic resonance (MR) spectroscopy, diffusion, and perfusion studies. MATERIAL AND METHODS: A total of 8 patients with 23 lesions were evaluated on a 1.5-T MR system. Diffusion-weighted imaging (DWI) was performed with three 'b' values of 50, 500, and 1000 s/mm2, and the apparent diffusion coefficient maps were calculated. The diffusion-weighted appearances and the T2-weighted MR appearances of the lesions were compared. MR spectroscopy was performed using the point-resolved single-voxel technique with two TE values of 135 ms and 270 ms. Perfusion studies were carried out using the dynamic contrast-enhanced technique, and the relative cerebral blood volume maps were qualitatively and quantitatively analyzed. RESULTS: DWI revealed the majority of the lesions as having increased diffusion within their necrotic centers, with the ADC ranging from 0.5 to 3.01 (mean ± SD: 1.49 ± 0.7). All the lesions revealed a predominant lipid peak on MR spectroscopy and were extremely hypovascular on perfusion MR studies. CONCLUSION: MR diffusion, spectroscopy, and perfusion studies help in characterizing toxoplasmosis lesions and, in most cases, can be used in combination to help establish the diagnosis of toxoplasmosis

  4. Clinical management and outcomes of patients with Hermansky-Pudlak syndrome pulmonary fibrosis evaluated for lung transplantation

    Science.gov (United States)

    El-Chemaly, Souheil; O’Brien, Kevin J.; Nathan, Steven D.; Weinhouse, Gerald L.; Goldberg, Hilary J.; Connors, Jean M.; Cui, Ye; Astor, Todd L.; Camp, Philip C.; Rosas, Ivan O.; Lemma, Merte; Speransky, Vladislav; Merideth, Melissa A.; Gahl, William A.

    2018-01-01

    Pulmonary fibrosis is a progressive, fatal manifestation of Hermansky-Pudlak syndrome (HPS). Some patients with advanced HPS pulmonary fibrosis undergo lung transplantation despite their disease-associated bleeding tendency; others die while awaiting donor organs. The objective of this study is to determine the clinical management and outcomes of a cohort with advanced HPS pulmonary fibrosis who were evaluated for lung transplantation. Six patients with HPS-1 pulmonary fibrosis were evaluated at the National Institutes of Health Clinical Center and one of two regional lung transplant centers. Their median age was 41.5 years pre-transplant. Three of six patients died without receiving a lung transplant. One of these was referred with end-stage pulmonary fibrosis and died before a donor organ became available, and donor organs were not identified for two other patients sensitized from prior blood product transfusions. Three of six patients received bilateral lung transplants; they did not have a history of excessive bleeding. One patient received peri-operative desmopressin, one was transfused with intra-operative platelets, and one received extracorporeal membrane oxygenation and intra-operative prothrombin complex concentrate, platelet transfusion, and desmopressin. One transplant recipient experienced acute rejection that responded to pulsed steroids. No evidence of chronic lung allograft dysfunction or recurrence of HPS pulmonary fibrosis was detected up to 6 years post-transplant in these three lung transplant recipients. In conclusion, lung transplantation and extracorporeal membrane oxygenation are viable options for patients with HPS pulmonary fibrosis. Alloimmunization in HPS patients is an important and potentially preventable barrier to lung transplantation; interventions to limit alloimmunization should be implemented in HPS patients at risk of pulmonary fibrosis to optimize their candidacy for future lung transplants. PMID:29547626

  5. Evaluation of Decellularized Porcine Jejunum as a Matrix for Lacrimal Gland Reconstruction In Vitro for Treatment of Dry Eye Syndrome.

    Science.gov (United States)

    Massie, Isobel; Spaniol, Kristina; Barbian, Andreas; Poschmann, Gereon; Stühler, Kai; Geerling, Gerd; Metzger, Marco; Mertsch, Sonja; Schrader, Stefan

    2017-10-01

    Dry eye syndrome (DES) can cause blindness in severe cases, but mainly palliative treatments exist. A tissue-engineered lacrimal gland (LG) could provide a curative treatment. We aimed to evaluate decellularized porcine jejunum (SIS-Muc) as a scaffold for porcine LG epithelial cells. To evaluate SIS-Muc as a potential scaffold, basement membrane proteins in SIS-Muc and native LG were compared (immunohistochemistry [IHC]). Porcine LG epithelial cells cultured on plastic were characterized (immunocytochemistry), and their culture supernatant was compared with porcine tears (proteomics). Epithelial cells were then seeded onto SIS-Muc in either a static (cell crown) or dynamic culture (within a perfusion chamber) and metabolic (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) and secretory capacities (β-hexosaminidase assay), protein expression (IHC), and ultrastructure transmission electron microscopy (TEM) compared in each. Collagen IV and laminin were found in both native LG and SIS-Muc. When cultured on plastic, LG epithelial cells expressed pan-cytokeratin, Rab3D, HexA, and produced mucins, but lysozyme and lactoferrin expression was nearly absent. Some porcine tear proteins (lipocalin-2 and lactoferrin) were found in LG epithelial cell culture supernatants. When LG cells were cultured on SIS-Muc, metabolic and β-hexosaminidase activities were greater in dynamic cultures than static cultures (P scaffold contacts. SIS-Muc is a suitable scaffold for LG cell expansion and may be useful toward reconstruction of LG tissue to provide a curative treatment for DES. Dynamic culture enhances cell metabolic and functional activities.

  6. Hamartomatous polyposis syndromes

    DEFF Research Database (Denmark)

    Jelsig, Anne Marie; Qvist, Niels; Brusgaard, Klaus

    2014-01-01

    Hamartomatous Polyposis Syndromes (HPS) are genetic syndromes, which include Peutz-Jeghers syndrome, Juvenile polyposis syndrome, PTEN hamartoma tumour syndrome (Cowden Syndrom, Bannayan-Riley-Ruvalcaba and Proteus Syndrome) as well as hereditary mixed polyposis syndrome. Other syndromes such as ......Hamartomatous Polyposis Syndromes (HPS) are genetic syndromes, which include Peutz-Jeghers syndrome, Juvenile polyposis syndrome, PTEN hamartoma tumour syndrome (Cowden Syndrom, Bannayan-Riley-Ruvalcaba and Proteus Syndrome) as well as hereditary mixed polyposis syndrome. Other syndromes...

  7. Clinical evaluation of the post-laminectomy syndrome in public hospitals in the city of São Luís, Brazil

    OpenAIRE

    Garcia, João Batista Santos; Rodrigues, Diego Parga; Leite, Diego Rafael Berbare; do Nascimento Câmara, Stephanie; da Silva Martins, Kenard; de Moraes, Érica Brandão

    2015-01-01

    Background and objectives Although not well known, post-laminectomy syndrome (PLS) is an important cause of chronic back pain, which may lead to decreased quality of life, disability and psychological disorders. This study aimed to evaluate the clinical characteristics and prevalence of PLS, to estimate its impact on the quality of life and to determine its association with anxiety, depression and disability in patients at public hospitals in São Luís, MA. Methods Cross-sectional, descriptive...

  8. Evaluation of comorbidities at diagnosis predicts outcome in myelodysplastic syndrome patients.

    Science.gov (United States)

    Breccia, Massimo; Federico, Vincenzo; Latagliata, Roberto; Mercanti, Caterina; D'Elia, Gianna Maria; Cannella, Laura; Loglisci, Giuseppina; Salaroli, Adriano; Santopietro, Michelina; Alimena, Giuliana

    2011-02-01

    Recent data suggest that proper assessment of comorbidities is useful to predict the outcome of MDS patients receiving allogeneic stem cell transplantation. However, the results obtained in this highly selected subset of patients cannot be applied to the whole MDS population. We evaluated the impact of comorbidities in 418 consecutive MDS patients diagnosed at our institute from 1992 to 2005. All patients were classified according to WHO criteria and all received only conservative and supportive treatment. One or more comorbidities were detected in 390 patients (93%) at the time of diagnosis, with a higher incidence in older patients. Cardiac diseases were the most frequent comorbidities (30%) while diabetes and correlated adverse events were the second cause of comorbidity (20%). We applied 3 comorbidity prognostic scores (CCI, HCT-CI and a MDS-CI score proposed by Della Porta et al.). According to CCI score, 253 patients had a score 0, 111 patients had a score 1 and 54 patients had a score >2. According to HCT-CI, 209 patients had a score 0, 105 patients had a score 1 and 106 patients had a score >2. With MDS-CI score, 288 patients had a score 0 and 129 patients had a score >1. We found a significant correlation between survival and stratification according to CCI and MDS-CI scores (p=0.01 and 0.02, respectively), but not according to HCT-CI score. The number of comorbidities as evaluated according to CCI was directly correlated to the development of RBC transfusion-dependency and was associated to a significantly higher risk of death not related to leukemic evolution (HR = 2.12, p ≤ 0.001). Conversely, higher risk of non-leukemic death did not correlate with higher transfusional requirement according to HCT-CI and MDS-CI scores (p = 0.3 and 0.43, respectively). As suggested by Della Porta et al., also in our experience the presence of cardiac, liver, renal, pulmonary diseases and solid tumours was found to independently affect the risk of death in a

  9. Usefulness of a new anthropometric indicator - VAI (Visceral Adiposity Index) in the evaluation of metabolic and hormonal disorders in women with polycystic ovary syndrome.

    Science.gov (United States)

    Brończyk-Puzoń, Anna; Jagielski, Paweł; Kulik-Kupka, Karolina; Koszowska, Aneta; Nowak, Justyna; Zubelewicz-Szkodzińska, Barbara

    2017-08-01

    Visceral adiposity index (VAI) is a new anthropometric indicator that makes it possible to define the risk of obesity-related cardiometabolic complications even before the diagnosis of metabolic syndrome. Evaluating the usefulness of VAI in order to differentiate metabolically unhealthy women (MU-PCOS) and defining the usefulness of this index in everyday practice. A prospective study was conducted among 43 women who met the Rotterdam criteria for diagnosing polycystic ovarian syndrome. Body composition was measured using bioelectrical impedance analysis. Statistical analysis was performed using STATISTICA v. 10 and relevant statistical tests. The adopted significance level was p = 0.05. Based on the study results, a significant positive correlation was found between the value of VAI and the concentration of insulin (r = 0.33; p index (r = 0.46; p correlation between VAI and the concentration of SHBG (r = -0.53; p HDL cholesterol (r = -0.88; p adiposity index makes it possible to introduce early prevention of metabolic disorders (including cardiometabolic disorders), as well as to evaluate the increase of hyperandrogenemia in women with polycystic ovary syndrome. The use of the cut-off point of VAI = 1.675 is a simple way to evaluate women with MU-PCOS.

  10. Classification between normal and tumor tissues based on the pair-wise gene expression ratio

    International Nuclear Information System (INIS)

    Yap, YeeLeng; Zhang, XueWu; Ling, MT; Wang, XiangHong; Wong, YC; Danchin, Antoine

    2004-01-01

    Precise classification of cancer types is critically important for early cancer diagnosis and treatment. Numerous efforts have been made to use gene expression profiles to improve precision of tumor classification. However, reliable cancer-related signals are generally lacking. Using recent datasets on colon and prostate cancer, a data transformation procedure from single gene expression to pair-wise gene expression ratio is proposed. Making use of the internal consistency of each expression profiling dataset this transformation improves the signal to noise ratio of the dataset and uncovers new relevant cancer-related signals (features). The efficiency in using the transformed dataset to perform normal/tumor classification was investigated using feature partitioning with informative features (gene annotation) as discriminating axes (single gene expression or pair-wise gene expression ratio). Classification results were compared to the original datasets for up to 10-feature model classifiers. 82 and 262 genes that have high correlation to tissue phenotype were selected from the colon and prostate datasets respectively. Remarkably, data transformation of the highly noisy expression data successfully led to lower the coefficient of variation (CV) for the within-class samples as well as improved the correlation with tissue phenotypes. The transformed dataset exhibited lower CV when compared to that of single gene expression. In the colon cancer set, the minimum CV decreased from 45.3% to 16.5%. In prostate cancer, comparable CV was achieved with and without transformation. This improvement in CV, coupled with the improved correlation between the pair-wise gene expression ratio and tissue phenotypes, yielded higher classification efficiency, especially with the colon dataset – from 87.1% to 93.5%. Over 90% of the top ten discriminating axes in both datasets showed significant improvement after data transformation. The high classification efficiency achieved suggested

  11. Evaluation of endocrine changes in women with the polycystic ovary syndrome during metformin treatment

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    Zelija Velija-Ašimi

    2013-08-01

    Full Text Available The aim of study was to evaluate endocrine changes in PCOS women during metformin treatment. One hundred women with PCOS, aged 20-40 years were included. A complete hormonal and metabolic pattern was recorded for each subject every 6 months. Metformin treatment after 6 and 12 months significantly reduced weight, BMI, waist circumference, insulin and HOMA-IR (p=0.000 with high differences of variances within repeated measurements. There was significant reduction of PRL, testosterone and estradiol (p=0.000 with small differences within repeated measurements. Metformin did not have effect on TSH. However, results showed important reduction of CRP, LH, LH/FSH, androstendione, DHEA-S and progesterone (p=0.000 with moderate differences within measures. Metformin restored menstrual cyclicity in most participants. At baseline in study group was 69% women with oligomenorrhoea, amenorrhoea or polymenorrhoea. After 12 months of treatment, only 20% PCOS women had irregular menstrual cycle (p=0.000. Hirsutism was also reduced. Intriguingly, during first 6 months of treatment in PCOS women 9 pregnancies occurred (p=0.000, while during last 6 months treatment were 2 pregnancies (p=0.317, in total 11(13%. Multiple regression model revealed that the presence of anovulation in PCOS women was strongly associated with BMI, waist, FSH and age. Insulin resistance was significantly predicted by BMI, cholesterol, progesterone and presence of hirsutism. The metformin therapy significantly improved insulin resistance, imbalance of endocrine hormones, hirsutism and menstrual cyclicity in women with PCOS. The most important predictors for duration of metformin treatment in PCOS women were testosterone, progesterone, FSH, CRP and presence of anovulation.

  12. Pulmonary hypertension evaluation by Doppler echocardiogram in children and adolescents with mouth breathing syndrome,

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    Marcela Silva Lima

    Full Text Available Abstract Introduction: Adenotonsillar hyperplasia (ATH and allergic rhinitis (AR are the most common causes of upper airway obstruction in children. Such diseases, by affecting the upper airways, can cause chronic alveolar hypoventilation, pulmonary vasoconstriction and pulmonary hypertension, which in some cases, are irreversible. Objective: This cross-sectional study aimed to evaluate the prevalence of pulmonary hypertension in two groups of mouth-breathing (MB 2-12 years old children with ATH and isolated allergic rhinitis, through Doppler echocardiography. Methods: 54 patients with ATH and indications for adenoidectomy and/or tonsillectomy and 24 patients with persistent allergic rhinitis were selected and submitted to Doppler echocardiography. The Systolic Pulmonary Artery Pressure (SPAP was determined by tricuspid regurgitation and the Mean Pulmonary Artery Pressure (MPAP was calculated from the SPAP. Similar measurements were carried out in 25 nasal breathing (NB individuals. Results: The mean MPAP and SPAP were higher in the MB than in the NB group (17.62 ± 2.06 [ATH] and 17.45 ± 1.25 [AR] vs. 15.20 ± 2.36 [NB] mmHg, p < 0.005, and 25.61 ± 3.38 [ATH] and 25.33 ± 2.06 [AR] vs. 21.64 ± 3.87 [NB] mmHg, p < 0.005, respectively and the mean acceleration time of pulmonary flow trace (Act was higher in the NB than in the MB group (127.24 ± 12.81 [RN] vs. 114.06 ± 10.63 ms [ATH] and 117.96 ± 10.28 [AR] MS [AR]; p < 0.0001. Conclusion: None of the MB children (ATH and AR met the PH criteria, although individuals with both ATH and isolated AR showed significant evidence of increased pulmonary artery pressure by Doppler echocardiography in relation to NB individuals. No differences were observed between the ATH and AR groups.

  13. Gene expression analysis of urine sediment: evaluation for potential noninvasive markers of interstitial cystitis/bladder pain syndrome.

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    Blalock, Eric M; Korrect, Garrett S; Stromberg, Arnold J; Erickson, Deborah R

    2012-02-01

    We determined whether gene expression profiles in urine sediment could provide noninvasive markers for interstitial cystitis/bladder pain syndrome with and/or without Hunner lesions. Fresh catheterized urine was collected and centrifuged from 5 controls, and 5 Hunner lesion-free and 5 Hunner lesion bearing patients. RNA was extracted from pelleted material and quantified by gene expression microarray using the GeneChip® Human Gene ST Array. Three biologically likely hypotheses were tested, including 1) all 3 groups are distinct from each other, 2) controls are distinct from the 2 types combined of patients with interstitial cystitis/bladder pain syndrome and 3) patients with Hunner lesion-interstitial cystitis/bladder pain syndrome are distinct from controls and patients with nonHunner-lesion interstitial cystitis/bladder pain syndrome combined. For statistical parity an unlikely fourth hypothesis was included, that is patients with nonHunner-lesion interstitial cystitis/bladder pain syndrome are distinct from controls and patients with Hunner lesion-interstitial cystitis/bladder pain syndrome combined. Analysis supported selective up-regulation of genes in the Hunner lesion interstitial cystitis/bladder pain syndrome group (hypothesis 3), which were primarily associated with inflammation. The inflammatory profile was statistically similar to that reported in a prior Hunner lesion interstitial cystitis/bladder pain syndrome bladder biopsy study. Gene expression analysis of urine sediment was feasible in this pilot study. Expression profiles failed to discriminate nonHunner-lesion interstitial cystitis/bladder pain syndrome from controls and they are unlikely to be a noninvasive marker for nonHunner-lesion interstitial cystitis/bladder pain syndrome. In contrast, patients with Hunner lesion had increased proinflammatory gene expression in urine sediment, similar to that in a prior microarray study of bladder biopsies. If these preliminary results are validated in

  14. THE WISE BLAZAR-LIKE RADIO-LOUD SOURCES: AN ALL-SKY CATALOG OF CANDIDATE γ-RAY BLAZARS

    International Nuclear Information System (INIS)

    D'Abrusco, R.; Paggi, A.; Smith, H. A.; Massaro, F.; Masetti, N.; Landoni, M.; Tosti, G.

    2014-01-01

    We present a catalog of radio-loud candidate γ-ray emitting blazars with WISE mid-infrared colors similar to the colors of confirmed γ-ray blazars. The catalog is assembled from WISE sources detected in all four WISE filters, with colors compatible with the three-dimensional locus of the WISE γ-ray emitting blazars, and which can be spatially cross-matched with radio sources from one of the three radio surveys: NVSS, FIRST, and/or SUMSS. Our initial WISE selection uses a slightly modified version of previously successful algorithms. We then select only the radio-loud sources using a measure of the radio-to-IR flux, the q 22 parameter, which is analogous to the q 24 parameter known in the literature but which instead uses the WISE band-four flux at 22 μm. Our final catalog contains 7855 sources classified as BL Lacs, FSRQs, or mixed candidate blazars; 1295 of these sources can be spatially re-associated as confirmed blazars. We describe the properties of the final catalog of WISE blazar-like radio-loud sources and consider possible contaminants. Finally, we discuss why this large catalog of candidate γ-ray emitting blazars represents a new and useful resource to address the problem of finding low-energy counterparts to currently unidentified high-energy sources

  15. Contribution of regional cerebral blood flow changes on the evaluation of neuropsychological impairment in patients with Tourette syndrome

    International Nuclear Information System (INIS)

    Borbely, K.; Kadar, K.; Nagy, D.; Szlobodnyik, C.S.; Gadoros, J.; Radics, E.; Rozsa, S.

    2002-01-01

    Aims: The literature to date has suggested that intellectual ability is normally distributed in Tourette syndrome (TS). However, patients with TS have significant discrepancies between their verbal and non verbal abilities. Specific cognitive deficits in TS include visuomotor integration problems, impaired fine motor skill, and executive dysfunction. The presence of a learning disability or cognitive deficit may lead to a greater obstacle for patients with TS than the tic disorder itself. It would be important that patients with TS will be evaluated to having neuropsychological difficulties as soon as possible. The aim of this study was to evaluate the correlation between the clinical severity and neuropsychological impairment (especially memory deficit) of patients with TS and rCBF abnormalities. Methods: The assessment included neurological, psychiatrical examination (Yale Scale [YS], staging of the severity of disease), CT/MRI, and a specific test of explicit and implicit memory (Probabilistic Classification Learning test, PCL). 99m Tc-HMPAO-SPECT studies were carried out with a standard technique for each patient. The data were analyzed visually and by a special ROIs program. RCBF data were correlated to the results of the PCL test and the YS. Results: The SPECT measurements showed significant (p 40 in the temporal medial and lateral regions, and also in the cerebellum, compared to the patients with YS<40. Also, an increase of rCBF was observed in the left striatal, temporal medial and lateral regions, compared to the contralateral homologous regions (p<0.05). The YS (disease severity) demonstrated significant (p<0.05) and strong correlation with the rCBF in the right temporal region (r= -0.83) and in the thalamus (r=-0.69). The performance in the explicit memory test showed significant (p<0.05) and strong correlation with the perfusion in both temporopolar (r=0.9) and left temporomedial region (r=0.92). Conclusion: RCBF SPECT proved to be concordant with

  16. The importance of group-wise registration in tract based spatial statistics study of neurodegeneration: a simulation study in Alzheimer's disease.

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    Shiva Keihaninejad

    Full Text Available Tract-based spatial statistics (TBSS is a popular method for the analysis of diffusion tensor imaging data. TBSS focuses on differences in white matter voxels with high fractional anisotropy (FA, representing the major fibre tracts, through registering all subjects to a common reference and the creation of a FA skeleton. This work considers the effect of choice of reference in the TBSS pipeline, which can be a standard template, an individual subject from the study, a study-specific template or a group-wise average. While TBSS attempts to overcome registration error by searching the neighbourhood perpendicular to the FA skeleton for the voxel with maximum FA, this projection step may not compensate for large registration errors that might occur in the presence of pathology such as atrophy in neurodegenerative diseases. This makes registration performance and choice of reference an important issue. Substantial work in the field of computational anatomy has shown the use of group-wise averages to reduce biases while avoiding the arbitrary selection of a single individual. Here, we demonstrate the impact of the choice of reference on: (a specificity (b sensitivity in a simulation study and (c a real-world comparison of Alzheimer's disease patients to controls. In (a and (b, simulated deformations and decreases in FA were applied to control subjects to simulate changes of shape and WM integrity similar to what would be seen in AD patients, in order to provide a "ground truth" for evaluating the various methods of TBSS reference. Using a group-wise average atlas as the reference outperformed other references in the TBSS pipeline in all evaluations.

  17. Evaluation of the clinical relevance of anti-annexin-A5 antibodies in Chinese patients with antiphospholipid syndrome.

    Science.gov (United States)

    Zhang, Shulan; Wu, Ziyan; Li, Jing; Wen, Xiaoting; Li, Liubing; Zhang, Wen; Zhao, Jiuliang; Zhang, Fengchun; Li, Yongzhe

    2017-02-01

    A hallmark feature of antiphospholipid syndrome (APS) is the presence of antiphospholipid antibodies (aPLs). Few studies have addressed the clinical relevance of anti-annexin A5 antibodies (aANXA5) in Chinese patients with APS. In this study, we evaluated the clinical performance of aANXA5 in the diagnosis of APS. Sera from 313 subjects were tested, including 170 samples from patients with APS, 104 samples from patients with non-APS diseases as disease controls (DC), and 39 healthy controls (HC). Serum IgG and IgM aANXA5 were determined by ELISA. Overall, the levels of both IgG and IgM aANXA5 were significantly increased in patients with primary APS (PAPS) and APS associated to other diseases (APSAOD) compared with DC and HC. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for IgG and IgM aANXA5 in the diagnosis of APS were 33.5 and 15.3, 99.0 and 99.0, 98.3 and 96.3, and 47.7 and 41.7%, respectively. Significant associations between IgG aANXA5 and arterial thrombotic events (OR, 2.60; 95% CI, 1.44-4.71) and between IgG aANXA5 and venous thrombotic events (OR, 2.80; 95% CI, 1.55-5.06) were identified. No correlations were identified between IgG or IgM aANXA5 and obstetric complications. Our data suggest that aANXA5 could serve as a diagnosis biomarker for patients with APS. More importantly, our data highlighted a potential role of IgG aANXA5 in identifying APS patients with high risk of thrombosis.

  18. Evaluation of periosteal fixation of lateral rectus and partial VRT for cases of exotropic Duane retraction syndrome

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    Pradeep Sharma

    2014-01-01

    Full Text Available Purpose: The purpose of this study is to evaluate the lateral rectus periosteal fixation and partial vertical rectus transpositioning (VRT as treatment modalities to correct exotropic Duane retraction syndrome (Exo-DRS. Materials and Methods: Prospective interventional case study of cases of Exo-DRS with limitation of adduction. A total of 13 patients were subdivided into two groups. Six patients underwent only lateral rectus periosteal fixation (group A and seven patients also underwent partial VRT (group B. Assessment involved prism bar cover test, abduction and adduction range, extent of binocular single visual field and exophthalmometry. These tests were repeated at 1 week, 1 month and 3 months post-operatively and data analyzed. Results: The pre-operative mean values and ranges were 26.2 Δ (22-35 exotropia for group A and −21.3 Δ (14-30 exotropia for group B. The post-operative mean and range was +0.6 Δ esotropia (+20 to −8 for group A and 8 Δ (−2 to −20 exotropia for group B. Mean grade of limitation of abduction changed from −3.8 to −3.6 versus −3.6 to −2.8 and mean grade of limitation of adduction changed from −1.9 to −0.7 versus −1.5 to −0.5 in the groups A and B respectively. Mean binocular single visual field changed from 14.7° to 23.3° in group A and 11.8° to 26.4° in the group B respectively. Conclusion: Lateral rectus periosteal fixation is an effective surgery to correct the exodeviation, anomalous head posture and improving adduction in Exo-DRS and partial VRT in addition is effective in improving abduction and binocular single visual fields.

  19. Evaluation of homoeopathic treatment in polycystic ovary syndrome: A single-blind, randomised, placebo-controlled pilot study

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    Chetna Deep Lamba

    2018-01-01

    Full Text Available Background and Objectives: This study was conducted with the primary objective of evaluating efficacy of Homoeopathy in establishing the menstrual regularity with improvement in either ultrasonological findings or hirsutism/acne. The quality of life was also assessed using polycystic ovary syndrome questionnaire (PCOSQ. Materials and Methods: A single-blind, randomised, placebo-controlled pilot study was conducted from February 2014 to May 2015 at two research centres. The cases fulfilling the eligibility criteria were enrolled (n = 60 and randomised to either the homoeopathic intervention (HI (n = 30 or identical placebo (P (n = 30 with uniform lifestyle modification (LSM for 6 months. Results: The menstrual regularity with improvement in other signs/symptoms was observed in 60% of the cases (n = 18 in HI + LSM group and none (n = 0 in control group (P = 0.001. Statistically significant difference (P = 0.016 was observed in reduction of intermenstrual duration (from 76.1 ± 37.7 to 46.6 ± 38.7 days in HI + LSM in comparison to placebo + LSM group (from 93.0 ± 65.2 to 93.9 ± 96.2 days. In PCOSQ, also, significant improvement was observed in HI group in domains of weight, fertility, emotions and menstrual problems (P < 0.05 with no difference in body hair (P = 0.708. No change was observed in respect of improvement in the ultrasound findings. Pulsatilla was the most frequently indicated medicine (n = 12, 40%. Conclusion: HI along with LSM has shown promising outcome; further comparative study with standard conventional treatment on adequate sample size is desirable.

  20. EVALUATION OF PARA- AND PERIRENAL FAT THICKNESS AND ITS ASSOCIATION WITH METABOLIC DISORDERS IN POLYCYSTIC OVARY SYNDROME.

    Science.gov (United States)

    Sahin, Serap Baydur; Durakoglugil, Tugba; Ayaz, Teslime; Sahin, Osman Zikrullah; Durakoglugil, Emre; Sumer, Fatih; Aktas, Ezgi; Alyildiz, Nese

    2015-08-01

    The aim of this study was to compare para- and perirenal fat (PFT) and subcutaneous abdominal fat (SFT) measurements between patients with polycystic ovary syndrome (PCOS) and control subjects and to assess the possible relation with metabolic disorders. This study included 68 patients with PCOS and 40 age- and body mass index (BMI)-matched healthy controls. We evaluated anthropometric, hormonal, and metabolic parameters, and abdominal ultrasonography was performed to measure PFT and SFT. The mean PFT values were 6.1 ± 2.9 mm in patients with PCOS and 4.3 ± 2.3 mm in healthy controls (P = .002). SFT values were also higher in the patient group (9.6 ± 5 mm) compared to healthy subjects (3.5 ± 0.5 mm) (P = .017). A significant positive correlation was found between PFT and BMI (r = 0.368), waist circumference (WC) (r = 0.441), Ferriman-Gallwey (FG) score (r = 0.313), blood pressure (systolic, SBP, r = 0.213; diastolic, DBP, r = 0.215), plasma glucose (r = 0.195), homeostasis model assessment-insulin resistance (HOMA-IR, r = 0.273), SFT (r = 0.555). Conversely, negative correlations were found between PFT and estradiol (r = -0.218) and sex hormone-binding globulin (SHBG, r = -0.304). Nonobese PCOS patients (6.1 ± 3.07 mm) had higher PFT values than nonobese controls (3.47 ± 1.5 mm); however, SFT measurements did not differ (P = .086). In multiple linear regression analysis, SFT (P = .006) was a significant and independent predictor for PFT, along with WC (P = .023). In a stepwise model, SFT was the predictor of PFT (P = .001). PFT values were higher particularly in nonobese PCOS patients compared to nonobese control subjects. There was a significant interaction between PCOS and obesity on PFT.