Gałązka, Krystyna; Tokarek, Tomasz; Gach, Tomasz; Szpor, Joanna
Enterocolic lymphocytic phlebitis (ELP) is a rare disease of unknown etiology involving most often the intramural and mesenteric small and medium-sized veins of the gastrointestinal tract. The diagnosis of the disorder is based on the histopathological examination of a surgical specimen as endoscopically obtained diagnostic material is usually too superficial. Clinical manifestation of ELP most frequently is characterized by acute symptoms, such as acute abdomen, signs suggesting acute appendicitis, gastrointestinal hemorrhage, sometimes it manifests as chronic gastrointestinal complaints. We report, to our knowledge for the first time in Poland, a case of ELP with clinical symptoms pointing to acute appendicitis, on laparoscopy manifesting as a tumorous mass in the colonic wall with an unchanged appendix.
van der Veek, Shelley M. C.; Derkx, Hhf; de Haan, Else; Benninga, Marc A.; Boer, Frits
Objectives: Children with functional abdominal pain (FAP) frequently report comorbid complaints such as anxiety and activity limitations. Their parents often experience heightened levels of anxiety, depression, and somatization. The aim of the present study was to investigate whether these comorbid
van der Veek, S.M.C.; Derkx, H.H.F.; de Haan, E.; Benninga, M.A.; de Boer, F.
Objectives: Children with functional abdominal pain (FAP) frequently report comorbid complaints such as anxiety and activity limitations. Their parents often experience heightened levels of anxiety, depression, and somatization. The aim of the present study was to investigate whether these comorbid
Parvaresh, Vahid; Tayebi, Tahmineh
The present study sets out to investigate the structures and functions of vague expressions in Persian. The data under scrutiny include a 15-hour corpus of informal conversations. The corpus reveals some unique vague expressions including "rhyming words," "replacing expressions," and "the affective completer."…
R. Oostenbrink (Rianne); H.P. Jongman (Henri); J.M. Landgraf (Jeanne); H. Raat (Hein); H.A. Moll (Henriëtte)
textabstractPurpose The aim of this study is to assess the influence of functional abdominal complaints (FAC) on health-related quality of life in a group of Dutch pre-school children. Methods Parents of children aged up to 6.0 visiting the outpatient pediatric department, Erasmus MC-Sophia,
Full Text Available Little is known about the long term occurrence and prevalence of upper abdominal complaints after previous partial gastrectomy. Therefore, a retrospective, uncontrolled, cross-sectional, descriptive, clinical, endoscopic study was done. A questionnaire was mailed to patients who had undergone partial gastrectomy and been sent for upper gastrointestinal endoscopy. Eight questions were scored on a five-point Likert scale, and a symptom score was calculated. During the five-year study period, 189 patients (137 men, 52 women were identified as having had a partial gastrectomy -- 143 (76% received the Billroth II operation and 46 (24% received the Billroth I operation. The questionnaire was mailed to 124 patients, of whom 79 (64% responded. Eighty-eight per cent of patients had undergone surgery more than 15 years earlier. Fifty-nine patients (75% suffered from upper abdominal symptoms. Regurgitation of food, retrosternal heartburn and bile reflux occurred significantly more often in patients who underwent the Billroth II operation. The mean symptom score of patients who underwent Billroth I resection was significantly lower (4.5 [SD 3.6] than that of patients who underwent Billroth II resection (7.1 [SD 4.4](P=0.04. One or more symptoms indicative of dumping were found in 70% of patients who underwent Billroth II resection and in 59% of patients who underwent Billroth I resection (not significant. Many patients who had undergone a partial gastrectomy developed upper abdominal symptoms during long term follow-up that were not specifically linked to dumping.
Haefele, W.; Renn, O.; Erdmann, G.
The notion of 'risk' is discussed in its social and technological contexts, leading to an investigation of the terms factuality, hypotheticality, uncertainty, and vagueness, and to the problems of acceptance and acceptability especially in the context of political decision finding. (DG) [de
Anarkhuu, B.; Munguntsetseg, B.; Khosbayar, T.; Enkh-Amar, A.; Bayasgalan, P.; Yadamjav, Ch.; Oyuntsetseg, K.; Bira, N.; Choi, P.W.
Full text: Gastric Cancer is the second leading cause of cancer related death in Mongolia (National Cancer Center, report-2006). Chronic infection with Helicobacter pylori affects approximately half the world and results in malignancy in a small subset of this population. There was sufficient evidence that the Working Group of the International Agency for Research on Cancer (IARC-1994) classified it as a class I carcinogen, the only bacterial agent on this list. The aim of the study is to detect and define the role of H.pylori virulence factors and host IL-1 polymorphisms to prevent further gastric cancer. In the future, this combined bacterial/host genotyping may provide an important opportunity to identify patients who are at high risk for the development of gastric carcinoma long before malignancy occurs. Patients and biopsy specimens. Two biopsy specimens and 5ml of blood samples were collected from each of 59 patients who had abdominal complaint, after informed consent was obtained. All patients lived in Ulaanbaatar, Mongolia, 100% were of Mongolian nationality. Their mean age was 40.33 years (range, 1575 years). One biopsy specimen was used to test urease, and another was stored for molecular testing. DNA isolation from blood and tissue sample was performed with ''Promega'' kit, according to the manufacturer's instruction. Tissue samples were homogenized treated with proteinase K prior to DNA extraction. H. pylori detection and genotyping. For H.pylori, detection was by UreC primer. For virulence gene typing of H.pylori cagA and vacA, gene specific primer were used. Genotyping of IL-1 polymorphisms. IL-1B polymorphisms were distinguished by 2 methods, 5-nuclease PCR assay and restriction fragment length polymorphism analysis (RFLP). Result. Strain characteristics of H. pylori were investigated in all 59 patients. 66,7% (40/59) and 76,3% (29/36) of the patients were infected with H. pylori by UreC PCR and by urea test, respectively. The vacAs1 genotype was
Arsham Borumand Saeid
Full Text Available In this note, by using the concept of vague sets, the notion of vague \\(BCK/BCI\\-algebra is introduced. And the notions of \\(\\alpha\\-cut and vague-cut are introduced and the relationships between these notions and crisp subalgebras are studied.
Full Text Available Irritable bowel syndrome and functional constipation represent a relevant and common health issue. However, real-world clinical practice includes patients with constipation who may or may not have other abdominal complaints (pain, bloating, abdominal discomfort with variable frequency. The goal of the present study was to obtain information on the workload entailed by patients with constipation and associated abdominal complaints, predominant clinical behaviors, education needs, and potential daily practice aids both in Primary Care and gastroenterology settings. The clinical behavior of doctors is generally similar at both levels, despite differences in healthcare approach: use of empiric therapies and clinically guided diagnostic tests, with some differences in colonoscopy use (not always directly accessible from Primary Care. Regarding perceptions, general support and osmotic laxatives are most valued by PC doctors, whereas osmotic laxatives, combined laxatives, and linaclotide are most valued by GE specialists. Furthermore, over half of respondents considered differentiating both diagnoses as challenging. Finally, considerable education needs are self-acknowledged at both levels, as is a demand for guidelines and protocols to help in managing this issue in clinical practice. A strength of this study is its providing a joint photograph of the medical approach and the perceptions of constipation with abdominal discomfort from a medical standpoint. Weaknesses include self-declaration (no formal validation and a response rate potentially biased by professional motivation.
Mareš, Milan; Mesiar, Radko
Roč. 49, č. 3 (2013), s. 433-445 ISSN 0023-5954 R&D Projects: GA ČR GAP402/11/0378 Keywords : alphabet * triangular norm * information * entropy * fuzziness * data source Subject RIV: BA - General Mathematics Impact factor: 0.563, year: 2013 http://library.utia.cas.cz/separaty/2013/E/mesiar-information in vague data sources.pdf
My study aims at introducing the theory of vagu eness,analyzing its linguistic realizations in advertising language from semantics,pragmatics,as well as psychology angles.The major purpose of this article is to draw advertisers' attention to the application of vagueness in advertising and make full use of th e psychology factors and to give them better knowledge of vague advertising so as to prepare them for the production of more successful advertisements.
Presentations of Gricean semantics, including Stephen Neale’s in “Silent Reference,” totally ignore vagueness, even though virtually every utterance is vague. I ask how Gricean semantics might be adjusted to accommodate vague speaker-meaning. My answer is that it can’t accommodate it: the Gricean program collapses in the face of vague speaker-meaning. The Gricean might, however, fi nd some solace in knowing that every other extant meta-semantic and semantic program is in the same boat.
I work out the difference between vagueness in philosophy and Unbestimmtheit (indefiniteness) in physics. Vague predicates do not allow a decision whether the predicate is true or false. Unbestimmtheit includes uncertainty and indeterminacy. I will describe the phenomenology of both concepts and discuss practical ways how to handle these cases. (author)
Full Text Available Terrain vague is usually synonym for a place exceeding the traditional categories of the city. Juxtaposing entropy to definite zones of containment, abandonment and emptiness to consolidated urban fabric, ceaseless transformation to historical stratification, informality and illegal activities to controlled jurisdictions, the terrain vague acts a sort of ruin, where the city is at the point of both being forgotten and disclosing its imminent future, eluding any of its regular uses and functioning mechanisms.
Full Text Available When asked to indicate which items from a set of candidates belong to a particular natural language category inter-individual differences occur: Individuals disagree which items should be considered category members. The premise of this paper is that these inter-individual differences in semantic categorization reflect both ambiguity and vagueness. Categorization differences are said to be due to ambiguity when individuals employ different criteria for categorization. For instance, individuals may disagree whether hiking or darts is the better example of sports because they emphasize respectively whether an activity is strenuous and whether rules apply. Categorization differences are said to be due to vagueness when individuals employ different cut-offs for separating members from non-members. For instance, the decision to include hiking in the sports category or not, may hinge on how strenuous different individuals require sports to be. This claim is supported by the application of a mixture model to categorization data for eight natural language categories. The mixture model can identify latent groups of categorizers who regard different items likely category members (i.e., ambiguity with categorizers within each of the groups differing in their propensity to provide membership responses (i.e., vagueness. The identified subgroups are shown to emphasize different sets of category attributes when making their categorization decisions.
Abdominal epilepsy is an exceptionally rare cause of abdominal pain that is more likely to ... We report on a child with episodic paroxysmal abdominal pain, accompanied by ... causes for the presenting complaints, work-up should proceed.
Lu, An; Ng, Wilfred
In many online shopping applications, such as Amazon and eBay, traditional Association Rule (AR) mining has limitations as it only deals with the items that are sold but ignores the items that are almost sold (for example, those items that are put into the basket but not checked out). We say that those almost sold items carry hesitation information, since customers are hesitating to buy them. The hesitation information of items is valuable knowledge for the design of good selling strategies. However, there is no conceptual model that is able to capture different statuses of hesitation information. Herein, we apply and extend vague set theory in the context of AR mining. We define the concepts of attractiveness and hesitation of an item, which represent the overall information of a customer's intent on an item. Based on the two concepts, we propose the notion of Vague Association Rules (VARs). We devise an efficient algorithm to mine the VARs. Our experiments show that our algorithm is efficient and the VARs capture more specific and richer information than do the traditional ARs.
Polarized neutron research, like many other subjects in neutron scattering developed in the footsteps of Cliff Shull. The classical polarized neutron technique he pioneered was generalized around 1970 to vectorial beam polarizations and this opened up the way to a ''nouvelle vague'' of neutron scattering experiments. In this paper I will first reexamine the old controversy on the question whether the nature of the neutron magnetic moment is that of a microscopic dipole or of an Amperian current loop. The problem is not only of historical interest, but also of relevance to modern applications. This will be followed by a review of the fundamentals on spin coherence effects in neutron beams and scattering, which are the basis of vectorial beam polarization work. As an example of practical importance, paramagnetic scattering will be discussed. The paper concludes with some examples of applications of the vector polarization techniques, such as study of ferromagnetic domains by neutron beam depolarization and Neutron Spin Echo high resolution inelastic spectroscopy. The sample results presented demonstrate the new opportunities this novel approach opened up in neutrons scattering research. (orig.)
In Causing Actions, Pietroski defends a distinctive view of the relationship between mind and body which he calls Personal Dualism. Central to his defence is the Argument from Differential Vagueness. It moves from the claim that mental events have different vagueness of spatiotemporal boundaries from neural events to ...
Sørensen, Tim Flohr
This article stipulates that vagueness is a socially important yet academically largely overlooked aspect of human interaction with the world. Vagueness and vague experiences can structure material categorisations of the world; it can contribute to the shaping of social relations and nurture...... and ambiguity can be integral to certain social and material phenomena. Third, the article examines recent archaeological analyses of burial practices in South Scandinavian passage graves from the Middle Neolithic in order to discuss the pursuit of certitude in archaeological observations and interpretations...
Tresp, C. [Aachen Technical Univ. (Germany); Becks, A.; Klinkenberg, R.; Hiltner, J. [Univ. of Dortmund (Germany)
In this paper the foundation of a knowledge representation system is introduced. It deals with fuzzy concepts and uncertain relationships. The problem we finally wish to solve, lays in the fact that on the one hand most actual methods of knowledge representation are not able to deal with vague knowledge. On the other hand, those few methods that care for vagueness lack well-defined semantics and therefore do not have a implementation-independent behavior. The proposed method is designed to model vague knowledge with well-defined semantics. Besides the language definition, basic patterns of reasoning are introduced.
Full Text Available Molodtsov has introduced the concept of soft sets and the application of soft sets in decision making and medical diagnosis problems. The basic properties of vague soft sets are presented. In this paper, we introduce the concept of interval-valued vague soft sets which are an extension of the soft set and its operations such as equality, subset, intersection, union, AND operation, OR operation, complement, and null while further studying some properties. We give examples for these concepts, and we give a number of applications on interval-valued vague soft sets.
Full Text Available The Open Geospatial Consortium (OGC Geography Markup Language (GML explicitly represents geographical spatial knowledge in text mode. All kinds of fuzzy problems will inevitably be encountered in spatial knowledge expression. Especially for those expressions in text mode, this fuzziness will be broader. Describing and representing fuzziness in GML seems necessary. Three kinds of fuzziness in GML can be found: element fuzziness, chain fuzziness, and attribute fuzziness. Both element fuzziness and chain fuzziness belong to the reflection of the fuzziness between GML elements and, then, the representation of chain fuzziness can be replaced by the representation of element fuzziness in GML. On the basis of vague soft set theory, two kinds of modeling, vague soft set GML Document Type Definition (DTD modeling and vague soft set GML schema modeling, are proposed for fuzzy modeling in GML DTD and GML schema, respectively. Five elements or pairs, associated with vague soft sets, are introduced. Then, the DTDs and the schemas of the five elements are correspondingly designed and presented according to their different chains and different fuzzy data types. While the introduction of the five elements or pairs is the basis of vague soft set GML modeling, the corresponding DTD and schema modifications are key for implementation of modeling. The establishment of vague soft set GML enables GML to represent fuzziness and solves the problem of lack of fuzzy information expression in GML.
Shaw, David M
In this article I argue that vagueness concerning consent to post-mortem organ donation causes considerable harm in several ways. First, the information provided to most people registering as organ donors is very vague in terms of what is actually involved in donation. Second, the vagueness regarding consent to donation increases the distress of families of patients who are potential organ donors, both during and following the discussion about donation. Third, vagueness also increases the chances that the patient's intention to donate will not be fulfilled due to the family's distress. Fourth, the consequent reduction in the number of donated organs leads to avoidable deaths and increased suffering among potential recipients, and distresses them and their families. There are three strategies which could be used to reduce the harmful effects of this vagueness. First, recategorizing the reasons (commonly referred to as 'overrules' under the current system) given by families who refuse donation from registered donors would bring greater clarity to donation discussions. Second, people who wish to donate their organs should be encouraged to discuss their wishes in detail with their families, and to consider recording their wishes in other ways. Finally, the consent system for organ donation could be made more detailed, ensuring both that more information is provided to potential donors and that they have more flexibility in how their intentions are indicated; this last strategy, however, could have the disadvantage of discouraging some potential donors from registering. © 2016 John Wiley & Sons Ltd.
Zhou, Shenghan; Liu, Wei; Chang, Wenbing
The selection of the best alternatives in project management has attracted increasing attention due to the uncertain environment. Vague TOPSIS is one of the powerful methods to solve this problem. In this work, firstly, a method of measuring the similarities of vague set which can take the uncertainty preference into account is raised and comparison between methods has been made to verify its effectiveness. Then, a vague set based TOPSIS in group decision is proposed to aid the decision making in project management. In this method, the weights of the experts for different criteria in the group decision are completely unknown and are calculated with the similarities of the judgments by them in the project. Finally, a computation example is shown to illustrate the method.
Powell, David R; Seemann, Torsten
Velvet is a popular open-source de novo genome assembly software tool, which is run from the Unix command line. Most of the problems experienced by new users of Velvet revolve around constructing syntactically and semantically correct command lines, getting input files into acceptable formats and assessing the output. Here, we present Velvet Assembler Graphical User Environment (VAGUE), a multi-platform graphical front-end for Velvet. VAGUE aims to make sequence assembly accessible to a wider audience and to facilitate better usage amongst existing users of Velvet. VAGUE is implemented in JRuby and targets the Java Virtual Machine. It is available under an open-source GPLv2 licence from http://www.vicbioinformatics.com/. firstname.lastname@example.org.
Mihajlovic, V.; Hiemstra, Djoerd; Blok, H.E.; de Jong, Franciska M.G.; Kraaij, W.
In this paper we present the extension of our prototype three-level database system (TIJAH) developed for structured information retrieval. The extension is aimed at modeling vague search on XML elements. All three levels (conceptual, logical, and physical) of the TIJAH system are enhanced to
Shi, Yan; Felsted, Amy E; Masand, Prakash M; Mothner, Brent A; Nuchtern, Jed G; Rodriguez, J Ruben; Vasudevan, Sanjeev A
Paraduodenal hernias are the most common type of congenital internal hernia. Because of its overall rare incidence, this entity is often overlooked during initial assessment of the patient. Lack of specific diagnostic criteria also makes diagnosis exceedingly difficult, and the resulting diagnostic delays can lead to tragic outcomes for patients. Despite these perceived barriers to timely diagnosis, there may be specific radiographic findings that, when combined with the appropriate constellation of clinical symptoms, would aid in diagnosis. This patient first presented at 8 years of age with vague symptoms of postprandial emesis, chronic abdominal pain, nausea, and syncope. Over the span of 6 years he was evaluated 2 to 3 times a year with similar complaints, all of which quickly resolved spontaneously. He underwent multiple laboratory, imaging, and endoscopic studies, which were nondiagnostic. It was not until he developed signs of a high-grade obstruction and extremis that he was found to have a large left paraduodenal hernia that had volvulized around the superior mesenteric axis. This resulted in the loss of the entire superior mesenteric axis distribution of the small and large intestine and necrosis of the duodenum. In cases of chronic intermittent obstruction without clear etiology, careful attention and consideration should be given to the constellation of symptoms, imaging studies, and potential use of diagnostic laparoscopy. Increased vigilance by primary care and consulting physicians is necessary to detect this rare but readily correctable condition. Copyright © 2015 by the American Academy of Pediatrics.
Swartz, Jonathan S
On July 31, 2001, the U.S. House of Representatives passed The Human Cloning Prohibition Act of 2001. The legislation proposes a complete ban on somatic cell nuclear transfer to create cloned human embryos; it threatens transgressors with criminal punishment and civil fines. House Bill 2505 is the first human cloning prohibition to pass either chamber of Congress. This note argues that the bill is unconstitutionally vague and inconsistent with the Supreme Court's recent Commerce Clause jurisprudence.
Wenzhong, Zhu; Jingyi, Li
Vagueness is one of the basic attributes of natural language. This is the same to advertising language. Vague language is a subject of increasing interest, and both foreign and domestic studies have attained success in it. Nevertheless, the study on the application of vague language in the context of English commercial advertising is relatively…
Introduction: Abdominal pain, in etiology sometimes difficult to be defined, is a frequent complaint in childhood. Abdominal epilepsy is a rare cause of abdominal pain. Objectives: In this article, we report on 5 year old girl patient with abdominal epilepsy. Methods: Some investigations (stool investigation, routine blood tests, ...
US Agency for International Development — iComplaints is a web-based Equal Employment Opportunity (EEO) complaint tracking and reporting system. The Office of Equal Opportunity Programs uses iComplaints to...
Federal Communications Commission — Individual informal consumer complaint data detailing complaints filed with the Consumer Help Center beginning October 31, 2014. This data represents information...
Waaddegaard, P; Dziegiel, Morten Hanefeld
In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed by penicil......In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed...... by penicillin treatment gave a good result....
T. Rubio; M. T. Gaztelu; A. Calvo; M. Repiso; H. Sarasíbar; F. Jiménez Bermejo; A. Martínez Echeverría
La tuberculosis abdominal cursa con un cuadro inespecífico, con difícil diagnóstico diferencial respecto a otras entidades de similar semiología. Presentamos el caso de un varón que ingresa por presentar dolor abdominal, pérdida progresiva y notoria de peso corporal y fiebre de dos meses de evolución. El cultivo de la biopsia de colon mostró presencia de bacilo de Koch.Abdominal tuberculosis develops according to a non-specific clinical picture, with a difficult differential diagnosis with re...
Full Text Available Multilevel feedback queue scheduler suffers from major issues of scheduling such as starvation for long tasks, fixed number of queues, and static length of time quantum in each queue. These factors directly affect the performance of the scheduler. At many times impreciseness exists in attributes of tasks which make the performance even worse. In this paper, our intent is to improve the performance by providing a solution to these issues. We design a multilevel feedback queue scheduler using a vague set which we call as VMLFQ scheduler. VMLFQ scheduler intelligently handles the impreciseness and defines the optimum number of queues as well as the optimal size of time quantum for each queue. It also resolves the problem of starvation. This paper simulates and analyzes the performance of VMLFQ scheduler with the other multilevel feedback queue techniques using MatLab.
In recent years, an impetuous development of new, unconventional theories, methods, techniques and technologies in computer and information sciences, systems analysis, decision-making and control, expert systems, data modelling, engineering, etc. , resulted in a considerable increase of interest in adequate mathematical description and analysis of objects, phenomena, and processes which are vague or imprecise by their very nature. Classical two-valued logic and the related notion of a set, together with its mathematical consequences, are then often inadequate or insufficient formal tools, and can even become useless for applications because of their (too) categorical character: 'true - false', 'belongs - does not belong', 'is - is not', 'black - white', '0 - 1', etc. This is why one replaces classical logic by various types of many-valued logics and, on the other hand, more general notions are introduced instead of or beside that of a set. Let us mention, for instance, fuzzy sets and derivative concepts, flou...
Koop, Herbert; Koprdova, Simona; Schürmann, Christine
Chronic abdominal wall pain is a poorly recognized clinical problem despite being an important element in the differential diagnosis of abdominal pain. This review is based on pertinent articles that were retrieved by a selective search in PubMed and EMBASE employing the terms "abdominal wall pain" and "cutaneous nerve entrapment syndrome," as well as on the authors' clinical experience. In 2% to 3% of patients with chronic abdominal pain, the pain arises from the abdominal wall; in patients with previously diagnosed chronic abdominal pain who have no demonstrable pathological abnormality, this likelihood can rise as high as 30% . There have only been a small number of clinical trials of treatment for this condition. The diagnosis is made on clinical grounds, with the aid of Carnett's test. The characteristic clinical feature is strictly localized pain in the anterior abdominal wall, which is often mischaracterized as a "functional" complaint. In one study, injection of local anesthesia combined with steroids into the painful area was found to relieve pain for 4 weeks in 95% of patients. The injection of lidocaine alone brought about improvement in 83-91% of patients. Long-term pain relief ensued after a single lidocaine injection in 20-30% of patients, after repeated injections in 40-50% , and after combined lidocaine and steroid injections in up to 80% . Pain that persists despite these treatments can be treated with surgery (neurectomy). Chronic abdominal wall pain is easily diagnosed on physical examination and can often be rapidly treated. Any physician treating patients with abdominal pain should be aware of this condition. Further comparative treatment trials will be needed before a validated treatment algorithm can be established.
Acute abdominal pain is a common reason for presentation at the emergency department. To establish a timely and adequate diagnosis, doctors use the pattern of complaints and physical examination as the basis for the evaluation of a patient. In this thesis we conducted a study that showed that
Waaddegaard, P; Dziegiel, M
In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed by penicil...
In light of the deficiencies and limitations for existing score functions, Lin has proposed a more effective and reasonable new score function for measuring vague values. By using Lin’s score function and a new weighted aggregation score function, an algorithm for multi-criteria group decision-making method was proposed to solve vague set based group decision-making problems under vague environments. Finally, a numerical example was illustrated to show the effectiveness of the proposed multi-...
system for handling complaints. While complaints often provide invaluable feedback on an individual's performance, they also offer dissatisfied patients an opportunity to air their views. Even if a complaint .... Communications Manager, Medical. Protection Society, Victoria House,. 2 Victoria Place, Leeds, UK. Pieter Carstens.
Volz, Kirsten G; Hertwig, Ralph
For centuries, decision scholars paid little attention to emotions: Decisions were modeled in normative and descriptive frameworks with little regard for affective processes. Recently, however, an "emotions revolution" has taken place, particularly in the neuroscientific study of decision making, putting emotional processes on an equal footing with cognitive ones. Yet disappointingly little theoretical progress has been made. The concepts and processes discussed often remain vague, and conclusions about the implications of emotions for rationality are contradictory and muddled. We discuss three complementary ways to move the neuroscientific study of emotion and decision making from agenda setting to theory building. The first is to use reverse inference as a hypothesis-discovery rather than a hypothesis-testing tool, unless its utility can be systematically quantified (e.g., through meta-analysis). The second is to capitalize on the conceptual inventory advanced by the behavioral science of emotions, testing those concepts and unveiling the underlying processes. The third is to model the interplay between emotions and decisions, harnessing existing cognitive frameworks of decision making and mapping emotions onto the postulated computational processes. To conclude, emotions (like cognitive strategies) are not rational or irrational per se: How (un)reasonable their influence is depends on their fit with the environment. © The Author(s) 2015.
Brock, Amy; Huang, Sui
Precision Oncology seeks to identify and target the mutation that drives a tumor. Despite its straightforward rationale, concerns about its effectiveness are mounting. What is the biological explanation for the "imprecision?" First, Precision Oncology relies on indiscriminate sequencing of genomes in biopsies that barely represent the heterogeneous mix of tumor cells. Second, findings that defy the orthodoxy of oncogenic "driver mutations" are now accumulating: the ubiquitous presence of oncogenic mutations in silent premalignancies or the dynamic switching without mutations between various cell phenotypes that promote progression. Most troublesome is the observation that cancer cells that survive treatment still will have suffered cytotoxic stress and thereby enter a stem cell-like state, the seeds for recurrence. The benefit of "precision targeting" of mutations is inherently limited by this counterproductive effect. These findings confirm that there is no precise linear causal relationship between tumor genotype and phenotype, a reminder of logician Carveth Read's caution that being vaguely right may be preferable to being precisely wrong. An open-minded embrace of the latest inconvenient findings indicating nongenetic and "imprecise" phenotype dynamics of tumors as summarized in this review will be paramount if Precision Oncology is ultimately to lead to clinical benefits. Cancer Res; 77(23); 6473-9. ©2017 AACR . ©2017 American Association for Cancer Research.
Peter Unger argues that his puzzle of the problem of the many leaves us with having to accept either countless embedded objects of the same kind or a Parmenidean rejection of distinct entities. This dilemma can be avoided if objects truly have vague boundaries. It is metaphysically impossible for an entity with a vague ...
Smith, Jeremiah; Fox, Sean M
Abdominal pain is a common complaint that leads to pediatric patients seeking emergency care. The emergency care provider has the arduous task of determining which child likely has a benign cause and not missing the devastating condition that needs emergent attention. This article reviews common benign causes of abdominal pain as well as some of the cannot-miss emergent causes. Copyright © 2016 Elsevier Inc. All rights reserved.
U.S. Environmental Protection Agency — The iComplaints system is an enterprise-level COTS (Commercial Off-The-Shelf) product that provides all of the funtionality required to collect, track, manage,...
Abdominal injury is an important cause of morbidity and mortality in childhood. Ten percent of trauma-related deaths are due to abdominal injury. Thousands of children are involved in auto accidents annually; many suffer severe internal injury. Child abuse is a second less frequent but equally serious cause of internal abdominal injury. The descriptions of McCort and Eisenstein and their associates in the 1960s first brought to attention the frequency and severity of visceral injury as important manifestations of the child abuse syndrome. Blunt abdominal trauma often causes multiple injuries; in the past, many children have been subjected to exploratory surgery to evaluate the extent of possible hidden injury. Since the advent of noninvasive radiologic imaging techniques including radionuclide scans and ultrasound and, especially, computed tomography (CT), the radiologist has been better able to assess (accurately) the extent of abdominal injury and thus allow conservative therapy in many cases. Penetrating abdominal trauma occurs following gunshot wounds, stabbing, and other similar injury. This is fortunately, a relatively uncommon occurrence in most pediatric centers and will not be discussed specifically here, although many principles of blunt trauma diagnosis are valid for evaluation of penetrating abdominal trauma. If there is any question that a wound has extended intraperitonelly, a sinogram with water-soluble contrast material allows quick, accurate diagnosis. The presence of large amounts of free intraperitoneal gas suggests penetrating injury to the colon or other gas-containing viscus and is generally considered an indication for surgery
... I find more information and related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). Gastro Kids , a ...
Hasan, N.; Razzaq, A.
Abdominal epilepsy (AE) is a rather uncommon clinical entity in children that might create diagnostic confusion especially when it lacks the typical manifestations of an epileptic seizure. We report the case of a young boy having apparently unexplained episodes of paroxysmal abdominal symptoms with no other suggestion of an underlying epileptic disorder. The case also explains how the clinical presentation can be misleading unless a high index of suspicion is maintained to reach the ultimate diagnosis. (author)
Kumar, R.; Saddique, M.; Iqbal, P.
To study the clinical presentation and outcome of cases of Abdominal Tuberculosis. Fifty four patients of Abdominal Tuberculosis were seen during the study period. Four patients were lost to follow-up, which were excluded. Detailed information of all the patients including age, sex, symptoms, signs, investigations and management was recorded, analyzed and compared with local and international data. Out of the 50 patients with Abdominal Tuberculosis, 31 were females and 19 males. Their ages ranged from 17 to 63 years, with a mean age of 25.1 years. Thirty five cases were admitted through Emergency and 15 through Outpatients departments. Abdominal pain was the most common symptom found in 44 (88%) patients followed by vomiting in 33 (66%). Abdominal tenderness was seen in 22 (44%) patients, while 16 (32%) patients had rigidity and other features of peritonitis. Surgery was performed in all these patients, limited right hemicolectomy in 17 (34%), segmental resection and anastomosis in 12 (24%), ileostomy and strictureplasty in six (12%) each, repair of perforation in five (10%) and adhesiolysis in four (8%) patients. Overall mortality was 8% due to septicaemia and multiorgan failure. Abdominal Tuberculosis is a significant clinical entity with lethal complications in neglected cases. It affects a younger age group and is more common in females. Clinical features are rather non-specific but vague ill health, low grade fever, weight loss and anorexia may help to diagnose the case. (author)
Cerminara, Caterina; El Malhany, Nadia; Roberto, Denis; Curatolo, Paolo
Focal epilepsy with ictal abdominal pain is an unusual partial epilepsy characterized by paroxysmal episodes of abdominal or visceral pain, disturbance of awareness and electroencephalographic abnormalities. We describe a new case of ictal abdominal pain in which gastrointestinal complaints were the only manifestation of seizures and review the previously described pediatric patients. In our patient clinical findings, ictal EEG abnormalities, and a good response to antiepileptic drugs allowed...
Lisman-van Leeuwen, Yvonne; Spee, Leo A A; Benninga, Marc A; Bierma-Zeinstra, Sita M A; Berger, Marjolein Y
PURPOSE: Abdominal pain is a common complaint in children. Because few data exist on its natural history, we wanted to investigate the prognosis of abdominal pain in children in general practice. METHODS: In a prospective cohort study of children (aged 4 to 17 years) complaining of abdominal pain,
Full Text Available Fuzzy based CPU scheduler has become of great interest by operating system because of its ability to handle imprecise information associated with task. This paper introduces an extension to the fuzzy based round robin scheduler to a Vague Logic Based Round Robin (VBRR scheduler. VBRR scheduler works on 2-layered framework. At the first layer, scheduler has a vague inference system which has the ability to handle the impreciseness of task using vague logic. At the second layer, Vague Logic Based Round Robin (VBRR scheduling algorithm works to schedule the tasks. VBRR scheduler has the learning capability based on which scheduler adapts intelligently an optimum length for time quantum. An optimum time quantum reduces the overhead on scheduler by reducing the unnecessary context switches which lead to improve the overall performance of system. The work is simulated using MATLAB and compared with the conventional round robin scheduler and the other two fuzzy based approaches to CPU scheduler. Given simulation analysis and results prove the effectiveness and efficiency of VBRR scheduler.
Schudnagis, Monika; Womser-Hacker, Christa
Discusses vagueness as a problem of materials information system development in the context of information retrieval within the paradigm of information science. Presents a prototype which combines an object-oriented graphical user interface with natural language feedback and correction functionality, as well as intelligent components for graphical…
Full Text Available Castleman′s disease is a rare, benign lymphoproliferative disorder of unknown origin. Paraneoplastic pemphigus is a common association which presents as oral mucosal ulcerations. Abdominal and retroperitoneal Castleman′s disease present either as a localized disease or as a systemic disease. We hereby present a 15-year-old male patient with oral mucosal lesions with localized vague right lower abdominal mass who was diagnosed to have Castleman′s disease with paraneoplastic pemphigus which was surgically excised.
Chung-Ching Lu; You-Lin Tain; Kwok-Wan Yeung; Mao-Meng Tiao
Ectopic pelvic kidney is a rare developmental anomaly. Ectopic pelvic kidney can present without the characteristic symptoms associated with the urinary tract pathology. Ectopic pelvic kidney is usually unknown, and nonspecific vague abdominal comfort maybe the only symptom. Early detection and recognition of an ectopic kidney can prevent long-term complications. We report a 3-year-5-month-old girl with ectopic pelvic kidney who experienced intermittent episodes of lower abdominal pain for ab...
De Baranchuk, J Z; Dayan, A; Gomez, A; Grimaldi, S; Morra, A
People can express their suffering voicing it, complaining with their body, with gestures, movements; for alerts eyes it is even more comprehensive and true than words. Complaints that human beings are capable of expressing are not so many, there are only a handful, and this work intends to be exhaustive in its exposition. It is possible to complain against third persons. It is also possible to do so against oneself assuming either the intransigent attitude of a father who judges a son who does not fulfill his expectancies, or as a son who resents the paternal demands which he feels he cannot comply. Other kind of complaints include physical symptoms, either isolated (cephalea, dysnea, urticaria) or constituting syndromes or illnesses. Losses suffered are also a source of complaints, whatever the lost object might be (person, situation, material things or a part of oneself). It can be mourned because of its absence, or else by feeling guilty of the real or imaginary damage inflicted or else by feeling indisolubly linked to it with a phantom tie. Other types of complaints are the feeling of dependancy towards something oppressive, be it a substance, such as alcohol, smoking, drugs or overeating, or it may be a person or a situation. In view of the compulsive addiction characteristics with which the subject lives, it is possible to assimilate this dependancy and the feeling of oppression and damage to the link with a toxic.
to file an online IG complaint. Active Duty Resources dfas logo Defense Finance Accounting Service Inspector General Air Force Reserve Resources dfas logo Defense Finance Accounting Service ARPC Air Reserve National Guard Resources dfas logo Defense Finance Accounting Service VPC-GR myPers AFPC Air Force Review
De Waele, Jan J
Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy.
U.S. Environmental Protection Agency — THIS DATA ASSET NO LONGER ACTIVE: This is metadata documentation for the Region 7 Air Compliance Complaint Database (ACCD) which logs all air pollution complaints...
Grøntved, A M; Karup, P
A questionnaire administered 2 years after classical laser uvulopalatopharyngoplasty (UPPP) showed that 42% of 69 patients had complaints. Most of the complaints, however, were comparatively minor. The most frequent complaint was a tendency to nasal regurgitation (13%), although only two patients...
Full text: There are numerous conditions that affect mainly or exclusively the pediatric population. These constitute true emergencies, related to patient's health. Delay in diagnosis and treatment of abdominal non-traumatic emergencies may result in rapid deterioration, peritonitis, sepsis, even death or in severe complications with subsequent morbidity. Abdominal emergencies in children mostly present with pain, tenderness, occasionally coupled by vomiting, fever, abdominal distension, and failure to pass meconium or stools. Diarrhea, blood per rectum, abnormal laboratory tests and lethargy may also be manifestations of acute abdominal conditions. Abdominal emergencies have a different aetiology, depending on age and whether the pain is acute or chronic. Symptoms have to be matched with age and gender. Newborns up to 1 months of age may have congenital diseases: atresia, low obstruction including Hirschsprung's disease, meconium ileus. Meconium plug is one of the commonest cause of low obstruction in newborns that may also develop necrotizing enterocolitis, incarcerated inguinal hernia and mid-gut volvulus. Past the immediate postnatal period, any duodenal obstruction should be considered midgut volvulus until proven otherwise and patients should undergo ultrasonography and/or properly performed upper GI contrast study that records the exact position of the deduno-jejunal junction. Infants 6 months-2 years carry the risk of intussusception, mid-gut volvulus, perforation, acute pyelonephritis. Preschool and school-aged children 2-12 years carry the risk of appendicitis, genito-urinary abnormalities including torsion, urachal abnormalities, haemolytic uremic syndrome and Henoch-Schonlein purpura. Children above 12 years suffer from the same conditions as in adults. Most conditions may affect any age despite age predilection. Abdominal solid organ ultrasonography (US) coupled with gastrointestinal ultrasonography is the principle imaging modality in radiosensitive
@@ Case History Mr. Li, a university student aged 23 years, paid his first visit on July 16, 2001, with the chief complaint of abdominal pain for one day. The patient stated that one day before when it happened to be the weekend, he got abdominal pain after supper, which went worse gradually and caused him to roll all over in bed. The pain was slightly alleviated half an hour later after he had taken some pain killers. Upon inquiry, the patient said that because of their newly graduation from the university, he and his classmates were so excited that they went to have a sumptuous lunch with alcoholic drinks. And in the evening he ate again a delicious supper cooked for him by his mother, after which he continued to have some fruit and dessert.
This book presents a comprehensive discussion on the characterization of vagueness in pictures. It reports on how the problem of representation of images has been approached in scientific practice, highlighting the role of mathematical methods and the philosophical background relevant for issues such as representation, categorization and reasoning. Without delving too much into the technical details, the book examines and defends different kinds of values of fuzziness based on a complex approach to categorization as a practice, adopting conceptual and empirical suggestions from different fields including the arts. It subsequently advances criticisms and provides suggestions for interpretation and application. By describing a cognitive framework based on fuzzy, rough and near sets, and discussing all of the relevant mathematical and philosophical theories for the representation and processing of vagueness in images, the book offers a practice-oriented guide to fuzzy visual reasoning, along with novel insights ...
Conclusion: Individuals with paranoid personality traits have more biases than normal individuals in terms of interpreting vague faces. The results of this study indicated the importance of attention to cognitive biases among individuals with paranoid personality traits or paranoid personality disorder because such biases can significantly influence behavioral patterns in individuals, and consequently degrade their functioning. Also, bias towards the processing of negative signs appears to be the most important cognitive element is involved in interpersonal relationships.
Mohsen Doustkam; Sepideh Pourheidari; Ahmad Mansouri
Introduction: According to the social cognitive theories, information processing biases can play an important role in social perception, interpretation of interpersonal relationships, and social interactions. These theories along with cognitive theories emphasize on information processing i.e. the way in which people perceive and interpret external stimuli in different ways. Therefore, the purpose of this study was to investigate interpretation bias towards vague faces in individuals with par...
Becker, G.J.; Stewart, J.; Holden, R.W.; Yune, H.Y.; Mail, J.T.; Klatte, E.C.
Abdominal angina due to occlusive disease of the mesenteric arteries has been the to become clinically manifest only in the presence of severe disease in at least two of the following vessels: celiac, SMA, and IMA. Still, many patients who gradually develop significant two-vessel disease have few or no associated symptoms. Differences in collateral circulation and in cardiac index account for some of the clinical variation. The usual clinical manifestations include severe post-prandial pain, sitophobia (fear of eating because of the anticipated symptoms), and profound weight loss. Uncommonly, diarrhea, nausea, or vomiting may be encountered. Smoking is a common historical feature. Most series document a female predilection. Aside from occasional abdominal bruits and (more commonly) findings of peripheral vascular occlusive disease, the physical exam discloses only cachexia. But the differential diagnosis of profound weight loss is extensive. Therefore, abdominal angina has always created a diagnostic challenge. Multiple imaging modalities are often employed, and a seemingly negative evaluation often culminates in biplane aortography. The latter typically reveals stenoses and/or occlusions in at least two of the three mesenteric arteries. The authors discuss how a variety of surgical treatments, including thromboendarterectomy and bypass grafting, have evolved. Recently reported results have been excellent
Ryu, Han Seung; Choi, Suck Chei
Abdominal pain is a common symptom that patients refer to a hospital. Organic causes should be differentiated in patients with abdominal pain and treatment should be administered in accordance with the causes. A meticulous history taking and physical examination are highly useful in making a diagnosis, and blood tests, imaging modalities, and endoscopy are useful for confirming diagnosis. However, in many cases, patients have functional disorders with no obvious abnormal findings obtained even if many diagnostic tests are performed. Patients with functional disorders usually complain the vague abdominal pain located in the center and other portions of the abdominal area. Although the most representative disease is irritable bowel syndrome, functional abdominal pain syndrome is currently researched as a new disease entity of functional abdominal pain. As various receptors related to functional abdominal pain have been discovered, drugs associated with those receptors are used to treat the disorders, and additional new drugs are vigorously developed. In addition, medical therapy with pharmacological or non-pharmacological psychiatric treatment is effective for treating functional abdominal pain.
In this case we presented a patient who were admitted to surgery department with complaints of abdominal pain and nausea. There were no pathological findings on physical examination, direct abdominal x-ray, chest radiograph and biochemical parameters. At proximal of the celiac trunk, it was shown approximately 3x2 cm in size fusiform aneurysmal dilatation on the patient%u2019s abdominal ultrasonography and turbulence, arterial flow on the patient%u2019s abdominal doppler ultrasonography subsequently. In abdominal computed tomography we detected dense calcifications, dilatation and hypodensities that may belong to a thrombus in the lumen superior mesenteric vein (SMV. At the same time, approximately 3.5 cm segment of trunk celiak we observed aneurysm dilatation which reaching 2 cm at the widest point. Celiac trunk aneurysm is a rare cause of abdominal pain and often noticed after the complicated, thus it must always be kept in mind in the differential diagnosis.
Serup, Jørgen; Carlsen, Katrina Hutton; Sepehri, Mitra
Tattoos cause a broad range of clinical problems. Mild complaints, especially sensitivity to sun, are very common and seen in 1/5 of cases. Medical complications are dominated by allergy to tattoo pigment haptens or haptens generated in the skin, especially in red tattoos but also in blue and green...... tattoos. Symptoms are major and can be compared to cumbersome pruritic skin diseases. Tattoo allergies and local reactions show distinct clinical manifestations, with plaque-like, excessive hyperkeratotic, ulcero-necrotic, lymphopathic, neuro-sensory, and scar patterns. Reactions in black tattoos......) transferred by tattooing remain a significant risk needing active prevention. It is noteworthy that cancer arising in tattoos, in regional lymph nodes, and in other organs due to tattoo pigments and ingredients has not been detected or noted as a significant clinical problem hitherto, despite millions...
Tsalkidis, Aggelos; Gardikis, Stefanos; Cassimos, Dimitrios; Kambouri, Katerina; Tsalkidou, Evanthia; Deftereos, Savas; Chatzimichael, Athanasios
Acute abdominal pain in children is a common cause for referral to the emergency room and for subsequent hospitalization to pediatric medical or surgical departments. There are rare occasions when the abdominal pain is derived from extra-abdominal organs or systems. The aim of the present study was to establish the most common extra-abdominal causes of acute abdominal pain. The notes of all children (1 month-14 years of age) examined for acute abdominal pain in the Accident and Emergency (A&E) Department of Alexandroupolis District University Hospital in January 2001-December 2005 were analyzed retrospectively. Demographic data, clinical signs and symptoms, and laboratory findings were recorded, as well as the final diagnosis and outcome. Of a total number of 28 124 children who were brought to the A&E department, in 1731 the main complaint was acute abdominal pain. In 51 children their symptoms had an extra-abdominal cause, the most frequent being pneumonia (n = 15), tonsillitis (n = 10), otitis media (n = 9), and acute leukemia (n = 5). Both abdominal and extra-abdominal causes should be considered by a pediatrician who is confronted with a child with acute abdominal pain.
Full Text Available Complaining is one form of communication for consumers to express their dissatisfaction. Understanding the consumer complaint behavior is an important thing for businesses; however, it is not easy to do. The initial step in understanding this behavior of consumer complaints is to map consumers based on their behavior of complaints and analyze the factors that influence this. This study examines the complaint behavior of consumers in Cibubur who have experienced dissatisfaction with a product. The objectives of this study are to map the consumer complaint behavior and identify its relationship with various factors such as consumer demographics, personality, attitude to businesses, attribution of the causes of dissatisfaction, and product attributes. A crosstab descriptive analysis method was used to map the consumers, while the Pearson correlation analysis methods was used to analyze consumer complaint behavioral relationships with various factors. The results of this study indicated that consumers in Cibubur based on their complaint behavior are classified into four groups: passive, voicers, irates and activist. The passive consumers dominate the category with a percentage of 49%. The voicers, irates, and activist belong to the complaining type and are dominated by young women, with high levels of education and income. Keywords: consumer complaint behavior, product, crosstab, pearson correlation
Colwell, Christopher B; Pons, Peter T; Pi, Randy
Complaints against Emergency Medical Services (EMS) agencies represent a concerning and potentially time-consuming problem for all involved in the delivery of prehospital emergency medical care. The objective of this study was to identify the source of complaints against an EMS system to help focus quality and performance improvement and customer service efforts. We conducted a retrospective review of complaints filed against a busy urban EMS agency over a 6-year period. All complaints were included, totaled by season and by year, and categorized by originator and nature of the complaint. A total of 286 complaints were registered during the 6-year period, with an average of 48 per year and 9.3 per 10,000 responses. The most common originators of complaints were patients (53%) followed by medical personnel (19%) and family members or friends (12%). Rude behavior accounted for 23% of the complaints registered, followed by technical skills (20%), transport problems (18%), and loss of belongings (13%). The identification of areas of dissatisfaction will allow focused quality and performance improvement programs directed at customer service and risk management.
Adelgais, Kathleen M; Kuppermann, Nathan; Kooistra, Joshua; Garcia, Madelyn; Monroe, David J; Mahajan, Prashant; Menaker, Jay; Ehrlich, Peter; Atabaki, Shireen; Page, Kent; Kwok, Maria; Holmes, James F
To determine the accuracy of complaints of abdominal pain and findings of abdominal tenderness for identifying children with intra-abdominal injury (IAI) stratified by Glasgow Coma Scale (GCS) score. This was a prospective, multicenter observational study of children with blunt torso trauma and a GCS score ≥13. We calculated the sensitivity of abdominal findings for IAI with 95% CI stratified by GCS score. We examined the association of isolated abdominal pain or tenderness with IAI and that undergoing acute intervention (therapeutic laparotomy, angiographic embolization, blood transfusion, or ≥2 nights of intravenous fluid therapy). Among the 12 044 patients evaluated, 11 277 (94%) had a GCS score of ≥13 and were included in this analysis. Sensitivity of abdominal pain for IAI was 79% (95% CI, 76%-83%) for patients with a GCS score of 15, 51% (95% CI, 37%-65%) for patients with a GCS score of 14, and 32% (95% CI, 14%-55%) for patients with a GCS score of 13. Sensitivity of abdominal tenderness for IAI also decreased with decreasing GCS score: 79% (95% CI, 75%-82%) for a GCS score of 15, 57% (95% CI, 42%-70%) for a GCS score of 14, and 37% (95% CI, 19%-58%) for a GCS score of 13. Among patients with isolated abdominal pain and/or tenderness, the rate of IAI was 8% (95% CI, 6%-9%) and the rate of IAI undergoing acute intervention was 1% (95% CI, 1%-2%). The sensitivity of abdominal findings for IAI decreases as GCS score decreases. Although abdominal computed tomography is not mandatory, the risk of IAI is sufficiently high that diagnostic evaluation is warranted in children with isolated abdominal pain or tenderness. Copyright © 2014 Elsevier Inc. All rights reserved.
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Types of complaints handled by the JS... § 658.401 Types of complaints handled by the JS complaint system. (a)(1) The types of complaints (JS related complaints) which shall be handled to resolution by the JS complaint system are as follows: (i...
... Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts and... to be similarly affected by the issues involved in the complaint, if applicable; (5) State the nature...
5 days of onset of symptoms with abdominal pain/distension and/or vomiting as chief complaint. Fourteen (63.7%) of .... one was a duodenal perforation (in addition to rib and femoral fracture), one was an ileal perforation and one was a right ...
Acute abdominal pain is a common presenting complaint in older patients. Presentation may differ from that of the younger patient and is often complicated by coexistent disease, delays in presentation, and physical and social barriers. The physical examination can be misleadingly benign, even with catastrophic conditions ...
Full Text Available Because clean energy and traditional energy have different advantages and disadvantages, it is of great significance to evaluate comprehensive benefits for hybrid power systems. Based on thorough analysis of important characters on hybrid power systems, an index system including security, economic benefit, environmental benefit, and social benefit is established in this paper. Due to advantages of processing abundant uncertain and fuzzy information, vague set is used to determine the decision matrix. Convert vague decision matrix to real one by vague combination ruleand determine uncertain degrees of different indexes by grey incidence analysis, then the mass functions of different comment set in different indexes are obtained. Information can be fused in accordance with Dempster-Shafer (D-S combination rule and the evaluation result is got by vague set and D-S evidence theory. A simulation of hybrid power system including thermal power, wind power, and photovoltaic power in China is provided to demonstrate the effectiveness and potential of the proposed design scheme. It can be clearly seen that the uncertainties in decision making can be dramatically decreased compared with existing methods in the literature. The actual implementation results illustrate that the proposed index system and evaluation model based on vague set and D-S evidence theory are effective and practical to evaluate comprehensive benefit of hybrid power system.
Shukla, P. K.
Describes an assignment in which students write a letter of complaint, and discusses how this assignment aids students in seeing the importance of effective written communication to their daily lives. (SR)
Security threat assessment of the Internet security system has become a greater concern in recent years because of the progress and diversification of information technology. Traditionally, the failure probabilities of bottom events of an Internet security system are treated as exact values when the failure probability of the entire system is estimated. However, security threat assessment when the malfunction data of the system's elementary event are incomplete--the traditional approach for calculating reliability--is no longer applicable. Moreover, it does not consider the failure probability of the bottom events suffered in the attack, which may bias conclusions. In order to effectively solve the problem above, this paper proposes a novel technique, integrating attack tree and vague sets for security threat assessment. For verification of the proposed approach, a numerical example of an Internet security system security threat assessment is adopted in this paper. The result of the proposed method is compared with the listing approaches of security threat assessment methods.
Full Text Available Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically.
Kruikemeier, S.; Coppen, R.; Friele, R.D.
Background: Handling patient complaints about health care issues is important. However, many patients who lodge a complaint are dissatisfied with the way their complaints are dealt with. In the Netherlands, there are two institutions to lodge a complaint: the Complaints Committee and the
Hansen, Torben; Wilke, Ricky; Zaichkowsky, Judy
This article fills a gap in the literature by providing insight about the handling of complaint management (CM) across a large cross section of retailers in the grocery, furniture, electronic and auto sectors. Determinants of retailers’ CM handling are investigated and insight is gained as to the......This article fills a gap in the literature by providing insight about the handling of complaint management (CM) across a large cross section of retailers in the grocery, furniture, electronic and auto sectors. Determinants of retailers’ CM handling are investigated and insight is gained...... as to the links between CM and redress of consumers’ complaints. The results suggest that retailers who attach large negative consequences to consumer dissatisfaction are more likely than other retailers to develop a positive strategic view on customer complaining, but at the same time an increase in perceived...
... Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis or plaque buildup causes the ... weak and bulge outward like a balloon. An AAA develops slowly over time and has few noticeable ...
Full Text Available Security measure is of great importance in both steganography and steganalysis. Considering that statistical feature perturbations caused by steganography in an image are always nondeterministic and that an image is considered nonstationary, in this paper, the steganography is regarded as a fuzzy process. Here a steganographic security measure is proposed. This security measure evaluates the similarity between two vague sets of cover images and stego images in terms of n-order Markov chain to capture the interpixel correlation. The new security measure has proven to have the properties of boundedness, commutativity, and unity. Furthermore, the security measures of zero order, first order, second order, third order, and so forth are obtained by adjusting the order value of n-order Markov chain. Experimental results indicate that the larger n is, the better the measuring ability of the proposed security measure will be. The proposed security measure is more sensitive than other security measures defined under a deterministic distribution model, when the embedding is low. It is expected to provide a helpful guidance for designing secure steganographic algorithms or reliable steganalytic methods.
Twenty years ago work started on something that would change the world forever. It would change the way we work, the way we communicate and the way we make our voices heard. On 13 March CERN will celebrate the 20th anniversary of the birth of the World Wide Web. Tim Berners-Lee with Nicola Pellow, next to the NeXT computer.In March 1989 here at CERN, Tim Berners-Lee submitted a proposal for a new information management system to his boss, Mike Sendall. ‘Vague, but exciting’, were the words that Sendall wrote on the proposal, allowing Berners-Lee to continue with the project, but unaware that it would evolve into one of the most important communication tools ever created. Tim Berners-Lee used a NeXT computer at CERN to create the first web server running a single website – info.cern.ch. Since then the World Wide Web has grown into the incredible phenomenon that we know today, a web of more than 60 billion pages, and hundreds of ...
Amyloidosis - abdominal wall fat pad biopsy; Abdominal wall biopsy; Biopsy - abdominal wall fat pad ... is the most common method of taking an abdominal wall fat pad biopsy . The health care provider cleans the ...
Shariati, Farnaz; Verter, Elizabeth; Chang, Wendy; Huang, Li; Joshi, Virendra
Unicentric Castleman disease is a rare condition of lymphoid hyperplasia, of which only 15% of cases occur in the abdomen. We report a 66-year-old man who presented with complaints of abdominal pain. Computed tomography scans revealed nephrolithiasis and a homogeneous calcified mass between the pancreas and stomach and several para-pancreatic nodes. Direct visualization during exploratory laparotomy revealed a mass on the lesser curvature of the stomach. Pyloromyotomy and mass resection were performed. Biopsy showed reactive lymphoid hyperplasia consistent with the hyaline vascular variant of Castleman disease.
Malik, R.; Ghafoor, T.; Sarfraz, M.; Hasan, N.
Objective: To study the frequency of subclinical hepatitis 'A' in children having non-specific abdominal symptoms. Subjects and Methods: Three hundred and sixty children of either gender, < 12 years of age, presenting with vague abdominal symptoms and no jaundice were evaluated for hepatitis. Eighty-eight (24.4%) children meeting the inclusion criteria of elevated serum alanine aminotransferase (ALT), twice the upper limits of normal (90 IU/L), and normal serum bilirubin were labeled as subclinical hepatitis. Results: A total of 360 children were evaluated for vague abdominal symptoms and 96 (26.7%) of them had hepatitis on laboratory profile. Eight patients developed early jaundice and were excluded from the study. Out of 88 (24.4%) cases of subclinical hepatitis, 82 (93.2%) had hepatitis-A, 03 (3.4%) had hepatitis-B, while no causative agent was found in 03 (3.4%) children. The common presenting symptoms were abdominal pain/discomfort, loss of appetite, nausea, vomiting, malaise, fatigue and fever. Hepatomegaly and splenomegaly was documented in 56% and 43% cases respectively. A history of exposure to a patient with hepatitis was present in 14/88 (15.9%) cases whereas no child was vaccinated against HAV. Serum ALT level declined to normal limits within 4 weeks for 77/88 (87.5%) cases and within 6 weeks for 84/88 (95.4%). All cases recovered spontaneously with out any complication. Conclusion: Hepatitis-A was rampant in children presenting with vague abdominal symptoms in our series. (author)
emotions resulting from the dissatisfaction and their coping strategies in the form of .... clothes or their complaint behaviour in cases of dissatisfaction. ... However, quality is a complex and multi-dimensional concept, which is relative ...... Exploring the importance of aesthetics', Journal of Fashion Marketing and Management,.
Dekker, J.; Valk, R.W.A. van der; Verhaak, P.F.M.
The aim of this study was to describe the disorders and the treatment of patients whose complaints were evaluated as being solely somatic in nature, as being somatic and having psychosocial consequences, or as being (at least partially) of a psychosocial origin. Data were used from a survey on
... 25 Indians 1 2010-04-01 2010-04-01 false Complaint. 11.1000 Section 11.1000 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Juvenile Offender Procedure § 11.1000 Complaint. A complaint must be filed by a law enforcement officer or...
... Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADMINISTRATIVE PROVISIONS GOVERNING THE JOB SERVICE SYSTEM Job Service Complaint System State Agency Js Complaint System § 658.412... satisfaction with the outcome, or (2) The complainant chooses not to elevate the complaint to the next level of...
... 6 Domestic Security 1 2010-01-01 2010-01-01 false Complaint. 13.7 Section 13.7 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.7 Complaint. (a) On or after the date the Department of Justice approves the issuance of a Complaint in accordance...
van Wilgen, CP; Dijkstra, PU; van der Laan, BFAM; Plukker, JTM; Roodenburg, JLN
The purpose of the study was to analyse the prevalence of shoulder complaints after nerve sparing neck dissection at least I year after surgery, and to analyse the influence of radiation therapy on shoulder complaints. Patients were interviewed for shoulder complaints, and patients filled out the
Iyer, Rajalakshmi; Nallasamy, Karthi
Abdominal pain is one of the common symptoms reported by children in urgent care clinics. While most children tend to have self-limiting conditions, the treating pediatrician should watch out for underlying serious causes like intestinal obstruction and perforation peritonitis, which require immediate referral to an emergency department (ED). Abdominal pain may be secondary to surgical or non-surgical causes, and will differ as per the age of the child. The common etiologies for abdominal pain presenting to an urgent care clinic are acute gastro-enteritis, constipation and functional abdominal pain; however, a variety of extra-abdominal conditions may also present as abdominal pain. Meticulous history taking and physical examination are the best tools for diagnosis, while investigations have a limited role in treating benign etiologies.
Full Text Available Intraabdominal hypertension and Abdominal compartment syndrome are causes of morbidity and mortality in critical care patients. Timely diagnosis and treatment may improve organ functions. Intra-abdominal pressure monitoring is vital during evaluation of the patients and in the management algorithms. The incidence, definition and risk factors, clinical presentation, diagnosis and management of intraabdominal hypertension and Abdominal compartment syndrome were reviewed here.
John, Gade; Peter, Kruse; Andersen, Ole Trier
Background: Abdominal auscultation has an important position in the physical examination of the abdomen. Little is known about rater agreement. The aim of this study was to describe rater agreement and thus, indirectly, the value of the examination. Methods: In a semi-virtual setup 12 recordings...... subjects and in patients with intestinal obstruction was acceptable for a clinical examination. Abdominal auscultation is a helpful clinical examination in patients with acute abdominal pain....
This article delineates a relatively unknown path in the history of medical philosophy and medical diagnosis. It is concerned with the phenomenon of vagueness in the physician's "style of thinking" and with the use of fuzzy sets, systems, and relations with a view to create a model of such reasoning when physicians make a diagnosis. It represents specific features of medical ways of thinking that were mentioned by the Polish physician and philosopher Ludwik Fleck in 1926. The paper links Lotfi Zadeh's work on system theory before the age of fuzzy sets with system-theory concepts in medical philosophy that were introduced by the philosopher Mario Bunge, and with the fuzzy-theoretical analysis of the notions of health, illness, and disease by the Iranian-German physician and philosopher Kazem Sadegh-Zadeh. Some proposals to apply fuzzy sets in medicine were based on a suggestion made by Zadeh: symptoms and diseases are fuzzy in nature and fuzzy sets are feasible to represent these entity classes of medical knowledge. Yet other attempts to use fuzzy sets in medicine were self-contained. The use of this approach contributed to medical decision-making and the development of computer-assisted diagnosis in medicine. With regard to medical philosophy, decision-making, and diagnosis; the framework of fuzzy sets, systems, and relations is very useful to deal with the absence of sharp boundaries of the sets of symptoms, diagnoses, and phenomena of diseases. The foundations of reasoning and computer assistance in medicine were the result of a rapid accumulation of data from medical research. This explosion of knowledge in medicine gave rise to the speculation that computers could be used for the medical diagnosis. Medicine became, to a certain extent, a quantitative science. In the second half of the 20th century medical knowledge started to be stored in computer systems. To assist physicians in medical decision-making and patient care, medical expert systems using the theory
Full Text Available After experiencing library service failure, the user may directly or indirectly voice his/her complaint, which is the best prescription to improve library public services. The paper explores the academic librarians and users’ attitudes towards complaints. Through surveying six hundred students from twenty universities and applying descriptive and inferential statistical techniques, the study investigates student users’ complaint preference and behavior afterwards, and perception of complaint handling and outcome. The study reports and compares their attitudes and perspectives towards library complaints. It further examines the differences in attitudes and behavior intention among respondents who had prior experience in filing complaints at libraries, did not complain, and had no prior experience in service failure. An ultimate analysis was made to contrast the user’s perception towards complaint handling of the library and of for-profit organization. [Article content in Chinese
Ameh, E A; Nmadu, P T
To determine the pattern, presentation and outcome of gastrointestinal injuries from blunt abdominal trauma in children. A retrospective study. Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Twenty one children managed for gastrointestinal injuries from blunt trauma from 1984-2002. The pattern, presentation, management and outcome of gastrointestinal injuries from blunt trauma. In the 19 year period, 1984-2002, 92 children were treated for blunt abdominal trauma, 21(23%) of who had injuries to the gastrointestinal tract. Three presenting after 24 hours had evidence of peritonitis. In six children with isolated gastrointestinal tract (GIT) injury who presented within two hours, abdominal signs were vague at initial evaluation but became marked over a few hours at repeated examination. In eight with associated intraabdominal injuries, abdominal signs were marked at initial examination and five presented with shock. Free peritoneal air was present on plain abdominal and chest radiograph in three of ten patients, dilated bowel loops in six and fluid levels in one. Diagnostic peritoneal lavage or paracentesis was positive in four patients with isolated GIT injuries and eight with associated intraabdominal injuries. There were 24 injuries in the 21 patients consisting of 15 perforations, five contusions, two seromuscular tears, and two gangrene from mesenteric injury. The small intestine was involved in 11 patients, colon six, stomach five, duodenum one and rectum one. Seven (35%) patients had associated extraabdominal injuries. Treatment consisted of simple closure of perforations, over sewing of contusions, resection and anastomosis for gangrene and repair with protective stoma for the rectal injury. One patient each developed prolonged ileus, urinary tract infection and chest infection, respectively postoperatively. Mortality was 28%, all of who had associated intraabdominal or extraabdominal injuries. Gastrointestinal injury from blunt abdominal trauma in
Lutwak, Nancy; Dill, Curt
The patient is a 61-year-old diabetic male with history of renal transplant who presented to the emergency department with complaints of intermittent abdominal discomfort accompanied by multiple episodes of vomiting and diarrhoea. He had delayed seeking medical attention until his friends insisted that he come to the emergency department, since the abdominal discomfort was worsening. The patient's ECG revealed an ST-segment elevation myocardial infarction.
Altamimi, Eyad M.; Al-Safadi, Mohammad H.
Background Recurrent abdominal pain (RAP) is a common complaint in children. Significant portion of them are of functional origin. This study aimed to assess the prevalence of abdominal pain-predominant functional gastrointestinal disorder (FGID) and its types in Jordanian school children. Methods This is a school-based survey at south Jordan. Information using the self-reporting form of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version (QPGS-RIII) - the official Arabi...
Kennedy, L; Mahoney, D H; Redel, C A
Recurrent abdominal pain is a common complaint in children with sickle cell disease. Helicobacter pylori gastritis has recently been described in association with recurrent abdominal pain in children. A case report is given of a 16-year-old black male with hemoglobin SS disease presenting with recurrent abdominal pain and hematemesis. Endoscopic exam of the upper gastrointestinal tract revealed gastritis, and biopsy confirmed H. pylori infection. Serology studies demonstrated increased anti-H. pylori antibody titers. The young man responded well to treatment, with resolution of his symptoms. Helicobacter pylori infection is a new diagnostic consideration for children with recurrent abdominal pain and should be included in the differential diagnosis of children with sickle cell disease, especially when abdominal pain is recurrent and accompanied by vomiting. Larger case studies will be necessary to determine the true incidence of H. pylori in children with sickle cell disease and recurrent abdominal pain.
Rocha, L. E. C.; Holme, P.
Interaction between consumers and companies can create conflict. When a consensus is unreachable there are legal authorities to resolve the case. This letter is a study of data from the Brazilian Department of Justice from which we build a bipartite network of categories of complaints linked to the companies receiving those complaints. We find the complaint categories organised in an hierarchical way where companies only get complaints of lower degree if they already got complaints of higher degree. The fraction of resolved complaints for a company appears to be nearly independent of the equity of the company but is positively correlated with the total number of complaints received. We construct feature vectors based on the edge-weight —the weight of an edge represents the times complaints of a category have been filed against that company— and use these vectors to study the similarity between the categories of complaints. From this analysis, we obtain trees mapping the hierarchical organisation of the complaints. We also apply principal component analysis to the set of feature vectors concluding that a reduction of the dimensionality of these from 8827 to 27 gives an optimal hierarchical representation.
With the aim of examining the subject of noise made by windmills and discovering the characteristics that are commonly found with regard to complaints in this respect, 10 cases were selected from a total of 40 in order to carry out a critical examination of the matter. The chosen cases were concerned with both small and medium-sized wind turbines located in groups or standing alone. The authors of the complaints lived within a distance of 160-166 meters from the cited windmills which could be described as producing an average amount of noise in relation to their size. It was clear from available material (including telephone interviews) that noise was experienced as being the most disturbing, although light-flashing from turbine blades, shadowing and aesthetic considerations related to scenic location were also named. In most cases the noise was so distressing that it influenced people's decisions on whether, or where, to go outside their homes and whether or not to open their windows. Most complaints were about machine noise and other audible tones, and about half of them concerned the swish of turning blades. Most people were especially bothered when the wind did not blow so hard (so that the wind in the trees etc. was not so loud). The persistancy of the noise generated was considered to contribute most to the depreciation of life quality. It was found that the amount of irritation coincided with noise loads of L r at a wind velocity of 5 or 8 m/s. A table is presented to illustrate registered noise conditions. (AB)
Pedersen, Christian Sejer; Møller, Henrik; Persson-Waye, Kerstin
From 203 cases of low-frequency complaints a random selection of twenty-one cases were investigated. The main aim of the investigation was to answer the question whether the annoyance is caused by an external physical sound or by a physically non-existing sound, i.e. low-frequency tinnitus. Noise...... of the complainants are annoyed by a physical sound (20-180 Hz), while others suffer from low-frequency tinnitus (perceived frequency 40-100 Hz). Physical sound at frequencies below 20 Hz (infrasound) is not responsible for the annoyance - or at all audible - in any of the investigated cases, and none...... of the complainants has extraordinary hearing sensitivity at low frequencies. For comparable cases of low-frequency noise complaints in general, it is anticipated that physical sound is responsible in a substantial part of the cases, while low-frequency tinnitus is responsible in another substantial part of the cases....
Reis, Cátia; Mestre, Catarina; Canhão, Helena; Gradwell, David; Paiva, Teresa
This work aimed to determine daytime sleepiness and sleep complaints prevalence and the corresponding influence on perceived fatigue and to evaluate the influence of sociodemographic parameters and labour variables on sleep complaints, sleepiness and fatigue. A questionnaire was developed including socio-economic and labour issues and instruments, focused in sleep and fatigue. The response rate was 32% and the final sample had 435 pilots. The prevalence of sleep complaints was 34.9%, daytime sleepiness 59.3% and fatigue 90.6%. The high prevalence of sleep complaints, sleepiness and fatigue was disclosed in pilots, with those who fly short/medium having an added risk of fatigue.
Masud, M.; Adil, M.; Gondal, Z.I.; Aquil, A.
Objective: To evaluate the diagnostic efficacy of laparoscopy in ill-defined recurrent chronic abdominal pain. Study Design: Prospective study. Place and Duration of Study: Surgical department, Military Hospital Rawalpindi, from Jul 2011 to Dec 2013. Material and Methods: A total of 102 patients who presented to surgical department with chronic recurrent abdominal pain of unknown etiology and underwent diagnostic laparoscopy were included in our study. Patients with acute onset of abdominal pain, hemodynamically unstable, pregnant or those in which diagnosis can be made by radiological techniques were excluded from our study. Patient's demographic data, clinical findings and laparoscopic findings were recorded. Finally data was analyzed by using SPSS version 21. Results: Out of 110 patients 96 were female while remaining 14 were male. The age range of the patients was 20- 70 years with mean age of 50 +- 10 years. The most common site of pain was lower abdomen while mean duration of abdominal pain was 34 weeks. Laparoscopic findings include acute recurrent appendicitis in 32 (29.09%) patients, cholecystitis with biliary sludge in 14 (12.72%), pelvic inflammatory disease in 12 (10.90%), ovarian cyst in 11(10%), adhesions in 10(9.09%), intestinal tuberculosis in 8 (7.27%), mesenteric lymphadenitis in 7 (6.36%), lymphoma in 4 (3.63%), ectopic pregnancy in 3 (2.7%), CA gallbladder in 2 (1.81%), meckels diverticulum in 2 (1.81%), endometriosis in 2 (1.81%) and crohns disease in 1 (0.9%) patients. Mean operative time was 48 min while average hospital stay was 2-3 days. No major complications were noticed. Conclusion: Laparoscopy in our clinical setup has significant role in diagnosing cases of vague abdominal pain which cannot be diagnosed by routine investigations. (author)
Meer, S.B. van der.; Forget, P.P.
Small bowel permeability was investigated in 87 children with recurrent abdominal pain by measuring the 24-h urinary excretion of orally administered 51 Cr-EDTA. The mean excreation was 3.64% ± 1.49% per 24 h. The difference between the mean urinary excretion in children with recurrent abdominal pain and control children (2.51% ± 0.70%), was significant (p<0.01, two sample t-test). The increased small permeability in children with recurrent abdominal pain might indicate an intestinal etiology for the patients complaints
Gieteling, M.J.; Lisman-van Leeuwen, Y.; Wouden, J.C. van der; Schellevis, F.G.; Berger, M.Y.
PURPOSE: Nonspecific abdominal pain (NSAP) is a common complaint in childhood. In specialist care, childhood NSAP is considered to be a complex and time-consuming problem, and parents are hard to reassure. Little is known about NSAP in family practice, but the impression is that family physicians
Gieteling, Marieke J.; Lisman-van Leeuwen, Yvonne; van der Wouden, Johannes C.; Schellevis, Francois G.; Berger, Marjolein Y.
PURPOSE Nonspecific abdominal pain (NSAP) is a common complaint in childhood. In specialist care, childhood NSAP is considered to be a complex and time-consuming problem, and parents are hard to reassure. Little is known about NSAP in family practice, but the impression is that family physicians
Full Text Available Whereas the currently emerging configurations of audiovisualcy in the age of digital networks are often addressed in terms of absolute novelty and innovation, this article wishes to shift the focus slightly, articulating instead the new in terms of the old. This essay proposes the argument that it was within the Nouvelle Vague and the French film culture of the 1960s that the DVD was “invented”. Obviously, this is a contrafactual argument, but if we understand the DVD as a discursive construction articulating a specific perspective on film, then the DVD simulates and emulates some key features of 1960s cinephilia that emerged within the context of the new waves. On the other hand, the Nouvelle Vague is understood as a broad discursive movement encompassing all segments of the institution cinema rather than five auteur-directors — Truffaut, Godard, Chabrol, Rohmer and Rivette — and their respective films. By arguing for the continuing importance of film history and culture, this article wishes to underline the fact that technological as well as aesthetic transformations are central to our understanding of media culture.
Full Text Available ... often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. ... help diagnose the cause of abdominal or pelvic pain and diseases of the internal organs, small bowel ...
Full Text Available ... the liver, kidneys, pancreas, ovaries and bladder as well as lymphoma. kidney and bladder stones. abdominal aortic ... and properly administer radiation treatments for tumors as well as monitor response to chemotherapy. top of page ...
The imaging search for a suspected abdominal abscess is common in hospitalized patients, especially after recent abdominal surgery. This paper examines the role of CT in the detection, localization, and treatment of abdominal abscess. The accuracy, limitations, and technical aspects of CT in this clinical setting are discussed. The diagnosis of an abscess is based on the demonstration of a circumscribed abnormal fluid collection. Although percutaneous aspiration with gram stain and culture is usually indicated to differentiate abscess from other fluid collections, the CT-based detection of extraluminal gas bubbles makes the diagnosis of an abscess highly likely. CT is compared with conventional radiographic studies, US, and radio-nuclide imaging. Specific CT and clinical features of abscesses in the following sites are emphasized: subphrenic space, liver, pancreas, kidneys, psoas muscle, appendix, and colonic diverticula. Most abdominal abscesses can be successfully treated with percutaneous drainage techniques. The techniques, results, and limitations of percutaneous abscess drainage are reviewed
Full Text Available ... intravenous contrast indicate mothers should not breastfeed their babies for 24-48 hours after contrast medium is ... preferred for evaluation of acute abdominal conditions in babies, such as vomiting or blood in stool. For ...
Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much ... CT scan, an experienced radiologist can diagnose many causes of abdominal pain or injury from trauma with ...
Abdominal film; X-ray - abdomen; Flat plate; KUB x-ray ... There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most ...
Vijayaraghavan, S Boopathy; Palanivelu, Chinnusamy; Sendhilkumar, Karuppusamy; Parthasarathi, Ramakrishnan
An abdominal cocoon is a rare condition in which the small bowel is encased in a membrane. The diagnosis is usually established at surgery. Here we describe the sonographic features of this condition.
Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... GI) contrast exams and ultrasound are preferred for evaluation of acute abdominal conditions in babies, such as ...
Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X- ... use high frequency sound waves to produce an image and do not expose the individual to radiation. ...
Full Text Available ... abdominal conditions in babies, such as vomiting or blood in stool. For some conditions, including but not limited to some liver, kidney, pancreatic, uterine or ... Content Some imaging tests and treatments have special pediatric considerations. The teddy ...
Full Text Available ... for tumors as well as monitor response to chemotherapy. top of page How should I prepare? You ... of acute abdominal conditions in babies, such as vomiting or blood in stool. For some conditions, including ...
Pereira, Jose M. [Department of Radiology, Hospital de S. Joao, Porto (Portugal)]. E-mail: email@example.com; Madureira, Antonio J. [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Vieira, Alberto [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Ramos, Isabel [Department of Radiology, Hospital de S. Joao, Porto (Portugal)
Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis.
Full Text Available ... pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as lymphoma. kidney and bladder stones. abdominal aortic aneurysms (AAA), injuries ...
Pereira, Jose M.; Madureira, Antonio J.; Vieira, Alberto; Ramos, Isabel
Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis
Altamimi, Eyad M; Al-Safadi, Mohammad H
Recurrent abdominal pain (RAP) is a common complaint in children. Significant portion of them are of functional origin. This study aimed to assess the prevalence of abdominal pain-predominant functional gastrointestinal disorder (FGID) and its types in Jordanian school children. This is a school-based survey at south Jordan. Information using the self-reporting form of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version (QPGS-RIII) - the official Arabic translation - was collected. Classes from academic years (grades) 6 - 8 were selected. SPSS Statistical Package Version 17 (IBM, Armonk, NY, USA) was used. Categorical data were analyzed using Fisher's exact test, and continuous data were analyzed using t -test. P abdominal pain-predominant FGID. Seventy-nine (68%) of them were females. Forty-seven (10.6%) had irritable bowel syndrome (IBS). Thirty-six (8%), 17 (3.8%), 11 (2.4%) and five (1.1%) had abdominal migraine, functional abdominal pain, functional abdominal pain syndrome and functional dyspepsia, respectively. Abdominal pain-predominant FGID has become a major health issue in Jordanian children. One of four children between the ages of 11 and 15 years exhibits at least one abdominal pain-predominant FGID. The most common form of abdominal pain-predominant FGID in our children was IBS. Females are affected more often than males. Intestinal and extra-intestinal symptoms are seen regularly with abdominal pain-predominant FGIDs.
Pathi, Ramon; Sage, Michael; Slavotinek, John; Hanieh, Ahmad
A case of an abdominal cerebrospinal fluid (CSF) pseudocyst in a patient with a ventriculoperitoneal shunt is reported to illustrate this known but rare complication. In the setting of a VP shunt, the frequency of abdominal CSF pseudocyst formation is approximately 3.2%, often being precipitated by a recent inflammatory or infective process or recent surgery. Larger pseudocysts tend to be sterile, whereas smaller pseudocysts are more often infected. Ultrasound and CTeach have characteristic findings Copyright (2004) Blackwell Publishing Asia Pty Ltd
Suarez, Tatiana; Garcia, Vanessa; Tamara, Estrada; Acosta, Federico
In this article we illustrate and discuss imaging features resulting from Tuberculosis abdominal affectation. We present patients evaluated with several imaging modalities who had abdominal symptoms and findings suggestive of granulomatous disease. Diagnosis was confirm including hystopatology and clinical outgoing. Cases involved presented many affected organs such as lymphatic system, peritoneum, liver, spleen, pancreas, kidneys, ureters, adrenal glands and pelvic organs Tuberculosis, Tuberculosis renal, Tuberculosis hepatic, Tuberculosis splenic Tomography, x-ray, computed
... 29 Labor 4 2010-07-01 2010-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Parental complaints. 98.32 Section 98.32 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Parental Rights and Responsibilities § 98.32 Parental complaints...
... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Complaints. 528.8 Section 528.8 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY NONDISCRIMINATION REQUIREMENTS § 528.8... of Thrift Supervision, Washington, DC 20552 for processing under Office regulations. Complaints...
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Discrimination complaints. 405.30 Section 405... INITIAL DISABILITY CLAIMS Introduction, General Description, and Definitions § 405.30 Discrimination... that an adjudicator has improperly discriminated against you, you may file a discrimination complaint...
Danny Pimentel Claro
Full Text Available Consumer complaints affect company market value and common sense suggests that a negative impact is expected. However, do complaints always negatively impact company market value? We hypothesize in this study that complaints may have a non-linear effect on market value. Positive (e.g. avoiding high costs to solve complaints and negative (e.g. speedy and intense diffusion tradeoffs may occur given the level of complaints. To test our non-linear hypothesis, a panel data was collected from cell phone service providers from 2005 to 2013. The results supported our tradeoff rationale. Low levels of complaints allow for companies to increase market value, while high levels of complaints cause increasing harm to market value. The sample, model and period considered in this study, indicates a level of 0.49 complaints per thousand consumers as the threshold for a shift in tradeoffs. The effects on market value become increasingly negative when trying to make reductions to move below this level, due to negative tradeoffs.
de Zwart, B. C.; Broersen, J. P.; van der Beek, A. J.; Frings-Dresen, M. H.; van Dijk, F. J.
To (a) describe differences in the outcome of cross sectional and longitudinal analysis on musculoskeletal complaints relative to age and work demands, and (b) to assess the entrance and drop out selection on musculoskeletal complaints among groups of employees relative to age and work demands. A
... Proceedings; Pleadings; Motions; Replies § 502.62 Complaints and fee. (a) The complaint must be verified and... reparation is sought and the nature of the proceeding so requires, the complaint shall set forth: the ports...
Ismael Arinas Pellón
Full Text Available In this genre analysis research paper, we compare U.S. patents, contracts, and regulations on technical matters with a focus upon the relation between vagueness and communicative purposes and subpurposes of these three genres. Our main interest is the investigation of intergeneric conventions across the three genres, based on the software analysis of three corpora (one for each genre, 1 million words per corpus. The result of the investigation is that intergeneric conventions are found at the level of types of expressed linguistic vagueness, but that intergeneric conventions at the level of actual formulations are rare. The conclusion is that at this latter level the influence from the situation type underlying the individual genre is more important than the overarching legal character of the genres, when we talk about introducing explicit vagueness in the text.El propósito de este artículo es comparar mediante herramientas de lingüística de corpus el uso de la vaguedad en contratos, legislación y patentes de los EE.UU. La comparación se centra en valorar hasta qué punto estos tres géneros comparten las mismas estrategias de vaguedad lingüística para lograr sus objetivos y sub-objetivos comunicativos. Los tres corpus compilados para este estudio comparten una combinación, tanto de lenguaje legal, como tecnológico y cada uno de ellos consta de algo más de un millón de tokens. El resultado de nuestra investigación apunta a que estos tres géneros comparten convenciones en el uso deliberado de tipos de vaguedad lingüística, pero la fraseología concreta de la vaguedad aplicada no es normalmente la misma. La conclusión es que, en este último nivel fraseológico, la situación subyacente en cada género es más importante que el común carácter legal de los géneros cuando se trata de introducir la vaguedad de forma explícita en el texto.
Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E
Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.
Full Text Available The complaint recognizer system plays an important role in making sure the correct classification of the hot complaint,improving the service quantity of telecommunications industry.The customers’ complaint in telecommunications industry has its special particularity which should be done in limited time,which cause the error in classification of hot complaint.The paper presents a model of complaint hot intelligent classification based on text mining,which can classify the hot complaint in the correct level of the complaint navigation.The examples show that the model can be efficient to classify the text of the complaint.
Bohiltea, R; Radoi, V; Tufan, C; Horhoianu, I A; Bohiltea, C
Abdominal pregnancy, a rare diagnosis, belongs to the ectopic pregnancy group, the leading cause of pregnancy related exitus. The positive diagnosis is very difficult to establish most often in an acute setting, leading to a staggering percent of feto-maternal morbidity and mortality. We present the case of 26-weeks-old abdominal pregnancy with partial feto-placental detachment in a patient, after hysteroscopy and in vitro fertilization, which until the acute symptoms that led to emergency laparotomy went unrecognized. The patient recovered completely and satisfactorily after surgery and, due to the high risk of uterine rupture with regard to a second pregnancy, opted for a surrogate mother. Abdominal pregnancy can be regarded as a difficult to establish diagnosis, with a greater chance in case of increased awareness. It is compulsory to be well informed in order not to be surprised by the diagnosis and to apply the correct treatment immediately as the morbidity and mortality rate is elevated.
Lee, Ser Yee; Pormento, James G; Koong, Heng Nung
Abdominal paracentesis and thoracocentesis are common bedside procedures with diagnostic, therapeutic and palliative roles. We describe a useful and familiar a useful and familiar technique with the use of a multiple lumen catheter commonly used for central venous line insertion for drainage of ascites or moderate to large pleural effusions. The use of a multiple lumen catheter allows easier and more rapid aspiration of fluid with a smaller probability of the side holes being blocked as compared to the standard needle or single catheter methods. This is particularly useful in situations where the dedicated commercial kits for thoracocentesis and abdominal paracentesis are not readily available.
Konen, Osnat; Rathaus, Valeria; Shapiro, Myra [Department of Diagnostic Imaging, Meir General Hospital, Sapir Medical Centre, Kfar Saba (Israel); Dlugy, Elena [Department of Paediatric Surgery, Schneider Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Freud, Enrique [Department of Paediatric Surgery, Sapir Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Kessler, Ada [Department of Diagnostic Imaging, Sourasky Medical Centre, Tel-Aviv (Israel); Horev, Gadi [Department of Diagnostic Imaging, Schneider Medical Centre, Tel-Aviv (Israel)
Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two
Risi, D.; Alessi, G.; Meli, C.; Marzano, M.; Fiori, E.; Caterino, S.
From February 1986 to March 1988 113 abdominal US exams were performed in emergency situation to evaluate the accuracy of this methodology: 13 were blunt traumas, 18 post-operative complications. A real-time scanner with a linear probe of 5 MHz was employed. The results were confirmed by surgical and/or clinical and instrumental evaluation. In 81% of the examinations, ultrasonography allowed a diagnosis to be made. Gallbladder and biliary pathologies were the most common findings. The results (sensibility 96%, specificity 88%, accuracy 95%) confirm the affidability of ultrasonography in abdominal emergencies, as shown in literature
Konen, Osnat; Rathaus, Valeria; Shapiro, Myra; Dlugy, Elena; Freud, Enrique; Kessler, Ada; Horev, Gadi
Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two. Conclusions: US
To review the current developments in staged abdominal re-operation for abdominal trauma. To overview the steps of damage control laparotomy. The ever increasing importance of the resuscitation phase with current intensive care unit (ICU) support techniques should be emphasized. General surgeons should be familiar to staged abdominal re-operation for abdominal trauma and collaborate with ICU teams, interventional radiologists and several other specialties to overcome this entity.
Cinar, Orhan; Jay, Loni; Fosnocht, David; Carey, Jessica; Rogers, LeGrand; Carey, Adrienne; Horne, Benjamin; Madsen, Troy
Abdominal pain is a top chief complaint of patients presenting to Emergency Departments (ED). Historically, uncertainty surrounded correct management. Evidence has shown adequate analgesia does not obscure the diagnosis, making it the standard of care. We sought to evaluate trends in treatment of abdominal pain in an academic ED during a 10-year period. We prospectively evaluated a convenience sample of patients in an urban academic tertiary care hospital ED from September 2000 through April 2010. Adult patients presenting with a chief complaint of abdominal pain were included in this study. Analgesic administration rates and times, pain scores, and patient satisfaction at discharge were analyzed to evaluate trends by year. There were 2,646 patients presenting with abdominal pain who were enrolled during the study period. Rates of analgesic administration generally increased each year from 39.9% in 2000 to 65.5% in 2010 (p value for trend trend of increase in analgesic administration. In patients presenting to the ED with abdominal pain, analgesia administration increased and time to medication decreased during the 10-year period. Despite overall improvements in satisfaction, significant numbers of patients presenting with abdominal pain still reported moderate to severe pain at discharge. Copyright © 2013 Elsevier Inc. All rights reserved.
In December 1998, Canada filed a complaint alleging that the European Communities (EC) had adopted regulations that amounted to a scheme to extend patent terms, limited to pharmaceutical and agricultural chemical products.
... CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Records and Reports § 211.198 Complaint... for exemption under § 211.137, such written records shall be maintained for 3 years after distribution...
... local franchising authority and the cable system operator. ... system operators shall establish a process for resolving complaints from subscribers about the quality of... for inspection by the Commission and franchising authorities, upon request. These records shall be...
BACKGROUND. Abdominal TB usually presents with nonspecific findings and may thus m.,mw a multitude of gastrointestinal disorders. Abdominal tuberculosis may therefore present as large and palpable intra-abdominal masses usually arising from lymphadenopathy which may mimic lymphomas and other malignancies.
Background: Abdominal TB usually presents with nonspecific findings and may thus mimic a multitude of gastrointestinal disorders. Abdominal tuberculosis may therefore present as large and palpable intra-abdominal masses usually arising from lymphadenopathy which may mimic lymphomas and other malignancies.
An important aspect of allowing patients to take control of their health care is the introduction of new procedures for dealing with complaints. This article examines the concepts that underpin the new Department of Health regulations on complaints management and what they will mean for health and social care professionals. It also explains why these regulations focus on restorative justice rather than blame when adverse events occur.
Full Text Available ... as ulcerative colitis or Crohn's disease , pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as ... injuries to abdominal organs such as the spleen, liver, kidneys or other internal organs in cases of ...
Grover, Madhusudan; Drossman, Douglas A
Functional abdominal pain syndrome (FAPS) is a relatively less common functional gastrointestinal (GI) disorder defined by the presence of constant or frequently recurring abdominal pain that is not associated with eating, change in bowel habits, or menstrual periods (Drossman Gastroenterology 130:1377-1390, 2006), which points to a more centrally targeted (spinal and supraspinal) basis for the symptoms. However, FAPS is frequently confused with irritable bowel syndrome and other functional GI disorders in which abdominal pain is associated with eating and bowel movements. FAPS also differs from chronic abdominal pain associated with entities such as chronic pancreatitis or chronic inflammatory bowel disease, in which the pain is associated with peripherally acting factors (eg, gut inflammation or injury). Given the central contribution to the pain experience, concomitant psychosocial disturbances are common and strongly influence the clinical expression of FAPS, which also by definition is associated with loss of daily functioning. These factors make it critical to use a biopsychosocial construct to understand and manage FAPS, because gut-directed treatments are usually not successful in managing this condition.
Full Text Available ... as ulcerative colitis or Crohn's disease , pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and ... abdominal conditions in babies, such as vomiting or blood in stool. For some conditions, including but not limited to some liver, kidney, pancreatic, uterine or ... Content Some imaging tests and treatments have special pediatric considerations. The teddy ...
... as liposuction , which is another way to remove fat. But, abdominal wall surgery is sometimes combined with liposuction. ... from the middle and lower sections of your abdomen to make it firmer ... removes excess fat and skin (love handles) from the sides of ...
Full Text Available ... an experienced radiologist can diagnose many causes of abdominal pain or injury from trauma with very high accuracy, ... Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes ... Ultrasound - Abdomen X-ray (Radiography) - Lower GI Tract X-ray ( ...
... AAAs don’t cause symptoms unless they leak, tear, or rupture. If this happens, you may experience: sudden pain in your abdomen, groin, back, legs, or buttocks nausea and vomiting abnormal stiffness in your abdominal muscles problems with urination or bowel movements clammy, sweaty ...
Murphy, Kevin P
Educational Objectives and Key Points. 1. Given that abdominal hernias are a frequent imaging finding, radiologists not only are required to interpret the appearances of abdominal hernias but also should be comfortable with identifying associated complications and postrepair findings. 2. CT is the imaging modality of choice for the assessment of a known adult abdominal hernia in both elective and acute circumstances because of rapid acquisition, capability of multiplanar reconstruction, good spatial resolution, and anatomic depiction with excellent sensitivity for most complications. 3. Ultrasound is useful for adult groin assessment and is the imaging modality of choice for pediatric abdominal wall hernia assessment, whereas MRI is beneficial when there is reasonable concern that a patient\\'s symptoms could be attributable to a hernia or a musculoskeletal source. 4. Fluoroscopic herniography is a sensitive radiologic investigation for patients with groin pain in whom a hernia is suspected but in whom a hernia cannot be identified at physical examination. 5. The diagnosis of an internal hernia not only is a challenging clinical diagnosis but also can be difficult to diagnose with imaging: Closed-loop small-bowel obstruction and abnormally located bowel loops relative to normally located small bowel or colon should prompt assessment for an internal hernia.
Vazquez, V.; Florencio, I.; Boluda, F.
We present a case of giant abdominal cystic lymphangioma in a 10-year-old boy. Despite numerous consultations with physicians to identify the underlying problem, it had originally been attributed to ascites of unknown cause. We review the characteristics of this lesion and the diagnostic features that aid in differentiating it from ascites
Alvarez, M.; Carriquiry, L.
Endometriosis of abdominal wall is a rare entity wi ch frequently appears after gynecological surgery. Case history includes three cases of parietal endometriosis wi ch were treated in Maciel Hospital of Montevideo. The report refers to etiological diagnostic aspects and highlights the importance of total resection in order to achieve definitive healing
Full Text Available ... particularly valuable for evaluating abdominal, pelvic or scrotal pain in children. Preparation will depend on the type ... help a physician determine the source of abdominal pain, such as gallstones, kidney stones, abscesses or an ...
Beaupert, Fleur; Carney, Terry; Chiarella, Mary; Satchell, Claudette; Walton, Merrilyn; Bennett, Belinda; Kelly, Patrick
The purpose of this paper is to explore approaches to the regulation of healthcare complaints and disciplinary processes. A literature review was conducted across Medline, Sociological Abstracts, Web of Science, Google Scholar and the health, law and social sciences collections of Informit, using terms tapping both the complaints process and regulation generally. A total of 118 papers dealing with regulation of health complaints or disciplinary proceedings were located. The review reveals a shift away from self-regulation towards greater external oversight, including innovative regulatory approaches including "networked governance and flexible or "responsive" regulation. It reports growing interest in adoption of strategic and responsive approaches to health complaints governance, by rejecting traditional legal forms in favor of more strategic and responsive forms, taking account of the complexity of adverse health events by tailoring responses to individual circumstances of complainants and their local environments. The challenge of how to collect and harness complaints data to improve the quality of healthcare at a systemic level warrants further research. Scope also exists for researching health complaints commissions and other "meta-regulatory" bodies to explore how to make these processes fairer and better able to meet the complex needs of complainants, health professionals, health services and society.
Malik, Rahat; Ghafoor, Tariq; Sarfraz, Muhammad; Hasan, Najmul
To study the frequency of subclinical hepatitis 'A' in children having non-specific abdominal symptoms. A descriptive study. This study was conducted at Combined Military Hospital (CMH), Peshawar from June to December 2000. Three hundred and sixty children of either gender, hepatitis. Eighty eight (24.4%) children meeting the inclusion criteria of elevated serum alanine aminotransferase (ALT), twice the upper limits of normal (90 IU/L), and normal serum bilirubin were labelled as subclinical hepatitis. A total of 360 children were evaluated for vague abdominal symptoms and 96 (26.7%) of them had hepatitis on laboratory profile. Eight patients developed early jaundice and were excluded from the study. Out of 88 (24.4%) cases of subclinical hepatitis, 82 (93.2%) had hepatitis-A, 03 (3.4%) had hepatitis-B, while no causative agent was found in 03 (3.4%) children. The common presenting symptoms were abdominal pain/discomfort, loss of appetite, nausea, vomiting, malaise, fatigue and fever. Hepatomegaly and splenomegaly was documented in 56% and 43% cases respectively. A history of exposure to a patient with hepatitis was present in 14/88 (15.9%) cases whereas no child was vaccinated against HAV. Serum ALT level declined to normal limits within 4 weeks for 77/88 (87.5%) cases and within 6 weeks for 84/88 (95.4%). All cases recovered spontaneously with out any complication. Hepatitis-A was rampant in children presenting with vague abdominal symptoms in our series.
S, Birkeland; RD, Christensen; N, Damsbo
The risk of being disciplined in connection with a complaint case causes distress to most general practitioners. The present study examined the characteristics of complaint cases resulting in disciplinary action.......The risk of being disciplined in connection with a complaint case causes distress to most general practitioners. The present study examined the characteristics of complaint cases resulting in disciplinary action....
Zambon, Fabiana; Moreti, Felipe; Behlau, Mara
To understand the coping strategies used by teachers with vocal complaints, compare the differences between those who seek and those who do not seek voice therapy, and investigate the relationships among coping and voice perceptual analysis, coping and signs and symptoms of voice, and coping and participation restrictions and limitations in vocal activities. Cross-sectional nonrandomized prospective study with control group. Ninety female teachers participated in the study, of similar ages, divided into three groups: group 1 (G1) comprised 30 teachers with vocal complaints who sought voice therapy, group 2 (G2) comprised 30 teachers with vocal complaints who never sought voice therapy, and group 3 (G3) comprised 30 teachers without vocal complaints. The following analysis were conducted: identification and characterization questionnaire, addressing personal and occupational description, recording speech material for voice perceptual analysis, Voice Signs and Symptoms Questionnaire, Voice Activity and Participation Profile (VAPP), and Voice Disability Coping Questionnaire (VDCQ)-Brazilian Version. In relation to the voice perceptual analysis, there was statistically significant difference between the groups with vocal complaint (G1+G2), which had showed voices with mild-to-moderate deviation, and the group without vocal complaint (G1), which showed voices within the normal variability of voice quality (mean for G1 = 49.9, G2 = 43.7, and G3 = 32.3, P Teachers with vocal complaints who looked for voice therapy use more coping strategies. Moreover, they present a tendency to use more problem-focused coping strategies. Voice symptoms prompt the teachers into seeking treatment; however, they are not correlated with the coping itself. In general, the higher the perception of limitation and restriction of participating in vocal activities, the greater the use of coping strategies. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.
... authorities within the Department to ensure that neither the disciplinary process nor criminal prosecutions... Professional Conduct for Practitioners-Rules and Procedures § 1003.104 Filing of complaints; preliminary... Immigration Courts shall be filed with the EOIR disciplinary counsel. Disciplinary complaints must be...
Full Text Available Abdominal elephantiasis is a rare entity. Abdominal elephantiasis is an uncommon, but deformative and progressive cutaneous disease caused by chronic lymphedema and recurrent streptococcal or Staphylococcus infections of the abdominal wall. We present 3 cases of patients with morbid obesity who presented to our hospital with abdominal wall swelling, thickening, erythema, and pain. The abdominal wall and legs were edematous, with cobblestone-like, thickened, hyperpigmented, and fissured plaques on the abdomen. Two patients had localised areas of skin erythema, tenderness, and increased warmth. There was purulent drainage from the abdominal wall in one patient. They were managed with antibiotics with some initial improvement. Meticulous skin care and local keratolytic treatment for the lesions were initiated with limited success due to their late presentation. All three patients refused surgical therapy. Conclusion. Early diagnosis is important for the treatment of abdominal elephantiasis and prevention of complications.
Noe, Joshua D; Li, B U K
Recurrent abdominal pain is a common chronic complaint that presents to your office. The constant challenge is one of detecting those with organic disease from the majority who have a functional pain disorder including functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and abdominal migraine. Beginning with a detailed history and physical exam, you can: 1) apply the symptom-based Rome III criteria to positively identify a functional disorder, and 2) filter these findings through the diagnostic clues and red flags that point toward specific organic disease and/or further testing. Once a functional diagnosis has been made or an organic disease is suspected, you can initiate a self-limited empiric therapeutic trial. With this diagnostic approach, you should feel confident navigating through the initial evaluation, management, and consultation referral for a child or adolescent with recurrent abdominal pain.
Vanaja Ratnakumari Billa
Full Text Available BACKGROUND In the recent times there has been increased incidence of abdominal trauma cases due to several causes. Quick and prompt intervention is needed to decrease the mortality of the patients. So we conducted a study to assess the cause and the management of abdominal trauma cases in our institution. The aim of this study was to know the incidence of blunt and penetrating injuries and their causes, age and sex incidence, importance of various investigations, mode of treatment offered and post-operative complications. To study the cause of death and evolve better management. MATERIALS AND METHODS The present study comprises of patients admitted to and operated in various surgical units in the Department of Surgery at Government General Hospital, attached to Guntur Medical College Guntur, from August 2014 to October 2016. RESULTS Increase incidence seen in age group 20-29 years (30%. Male predominance 77.5%. Mechanism of injury–road traffic accidents 65%. Isolated organ injury–colon and rectum 40%. Other associated injuries–chest injuries with rib fractures 7.5%. Complications–wound infection 17.5%. Duration of hospital stay 8–14 days. Bowel injury management–closure of perforation 84.6%. Resection anastomosis 15.38%. CONCLUSION Thorough clinical examination, diagnostic paracentesis, plain X-ray erect abdomen and ultrasound proved to be very helpful in the diagnosis of intra-abdominal injuries. Spleen is the commonest organ involved in blunt trauma and colon is the commonly injured organ in penetrating abdominal trauma, many patients have associated extremity and axial skeleton injuries. With advances in diagnosis and intensive care technologies, most patients of solid visceral injuries with hemodynamic stability can be managed conservatively. Surgical site infection is the most common complication following surgery. The mortality is high; reason might be patient reaching the hospital late, high incidence of postoperative septic
Endo, Satoshi; Yamada, Kenji; Ito, Masatoshi; Ito, Hisao; Yamaura, Harutsugu
CT findings in 33 patients who had an abdominal tumor were evaluated. CT revealed a tumor in 31 cases. The organ from which the tumor originated was correctly diagnosed in 18 patients. Whether the tumor was solid or cystic was correctly predicted in 28 patients. The diagnosis malignant or benign nature of tumor was correct, incorrect and impossible, in 23, 3, and five patiens, respectively. (Kondo, M.)
Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B
Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management. Copyright © 2015. Published by Elsevier Masson SAS.
A. F. Potapov
Full Text Available Objective. To comparatively analyze the efficiency of methods for extracorporeal detoxification (ED of the body in abdominal sepsis (AS and to choose the optimum detoxifying methods in relation to the level of endotoxicosis.Material and methods. 56 patients (41 males and 15 females; mean age 39.4±12.2 years with surgical abdominal infection of various genesis, complicated by the development of sepsis whose treatment included ED methods, were examined. The level of intoxication and the efficiency of detoxification were evaluated by general clinical and biochemical blood parameters, the leukocytic intoxication index, the levels of low and medium molecular-weight substances in the body’s media. Hemosorption, plasmapheresis, hemodialysis, hemodiafiltration, and hemofiltration were used for detoxification.Results. Surgical abdominal infection is accompanied by endotoxemia that has no clear nosological specificity, but it depends on the pattern of a clinical course of the disease and is most pronounced in the septic syndrome. In AS, 80.4% of the patients are observed to have an irreversible decompensation phase and a terminal degree of endotoxicosis, which require detoxification. The use of different ED methods according to the level of intoxication may reduce the level of endotoxicosis and yield a persistent beneficial effect in 85.2% of cases of its application. Conclusion. Filtration and dialysis techniques (hemodialysis, hemofiltration, and hemodiafiltration are the methods of choice in AS. Hemosorption and plasmapheresis may be recommended for use at the early stages of endotoxicosis development and in preserved renal excretory function.
Yeom, Suk Keu, E-mail: firstname.lastname@example.org [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Hye Jin, E-mail: email@example.com [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Byun, Jae Ho, E-mail: firstname.lastname@example.org [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Ah Young, E-mail: email@example.com [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Lee, Moon-Gyu, E-mail: firstname.lastname@example.org [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Ha, Hyun Kwon, E-mail: email@example.com [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of)
Objective: In order to retrospectively evaluate the CT findings of abdominal aspergillosis in immunocompromised patients. Materials and methods: CT scans were reviewed with regard to the sites, number, morphologic appearance, attenuation, and the contrast enhancement patterns of the lesions in six patients (5 women, 1 man; mean age, 43.4 years; range, 23-59 years) with pathologically proved abdominal aspergillosis by two gastrointestinal radiologists in consensus. Medical records were also reviewed to determine each patient's clinical status and outcome. Results: All patients were immunocompromised state: 4 patients received immunosuppressive therapy for solid organ transplantation and 2 patients received chemotherapy for acute myeloid leukemia. Aspergillosis involved blood vessels (n = 3), liver (n = 2), spleen (n = 2), gastrointestinal tract (n = 2), native kidney (n = 1), transplanted kidney (n = 1), peritoneum (n = 1), and retroperitoneum (n = 1). CT demonstrated solid organ or bowel infarction or perforation secondary to vascular thrombosis or pseudoaneurysm, multiple low-attenuating lesions of solid organs presenting as abscesses, concentric bowel wall thickening mimicking typhlitis, or diffuse or nodular infiltration of the peritoneum and retroperitoneum. Conclusion: Familiarity with findings commonly presenting as angioinvasive features or abscesses on CT, may facilitate the diagnosis of rare and fatal abdominal aspergillosis.
Pires, Carolina; Silva, Dina; Maroco, João; Ginó, Sandra; Mendes, Tiago; Schmand, Ben A.; Guerreiro, Manuela; de Mendonça, Alexandre
Diagnosis of mild cognitive impairment relies on the presence of memory complaints. However, memory complaints are very frequent in healthy people. The objective of this study was to determine the severity and type of memory difficulties presented by elderly patients who seek for clinical help, as compared to the memory difficulties reported by subjects in the community. Assessment of subjective memory complaints was done with the subjective memory complaints scale (SMC). The mini-mental state examination was used for general cognitive evaluation and the geriatric depression scale for the assessment of depressive symptoms. Eight-hundred and seventy-one nondemented subjects older than 50 years were included. Participants in the clinical setting had a higher total SMC score (10.3 ± 4.2) than those in the community (5.1 ± 3.0). Item 3 of the SMC, Do you ever forget names of family members or friends? contributed significantly more to the variance of the total SMC score in the clinical sample (18%) as compared to the community sample (11%). Forgetting names of family members or friends plays an important role in subjective memory complaints in the clinical setting. This symptom is possibly perceived as particularly worrisome and likely drives people to seek for clinical help. PMID:22536537
Paul, J A; van Dijk, F J; Frings-Dresen, M H
Many pregnant women have musculoskeletal complaints, the onset and aggravation of which are thought to be associated with their activity or work postures. The purpose of this paper was to obtain more insight into the influence of pregnancy on the load of the musculoskeletal system at work to provide a better basis for preventing complaints. To this end, literature pertinent to a model called "work load of the musculoskeletal system" was reviewed. The model was developed to describe how work contributes to musculoskeletal complaints. It was found that pregnancy causes changes in a worker's characteristics. These changes can lead to changes in the work situation, activity pattern, and postural characteristics and possibly result in a change in work load. In addition, physical changes such as weight gain increase the work load in a given posture. The load-bearing capacity of the musculoskeletal system decreases due to pregnancy. The changes in load and the decrease in load-bearing capacity singly or simultaneously increase the risk of musculoskeletal complaints. The multifactorial cause of musculoskeletal complaints during pregnancy reveals various possibilities for prevention.
Full Text Available A supplier selection process mainly involves evaluation of different alternative suppliers based on different criteria. This process can be handled as a combination of the customer needs and the technical requirements. Also customers can be considered as the companies to purchase the suppliers’ technical expertise. Hence, this kind of relationship can be analyzed as a house of quality model typical of quality function deployment (QFD. This paper develops a supplier evaluation approach based on the analytic network process (ANP, QFD, and the technique for order performance by similarity to ideal solution (TOPSIS methods to help an investment bank in Turkey as a real world application. Fuzzy logic is used to capture the vagueness in people’s verbal assessments. In the first phase, matrices used to define the importance of the supplier selection criteria and the technical requirements are calculated with the fuzzy ANP method. The technical requirements and the criteria are combined in the house of quality to evaluate the relationship between them. In the second phase, fuzzy TOPSIS is used to rank the suppliers based on the weighted criteria obtained from the first phase. The study was followed by the sensitivity analysis of the results.
Caperell, Kerry; Pitetti, Raymond; Cross, Keith P
To investigate the demographic and clinical factors of children who present to the pediatric emergency department (ED) with abdominal pain and their outcomes. A review of the electronic medical record of patients 1 to 18 years old, who presented to the Children's Hospital of Pittsburgh ED with a complaint of abdominal pain over the course of 2 years, was conducted. Demographic and clinical characteristics, as well as visit outcomes, were reviewed. Subjects were grouped by age, race, and gender. Results of evaluation, treatment, and clinical outcomes were compared between groups by using multivariate analysis and recursive partitioning. There were 9424 patient visits during the study period that met inclusion and exclusion criteria. Female gender comprised 61% of African American children compared with 52% of white children. Insurance was characterized as private for 75% of white and 37% of African American children. A diagnosis of appendicitis was present in 1.9% of African American children and 5.1% of white children. Older children were more likely to be admitted and have an operation associated with their ED visit. Appendicitis was uncommon in younger children. Constipation was commonly diagnosed. Multivariate analysis by diagnosis as well as recursive partitioning analysis did not reflect any racial differences in evaluation, treatment, or outcome. Constipation is the most common diagnosis in children presenting with abdominal pain. Our data demonstrate that no racial differences exist in the evaluation, treatment, and disposition of children with abdominal pain.
This article argues that Blur Building, Diller & Scofidio's architectural project for the Swiss Expo 2002, demonstrated performatively and interactively how contemporary worldmaking involves cultural and technological invention and construction both, implying our cultural co-evolution with ubiqui......This article argues that Blur Building, Diller & Scofidio's architectural project for the Swiss Expo 2002, demonstrated performatively and interactively how contemporary worldmaking involves cultural and technological invention and construction both, implying our cultural co......-evolution with ubiquitous computing and media such that "worlding" must today be approached and approximated as a question of realities that mix virtuality and actuality. This article not only touches upon the actual inventions produced in this project--with its atmospheric architecture of tensegrity structures, its vast...
An abdominal tuberculosis case mimicking an abdominal mass. Derya Erdog˘ an a. , Yasemin Ta ¸scı Yıldız b. , Esin Cengiz Bodurog˘lu c and Naciye Go¨nu¨l Tanır d. Abdominal tuberculosis is rare in childhood. It may be difficult to diagnose as it mimics various disorders. We present a 12-year-old child with an unusual ...
T. A. Olajide
Full Text Available Choristoma is development of a normal tissue in an aberrant location. This report describes jejunal salivary choristoma (JSC causing recurring episodes of abdominal discomfort in a 5-year-old girl. Exploratory laporatomy revealed a pale yellow subserosal jejunal lesion. Wedge resection of the lesion and repair of the bowel were performed. The child did well postoperatively and has since that time been free of pain at follow-up. Histopathological examination of the resected lesion revealed salivary gland choriostoma. Literature review (PUBMED search engine revealed no previous report of this rare clinicopathologic entity. We conclude that choriostoma should be considered a possible differential when evaluating abdominal complaint in children.
Oxler, K F
Patients demand to be active participants on and partners with the health care team to design their care regimen. Patients bring unique perceptions and expectations and use these to evaluate service quality and satisfaction. If customer satisfaction is not achieved and a patient complaint results, staff must have the skills to respond and launch a service recovery program. Service recovery, when done with style and panache, can retain loyal customers. Achieving patient satisfaction and resolving patient complaints require commitment from top leadership and commitment from providers to dedicate the time to understand their patients' needs.
Juhl, Hans Jørn; Poulsen, Carsten Stig; Thøgersen, John
The purpose of this paper is twofold. Firstly we present in a non-technical form some of the measurement problems involved in interpreting consumer complaint data and secondly we provide some empirical results based upon a complaint study carried out in Denmark in 2002. Several measurement models...... are developed, ranging from the Rasch model via latent structure analysis with several correlated latent variables to suggestions about a comprehensive framework, combining Fishbein-Ajzen's Theory of Planned Behaviour and latent trait models. The empirical results show that the propensity to complain in Denmark...
Full Text Available Aim of the present study was to document ethnomedicinal plants used against gastrointestinal complaints in five selected remote regions of Pakistan and to select potential medicinal plants for further in vitro and in vivo investigation. Data on ethnomedicinal plants and ethnographic profile of respondents was documented using semistructured questionnaires. The present study revealed utilization of 52 medicinal plants for the treatment of different gastrointestinal infections in studied regions. Apiaceae was the most dominant family reported to be used for the treatment of these infections (4 plants. Among all the plant parts fruit (24%, whole plants and leaves (23% each were the most preferred plant parts used by the healers. Dosage of recipe was found to be related with the age of the patient. Highest degree of informant consensus was reported for vomiting, nausea (0.92 each, abdominal pain (0.9, and diarrhea (0.89. Withania coagulans scored highest FL value (86% followed by Mentha longifolia and Melia azadirachta ranked second with FL value (75% each. Young generation was found to possess little traditional knowledge about utilizing plant recipes against these infections. Plants with high Fic and FL values should be subjected for further phytochemical and pharmacological investigation for scientific validation.
Full Text Available Abstract Complaint (as a type of Gravamen is one of the sub-genres of lyrical literature in which the poet or the writer expresses his/her personal feelings that are mostly used to express the emotions, the woes or complaints of the environment, the friends and society and mostly it depicts the frustration, despair and deprivation of the suffered, sensitive poet. This type of poetry, more or less, regular or sporadic, is reflected in the poetry of the past poets of Iran in the form of “HasbiyyehSorayi” as type of Complaint. According to the researchers, Complaintcan be divided into five kinds: philosophical, mystical, personal, social and political. In Social Complaint, Shahriyar posits himself against the social ills such as corruption, degradation, illiteracy positions, expressing his criticism in the form of woes and poems. A part of Shahriyar’s complaining and criticizing is about the incorrect attitude of the cosmopolitan residents of the capital city of Tehran against the townspeople, disclosing the defects and shortcomings of the environment and the city of Tehran through various methods. In the political Complaints, the poet examines the failures and the frustrations caused by the Constitutional Revolution, the repressive dictatorship and his hated and antipathy from the political actions of that time. Of course, due to the interconnectedness of social and political issues, this of issue of Bath Ashshekva is interwoven with the poet’s poem. The personal Complaint incorporates the poet’s illness and aging that is derived from the poet’s natural passage of his life. The poet’s enormous spiritual and psychological sufferings are caused by his frustration in the abortive love affair that shows itself in the form of the lover’s complains of love, life, fortunate, old and young ages. We can call these types of grievances as unparalleled. They can make Shahriyar frustrated with love and alienation. In his mystical grievances
Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain.
Børglum, Jens; Gögenür, Ismail; Bendtsen, Thomas F
been introduced with success. Future research should also investigate the effect of specific abdominal wall blocks on neuroendocrine and inflammatory stress response after surgery. Summary USG abdominal wall blocks in adults are commonplace techniques today. Most abdominal wall blocks are assigned......Purpose of review Abdominal wall blocks in adults have evolved much during the last decade; that is, particularly with the introduction of ultrasound-guided (USG) blocks. This review highlights recent advances of block techniques within this field and proposes directions for future research....... Recent findings Ultrasound guidance is now considered the golden standard for abdominal wall blocks in adults, even though some landmark-based blocks are still being investigated. The efficiency of USG transversus abdominis plane blocks in relation to many surgical procedures involving the abdominal wall...
Risby, Kirsten; Jakobsen, Marianne Skytte; Qvist, Niels
related complications; and post-discharge gastrointestinal surgery. RESULTS: GDM was placed in 34 (gastroschisis=27, omphalocele=7) patients during the study period. Complete closure of the fascia was obtained in one patient with omphalocele and in 22 patients with gastroschisis. Mesh related surgical...... complications were seen in five (15%) children: four had detachment of the mesh and one patient developed abdominal compartment syndrome. Mesh related clinical infection was observed in five children. In hospital mortality occurred in four cases (2 gastroschisis and 2 omphalocele) and was not procedure...
Frick, M.P.; Feinberg, S.B.
This nine-chapter book gives an overview of the integrated approach to abdominal imaging. Chapter 1 provides an introduction to the physics used in medical imaging; chapter 2 is on the selection of imaging modalities. These are followed by four chapters that deal, respectively, with plain radiography, computed tomographic scanning, sonography, and nuclear imaging, as applied to the abdomen. Two chapters then cover contrast material-enhanced studies of the gastrointestinal (GI) tract: one focusing on technical considerations; the other, on radiologic study of disease processes. The final chapter is a brief account of different interventional procedures
Lech, Christie; Swaminathan, Anand
This article discusses abdominal aortic emergencies. There is a common thread of risk factors and causes of these diseases, including age, male gender, hypertension, dyslipidemia, and connective tissue disorders. The most common presenting symptom of these disorders is pain, usually in the chest, flank, abdomen, or back. Computed tomography scan is the gold standard for diagnosis of pathologic conditions of the aorta in the hemodynamically stable patient. Treatment consists of a combination of blood pressure and heart rate control and, in many cases, emergent surgical intervention. Copyright © 2017 Elsevier Inc. All rights reserved.
van Assen, Tijmen; de Jager-Kievit, Jenneke W A J; Scheltinga, Marc R; Roumen, Rudi M H
The abdominal wall is often neglected as a cause of chronic abdominal pain. The aim of this study was to identify chronic abdominal wall pain syndromes, such as anterior cutaneous nerve entrapment syndrome (ACNES), in a patient population diagnosed with functional abdominal pain, including irritable bowel syndrome, using a validated 18-item questionnaire as an identification tool. In this cross-sectional analysis, 4 Dutch primary care practices employing physicians who were unaware of the existence of ACNES were selected. A total of 535 patients ≥18 years old who were registered with a functional abdominal pain diagnosis were approached when they were symptomatic to complete the questionnaire (maximum 18 points). Responders who scored at least the 10-point cutoff value (sensitivity, 0.94; specificity, 0.92) underwent a diagnostic evaluation to establish their final diagnosis. The main outcome was the presence and prevalence of ACNES in a group of symptomatic patients diagnosed with functional abdominal pain. Of 535 patients, 304 (57%) responded; 167 subjects (31%) recently reporting symptoms completed the questionnaire. Of 23 patients who scored above the 10-point cutoff value, 18 were available for a diagnostic evaluation. In half of these subjects (n = 9) functional abdominal pain (including IBS) was confirmed. However, the other 9 patients were suffering from abdominal wall pain syndrome, 6 of whom were diagnosed with ACNES (3.6% prevalence rate of symptomatic subjects; 95% confidence interval, 1.7-7.6), whereas the remaining 3 harbored a painful lipoma, an abdominal herniation, and a painful scar. A clinically relevant portion of patients previously diagnosed with functional abdominal pain syndrome in a primary care environment suffers from an abdominal wall pain syndrome such as ACNES.
Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) abdominal ultrasound imaging produces pictures ...
Full Text Available "Peritonitis fibrosa incapsulata", first described in 1907, is a condition characterized by encasement of the bowel with a thick fibrous membrane. This condition was renamed as "abdominal cocoon" in 1978. It presents as small bowel obstruction clinically. 35 cases of abdominal cocoon have been reported in the literature over the last three decades. Abdominal cocoon is more common in adolescent girls from tropical countries. Various etiologies have been described, including tubercular. It is treated surgically by releasing the entrapped bowel. We report a laparoscopic experience of tubercular abdominal cocoon and review the literature.
... Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) RULES OF PRACTICE IN ENFORCEMENT PROCEEDINGS UNDER SECTION 41 OF THE LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT Prehearing Procedures § 1921.3 Complaints. (a) Issuance. The Deputy Solicitor of Labor shall...
... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Individual complaints. 268.105 Section 268.105... RULES REGARDING EQUAL OPPORTUNITY Board Program To Promote Equal Opportunity § 268.105 Individual... individual and the Board and to describe generally the action(s) or practice(s) that form the basis of the...
... 29 Labor 4 2010-07-01 2010-07-01 false Individual complaints. 1614.106 Section 1614.106 Labor... EMPLOYMENT OPPORTUNITY Agency Program To Promote Equal Employment Opportunity § 1614.106 Individual... individual and the agency and to describe generally the action(s) or practice(s) that form the basis of the...
Paul, J. A.; van Dijk, F. J.; Frings-Dresen, M. H.
Many pregnant women have musculoskeletal complaints, the onset and aggravation of which are thought to be associated with their activity or work postures. The purpose of this paper was to obtain more insight into the influence of pregnancy on the load of the musculoskeletal system at work to provide
DEBLECOURT, ACE; KNIPPING, AA; DEVOOGD, N; VANRIJSWIJK, MH
Patients with musculoskeletal disorders, including fibromyalgia syndrome (FS), often state that weather conditions modulate their complaints. There have been a few studies concerning this issue, but the results appear to be contradictory. We tried to relate the subjective symptoms of pain,
J.J. Luime (Jolanda)
textabstractShoulder complaints are expressed in a variety of symptoms. In many cases, the prominent symptom is pain. In some cases, pain is present most of the day and frequently also at night. In other cases, it is provoked primarily by physical activities. Often it is accompanied
advice offices exist to guide complainants and the Danish Ombudsman claimed the duty to also provide interpreter assistance yet with no obligation to generally offer foreigner complaint information. Currently only little homepage information is available in English. More research is needed on complainant...
Vaessen, T.J.A.; Overeem, S.; Sitskoorn, M.M.
Obstructive sleep apnea (OSA) is associated with impairments in cognitive functioning. Although cognitive complaints are related to quality of life, work productivity and health care expenditures, most research and all reviews have focused exclusively on objective cognitive functioning so far. In
DEBLECOURT, ACE; KNIPPING, AA; DEVOOGD, N; VANRIJSWIJK, MH
Patients with musculoskeletal disorders, including fibromyalgia syndrome (FS), often state that weather conditions modulate their complaints. There have been a few studies concerning this issue, but the results appear to be contradictory. We tried to relate the subjective symptoms of pain,
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Complaint procedures. 22.1406 Section 22.1406 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITIONS Employment of Workers with...
... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Complaint procedures. 422.1406 Section 422.1406 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE SOCIOECONOMIC PROGRAMS APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITIONS Employment of Workers With Disabilities 422...
....gov or from the Office of the Secretary. SUPPLEMENTARY INFORMATION: The text of the Complaint appears... the harness secured but with her head tilted back and her neck hyperextended. Her face was pressed... Generation Two model, increased the font size of the warning, and changed the text of the warning label to...
... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL CIVIL MONEY PENALTIES... all administrative civil money penalty actions by serving on the respondent(s) a complaint signed by... Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061...
Marincek, B. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)
Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)
Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)
Full Text Available Introduction: histamine intolerance (HI is a poorly described disease in gastroenterology that may present with predominant digestive complaints. The goals of this study include a report of two cases diagnosed in a pediatric gastroenterology clinic. Material and methods: observational, retrospective study of patients diagnosed with HI from September 2010 to December 2011 at the pediatric gastroenterology clinic of a tertiary hospital. They were deemed to have a diagnosis of HI in the presence of 2 or more characteristic digestive complaints, decreased diamino oxidase (DAO levels and/or response to a low histamine diet with negative IgE-mediated food allergy tests. Results: sixteen patients were diagnosed. Males predominated versus females (11/5. Mean age at symptom onset was 4 years (6 months vs. 13 years and 6 months and mean age at diagnosis was 6 years and 6 months (17 months vs. 13 years and 11 months, with an interval of 2 years and 1 month between symptom onset and diagnosis (5 months vs. 4 years. Predominant symptoms included diffuse abdominal pain (16/16, intermittent diarrhea (10/16, headache (5/16, intermittent vomiting (4/16, and skin rash (2/16. The diagnosis was established by measuring plasma diamino oxidase levels, which were below 10 kU/L (normal > 10 kU/L in 14 cases, and symptom clearance on initiating a low histamine diet. In two patients DAO levels were above 10 kU/L but responded to diet. Treatment was based on a diet low in histamine-contaning food, and antihistamines H1 y H2 had to be added for two cases. Conclusions: histamine intolerance is a little known disease with a potentially relevant incidence. Predominant complaints include diffuse abdominal pain, diarrhea, headache, and chronic intermittent vomiting. Its diagnosis is based on clinical suspicion, plasma DAO measurement, and response to a low histamine diet. Management with the latter provides immediate improvement.
Cecilia U D Stenfors
Full Text Available BACKGROUND: Cognitive complaints involving problems with concentration, memory, decision-making and thinking are relatively common in the work force. The sensitivity of both subjective and objective cognitive functioning to common psychiatric conditions, stress levels and to cognitive load makes it plausible that psychosocial working conditions play a role in cognitive complaints. Thus, this study aimed to test the associations between psychosocial work factors and cognitive complaints in nationally representative samples of the Swedish work force. Cross-sectional (n = 9751 and prospective (n = 3644; two time points two years apart sequential multiple regression analyses were run, adjusting for general confounders, depressive- and sleeping problems. Additional prospective analyses were run adjusting for baseline cognitive complaints. CROSS/SECTIONAL RESULTS: High quantitative demands, information and communication technology (ICT demands, under qualification and conflicts were positively associated with cognitive complaints, while social support, good resources at work and over qualification were negatively associated with cognitive complaints in all models. Skill discretion and decision authority were weakly associated with cognitive complaints. Conflicts were more strongly associated with cognitive complaints in women than in men, after adjustment for general confounders. PROSPECTIVE RESULTS: Quantitative job demands, ICT demands and under qualification were positively associated with future cognitive complaints in all models, including when adjusted for baseline cognitive complaints. Decision authority was weakly positively associated with future cognitive complaints, only after adjustment for depressive- and sleeping problems respectively. Social support was negatively associated with future cognitive complaints after adjustment for general confounders and baseline cognitive complaints. Skill discretion and resources were negatively
Shakya, K N; Dongol, U M S; Khadka, S B
Pain abdomen is a common pediatric complaint that brings patient to the hospital in Nepal. Knowledge about its etiology and frequency helps in its evaluation and management. The present study was undertaken to find out the causes and their frequency of pain abdomen in Nepali children. Children with pain abdomen presenting at the emergency room and pediatric outpatient department of Kathmandu Medical College, Kathmandu from January, 2006 to December 2007 were clinically evaluated and investigated to find out the causes and frequency of their pain abdomen. The outcomes were tabulated and analyzed for interpretation. Of 444 patients attended, 356 completed investigations and came for follow up. Cause of pain abdomen was apparent in 117 (32.9%) only. 91.5% were medical causes, comprising predominantly of diarrheal diseases (28.3%), infantile colic (9.4%), urinary tract infection (7.7%) and acid peptic disease (6.8%). 8.5% causes were related to surgical conditions, which needed operative management. Secondary or extra-abdominal causes were found in 20 cases (17.1%). Pneumonia (2), functional (5), vulvovaginitis (2) and infantile colic (11) were predominant causes. Our study showed that the causes of pain abdomen in children were predominantly medical. Gastroenteritis was the most frequent cause. Secondary causes, including functional and emotional causes were infrequent. Small percentage needing surgical management formed a diagnostic challenge.
complaints of vaginal bleeding with or without pains, history of amenorrhea or infertility ; clinical and ultrasound impressions of early pregnancy complaints including ectopic pregnancies and pelvic inflammatory diseases (PID) with exclusion of uro-genital and gastrointestinal complaints/ cases. Pregnancies greater than 12 ...
... complaints of vaginal bleeding, with or without pain, history of amenorrhea or infertility, clinical and ultrasound impression of early pregnancy complaints, including ectopic pregnancies and pelvic inflammatory diseases (PID), with exclusion of urogenital and gastrointestinal complaints/cases. Pregnancies greater than 12 ...
... Certain Credit Card Complaint Data AGENCY: Bureau of Consumer Financial Protection. ACTION: Notice of... Bureau plans to exercise its discretion to publicly disclose certain credit card complaint data that do not include personally identifiable information. The Bureau receives credit card complaints from...
... 25 Indians 1 2010-04-01 2010-04-01 false Customer complaint procedures. 141.59 Section 141.59... THE NAVAJO, HOPI AND ZUNI RESERVATIONS Enforcement Powers, Procedures and Remedies § 141.59 Customer complaint procedures. (a) Any customer of a licensee may file a complaint with the Commissioner alleging...
... local franchise authority may file rate complaints with the Commission within 180 days of the effective... that increase the local franchise authority receives more than one subscriber complaint concerning the increase. (b) Before filing a rate complaint with the Commission, the local franchise authority must first...
Office complaint redressal committee. CIRCULAR. In terms of the guidelines issued by DoPT vide its office memorandum dated 13.02.1998 an appropriate complaint mechanism should be created in every organization for redressal of the complaint in connection with sexual harassment of working women. Accordingly ...
Donawa, M E
The importance of customer complaints for providing valuable information on the use of medical devices is clearly reflected in United States (US) and European quality system requirements for handling complaints. However, there are significant differences in US and European complaint handling requirements. This article will discuss those differences and methods for ensuring compliance.
Joosten, A; Mazeland, H; Meyboom-de Jong, B
BACKGROUND: Dutch GPs are frequently consulted by patients presenting physical complaints which have a psychosocial cause. Until now, this type of complaint has often been the subject of study, but the way in which psychosocial explanations for complaints are broached and discussed has not yet been
... 6 Domestic Security 1 2010-01-01 2010-01-01 false Service of Complaint. 13.8 Section 13.8 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.8 Service of Complaint. (a) Service of a Complaint must be Made by certified or registered mail or by...
... AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Oversight Through Review of... resolution of complaints; (4) Generate reports designed to show possible patterns of complaints; and (5... will be accessible through the Department's website to persons who wish to file complaints. Such forms...
... 47 Telecommunication 4 2010-10-01 2010-10-01 false Rate change while complaint pending. 76.1606... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1606 Rate change while complaint pending. A regulated cable operator that proposes to change any rate while a cable service tier complaint is pending...
Bekri, Eleni; Yannopoulos, Panayotis; Disse, Markus
In the present study, a combined linear programming methodology, based on Li et al. (2010) and Bekri et al. (2012), is employed for optimizing water allocation under uncertain system conditions in the Alfeios River Basin, in Greece. The Alfeios River is a water resources system of great natural, ecological, social and economic importance for Western Greece, since it has the longest and highest flow rate watercourse in the Peloponnisos region. Moreover, the river basin was exposed in the last decades to a plethora of environmental stresses (e.g. hydrogeological alterations, intensively irrigated agriculture, surface and groundwater overexploitation and infrastructure developments), resulting in the degradation of its quantitative and qualitative characteristics. As in most Mediterranean countries, water resource management in Alfeios River Basin has been focused up to now on an essentially supply-driven approach. It is still characterized by a lack of effective operational strategies. Authority responsibility relationships are fragmented, and law enforcement and policy implementation are weak. The present regulated water allocation puzzle entails a mixture of hydropower generation, irrigation, drinking water supply and recreational activities. Under these conditions its water resources management is characterised by high uncertainty and by vague and imprecise data. The considered methodology has been developed in order to deal with uncertainties expressed as either probability distributions, or/and fuzzy boundary intervals, derived by associated α-cut levels. In this framework a set of deterministic submodels is studied through linear programming. The ad hoc water resources management and alternative management patterns in an Alfeios subbasin are analyzed and evaluated under various scenarios, using the above mentioned methodology, aiming to promote a sustainable and equitable water management. Li, Y.P., Huang, G.H. and S.L., Nie, (2010), Planning water resources
Lindholt, Jes S.
Although the number of elective operations for abdominal aortic aneurysms (AAA) is increasing, the sex- and age-standardised mortality rate of AAAs continues to rise, especially among men aged 65 years or more. The lethality of ruptured AAA continues to be 80-95%, compared with 5-7% by elective...... surgery of symptomfree AAA. In order to fulfil all WHO, European, and Danish criteria for screening, a randomised hospitalbased screening trial of 12,639 65-73 year old men in Viborg County (Denmark) was initiated in 1994. It seemed that US screening is a valid, suitable and acceptable method of screening...... patients without previous hospital discharge diagnoses due to cardiovascular disease than among similar men without AAA. The absolute risk difference after 5 years was 16%. So, they will benefit from general cardiovascular preventive action as smoking cessation, statins and low-dose aspirin, which could...
Alvarez, Romina J.; Villavicencio, Roberto L.; Oxilia, Hector G.
Purpose: As scarce information is available, in this research we have tried to describe the imaging findings of the Burkitt's lymphoma. Retrospective analysis of the clinical and imaging presentation of a 4 years old boy, is given. Biopsy confirmed the BL. Different imaging techniques were combined. The X-rays were negative. The US revealed a moderate hepatomegaly with multiple hypoechoic nodules and free fluid in the abdominal cavity. The CT showed the hepatomegaly as well as solid nodules in great number and different sizes(due to the densitometric behaviour and to post contrast enhancement), a scarce amount of ascites and a density increase of the mesentery fat. The MRI characterized and revealed in detail the US and the CT findings. The Burkitt's lymphoma is a rare entity; several methods are needed to approach the diagnosis. It represents a great clinical and imaging challenge. (author)
Clouse, Ray E; Mayer, Emeran A; Aziz, Qasim; Drossman, Douglas A; Dumitrascu, Dan L; Mönnikes, Hubert; Naliboff, Bruce D
Functional abdominal pain syndrome (FAPS) differs from the other functional bowel disorders; it is less common, symptoms largely are unrelated to food intake and defecation, and it has higher comorbidity with psychiatric disorders. The etiology and pathophysiology are incompletely understood. Because FAPS likely represents a heterogeneous group of disorders, peripheral neuropathic pain mechanisms, alterations in endogenous pain modulation systems, or both may be involved in any one patient. The diagnosis of FAPS is made on the basis of positive symptom criteria and a longstanding history of symptoms; in the absence of alarm symptoms, an extensive diagnostic evaluation is not required. Management is based on a therapeutic physician-patient relationship and empirical treatment algorithms using various classes of centrally acting drugs, including antidepressants and anticonvulsants. The choice, dose, and combination of drugs are influenced by psychiatric comorbidities. Psychological treatment options include psychotherapy, relaxation techniques, and hypnosis. Refractory FAPS patients may benefit from a multidisciplinary pain clinic approach.
Gefke, K; Schroeder, T V; Thisted, B
The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553...... patients, 51 (9%) of whom died within the first 48 hours. Of the 502 patients who survived for more than 48 hours, 109 required ICU therapy for more than 48 hours, whereas 393 patients were in the ICU for less than 48 hours. The incidence of preoperative risk factors was similar for the two groups...... combined failed to permit identification of patients in whom the perioperative survival rate was 0%. Even 20% of patients with multiorgan failure survived for 6 months. Of those patients who needed ICU therapy for more than 48 hours, 41 (38%) were alive at the end of 1988. In response to a questionnaire...
Nevein Mohammed Mohammed Gharib
Full Text Available Background: Obesity is a medical condition that may adversely affect wellbeing and leading to increased incidence of many health problems. Abdominal obesity tends to be associated with weight gain and obesity and it is significantly connected with different disorders like coronary heart disease and type II diabetes mellitus.This study was conducted to investigate the efficacy of vacuum therapy as compared to abdominal exercises on abdominal obesity in overweight and obese women. Methods: Thirtyoverweight and obese women participated in this study with body mass index > 25 kg/m2andwaist circumference ≥ 85 cm. Their ages ranged from 28 - 40 years old.The subjects were excluded if they have diabetes, abdominal infection diseases or any physical limitation restricting exercise ability. They were randomly allocated into two equal groups; group I and group II. Group I received vacuum therapy sessions (by the use of LPG device in addition to aerobic exercise training. Group II received abdominal exercises in addition to the same aerobic exercisesgiven to group I. This study was extended for successive 8 weeks (3 sessions/ week. All subjects were assessed for thickness ofnthe abdominal skin fold, waist circumference and body mass index. Results: The results of this study showeda significant difference between group I and group II post-interventionas regarding to the mean values of waist circumference and abdominal skin fold thickness (p<0.05. Conclusion: It can be concluded that aerobic exercises combined with vacuum therapy (for three sessions/week for successive 8 weeks have a positive effect on women with abdominal obesity in terms of reducing waist circumference and abdominal skin fold thickness.
Full Text Available The complaint about the protraction of proceedings (“contestaţia privind tergiversarea judecății” has the role of sanctioning the passivity of the court of law which does not use the means necessary for correcting irregular conduct, or even worse, it disregards the legal provisions requiring a certain conduct from the court itself. The complaint about the protraction of proceedings should not be seen as a possibility to sanction the judge empowered to solve the case. This appeal is actually a remedy provided by law, intended to correct those situations in which the court of law is causing undue delay to the cases, or even more, it doesn`t take the necessary measures for protecting the right to a fair trial within a reasonable and foreseeable time.
Hanna, Dominique; Cloutier, Richard; Lapointe, Roch; Desgagné, Antoine
Elephantiasis is a well-known condition in dermatology usually affecting the legs and external genitalia. It is characterized by chronic inflammation and obstruction of the lymphatic channels and by hypertrophy of the skin and subcutaneous tissues. The etiology is either idiopathic or caused by a variety of conditions such as chronic filarial disease, leprosy, leishmaniasis, and chronic recurrent cellulites. Elephantiasis of the abdominal wall is very rare. A complete review of the English and French literature showed only two cases reported in 1966 and 1973, respectively. We report a third case of abdominal elephantiasis and we briefly review this entity. We present the case of a 51-year-old woman who had progressively developed an enormous pediculated abdominal mass hanging down her knees. The skin was thickened, hyperpigmented, and fissured. She had a history of multiple abdominal cellulites. She underwent an abdominal lipectomy. Histopathology of the specimen confirmed the diagnosis of abdominal elephantiasis. Abdominal elephantiasis is a rare disease that represents end-stage failure of lymph drainage. Lipectomy should be considered in the management of this condition.
Bermejo, Isaac; Nicolaus, Leonhard; Kriston, Levente; Hölzel, Lars; Härter, Martin
To ensure an adequate health care of migrants, differentiated information on the association of cultural background and migration related factors and psychosomatic complaints are necessary. Cross-sectional questionnaire based survey regarding psychosomatic complaints of migrants from Turkey (n = 77), Italy (n = 95), and Spain (n = 67) and ethnic German resettled from the states of the former Soviet Union (n = 196). Questionnaires distributed by non-health specific counselling agencies of welfare associations. The cultural background was a relevant factor for psychosomatic complaints, showing higher complaints in Turkish and ethnic German resettled migrants, also compared to a sample of age corresponding Germans. In contrast, Spanish and Italian migrants showed a lower risk for psychosomatic complaints. Also gender, feeling unwell in Germany and fatalism showed a significant association with psychosomatic complaints. Migrants in Germany do not have per se a higher risk for psychosomatic complaints. A distinct differentiation by cultural background is necessary. © Georg Thieme Verlag KG Stuttgart · New York.
Ni Kadek Ariasih
Full Text Available STMIK STIKOM Indonesia is one of the institutions in the field of computer-based education. In order to support the effectiveness of the implementation of teaching and learning activities that take place, it is need a service that support the availability of adequate class facilities and complaints services if there are constraints on facilities in the classroom. So far, the management of complaints complaints against classroom facilities or in the labarotorium which is handled by the Household Management Section is still on manua basis. In terms of record and handle complaints it is required information system which called STIKI Class Facilities E-Complaint. This system can assist the Household Management Section in monitoring complaints from the condition of existing room facilities if experiencing problems and also can improve the quality of service in handling complaints. The software development process model used is prototype and Web-based model with PHP and MySQL database.
Hailu, Fekade Getachew; Yihunie, Getnet Tesfaye; Essa, Ahmed Amdihun; Tsega, Walelign Kindie
Abdominal pregnancy may account for up to 1.4% of all ectopic pregnancies. The incidence of abdominal pregnancy differs in various literatures and ranges between 1:10,000 pregnancies to 1:30, 000 pregnancies. The clinical symptoms of an uncomplicated abdominal pregnancy are unspecific. There are reports of maternal and fetal survival from advanced abdominal pregnancies. Our case was a 26 years old gravida 4, para 3 (2 alive, one early neonatal death) woman. She presented to Felegehiwot Referal Hospital with a principal complaint of vomiting, epigastric pain, headache, and blurring of vision. Emergency cesarean delivery was decided with the impression of bicornuate uterus with intrauterine pregnancy, intrauterine growth restriction and sever preeclampsia.it was found to be advanced abdominal pregnancy. Placenta was removed and pack was used to control bleeding. Both the mother and neonate were discharged in a good condition. Abdominal pregnancy with live fetus is an extremely rare condition and requires a high index of suspicion. Endometrial cavity may not be required for development of severe preeclampsia and packing is effective in controlling bleeding in selected cases.
Henneman, P L
The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed
Bower, Curtis; Roth, J Scott
The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias. Copyright © 2013 Elsevier Inc. All rights reserved.
Alwan, Riham; Drake, Meredith; Gurria Juarez, Juan; Emery, Kathleen H; Shaaban, Aimen F; Szabo, Sara; Sobolewski, Brad
A previously healthy 3-week-old boy presented with 5 hours of marked fussiness, abdominal distention, and poor feeding. He was afebrile and well perfused. His examination was remarkable for localized abdominal tenderness and distention. He was referred to the emergency department in which an abdominal radiograph revealed gaseous distention of the bowel with a paucity of gas in the pelvis. Complete blood cell count and urinalysis were unremarkable. His ongoing fussiness and abnormal physical examination prompted consultation with surgery and radiology. Our combined efforts ultimately established an unexpected diagnosis. Copyright © 2017 by the American Academy of Pediatrics.
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Service of complaint and other papers. 901.36... Termination of Enrollment § 901.36 Service of complaint and other papers. (a) Complaint. The complaint or a... papers other than complaint. Any paper other than the complaint may be served upon the respondent as...
Mortimer, Alice Emily
A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer. 2014 BMJ Publishing Group Ltd.
Full Text Available ... not use ionizing radiation, has no known harmful effects, and is particularly valuable for evaluating abdominal, pelvic or scrotal pain in children. Preparation will depend on the type of examination. ...
Full Text Available ... child's abdominal ultrasound examination. Doppler ultrasound , also called color Doppler ultrasonography, is a special ultrasound technique that ... and processes the sounds and creates graphs or color pictures that represent the flow of blood through ...
Full Text Available ... Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) ... uterus Abdominal ultrasound images can be used to help diagnose appendicitis in children. Except for traumatic injury, ...
Full Text Available ... children. Except for traumatic injury, appendicitis is the most common reason for emergency abdominal surgery. Ultrasound imaging ... of page How is the procedure performed? For most ultrasound exams, you will be positioned lying face- ...
Full Text Available ... of an apparent enlarged abdominal organ identify the location of abnormal fluid in the abdomen help determine ... places the transducer on the skin in various locations, sweeping over the area of interest or angling ...
Full Text Available ... arteries and veins in the abdomen, arms, legs, neck and/or brain (in infants and children) or ... help a physician determine the source of abdominal pain, such as gallstones, kidney stones, abscesses or an ...
Full Text Available ... for traumatic injury, appendicitis is the most common reason for emergency abdominal surgery. Ultrasound imaging can also: ... be necessary. Your doctor will explain the exact reason why another exam is requested. Sometimes a follow- ...
Full Text Available ... kidneys. top of page What are some common uses of the procedure? Abdominal ultrasound imaging is performed ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...
Full Text Available ... ultrasound images are captured in real-time, they can show the structure and movement of the body's ... kidneys bladder testicles ovaries uterus Abdominal ultrasound images can be used to help diagnose appendicitis in children. ...
Full Text Available ... apparent enlarged abdominal organ identify the location of abnormal fluid in the abdomen help determine causes of ... are used to extract sample cells from an abnormal area for laboratory testing. Ultrasound may also be ...
Full Text Available ... imaging produces pictures of the internal organs and blood vessels located within a child's abdomen. A Doppler ultrasound study may be part of a child's abdominal ultrasound ...
Full Text Available ... kidneys. top of page What are some common uses of the procedure? Abdominal ultrasound imaging is performed ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...
Schneider, G.; Ahlhelm, F.; Altmeyer, K.; Kramann, B.; Hennes, P.; Pueschel, W.; Karadiakos, N.
We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies. (orig.)
Full Text Available ... not use ionizing radiation, has no known harmful effects, and is particularly valuable for evaluating abdominal, pelvic ... of the reflected sound waves (called the Doppler effect). A computer collects and processes the sounds and ...
Pedro Enrique Miguel Soca
Full Text Available Considering as a start point the discussion of an article published by this same journal (Finlay in its previous issue, this letter deals with some alterations associating abdominal obesity and dyslipidemia.
Schneider, G.; Ahlhelm, F.; Altmeyer, K.; Kramann, B. [Dept. of Diagnostic Radiology, University Hospital, Homburg (Germany); Hennes, P. [Dept. of Pediatrics, University Hospital, Homburg (Germany); Pueschel, W. [Dept. of Pathology, University Hospital, Homburg (Germany); Karadiakos, N. [Dept. of Pediatric Surgery, University Hospital, Homburg (Germany)
We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies. (orig.)
Full Text Available ... various body organs such as the liver or kidneys. top of page What are some common uses ... appendix stomach/ pylorus liver gallbladder spleen pancreas intestines kidneys bladder testicles ovaries uterus Abdominal ultrasound images can ...
Jensen, Kristian Kiim
Incisional hernia is a common long-term complication to abdominal surgery, occurring in more than 20% of all patients. Some of these hernias become giant and affect patients in several ways. This patient group often experiences pain, decreased perceived body image, and loss of physical function......, which results in a need for surgical repair of the giant hernia, known as abdominal wall reconstruction. In the current thesis, patients with a giant hernia were examined to achieve a better understanding of their physical and psychological function before and after abdominal wall reconstruction. Study...... was lacking. Study II was a case-control study of the effects of an enhanced recovery after surgery pathway for patients undergoing abdominal wall reconstruction for a giant hernia. Sixteen consecutive patients were included prospectively after the implementation of a new enhanced recovery after surgery...
ÖNGÖREN, Ali Ulvi
Human fascioliasis, caused by Fasciola hepatica, is emerging as an important chronic zoonotic disease in many areas of the world, including Turkey. It primarily involves the liver and may also cause severe damage in the tissue. Herein we report on a patient with ectopic intra-abdominal fascioliasis that presented to our clinic with abdominal pain and distention. Physical and radiological examination as well as an exploratory laparotomy revealed a 10 × 10-cm mass in the splenic flexura of the ...
This volume is a new and updated edition of an extensively illustrated text and reference on the capabilities and imaging of gray scale ultrasonography for each major abdominal organ. Each major organ system is treated separately, including liver, gallbladder and bile ducts, pancreas, kidney, retroperitoneum, abdominal vasculature, and more. There are over 500 illustrations and ten pages of full color plates for cross sectional anatomy
Lee, In Jae; Ha, Hyun Kwon; Lee, Moon Gyu; Kim, Pyo Nyun; Auh, Yong Ho
Abdominal actinomycosis is a chronic, progressive, suppurative disease with a favorable response to intravenous treatment with penicillin. In many instances, however, its clinical and radiological findings may overlap with those of other inflammatory and neoplastic conditions, and the familiarity with the various radiological features can thus avoid diagnostic delays. The purpose of this paper is to describe and discuss the CT findings of abdominal actinomycosis
Cesari, Whitney A; Vaikunth, Sumeet S; Lewis, Jim B; Panda, Mukta
To identify the chief complaints and demographics at Clinica Esperanza, a student-run free clinic for an underserved Hispanic population. A retrospective chart review of patient files from 2005 through 2010 was undertaken, as approved by the University of Tennessee Health Science Center's Institutional Review Board. From 2005 through 2010, Clinica Esperanza fielded 2551 patient visits, consisting of 951 unique patients, 609 females and 342 males. Mean age was 34 years, and 60% of patients presented once, while 13% followed up for 1 year, 9% for 2 years, 6% for 3, 6% for 4, and 4% for 5. "Pap smear," "abdominal pain," and "follow-up lab results" ranked, in order, as the 3 top chief complaints. Resulting data have led to several improvements. The clinic has remained open weekly to improve patient continuity. With the top 10 chief complaints identified, they are better addressed. More funding is allocated for speculums and proper training of Pap smear technique. Systematic reporting of lab results is being implemented. Physical therapists and pharmacists now participate to address musculoskeletal and medication-based needs, respectively. A volunteer gastroenterologist has been recruited to provide specialized care for abdominal pain. An electrocardiogram machine is now used to evaluate chest pain. To improve student-patient communication, online language learning modules have been created. Based on these data, improvements in health care services have been made, including better continuity, emphasis on top chief complaints, and provider education in medical Spanish. Future plans include on-site pharmacy, smoother referrals, and similar clinics on the University of Tennessee Health Science Center's other campuses.
Schonfeld, Deborah; Lee, Lois K
This review will examine the current evidence regarding pediatric blunt abdominal trauma and the physical exam findings, laboratory values, and radiographic imaging associated with the diagnosis of intra-abdominal injuries (IAI), as well as review the current literature on pediatric hollow viscus injuries and emergency department disposition after diagnosis. The importance of the seat belt sign on physical examination and screening laboratory data remains controversial, although screening hepatic enzymes are recommended in the evaluation of nonaccidental trauma to identify occult abdominal organ injuries. Focused Assessment with Sonography for Trauma (FAST) has modest sensitivity for hemoperitoneum and IAI in the pediatric trauma patient. Patients with concern for undiagnosed IAI, including bowel injury, may be considered for hospital admission and serial abdominal exams without an increased risk of complications, if an exploratory laparotomy is not performed emergently. Although the FAST exam is not recommended as the sole screening tool to rule out IAI in hemodynamically stable trauma patients, it may be used in conjunction with the physical exam and laboratory findings to identify children at risk for IAI. Children with a normal physical exam and normal abdominal CT may not require routine hospitalization after blunt abdominal trauma.
Franz, M; Schepank, H; Schellberg, D
Prevalence and course of psychogenically influenced symptoms in neurology and their dependence on age and gender are reported. The epidemiological basis of the data is a long-term follow-up investigation of a high-risk population for about 10 years (n = 240): the Mannheim Cohort Study on Epidemiology of Psychogenic Disorders. Seven psychogenic symptoms of neurologic relevance (headache, lumbar and cervical vertebral complaints, functional vertigo, hyperkinesias, pareses, sleep and concentration disturbances) are characterized in regard to frequency, course and diagnostic significance.
D'Ippolito, Giuseppe; Rosas, George de Queiroz; Mota, Marcos Alexandre; Akisue, Sandra R. Tsukada; Galvao Filho, Mario de Melo.
Abdominal hernias are a common clinical problem Clinical diagnosis of abdominal hernias can sometimes be challenging, particularly in obese patients or patients with previous abdominal surgery. CT scan of the abdomen allows visualization of hernias and their contents and the differentiation from other masses of the abdominal wall such as tumors, hematomas and abscesses. Moreover, CT may identify complications such as incarceration, bowel obstruction, volvulus and strangulation. This study illustrates the CT scan findings observed in different types of abdominal wall hernias. (author)
Groenier, KH; de Winter, AF; Winters, JC; de Vet, HCW; Meyboom-de Jong, B
Objective: To construct a classification of patients with shoulder complaints based on their physical examination. To investigate (1) the interobserver reliability, (2) to what extent the setting in which the patients were recruited, and demographic and clinical characteristics are related to the
de Vries, U.M.R.T.
This article analyzes a type of ADR seeking to resolve complaints of consumers and in particular of hospital patients. In doing so, it aims to establish how this type of procedure differs from “normal” litigation and why it proves to be successful. It aims to show that its success is not only due to
Jellesma, F. C.; Rieffe, C.J.; Meerum Terwogt, M.
Objective: To evaluate the Somatic Complaint List (SCL) in children. Method: At T1, 365 fourth and 352 fifth graders completed the SCL, the Children's Somatization Inventory (CSI-C), and the Mood Questionnaire. Parents (n=564) completed the parental form of the CSI-C (CSI-P). Six months later, the
Full Text Available Results are considered screening test student relatively complaints about a feel. In an experiment took part a 165 student 9 and 11 classes. It is marked that at a student 9 classes of complaints about a feel anymore. The most widespread diseases among schoolboys are respirator diseases (quinsy, cold, cough. Also complaints take place about frequent fatigueability and head pains after completion of educational process.
Ni Kadek Ariasih; I Made Gede Sri Artha
STMIK STIKOM Indonesia is one of the institutions in the field of computer-based education. In order to support the effectiveness of the implementation of teaching and learning activities that take place, it is need a service that support the availability of adequate class facilities and complaints services if there are constraints on facilities in the classroom. So far, the management of complaints complaints against classroom facilities or in the labarotorium which is handled by the Househo...
Nelson Oly Ndubisi
Full Text Available The aim of this paper is to investigate whether male and female Malaysian consumers differ in their dissatisfaction complaint behavior and its aftermath. The study examines the moderation effect of gender in the relationship between public complaint behavior, private complaint behavior and customer defection. Data for the study was collected from 218 randomly selected customers of retail banks in Malaysia. The results show that public and private complaints are significantly associated with defection. These findings are generic across sex-type. Theoretical and managerial implications of the findings are discussed.
Zhao Dawei; Wang Wei; Yuan Chunwang; Jia Cuiyu; Zhao Xuan; Zhang Tong; Ma Daqing
Objective: To evaluate abdominal imaging in AIDS. Methods: The imaging examinations (including US, CT and MR) of 6 patients with AIDS associated abdominal foci were analysed retrospectively. All the cases were performed US, and CT scan, of which 4 performed enhanced CT scan and 1 with MR. Results: Abdominal tuberculosis were found in 4 patients, including abdominal lymph nodes tuberculosis (3 cases) and pancreatic tuberculosis (1 case). The imaging of lymph nodes tuberculosis typically showed enlarged peripheral tim enhancement with central low-attenuation on contrast-enhanced CT. Pancreatic tuberculosis demonstrated low-attenuation area in pancreatic head and slightly peripheral enhancement. Disseminated Kaposi's sarcoma was seen in 1 case: CT and MRI scan demonstrated tumour infiltrated along hepatic portal vein and bronchovascular bundles. Pelvic tumor was observed in 1 case: CT scan showed large mass with thick and irregular wall and central low attenuation liquefacient necrotic area in the pelvic cavity. Conclusion: The imaging findings of AIDS with abdominal foci is extraordinarily helpful to the diagnosis of such disease. Tissue biopsy is needed to confirm the diagnosis. (authors)
Ozdemir, Tunç; Akgül, Ahsen Karagözlü; Arpaz, Yağmur; Arikan, Ahmet
Spontaneous perforation of the bile duct (SPBD) is a rare cause of acute abdominal pain during childhood. Pancreatico-biliary malfunction has been postulated to contribute to its etiology. Factors related to diagnosis and treatment and difference from the other common causes of acute abdominal pain are emphasized. Five patients (3 boys, 2 girls, mean age 4.6) were admitted with peritonitis and operated with initial diagnosis of perforated appendicitis. During laparotomy, SPBD was detected. Presentation, laboratory findings and operative technique of the patients were evaluated retrospectively. Common complaints were abdominal pain and bilious vomiting. Abdominal distention was present in all patients. Leukocytosis and mild hyperbilirubinemia were detected in 5, elevated serum transaminase levels in 4, hyperglycemia in 1 and constipation in 1 patient(s). Abdominal ultrasonography showed a large amount of free fluid. During laparotomy, sterile bile peritonitis was detected initially. After exploration, SPBD was seen. T-tube drainage of the bile duct was carried out. Patients were discharged after removal of the T-tubes. Pancreatico-biliary malfunction was detected in 4 of 5 patients. In patients with generalized peritonitis, elevated transaminase levels and hyperbilirubinemia, SPBD must be considered. Even though the T-tube drainage is the treatment of choice, Roux-en-Y hepatico-portoenterostomy may be mandatory in certain patients.
Riney, Lauren C; Reed, Jennifer L; Kruger, Laura L; Brody, Alan J; Pomerantz, Wendy J
Abdominal pain is one of the most common complaints in the pediatric ED. Because of the broad range of potential diagnoses, it can pose challenges in diagnosis and therapy in the preadolescent girl. An 11-year-old previously healthy girl presented to our pediatric ED with fever, decreased appetite, vaginal bleeding, and abdominal pain. Initial evaluation yielded elevated creatinine levels, leukocytosis with bandemia, elevated inflammatory markers, and urine concerning for a urinary tract infection. She began receiving antibiotics for presumed pyelonephritis and was admitted to the hospital. After worsening respiratory status and continued abdominal pain, a computed tomography scan was obtained and a pelvic foreign body and abscess were identified. Adolescent gynecology was consulted for examination under anesthesia for abscess drainage and foreign body removal. A foreign body in the vagina or uterus can present as vaginal discharge, vaginal bleeding, abdominal pain, dysuria, or hematuria. Because symptoms can be diverse, an intravaginal or uterine foreign body should be considered in the preteen female patient presenting to the ED with abdominal pain. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
Objective: An evaluation of CT diagnosis of abdominal trauma. Methods: CT appearance of abdominal trauma was analyzed retrospectively in 95 cases. thirty-three patients were cured by operation, and the other 59 patients received conservative treatment. Fifty-one patients out of 59 were seen healed or improved by a follow up CT scan after the conservative treatment. Results: The study included: 31 cases of splenic contusion, accompanying with hemoperitoneum in 25 cases; 3 cases of hepatic laceration; 33 cases of liver and spleen compound trauma accompanying with hemoperitoneum; 18 cases of renal contusion, with subcapsular hemorrhage in 12 cases; 4 cases of midriff colic; 3 cases of mesentery breach; 3 cases of digestive tract perforation. Conclusion: CT is sensitive and precise in evaluating abdominal trauma, providing important information for treatment. (author)
Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.
The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa
Jensen, K K; Henriksen, N A; Jorgensen, L N
PURPOSE: There is no consensus as to the treatment strategy for abdominal wall hernias in fertile women. This study was undertaken to review the current literature on treatment of abdominal wall hernias in fertile women before or during pregnancy. METHODS: A literature search was undertaken in Pub......Med and Embase in combination with a cross-reference search of eligible papers. RESULTS: We included 31 papers of which 23 were case reports. In fertile women undergoing sutured or mesh repair, pain was described in a few patients during the last trimester of a subsequent pregnancy. Emergency surgery...... of incarcerated hernias in pregnant women, as well as combined hernia repair and cesarean section appears as safe procedures. No major complications were reported following hernia repair before or during pregnancy. The combined procedure of elective cesarean section and abdominal wall hernia repair was reported...
Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael
OBJECTIVE: The objective of the study was to compare long-term results of subtotal vs total abdominal hysterectomy for benign uterine diseases 14 years after hysterectomy, with urinary incontinence as the primary outcome measure. STUDY DESIGN: This was a long-term follow-up of a multicenter......, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal...... from discharge summaries from all public hospitals in Denmark. The results were analyzed as intention to treat and per protocol. Possible bias caused by missing data was handled by multiple imputation. The primary outcome was urinary incontinence; the secondary outcomes were pelvic organ prolapse...
Sivit, Carlos J.
Imaging is often a fundamental part in the evaluation of an injured or ill child. A variety of imaging modalities (radiography, angiography/fluoroscopy, sonography, CT, magnetic resonance imaging and scintigraphy) are among the options. CT is worth focused attention because of its usefulness in a variety of emergency department settings, its increasing use, and its potential radiation risks. CT plays an important role in the evaluation of traumatic and nontraumatic abdominal emergencies in children. Therefore, the goal of this paper is to review current imaging approaches and controversies in the evaluation of common acute abdominal emergencies. Through discussion of various modalities, especially CT in evaluation of abdominal pain and trauma, the relative advantages and disadvantages including radiation risk will be reviewed. (orig.)
Ordóñez, A; Maganto, C; González, R
Somatic complaints are common in childhood. Research has shown their relationship with emotional awareness and maladjustment. The study had three objectives: 1) to analyze the prevalence of somatic complaints; 2) To explore the relationships between the variables evaluated: somatic complaints, differentiating emotions, verbal sharing of emotions, not hiding emotions, body awareness, attending to others' emotions, analysis of emotions, and personal, social, family, and school maladjustments; and 3) To identify predictors of somatic complaints. The study included a total of 1,134 randomly selected schoolchildren of both sexes between 10-12 years old (M=10.99; SD=0.88). The Somatic Complaint List, Emotional Awareness Questionnaire, and Self-reported Multifactor Test of Childhood Adaptation were used to gather information. The results showed that the prevalence of somatic complaints was 90.2%, with fatigue, headache and stomachache being the most frequently. Dizziness and headache were more common in girls, and the frequency of complaints decreases with age. Somatic complaints are negatively related to emotional awareness, and positively related to maladjustment. The variables that contribute the most to the prediction of somatic complaints are personal maladjustment (25.1%) and differentiating emotions (2.5%). The study shows that personal maladjustment is the best predictor of somatic complaints; the more emotional awareness and better adapted the child, the fewer somatic complaints they lodge. Childhood is a stage with significant physical discomfort. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.
Ahn, K. S.; Cho, Y. H.; Kim, O.
Simple abdomen film has played an important role in decision of emergency operations in patients with the abdominal trauma. Nowadays, it still acts as a primary and inevitable processes in emergency condition. At the Department of Radiology, Hanil Hospital, 70 patients, who were laparotomied due to penetrating or nonpernetraing abdominal trauma, were observed and analyzed with simple abdomen film after comparison with the operative findings. The results are as follows: 1. Most frequent age distribution was 10 to 39 years and marked 70%. Male was in 90% incidence. 2. Penetrating injury largely involved the small bowel and abdominal wall. Non-penetrating injury usually involved the spleen, small bowel, liver, kidney, pancreas, duodenum. 3. Single organ injury occurred in higher incidence at the small bowel and abdominal wall. Multiple organ injury occurred in higher incidence at the spleen, liver, kidney and pancreas. 4. Organ distribution was 26% in spleen, 22% in small bowel, 14% in liver, 11% in abdominal wall. 7% in pancreas, 7% in kidney. 5% in duodenum, 4% in GB and CBD, 2% in diaphragm, 2% in colon, and 1% in stomach. 5. The specific roentgen findings and their frequency which useful in differential diagnosis at abdominal trauma, were as follows: a) flank fluid; Detectable possibility was 71% in liver laceration, 69% in spleen laceration and 57% in pancreas laceration. b) ipsilateral psoas shadow obliteration; Detectable possibility was 57% in liver laceration, 57% in kidney laceration and 46% in spleen laceration. c) free air; Detactable possibility was 60% in duodenal perforation, and 36% in peroration of upper part of small bowel. d) Reflex ileus; Detectable possibility was 64% in small bowel, 50% in liver laceration and 35% in spleen laceration. e) rib fracture; Detactable possibility was 36% in liver laceration and 23% in spleen laceration. f) pleural effusion; Detectable possibility was 29% in liver laceration and 27% in spleen laceration
Sýkora, Josef; Huml, Michal; Siala, Konrad; Pomahačová, Renáta; Jehlička, Petr; Liška, Jiří; Kuntscherová, Jana; Schwarz, Jan
Abdominal pain-related functional gastrointestinal disorders in children include functional dyspepsia, functional abdominal pain, irritable bowel syndrome, and abdominal migraine. We aimed to evaluate a possible association between functional abdominal pain disorders and Helicobacter pylori infection and faecal calprotectin level. Prospective observational study including consecutive children with functional gastrointestinal disorders fulfilling Rome III criteria (cases) and age/sex-matched healthy controls. H pylori has been detected by biopsy-based tests and stool-antigen detection, faecal calprotectin by enzyme-linked immunosorbent assay. A total of 56 cases (27 with functional dyspepsia) and 56 controls were enrolled. H pylori being detected in 17 of 56 cases (30.4%) and 4 of 56 controls (7.1%, odds ratio: 5.7; 95% confidence interval [CI]: 1.8-18.2, P = 0.003). H pylori was detected significantly more frequently in cases with functional dyspepsia (14/27, 51.9% odds ratio: 14.0; 95% CI: 3.9-49.7, P = 0.00001) than in controls and not in cases with other well-recognized functional gastrointestinal complaints (3/29, 10.3%). The median faecal calprotectin level was similar in cases (7.8 μg/g, 95% CI: 7.8-8.4) including those with gastritis, and controls (9.1 μg/g, 95% CI: 7.8-11.3). Gastritis features were more frequent in H pylori-infected and noninfected cases with functional dyspepsia (27/27, 100%) than in cases with other abdominal functional complaints (15/29, 51.7%, P = 0.007). H pylori gastritis and noninfectious gastritis were associated with functional dyspepsia in children referred for abdominal pain-related functional gastrointestinal disorders while faecal calprotectin is not a predictor of gastritis and is similar in children with functional abdominal pain symptoms and in controls.
Butt, Muhammad U; Zacharias, Nikolaos; Velmahos, George C
Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries. PMID:19374761
Velmahos George C
Full Text Available Abstract Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries.
Bryant, James E; Gaughan, Earl M
Abdominal surgery in foals under 30 days old has become more common with improved neonatal care. Early recognition of a foal at risk and better nursing care have increased the survival rates of foals that require neonatal care. The success of improved neonatal care also has increased the need for accurate diagnosis and treatment of gastrointestinal, umbilical, and bladder disorders in these foals. This chapter focuses on the early and accurate diagnosis of specific disorders that require abdominal exploratory surgery and the specific treatment considerations and prognosis for these disorders.
Lee, W.-K., E-mail: firstname.lastname@example.org [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Van Tonder, F.; Tartaglia, C.J.; Dagia, C. [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Cazzato, R.L. [Department of Radiology, Universita Campus Bio-Medico di Roma, Rome (Italy); Duddalwar, V.A. [Department of Radiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California (United States); Chang, S.D. [Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, British Columbia (Canada)
The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.
Lee, W.-K.; Van Tonder, F.; Tartaglia, C.J.; Dagia, C.; Cazzato, R.L.; Duddalwar, V.A.; Chang, S.D.
The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.
Nama, Vivek; Gyampoh, Bright; Karoshi, Mahantesh; McRae, Reynold; Opemuyi, Isaac
Although the case fatality rate for ectopic pregnancies has decreased to 0.08% in industrialized countries, it still represents 3.8% of maternal mortality in the United States alone. In developing countries, the case fatality rate varies from 3% to 27%. Laparoscopic management of tubal pregnancies is now the standard form of treatment where this technology is available. Abdominal pregnancies are rare, and secondary implantation of tubal ectopic pregnancies is the most common cause of abdominal gestations. We present an interesting case of secondary implantation of a tubal ectopic pregnancy to highlight the appendix as a possible secondary implantation site after a tubal ectopic pregnancy.
Al-Jaberi, Tareq M.; Gharabeih, Kamal I.; Yaghan, Rami J.
Diseases of abnormal appendages are rare causes of abdominal pain in all age groups. Nine patients with torsion and infraction of abdominal appendages were retrospectively reviewed. Four patients had torsion and infarction of the appendices epiploicae, four patients had torsion and infarction of the falciform ligament. The patient with falciform ligament disease represents the first reported case of primary torsion and infarction of the falciform ligament, and the patient with the transverse colon epiplocia represents the first reported case of vibration-induced appendix epiplocia torsion and infarction. The patient with the falciform ligament disease presented with a tender upper abdominal mass and the remaining patients were operated upon with the preoperative diagnosis of acute appendicitis. The presence of normal appendix with free serosanguinous fluid in the peritoneal cavity should raise the possibility of a disease and calls for further evaluation of the intra-abdominal organs. If the diagnosis is suspected preoperatively, CT scan and ultrasound may lead to a correct diagnosis and possibly conservative management. Laparoscopy is playing an increasing diagnostic and therapeutic role in such situations. (author)
This paper reports that the American Gas Association has rebutted complaints that natural gas prices have dropped at the wellhead but not at the burner tip. AGA Pres. Mike Baly the an association study of the issue found that all classes of customers paid less for gas in 1991 than they did in 1984, when gas prices were at their peak. He the, the study also shows that 100% of the wellhead price decline has been passed through to natural gas consumers in the form of lower retail prices. Baly the the average cost of gas delivered to all customers classes fell by $1.12/Mcf from 1984 to 1991, which exceeds the $1.10/Mcf decline in average wellhead prices during the same period
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Handling of JS-related complaints. 658.421... ADMINISTRATIVE PROVISIONS GOVERNING THE JOB SERVICE SYSTEM Job Service Complaint System Federal Js Complaint System § 658.421 Handling of JS-related complaints. (a) No JS-related complaint shall be handled at the...
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Establishment of JS complaint system at the... Complaint System Federal Js Complaint System § 658.420 Establishment of JS complaint system at the ETA regional office. (a) Each Regional Administrator shall establish and maintain a JS complaint system at the...
Does the Health Professions Council of South Africa (HPCSA) receive more complaints about anaesthesiologists than any other speciality, and if they do, are these complaints mainly restricted to billing issues, i.e. relating to the financial consent process or costs? Although disputed, and subsequently corrected, the South ...
... AND PROCEDURES Procedures for Original Jurisdiction Cases Special Counsel Disciplinary Actions § 1201... to file briefs, memoranda, or both in any disciplinary action complaint the Special Counsel brings... actions listed below, he or she must file a written complaint in accordance with § 1201.122 of this part...
... PRACTICES AND PROCEDURES Procedures for Original Jurisdiction Cases Special Counsel Disciplinary Actions... Special Counsel files a complaint proposing a disciplinary action against an employee under 5 U.S.C. 1215... Counsel disciplinary action complaint may file an answer with the Clerk of the Board within 35 days of the...
Polonski, G J
Encouraging customer feedback and developing an automated customer complaint system are two essential steps a health plan must take if it wishes to develop a balanced relationship with the customer. The author explores how the right attitude and appropriate action can ensure that both customers and the company reap the benefits of a comprehensive customer complaint system.
... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Mediation of age discrimination... Discrimination Prohibited on the Basis of Age § 7.180 Mediation of age discrimination complaints. (a) The OCR will refer all accepted complaints alleging age discrimination to the Mediation Agency designated by...
... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Mixed case complaints. 268.302 Section 268.302... RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case... discrimination or it may contain additional allegations that the MSPB has jurisdiction to address. A mixed case...
... 19 Customs Duties 3 2010-04-01 2010-04-01 false Motion filed after complaint. 210.53 Section 210.53 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.53 Motion filed after complaint. (a) A...
Bendall-Lyon, D; Powers, T L
Patient satisfaction and retention can be influenced by the development of an effective service recovery program that can identify complaints and remedy failure points in the service system. Patient complaints provide organizations with an opportunity to resolve unsatisfactory situations and to track complaint data for quality improvement purposes. Service recovery is an important and effective customer retention tool. One way an organization can ensure repeat business is by developing a strong customer service program that includes service recovery as an essential component. The concept of service recovery involves the service provider taking responsive action to "recover" lost or dissatisfied customers and convert them into satisfied customers. Service recovery has proven to be cost-effective in other service industries. The complaint management process involves six steps that organizations can use to influence effective service recovery: (1) encourage complaints as a quality improvement tool; (2) establish a team of representatives to handle complaints; (3) resolve customer problems quickly and effectively; (4) develop a complaint database; (5) commit to identifying failure points in the service system; and (6) track trends and use information to improve service processes. Customer retention is enhanced when an organization can reclaim disgruntled patients through the development of effective service recovery programs. Health care organizations can become more customer oriented by taking advantage of the information provided by patient complaints, increasing patient satisfaction and retention in the process.
... Protection Bureau, at (202) 435-7700. SUPPLEMENTARY INFORMATION: I. Background A. Credit Card Policy... disclosure of data from consumer complaints about financial products and services other than credit cards... Statement'') describing its plans to disclose consumer credit card complaint data. The present notice (the...
... 49 Transportation 8 2010-10-01 2010-10-01 false Satisfaction of complaint. 1111.6 Section 1111.6 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE COMPLAINT AND INVESTIGATION PROCEDURES § 1111.6 Satisfaction of...
... this section), the amount of money or the value of property or services demanded or requested in... simultaneously, regardless of the amount of money, or the value of property or services, demanded or requested. ... § 35.6 Prerequisites for issuing a complaint. (a) The reviewing official may issue a complaint under...
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Contents of complaint. 8.55 Section 8.55 Money and Finance: Treasury Office of the Secretary of the Treasury PRACTICE BEFORE THE BUREAU OF... he or she is able to prepare a defense. (b) Demand for answer. The complaint will give notification...
... amount of money, or the value of property or services, demanded or requested. [56 FR 47135, Sept. 18... time such claim is submitted (as defined in paragraph (b) of this section), the amount of money or the... complaint. (a) The reviewing official may issue a complaint under § 13.7 only if— (1) The Department of...
... in paragraph (b) of this section), the amount of money or the value of property or services demanded... that are unrelated or were not submitted simultaneously, regardless of the amount of money, or the... § 1013.6 Prerequisites for issuing a complaint. (a) The reviewing official may issue a complaint under...
... 6 Domestic Security 1 2010-01-01 2010-01-01 false Prerequisites for issuing a Complaint. 13.6 Section 13.6 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.6 Prerequisites for issuing a Complaint. (a) The Reviewing Official may issue a...
... convenience of the user, the revised text is set forth as follows: § 227.2 Consumer-complaint procedure. (a... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Consumer complaint procedure. 227.2 Section 227... SYSTEM UNFAIR OR DECEPTIVE ACTS OR PRACTICES (REGULATION AA) General Provisions § 227.2 Consumer...
Bouwman, R.J.R.; Bomhoff, Manja; Robben, Paul; Friele, R.D.
Objectives: It is assumed that classifying and aggregated reporting of patients' complaints by regulators helps to identify problem areas, to respond better to patients and increase public accountability. This pilot study addresses what a classification of complaints in a regulatory setting
... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Procedures § 1977.15 Filing of complaint for discrimination. (a) Who... 1977.15 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... required. (c) Place of filing. Complaint should be filed with the Area Director (Occupational Safety and...
Knox, G.; van Oest, R.D.
Although customer complaints are a well-studied aspect of business, no study has measured the impact of actual complaints and recoveries on subsequent customer purchasing. The authors develop a customer base model to investigate the effectiveness of recovery in preventing customer churn. They
... 7 Agriculture 12 2010-01-01 2010-01-01 false Handling dwelling construction complaints. 1924.259 Section 1924.259 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING... Construction Defects § 1924.259 Handling dwelling construction complaints. This section describes the procedure...
... companies, consumer groups, and trade associations to obtain feedback prior to beginning to accept new types... industry group suggesting distinguishing company response categories according to the type of company and... contains certain fields for each unique \\3\\ complaint \\4\\--complaints about other types of consumer...
... pattern of delays in processing cases, of inadequate workplace inspections, or the granting of variances... investigation should be made, he shall cause such investigation, including any workplace inspection, to be made... complaints received on the same or similar issues and whether the complaints relate to safety and health...
Linthorst, Gabor E; Lauw, Fanny N; Hanekamp, Lilian A; Hoekstra, Joost B L
We describe the course of two complaints that were filed by patients to the Dutch Medical Disciplinary Board against two internal medicine residents. In the procedure following the complaints the supervisor and the teacher were actively involved, which resulted in one complaint being dropped. We describe the importance of adequate moral support in such cases, as the complaint may lead to loss of work satisfaction or self-esteem, especially for those in training. We make some recommendations on how the resident and the supervisor/head of the department should engage in complaints filed to the Medical Disciplinary Board. In addition, we suggest that routine 'error-meetings' may help to provide an open atmosphere where disclosure of errors and the various procedures at the hospital or disciplinary boards are promoted.
Elizabeta Krstić Vukelja
Full Text Available Complaint, as the expression of customer dissatisfaction with the quality of products or services, is very valuable information. Well-built system for collecting, processing and analysis of complaints allows organizations to create the information base for making decisions based on facts. This data base provides an effective adoption and implementation of measures for continuous improvement of products/services quality. To make the system work effectively, it is necessary to continuously use the same methodology for collecting and processing complaints to be able constant comparisons from period to period. Greater investment in quality of products/services does not mean reducing the number of complaints in the same time due to the effects of the phenomenon of “unrealistic expectations”. In addition to complaints, a valuable source of information on customer satisfaction is the system of praise.
Full Text Available ... to evaluate the: appendix stomach/ pylorus liver gallbladder spleen pancreas intestines kidneys bladder testicles ovaries uterus Abdominal ultrasound images can be used to help diagnose appendicitis in children. Except for traumatic injury, appendicitis is the most common reason for emergency ...
Full Text Available ... procedure work? How is the procedure performed? What will my child experience during and after the procedure? Who interprets the results and how do we get them? What are the benefits vs. risks? What are the limitations of Abdominal ...
Shah, S.I.; Aurangzeb; Khan, I.; Bhatti, A.M.; Khan, A.A.
Objective: To describe the frequency of dehydration as a medical cause of acute abdomen. Subjects and Methods: All the patients reporting with abdominal pain to the surgical outpatient department or the emergency department were reviewed in the study. The clinical findings in all these cases were studied along with the mode of their management and outcome. Results: Of all the patients presenting with abdominal pain, 3.3% (n=68) were suffering from dehydration related abdominal pain. They were predominantly males in a ratio of 8.7: 1, mostly in the 2nd and 3rd decades of their lives. All these cases were suffering from acute or chronic dehydration were provisionally diagnosed by general practitioners as 'acute abdomen' and referred for surgical consultation. Associated symptoms included vomiting in 42.6%, backache in 91.2%, headache in 95.6%, and pain in lower limbs in 97.1 % of the cases. 83.8% required indoor management with intravenous fluids. All the patients became asymptomatic with rehydration therapy. Conclusion: Dehydration is a possible cause of severe abdominal pain. There is a need to educate the general public about the benefits of adequate fluid intake. (author)
Full Text Available ... particularly valuable for evaluating abdominal, pelvic or scrotal pain in young children. It is also valuable for evaluating the brain, spinal cord and hip joints in newborns and infants. Risks For standard diagnostic ultrasound , there are no known harmful effects on ...
Koh, B. H.; Choi, J. Y.; Hahm, C. K.; Kang, S. R.
In spite of many advances in medicine, anesthetic technique and surgical managements, pulmonary problems are the most frequent postoperative complications, particularly after abdominal surgery. As postoperative pulmonary complications, atelectasis, pleural effusion, pneumonia, chronic bronchitis and lung abscess can be occurred. This study include evaluation of chest films of 2006 patients (927 male, 1079 female), who had been operated abdominal surgery from Jan. 1979 to June, 1980 in the Hanyang university hospital. The results were as follows: 1. 70 cases out of total 2006 cases (3.5%) developed postoperative chest complications, 51 cases (5.5%) in male, 19 cases (1.8%) in female. 2. The complication rate was increased according to the increase of age. The incidence of the postoperative complications over 40 years of age was higher than the overall average complications rate. 3. The most common postoperative pulmonary complication was pleural effusion, next pneumonia, atelectasis and pulmonary edema respectively. 4. The complication rate of the group of upper abdominal surgery is much higher than the group of lower abdominal surgery. 5. Complication rate was increased according to increase of the duration of operation. 6. There were significant correlations between the operation site and side of the complicated hemithorax
Full Text Available ... is Abdominal Ultrasound Imaging? What are some common uses of the procedure? How should we prepare for an ultrasound exam? What does the ultrasound equipment look like? How does the procedure work? How is the procedure performed? What will my ...
abdominal hypertension and abdominal compartment syndrome, affect ... timely surgical intervention is crucial. Key words: .... On the second postoperative day, he was noted to be restless ... Although surgery is very effective in managing ACS.
Abdominal myomectomy and outcome in Ilorin, Nigeria 37. Malawi Medical Journal 29 (1): ... rate of 3.34% has been reported for Maiduguri, northeastern. Nigeria.4 Abdominal ... of Nigeria.6. Infertility secondary to uterine fibroid is one of the.
... Disciplinary Actions § 1201.122 Filing complaint; serving documents on parties. (a) Place of filing. A Special Counsel complaint seeking disciplinary action under 5 U.S.C. 1215(a)(1) (including a complaint alleging a...
Solveig Nergård, MD
Conclusions:. Using the IMV in free abdominal flap breast reconstruction had a significant effect on abdominal skin perfusion and may contribute to abdominal wound healing problems. The reperfusion of the abdominal skin was a dynamic process showing an increase in perfusion in the affected areas during the postoperative days.
Tatiana Kores Dorsa
were seen in a tertiary pediatric gastroenterology outclinic. Organic diseases were excluded by physical examination and laboratory procedures, and clinical complaints were evaluated according to Rome II criteria for children abdominal pain. In order to establish definitive diagnosis, patients were followed for a mean of three years. RESULTS: Allocation of the 71 patients was: organic disease (n=12, complete remission of symptoms following first clinical presentation (n=7, and functional disease (n=52. Nine patients from the organic disease group, who had been diagnosed as having lactose intolerance, were re-allocated to the functional disease criteria since their symptoms did not relieve when lactose was excluded from their diet. Out of the 52 patients of the functional disease group (median age=9.3 years, 50% boys, nine children with initial diagnosis of functional abdominal pain were re-allocated to functional constipation diagnosis during follow-up, and other 43 patients fulfilled the functional disease diagnosis defined by Rome II: 24 with functional dyspepsia, 18 with functional abdominal pain and one with irritable bowel syndrome. CONCLUSIONS: In a group of children with chronic abdominal pain, functional diseases were found more frequently than organic diseases, and functional dyspepsia was the commonest subtype. Long term follow-up was useful to establish definitive diagnosis in children with chronic abdominal pain.
Rosid, M. A.; Rachmadany, A.; Multazam, M. T.; Nandiyanto, A. B. D.; Abdullah, A. G.; Widiaty, I.
Internet of Things (IoT) has influenced human life where IoT internet connectivity extending from human-to-humans to human-to-machine or machine-to-machine. With this research field, it will be created a technology and concepts that allow humans to communicate with machines for a specific purpose. This research aimed to integrate between application service of the telegram sender with application of e-complaint at a college. With this application, users do not need to visit the Url of the E-compliant application; but, they can be accessed simply by submitting a complaint via Telegram, and then the complaint will be forwarded to the E-complaint Application. From the test results, e-complaint integration with Telegram Bot has been run in accordance with the design. Telegram Bot is made able to provide convenience to the user in this academician to submit a complaint, besides the telegram bot provides the user interaction with the usual interface used by people everyday on their smartphones. Thus, with this system, the complained work unit can immediately make improvements since all the complaints process can be delivered rapidly.
Rahmat Muhajir Nugroho
Full Text Available This study aimed to evaluate the mechanism for settling disputes in the Constitutional Court containing elements of constitutional complaint. In particular, this study focused on two things: first assessing the urgency/ importance of the idea of setting constitutional complaint in the Constitutional Court's authority. Secondly, to formulate recommendations on setting constitutional complaint in the Constitutional Court's authority. The method used in this research is descriptive qualitative. This type of research is a doctrinal law. This research studied the concept and implementation of the judicial settlement of cases that contain elements of constitutional complaint (complaint constitution by the Constitutional Court. The conclusion of this study is an important constitutional complaint mechanism is contained within the competence of the Constitutional Court to solve problems of injustice experienced by citizens as a result of public policies undertaken by the government in a broad sense, namely the executive, legislature and judiciary. Setting constitutional complaint within the competence of the Constitutional Court does not have to be explicitly stipulated in the constitution, but enough in the explanation of the Constitutional Court Act. That is not to add direct authority of the Court, but expand the meaning of the authority of the Court in testing the law.
Chiou, Eric; Nurko, Samuel
Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are both associated with recurrent abdominal pain and are among the most commonly diagnosed medical problems in pediatrics. The majority of patients with mild complaints improve with reassurance and time. For a distinct subset of patients with more severe and disabling illness, finding effective treatment for these disorders remains a challenge. Based on the biopsychosocial model of functional disease, the Rome III criteria have helped frame FAP and IBS in terms of being a positive diagnosis and not a diagnosis of exclusion. However, the lack of a single, proven intervention highlights the complex interplay of pathologic mechanisms likely involved in the development of childhood FAP and IBS and the need for a multidisciplinary, integrated approach. This article discusses the epidemiology, proposed mechanisms, clinical approach and therapeutic options for the management of FAP and IBS in children and adolescents. PMID:21731470
Trommer, G.; Koesling, S.; Bewer, A.
We report a case of previously undiagnosed Yersinia enterocolitica infection in a 46-year old woman. She consulted her physician because of continual weight loss and physical lassitude. A leucocytosis was found. Sonography revealed an excessive enlargement of abdominal lymph nodes. A malignant lymphoma was suspected and the patient underwent a staging by CT. There the disease was limited on mesenteric and retroperitoneal lymph nodes. Bone marrow biopsy and CT-guided lymph node biopsy did not confirm a systemic lymphatic disease. The patient did not undergo a special therapy. After six months, CT showed a clear regression of enlarged lymph nodes. Finally, a previous Yersinia enterocolitica infection of immunotype 03 could be proved serologically. At this time, the patient had no complaints. Diagnostic and differential diagnosis of benign abdominal lymph node enlargement are discussed based on literature. (orig.) [de
Abdominal compartment syndrome was recognized clinically in the 19th century when Marey and Burt observed its association with declines in respiratory function. Abdominal compartment syndrome is first used as a medical terminology from Fietsman in a case of ruptured abdominal aortic aneurysm. A condition caused by abnormally increased pressure within the abdomen. Causes of abdominal compartment syndrome include trauma, surgery, or infection. Common symptoms: abdominal distension, fast heart rate, insufficient urine production, or low blood pressure Medical procedure: nasogastric intubation Surgery: laparotomy Specialists: radiologist, primary care provider (PCP), surgeon, and emergency medicine doctor [6, 10]. Keywords: Stomach. Gastroparesis . Diabetes Mellitus [bg
Full Text Available Theme: Many reports stress the importance of solving customer complaints in order to maintain customer satisfaction, but also to learn from mistakes and further improve the customer service. However, relatively few empirical studies have been conducted regarding the effect of complains handling activities on customer satisfaction and on company-customer relationships. Objectives of research: This paper attempts to identify the main elements of the complaints handling strategy that are considered essential for customers, and their effect on customer satisfaction. Literature analysis/previous research: Previous studies define a complaint as a conflict between a consumer and a business organisation in which the fairness of the resolution procedures, the interpersonal communication and behaviour, and the outcome of the complaint resolution process are the principal evaluative criteria used by the customer. In our opinion, a complaint is not necessary a conflict, however, it can create a conflict between a customer and a business organisation, when the answer to the consumerâ€™s complaint is not satisfactory. Therefore, the way in which business organisations deal with consumer complaints can significantly influence the consumersâ€™ level of satisfaction and loyalty. Research methodology: The empirical analysis of primary data collected through face-to-face interviews with 150 French customers provides a detailed picture of the specific elements of complains handling which are perceived as important in four different settings defined in relation to the perceived importance of the product or service, and the emergency of the experienced problem. Results: The identified elements of the complaint-handling procedure have a variable importance from one element to the other, and in the context of various complaint situations. This finding highlights the fact that, depending on each situation, the factors that will determine customer
Mareeswari, V.; Gopalakrishnan, V.
In numerous nations, there are city bodies that are the nearby representing bodies that help keep up and run urban communities. These administering bodies are for the most part called MC (Municipal Cooperation). The MC may need to introduce edit cameras and other observation gadgets to guarantee the city is running easily and productively. It is imperative for an MC to know the deficiencies occurring inside the city. As of now, this must be for all intents and purposes conceivable by introducing sensors/cameras and so forth or enabling nationals to straightforwardly address them. The everyday operations and working of the city are taken care by administering bodies which are known as Government Authorities. Presently keeping in mind the end goal to keep up the huge city requires that the Government Authority should know about any issue or deficiency either through (sensors/CCTV cameras) or by enabling the nationals to grumble about these issues. The second choice is generally granted on the grounds that it gives the best possible substantial data. The GA by and large enables its residents to enlist their grievance through a few mediums. In this application, the citizens are facilitated to send the complaints directly from their smartphone to the higher officials. Many APIs are functioning as the web services which are really essential to make it easier to register a complaint such as Google Places API to detect your current location and show that in Map. The Web portal is used to process various complaints well supported with different web services.
Vogel, H.; Toedt, H.C.
The CT-examinations of 131 patients were analyzed after abdominal surgery. After nephrectomy, splenectomy, partial hepatectomy and pancreatectomy a displacement of the neighbouring intraabdominal and retroperitoneal organs was seen. Scar-tissue was observed containing fat, which faciltated the differential diagnosis to tumor recurrency. The changes of the roentgenmorphology were not so obvious after gastrointestinal surgery. After vascular surgery the permeability of an anastomosis or an operated artery could be demonstrated by bolus injection. (orig.).
Vogel, H.; Toedt, H.C.; Hamburg Univ.
The CT-examinations of 131 patients were analyzed after abdominal surgery. After nephrectomy, splenectomy, partial hepatectomy and pancreatectomy a displacement of the neighbouring intraabdominal and retroperitoneal organs was seen. Scar-tissue was observed containing fat, which fascilated the differentialdiagnosis to tumorrecurrency. The changes of the roentgenmorphology were not so abvious after gastro-intestinal surgery. After vascular surgery the permeability of an anastomosis or an operated artery could be demonstrated by bolusinjection. (orig.) [de
Adis L. Peña Cedeño
Full Text Available Se realizó un estudio de los fetos con malformaciones congénitas, dadas por defecto de la pared abdominal (DPA, nacidos en el Hospital Universitario Ginecoobstétrico de Guanabacoa durante los años 1984 al 2000, para determinar la frecuencia de los distintos tipos de defectos de la pared abdominal y las malformaciones asociadas a éstas. Se revisaron los protocolos de necropsias e historias clínicas en este período y se obtuvieron 25 casos con DPA. La malformación más frecuente fue el onfalocele con 14 casos, seguido de la gastrosquisis con 6 casos. Se hallaron malformaciones asociadas en el 68 % de los casos, y se comprobó la efectividad del Programa Nacional de Malformaciones Congénitas, pues en el 80 % de las pacientes se interrumpió precozmente el embarazo.A study of the fetuses with congenital malformations due to defect of the abdominal wall (AWD that were born at the Gynecoobstetric Teaching Hospital of Guanabacoa from 1984 to 2000 was conducted aimed at determining the frequency of the different types of defects of the abdominal wall and the malformations associated with them. The protocosl of necropsies and medical histories corresponding to this period were reviewed and 25 cases with AWD were detected. The most common malformation was omphalocele with 14 cases, followed by gastrosquisis with 6 cases. Associated malformations were found in 68 % of the cases and it was proved the effectiveness of the National Program of Congenital Malformations, since pregnancy was interrupted early in 80 % of the patients.
Full Text Available Traumatic abdominal wall hernia is a rare type of hernia, which follows blunt trauma to the abdomen, where disruption of the musculature and fascia occurs with the overlying skin remaining intact. Diagnosis of this problem is very difficult and delayed. Traumatic hernia is often diagnosed during laparatomy or laparascopy, but CT scan also has a role in distinguishing this pathology. Delay in diagnosis is very dangerous and can result in gangrene and necrosis of the organs in the hernia. The case report of a 35 years old man with liftruck blunt trauma is reported. His vital signs were stable. On physical examination, tenderness of RUQ was seen. He underwent Dpl for suspected hemoprotein. Dpl was followed up by laparatomy. Laparatomy revealed that the transverse and ascending colon partially herniated in the abdominal wall defect. The colon was reduced in the abdomen and repair of abdominal hernia was done. The patient was discharged after 5 day. The etiology, pathogenesis and management are discussed.
Kohli, N; Walsh, P M; Roat, T W; Karram, M M
To report our experience with erosion of permanent suture or mesh material after abdominal sacrocolpopexy. A retrospective chart review was performed to identify patients who underwent sacrocolpopexy by the same surgeon over 8 years. Demographic data, operative notes, hospital records, and office charts were reviewed after sacrocolpopexy. Patients with erosion of either suture or mesh were treated initially with conservative therapy followed by surgical intervention as required. Fifty-seven patients underwent sacrocolpopexy using synthetic mesh during the study period. The mean (range) postoperative follow-up was 19.9 (1.3-50) months. Seven patients (12%) had erosions after abdominal sacrocolpopexy with two suture erosions and five mesh erosions. Patients with suture erosion were asymptomatic compared with patients with mesh erosion, who presented with vaginal bleeding or discharge. The mean (+/-standard deviation) time to erosion was 14.0+/-7.7 (range 4-24) months. Both patients with suture erosion were treated conservatively with estrogen cream. All five patients with mesh erosion required transvaginal removal of the mesh. Mesh erosion can follow abdominal sacrocolpopexy over a long time, and usually presents as vaginal bleeding or discharge. Although patients with suture erosion can be managed successfully with conservative treatment, patients with mesh erosion require surgical intervention. Transvaginal removal of the mesh with vaginal advancement appears to be an effective treatment in patients failing conservative management.
Appendicitis is a frequently encountered surgical problem in the Emergency Department (ED). Appendicitis typically results from obstruction of the appendiceal lumen, although trauma has been reported as an infrequent cause of acute appendicitis. Intestinal injury and hollow viscus injury following blunt abdominal trauma are well reported in the literature but traumatic appendicitis is much less common. The pathophysiology is uncertain but likely results from several mechanisms, either in isolation or combination. These include direct compression/crush injury, shearing injury, or from indirect obstruction of the appendiceal lumen by an ileocecal hematoma or traumatic impaction of stool into the appendix. Presentation typically mirrors that of non-traumatic appendicitis with nausea, anorexia, fever, and right lower quadrant abdominal tenderness and/or peritonitis. Evaluation for traumatic appendicitis requires a careful history and physical exam. Imaging with ultrasound or computed tomography is recommended if the history and physical do not reveal an acute surgical indication. Treatment includes intravenous antibiotics and surgical consultation for appendectomy. This case highlights a patient who developed acute appendicitis following blunt trauma to the abdomen sustained during a motor vehicle accident. Appendicitis must be considered as part of the differential diagnosis in any patient who presents to the ED with abdominal pain, including those whose pain begins after sustaining blunt trauma to the abdomen. Because appendicitis following trauma is uncommon, timely diagnosis requires a high index of suspicion. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available BACKGROUND AND STUDY AIMS: Chronic abdominal pain is one of the most common chief complaints, but the underlying pathophysiology often remains unknown after routine clinical evaluation. Capsule endoscopy (CE is a new technique for the visualization of the entire small bowel. The aim of this study was to evaluate the diagnostic efficacy of CE in patients with chronic abdominal pain of obscure origin. PATIENTS AND METHODS: Two hundred forty three patients with chronic abdominal pain with no significant lesions were enrolled in this study. CE was performed in all patients. RESULTS: A diagnosis was made in 23.0% of patients screened with CE. Of the 243 patients, 19 (7.8% were diagnosed with Crohn's disease, 15 (6.2% with enteritis, 11 (4.5% with idiopathic intestinal lymphangiectasia, 5 (2.1% with uncinariasis, and a number of other diagnoses including small bowel tumor, ascariasis, and anaphylactoid purpura. Five patients had abnormal transit time, and capsule retention occurred in two patients. CONCLUSIONS: In contrast to other previous studies, we found that CE is an effective diagnostic tool for patients with abdominal pain.
Seelos, L; Adamson, C
More and more organizations find that a constructive and open dialogue with their customers can be an effective strategy for building long-term customer relations. In this context, it has been recognized that effective complaint-contact handling can make a significant contribution to organizations' attempts to maximize customer satisfaction and loyalty. Within the NHS, an intellectual awareness exists that effective complaint/contact handling can contribute to making services more efficient and cost-effective by developing customer-oriented improvement initiatives. Recent efforts have focused on redefining NHS complaint-handling procedures to make them more user-friendly and effective for both NHS employees and customers. Discusses the challenges associated with opening up the NHS to customer feedback. Highlights potential weaknesses in the current approach and argues that the real challenge is for NHS managers to facilitate a culture change that moves the NHS away from a long-established defensive complaint handling practice.
... THE CORPORATE AND CRIMINAL FRAUD ACCOUNTABILITY ACT OF 2002, TITLE VIII OF THE SARBANES-OXLEY ACT OF... communication will be considered to be the date of filing; if the complaint is filed in person, by hand-delivery...
van Rijsbergen, M.W.A.; Mark, R.E.; de Kort, P.L.; Sitskoorn, M.M.
Background Most studies to date have assessed poststroke cognitive impairment objectively, whereas less attention is paid to subjective cognitive complaints (SCC). We, therefore, systematically searched the literature to summarize and evaluate the current knowledge about poststroke SCC. Methods
Magda Aline Bauer
Full Text Available Abstract Introduction: Hearing is essential for the processing of acoustic information and the understanding of speech signals. Hearing loss may be associated with cognitive decline, depression and reduced functionality. Objective: To analyze the prevalence of hearing complaints in elderly individuals from Rio Grande do Sul and describe the profile of the study participants with and without hearing complaints. Methods: 7315 elderly individuals interviewed in their homes, in 59 cities in the state of Rio Grande do Sul, Brazil, participated in the study. Inclusion criteria were age 60 years or older and answering the question on auditory self-perception. For statistical purposes, the chi-square test and logistic regression were performed to assess the correlations between variables. Results: 139 elderly individuals who did not answer the question on auditory self-perception and 9 who self-reported hearing loss were excluded, totaling 7167 elderly participants. Hearing loss complaint rate was 28% (2011 among the elderly, showing differences between genders, ethnicity, income, and social participation. The mean age of the elderly without hearing complaints was 69.44 (±6.91 and among those with complaint, 72.8 (±7.75 years. Elderly individuals without hearing complaints had 5.10 (±3.78 years of formal education compared to 4.48 (±3.49 years among those who had complaints. Multiple logistic regression observed that protective factors for hearing complaints were: higher level of schooling, contributing to the family income and having received health care in the last six months. Risk factors for hearing complaints were: older age, male gender, experiencing difficulty in leaving home and carrying out social activities. Conclusions: Among the elderly population of the state of Rio Grande do Sul, the prevalence of hearing complaints reached 28%. The complaint is more often present in elderly men who did not participate in the generation of family
Suryawan, I Nengah; Putra Yadnya, Ida Bagus; Puspani, Ida Ayu Made
This paper is aimed at analyzing how complaint speech act of hotel and restaurant guests are performed and responded based on categories of speech acts and how they are performed considering the aspects of acts: locutionary, illocutionary, and perlocutionary. The method and technique of collecting data in this study is documentation method in which the data were collected using the technique of note taking and were qualitatively analyzed. The findings show that complaint of hotel and restaura...
Studer, Regina; Danuser, Brigitta; Hildebrandt, Horst; Arial, Marc; Gomez, Patrick
Despite the importance of respiration and hyperventilation in anxiety disorders, research on breathing disturbances associated with hyperventilation is rare in the field of music performance anxiety (MPA, also known as stage fright). The only comparable study in this area reported a positive correlation between negative feelings of MPA and hyperventilation complaints during performance. The goals of this study were (a) to extend these previous findings to the period before performance, (b) to test whether a positive correlation also exists between hyperventilation complaints and the experience of stage fright as a problem, (c) to investigate instrument-specific symptom reporting, and (d) to confirm gender differences in negative feelings of MPA and hyperventilation complaints reported in other studies. We assessed 169 university students of classical music with a questionnaire comprising: the State-Trait Anxiety Inventory for negative feelings of MPA, the Nijmegen Questionnaire for hyperventilation complaints, and a single item for the experience of stage fright as a problem. We found a significant positive correlation between hyperventilation complaints and negative feelings of MPA before performance and a significant positive correlation between hyperventilation complaints and the experience of stage fright as a problem. Wind musicians/singers reported a significantly higher frequency of respiratory symptoms than other musicians. Furthermore, women scored significantly higher on hyperventilation complaints and negative feelings of MPA. These results further the findings of previous reports by suggesting that breathing disturbances associated with hyperventilation may play a role in MPA prior to going on stage. Experimental studies are needed to confirm whether hyperventilation complaints associated with negative feelings of MPA manifest themselves at the physiological level. Copyright © 2010 Elsevier Inc. All rights reserved.
Michelle M. Lilly; Melissa J. London; Mary C. Mercer
Background: This study aims to: (1) examine rates of obesity and physical health complaints among 911 telecommunicators; and (2) document the role of emotion dysregulation, psychological inflexibility, duty-related distress and dissociation, and psychopathology in predicting obesity and physical health complaints in this population. Methods: The sample consisted of 911 telecommunicators from across the country (N = 758). Participants completed an online survey assessing their mental and ph...
Roberts, Derek J; Ball, Chad G; Kirkpatrick, Andrew W
This article reviews recent developments related to intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) and clinical practice guidelines published in 2013. IAH/ACS often develops because of the acute intestinal distress syndrome. Although the incidence of postinjury ACS is decreasing, IAH remains common and associated with significant morbidity and mortality among critically ill/injured patients. Many risk factors for IAH include those findings suggested to be indications for use of damage control surgery in trauma patients. Medical management strategies for IAH/ACS include sedation/analgesia, neuromuscular blocking and prokinetic agents, enteral decompression tubes, interventions that decrease fluid balance, and percutaneous catheter drainage. IAH/ACS may be prevented in patients undergoing laparotomy by leaving the abdomen open where appropriate. If ACS cannot be prevented with medical or surgical management strategies or treated with percutaneous catheter drainage, guidelines recommend urgent decompressive laparotomy. Use of negative pressure peritoneal therapy for temporary closure of the open abdomen may improve the systemic inflammatory response and patient-important outcomes. In the last 15 years, investigators have better clarified the pathogenesis, epidemiology, diagnosis, and appropriate prevention of IAH/ACS. Subsequent study should be aimed at understanding which treatments effectively lower intra-abdominal pressure and whether these treatments ultimately affect patient-important outcomes.
Full Text Available Background. Hydatid cyst is caused by the tapeworm Echinococcus granulosus. The abdomen, specifically the liver, is the most common site affected. Objective. Determine the presentation patterns, types of surgical management, and outcomes of patients operated for intra-abdominal hydatid cyst (IAHC. Methodology. A retrospective descriptive study of patients admitted and operated for IAHC from September 1, 2011, to August 31, 2015. Results. Forty-two patients whose age ranged from 10 to 65 (mean of 37 years were operated on. Females comprised 27 (64.3% of the patients. The commonest presenting complaint was abdominal pain (41, 97.6%. Abdominal mass was documented in 23 (54.7% cases. Abdominal ultrasound (AUS and CT were the main imaging studies done on 38 (90.5% and 24 (57.1% patients, respectively. Cysts measuring more than 10 cm in diameter were the most common finding in both studies. Liver was the primary site involved, 30 (71.4% cases, the right lobe being the main side, 73%. Thirty-eight (90.5% patients underwent deroofing, evacuation, marsupialization, and omentoplasty (DEMO. There was no perioperative death, but 4 (9.5% of the patients had post-op complications. Conclusion. Abdominal pain was the most common presenting complaint. AUS and CT remain the preferred imaging. DEMO was the most common surgery.
Hsieh, Sophie Yahui
This study aims to construct an instrument for identifying certain attributes or capabilities that might enable healthcare staff to use complaints to improve service quality. PubMed and ProQuest were searched, which in turn expanded access to other literature. Three paramount dimensions emerged for healthcare quality management systems: managerial, operational, and technical (MOT). The paper reveals that the managerial dimension relates to quality improvement program infrastructure. It contains strategy, structure, leadership, people and culture. The operational dimension relates to implementation processes: organizational changes and barriers when using complaints to enhance quality. The technical dimension emphasizes the skills, techniques or information systems required to achieve successfully continuous quality improvement. The MOT model was developed by drawing from the relevant literature. However, individuals have different training, interests and experiences and, therefore, there will be variance between researchers when generating the MOT model. The MOT components can be the guidelines for examining whether patient complaints are used to improve service quality. However, the model needs testing and validating by conducting further research before becoming a theory. Empirical studies on patient complaints did not identify any analytical tool that could be used to explore how complaints can drive quality improvement. This study developed an instrument for identifying certain attributes or capabilities that might enable healthcare professionals to use complaints and improve service quality.
Teixeira, Adriane Ribeiro
Full Text Available Introduction: Presbycusis is a public health problem. Despite its high prevalence, many elders do not have their hearing ability investigated periodically, because they do not have a specific complaint. Objective: To check whether there is a relationship between the complaint and the presence of hearing loss in elder people. Method: Transversal study in elders from a neighborhood in the city of Canoas, Rio Grande do Sul. After the definition of the neighborhood's geographic boundaries, all houses were visited, the older people's addresses were ascertained and the invitations to take part in the research were provided. A questionnaire survey was applied which had a question about hearing loss complaint and air-conducted hearing thresholds were obtained and studied. Out of the 72 identified elders 50 elders agreed to participate, 35 (70% women, and 15 (30% men. Results: It was confirmed that only 12 (24% elders showed a specific complaint of hearing loss, although 33 (66% elders showed slight, moderate, severe and profound hearing losses. Conclusion: Data analysis confirmed there was no relationship between the complaint and the presence of hearing loss in the assessed group, and demonstrated the need to forward the elders for audiological evaluation even without any specific complaint.
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Action on JS-related complaints. 658.416... ADMINISTRATIVE PROVISIONS GOVERNING THE JOB SERVICE SYSTEM Job Service Complaint System State Agency Js Complaint System § 658.416 Action on JS-related complaints. (a) The appropriate State agency official handling an...
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Transferring complaints to proper JS office... Agency Js Complaint System § 658.415 Transferring complaints to proper JS office. (a) Where a JS-related... local office serving the area in which the employer is located. Where a JS-related complaint deals with...
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Handling of non-JS-related complaints by the... Federal Js Complaint System § 658.422 Handling of non-JS-related complaints by the Regional Administrator. (a) Each non-JS-related complaint filed by an MSFW alleging violations of employment related laws...
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Referral of non-JS-related complaints. 658... ADMINISTRATIVE PROVISIONS GOVERNING THE JOB SERVICE SYSTEM Job Service Complaint System State Agency Js Complaint System § 658.414 Referral of non-JS-related complaints. (a) To facilitate the operation of the...
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Establishment of State agency JS complaint... Agency Js Complaint System § 658.410 Establishment of State agency JS complaint system. (a) Each State... State Administrator shall have overall responsibility for the operation of the State agency JS complaint...
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Service of complaint and other papers. 18.10... CONFLICT OF INTEREST Administrative Enforcement Proceedings § 18.10 Service of complaint and other papers.... (b) Service of papers other than complaint. Any paper other than the complaint may be served upon a...
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Job service complaint system; enforcement of... Job service complaint system; enforcement of work contracts. (a) Filing with DOL. Complaints arising under this subpart must be filed through the Job Service Complaint System, as described in 20 CFR part...
Díaz-Rodríguez, Natalia; Cadahía, Olmo León; Cuéllar, Manuel Pegalajar; Lilius, Johan; Calvo-Flores, Miguel Delgado
Human activity recognition is a key task in ambient intelligence applications to achieve proper ambient assisted living. There has been remarkable progress in this domain, but some challenges still remain to obtain robust methods. Our goal in this work is to provide a system that allows the modeling and recognition of a set of complex activities in real life scenarios involving interaction with the environment. The proposed framework is a hybrid model that comprises two main modules: a low level sub-activity recognizer, based on data-driven methods, and a high-level activity recognizer, implemented with a fuzzy ontology to include the semantic interpretation of actions performed by users. The fuzzy ontology is fed by the sub-activities recognized by the low level data-driven component and provides fuzzy ontological reasoning to recognize both the activities and their influence in the environment with semantics. An additional benefit of the approach is the ability to handle vagueness and uncertainty in the knowledge-based module, which substantially outperforms the treatment of incomplete and/or imprecise data with respect to classic crisp ontologies. We validate these advantages with the public CAD-120 dataset (Cornell Activity Dataset), achieving an accuracy of 90.1% and 91.07% for low-level and high-level activities, respectively. This entails an improvement over fully data-driven or ontology-based approaches. PMID:25268914
Full Text Available Human activity recognition is a key task in ambient intelligence applications to achieve proper ambient assisted living. There has been remarkable progress in this domain, but some challenges still remain to obtain robust methods. Our goal in this work is to provide a system that allows the modeling and recognition of a set of complex activities in real life scenarios involving interaction with the environment. The proposed framework is a hybrid model that comprises two main modules: a low level sub-activity recognizer, based on data-driven methods, and a high-level activity recognizer, implemented with a fuzzy ontology to include the semantic interpretation of actions performed by users. The fuzzy ontology is fed by the sub-activities recognized by the low level data-driven component and provides fuzzy ontological reasoning to recognize both the activities and their influence in the environment with semantics. An additional benefit of the approach is the ability to handle vagueness and uncertainty in the knowledge-based module, which substantially outperforms the treatment of incomplete and/or imprecise data with respect to classic crisp ontologies. We validate these advantages with the public CAD-120 dataset (Cornell Activity Dataset, achieving an accuracy of 90.1% and 91.07% for low-level and high-level activities, respectively. This entails an improvement over fully data-driven or ontology-based approaches.
van der Veek, Shelley M C; Derkx, Bert H F; Benninga, Marc A; Boer, Frits; de Haan, Else
This randomized controlled trial investigated the effectiveness of a 6-session protocolized cognitive behavior therapy (CBT) compared with 6 visits to a pediatrician (intensive medical care; IMC) for the treatment of pediatric functional abdominal pain (FAP). One hundred four children aged 7 to 18 were randomized to CBT or IMC. CBT was delivered primarily by trained master's degree students in psychology; IMC was delivered by pediatricians or pediatric gastroenterologists. Assessments were performed pretreatment, posttreatment, and at 6- and 12-month follow-up. Primary outcomes were level of abdominal pain (AP) as reported on questionnaires and diaries. Secondary outcomes were other gastrointestinal complaints, functional disability, other somatic complaints, anxiety, depression, and quality of life. Both CBT and IMC resulted in a significant decrease in AP (P .05 for all end points). According to the questionnaire-derived data, 1 year after treatment, 60% of children that received CBT had significantly improved or recovered, versus 56.4% of children receiving IMC, which did not significantly differ (P = .47). These percentages were 65.8% versus 62.8% according to the diary-derived data, which also did not significantly differ (P = .14). Additionally, nearly all secondary outcomes improved after treatment. CBT was equally effective as IMC in reducing AP in children with FAP. More research into the specific working mechanisms of CBT for pediatric FAP is needed.
Ewa Małgorzata Szepietowska
Full Text Available Objective: The aim of the study was to determine whether the intensity of cognitive complaints can, in conjunction with other selected variables, predict the general level of cognitive functions evaluated with the Montreal Cognitive Assessment (MoCA test. Current reports do not show clear conclusions on this subject. Some data indicate that cognitive complaints have a predictive value for low scores in standardised tasks, suggesting cognitive dysfunction (e.g. mild cognitive impairment. Other data, however, do not support the predictive role of complaints, and show no relationship to exist between the complaints and the results of cognitive tests. Material and methods: The study included 118 adults (58 women and 60 men. We used the MoCA test, a self-report questionnaire assessing the intensity of cognitive complaints (Patient-Reported Outcomes in Cognitive Impairment – PROCOG and Dysexecutive Questionnaire/Self – DEX-S, and selected subtests of the Wechsler Adult Intelligence Scale-Revised (WAIS-R PL. On the basis of the results from the MoCA test, two separate groups were created, one comprising respondents with lower results, and one – those who obtained scores indicating a normal level of cognitive function. We compared these groups according to the severity of the complaints and the results obtained with the other methods. Logistic regression analysis was performed taking into account the independent variables (gender, age, result in PROCOG, DEX-S, and neurological condition and the dependent variable (dichotomized result in MoCA. Results: Groups with different levels of performance in MoCA differed in regards of some cognitive abilities and the severity of complaints related to semantic memory, anxiety associated with a sense of deficit and loss of skills, but provided similar self-assessments regarding the efficiency of episodic memory, long-term memory, social skills and executive functions. The severity of complaints does not allow
Abdominal aortic aneurysms and abdominal hernias become an important health problems of our times. Abdominal aortic aneurysm and its rupture is one of the most dangerous fact in vascular surgery. There are some theories pointing to a multifactoral genesis of these kinds of diseases, all of them assume the attenuation of abdominal fascia and abdominal aortic wall. The density and continuity of these structures depend on collagen and elastic fibers structure. Reducing the strength of the fibers may be due to changes in the extracellular matrix (ECM) by the proteolytic enzymes-matrix metalloproteinases (MMPs) that degrade extracellular matrix proteins. These enzymes play an important role in the development of many disease: malignant tumors (colon, breast, lung, pancreas), cardiovascular disease (myocardial infarction, ischemia-reperfusion injury), connective tissue diseases (Ehler-Danlos Syndrome, Marfan's Syndrome), complications of diabetes (retinopathy, nephropathy). One of the most important is matrix metalloproteinase-2 (MMP-2). The aim of the study was an estimation of the MMP-2 blood levels in patients with abdominal aortic aneurysm and primary abdominal hernia, and in patients with only abdominal aortic aneurysm. The study involved 88 patients aged 42 to 89 years, including 75 men and 13 women. Patients were divided into two groups: patients with abdominal aortic aneurysm and primary abdominal hernia (45 persons, representing 51.1% of all group) and patients with only abdominal aortic aneurysm (43 persons, representing 48,9% of all group). It was a statistically significant increase in MMP-2 blood levels in patients with abdominal aortic aneurysm and primary abdominal hernia compared to patients with only abdominal aortic aneurysm. It was a statistically significant increase in the prevalence of POCHP in patients with only abdominal aortic aneurysm compared to patients with abdominal aortic aneurysm and primary abdominal hernia. Statistically significant
Full text: Immunoglobulin G4-related disease was recognized as a systemic disease since various extrapancreatic lesions were observed in patients with autoimmune pancreatitis (AIP). The real etiology and pathogenesis of IgG4-RD is still not clearly understood. Moreover the exact role of IgG4 or IgG4-positive plasma cells in this disease has not yet been elucidated. only some inconsistent biological features such as hypergammaglobulinemia or hypocomplementemia support the autoimmune nature of the disease process. various names have been ascribed to this clinicopathological entity including IgG4-related sclerosing disease, IgG4-related systemic sclerosing disease, IgG4-related disease, IgG4-related autoimmune disease, hyper-IgG4 disease and IgG4-related systemic disease. The extrapancreatic lesions of IgG4-RD also exhibit the same characteristic histologic features including dense lymphoplasmacytic infiltrate, massive storiform fibrosis, and obliterative phlebitis as seen in IgG4-related pancreatitis. Abdominal manifestations include the following organs/systems: Bile ducts: Sclerosing cholangitis; Gallbladder and liver: Acalculous sclerosis cholecytitis with diffuse wall thickening; hepatic inflammatory pseudotumorts; Kidneys: round or wedge-shaped renal cortical nodules, peripheral cortical; lesions, mass like lesions or renal pelvic involvement; Prostate, urethra, seminal vesicle, vas deferens, uterine cervix; Autoimmune prostatitis; Retroperitoneum: Retroperitoneal fibrosis. thin or mildly thick homogeneous soft tissue lesion surrounding the abdominal aorta and its branches but also bulky masses causing hydronephroureterosis; Mesentery: Sclerosing mesenteritis usually involving the root of the mesentery; Bowel: Inflammatory bowel diseases mimicking Crohn’s disease or ulcerative colitis. various types of sclerosing nodular lesions of the bowel wall; Stomach: Gastritis, gastric ulcers and focal masses mimicking submucosal tumor; omentum: Infiltration mimicking
Farmer, Adam D; Aziz, Qasim
Functional abdominal pain syndrome is characterised by frequent or continuous abdominal pain associated with a degree of loss of daily activity. It has a reported population prevalence of between 0.5% and 1.7%, with a female preponderance. The pathophysiology of functional abdominal pain is incompletely understood although it has been postulated that peripheral sensitisation of visceral afferents, central sensitisation of the spinal dorsal horn and aberrancies within descending modulatory sys...
Anderson, K; Allan, D; Finucane, P
Health practitioners often regard complaints about the quality of patient care in a negative light. However, complaints can indicate strategies to improve care. Therefore, an audit was undertaken of all formal complaints about patient care at a major Australian hospital over a 30-month period. The profile of complainants, the reasons for complaints, and the outcome were analysed. A total of 1308 complaints, concerning the care of 1267 patients, were received. The complaint rate was 1.12 per 1000 occasions of service. In all, 57% of complaints were lodged by advocates and 71% of complaints related to poor communication or to the treatment provided. In 97% of occasions, an explanation and/or an apology resulted. To date, no complaint has proceeded to litigation. Complaints are potentially useful quality assurance tools and can identify remediable system flaws. Health professionals and employers should understand why patients complain and be able to respond appropriately.
Birkeland, Søren; Depont Christensen, Rene; Damsbo, Niels; Kragstrup, Jakob
The risk of being disciplined in connection with a complaint case causes distress to most general practitioners. The present study examined the characteristics of complaint cases resulting in disciplinary action. The Danish Patients' Complaints Board's decisions concerning general practice in 2007 were examined. Information on the motives for complaining, as well as patient and general practitioner characteristics, was extracted and the association with case outcome (disciplinary or no disciplinary action) was analysed. Variables included complaint motives, patient gender and age, urgency of illness, cancer diagnosis, healthcare settings (daytime or out-of-hours services), and general practitioner gender and professional seniority. Cases where the complaint motives involved a wish for placement of responsibility (OR = 2.35, p = 0.01) or a wish for a review of the general practitioner's competence (OR = 1.95, p = 0.02) were associated with increased odds of the general practitioner being disciplined. The odds of discipline decreased when the complaint was motivated by a feeling of being devalued (OR = 0.39, p = 0.02) or a request for an explanation (OR = 0.46, p = 0.01). With regard to patient and general practitioner characteristics, higher general practitioner professional seniority was associated with increased odds of discipline (OR = 1.97 per 20 additional years of professional seniority, p = 0.01). None of the other characteristics was statistically significantly associated with discipline in the multiple logistic regression model. Complaint motives and professional seniority were associated with decision outcomes. Further research is needed on the impact of professional seniority on performance.
Olsson, Erik Masao
Purpose - The purpose of this paper is to investigate healthcare customer complaints concerning interpersonal matters in cancer care. Design/methodology/approach - Complaints from cancer patients and their relatives (n=116) that dealt with interpersonal matters registered between 2009 and 2011 at four local Patients' Advisory Committees in Western Sweden were sampled and analyzed using qualitative content analysis. Findings - Complaints concerned lack of information and consideration from healthcare providers. Lack of empathy and civility also caused dissatisfaction, the latter particularly for women. Relatives complained that they did not feel included in the care process or were not offered proper support. Most complaints by relatives were filed by a female relative and concerned a male patient. Research limitations/implications - Information about patient demographics other than gender could not be investigated due to database limitations. Hence, factors such as age, country of birth, and geographical residence were not included for analysis. In addition, neither the type nor stage of cancer among the sampled patients was able to be addressed. Practical implications - Patient complaints should not only be viewed as a post-consumption judgment, but also as a service interaction activity. This may require healthcare providers to enhance their interpersonal skills, allowing patients and relatives to provide feedback during service interaction to satisfactorily address dissatisfaction. Visualizing gender disparities may help healthcare providers prevent stereotypical encounters. In addition, the provider should be invited to participate in the customer's value creating network, which may also include knowledge and skills from other sources, such as relatives. Originality/value - Value co-creation offers a different view on patient complaints. Incorporating social construction into value co-creation may reveal socially constructed disparities. The paper provides
Liljekvist, Mads Svane; Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob
Acute abdominal pain is a common clinical condition. Clinical signs and symptoms can be difficult to interpret, and diagnostic imaging may help to identify intra-abdominal disease. Conventional X-ray, ultrasound (US) and computed tomography (CT) of the abdomen vary in usability between common surgical causes of acute abdominal pain. Overall, conventional X-ray cannot confidently diagnose or rule out disease. US and CT are equally trustworthy for most diseases. US with subsequent CT may enhance diagnostic precision. Magnetic resonance seems promising for future use in acute abdominal imaging.
Full Text Available Beatrice Scicchitano,1 Gareth Humphreys,1 Sally G Mitton,2 Thiagarajan Jaiganesh1 1Children's Emergency Department, 2Department of Paediatric Gastroenterology, St Georges Hospital, St Georges Healthcare NHS Trust, Tooting, London, United Kingdom Abstract: The childhood condition of abdominal migraine has been described under many different synonyms, including "abdominal epilepsy", "recurrent abdominal pain", "cyclical vomiting syndrome", and "functional gastrointestinal disorder". In the early literature, abdominal migraine is included in the "childhood periodic syndrome", first described by Wyllie and Schlesinger in 1933. Abdominal migraine has emerged over the last century as a diagnostic entity in its own right thanks to the development of well defined diagnostic criteria and its recent inclusion in the International Headache Society's Classification of Headache disorders. Despite this progress, little is known about the pathophysiology of the condition, and the treatment options are poorly defined. Here we summarize the recent literature, with particular focus on establishing the diagnosis of abdominal migraine and its pathophysiology, and suggest an approach to management. Keywords: abdominal migraine, recurrent abdominal pain, abdominal epilepsy, cyclical vomiting
Kern, A.; Schunk, K.; Oberholzer, K.; Thelen, M.; Kessler, M.
A clinical evaluation of hydro-MRI as an alternative method to barium studies in children with abdominal pain of unknown origin is presented. Patients and Methods: 20 children with abdominal pain of unknown origin aged from 9 - 16 years were examined after oral bowel opacification using 1000 ml of 2.5% mannitol solution with a 1.0T MRI system. The investigation was done in 2 planes (coronal and axial) under breath-hold conditions. Imaging procedures included various sequences (T2W HASTE + FS, contrast-enhanced T1W FLASH FS). Suspicious findings in bowel segments and extra-intestinal changes were assessed. Results: In 21/24 examinations the small bowel was completely visualized, in 15/24 cases colon segments were identified. An accurate assessment of the terminal ileum was not possible in 3/24 procedures. Breathing artefacts occurred in 3/24 examinations. Signs of Crohn's disease were found in 4 examinations, inflammatory changes of the ileum were detected in 3 cases. Inflammation of the colon was demonstrated in 2 children. Furthermore, pathological findings included constipation in one child and inflammation of the ileo-colic and mesenterial lymph nodes were found in another child. Extra-intestinal changes in 3 children were caused by ovarian cysts, and in one case by pleural effusion. In 4 examinations we detected ascites in the absence of other pathological findings. In 5 children there was no pathological correlation in the bowel or extra-intestinal region for the complaints. The children tolerated the hydro-MRI very well. There were no side effects using oral mannitol. (orig.) [de
Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S
One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEPventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.
Escribano, J.; Gonzalez, J.; Alvarez, M.; Rivero, S.; Raya, J.L.; Ruza, M.
To analyze the ultrasonography findings in abdomen in the AIDS patients in our hospital, as well as the indications for this exploration, assessing the role of abdominal ultrasound (AU). The ultrasonographic and clinical findings in 527 patients who underwent a total of 715 explorations between 1992 and 1996 were studied. Hepatomegaly and/or splenomegaly, usually homogeneous, were observed in nearly half of the studies (45%); one third of the patients with marked splenomegaly presented visceral leishmaniasis. Focal lesions in liver and/or spleen, corresponding to angiomas, abscesses, lymphomatous lesions and metastasis, were detected in 5.7% of the explorations. Thirty-five percent of the AU revealed the presence of lymphadenopathy; nodes measuring over 2.5 cm were usually related to potential treatable infection or neoplasm. Thickening of the gallbladder wall did not usually indicate the presence of acute cholecystitis unless Murphy''s sign was also detected. Bile duct dilation and wall thickening was related to opportunistic cholangitis, and the increase in the echogenicity of the renal parenchyma was linked to AIDS-related nephropathy. Despite the fact that many of findings with AU are nonspecific, we consider that this approach should be the principal diagnostic technique in AIDS patients with suspected abdominal pathology or fever of unknown origin. (Author) 43 refs,
issues but, for now, it is necessary only to emphasize the reluctance to use the term "tribe". .... the malaise--political, economic, social that has gripped so much of Africa ..... might have, there is little doubt that it. is even far more a product of western reality .... such units insofar as they represent populations integrated for the.
Matalon, Shanna A; Askari, Reza; Gates, Jonathan D; Patel, Ketan; Sodickson, Aaron D; Khurana, Bharti
Abdominal wall injuries occur in nearly one of 10 patients coming to the emergency department after nonpenetrating trauma. Injuries range from minor, such as abdominal wall contusion, to severe, such as abdominal wall rupture with evisceration of abdominal contents. Examples of specific injuries that can be detected at cross-sectional imaging include abdominal muscle strain, tear, or hematoma, including rectus sheath hematoma (RSH); traumatic abdominal wall hernia (TAWH); and Morel-Lavallée lesion (MLL) (closed degloving injury). These injuries are often overlooked clinically because of (a) a lack of findings at physical examination or (b) distraction by more-severe associated injuries. However, these injuries are important to detect because they are highly associated with potentially grave visceral and vascular injuries, such as aortic injury, and because their detection can lead to the diagnosis of these more clinically important grave traumatic injuries. Failure to make a timely diagnosis can result in delayed complications, such as bowel hernia with potential for obstruction or strangulation, or misdiagnosis of an abdominal wall neoplasm. Groin injuries, such as athletic pubalgia, and inferior costochondral injuries should also be considered in patients with abdominal pain after nonpenetrating trauma, because these conditions may manifest with referred abdominal pain and are often included within the field of view at cross-sectional abdominal imaging. Radiologists must recognize and report acute abdominal wall injuries and their associated intra-abdominal pathologic conditions to allow appropriate and timely treatment. © RSNA, 2017.
Full Text Available Excellent healthcare services delivered to patients would not necessarily entail an excellent patient service fulfillment, fulfill patient expectations, and attain high satisfaction levels. Hence, patient satisfaction is multifactorial and difficult to measure. Appliance of satisfaction model, service dissatisfaction and satisfaction feedback are able to translate the nonlinear attributes for a more accurate service dissatisfaction and satisfaction feedback assessment. Service recipients of experienced Inpatient and Outpatient (IOPs can be translated into levels of compliments and complaints to describe degrees of patient satisfaction and dissatisfaction, respectively. Compliments and complaints voiced by patients should be taken seriously. As a result, the translation of service satisfaction and service dissatisfaction based on compliments and complaints from patients in the form of satisfaction index SCi and dissatisfaction index SCa introduced a new theoretical concept of concurrent and balance measurement in evaluating customer (VOC or VOPs feedback. In normal practice, the service improvement is usually based on complaints or dissatisfaction aspect, but the compliments or satisfaction aspect on the same service delivery was always neglected. In this study, the formulation which was based on a non-linear assessment, not only amplified the effectiveness in communicating patients’ compliments and complaints in a more receptive manner but also corresponded with Kano model.
Beckers, Henny Jm; van Kooten-Noordzij, Marina Aw; de Crom, Ronald Mpc; Schouten, Jan Sag; Webers, Carroll Ab
To study visual complaints and eye diseases among professional and amateur orchestral musicians in the Netherlands. In this observational study, members from professional and amateur symphony or wind orchestras were asked to complete a questionnaire collecting demographic data, musical, medical, and family history, and data on present visual complaints and/or eye diseases. Questions about playing in the orchestra were also asked. Data from 70 professionals and 48 amateurs showed that most musicians needed glasses or contact lenses for playing in the orchestra (61% of the professionals, 63% of the amateurs). A majority (66% of professionals, 71% of amateurs) had visited an ophthalmologist at least once during their lifetime, and 10% of the professionals and 23% of the amateurs were currently under treatment of an ophthalmologist. Visual complaints while playing in the orchestra were quite common and included poor lighting conditions, problems with reading small notes, blurred vision, tired eyes, and itching or burning eyes. Professional musicians especially reported adverse effects of eye complaints encountered in the orchestra for daily life; 35% got tired earlier and 33% felt that they could not adequately perform their tasks in the orchestra. The results show that visual complaints and eye problems probably are quite common among orchestral musicians and therefore warrant further interest and research.
Juvenal da Rocha Torres Neto
Full Text Available Dentre as modalidades terapêuticas da sepse abdominal, a peritoneostomia tem papel decisivo permitindo explorações e lavagens da cavidade de forma facilitada. Observamos pacientes com diagnóstico clínico de sepse abdominal internados no Serviço de Coloproctologia do Hospital Universitário da Universidade Federal de Sergipe, e que foram submetidos a peritoneostomia de janeiro de 2004 a janeiro de 2006. Foram avaliados quanto ao diagnóstico primário e secundário, tipo de peritonite secundária, antibioticoterapia, esquema de lavagens, tempo de peritoneostomia, complicações e desfecho. Estudamos 12 pacientes, com idade de 15 a 57, média de 39,3 anos. Diagnóstico primário: abdome agudo inflamatório em 6(50%, abdome agudo obstrutivo em 2(16,7%, abdome agudo perfurativo em 2(16,7%, fístula enterocutânea em 1(8,3% e abscesso intra-cavitário em 1(8,3%. Diagnóstico secundário: perfuração de cólon em 4(33,3%, abscessos intra-cavitários em 3(25%, deiscências de anastomoses em 3(25%, 1(8,3% com tumor perfurado de sigmóide e 1(8,3% com necrose de cólon abaixado. Peritonite fecal em 10(83,3% e purulenta em 2(16,7%. A antibioticoterapia teve duração média de 19 dias. Lavagens de demanda em 6(50%, programadas em 4(33,3% e regime misto em 2(16,7%. O tempo médio de peritoneostomia foi de 10,9 dias (1-36. Como complicações: evisceração em 2(16,7% e fistulização em 1(8,3%. Quatro pacientes evoluíram com óbito.Among the therapeutics approach form of abdominal sepsis, the laparostomy has a decisive role allowing cavity explorations and lavages in an easier way. We study patients with abdominal sepsis diagnoses admitted to our surgical service of Coloproctology form Sergipe´s Federal University Hospital who underwent a Bogotá Bag laparostomy associated or not with polypropylene mesh from January 2004 to January 2006. These patients were assessed as: first and second diagnosis; secondary peritonitis type; antibiotic
Bjørnson; Steiner; Keddie
In response to grower complaints of poor performance of Phytoseiulus persimilis, mites from 14 commercial insectaries and research colonies were examined for pathogens. Some were found to have abdominal discolorations, manifested initially as two white stripes along the dorsal sides of the body within the Malpighian tubules. Advanced signs appeared as a large, centrally located, white spot or U-shaped discoloration in the distal opisthosoma within the rectum/anal atrium. White material often accumulated and hardened within the anus and formed a rectal plug that inhibited further excretion. Most affected mites were lethargic. Adults and immatures with abdominal discoloration contained numerous densely packed, birefringent, dumbbell-shaped entities. Though occasionally observed in the colon, they occurred most frequently within the Malpighian tubules and/or rectum and anal atrium. Dumbbells measured 2-4 &mgr;m long and contained prominent concentric rings. When observed by transmission electron microscopy, the entities lacked cellular organelles. Asymptomatic mites contained few or no such entities. Dumbbell-shaped inclusions were observed in P. persimilis from all sources examined. High levels of potassium, low levels of phosphorous and sulfur, and traces of chlorine were detected by energy-dispersive X-ray analysis. Guanine and uric acid, known nitrogenous wastes of arachnids, do not contain these elements. The chemical composition and structure indicate that the dumbbells are crystals. Both asymptomatic mites and those specimens exhibiting abdominal discoloration were examined for pathogens using light and transmission electron microscopy. Microsporidia, virus-like particles, and a rickettsia (genus Wolbachia) were observed in some mites but showed no correlation with white abdominal discoloration or associated crystal formation. Neither were pathogens always detected in symptomatic mites. Although birefringent crystals may be naturally occurring excretory
Nissan, Batel; Lachish, Tamar; Schwartz, Eli
Persistent abdominal symptoms (PAS) are common among returning-travellers. In the absence of sensitive tests to identify intestinal parasites, gastrointestinal (GI) symptoms often remain a diagnostic challenge. In this study we examined the effectiveness of empirical anti-parasitic treatment in returning-travellers with PAS despite no positive stool-test. A retrospective study among returning travellers who approached the clinic between the years 2014 and 2016 with GI complaints without a positive stool-test. The empirical treatment included broad-spectrum anti-parasitic agents-oral Tinidazole and Albendazole. A follow-up questionnaire was performed at least 6 months post-treatment. A total of 102 patients responded the questionnaire-50% women; average age 31.14 (±12.20) years. The average duration of complaints before treatment was 16.52 (±30.06) months. Common GI symptoms included abdominal pain (83.3%) and diarrhoea (78.4%); 67.6% of the patients complained of extreme fatigue. Overall, 69% of the patients reported an improvement in GI symptoms, 37% of them reported full recovery within a few weeks post-treatment. Furthermore, there was an improvement in the energy level and general well-being in 68% and 70% of the patients, respectively. Only 33% of the patients reported minor side effects related to the treatment. The improvement in GI symptoms, energy level and general well-being shortly after anti-parasitic treatment justifies this empirical approach in returning-travellers with PAS despite negative stool-tests. The association between fatigue and PAS post-travel and the improvement in both as a response to treatment defines fatigue as part of a new syndrome-'Post-travel fatigue and abdominal symptoms'. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: email@example.com
Abdominal wall endometriosis is a likely sequelae of caesarean section as viable endometrial tissue are deposited in the peritoneal cavity or anterior abdominal wall. One such case to sensitize clinicians of this rare presentation of the disease is presented. The patient was a 48 year old woman who presented with a lesion ...
Matushita, J.P.K.; Matushita, J.S.
A case report of synovial sarcoma arising in the abdominal wall is presented. A brief review of the clinical and radiological features of synovial sarcoma is made. Pre-operative diagnosis of an abdominal wall synovial sarcoma is virtually impossible, but should be considered when a soft tissue swelling is found to show amorphous stippled calcification X-ray. (author) [pt
Asymptomatic incisional endometrioma of the anterior abdominal wall is rare. Clinical diagnosis may be difficult. We present a 26 year old woman with incisional abdominal wall endometrioma discovered 5 years after caeserian section. It was painless and there was no change in size with menstruation. The patient's body ...
Flicek, Kristina T; Vikram, Holenarasipur R; De Petris, Giovanni D; Johnson, C Daniel
To describe the abdominal imaging findings of patients with gastrointestinal Basidiobolus ranarum infection. A literature search was performed to compile the abdominal imaging findings of all reported worldwide cases of gastrointestinal basidiobolomycosis (GIB). In addition, a retrospective review at our institution was performed to identify GIB cases that had imaging findings. A radiologist aware of the diagnosis reviewed the imaging findings in detail. Additional information was obtained from the medical records. A total of 73 GIB cases have been published in the medical literature. The most common abdominal imaging findings were masses in the colon, the liver, or multiple sites and bowel wall thickening. Initially, many patients were considered to have either a neoplasm or Crohn disease. We identified 7 proven cases of GIB at our institution, of which 4 had imaging studies (4 computed tomography [CT] examinations, 4 abdominal radiographs, and an upper gastrointestinal study). Imaging studies showed abnormalities in all 4 cases. Three-fourths of our study patients had an abdominal mass at CT. Two of 3 masses involved the kidneys and included urinary obstruction. All masses showed an inflammatory component with adjacent soft tissue stranding, with or without abscess formation. Radiologists should consider GIB when a patient from an arid climate presents with abdominal pain, weight loss, and an inflammatory abdominal mass on CT. Abdominal masses of the colon or liver, bowel wall thickening, and abscesses are the most common imaging findings.
Rajindrajith, Shaman; Zeevenhooven, Judith; Devanarayana, Niranga Manjuri; Perera, Bonaventure Jayasiri Crispus; Benninga, Marc A.
Chronic abdominal pain is a common problem in pediatric practice. The majority of cases fulfill the Rome IV criteria for functional abdominal pain disorders (FAPDs). At times, these disorders may lead to rather serious repercussions. Area covered: We have attempted to cover current knowledge on
Jan 1, 2006 ... a significant cause of abdominal injuries in Kenyatta National Hospital (KNH). The rate-of ... of selective management of abdominal injuries in. 1960 by ..... that pays great attention to the condition of the patient. (11). To aid in ...
Moorhouse, Andy T; Waddington, David C; Adams, Mags D
The development and application of a procedure for the assessment of low frequency noise (LFN) complaints are described. The development of the assessment method included laboratory tests addressing low frequency hearing threshold and the effect on acceptability of fluctuation, and field measurements complemented with interview-based questionnaires. Environmental health departments then conducted a series of six trials with genuine "live" LFN complaints to test the workability and usefulness of the procedure. The procedure includes guidance notes and a pro-forma report with step-by-step instructions. It does not provide a prescriptive indicator of nuisance but rather gives a systematic procedure to help environmental health practitioners to form their own opinion. Examples of field measurements and application of the procedure are presented. The procedure and examples are likely to be of particular interest to environmental health practitioners involved in the assessment of LFN complaints.
Ted L. Rosenthal
Full Text Available We studied it age, gender, diagnostic status, and psychiatric features affected 291 consecutive sleep disorder patient's body complaints on a brief checklist. Gender had a strong impact on all four (tested dependent measures, with women reporting more distress than men. Age produced significant regressions on two measures, with younger patients complaining more than older. Presence of psychiatric features was associated with more complaints on one dependent measure - previously found to reflect internal medicine patients' emotional distress. The results of regression analyses were largely supported by follow-up ANOVAs. However, contrasting insomniac versus hypersomniac versus all other sleep disorder diagnoses did not affect body complaints on any dependent measure. The results caution against combining males and females to compare self-reported distress between sleep disorders.
Lilly, Michelle M; London, Melissa J; Mercer, Mary C
This study aims to: (1) examine rates of obesity and physical health complaints among 911 telecommunicators; and (2) document the role of emotion dysregulation, psychological inflexibility, duty-related distress and dissociation, and psychopathology in predicting obesity and physical health complaints in this population. The sample consisted of 911 telecommunicators from across the country (N = 758). Participants completed an online survey assessing their mental and physical health functioning. A total of 82.5% of the sample reported a body mass index that fell within the overweight or obese category and an average of 17 physical health complaints within the past month. Peritraumatic reactions (distress and dissociation), emotion dysregulation, and psychological inflexibility had effects on physical health largely through psychopathology (alcohol abuse, post-traumatic stress disorder, and depression). Development of adapted prevention and intervention efforts with this population is needed.
Nilsen, Stein Tore; Malterud, Kirsti; Werner, Erik L.
Objectives: To explore general practitioners ’(GPs’) specific negotiation strategies regarding sick-leave issues with patientssuffering from subjective health complaints. Design: Focus-group study. Setting: Nine focus-group interviews in three citiesin different regions of Norway. Participants: 48...... GPs (31 men, 17 women; age 32–65), participating in a course dealing with diagnostic practice and assessment of sickness certifi cates related to patients with subjective health complaints. Results: TheGPs identified some specific strategies that they claimed to apply when dealing with the question...... to sick leave. Conclusions and implications: GPs seem to have a conscious approach to negotiations of sickness certification, as they report applying specific strategies to limit the duration of sick leave due to subjective health complaints. This give-and-take way of handling sick leave negotiations has...
Carney, Terry; Beaupert, Fleur; Chiarella, Mary; Bennett, Belinda; Walton, Merrilyn; Kelly, Patrick J; Satchell, Claudette S
Complaints and disciplinary processes play a significant role in health professional regulation. Many countries are transitioning from models of self-regulation to greater external oversight through systems including meta-regulation, responsive (risk-based) regulation, and "networked governance". Such systems harness, in differing ways, public, private, professional and non-governmental bodies to exert influence over the conduct of health professionals and services. Interesting literature is emerging regarding complainants' motivations and experiences, the impact of complaints processes on health professionals, and identification of features such as complainant and health professional profiles, types of complaints and outcomes. This article concentrates on studies identifying vulnerable groups and their participation in health care regulatory systems.
Full Text Available The aim of the study was to identify the main ergonomic and organizational risks contributing to stress, visual and musculoskeletal disorders in open plan office workers. A total of 73 subjects of mean age 28.3 ±4.7 years were studied. Measurements of salivary cortisol and self-ratings for strain, fatigue, stress symptoms, visual and musculoskeletal complaints were performed. The work places were organized well, but the studied staff reported high work load and time pressure. The data showed higher cortisol levels during the workday under time pressure. High incidence of visual and musculoskeletal complaints mainly in the region of the back and the neck were found, associated with flickering and blinks on the screen monitors and overtime. Optimizing workplace organization could help reduce stress and health complaints of office staff.
Won, Wylen Wade; Sharma, Ajay; Wu, Wenbo
Abdominal radiography and ultrasonography are commonly used as part of the initial diagnostic plan for cats with nonspecific signs of abdominal disease. This retrospective study compared the clinical usefulness of abdominal radiography and ultrasonography in 105 feline patients with signs of abdominal disease. The final diagnosis was determined more commonly with ultrasonography (59%) compared to radiography (25.7%). Ultrasonography was also able to provide additional clinically relevant information in 76% of cases, and changed or refined the diagnosis in 47% of cases. Based on these findings, ultrasonography may be sufficient as an initial diagnostic test for the investigation of feline abdominal disease. PMID:26483582
Litschauer-Poursadrollah, Margaritha; El-Sayad, Sabine; Wantke, Felix; Fellinger, Christina; Jarisch, Reinhart
Meteorism, abdominal spasms, diarrhea, casually obstipation, flatulence and nausea are symptoms of fructose malabsorption (FIT) and/or lactose intolerance (LIT), but are also symptoms of irritable bowel syndrome (IBS). Therefore these diseases should be considered primarily in patients with digestive complaints. For diagnosis an H(2)-breath test is used.In 1,935 patients (526 m, 1,409 f) a fructose intolerance test and in 1,739 patients (518 m,1,221 f) a lactose intolerance test was done.FIT is found more frequently than LIT (57 versus 52 % in adults (p intolerance (HIT). Headache (ca. 10 %), fatigue (ca. 5 %) and dizziness (ca. 3 %) may occur after the test, irrespective whether the test was positive or negative.In more than 2/3 of patients a diet reduced in fructose or lactose may lead to improvement or remission of these metabolic disorders. IBS, which is often correlated with FIT (183/221 patients = 83 %), can be improved by relevant but also not relevant diets indicating that irritable bowel disease seems to be caused primarily by psychological disorders.
Full Text Available Technical structure of Complaint Poetry Until 3 A.H * Gholam Abbas Rezai * * Sherafat Karimi Abstract Complaint refers to the poetic works in which the poet talks about the Vehemence of his/her painful feeling. It is the description of pains, personal and social problems and in a way is confiding whatever has annoyed his/her soul and body. Complaint can be categorized into social and personal ones. The personal complaints composed at the time of Islam were generally complaining about the Time, death, aging and separation from the beloved. This was due to the poets' shallow viewpoint on life and their nihilistic inclinations. These subjects were still present in first three centuries and were added by new subjects such as complaining about sensual desires. The general characteristic, style, structure and elements of meaning were simplicity in word and meaning , sincere and ample feeling, using many words with denotative meanings, utilizing maxims, proverbs and wise sayings, rhetorical statements, rich cadence (musical tones, as well as uniformity and simple imagination. Complaint is an independent poetic technique which as a result of the close relation to other sorts of poetic subjects is threaded through various sorts of elegy and sometimes is composed as an independent elegy. Key words : Complaint Poetry Structure Style Poetic Subject * Associate Professor, Department of Arabic Language and Literature, university of Tehran . E-mail: GHREZAEE@UT.AC.IR . ** PhD .candidate university of Tehran .E-mail: KARIMI.SHARAFAT@yahoo.com
Brugger, Peter C.; Prayer, Daniela
This review deals with the in vivo magnetic resonance imaging (MRI) appearance of the human fetal abdomen. Imaging findings are correlated with current knowledge of human fetal anatomy and physiology, which are crucial to understand and interpret fetal abdominal MRI scans. As fetal MRI covers a period of more than 20 weeks, which is characterized not only by organ growth, but also by changes and maturation of organ function, a different MR appearance of the fetal abdomen results. This not only applies to the fetal intestines, but also to the fetal liver, spleen, and adrenal glands. Choosing the appropriate sequences, various aspects of age-related and organ-specific function can be visualized with fetal MRI, as these are mirrored by changes in signal intensities. Knowledge of normal development is essential to delineate normal from pathological findings in the respective developmental stages
Brugger, Peter C. [Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Waehringerstrasse 13, 1090 Vienna (Austria)]. E-mail: firstname.lastname@example.org; Prayer, Daniela [Department of Radiology, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna (Austria)
This review deals with the in vivo magnetic resonance imaging (MRI) appearance of the human fetal abdomen. Imaging findings are correlated with current knowledge of human fetal anatomy and physiology, which are crucial to understand and interpret fetal abdominal MRI scans. As fetal MRI covers a period of more than 20 weeks, which is characterized not only by organ growth, but also by changes and maturation of organ function, a different MR appearance of the fetal abdomen results. This not only applies to the fetal intestines, but also to the fetal liver, spleen, and adrenal glands. Choosing the appropriate sequences, various aspects of age-related and organ-specific function can be visualized with fetal MRI, as these are mirrored by changes in signal intensities. Knowledge of normal development is essential to delineate normal from pathological findings in the respective developmental stages.
Full Text Available Appendecitis is one of the most frequent surgeries. Inflammation of appendix may be due to variable causes such as fecalit, hypertrophy of Peyer’s plaques, seeds of fruits and parasites. In this study we presented an uncommon type of appendicitis which occurred after abdominal blunt trauma. In this article three children present who involved acute appendicitis after blunt abdominal trauma. These patients were 2 boys (5 and 6-year-old and one girl (8-year-old who after blunt abdominal trauma admitted to the hospital with abdominal pain and symptoms of acute abdomen and appendectomy had been done for them.Trauma can induce intramural hematoma at appendix process and may cause appendicitis. Therefore, physicians should be aware of appendicitis after blunt abdominal trauma
Tamura, Atsutaka; Omori, Kiyoshi; Miki, Kazuo; Lee, Jong B; Yang, King H; King, Albert I
Typical automotive related abdominal injuries occur due to contact with the rim of the steering wheel, seatbelt and armrest, however, the rate is less than in other body regions. When solid abdominal organs, such as the liver, kidneys and spleen are involved, the injury severity tends to be higher. Although sled and pendulum impact tests have been conducted using cadavers and animals, the mechanical properties and the tissue level injury tolerance of abdominal solid organs are not well characterized. These data are needed in the development of computer models, the improvement of current anthropometric test devices and the enhancement of our understanding of abdominal injury mechanisms. In this study, a series of experimental tests on solid abdominal organs was conducted using porcine liver, kidney and spleen specimens. Additionally, the injury tolerance of the solid organs was deduced from the experimental data.
Barmat, Larry; Glaser, Gretchen; Davis, George; Craparo, Frank
To report the first placement of an abdominal cervicoisthmic cerclage using the da Vinci robot. Case report. Tertiary-care hospital. A 39-year-old female with a history of cervical insufficiency who required a cerclage and was not a candidate for transvaginal cerclage placement. Abdominal cervicoisthmic cerclage placement using the da Vinci robot. Ability to safely and successfully place an abdominal cerclage using the da Vinci robot. Abdominal cerclage was successfully placed using the da Vinci robot. The patient had minimal blood loss and was discharged to home on the same day as surgery. Da Vinci robot-assisted abdominal cerclage placement is an innovative application of robotic surgery and may alter the standard of care for women who require this surgery.
hypertension after abdominal closure (8%) and only one of ... Ann Pediatr. Surg 13:69–73 c 2017 Annals of Pediatric Surgery. Annals of ... intra-abdominal hypertension ..... measurements as a guide in the closure of abdominal wall defects.
Wewer, Anne Vibeke; Strandberg, C; Pærregaard, Anders
We report on our experience with routine abdominal ultrasonography in 120 children (aged 3-15 years) with recurrent abdominal pain, in order to determine the diagnostic value of this investigation. Eight children (7%) revealed sonographic abnormalities: gallbladder stone (n = 2), splenomegaly (n...... = 1) and urogenital abnormalities (n = 5). The recurrent abdominal pain could be explained by these findings in only two (may be three) cases. CONCLUSION: The diagnostic value of abdominal ultrasonography in unselected children with recurrent abdominal pain is low. However, the direct visualization...... of the abdominal structures as being normal may be helpful to the parents and the child in their understanding and acceptance of the benign nature of recurrent abdominal pain....
Full Text Available Case presentation: A 27-year-old man came to our emergency department with chief complaints of abdominal pain, nausea and vomiting, colicky pain in all area of abdomen without any radiation and generalized myalgia. In his background, he had no previous medical problem. In his social history he had worked in an automobile battery-reclaiming factory for 5 years. During his physical examination, his appearance was pale with perioral priority, ill and agitated but not toxic with a blood pressure of 127/85 mmHg and a pulse of 80 beats/min, respiratory rate of 14 breaths/min and oral temperature of 37.3 °C, mild generalized abdominal tenderness without rebound. No obvious signs of sensory and motor neuropathy were found. In the head and neck examination, we found lead-lined teeth. Learning points: The most common cause of chronic metal poisoning is lead. Exposure occurs through inhalation or ingestion. Both inorganic and organic forms of lead that exist naturally produce clinical toxicity. Gastrointestinal manifestations occur more frequently with acute rather than with chronic poisoning, and concurrent hemolysis may cause the colicky abdominal pains. Patients may have complained of a metallic taste and, with long-term exposure, have bluish-gray gingival lead lines. In addition, constitutional symptoms, including arthralgia, generalized weakness, and weight loss raises the possibility of lead toxicity.
By utilizing a 4.5-second CT (computed tomography) scanner which allows sequential scans the changes of the iodine concentration in abdominal organs can be observed as dynamics reflected in CT number. The abdominal dynamic CT was performed as following method. After performing the preliminary scan 50ml of 60% meglumine iothalamate was rapidly injected intravenously by hands. The sequential scanning was initiated when a half dose of contrast medium was injected. In completion of the 4 sequential scans under arrested respiration the conventional post contrast scanning was performed. The analysis of 112 cases dynamically studied by CT came to the following conclusion. CT number of the abdominal aorta was greatest on the 1st or 2nd scan of the sequential scans (7.5 - 20.5 seconds after initiation of injection). Following this peak formation, CT number of the abdominal aorta declined rapidly due to both prompt diffusion of contrast medium into the extravascular space and dilution by the intravascular fluid. Iodine concentration of the abdominal aorta during the peak period was calculated as 11.3 mg/ml by the present method, being theoretically sufficient for delineation of the vessels smaller than medium size. In the patients with impaired renal function, several characteristic patterns were noted on the dynamics of contrast medium within the abdominal organs. The abdominal dynamic CT was felt to be promissing for evaluation of the renal function. (author)
Sperber, A D; Drossman, D A
Functional abdominal pain syndrome (FAPS) is a debilitating disorder with constant or nearly constant abdominal pain, present for at least 6 months and loss of daily functioning. To review the epidemiology, pathophysiology and treatment of FAPS. A literature review using the keywords: functional abdominal pain, chronic abdominal pain, irritable bowel syndrome and functional gastrointestinal disorders. No epidemiological studies have focused specifically on FAPS. Estimates of prevalence range from 0.5% to 1.7% and tend to show a female predominance. FAPS pathophysiology appears unique in that the pain is caused primarily by amplified central perception of normal visceral input, rather than by enhanced peripheral stimulation from abdominal viscera. The diagnosis of FAPS is symptom-based in accordance with the Rome III diagnostic criteria. These criteria are geared to identify patients with severe symptoms as they require constant or nearly constant abdominal pain with loss of daily function and are differentiated from IBS based on their non-association with changes in bowel habit, eating or other gut-related events. As cure is not feasible, the aims of treatment are reduced suffering and improved quality of life. Treatment is based on a biopsychosocial approach with a therapeutic patient-physician partnership at its base. Therapeutic options include central nonpharmacological and pharmacological modalities and peripheral modalities. These can be combined to produce an augmentation effect. Although few studies have assessed functional abdominal pain syndrome or its treatment specifically, the treatment strategies outlined in this paper appear to be effective. © 2011 Blackwell Publishing Ltd.
Seo, Jung Wook [Inje Univ. Ilsan Paik Hospital, Goyang (Korea, Republic of)
To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer.
Seo, Jung Wook
To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer
... attending; (5) A description of the nature of the problem of the child relating to the proposed or refused initiation or change, including facts relating to the problem; and (6) A proposed resolution of the problem... section, the hearing officer must make a determination on the face of the due process complaint of whether...
LAURENS, RRP; WIT, HP; EBELS, T
In a randomised study, we investigated the sound production of mechanical heart valve prostheses and the complaints related to this sound. The CarboMedics, Bjork-Shiley monostrut and StJude Medical prostheses were compared. A-weighted levels of the pulse-like sound produced by the prosthesis were
Skorobogatova, Natalija; Žemaitienė, Nida; Šmigelskas, Kastytis; Tamelienė, Rasa
The aim of this study was to analyze nurses' professional burnout and health complaints and the relationship between the two components. The anonymous survey included 94 neonatal intensive care nurses from two centers of perinatology. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to evaluate professional burnout; it consisted of 3 components, Emotional Exhaustion, Depersonalization, and Personal Accomplishments, with 22 items in total. Health complaints were evaluated by 21 items, where nurses were asked to report the occurrence of symptoms within the last year. Scale means were presented with standard deviations (SD). Inferential analysis was conducted with multivariate logistic regression, adjusting for age, residence, and work experience. The mean score of professional burnout on the Emotional Exhaustion subscale was 14.4 (SD=7.91), Depersonalization 3.8 (SD=4.75), and Personal Accomplishment 29.1 (SD=10.12). The health assessment revealed that sleeplessness, lack of rest, nervousness, and tiredness were the most common complaints. The regression analysis revealed that tiredness was independently associated with significantly increased odds of professional burnout (OR=4.1). In our study, more than half of the nurses in neonatal intensive care had moderate or high levels of emotional exhaustion, while levels of depersonalization were significantly lower. In contrast, the level of personal accomplishment was low in more than half of the nurses. The most common health complaints were sleep disturbances, nervousness, and tiredness. Tiredness was most strongly associated with professional burnout.
... complaint. At the end of this process, the issuer reports to Consumer Response how it has addressed the... Proceedings (``OAEP'') discloses every month in its Air Travel Consumer Report.\\11\\ Unlike NHTSA, OAEP does... the OEAP began publishing the Air Travel Consumer Report.\\13\\ Outside reviewers have also publicized...
Wang, Chiachih D. C.; Scalise, Dominick A.; Barajas-Munoz, I. Alejandro; Julio, Kathy; Gomez, Ayleen
This study investigated adult attachment and acculturation frameworks of reported psychosomatic complaints related to perceived discrimination among a sample of Latino/Hispanic university students (N = 160). The model supported by the data suggests that attachment anxiety, acculturation toward the dominant cultural norms, and adherence to…
Newson, Rachel S.; Kemps, Eva B.
The current study investigated the nature of subjective cognitive complaints of older adults in relation to a broad array of individual cognitive functions known to decline with age. A 60-item questionnaire was developed to examine: (1) whether older adults experience problems with these cognitive functions (problems with cognition); (2) the…
... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Answer to the complaint. 22.15 Section 22.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL CONSOLIDATED RULES OF... respondent has any knowledge. Where respondent has no knowledge of a particular factual allegation and so...
Bos, J; Mol, E.; Visser, B.; Frings-Dresen, M.H.W.
Objectives: The purpose of the present study was threefold: (1) to compare the work demands on firefighters (FFs) and office workers (OWs), (2) to compare the prevalence of health complaints and disabilities in the work situation in these two groups, and (3) to explore the effect of work demands on
... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Satisfaction of complaint. 12... RELATING TO REPARATIONS General Information and Preliminary Consideration of Pleadings § 12.17 Satisfaction... as the complainant will accept in satisfaction of his claim; and (b) by submitting to the Commission...
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Contents of complaint. 15.737-12 Section 15.737-12 Money and Finance: Treasury Office of the Secretary of the Treasury POST EMPLOYMENT... charges against him/her so that the respondent is able to prepare a defense. (b) Demand for answer. In the...
... available to it, or both. (b) The complainant shall have the burden of establishing a prima facie case that... denial was lawful, once a prima facie case is established by the complainant. (c) The Commission shall... complaint if it determines that the complainant has not established a prima facie case, or that the rate...
... any person on the employee's behalf, a complaint alleging a violation of section 405. (b) Nature of... with the OSHA Area Director responsible for enforcement activities in the geographical area where the employee resides or was employed, but filing with any OSHA officer or employee is sufficient. Addresses and...
... violations. (c) Place of Filing. The complaint should be filed with the OSHA Area Director responsible for... by an employer in violation of any of the statutes listed in § 24.100(a) may file, or have filed by... with any OSHA officer or employee. Addresses and telephone numbers for these officials are set forth in...
... constitute the violations. (c) Place of filing. The complaint should be filed with the OSHA Area Director... or she has been discriminated against by an employer in violation of the Act may file, or have filed..., but may be filed with any OSHA officer or employee. Addresses and telephone numbers for these...
... subcontractor of an air carrier in violation of the Act may file, or have filed by any person on the employee's... acts and omissions, with pertinent dates, which are believed to constitute the violations. (c) Place of filing. The complaint should be filed with the OSHA Area Director responsible for enforcement activities...
Palm, W.M.; Ferrarini, L.; van der Flier, W.M.; Westendorp, R.G.J.; Bollen, E.L.E.M.; Middelkoop, H.A.M.; Milles, J.R.; van der Grond, J.; van Buchem, M.A.
Purpose To evaluate ventricular shape differences along the complete surface of the lateral and third ventricles of persons with subjective memory complaints (MC). Materials and Methods We included 28 controls and 21 persons with MC. FLAIR, T2, and PD-weighted brain MRI scans were acquired at 1.5
A. Sajjad (Ayesha); S.S. Mirza (Saira); M.L.P. Portegies (Marileen); M.J. Bos (Michiel); A. Hofman (Albert); P.J. Koudstaal (Peter Jan); H.W. Tiemeier (Henning); M.A. Ikram (Arfan)
textabstractBackground and Purpose-Persons with cognitive impairment, as assessed by cognitive tests, are at a higher risk of stroke. Subjective memory complaints might be an earlier marker for stroke, especially in persons with higher education. Their cognitive reserve might mask their cognitive
The highest reported taboo theme was homosexuality, followed by tattooing or piercing, and abortion. There is a significant positive correlation between health complaints of the students and taboo themes in their families. The findings call for intensified efforts on enlightenment (life skills) programmes designed to ...
... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Informal hearing on agency complaints. 223.19 Section 223.19 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE SURETY COMPANIES DOING BUSINESS...
Groot, I.J.M. de; Witte, L.P de
OBJECTIVE: While life expectancy is improving for persons with spinal muscular atrophy, new physical complaints may arise. To investigate this, we studied persons with a long duration and severe course (high functional limitations) of the disease. DESIGN: Cross-sectional descriptive study.
Roelen, C.A.M.; Schreuder, K.J.; Koopmans, P.C.; Groothoff, J.W.
Background Illness and illness behaviour are important problems in the Dutch workforce. Illness has been associated with job demands, with high demands relating to poorer health. It has not been reported whether subjective health complaints relate to job demands. Aims To investigate whether
The Application for Tips and Complaints System collects information on potential violators. Learn how this data is collected in the system, how it will be used, access to the data, the purpose of data collection, and record retention policies for this data
... be identified, the local Privacy Act officer will assume these duties. Issues that cannot be resolved... 32 National Defense 6 2010-07-01 2010-07-01 false Privacy Act complaints. 806b.4 Section 806b.4 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE ADMINISTRATION PRIVACY ACT...
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Quality complaints. 51-6.11 Section 51-6.11 Public Contracts and Property Management Other Provisions Relating to Public... commodities received from Defense Logistics Agency supply centers, General Services Administration supply...
Roelen, Corne A. M.; Koopmans, Petra C.; Groothoff, Johan W.
Objective: The Dutch population is healthy in terms of living and working conditions, but the levels of subjective health complaints (SHC) and sickness absence are high in the Dutch workforce. Are SHC related to sickness absence? Participants: The study population included the personnel of four
Migueza, S.A.; Hallbeck, M.S.; Vink, P.
A participatory ergonomics approach is used to create a new work environment, which is aimed at reducing neck complaints in a cell phone assembly. The participatory ergonomics program included an initiative, problem identification, a selection of solutions, an implementation and evaluation.
... within ten days after the interview their personal written statements concerning the problem; (4) Place... shall take necessary action to: (1) Interview, as appropriate, all parties concerned to obtain information relevant to the problems or complaints; (2) Place a written summary of each interview in the ASW's...
Rupture is the most serious and lethal complication of the abdominal aortic aneurysm. Despite all improvements during the past 50 years, ruptured abdominal aortic aneurysms are still associated with very high mortality. Namely, including patients who die before reaching the hospital, the mortality rate due to abdominal aortic aneurysm rupture is 90%. On the other hand, during the last twenty years, the number of abdominal aortic aneurysms significantly increased. One of the reasons is the fact that in majority of countries the general population is older nowadays. Due to this, the number of degenerative AAA is increasing. This is also the case for patients with abdominal aortic aneurysm rupture. Age must not be the reason of a treatment refusal. Optimal therapeutic option ought to be found. The following article is based on literature analysis including current guidelines but also on my Clinics significant experience. Furthermore, this article show cases options for vascular medicine in undeveloped countries that can not apply endovascular procedures at a sufficient level and to a sufficient extent. At this moment the following is evident. Thirty-day-mortality after repair of ruptured abdominal aortic aneurysms is significantly lower in high-volume hospitals. Due to different reasons all ruptured abdominal aortic aneurysms are not suitable for EVAR. Open repair of ruptured abdominal aortic aneurysm should be performed by experienced open vascular surgeons. This could also be said for the treatment of endovascular complications that require open surgical conversion. There is no ideal procedure for the treatment of AAA. Each has its own advantages and disadvantages, its own limits and complications, as well as indications and contraindications. Future reductions in mortality of ruptured abdominal aortic aneurysms will depend on implementation of population-based screening; on strategies to prevent postoperative organ injury and also on new medical technology
de Vente, Wieke; Kamphuis, Jan Henk; Blonk, Roland W B; Emmelkamp, Paul M G
The process of recovery from work-related stress, consisting of complaint reduction and work-resumption, is not yet fully understood. The aim of this study was to investigate predictors of complaint reduction and work-resumption, as well as testing complaint reduction as a mediator in the association between predictors and work-resumption. Seventy-one patients on sickness-leave because of work-related stress complaints were followed over a period of 13 months. Predictors comprised personal (demographics, coping, cognitions), work-related (job-characteristics, social support), and illness-related (complaint duration, absence duration) variables. Dependent variables were distress complaints, burnout complaints, and work-resumption. Complaints reduced considerably over time to borderline clinical levels and work-resumption increased to 68% at 13 months. Predictors of stronger reduction of distress complaints were male gender, less working hours, less decision authority, more co-worker support, and shorter absence duration. Predictors of stronger reduction of burnout complaints were male gender, lower age, high education, less avoidant coping, less decision authority, more job security, and more co-worker support. Predictors of work-resumption were lower age and stronger reduction of burnout complaints. No indication for a mediating role of burnout complaints between the predictor age and work-resumption was found. Complaint reduction and work-resumption are relatively independent processes. Symptom reduction is influenced by individual and work-related characteristics, which holds promise for a multidisciplinary treatment approach for work-related stress.
Tu, Yu-Ling; Yeh, Kuo-Wei; Chen, Li-Chen; Yao, Tsung-Chieh; Ou, Liang-Shiou; Lee, Wen-I; Huang, Jing-Long
Abdominal pain in systemic lupus erythematosus (SLE) patients has rarely been analyzed in pediatric populations. We planned to investigate the potential differences between childhood-onset and adult-onset SLE patients who were hospitalized because of acute abdominal pain. A retrospective study including 23 childhood-onset SLE patients with 38 admissions and 88 adult-onset SLE patients with 108 admissions from 1999 to 2008 were conducted in our hospital. All of them had the chief complaint of diffuse abdominal pain. The etiologies of acute abdominal pain in adult-onset SLE patients were more diverse than childhood-onset SLE patients. The most common cause of acute abdominal pain in SLE patients was lupus mesenteric vasculitis (LMV) (18.5%), followed by acute gastroenteritis (14.4%), pancreatitis (10.3%), appendicitis (7.5%), and cholecystitis (6.2%). Compared with adults, children were admitted more often due to LMV (31.6% versus 13.9%; P = 0.016), had more frequently recurrent episodes (39.1% versus 14.8%; P = 0.009), and were more often treated with immunosuppressive agents (31.6% versus 7.4%; P abdominal pain should be considered in SLE patients. LMV is the most common cause of acute abdomen in childhood-onset SLE patients with low mortality and morbidity provided by prompt diagnosis and timely administration of high-dose intravenous corticosteroids after excluding real surgical abdomen. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.
Lamb, C.R.; Kleine, L.J.; McMillan, M.C.
A wide variety of normal and pathologic factors may induce intraabdominal calcification. In general, the most reliable indication of the cause of a calcification is its location; therefore, if the affected organ can be identified the radiographic diagnosis is often straightforward or, at least, limited to relatively few possibilities. With this principle in mind, a series of patients with abdominal calcification are described for the purpose of illustrating the appearance of calcification of various abdominal organs. In addition, etiology for the calcification in each patient is discussed. Certain extraabdominal calcifications which may be seen on abdominal radiographs are also mentioned
Tsuchikura, Keiko; Ogawa, Teruyuki; Nakajima, Akihisa; Ono, Yasuhiko
Cranial and abdominal computerized tomography (CT) was performed in a 10-year-old boy with Wilson's disease complicated by liver cirrhosis. Abdominal CT showed diffuse high density areas over the whole part of the liver propably due to copper sediments, although there was no abnormal cranial CT findings. Decreased high density area of the liver was seen 60 days after the administration of D-penicillamine, suggesting the excretion of copper from the liver. Abdominal CT, as well as cranial CT, may be of help to diagnose Wilson's disease and evaluate therapeutic effects. (Namekawa, K.).
Lee, Yong Zoon; Ra, Woo Youn; Woo, Won Hyung [Hankang Sacred heart Hospital, Chung Ang University School of Medicine, Seoul (Korea, Republic of)
This study comprises 25 cases of blunt abdominal trauma proved by surgery. It is concluded that visceral damage by blunt abdominal trauma may be suspected, but can not be satisfactorily diagnosed upon a single plane abdominal roentgenologic examination with clinical support. Contrary to some reports in the literature, rupture of the hallow, viscus is more susceptible than solid organ and ileum is more than jejunum. It is a useful roentgenologic sign denoting distension and small cresent air shadow in the duodenal sweep of the damaged pancreas.
Darmanin Ellul R
Full Text Available Objective: To investigate self-reported health complaints and the use of medicines among adolescents in Malta.Methods: A self-administered questionnaire was used to survey self-reported health complaints, the use and the sources of medicines that had been accessed, during the preceding 3 months among adolescents attending secondary schools in Malta. A stratified random sample design generated a sample size of 514 students. The health complaints and use of medicines that were investigated included ear problems/hay fever/cold/cough, headache, skin problems, sport injuries, indigestion/diarrhoea/constipation, eye problems and menstrual pain (for girls. The use of vitamins and antibiotics was also investigated. Results: A total of 477 students participated in the final data collection. Correct information was submitted by 474 students, (aged 14-16 years, who formed the analytical sample, of which 53.8% were girls. The students reported a mean number of 2.70 (SD = 1.39 out of a total of 7 health complaints and 90.3% reported using at least 1 medicine during the preceding 3 months. The community pharmacy was cited as the most commonly accessed source for most of the medicines that were investigated. A proportion of 24.3% of the students had taken at least 1 medicine without adult guidance during the preceding 3 months. Almost 10% of those who had taken antibiotics, had accessed them from the home medicine cabinet.Conclusion: A high proportion of adolescents in Malta reported the use of medicines to alleviate the symptoms of common health complaints. This result is concordant with previous research carried out in the United Kingdom, Germany, Slovakia and Kuwait. A considerable proportion of students in this study had obtained medicines without adult guidance and accessed antibiotics from the home medicine cabinet. This highlights the importance of carefully designed education programs for adolescents that will integrate information about the proper use
Stephens, S.; Marting, I.; Dixon, A.K.
Sixty-nine patients are presented in whom a substantial error was made on the initial abdominal computed tomography report. Certain features of these errors have been analysed. In 30 (43.5%) a lesion was simply not recognised (error of observation); in 39 (56.5%) the wrong conclusions were drawn about the nature of normal or abnormal structures (error of interpretation). The 39 errors of interpretation were more complex; in 7 patients an abnormal structure was noted but interpreted as normal, whereas in four a normal structure was thought to represent a lesion. Other interpretive errors included those where the wrong cause for a lesion had been ascribed (24 patients), and those where the abnormality was substantially under-reported (4 patients). Various features of these errors are presented and discussed. Errors were made just as often in relation to small and large lesions. Consultants made as many errors as senior registrar radiologists. It is like that dual reporting is the best method of avoiding such errors and, indeed, this is widely practised in our unit. (Author). 9 refs.; 5 figs.; 1 tab
Bolinger, Elizabeth; Reese, Caitlin; Suhr, Julie; Larrabee, Glenn J
We examined the effect of simulated head injury on scores on the Neurological Complaints (NUC) and Cognitive Complaints (COG) scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF). Young adults with a history of mild head injury were randomly assigned to simulate head injury or give their best effort on a battery of neuropsychological tests, including the MMPI-2-RF. Simulators who also showed poor effort on performance validity tests (PVTs) were compared with controls who showed valid performance on PVTs. Results showed that both scales, but especially NUC, are elevated in individuals simulating head injury, with medium to large effect sizes. Although both scales were highly correlated with all MMPI-2-RF over-reporting validity scales, the relationship of Response Bias Scale to both NUC and COG was much stronger in the simulators than controls. Even accounting for over-reporting on the MMPI-2-RF, NUC was related to general somatic complaints regardless of group membership, whereas COG was related to both psychological distress and somatic complaints in the control group only. Neither scale was related to actual neuropsychological performance, regardless of group membership. Overall, results provide further evidence that self-reported cognitive symptoms can be due to many causes, not necessarily cognitive impairment, and can be exaggerated in a non-credible manner.
Ghazizadeh, Mahtab; McDonald, Anthony D; Lee, John D
This study applies text mining to extract clusters of vehicle problems and associated trends from free-response data in the National Highway Traffic Safety Administration's vehicle owner's complaint database. As the automotive industry adopts new technologies, it is important to systematically assess the effect of these changes on traffic safety. Driving simulators, naturalistic driving data, and crash databases all contribute to a better understanding of how drivers respond to changing vehicle technology, but other approaches, such as automated analysis of incident reports, are needed. Free-response data from incidents representing two severity levels (fatal incidents and incidents involving injury) were analyzed using a text mining approach: latent semantic analysis (LSA). LSA and hierarchical clustering identified clusters of complaints for each severity level, which were compared and analyzed across time. Cluster analysis identified eight clusters of fatal incidents and six clusters of incidents involving injury. Comparisons showed that although the airbag clusters across the two severity levels have the same most frequent terms, the circumstances around the incidents differ. The time trends show clear increases in complaints surrounding the Ford/Firestone tire recall and the Toyota unintended acceleration recall. Increases in complaints may be partially driven by these recall announcements and the associated media attention. Text mining can reveal useful information from free-response databases that would otherwise be prohibitively time-consuming and difficult to summarize manually. Text mining can extend human analysis capabilities for large free-response databases to support earlier detection of problems and more timely safety interventions.
... cable programming service. The franchise authority may file a complaint with the Commission only upon receipt of more than one subscriber complaint made to the franchise authority within 90 days after the...
Loomba-Albrecht, Lindsey A; Bremer, Andrew A; Styne, Dennis M; Glaser, Nicole S
Descriptive data characterizing the frequency of various chief complaints and presenting symptomatology in children with hyperthyroidism are lacking. Furthermore, difficulties in recognizing atypical presentations may delay diagnosis and increase morbidity. We performed a retrospective review of the medical records of 76 children with hyperthyroidism to characterize their chief complaints at initial presentation to care and document other presenting symptomatology. Cardiac symptoms were the most frequent chief complaint, accounting for 23% of presenting complaints. Major mood and behavior disturbances were also frequently present (21%), but were infrequently cited as the chief complaint (6%). This study is the first to describe chief complaints separately from the other signs and symptoms of hyperthyroidism noted at the time of presentation to medical attention. Cardiac complaints were the most common: however, complaints associated with behavioral and mood disorders also occurred frequently. Clinicians should be aware of these presentations so that hyperthyroidism is diagnosed promptly to avoid morbidity associated with delayed diagnosis.
... INTERNATIONAL TRADE COMMISSION [DN 2884] Certain Audiovisual Components and Products Containing.... International Trade Commission has received a complaint entitled Certain Audiovisual Components and Products... audiovisual components and products containing the same. The complaint names as respondents Funai Electric...
... INTERNATIONAL TRADE COMMISSION [DN 2884] Certain Audiovisual Components and Products Containing.... International Trade Commission has received a complaint entitled Certain Audiovisual Components and Products... audiovisual components and products containing the same. The complaint names as respondents Funai Electric...
... to comment on a proposed information collection titled ``Principles of Excellence Complaint Intake... leveraging the systems architecture of the Department of Defense's Complaint System. FOR FURTHER INFORMATION... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Proposed Information Collection...
... complaint names as respondent Apple Inc. of CA. The complainant, proposed respondents, other interested... behalf of S3 Graphics Co., Ltd. and S3 Graphics Inc. on September 23, 2011. The complaint alleges...
.... The complaint names as respondent Apple Inc. of CA. The complainant, proposed respondents, other... Commission has received a complaint filed on behalf of VIA Technologies Inc., IP-First, LLC and Centaur...
causes abdominal symptoms. Median ... compression of the coeliac artery by the median arcuate ligament. ... existing symptoms might cause frustration to patient and relatives. ... disease, chest pathology, etc., were excluded from the study.
Farrath, Samiris; Parreira, José Gustavo; Perlingeiro, Jacqueline A G; Solda, Silvia C; Assef, José Cesar
To identify predictors of abdominal injuries in victims of blunt trauma. retrospective analysis of trauma protocols (collected prospectively) of adult victims of blunt trauma in a period of 15 months. Variables were compared between patients with abdominal injuries (AIS>0) detected by computed tomography or/and laparotomy (group I) and others (AIS=0, group II). Student's t, Fisher and qui-square tests were used for statistical analysis, considering p3) in head (18.5% vs. 7.9%), thorax (29.2% vs. 2.4%) and extremities (40.0% vs. 13.7%). The highest odds ratios for the diagnosis of abdominal injuries were associated flail chest (21.8) and pelvic fractures (21.0). Abdominal injuries were more frequently observed in patients with hemodynamic instability, changes in Glasgow coma scale and severe lesions to the head, chest and extremities.
Dookeran, K.A.; Thompson, M.M.; Allum, W.H.
Delayed post-irradiation steatorrhoea secondary to acute pancreatic insufficiency is rare. The authors describe a case occurring in a patient 23 years following radical abdominal radiotherapy for testicular seminoma. (Author)
Dookeran, K.A.; Thompson, M.M.; Allum, W.H. (Leicester Royal Infirmary (United Kingdom). Dept. of Surgery)
Delayed post-irradiation steatorrhoea secondary to acute pancreatic insufficiency is rare. The authors describe a case occurring in a patient 23 years following radical abdominal radiotherapy for testicular seminoma. (Author).
... are two main types of abdominal wall defects: omphalocele and gastroschisis . Omphalocele is an opening in the center of the ... covering the exposed organs in gastroschisis. Fetuses with omphalocele may grow slowly before birth (intrauterine growth retardation) ...
Roberto de Cleva
Full Text Available OBJECTIVE:Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior.METHODS:We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique.RESULTS:The mean age of the patients was 56±13 years, and 41.6% 25 were female; 50 patients (83.3% had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior. The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6±0.6 L and FVC (2.0±0.7 L with maintenance of FEV1/FVC of 0.8±0.2 in both groups. The maximum intra-abdominal pressure values were similar (p= 0.59 for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed.CONCLUSIONS:Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery.
Cleva, Roberto de; Assumpção, Marianna Siqueira de; Sasaya, Flavia; Chaves, Natalia Zuniaga; Santo, Marco Aurelio; Fló, Claudia; Lunardi, Adriana C; Jacob Filho, Wilson
Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC) to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior). We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique. The mean age of the patients was 56 ± 13 years, and 41.6% 25 were female; 50 patients (83.3%) had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior). The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6 ± 0.6 L) and FVC (2.0 ± 0.7 L) with maintenance of FEV1/FVC of 0.8 ± 0.2 in both groups. The maximum intra-abdominal pressure values were similar (p=0.59) for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed. Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery.
Gong, Shuangping; Dai, Yonghui; Ji, Jun; Wang, Jinzhao; Sun, Hai
Customer complaint has been the important feedback for modern enterprises to improve their product and service quality as well as the customer's loyalty. As one of the commonly used manners in customer complaint, telephone communication carries rich emotional information of speeches, which provides valuable resources for perceiving the customer's satisfaction and studying the complaint handling skills. This paper studies the characteristics of telephone complaint speeches and proposes an anal...
Farías, Emigdio Torres; Gómez, Luis Guillermo Torres; Allegre, René Márquez; Higareda, Salvador Hernández
Abdominal advanced pregnancy is an obstetric complication that put at risk maternal and fetal life. We report a case of advanced abdominal pregnancy with intact ovaries and fallopian tubes, without ureteroperitoneal fistulae and, late prenatal diagnosis, in a multiparous patient without risk factors, with alive newborn, and whose pregnancy was attended at Unidad Medica de Alta Especialidad, Hospital de Gineco-Obstetricia, Centro Medico Nacional de Occidente del IMSS, Guadalajara, Jalisco, México.
Mehta, Varun; Midha, Vandana; Mahajan, Ramit; Narang, Vikram; Wander, Praneet; Sood, Ridhi; Sood, Ajit
Though a majority of cases of lead intoxication come from occupational exposures, traditional and folk remedies have also been reported to contain toxic amounts of lead. We present a large series of patients with lead poisoning due to intake of Ayurvedic medicines, all of whom presented with unexplained abdominal pain. This was a retrospective, observational case series from a tertiary care center in India. The charts of patients who underwent blood lead level (BLL) testing as a part of workup for unexplained abdominal pain between 2005 and 2013 were reviewed. The patients with lead intoxication (BLLs >25 μg/dl) were identified and demographics, history, possible risk factors, clinical presentation and investigations were reviewed. Treatment details, duration, time to symptomatic recovery, laboratory follow-up and adverse events during therapy were recorded. BLLs were tested in 786 patients with unexplained abdominal pain and high levels were identified in 75 (9.5%) patients, of which a majority (73 patients, 9.3%) had history of Ayurvedic medication intake and only two had occupational exposure. Five randomly chosen Ayurvedic medications were analyzed and lead levels were impermissibly high (14-34,950 ppm) in all of them. Besides pain in abdomen, other presenting complaints were constipation, hypertension, neurological symptoms and acute kidney injury. Anemia and abnormal liver biochemical tests were observed in all the 73 patients. Discontinuing the Ayurvedic medicines and chelation with d-penicillamine led to improvement in symptoms and reduction in BLLs in all patients within 3-4 months. The patients presenting with severe recurrent abdominal pain, anemia and history of use of Ayurvedic medicines should be evaluated for lead toxicity. Early diagnosis in such cases can prevent unnecessary investigations and interventions, and permits early commencement of the treatment.
Ashindoitiang, J A; Atoyebi, A O; Arogundade, R A
The plain abdominal x-ray is still the first imaging modality in diagnosis of acute abdomen. The aim of this study was to find the value of plain abdominal x-ray in the management of abdominal emergencies seen in Lagos university teaching hospital. The accurate diagnosis of the cause of acute abdominal pain is one of the most challenging undertakings in emergency medicine. This is due to overlapping of clinical presentation and non-specific findings of physical and even laboratory data of the multifarious causes. Plain abdominal radiography is one investigation that can be obtained readily and within a short period of time to help the physician arrive at a correct diagnosis The relevance of plain abdominal radiography was therefore evaluated in the management of abdominal emergencies seen in Lagos over a 12 month period (April 2002 to March 2003). A prospective study of 100 consecutively presenting patients with acute abdominal conditions treated by the general surgical unit of Lagos University Teaching Hospital was undertaken. All patients had supine and erect abdominal x-ray before any therapeutic intervention was undertaken. The diagnostic features of the plain films were compared with final diagnosis to determine the usefulness of the plain x-ray There were 54 males and 46 females (M:F 1.2:1). Twenty-four percent of the patients had intestinal obstruction, 20% perforated typhoid enteritis; gunshot injuries and generalized peritonitis each occurred in 13%, blunt abdominal trauma in 12%, while 8% and 10% had acute appendicitis and perforated peptic ulcer disease respectively. Of 100 patients studied, 54% had plain abdominal radiographs that showed positive diagnostic features. Plain abdominal radiograph showed high sensitivity in patients with intestinal obstruction 100% and perforated peptic ulcer 90% but was less sensitive in patients with perforated typhoid, acute appendicitis, and blunt abdominal trauma and generalized peritonitis. In conclusion, this study
Farmer, Adam D; Aziz, Qasim
Functional abdominal pain syndrome is characterised by frequent or continuous abdominal pain associated with a degree of loss of daily activity. It has a reported population prevalence of between 0.5% and 1.7%, with a female preponderance. The pathophysiology of functional abdominal pain is incompletely understood although it has been postulated that peripheral sensitisation of visceral afferents, central sensitisation of the spinal dorsal horn and aberrancies within descending modulatory systems may have an important role. The management of patients with functional abdominal pain requires a tailored multidisciplinary approach in a supportive and empathetic environment in order to develop an effective therapeutic relationship. Patient education directed towards an explanation of the pathophysiology of functional abdominal pain is in our opinion a prerequisite step and provides the rationale for the introduction of interventions. Interventions can usefully be categorised into general measures, pharmacotherapy, psychological interventions and 'step-up' treatments. Pharmacotherapeutic/step-up options include tricyclic antidepressants, serotonin noradrenergic reuptake inhibitors and the gabapentinoids. Psychological treatments include cognitive behavioural therapy and hypnotherapy. However, the objective evidence base for these interventions is largely derived from other chronic pain syndrome, and further research is warranted in adult patients with functional abdominal pain. © The Royal Society of Medicine.
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Filing and assignment of JS-related... Agency Js Complaint System § 658.411 Filing and assignment of JS-related complaints. (a) JS-related... office personnel shall be as follows: (1) All JS-related complaints filed with a local office, and...
... 10 Energy 4 2010-01-01 2010-01-01 false How much time does an employee have to file a complaint... Complaint Resolution Process § 708.14 How much time does an employee have to file a complaint? (a) You must... filing stops running on the day the internal grievance is filed and begins to run again on the earlier of...
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Job Service Complaint System; enforcement of... for Temporary Agricultural Employment in the United States (H-2A Workers) § 655.1316 Job Service... through the Job Service Complaint System, as described in 20 CFR part 658, Subpart E. Complaints which...
... Through Review of Complaints § 96.72 Referral of complaints to the Secretary and other authorities. (a) An... authority, the Attorney General, or other law enforcement authorities any substantiated complaints that involve conduct that is: (1) Subject to the civil or criminal penalties imposed by section 404 of the IAA...
Nikoghosyan-Bossen, Gohar; Hauberg, Agnes; Homøe, Preben
The analysis of malpractice complaints can provide valuable information on patient safety. This study offers a detailed examination of the backgrounds concerning reasons and outcomes of ear, nose and throat (ENT) malpractice complaints handled by the National Board of Patients' Complaints (NBPC),...
Ginó, Sandra; Mendes, Tiago; Maroco, João; Ribeiro, Filipa; Schmand, Ben A.; de Mendonça, Alexandre; Guerreiro, Manuela
BACKGROUND: Subjective memory complaints are frequently reported by the elderly. There is less information about the characterization of subjective memory complaints in young people. OBJECTIVE: To determine different memory complaints between young and elderly people with the use of the Subjective
Ginó, S.; Mendes, T.; Maroco, J.; Ribeiro, F.; Schmand, B.A.; de Mendonca, A.; Guerreiro, M.
Background: Subjective memory complaints are frequently reported by the elderly. There is less information about the characterization of subjective memory complaints in young people. Objective: To determine different memory complaints between young and elderly people with the use of the Subjective
Vente, W. de; Kamphuis, J.H.; Blonk, R.W.; Emmelkamp, P.M.
Purpose The process of recovery from work-related stress, consisting of complaint reduction and work-resumption, is not yet fully understood. The aim of this study was to investigate predictors of complaint reduction and work-resumption, as well as testing complaint reduction as a mediator in the
de Vente, W.; Kamphuis, J.H.; Blonk, R.W.B.; Emmelkamp, P.M.G.
Purpose: The process of recovery from work-related stress, consisting of complaint reduction and work-resumption, is not yet fully understood. The aim of this study was to investigate predictors of complaint reduction and work-resumption, as well as testing complaint reduction as a mediator in the
Omar W Heyward
Full Text Available In recent years the popularity of disabled sports and competition among disabled athletes has grown considerably. With this rise in exposure of, and participation in wheelchair sports comes an increase in related stressors, including musculoskeletal load. External mechanical loading may increase the risk of shoulder complaints. The objective of this literature review was to 1 identify and describe the prevalence and/or incidence of shoulder complaints in wheelchair athletes in the literature, to 2 examine the factors and underlying mechanisms that could be potentially involved, and 3 provide some insights into the development of preventative measures.A literature search was conducted using PubMed, Scopus and Embase databases, to identify relevant published articles. All articles in the English language that contained any type of shoulder complaint in relation with a wheelchair sports player, at any level of status (recreational to elite, of any sport, were included. Articles were excluded if they did not include any statistical analysis. Articles that included studies with wheelchair athletes in combination with athletes of other disability sports were excluded in order to be able to differentiate between the two. Narrative, exploratory and case studies were also excluded. Two reviewers independently assessed articles for inclusion. Thirteen articles matched the selection criteria. These were judged on their quality by use of an adapted version of the Webster checklist.Of the included studies the overall quality was low. A relatively high prevalence of complaints was found, ranging from 16% to 76%. Pain was found to be a common complaint in wheelchair athletes. Based on the current literature the cause of shoulder problems is difficult to identify and is likely multifactorial, nevertheless characteristics of the user (i.e. increased years of disability, age and BMI were shown to increase risk. Preventative measures were indistinct. There may be
Bartolozzi, C.; Lencioni, R.; Donati, F.; Cioni, D.
Following the introduction of rapid, high-quality scan techniques and the development of new, tissue-specific contrast agents, the applications of MRI for abdominal imaging are experiencing unprecedented growth. This article examines the current status of liver and pancreatic MRI, highlighting technical and methodological approach, use of contrast agents, and main clinical applications. The MRI technique appears to be the ideal diagnostic tool for detection and characterization of benign and malignant liver neoplasms, and for evaluating tumor response after nonsurgical treatments. Dynamic imaging after bolus injection of a gadolinium chelate is currently a fundamental component of an MRI examination of the liver in many instances. Optimal dynamic scanning depends on the use of a multisection spoiled gradient-echo technique that allows one to image the entire region of interest during a single suspended respiration. Images are obtained during four phases relative to the injection of the contrast agent: precontrast, arterial (pre-sinusoidal), portal (sinusoidal), and delayed (extracellular) phase. Liver-specific contrast agents, including hepatobiliary agents and reticuloendothelial system-targeted iron oxide particles, however, may offer advantages over gadolinium chelates in some clinical settings. Computed tomography is still preferred to MRI for imaging the pancreas. However, state-of-the-art MRI may currently be at least as accurate as spiral CT for depiction of inflammatory and neoplastic pancreatic diseases. Moreover, MRI has the advantage of allowing simultaneous investigation of the biliary tree, owing to cholangiopancreatography techniques. Hence, a comprehensive assessment of most pancreatic diseases can be achieved with a single examination. (orig.)
Ende, J F; Huda, W; Ros, P R; Litwiller, A L
To investigate image mottle in conventional CT images of the abdomen as a function of radiographic technique factors and patient size. Water-filled phantoms simulating the abdomens of adult (32 cm in diameter) and pediatric (16 cm in diameter) patients were used to investigate image mottle in CT as a function of x-ray tube potential and mAs. CT images from 39 consecutive patients with noncontrast liver scans and 49 patients with iodine contrast scans were analyzed retrospectively. Measurements were made of the mean liver parenchyma Hounsfield unit value and the corresponding image mottle. For a given water phantom and x-ray tube potential, image mottle was proportional to the mAs-0.5. Increasing the phantom diameter from 16 cm (pediatric) to 32 cm increased the mottle by a factor of 2.4, and increasing the x-ray tube potential from 80 kVp to 140 kVp reduced the mottle by a factor of 2.5. All patients were scanned at 120 kVp, with no correlation between patient size and the x-ray tube mAs. The mean mottle level was 7.8 +/- 2.2 and 10.0 +/- 2.5 for the noncontrast and contrast studies, respectively. An increase in patient diameter of 3 cm would require approximately 65% more mAs to maintain the same level of image mottle. The mottle in abdominal CT images may be controlled by adjusting radiographic technique factors, which should be adjusted to take into account the size of the patient undergoing the examination.
Farid, Mohammed; Nicholson, Simon; Kotwal, Ashutosh; Akali, Augustine
Objective: Previous abdominal wall surgery is viewed as a contraindication to abdominal free tissue transfer. We present two patients who underwent multiple abdominal liposuction procedures, followed by successful free deep inferior epigastric artery perforator flap. We review the literature pertaining to reliability of abdominal free flaps in those with previous abdominal surgery. Methods: Review of case notes and radiological investigations of two patients, and a PubMed search using the ter...
The complainants lodged a constitutional complaint 'against the Federal German Bundestag, for remaining inactive in matters of the licensing and operation of nuclear installations', and filed a petition for a temporary order. The Federal Constitutional Court dismissed the petition and inflicted a fee of 500 DM to be paid by each complainant. From the headnotes: The petition is inadmissible. It is left open whether the underlying constitutional complaint is inadmissible, or unjustified. The petition is dismissed because the complainants can seek relief by resorting to the general courts of law. They can appeal to the administrative courts in matters covered by section 7 Atomic Energy Act, and may there state their opposition against the 'permissible risk philosophy'. (orig./HSCH) [de
Hiller, W; Goebel, G
Dimensions of psychological complaints due to chronic and disabling tinnitus were investigated by means of the Tinnitus Questionnaire (TQ), administered to a sample of 138 tinnitus sufferers who had been admitted to a psychosomatic hospital. Factor analysis revealed that tinnitus-related patterns of emotional and cognitive distress, intrusiveness, auditory perceptual difficulties, sleep disturbances, and somatic complaints can be differentiated. Cognitive distortions and inappropriate attitudes towards the tinnitus and it's personal consequences were found to be highly intercorrelated forming a subgroup within a broader and more general distress factor. The stability of the factor solution obtained was examined by systematically varying the number of factors to be extracted. Based on the results of this method, scales are proposed for the questionnaire which can be used in clinical and scientific work to specifically assess major areas of tinnitus-related distress and their degree of severity. Implications for a further evaluation of the instrument are discussed.
Darshana D. Rasalkar
Full Text Available We report a case of intra-abdominal testicular tumor in a 36-year-old married lady presenting with chief complaints of primary amenorrhea. The patient was later diagnosed with testicular feminization syndrome, a form of male pseudohermaphroditism. This testicular tumor was histologically proven as seminoma. Due to rarity, imaging findings in patients with testicular feminization syndrome and intraabdominal testicular tumor have been poorly documented. So far, only one case report had described the combined role of CT and MR imaging in intraabdominal testicular sex-cord stromal tumor. To our knowledge, this case is first to document USG and MR imaging in addition to MR spectroscopy features in intraabdominal testicular seminoma.
Jensen, Kenneth; Kehlet, Henrik; Lund, Claus M
insufficiency and time of discharge readiness. RESULTS: The structured regime consisting of total intravenous anaesthesia (propofol-remifentanil), well defined fluid administration, prophylactic antiemetics (dexamethasone, ondansetron, droperidol), weak analgesics (celecoxib, paracetamol) and intraoperative......BACKGROUND AND OBJECTIVE: To evaluate the applicability, effectiveness, immediate postoperative complaints and requirements for a postanaesthesia care unit stay after elective abdominal hysterectomy under a well defined, multimodal anaesthetic regime. METHODS: Observational study of 145 consecutive......, was seen in 52%. CONCLUSION: We conclude that a structured multimodal anaesthetic regime is feasible in daily clinical practice and advantageous, and that postoperative pain and oxygen requirements (to sustain an SpO2 >92%) are the major determinants for length of stay in the postanaesthesia care unit...
Azami, Ayaka; Takano, Yoshinao; Honda, Michitaka; Todate, Yukitoshi; Tada, Takeshi; Waragai, Mitsuru; Fukushima, Daizo; Suzuki, Nobuyasu; Sato, Atai; Abe, Tsuyoshi; Teranishi, Yasushi; Sakuma, Hideo
A desmoplastic small round cell tumor(DSRCT)is a very rare malignant tumor that mainly occurs in the intra-abdominal cavity in young adults.This neoplasm has an extremely poor prognosis, with a clinical course characterized by rapid progression and metastasis.We present a 31-year-old man who presented with chief complaints of dysphagia, ataxic gait, and hoarseness.He first underwent surgical resection of a tumor in the medulla oblongata; however, the lesion was suspected to be a metastatic neoplasm.Following a thorough medical examination, the patient was diagnosed with retroperitoneal DSRCT with multiple metastatic lesions.He received multidisciplinary treatment including debulking surgery for the primary lesion; radiotherapy for metastatic lesions in the brain, abdomen, and cervical lymph nodes; hepatic artery embolization for liver metastasis; and systemic chemotherapy.The patient died of progressive disease 17 months after the initial diagnosis.
Chiou, Eric; Nurko, Samuel
Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are among the most commonly diagnosed medical problems in pediatrics. Symptom-based Rome III criteria for FAP and IBS have been validated and help the clinician in making a positive diagnosis. The majority of patients with mild complaints improve with reassurance and time. For a distinct subset of patients with more severe and disabling illness, finding effective treatment for these disorders remains a challenge. Over the years, a wide range of therapies have been proposed and studied. The lack of a single, proven intervention highlights the complex interplay of biopsychosocial factors probably involved in the development of childhood FAP and IBS, and the need for a multidisciplinary, integrated approach. This article reviews the current literature on the efficacy of pharmacologic, dietary and psychosocial interventions for FAP and IBS in children and adolescents.
Lindley, K J; Glaser, D; Milla, P J
To determine prognostic indicators in children with severe functional abdominal pain (FAP) and to test the hypothesis that "healthcare consumerism" in these families might be deleterious to the child. Retrospective analysis of a cohort of 23 children aged 12 months after onset. Poor outcome was associated with refusal to engage with psychological services, involvement of more than three consultants, lodging of a manipulative complaint with hospital management by the child's family, and lack of development of insight into psychosocial influences on symptoms. Three of four adverse prognostic indicators reflected healthcare consumerism by the families. Actions of families who lack insight into their child's illness may perpetuate FAP in childhood. A culture of parental consumerism in healthcare, however well intentioned, needs to be accompanied by robust systems to protect the interests of the child.
Nilsen, Stein; Malterud, Kirsti; Werner, Erik L; Maeland, Silje; Magnussen, Liv Heide
To explore general practitioners' (GPs') specific negotiation strategies regarding sick-leave issues with patients suffering from subjective health complaints. Focus-group study. Nine focus-group interviews in three cities in different regions of Norway. 48 GPs (31 men, 17 women; age 32-65), participating in a course dealing with diagnostic practice and assessment of sickness certificates related to patients with subjective health complaints. The GPs identified some specific strategies that they claimed to apply when dealing with the question of sick leave for patients with subjective health complaints. The first step would be to build an alliance with the patient by complying with the wish for sick leave, and at the same time searching for information to acquire the patient's perspective. This position would become the basis for the main goal: motivating the patient for a rapid return to work by pointing out the positive effects of staying at work, making legal and moral arguments, and warning against long-term sick leave. Additional solutions might also be applied, such as involving other stakeholders in this process to provide alternatives to sick leave. GPs seem to have a conscious approach to negotiations of sickness certification, as they report applying specific strategies to limit the duration of sick leave due to subjective health complaints. This give-and-take way of handling sick-leave negotiations has been suggested by others to enhance return to work, and should be further encouraged. However, specific effectiveness of this strategy is yet to be proven, and further investigation into the actual dealings between doctor and patients in these complex encounters is needed.
Santangelo, G; Vitale, C; Trojano, L; Angrisano, M G; Picillo, M; Errico, D; Agosti, V; Grossi, D; Barone, P
Subthreshold depression (SubD) is characterized by clinically relevant depressive symptoms not meeting criteria for major depression. The possible association of SubD with subjective cognitive complaints and/or objective cognitive impairments was investigated in a sample of consecutive, non-demented Parkinson's disease (PD) outpatients. Amongst 115 patients, SubD was identified in 30 patients, major depression in 33; 36 patients were classified as non-depressed. Enrolled patients were administered tests and questionnaires validated in PD for assessing objective and subjective cognitive dysfunctions. On objective cognitive measures SubD patients did not differ from non-depressed patients, whereas depressed patients achieved significantly lower scores than the other two groups. SubD and depressed patients reported more cognitive complaints than non-depressed patients. SubD is a non-motor aspect of PD that is not related to objective cognitive deficits but is associated with subjective cognitive complaints, thus impacting on patients' well-being. © 2013 The Author(s) European Journal of Neurology © 2013 EFNS.
Baranguán Castro, María Luisa; Ros Arnal, Ignacio; García Romero, Ruth; Rodríguez Martínez, Gerardo; Ubalde Sainz, Eduardo
The low FODMAP diet (fermentable oligosaccharides, monosaccharides, disaccharides, and polyols) has shown to be effective in adult patients with irritable bowel syndrome, but there are few studies on paediatric patients. The aim of this study is to assess the implementation and the outcomes of a low FODMAP diet in the treatment of functional abdominal pain in children from a Mediterranean area. A table was designed in which foods were classified according to their FODMAP content, as well as a 'Symptoms and Stools Diary'. A prospective study was conducted on children with functional abdominal pain in our Paediatric Gastroenterology Unit. A total of 22 patients were enrolled in the trial, and 20 completed it. Data were collected of the abdominal pain features over a period of 3 days, and then patients followed a two-week low FODMAP diet. Afterwards, information about abdominal pain features was collected again. After the diet, they showed fewer daily abdominal pain episodes compared to baseline (1.16 [IQR: 0.41-3.33] versus 2 [IQR: 1.33-6.33] daily episodes, P=.024), less pain severity compared to baseline (1.41cm [IQR: 0.32-5.23] versus 4.63cm [IQR: 2.51-6.39] measured by 10-cm Visual Analogue Scale, P=.035), less interference with daily activities, and less gastrointestinal symptoms. Only 15% of patients found it difficult to follow the diet. The implementation of a low FODMAP diet for 2 weeks in a Mediterranean paediatric population diagnosed with functional abdominal pain is possible with adapted diets. It was highly valued by patients, and they showed an improvement in abdominal pain symptoms assessed by objective methods. Copyright © 2018. Publicado por Elsevier España, S.L.U.
Kansu, Aydan; Kuloğlu, Zarife; Demir, Arzu; Yaman, Aytaç
Chronic abdominal pain (CAP) in childhood is common and in the majority functional. While CAP is one of the complaints of coeliac disease (CD), whether CAP as a sole complaint is indicative of CD is unclear. Our aim was to evaluate the relationship between CAP and CD. The study was conducted on 1047 children (61.1% female, mean age 9.6 ± 4.1 years) with CAP. Patients were evaluated according to the Rome III criteria. Patients with alarm symptoms and conditions known to be associated with CD were excluded. Patients were screened for CD using a rapid tissue transglutaminase (tTG) test; positive cases were tested by tTG ELISA, and duodenal biopsies were obtained if tTG was above the normal limit. Functional dyspepsia (FD), irritable bowel syndrome (IBS) and functional abdominal pain (FAP) were diagnosed in 384 (36.7%), 274 (26.2%) and 389 (37.2%) patients, respectively. In 13 patients, the tTG rapid test was positive; 10 were also positive for tTG by ELISA and histopathological evaluations diagnosed CD in all 10 patients. The overall prevalence of CD was 0.95% (2.2%, 0.5% and 0.5% in patients with IBS, FD and FAP, respectively). The prevalence of CD in patients with IBS was higher than expected but with borderline statistical significance (P = 0.053). CD is found as common in children with FD and FAP as in the general population. CD was more commonly diagnosed in IBS patients with borderline statistical significance. We suggest that particular attention be paid to children with IBS. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
Takagi, Hisato; Umemoto, Takuya
To summarize the association of vitamins (B6, B12, C, D, and E) and abdominal aortic aneurysm (AAA), we reviewed clinical studies with a comprehensive literature research and meta-analytic estimates. To identify all clinical studies evaluating the association of vitamins B6/B12/C/D/E and AAA, databases including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through April 2015, using Web-based search engines (PubMed and OVID). For each case-control study, data regarding vitamin levels in both the AAA and control groups were used to generate standardized mean differences (SMDs) and 95% confidence intervals (CIs). Pooled analyses of the 4 case-control studies demonstrated significantly lower circulating vitamin B6 levels (SMD, -0.33; 95% CI, -0.55 to -0.11; P=0.003) but non-significantly lower vitamin B12 levels (SMD, -0.42; 95% CI, -1.09 to 0.25; P=0.22) in patients with AAA than subjects without AAA. Pooled analyses of the 2 case-control studies demonstrated significantly lower levels of circulating vitamins C (SMD, -0.71; 95% CI, -1.23 to -0.19; P=0.007) and E (SMD, -1.76; 95% CI, -2.93 to 0.60; P=0.003) in patients with AAA than subjects without AAA. Another pooled analysis of the 3 case-control studies demonstrated significantly lower circulating vitamin D (25-hydroxyvitamin D) levels (SMD, -0.25; 95% CI, -0.50 to -0.01; P=0.04) in patients with AAA than subjects without AAA. In a double-blind controlled trial, 4.0-year treatment with a high-dose folic acid and vitamin B6/B12 multivitamin in kidney transplant recipients did not reduce a rate of AAA repair despite significant reduction in homocysteine level. In another randomized, double-blind, placebo-controlled trial, 5.8-year supplementation with α-tocopherol (vitamin E) had no preventive effect on large AAA among male smokers. In clinical setting, although low circulating vitamins B6/C/D/E (not B12) levels are associated with AAA presence, vitamins B6/B12/E
Full Text Available Una niña indigena de 4 años de edad, procedente de Carurú, Vaupés, un municipio semiselvático de 2.000 habitantes, presentó hematoquecia repetida con sincope y muerte 4 días después, a pesar de recibir transfusiones sanguíneas. El estudio postmortem descubrió dos masas de 3-4 cm de diámetro en el ileon distal que, al microscopio, correspondieron a inflamación severa de toda la pared intestinal, rica en eosinofilos y en granulomas con células gigantes que circunscribian y fagocitaban huevos y larvas de Angiostrongylus costaricensis, helminto situado también dentro de las arterias de la submucosa, vasos que presentaban engrosamiento de la intima y focos con inflamación granulomatosa con eosinófilos. La niña no presentó leucocitosis ni eosinofilia. Este es el segundo caso de angiostrongilosis de esta región. El primero fue el de una mujer indigena de 34 años también con hematoquecia anemizante. La angiostrongilosis abdominal se diagnosticó por primera vez en Colombia en 1979, en un niño de 5 años, de Dagua, Valle. La niña aquí presentada es el sexto paciente con esta entidad en Colombia. La hematoquecia como manifestación predominante de la angiostrongilosis es extraordinaria para una enfermedad parasitaria; se ha registrado solamente en tres ocasiones anteriores. La abundancia de cristales de Charcot-Leyden, que se tiñen muy bien con la coloración de Ziehl-Neelsen o de Fite-Faraco, en los infiltrados de la pared intestinal. sugiere que su búsqueda en las heces puede ser una ayuda en el diagnóstico de casos sospechosos. pues, los huevos y las larvas no se eliminan en las heces y el diagnóstico definitivo de la angiostrongilosis es histopatológico. Revisamos las caracteristicas clinicas, parasitológicas e histopatológicas de esta parasitosis que será más prevalente en Colombia a medida que los médicos. especialmente los patólogos, la conozcan mejor.
Dhillon, S.; Halligan, S.; Goh, V.; Matravers, P.; Chambers, A.; Remedios, D.
AIM: The technical performance of abdominal ultrasound in the investigation of acute abdominal pain has been thoroughly investigated but its therapeutic effects are less well understood. We aimed to determine the therapeutic effect of abdominal ultrasound in the investigation of acute abdominal pain. MATERIAL AND METHODS: A pre- and post-intervention observational study design was used to determine the diagnostic and therapeutic effects of abdominal ultrasound for acute abdominal pain. Referring clinicians completed a pre-ultrasound questionnaire that detailed their leading diagnosis, confidence in this and intended management in 100 consecutive adult patients. Following ultrasound a second questionnaire was completed. This again detailed the leading diagnosis, confidence in this and their intended management. Clinicians quantified the management contribution of ultrasound both for the individual case in question and in their clinical experience generally. RESULTS: The leading diagnosis was either confirmed or rejected in 72 patients and a new diagnosis provided where no prior differential diagnosis existed in 10. Diagnostic confidence increased significantly following ultrasound (mean score 6·5 pre-ultrasound vs 7·6 post-ultrasound, P < 0·001). Intended management changed following ultrasound in 22 patients; 15 intended laparotomies were halted and a further seven patients underwent surgery where this was not originally intended. Ultrasound was rated either 'very' or 'moderately' helpful in 87% of patients, with 99% of clinicians finding it either 'very' or 'moderately' helpful generally. CONCLUSION: Abdominal ultrasound has considerable diagnostic and therapeutic effect in the setting of acute abdominal pain. Dhillon, S. et al. (2002)
Ryu, Seon Young; Lee, Sang Bong; Kim, Tae Woo; Lee, Taek Jun
Memory complaints are a frequent phenomenon in elderly individuals and can lead to opportunistic help-seeking behavior. The aim of this study was to compare different aspects of memory complaints (i.e., prospective versus retrospective complaints) in individuals with subjective cognitive impairment (SCI), amnestic mild cognitive impairment (aMCI), and mild Alzheimer's disease (AD). The study included a total of 115 participants (mean age: 68.82 ± 8.83 years) with SCI (n = 34), aMCI (n = 46), and mild AD (n = 35). Memory complaints were assessed using the Prospective and Retrospective Memory Questionnaire (PRMQ), which consists of 16 items that describe everyday memory failure of both prospective memory (PM) and retrospective memory (RM). For aMCI and AD subjects, informants also completed an informant-rating of the PRMQ. All participants completed detailed neuropsychological tests. Results show that PM complaints were equivalent among the three groups. However, RM complaints differed. Specifically, RM complaints in aMCI were higher than SCI, but similar to AD. Informant-reported memory complaints were higher for AD than aMCI. Our study suggests that RM complaints of memory complaints may be helpful in discriminating between SCI and aMCI, but both PM and RM complaints are of limited value in differentiating aMCI from AD.
Rothman, Josephine Philip; Gunnarsson, Ulf; Bisgaard, Thue
INTRODUCTION: Evidence for the effect of post-operative abdominal binders on post-operative pain, seroma formation, physical function, pulmonary function and increased intra-abdominal pressure among patients after surgery remains largely un-investigated. METHODS: A systematic review was conducted...... formation and physical function. RESULTS: A total of 50 publications were identified; 42 publications were excluded leaving eight publications counting a total of 578 patients for analysis. Generally, the scientific quality of the studies was poor. Use of abdominal binder revealed a non-significant tendency...... to reduce seroma formation after laparoscopic ventral herniotomy and a non-significant reduction in pain. Physical function was improved, whereas evidence supports a beneficial effect on psychological distress after open abdominal surgery. Evidence also supports that intra-abdominal pressure increases...
Wei Wenzhou; Zhu Gongsheng; Zeng Lingyan; Yin Xianglin; Yang Fuwen; Liu Changsheng
Objective: To optimize the abdominal helical CT scanning parameters in pediatric patients and to reduce its radiation hazards. Methods: 60 canines were evenly grouped into 4 groups on the basis of pediatric abdominal perimeter, scanned with 110,150,190 and 240 mAs, and their qualities of canine CT images were analyzed. 120 pediafric patients with clinic suspected abdominal diseases were divided into 4 groups on the basis of abdominal perimeter, scanned by optimal parameters and their image qualities were analyzed. Results: After CT exposure were reduced, the percentages of total A and B were 90.9 % and 92.0 % in experimental canines and in pediatric patients, respectively. Compared with conventional CT scanning, the exposure and single slice CT dose index weighted (CTDIw) were reduced to 45.8%-79.17%. Conclusion: By adjusted the pediatric helical CT parameters basedon the of pediatric abdominal perimeter, exposure of patient to the hazards of radiation is reduced. (authors)
Full Text Available In recent decades a significant increase has been observed in the number of complaints filed with ethical committees. The possibility of being the subject of a complaint is therefore a growing concern for professionals. However, research on ethics and codes of conduct in psychology is still very limited and real data on the complaints filed with Ethics Committees against psychologists are practically nonexistent. This article describes the results of a descriptive analysis of the complaints reviewed by the COPC Ethics Committee from 1998 to 2011. A total of 324 complaints were filed, but only 20% led to opening disciplinary proceedings, the judicial context being the professional area in which the highest percentage of complaints were filed (85%. Among the most prevalent reasons for complaints were making assessments without prior examination and partiality.
Milanesi, Rafaela; Caregnato, Rita Catalina Aquino
There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. RESUMO Em pacientes críticos com quadros abdominais agudos a esclarecer é crescente a solicitação da aferição da pressão intra-abdominal. Sintetizar resultados de pesquisas sobre a mensuração da pressão intra-abdominal pela via vesical e analisar o nível de evidência foram os objetivos desta revisão integrativa da literatura, realizada nas bases LILACS, MEDLINE e PubMed, no período de 2005 a julho de 2012. Identificaram-se 20 artigos, sendo 12 revisões de literatura, 4 estudos exploratório-descritivos, 2 opiniões de especialistas, 1 estudo de coorte prospectivo e 1 relato de experiência. O método vesical para mensuração da pressão intra-abdominal foi considerado padrão-ouro. Existem variações na técnica, entretanto pontos em comum foram identificados: posição supina completa, na ausência de contratura abdominal, ao final da expiração e expressa em mmHg. A maioria indica posicionar o ponto zero do
Ankareddi Vijaya Lakshmi
Full Text Available BACKGROUND Blunt abdominal trauma is an emergency and is associated with significant morbidity and mortality. The aim of the study is to study incidence, demographic profile, epidemiological factors, mechanism of trauma, treatment modalities, associated injuries, postoperative complications and morbidity and mortality. MATERIALS AND METHODS A retrospective analysis of 72 patients of blunt abdominal trauma who were admitted in government general hospital between May 2013 to April 2015 in Department of General Surgery, Government General Hospital, Guntur, with in a span of 24 months were studied. Demographic data, mechanism of trauma, management and outcome were studied. RESULTS Most of the patients in our study were in the age group of 21-30 years. Spleen was the commonest organ involved and most common procedure performed was splenectomy. Most common extra-abdominal injury was rib fractures. Wound infection was the commonest complication. CONCLUSION Initial resuscitative measures, thorough clinical examination and correct diagnosis forms the vital part of the management. FAST is more useful in blunt abdominal trauma patients who are unstable. X-ray revealed 100% accuracy in hollow viscous perforation in blunt abdominal trauma patients. CT abdomen is more useful in stable patients. Definitive indication for laparotomy was haemodynamic instability and peritonitis. Associated injuries influenced morbidity and mortality. Early diagnosis and prompt treatment can save many lives.
C. D. Gillespie
Full Text Available Cystic fibrosis (CF is a multisystem disease with a range of abdominal manifestations including those involving the liver, pancreas, and kidneys. Recent advances in management of the respiratory complications of the disease has led to a greater life expectancy in patients with CF. Subsequently, there is increasing focus on the impact of abdominal disease on quality of life and survival. Liver cirrhosis is the most important extrapulmonary cause of death in CF, yet significant challenges remain in the diagnosis of CF related liver disease. The capacity to predict those patients at risk of developing cirrhosis remains a significant challenge. We review representative abdominal imaging findings in patients with CF selected from the records of two academic health centres, with a view to increasing familiarity with the abdominal manifestations of the disease. We review their presentation and expected imaging findings, with a focus on the challenges facing diagnosis of the hepatic manifestations of the disease. An increased familiarity with these abdominal manifestations will facilitate timely diagnosis and management, which is paramount to further improving outcomes for patients with cystic fibrosis.