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Sample records for vietnamese patients presenting

  1. Risk factors of periodontal disease in Vietnamese patients.

    Science.gov (United States)

    Pham, Thuy A V; Kieu, Thoai Q; Ngo, Lan T Q

    2017-05-12

    The aim of the present study was to assess the association of periodontitis with dental and smoking behaviors, self-perception of oral status, dental knowledge, and obesity in Vietnamese patients. A cross-sectional study was conducted on 367 adults who first visited the Faculty of Odonto-Stomatology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. Information on demographic characteristics, dental and smoking behaviors, self-perception of oral status, dental knowledge, and nutritional status was investigated by a self-administered questionnaire. Periodontal status, including plaque index, probing depth, and bleeding on probing, was examined. Multiple logistic regression analysis was performed to explore risk factors that were associated with periodontitis after adjusting for confounding factors. Dental and smoking behaviors, dental knowledge, and nutritional status were all significantly related to periodontitis. The multiple logistic regression analysis showed that patients who had risk factors significantly associated with periodontitis were those who had dental scaling during the past year (odds ratio [OR]: 2.2), current smokers (OR: 2.47), who received instructions on oral hygiene (OR=1.73), and those who were overweight/obese (OR: 4.78). Periodontitis was correlated with dental and smoking behaviors, dental knowledge, and nutritional status in Vietnamese dental patients. Promoting a healthy lifestyle, reducing tobacco consumption, motivating oral self-care behaviors, together with normal weight maintenance, are necessary to reduce periodontal disease burdens. © 2017 John Wiley & Sons Australia, Ltd.

  2. Data on Vietnamese patients׳ financial burdens and risk of destitution

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    Quan-Hoang Vuong

    2016-12-01

    Full Text Available The research process started in the first week of August 10, 2014 and ended early February 2015, obtaining qualified data for 330 patients from many hospitals in northern Vietnam. Its expansion was performed for an enlarged dataset through May 2015, containing 900 records. This article exemplifies the attempt to examine the likelihood of destitution among Vietnamese patients due to insufficient insurance coverage, cost of treatment and patient׳s status of residency during a curative hospital stay. The result suggests that the patients, who are poor and come from rural areas, face serious obstacles in accessing health care services. This data article presents attributes and values of the data set used in the article provided at DOI: http://dx.doi.org/10.1186/s40064-015-1279-x Vuong (2015 [4].

  3. Data on Vietnamese patients׳ financial burdens and risk of destitution.

    Science.gov (United States)

    Vuong, Quan-Hoang; Nguyen, Trong-Khang

    2016-12-01

    The research process started in the first week of August 10, 2014 and ended early February 2015, obtaining qualified data for 330 patients from many hospitals in northern Vietnam. Its expansion was performed for an enlarged dataset through May 2015, containing 900 records. This article exemplifies the attempt to examine the likelihood of destitution among Vietnamese patients due to insufficient insurance coverage, cost of treatment and patient׳s status of residency during a curative hospital stay. The result suggests that the patients, who are poor and come from rural areas, face serious obstacles in accessing health care services. This data article presents attributes and values of the data set used in the article provided at DOI: http://dx.doi.org/10.1186/s40064-015-1279-x Vuong (2015) [4].

  4. The pharmacokinetics of artemisinin suppositories in Vietnamese patients with malaria

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    Koopmans, R.; Duc, D. D.; Kager, P. A.; Khanh, N. X.; Dien, T. K.; de Vries, P. J.; van Boxtel, C. J.

    1998-01-01

    Eight male Vietnamese malaria patients received 600 mg of artemisinin in a single dose of 3 suppositories containing 200 mg each; 24 h later they received a single oral dose of mefloquine, 15 mg/kg. Plasma artemisinin concentrations were measured until 24 h after dosing, and parasites were counted

  5. Common mutations in G6PD of Vietnamese-Kinh deficient patients

    African Journals Online (AJOL)

    DANG THI LAN ANH

    2013-03-20

    Mar 20, 2013 ... This study was conducted to identify the common mutations occurring within the G6PD gene in the G6PD -. Vietnamese deficient patients, which may be the main causative mutations of the G6PD deficiency in. Vietnamese-kinh. Sequencing was performed to detect mutations in the coding region of G6PD ...

  6. Common mutations in G6PD of Vietnamese-Kinh deficient patients ...

    African Journals Online (AJOL)

    This study was conducted to identify the common mutations occurring within the G6PD gene in the G6PD - Vietnamese deficient patients, which may be the main causative mutations of the G6PD deficiency in Vietnamese-kinh. Sequencing was performed to detect mutations in the coding region of G6PD gene for 30 ...

  7. Diabetes Control among Vietnamese Patients in Ho Chi Minh City: An Observational Cross-Sectional Study

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    Yokokawa, Hirohide; Khue, Nguyen Thy; Goto, Aya; Nam, Tran Quang; Trung, Tran The; Khoa, Vo Tuan; Ngoc, Nguyen Thi Boi; Minh, Pham Nghiem; Vinh, Nguyen Quang; Okayama, Akira; Yasumura, Seiji

    2010-01-01

    The objective of this study was to assess the extent of diabetic control and its associated factors among Vietnamese patients with diabetes mellitus (DM). The study was conducted among 652 outpatients who were recruited at a public general hospital (People Hospital 115) and a private clinic (Medic Center) in Ho Chi Minh City, Vietnam. Median age…

  8. Clinician Response to Child Abuse Presentations in the Vietnamese Hospital Emergency Setting.

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    Flemington, Tara; Fowler, Cathrine; Tran, Quang Nhat; Fraser, Jennifer

    2017-06-01

    Ongoing fiscal stability has enabled the National Assembly in Vietnam to turn its attention to improving the health and well-being of women and children. Training pediatric health care professionals in the recognition and response to child abuse presentations in the emergency setting has the potential to improve outcomes for the disproportionate number of vulnerable children presenting to the emergency setting with nonaccidental injuries. This study explored the training needs and expectations of the staff preparing to undertake such a clinical training program. This qualitative study is based on semistructured interviews with 16 clinicians from the emergency setting of a leading pediatric hospital in Vietnam. Interview questions focused on current practice in recognizing and responding to child abuse and neglect presentations, the level of training and experience of participants, and subjective reports of confidence in recognizing abuse. Interviews were conducted in English and Vietnamese, with check-translation of transcripts performed by an independent translator. A culture of collegiality and innovative workplace practices was revealed. Analysis revealed two overarching themes that were related to the need for evidence, forensic analysis, respecting families, and consultation. Despite participant confidence in recognizing and reporting child abuse and neglect presentations, knowledge deficits were found. This article presents a critical analysis of the context within which the first evidence-based clinical training program of its kind in Vietnam was developed and implemented in a pediatric children's hospital. Clinicians felt a strong moral obligation to protect children from further harm, however encountered a number of barriers inhibiting this process. Findings significantly shaped the Safe Children Vietnam training program and will also contribute to the development of protocols and improvement of community support services at the study site.

  9. Information Expensiveness Perceived by Vietnamese Patients with Respect to Healthcare Provider's Choice.

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    Quan-Hoang, Vuong

    2016-10-01

    Patients have to acquire information to support their decision on choosing a suitable healthcare provider. But in developing countries like Vietnam, accessibility issues remain an obstacle, thus adversely affect both quality and costliness of healthcare information. Vietnamese use both sources from health professionals and friends/relatives, especially when quality of the Internet-based cheaper sources appear to be still questionable. The search of information from both professionals and friends/relatives incurs some cost, which can be viewed as low or high depending low or high accessibility to the sources. These views potentially affect their choices. To investigate the effects that medical/health services information on perceived expensiveness of patients' labor costs. Two related objectives are a) establishing empirical relations between accessibility to sources and expensiveness; and, b) probabilistic trends of probabilities for perceived expensiveness. There is evidence for established relations among the variables "Convexp" and "Convrel" (all p's information sources (experts and friends/relatives) have influence on patients perception of information expensiveness. The use of experts source tends to increase the probability of perceived expensiveness. a) Probabilistic trends show Vietnamese patients have propensity to value healthcare information highly and do not see it as "expensive"; b) The majority of Vietnamese households still take non-professional advices at their own risks; c) There is more for the public healthcare information system to do to reduce costliness and risk of information. The Internet-based health service users communities cannot replace this system.

  10. Adiponectin and pro-inflammatory cytokines are modulated in Vietnamese patients with type 2 diabetes mellitus.

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    Tong, Hoang Van; Luu, Nguyen Kim; Son, Ho Anh; Hoan, Nguyen Van; Hung, Trinh Thanh; Velavan, Thirumalaisamy P; Toan, Nguyen Linh

    2017-05-01

    Adipose tissue-derived hormones are associated with metabolic disorders including type 2 diabetes mellitus. The present study investigated the levels of adiponectin and pro-inflammatory cytokines including tumor necrosis factor-α (TNF-α), interleukin-1 beta (IL-1β) and IL-10 in Vietnamese patients with type 2 diabetes mellitus, and their correlations with clinical parameters of overweight and type 2 diabetes mellitus. Based on body mass index, 73 patients with type 2 diabetes mellitus were categorized either as overweight or non-overweight. As healthy controls, 57 overweight and non-overweight individuals without type 2 diabetes mellitus were included. The adiponectin, TNF-α, IL-1β and IL-10 levels were measured in the sera samples in all study participants by enzyme-linked immunosorbent assay and were correlated with clinical parameters. The adiponectin levels were lower in patients with type 2 diabetes mellitus (2.5 ± 1.5 μg/mL) compared with controls (16 ± 18.6 μg/mL; P type 2 diabetes mellitus and in overweight controls compared with non-overweight controls (P type 2 diabetes mellitus. The quantitative insulin sensitivity check index and homeostasis model assessment insulin resistance indexes were correlated with the relative ratios of adiponectin/TNF-α, adiponectin/IL-1β, adiponectin/IL-10, TNF-α/IL-10 and IL-1β/IL-10. Adiponectin and pro-inflammatory cytokines are associated with type 2 diabetes mellitus, and might serve as a prognostic marker and a therapeutic intervention for overweight-related type 2 diabetes mellitus. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  11. Psychological distress among Vietnamese adults attending Vietnamese-speaking general practices in South Western Sydney: prevalence and associations.

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    Nguyen, Thi; Dennis, Sarah; An, Huy; Vagholkar, Sanjyot; Liaw, Siaw Teng

    2016-01-01

    Objective: The aim of the present study was to determine the prevalence of psychological distress among Vietnamese adults attending Vietnamese-speaking general practices and explore possible risk factors in this population.Methods: A cross-sectional survey of Vietnamese adult patients was conducted at 25 general practices with Vietnamese-speaking general practitioners (GPs) in south-western Sydney between October 2012 and February 2013. Patients completed the Kessler (K10) scale and a demographic questionnaire, available in Vietnamese or English. Data were analysed using SPSS version 21.Results: Of the 350 patients invited to participate, 247 completed surveys (response rate 71%). One-quarter (25%) of participants had a very high K10 score for psychological distress, nearly twice that reported in the NSW Health Survey. Participants with high exposure to trauma were at increased risk of psychological distress (odds ratio 5.9, 95% confidence interval 2.4-14.4; P speaking general practices is associated with exposure to trauma. This highlights the importance of personal, social and professional support in effective management. Vietnamese-speaking GPs who see Vietnamese or similar refugee groups should actively seek out a history of exposure to trauma, a past history of mental illness and the existence of support systems.

  12. Seeking balance between the past and the present: Vietnamese refugee parenting practices and adolescent well-being

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    Hauff, Edvard; Allen, James; Middelthon, Anne-Lise

    2012-01-01

    This qualitative study examines the resources that Vietnamese refugee parents use in raising their adolescent youth in exile and how they, and their adolescents, regard their experiences of different parenting styles. The study is based on 55 semi-structured interviews and several focus groups performed with a small sample of Vietnamese refugee parents and their adolescent children. Three main themes from the interviews were identified: the role of the extended family and siblings in bringing up children; language acquisition and cultural continuity and, finally, religion and social support. Our findings suggest extended kin are involved in the raising of adolescent children, providing additional family ties and support. Parents regarded Vietnamese language acquisition by their youth as facilitating both communication with extended kin and cultural transmission. Several parents stressed the importance of religious community to socialising and creating a sense of belonging for their youth. Vietnamese refugee parents seek a balance between Vietnamese values and their close extended family social networks, and the opportunities in Norway to develop autonomy in pursuit of educational and economic goals. Together these parenting practices constituted a mobilization of resources in support of their youth. These findings may have important implications for future research on resiliency and the role of these strategies as protective factors mediating mental health outcomes. They may also have implications for treatment, in terms of the types of resources treatment can access and for prevention strategies that maximize key cultural resources for Vietnamese refugee youth. PMID:22711948

  13. Seeking balance between the past and the present: Vietnamese refugee parenting practices and adolescent well-being.

    Science.gov (United States)

    Tingvold, Laila; Hauff, Edvard; Allen, James; Middelthon, Anne-Lise

    2012-07-01

    This qualitative study examines the resources that Vietnamese refugee parents use in raising their adolescent youth in exile and how they, and their adolescents, regard their experiences of different parenting styles. The study is based on 55 semi-structured interviews and several focus groups performed with a small sample of Vietnamese refugee parents and their adolescent children. Three main themes from the interviews were identified: the role of the extended family and siblings in bringing up children; language acquisition and cultural continuity and, finally, religion and social support. Our findings suggest extended kin are involved in the raising of adolescent children, providing additional family ties and support. Parents regarded Vietnamese language acquisition by their youth as facilitating both communication with extended kin and cultural transmission. Several parents stressed the importance of religious community to socialising and creating a sense of belonging for their youth. Vietnamese refugee parents seek a balance between Vietnamese values and their close extended family social networks, and the opportunities in Norway to develop autonomy in pursuit of educational and economic goals. Together these parenting practices constituted a mobilization of resources in support of their youth. These findings may have important implications for future research on resiliency and the role of these strategies as protective factors mediating mental health outcomes. They may also have implications for treatment, in terms of the types of resources treatment can access and for prevention strategies that maximize key cultural resources for Vietnamese refugee youth.

  14. Mutation analysis of the COL1A1 and COL1A2 genes in Vietnamese patients with osteogenesis imperfecta.

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    Ho Duy, Binh; Zhytnik, Lidiia; Maasalu, Katre; Kändla, Ivo; Prans, Ele; Reimann, Ene; Märtson, Aare; Kõks, Sulev

    2016-08-12

    The genetics of osteogenesis imperfecta (OI) have not been studied in a Vietnamese population before. We performed mutational analysis of the COL1A1 and COL1A2 genes in 91 unrelated OI patients of Vietnamese origin. We then systematically characterized the mutation profiles of these two genes which are most commonly related to OI. Genomic DNA was extracted from EDTA-preserved blood according to standard high-salt extraction methods. Sequence analysis and pathogenic variant identification was performed with Mutation Surveyor DNA variant analysis software. Prediction of the pathogenicity of mutations was conducted using Alamut Visual software. The presence of variants was checked against Dalgleish's osteogenesis imperfecta mutation database. The sample consisted of 91 unrelated osteogenesis imperfecta patients. We identified 54 patients with COL1A1/2 pathogenic variants; 33 with COL1A1 and 21 with COL1A2. Two patients had multiple pathogenic variants. Seventeen novel COL1A1 and 10 novel COL1A2 variants were identified. The majority of identified COL1A1/2 pathogenic variants occurred in a glycine substitution (36/56, 64.3 %), usually serine (23/36, 63.9 %). We found two pathogenic variants of the COL1A1 gene c.2461G > A (p.Gly821Ser) in four unrelated patients and one, c.2005G > A (p.Ala669Thr), in two unrelated patients. Our data showed a lower number of collagen OI pathogenic variants in Vietnamese patients compared to reported rates for Asian populations. The OI mutational profile of the Vietnamese population is unique and related to the presence of a high number of recessive mutations in non-collagenous OI genes. Further analysis of OI patients negative for collagen mutations, is required.

  15. Congenital Erythropoietic Porphyria: Mutation of the Uroporphyrinogen III Cosynthase Gene in a Vietnamese Patient

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    Dao Hoang Thien Kim

    2013-03-01

    Full Text Available Congenital erythropoietic porphyria (CEP arises from an autosomal recessive inherited disorder of the porphyrin metabolism, which leads to the accumulation of uroporphyrinogen I in bone marrow, skin and several other tissues by a deficiency of uroporphyrinogen III cosynthase (UROS. We studied a Vietnamese patient and her family suffering from severe cutaneous photosensitivity with skin fragility, bullous lesions and hypertrichosis on light-exposed areas. A missense mutation in the UROS gene was identified as a transversion of G to T at nucleotide 11,776, resulting in a substitution of valine by phenylalanine at codon 3 of exon 2. The patient showed a homozygous mutant profile, and the heterozygous state was observed in the parents. The activity of mutated UROS expressed in Escherichia coli was less than 16.1% that of the control, indicating that the markedly reduced activity of UROS is responsible for CEP. We described for the first time a mutation in the UROS gene in a Southeast Asian patient and a molecular diagnosis for the identification of clinically asymptomatic heterozygous mutation carriers and families with CEP.

  16. WHO antiretroviral therapy guidelines 2010 and impact of tenofovir on chronic kidney disease in Vietnamese HIV-infected patients.

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    Daisuke Mizushima

    Full Text Available OBJECTIVE: The 2010 WHO antiretroviral therapy (ART guidelines have resulted in increased tenofovir use. Little is known about tenofovir-induced chronic kidney disease (CKD in HIV-infected Vietnamese with mean body weight of 55 kg. We evaluated the prevalence and risk factors of CKD in this country. DESIGN: Cross-sectional study was performed. METHODS: Clinical data on HIV-infected Vietnamese cohort were collected twice a year. To evaluate the prevalence of CKD, serum creatinine was measured in 771 patients in October 2011 and April 2012. CKD was defined as creatinine clearance less than 60 ml/min at both time points. Multivariate logistic regression was used to determine the factors associated with CKD. RESULTS: Tenofovir use increased in Vietnam from 11.9% in April 2011 to 40.3% in April 2012. CKD was diagnosed in 7.3%, of which 7% was considered moderate and 0.3% was severe. Multivariate analysis of October-2011 data identified age per year-increase (OR: 1.229, 95%CI, 1.170-1.291, body weight per 1 kg-decrement (1.286, 1.193-1.386, and tenofovir use (2.715, 1.028-7.168 as risk factors for CKD. CONCLUSIONS: Older age, low body weight and tenofovir use were independent risk factors for CKD in Vietnam. Further longitudinal study is required to evaluate the impact of TDF on renal function in Vietnam and other countries with small-body weight patients.

  17. Detection of hepatitis A virus RNA from children patients with acute and fulminant hepatitis of unknown etiology in Vietnam: Genomic characterization of Vietnamese HAV strain.

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    Hoang, Phuc Le; Trong, Khanh Huu; Tran, Tung Thanh; Huy, Tran Thien Tuan; Abe, Kenji

    2008-10-01

    Although it is thought that Vietnam is a high endemic region of hepatitis A virus (HAV) infection, there is no report on genomic characterization of HAV spread in Vietnam. The purpose of the present paper was therefore to identify various virus infections from 33 children with acute or fulminant hepatitis of unknown etiology admitted to Children's Hospital No.1 in Ho Chi Minh City, Vietnam. Anti-HAV IgM and IgG were assayed by ELISA. Viral RNA and DNA were determined by PCR method. HAV genes isolated by PCR were sequenced and characterized by phylogenetic analysis. Anti-HAV IgM was detected in 18 of 26 acute hepatitis (69.2%) and one of seven (14.3%) fulminant hepatitis patients. Furthermore, HAV-RNA in serum was identified in five of 26 acute (19.2%) and two of seven (28.6%) fulminant hepatitis patients, respectively, on nested reverse transcription-polymerase chain reaction. Among the seven HAV-RNA-positive patients tested, two (28.6%) were negative for anti-HAV IgM. We also obtained seven isolates containing the HAV genome with the viral protein 1 (VP1) region sequence. All Vietnamese HAV isolates formed a cluster and belonged to genotype IA according to phylogenetic analysis based on the short sequences of VP1-2A junction region. HAV is an important agent with regard to fulminant hepatitis among children in Vietnam. To the authors' knowledge this is the first report on Vietnamese HAV strain confirmed on sequencing.

  18. Integrating community health workers into a patient-centered medical home to support disease self-management among Vietnamese Americans: lessons learned.

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    Wennerstrom, Ashley; Bui, Tap; Harden-Barrios, Jewel; Price-Haywood, Eboni G

    2015-01-01

    There is evidence that patient-centered medical homes (PCMHs) and community health workers (CHWs) improve chronic disease management. There are few models for integrating CHWs into PCMHs in order to enhance disease self-management support among diverse populations. In this article, we describe how a community-based nonprofit agency, a PCMH, and academic partners collaborated to develop and implement the Patient Resource and Education Program (PREP). We employed CHWs as PCMH care team members to provide health education and support to Vietnamese American patients with uncontrolled diabetes and/or hypertension. We began by conducting focus groups to assess patient knowledge, desire for support, and availability of community resources. Based on findings, we developed PREP with CHW guidance on cultural tailoring of educational materials and methods. CHWs received training in core competencies related to self-management support principles and conducted the 4-month intervention for PCMH patients. Throughout the program, we conducted process evaluation through structured team meetings and patient satisfaction surveys. We describe successes and challenges associated with PREP delivery including patient recruitment, structuring/documenting visits, and establishing effective care team integration, work flow, and communication. Strategies for mitigating these issues are presented, and we make recommendations for other PCMHs seeking to integrate CHWs into care teams. © 2014 Society for Public Health Education.

  19. Cultural differences in symptom representation for depression and somatization measured by the PHQ between Vietnamese and German psychiatric outpatients.

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    Dreher, Annegret; Hahn, Eric; Diefenbacher, Albert; Nguyen, Main Huong; Böge, Kerem; Burian, Hannah; Dettling, Michael; Burian, Ronald; Ta, Thi Minh Tam

    2017-11-01

    Despite an extensive body of research on somatic symptom presentation among people of East- and Southeast-Asian descent, results are still inconclusive. Examining and comparing symptom presentation in clinically and ethnically well-characterized populations may constitute a step towards understanding symptom presentation between patients with a different cultural background. This study aims to compare Vietnamese and German patients regarding cultural dynamics of symptom presentation upon first admission to a psychiatric outpatient service. 110 Vietnamese and 109 German patients seeking psychiatric treatment at two outpatient clinics completed the Patient Health Questionnaire (PHQ). The somatic symptom subscale (PHQ-15), the depression subscale (PHQ-9) and PHQ-subscales examining anxiety and psychosocial stress levels were analyzed and compared for both groups using multivariate analysis of covariance. Regression analysis was utilized to examine the influences of sociodemographic and migration specific factors. Vietnamese and German patients showed comparable Cronbach's alpha for all subscales. Vietnamese patients endorsed significantly higher levels of somatic symptoms overall and on certain items (as pain-related items, dizziness, and fainting spells) despite similar levels of depression severity in comparison with German patients. Vietnamese patients with poor German language skills showed a significantly higher focus on somatic symptoms. Raising awareness for cultural dynamics of symptom presentation in patients with depression is indispensable. Cross-cultural symptom assessment using the PHQ seems feasible and expands our understanding of depressive and psychosomatic symptoms when assessed by clinicians. Copyright © 2017. Published by Elsevier Inc.

  20. A syntactic component for Vietnamese language processing

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    Phuong Le-Hong

    2015-06-01

    Full Text Available This paper presents the development of a syntactic component for the Vietnamese language. We first discuss the construction of a lexicalized tree-adjoining grammar using an automatic extraction approach. We then present the construction and evaluation of a deep syntactic parser based on the extracted grammar. This is a complete system integrating necessary tools to process Vietnamese text, which permits to take as input raw texts and produce syntactic structures. A dependency annotation scheme for Vietnamese and an algorithm for extracting dependency structures from derivation trees are also proposed. At present, this is the first Vietnamese parsing system capable of producing both constituency and dependency analyses with encouraging performances: 69.33% and 73.21% for constituency and dependency analysis accuracy, respectively. The parser also compares favourably to a statistical parser which is trained and tested on the same data sets.

  1. Cross-Linguistic Analysis of Vietnamese and English with Implications for Vietnamese Language Acquisition and Maintenance in the United States

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    Giang Tang

    2007-01-01

    Full Text Available Two overall goals of this paper are a to provide a linguistic basis for promoting first language maintenance of Vietnamese in a larger United States context and b to stimulate future research in language acquisition of Vietnamese-English speakers. This paper is divided into three sections. Section 1 discusses previous studies on first language (L1 maintenance among Vietnamese Americans. Section 2 presents a cross-linguistic comparison of Vietnamese and English across speech-sound, word, and grammatical language levels. A cross-linguistic analysis may help educators better understand speaking patterns of Vietnamese American students. Based on this cross-linguistic comparison, Section 3 presents potential bi-directional interactions between Vietnamese and English within an individual speaker. These predictions are intended to provide a framework for future empirical studies related to bilingual development.

  2. Vietnamese Advanced Course: Typical North Vietnamese Expressions.

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    Defense Language Inst., Washington, DC.

    This text, prepared by the Defense Language Institute (DLI), is a dictionary of idioms which lists 621 words, phrases, and expressions frequently used in newspapers, magazines, and literary works published in North Vietnam. It is intended for use as a reference work for DLI courses in Vietnamese. Entries are listed alphabetically, translated, and…

  3. Epstein-Barr virus genetic variation in Vietnamese patients with nasopharyngeal carcinoma: full-length analysis of LMP1.

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    Nguyen-Van, Do; Ernberg, Ingemar; Enrberg, Ingemar; Phan-Thi Phi, Phi; Tran-Thi, Chinh; Hu, LiFu

    2008-10-01

    Genetic variation in tumor virus genes and its impact on function might contribute to the understanding of geographic differences in risks for virus-associated tumors. This is particularly true for the genes known to contribute to the biology of the tumor. It is has been proposed that Epstein-Barr virus (EBV) gene variation has a role in the high risk of nasopharyngeal carcinoma (NPC) in South-East Asia. NPC is among the five most common cancers in Vietnam. EBV-NPC cells always express EBV nuclear antigen 1 (EBNA1) and also frequently latent membrane protein 1 and 2 (LMP1 & LMP2). To investigate EBV gene variation in Vietnamese NPC patients we analyzed the full length of LMP1 gene including its promoter region, and the N-termini of both EBNA1 and LMP2A genes from five NPC biopsies. We detected two EBV variants V1 and V2 based on the LMP1 nucleotide sequence pattern compared with the prototype B95-8 and some available sequences including Chinese variants. The V1 variant shows strong similarity to a variant dominant in Southern China (China 1), while the V2 variant is similar to a Thai variant SEA 2 and partly identity with GD1 in the C-terminus. The promoter region and transmembrane domain of the SEA 2-like samples contained some specific differences compared with previously published variants. In contrast, analysis of EBNA1 N- and LMP2A N-termini only revealed minor changes. Our findings reinforces that the polymorphisms of whole LMP1 sequence should be considered in future EBV molecular epidemiology studies in different geographic populations.

  4. Vietnamese validation of the short version of Internet Addiction Test

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    Bach Xuan Tran

    2017-12-01

    Full Text Available Background and aims: The main goal of the present study was to examine the psychometric properties of a Vietnamese version of the short-version of Internet Addiction Test (s-IAT and to assess the relationship between s-IAT scores and demographics, health related qualify of life and perceived stress scores in young Vietnamese. Methods: The Vietnamese version of s-IAT was administered to a sample of 589 participants. Exploratory factor and reliability analyses were performed. Regression analysis was used to identify the associated factors. Results: The two-factor model of Vietnamese version of s-IAT demonstrated good psychometric properties. The internal consistency of Factor 1 (loss of control/time management was high (Cronbach's alpha=0.82 and Factor 2 (craving/social problems was satisfactory (Cronbach's alpha=0.75. Findings indicated that 20.9% youths were addicted to the Internet. Regression analysis revealed significant associations between Internet addiction and having problems in self-care, lower quality of life and high perceived stress scores. Discussion and conclusions: The Vietnamese version of s-IAT is a valid and reliable instrument to assess IA in Vietnamese population. Due to the high prevalence of IA among Vietnamese youths, IA should be paid attention in future intervention programs. s-IAT can be a useful screening tool for IA to promptly inform and treat the IA among Vietnamese youths. Keywords: Factor analysis, Short-version, Internet Addiction Test, Psychometric properties, Vietnamese

  5. Labor Market Discrimination: Vietnamese Immigrants

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    Linus Yamane

    2012-01-01

    Full Text Available Vietnamese and East European immigrants face similar obstacles in the U.S. labor market. This provides for an interesting test of racial discrimination in the labor market. Does it make any difference if an immigrant is Asian or White? When Vietnamese immigrants are compared to East European immigrants, Vietnamese men earn 7-9% less than comparable East European men, with more discrimination among the less educated, and in the larger Vietnamese population centers like California. Vietnamese women earn as much as comparable East European women. Vietnamese immigrants, male and female, are much less likely to hold managerial and supervisory positions than comparable East European immigrants.

  6. Preparing Vietnamese student teachers for teaching with a student-centered approach

    NARCIS (Netherlands)

    Nguyen, T.T.; Dekker, R.; Goedhart, M.J.

    2008-01-01

    The Vietnamese curriculum reform which trends toward a student-centered approach requires Vietnamese teacher educators to prepare student teachers for teaching using this approach. In this article, we present a case study of three Vietnamese student teachers working in groups in a methods course to

  7. The New Migrants from Asia: Vietnamese in the United States.

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    Do, Hien Duc

    1996-01-01

    Presents instructional materials for a unit of study reexamining the effects of the Vietnam War on the Vietnamese migration to the United States. These materials discuss the historical background of this migration as well as the development of Vietnamese American communities and their relationship to other Asian American communities. (MJP)

  8. Expression of Intratumoral IGF-II Is Regulated by the Gene Imprinting Status in Triple Negative Breast Cancer from Vietnamese Patients

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    Vinodh Kumar Radhakrishnan

    2015-01-01

    Full Text Available African American women suffer higher incidence and mortality of triple negative breast cancer (TNBC than Caucasian women. TNBC is very aggressive, causing the worst clinical outcome. We previously demonstrated that tumors from these patients express high IGF-II and exhibit high activation of the IGF signaling pathways. IGF-II gene expression is imprinted (monoallelic, promotes tumor progression, and metastasis and regulates Survivin, a TNBC prognostic marker. Since BC mortality has increased among young Vietnamese women, we analyzed 48 (paired TNBC samples from Vietnamese patients to assess IGF-II expression. We analyzed all samples by qrtPCR for identification of IGF-II heterozygosity and to determine allelic expression of the IGF-II gene. We also analyzed the tissues for proIGF-II and Survivin by RT-PCR and Western blotting. A total of 28 samples displayed IGF-II heterozygosity of which 78% were biallelic. Tumors with biallelic IGF-II gene expression exhibited the highest levels of proIGF-II and Survivin. Although 100% of these tissues corresponding normal samples were biallelic, they expressed significantly lower levels of or no proIGF-II and Survivin. Thus, IGF-II biallelic gene expression is differentially regulated in normal versus tumor tissues. We propose that intratumoral proIGF-II is dependent on the IGF-II gene imprinting status and it will promote a more aggressive TNBC.

  9. HER2 Status and Its Heterogeneity in Gastric Carcinoma of Vietnamese Patient

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    Dang Anh Thu Phan

    2017-07-01

    Full Text Available Background Human epidermal growth factor receptor 2 (HER2 is related to the pathogenesis and poor outcome of numerous types of carcinomas, including gastric carcinoma. Gastric cancer patients with HER2 positivity have become potential candidates for targeted therapy with trastuzumab. Methods We investigated 208 gastric cancer specimens using immunohistochemistry (IHC, fluorescence in situ hybridization and dual in situ hybridization (ISH. We also investigated the concordance between IHC and ISH. The correlation between HER2 status and various clinicopathological findings was also investigated. Results In total, 15.9% (33/208 and 24.5% (51/208 of gastric cancers showed HER2 gene amplification and protein overexpression, respectively. A high level of concordance between ISH and IHC analyses (91.3%, κ = 0.76 was found. A significant correlation between HER2 status and intestinal-type (p < .05 and differentiated carcinomas (p < .05 was also noted. The HER2 heterogeneity was high in gastric cancers; we found 68.8% phenotypic heterogeneity and 57.6% genotypic heterogeneity. Heterogeneity in HER2 protein expression and gene amplification showed a close association with diffuse histologic type and IHC 2+. Conclusions HER2 protein overexpression and gene amplification were detected in 24.5% and 15.9% of gastric cancer specimens, respectively. Intestinal-type showed a higher level of HER2 protein overexpression and gene amplification than diffuse type. HER2 status also showed a significant relationship with well- and moderately-differentiated carcinomas. The ratio of phenotypic and genotypic heterogeneity of HER2 was high in gastric carcinomas and was associated with HER2 IHC 2+ and diffuse histologic type.

  10. HER2 Status and Its Heterogeneity in Gastric Carcinoma of Vietnamese Patient.

    Science.gov (United States)

    Phan, Dang Anh Thu; Nguyen, Vu Thien; Hua, Thi Ngoc Ha; Ngo, Quoc Dat; Doan, Thi Phuong Thao; Nguyen, Sao Trung; Thai, Anh Tu; Nguyen, Van Thanh

    2017-07-01

    Human epidermal growth factor receptor 2 (HER2) is related to the pathogenesis and poor outcome of numerous types of carcinomas, including gastric carcinoma. Gastric cancer patients with HER2 positivity have become potential candidates for targeted therapy with trastuzumab. We investigated 208 gastric cancer specimens using immunohistochemistry (IHC), fluorescence in situ hybridization and dual in situ hybridization (ISH). We also investigated the concordance between IHC and ISH. The correlation between HER2 status and various clinicopathological findings was also investigated. In total, 15.9% (33/208) and 24.5% (51/208) of gastric cancers showed HER2 gene amplification and protein overexpression, respectively. A high level of concordance between ISH and IHC analyses (91.3%, κ = 0.76) was found. A significant correlation between HER2 status and intestinal-type (p HER2 heterogeneity was high in gastric cancers; we found 68.8% phenotypic heterogeneity and 57.6% genotypic heterogeneity. Heterogeneity in HER2 protein expression and gene amplification showed a close association with diffuse histologic type and IHC 2+. HER2 protein overexpression and gene amplification were detected in 24.5% and 15.9% of gastric cancer specimens, respectively. Intestinal-type showed a higher level of HER2 protein overexpression and gene amplification than diffuse type. HER2 status also showed a significant relationship with well- and moderately-differentiated carcinomas. The ratio of phenotypic and genotypic heterogeneity of HER2 was high in gastric carcinomas and was associated with HER2 IHC 2+ and diffuse histologic type.

  11. Whole genome analysis of a Vietnamese trio

    Indian Academy of Sciences (India)

    We here present the first whole genome analysis of an anonymous Kinh Vietnamese (KHV) trio whose genomes were deeply sequenced to 30-fold average ... Wellcome Trust Center for Human Genetics, Oxford University, Oxford, UK; High Performance Computing Center, Hanoi University of Science and Technology, ...

  12. Introduction to "Mapping Vietnameseness"

    Directory of Open Access Journals (Sweden)

    Hue-Tam Ho Tai

    2016-09-01

    Full Text Available Vietnam and China are currently engaged in a map war, with each country using ancient maps to buttress its claims to territorial sovereignty over some uninhabited islands in the South China Sea (in Chinese terminology, also known as the Eastern Sea (in Vietnamese. But what do maps in fact represent? What is meant by “territory”? How are territorial limits conceived? These questions were raised in a May 2015 workshop inspired by Thongchai Winichakul’s Siam Mapped: A History of the Geo-Body of a Nation (1994, a groundbreaking book that traces the transformation of Thai geographical consciousness as a result of Siam’s encounter with Western powers in the nineteenth century. While many of Thongchai’s insights apply to the Vietnamese case, as the first of the three articles included in this special issue of Cross-Currents shows, some of the 2015 workshop participants’ conclusions departed from his, especially regarding the formation of a Vietnamese geographical consciousness before the colonial period.[i] This is true of the other two papers, which focus specifically on the construction of borders and the associated production of maps in the nineteenth century before French colonial conquest... Notes 1 Thanks are due to the Max Planck Institute for the Study of Religious and Ethnic Change in Gottingen, Germany, for its gracious hosting and generous funding of the conference, together with the Asia Center of Harvard University.

  13. Data on Vietnamese patients׳ behavior in using information sources, perceived data sufficiency and (non)optimal choice of health care provider.

    Science.gov (United States)

    Vuong, Quan Hoang

    2016-06-01

    This data article introduces a data set containing 1459 observations that can enable researchers to examine issues related to and perform statistical investigations into questions of relationships between sources of health care information, data sufficiency, trust levels between patients and healthcare experts (and the advice). The data set also records assessment of Vietnamese patients on whether their choice of health care provider is best available (optimal vs. nonoptimal). The data come from a survey in many hospitals in Hanoi and several neighboring provinces/cities in the North of Vietnam, during the last quarter of 2015. Variables that can be useful for future analysis include sources and availability of information, cost, and amount of time for seeking information. The quality of information and health professionals' credibility are critical factors in helping patients choose a health care provider. Mendeley Data, v1 http://dx.doi.org/10.17632/gmbz53tpwc.1; and can enable the modeling after useful discrete data models such as BCL, with one example being provided in this data article.

  14. A layer of Dongsonian vocabulary in Vietnamese

    OpenAIRE

    Ferlus, Michel

    2009-01-01

    This is a slightly modified version of the text presented under the same title at 17th Annual Meeting of the Southeast Asian Linguistics Society, University of Maryland, College Park, USA, August 31 - September 2, 2007.; International audience; The present paper aims at demonstrating by means of linguistic evidence how the pestle used to husk rice was invented by the Dongsonians, the ancestors of the Vietnamese. That innovation spread in Southeast Asia as far as India, through the Austroasiat...

  15. Prevalence of comorbidities and their impact on hospital management and short-term outcomes in Vietnamese patients hospitalized with a first acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Hoa L Nguyen

    Full Text Available Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with a first acute myocardial infarction (AMI at the Vietnam National Heart Institute in Hanoi for purposes of describing the prevalence of cardiovascular (CVD and non-CVD comorbidities and their impact on hospital management, in-hospital clinical complications, and short-term mortality in these patients.The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010.The average age of study patients was 66 years and one third were women. The proportions of patients with none, any 1, and ≥ 2 CVD comorbidities were 34%, 42%, and 24%, respectively. Among the CVD comorbidities, hypertension was the most commonly reported (59%. There were decreasing trends in the proportion of patients who were treated with effective cardiac medications and coronary interventions as the number of CVD comorbidities increased. Patients with multiple CVD comorbidities tended to develop acute clinical complications and die at higher rates during hospitalization compared with patients with no CVD comorbidities (Odds Ratio: 1.40; 95% Confidence Interval: 0.40-4.84.Our data suggest that patients with multiple cardiac comorbidities tended to experience high in-hospital death rates in the setting of AMI. Full-scale surveillance of Hanoi residents hospitalized with AMI at all Hanoi hospitals is needed to confirm these findings. Effective strategies to manage Vietnamese patients hospitalized with AMI who have multiple comorbidities are warranted to improve their short-term prognosis.

  16. Prevalence of comorbidities and their impact on hospital management and short-term outcomes in Vietnamese patients hospitalized with a first acute myocardial infarction.

    Science.gov (United States)

    Nguyen, Hoa L; Nguyen, Quang Ngoc; Ha, Duc Anh; Phan, Dat Tuan; Nguyen, Nguyen Hanh; Goldberg, Robert J

    2014-01-01

    Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with a first acute myocardial infarction (AMI) at the Vietnam National Heart Institute in Hanoi for purposes of describing the prevalence of cardiovascular (CVD) and non-CVD comorbidities and their impact on hospital management, in-hospital clinical complications, and short-term mortality in these patients. The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010. The average age of study patients was 66 years and one third were women. The proportions of patients with none, any 1, and ≥ 2 CVD comorbidities were 34%, 42%, and 24%, respectively. Among the CVD comorbidities, hypertension was the most commonly reported (59%). There were decreasing trends in the proportion of patients who were treated with effective cardiac medications and coronary interventions as the number of CVD comorbidities increased. Patients with multiple CVD comorbidities tended to develop acute clinical complications and die at higher rates during hospitalization compared with patients with no CVD comorbidities (Odds Ratio: 1.40; 95% Confidence Interval: 0.40-4.84). Our data suggest that patients with multiple cardiac comorbidities tended to experience high in-hospital death rates in the setting of AMI. Full-scale surveillance of Hanoi residents hospitalized with AMI at all Hanoi hospitals is needed to confirm these findings. Effective strategies to manage Vietnamese patients hospitalized with AMI who have multiple comorbidities are warranted to improve their short-term prognosis.

  17. Effects of short-course oral corticosteroid therapy in early dengue infection in Vietnamese patients: a randomized, placebo-controlled trial.

    Science.gov (United States)

    Tam, Dong T H; Ngoc, Tran V; Tien, Nguyen T H; Kieu, Nguyen T T; Thuy, Truong T T; Thanh, Lai T C; Tam, Cao T; Truong, Nguyen T; Dung, Nguyen T; Qui, Phan T; Hien, Tran T; Farrar, Jeremy J; Simmons, Cameron P; Wolbers, Marcel; Wills, Bridget A

    2012-11-01

    Patients with dengue can experience a variety of serious complications including hypovolemic shock, thrombocytopenia, and bleeding. These problems occur as plasma viremia is resolving and are thought to be immunologically mediated. Early corticosteroid therapy may prevent the development of such complications but could also prolong viral clearance. We performed a randomized, placebo-controlled, blinded trial of low-dose (0.5 mg/kg) or high-dose (2 mg/kg) oral prednisolone therapy for 3 days in Vietnamese patients aged 5-20 years admitted with dengue and fever for ≤72 hours, aiming to assess potential harms from steroid use during the viremic phase. Intention-to-treat analysis was performed using linear trend tests with a range of clinical and virological endpoints specified in advance. In addition to recognized complications of dengue, we focused on the are under the curve for serial plasma viremia measurements and the number of days after enrollment to negative viremia and dengue nonstructural protein 1 status. Between August 2009 and January 2011, 225 participants were randomized to 1 of the 3 treatment arms. Baseline characteristics were similar across the groups. All patients recovered fully and adverse events were infrequent. Aside from a trend toward hyperglycemia in the steroid recipients, we found no association between treatment allocation and any of the predefined clinical, hematological, or virological endpoints. Use of oral prednisolone during the early acute phase of dengue infection was not associated with prolongation of viremia or other adverse effects. Although not powered to assess efficacy, we found no reduction in the development of shock or other recognized complications of dengue virus infection in this study.

  18. Vietnamese fusion restaurant business plan

    OpenAIRE

    Nguyen, Trang; Heino, Thuy

    2017-01-01

    Helsinki is becoming more and more dynamic with diverse cultures and international ethnicities.Therefore, the appearance of ethnic food and cuisines is essential. Fusion food is emerging as a new popular trend amongst Finns. Vietnamese food is famous for its taste, freshness and nutrition. Vietnamese cuisines have become a part of daily food selection in many countries such as Germany, Czech Republic, Holland and the United States of America. However, it is still new to Finns since there are ...

  19. 31 CFR 500.554 - Gifts of North Korean, North Vietnamese, Cambodian, or South Vietnamese origin.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Gifts of North Korean, North... § 500.554 Gifts of North Korean, North Vietnamese, Cambodian, or South Vietnamese origin. (a) Except as... importation of North Korean, North Vietnamese, Cambodian, or South Vietnamese origin goods sent as gifts to...

  20. Economic Benefits and Treatment Progress as Determinants of the Sustainability of Vietnamese Voluntary Co-Located Patients Clusters.

    Science.gov (United States)

    Vuong, Quan-Hoang

    2017-04-13

    Over the past 15 years or so, in Vietnam, a phenomenon has steadily grown more and more widespread: the forming of co-located patients communities. Poor patients choose to live together, seeking/lending supports from/to one another. Despite the undeniable existence of these communities, little is researched or known about how co-located patients perceive the value of what they receive as cluster members, or how they assess their future connection to the communities they are living in. The study employs multiple logistic regressions method to investigate relationships between factors such as perceived satisfaction from community-provided financial means, reported health improvements, along with patients' short-and longer-term commitments to these communities. The results suggest meaningful empirical relationships: 1) between, on one hand, gender, perceived values and sustainability of patients communities, financial stress faced by patients and the financial benefits they received from the community, and, on the other hand, their propensity to stay connected to it; and 2) between economic conditions, length of stay with a community, general level of satisfaction, health improvements on one hand and long-term commitment to these communities on the other hand. Patients who choose to stick to co-location clusters do so for an economic reason: finding means to fight their financial hardship. This may suggest a degree of complication higher than one would have thought in dealing with poor patients from a social point of view. Concretely, the majority of the public only focuses on charity programs and in-king donations, while ignoring the more sustainable - and, at the same time, more complicated - alternative which is to create suitable income-generating jobs for patient. In addition, patients are not only those who seek to ask for supports but can potentially be the donors contributing to the sustainability of those voluntary communities.

  1. Economic benefits and treatment progress as determinants of the sustainability of Vietnamese voluntary co-located patients clusters

    Directory of Open Access Journals (Sweden)

    Quan-Hoang Vuong

    2017-04-01

    Full Text Available Background. Over the past 15 years or so, in Vietnam, a phenomenon has steadily grown more and more widespread: the forming of co-located patients communities. Poor patients choose to live together, seeking/lending supports from/to one another. Despite the undeniable existence of these communities, little is researched or known about how co-located patients perceive the value of what they receive as cluster members, or how they assess their future connection to the communities they are living in. Materials and Methods. The study employs multiple logistic regressions method to investigate relationships between factors such as perceived satisfaction from community-provided financial means, reported health improvements, along with patients’ shortand longer-term commitments to these communities. Results. The results suggest meaningful empirical relationships: 1 between, on one hand, gender, perceived values and sustainability of patients communities, financial stress faced by patients and the financial benefits they received from the community, and, on the other hand, their propensity to stay connected to it; and 2 between economic conditions, length of stay with a community, general level of satisfaction, health improvements on one hand and long-term commitment to these communities on the other hand. Conclusions. Patients who choose to stick to co-location clusters do so for an economic reason: finding means to fight their financial hardship. This may suggest a degree of complication higher than one would have thought in dealing with poor patients from a social point of view. Concretely, the majority of the public only focuses on charity programs and in-king donations, while ignoring the more sustainable – and, at the same time, more complicated – alternative which is to create suitable income-generating jobs for patient. In addition, patients are not only those who seek to ask for supports but can potentially be the donors contributing to

  2. VnCoreNLP: A Vietnamese Natural Language Processing Toolkit

    OpenAIRE

    Vu, Thanh; Nguyen, Dat Quoc; Nguyen, Dai Quoc; Dras, Mark; Johnson, Mark

    2018-01-01

    We present an easy-to-use and fast toolkit, namely VnCoreNLP---a Java NLP annotation pipeline for Vietnamese. Our VnCoreNLP supports key natural language processing (NLP) tasks including word segmentation, part-of-speech (POS) tagging, named entity recognition (NER) and dependency parsing, and obtains state-of-the-art (SOTA) results for these tasks. We release VnCoreNLP to provide rich linguistic annotations to facilitate research work on Vietnamese NLP. Our VnCoreNLP is open-source under GPL...

  3. The comparative study of resonance disorders for Vietnamese and Korean cleft palate speakers using nasometer.

    Science.gov (United States)

    Shin, Yu-Jeong; Kim, Yongsoo; Kim, Hyun-Gi

    2017-12-01

    Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnoses using a nasometer. The aim of this study is to find the nasalance differences between Vietnamese cleft palate children and Korean cleft palate children by measuring the nasalance of five oral vowels. Ten Vietnamese cleft palate children after surgery, three Vietnamese children for the control group, and ten Korean cleft palate children after surgery with the same age participated in this experimentation. Instead of Korean control, the standard value of Korean version of the simplified nasometric assessment procedures (kSNAP) was used. The results are as follows: (1) the highest nasalance score among the Vietnamese normal vowels is the low vowel /a/; however, that of Korean normal vowels is the high vowel /i/. (2) The average nasalance score of Korean cleft palate vowels is 18% higher than that of Vietnamese cleft palate vowels. There was a nasalance score of over 45% among the vowels /e/ and /i/ in Vietnamese cleft palate patients and /i/, /o/, and /u/ in Korean cleft palate patients. These different nasalance scores of the same vowels seem to cause an ethnic difference between Vietnamese and Korean cleft palate children.

  4. Wild Vietnamese relatives of blueberries

    Science.gov (United States)

    rom 25 October to 14 November 2015, wild relatives of cultivated blueberry, Vaccinium corymbosum, were collected during a Vietnamese-US cooperative expedition in Northern Vietnam. The exploration involved representatives of the Plant Resources Center, Vietnam Academy of Agricultural Sciences, in Han...

  5. Metabolic syndrome among Ghanaian patients presenting with ...

    African Journals Online (AJOL)

    Metabolic syndrome (MetS) is a general risk factor for cardiovascular and chronic kidney disease (CKD) in Western populations. This study assessed the relationship between MetS and its compo-nents in Ghanaian patients presenting with CKD. The study population comprised of 146 non-dialysed individuals with CKD with ...

  6. Extranodal presentation in patients with acquired immunodeficiency ...

    African Journals Online (AJOL)

    Kaposi's sarcoma, non-Hodgkin's lymphoma (NHL), including primary central nervous system lymphoma (PCNSL), and cervical cancer define the acquired immune deficiency syndrome (AIDS). NHL is the second most common malignancy associated with HIV infection. The clinical presentation varies, and while patients ...

  7. Colonoscopic findings in patients presenting with lower ...

    African Journals Online (AJOL)

    Conclusion: In our practice, haemorrhoids and colonic diverticulosis were the leading causes of LGIB at endoscopy. Colonoscopy is therefore recommended for all patients presenting with LGIB, especially for those who are 50 years and older in age. Keywords: Lower gastrointestinal bleeding, Colonoscopy, Nigeria ...

  8. Waterpipe Tobacco Smoking and Gastric Cancer Risk among Vietnamese Men.

    Directory of Open Access Journals (Sweden)

    Hang Thi Minh Lai

    Full Text Available The association of waterpipe tobacco (WPT smoking with gastric cancer (GC risk was suggested.A hospital-based case-control study was conducted to examine the association of WPT with GC risk among Vietnamese men, in Hanoi city, during the period of 2003-2011. Newly-diagnosed GC cases (n = 454 and control patients (n = 628 were matched by age (+/- 5 years and the year of hospitalization. Information on smoking and alcohol drinking habits and diet including salty food intake and fruits/vegetables consumption were obtained by the interview. Maximum likelihood estimates of odds ratios (ORs and corresponding 95% confidence intervals (Cis were obtained using conditional logistic regression models.The group with the highest consumption of citrus fruits showed a significantly low GC risk (OR = 0.6, 95%CI = 0.4-0.8, P for trend = 0.002. However, there was no association of raw vegetable consumption with GC risk. Referring to never smokers, GC risk was significantly higher in current WPT smokers (OR = 1.8, 95%CI = 1.3-2.4, and it was more evident in exclusively WPT smokers (OR = 2.7, 95%CI = 1.2-6.5. GC risk tended to be higher with daily frequency and longer duration of WPT smoking but these trends were not statistically significant (P for trend: 0.144 and 0.154, respectively. GC risk of those who started smoking WPT before the age of 25 was also significantly high (OR = 3.7, 95%CI = 1.2-11.3. Neither cigarette smoking nor alcohol drinking was related to GC risk.The present findings revealed that WPT smoking was positively associated with GC risk in Vietnamese men.

  9. Influence of traditional Vietnamese culture on the utilisation of mainstream health services for sexual health issues by second-generation Vietnamese Australian young women.

    Science.gov (United States)

    Rawson, Helen; Liamputtong, Pranee

    2009-03-01

    The present paper discusses the impact the traditional Vietnamese culture has on the uptake of mainstream health services for sexual health matters by Vietnamese Australian young women. It is part of a wider qualitative study that explored the factors that shaped the sexual behaviour of Vietnamese Australian young women living in Australia. A Grounded Theory methodology was used, involving in-depth interviews with 15 Vietnamese Australian young women aged 18 to 25 years who reside in Victoria, Australia. The findings demonstrated that the ethnicity of the general practitioner had a clear impact on the women utilising the health service. They perceived that a Vietnamese doctor would hold the traditional view of sex as held by their parents' generation. They rationalised that due to cultural mores, optimum sexual health care could only be achieved with a non-Vietnamese health professional. It is evident from the present study that cultural influences can impact on the sexual health of young people from culturally diverse backgrounds and in Australia's multicultural society, provision of sexual health services must acknowledge the specific needs of ethnically diverse young people.

  10. Normative nasalance scores for Vietnamese-speaking children.

    Science.gov (United States)

    Nguyen, Van Thai; Lehes, Lagle; Truong, Thi Thuy Hang; Hoang, Thi Van Anh; Jagomägi, Triin

    2017-10-26

    The Nasometer is increasingly being used to complement auditory perceptual assessment of nasality. Nasalance scores which are obtained from the Nasometer vary across languages. Normative nasalance scores have been established for many languages but not for the Vietnamese language. The objective of this study was to obtain the normative nasalance scores for Vietnamese-speaking children. In this study, 102 healthy Vietnamese children speaking in the central regional dialect aged from 7 to 9 years (45 boys, 57 girls; mean age = 7.5 years) at a primary school in Hue, Vietnam participated. Three speech stimuli, which were specific for the Vietnamese language, were designed: oral stimuli (19 words and 18 sentences), oro-nasal stimuli (eight sentences) and nasal stimuli (seven sentences). The children were asked to repeat these stimuli after the examiner. The Nasometer II (model 6450) was used to obtain the nasalance scores. The procedure took about 10 minutes for each child. The mean nasalance scores and the standard deviation of each stimulus were: 13.1 ± 5.8 (oral stimuli), 30.7 ± 6.6 (oro-nasal stimuli) and 56.9 ± 9.2 (nasal stimuli). No significant differences between the genders were found. The normative nasalance scores provide essential reference information for clinicians who deal with nasalance disorders, especially patients with cleft palate. The nasalance scores in this study were established for Vietnamese children speaking in the central regional dialect and can be applied to both genders.

  11. The Vietnamese: An Often-Overlooked Minority.

    Science.gov (United States)

    Le, P.

    1978-01-01

    Almost every one of the Vietnamese immigrants in Canada has experienced problems concerning language, weather, life style, housing, schooling, and employment. Despite the stress and strain, however, family ties and some cultural aspects remain strong and many Vietnamese are optimistic about their future as a community in Canada. (Author/EB)

  12. Vietnamese Students in the Public School.

    Science.gov (United States)

    Manitoba Dept. of Education, Winnipeg.

    The purpose of this booklet is to familiarize teachers and administrators with the background of Vietnamese immigrant students in Canadian public schools. A historical and cultural overview is provided which briefly describes Vietnamese customs, attitudes, roles of family members, and religion. The need for supporting and enhancing the self esteem…

  13. Eliciting Patients’ Health Concerns in Consulting Rooms and Wards in Vietnamese Public Hospitals

    Directory of Open Access Journals (Sweden)

    Huong Thi Linh Nguyen

    2018-03-01

    Full Text Available This article examines the doctor’s elicitation of the patient’s presenting health concern in two clinical settings in the Vietnamese public hospital system: the consulting room and the ward. The data were taken from 66 audio-recorded consultations. Our analysis shows that the elicitors used by the doctor in the consulting room often communicate a weak epistemic stance towards the patient’s health issue, while those used in the ward tend to signal a strong epistemic stance. In addition, this contrast between the elicitors employed in the consulting room and the ward is evident in our data regardless of whether the consultation is a first visit or a same follow-up (in which the doctor is the same one that treated the patient on their last visit, though the contrast is less clear for different follow-ups (in which the doctor has not treated the patient before. An additional finding is that the clinical setting has some bearing on the use of inappropriate elicitation formats (in which the doctor opens the visit with an elicitor which is more appropriate for another type of visit. The precise way in which each of the consulting room and the ward operates is, of course, a feature of the Vietnamese public hospital system itself. Hence, the overall contrast between the elicitors and elicitation formats used in these two settings illustrates how, on a more general level, the institutional context can have an impact on doctor-patient communication.

  14. 31 CFR 500.559 - Accounts of North Korean, North Vietnamese, Cambodian or South Vietnamese sole proprietorships.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Accounts of North Korean, North Vietnamese, Cambodian or South Vietnamese sole proprietorships. 500.559 Section 500.559 Money and Finance... Licensing Policy § 500.559 Accounts of North Korean, North Vietnamese, Cambodian or South Vietnamese sole...

  15. The Labor Market Status of Foreign Born Vietnamese Americans

    OpenAIRE

    Linus Yamane

    2001-01-01

    Vietnamese Americans experience significant wage discrimination and occupational discrimination. Vietnamese men and women earn less than comparable non-Hispanic white Americans. Vietnamese men face discrimination in wages on the order of 10%, and this does not seem to vary significantly by region of residence or level of education. Vietnamese women face varying amounts of discrimination depending on their region of residence and their level of education. Vietnamese men and women are less like...

  16. Prosthetic Management of Patients Presenting with Juvenile ...

    African Journals Online (AJOL)

    Conclusion: The main objective of prosthetic rehabilitation is the restoration of the integrity of the dental arches. However, the choice of teeth replaced in the partial dentures provided for the patients in this study was based on the choice of the patients, and their choice was determined by aesthetics and affordability.

  17. Religious and Spiritual Dimensions of the Vietnamese Dementia Caregiving Experience

    Science.gov (United States)

    Hinton, Ladson; Tran, Jane NhaUyen; Tran, Cindy; Hinton, Devon

    2010-01-01

    This paper focuses on the role of religion and spirituality in dementia caregiving among Vietnamese refugee families. In-depth qualitative interviews were conducted with nine Vietnamese caregivers of persons with dementia, then tape-recorded, transcribed, and analyzed for emergent themes. Caregivers related their spirituality/religion to three aspects of caregiving: (1) their own suffering, (2) their motivations for providing care, and (3) their understanding of the nature of the illness. Key terms or idioms were used to articulate spiritual/religious dimensions of the caregivers’ experience, which included sacrifice, compassion, karma, blessings, grace and peace of mind. In their narratives, the caregivers often combined multiple strands of different religions and/or spiritualities: Animism, Buddhism, Taoism, Confucianism and Catholicism. Case studies are presented to illustrate the relationship between religion/spirituality and the domains of caregiving. These findings have relevance for psychotherapeutic interventions with ethnically diverse populations. PMID:20930949

  18. Socioeconomic influences on Vietnamese-Canadian women's breast and cervical cancer prevention practices: a social determinant's perspective.

    Science.gov (United States)

    Donnelly, Tam Truong; McKellin, William; Hislop, Gregory; Long, Bonita

    2009-01-01

    Breast cancer and cervical cancer are major contributors to morbidity and mortality for the Vietnamese Canadian women. Vietnamese women face multiple barriers to obtaining effective preventive care and treatment for these diseases. This paper reports the influence of socioeconomic factors on Vietnamese Canadian women's breast and cervical cancer screening behaviors. In-depth semistructured interviews were conducted with Vietnamese Canadian women and health care providers. The study revealed that low socioeconomic status is a major barrier to women's participation in breast and cervical cancer screening, despite the fact that health care in Canada is funded publicly by the Medicare system. The Vietnamese Canadian women and health care providers in the present study identified a number of major dimensions through which socioeconomic issues were associated with Vietnamese Canadian women's access to and use of health care for the prevention of breast and cervical cancer, including (a) financial concerns; (b) language, occupational opportunities, and downward mobility; (c) economics and women's households; and (d) low socioeconomic status and screening behaviors. Implications are discussed for increasing Vietnamese Canadian women's utilization of breast and cervical cancer screening services.

  19. Vietnamese women at solidarity meeting of world women in Cuba.

    Science.gov (United States)

    1998-01-01

    This article summarizes experiences of a Vietnamese delegation at a solidarity meeting of world women during April 13-16, 1998, in Cuba. The President of the Viet Nam Women's Union headed the delegation. The advisor was the vice-chairperson of the Vietnamese National Assembly. The delegation participated in 6 forums: women and sustainable economic development; women, health, education, and social security; women, communication and the mass media; women in politics and decision-making; women, violence and discrimination; and national independence, sovereignty, peace, and women. The delegation also participated in sessions on women's issues; implementation issues; women parliamentarians; and migrant and displaced women. The delegation met with delegates from other countries and participated in a world meeting and an Asian-Pacific meeting to support Cuban women. The entire delegation presented a stage show of songs, which was well received by the 3000 participants. The delegation met with Cuban delegates to discuss the formation of women's groups and to build better relations between the women of both countries. The delegation visited a training center of women cadres and the center for gender education. Participants adopted the Havana Declaration, which states the intention of world women to eradicate poverty and war and to promote peace, progress, and happiness in all countries. The Havana Declaration condemned the US embargo against Cuba. Fidel Castro spoke and expressed gratitude for the strong support from world women, especially Vietnamese women.

  20. Juvenile systemic lupus erythematosus onset patterns in Vietnamese children

    DEFF Research Database (Denmark)

    Dung, Nguyen Thi Ngoc; Loan, Huynh Thoai; Nielsen, Susan

    2013-01-01

    to have systemic lupus erythematosus (f/m = 4/1) were referred to the Ho Chi Minh City Children's Hospital No.1 during a 12-month period in 2009. RESULTS: The mean age at diagnosis was 12.8 years (SD = 2.5). Thirty-seven (82%) fulfilled criteria for lupus nephritis (LN). At diagnosis, impressively high...... No. 1 during a16 month period from 2008-2009. These patients had a strikingly high prevalence of Coombs positive anaemia, a high prevalence of lupus nephritis, and very high SLEDAI and ECLAM scores at the time of diagnosis. While there may be referral biases, our Vietnamese SLE patients appear...

  1. Consonants, vowels and tones across Vietnamese dialects.

    Science.gov (United States)

    PhȦm, Ben; McLeod, Sharynne

    2016-04-01

    Vietnamese is spoken by over 89 million people in Vietnam and it is one of the most commonly spoken languages other than English in the US, Canada and Australia. This study defines between one and nine different dialects of Vietnamese spoken in Vietnam. In Vietnamese schools, children learn Standard Vietnamese which is based on the northern dialect; however, if they live in other regions they may speak a different dialect at home. This paper describes the differences between the consonants, semivowels, vowels, diphthongs and tones for four dialects: Standard, northern, central and southern Vietnamese. The number and type of initial consonants differs per dialect (i.e. Standard = 23, northern = 20, central = 23, southern = 21). For example, the letter "r" is pronounced in the Standard and central dialects as the retroflex /ʐ/, northern dialect as the voiced alveolar fricative /z/ or the trilled /r/ and in the southern dialect as the voiced velar fricative /ɣ/. Additionally, the letter "v" is pronounced in the Standard, northern and central dialects as the voiced bilabial fricative /v/, the southern dialect as the voiced palatal approximant /j/ and in the lower northern dialect (Ninh Binh) as the voiceless bilabial fricative /f/. Similarly, the number of final consonants differs per dialect (i.e. Standard = 6, northern = 10, central = 10, southern = 8). Finally, the number and type of tones differs per dialect (i.e. Standard = 6, northern = 6, central = 5, southern = 5). Understanding differences between Vietnamese dialects is important so that speech-language pathologists and educators provide appropriate services to people who speak Vietnamese.

  2. Trauma, PTSD and the longer-term mental health burden amongst Vietnamese refugees : a comparison with the Australian-born population.

    Science.gov (United States)

    Silove, Derrick; Steel, Zachary; Bauman, Adrian; Chey, Tien; McFarlane, Alexander

    2007-06-01

    Uncertainty persists about the impact of trauma on the long-term mental health of resettled refugees. The present study aimed to assess the contributions of trauma and PTSD to overall mental disorder and related need for services amongst Vietnamese refugees resettled for over a decade in Australia. The data were compared with a survey of the host population. The study involved a probabilistic sample of Vietnamese refugees (n = 1,161) resettled in Australia for 11 years. The Australian-born sample (n = 7,961) was drawn from a national survey using the same diagnostic measure, the Composite International Diagnostic Interview (CIDI). The PTSD prevalence for both groups was 3.5% and the diagnosis was present in 50% of Vietnamese and 19% of Australians with any mental disorder(s). Trauma made the largest contribution to mental disorder in the Vietnamese (odds ratio >8), whereas amongst Australians, younger age (odds ratio >3) and trauma (odds ratio >4) each played a role. PTSD was equally disabling in both populations but Vietnamese with the disorder reported more physical, and Australians more mental disability. Approximately one in three Australians and one in 10 Vietnamese with PTSD sought help from mental health professionals. Trauma and PTSD continue to affect the mental health of Vietnamese refugees even after a decade of resettlement in Australia. The tendency of Vietnamese with PTSD to report symptoms of physical disability may create obstacles to their obtaining appropriate mental health care.

  3. The Use of Traditional Vietnamese Medicine Among Vietnamese Immigrants Attending an Urban Community Health Center in the United States.

    Science.gov (United States)

    Nguyen, Long T; Kaptchuk, Ted J; Davis, Roger B; Nguyen, Giac; Pham, Van; Tringale, Stephen M; Loh, Yen Lin; Gardiner, Paula

    2016-02-01

    Little is known about Traditional Vietnamese Medicine (TVM) and its use among Vietnamese immigrants in the United States. This study aimed to characterize TVM and improve understanding of its use among Vietnamese outpatients attending an urban clinic. This cross-sectional observation study was performed by mailing bilingual surveys to a stratified random sample of 400 Vietnamese adult patients (≥18 years of age) who had visited a community health center in Boston, Massachusetts, at least once in the prior 12 months. The data were analyzed by using descriptive and multivariable regression statistics. The use of TVM and the factors influencing their use were reported. Among the 216 respondents, 68% reported using TVM. Of those users, the median age was 56 years and 68% were female, 51% had lived in the United States for less than 13 years, and 91% spoke English "not well or not at all." Among the 89% who reported using TVM of indigenous origin, 62% used "wind scraping," 35% used herbal pills/products, and 30% used "wind snatching." Sixty-one percent used therapies of foreign origin; of those, 51% used Asian-originated TVM (herbs, 25%; Eastern massage, 23%) and 38% used Western-influenced TVM (diet supplements, 28%; Western massage, 8%). TVM was mostly used for pain conditions (57%), "staying well" (38%), and cough/colds (27%). Forty-five percent ignored the question on revealing TVM use to providers; of those who answered, 57% said "no." Fifty-one percent of TVM users reported using Western medicine for the same problem, while 46% used TVM and Western medicine within 2 days of each other. Self-rated health (odds ratio [OR], 2.61; 95% confidence interval [CI], 1.34-5.06), household size (OR, 2.09; 95% CI, 1.04-4.22), and education (OR, 2.65; 95% CI, 1.03-6.80) were associated with TVM use. TVM is an important component of the healthcare of urban Vietnamese and needs to be further investigated. Healthcare providers need to encourage open discussion to better care for

  4. Higher Education Learning Experiences among Vietnamese Immigrant Women in Taiwan

    Science.gov (United States)

    Wu, Ya-Ling; Wu, Hsing-Chen

    2015-01-01

    Based on a sociocultural approach to adult learning and poststructural feminist theories, this study draws on interviews with 11 married Vietnamese women to explore the higher education learning experiences of Vietnamese immigrant women in Taiwan. On the basis of their husbands' permission and support, Vietnamese immigrant women embraced the…

  5. Bullying the Meek: A Conceptualisation of Vietnamese School Bullying

    Science.gov (United States)

    Horton, Paul; Kvist Lindholm, Sofia; Nguyen, Thu Hang

    2015-01-01

    Drawing on ethnographic research conducted at three lower secondary schools in the northern Vietnamese cities of Hanoi and Haiphong, this article provides a contextually nuanced conceptualisation of Vietnamese school bullying. In doing so, the article not only addresses the lack of knowledge about Vietnamese school bullying, but also poses a…

  6. Evaluation of the quality of Chinese and Vietnamese cassia using LC-MS and multivariate analysis.

    Science.gov (United States)

    Tanaka, Ken; Li, Feng; Tezuka, Yasuhiro; Watanabe, Shiro; Kawahara, Nobuo; Kida, Hiroaki

    2013-01-01

    In the present study, the chemical composition of water extracts of Chinese and Vietnamese cassia (Cinnamomum cassia) were compared using multivariate analysis of LC-MS data. By principal component analysis of the LC-MS data, 6 compounds, cinnzeylanine (1), cinnzeylanol (2), anhydrocinnzeylanol (3), cinncasinol A (4), epicatechin (5) and procyanidin B2 (6), were identified as the marker compounds to characterize Chinese and Vietnamese cassia. It was clarified that Chinese cassia contains relatively larger amounts of epicatechin and procyanidin B2. On the other hand, Vietnamese cassia is characterized by a relatively larger amount of diterpenes. As catechin derivatives and diterpenes have different types of activity, it is important to choose the cassia that best suits the product for which it is to be used, whether in food or in herbal medicine.

  7. Clinical and microbiological features of HIV-associated tuberculous meningitis in Vietnamese adults

    NARCIS (Netherlands)

    Torok, M. Estee; Chau, Tran Thi Hong; Mai, Pham Phuong; Phong, Nguyen Duy; Dung, Nguyen Thi; Chuong, Ly Van; Lee, Sue J.; Caws, M.; de Jong, Menno D.; Hien, Tran Tinh; Farrar, Jeremy J.

    2008-01-01

    METHODS: The aim of this prospective, observational cohort study was to determine the clinical and microbiological features, outcome, and baseline variables predictive of death, in Vietnamese adults with HIV-associated tuberculous meningitis (TBM). 58 patients were admitted to the Hospital for

  8. Characteristics of patients presenting with erythema nodosum and sarcoidosis.

    LENUS (Irish Health Repository)

    O'Connor, T M

    2012-01-31

    We explored the relationship between erythema nodosum (EN) and sex, age, serum angiotensin converting enzyme (ACE), bronchoalveolar lavage lymphocytosis (BAL-I), interstitial granulomas and radiological stage in patients presenting with pulmonary sarcoidosis in Ireland. Sixty-nine patients diagnosed with sarcoidosis between 2003 and 2006 were studied. Forty one patients (59%) were male. Sixteen patients (23%) presented with EN. Forty one patients of 65 (63%) had transbronchial biopsies demonstrating non-caseating granulomas. Patients with sarcoidosis presenting with EN were more likely to be female (p=0.042), younger (p=0.012) and have earlier stage pulmonary disease (p=0.02). There were no correlations between serum ACE, interstitial granulomas and disease stage. BAL-I did however predict increasing disease radiological stage (p=0.042). In this study, one quarter of patients with sarcoidosis presented with EN among their presenting features. These patients were more likely to be young females with early stage radiological disease.

  9. Pattern of presentations seen in sickle cell retinopathy patients at ...

    African Journals Online (AJOL)

    Objective: To describe the pattern of presentation of sickle cell retinopathy patients who presented at the Eye Foundation Hospital Lagos, Nigeria between January 2002 and March 2003. Materials and Methods: The medical records of 27 patients who presented at the Eye Foundation Hospital with retinal changes due to ...

  10. Celiac disease patients presenting with anemia have more severe disease than those presenting with diarrhea.

    Science.gov (United States)

    Abu Daya, Hussein; Lebwohl, Benjamin; Lewis, Suzanne K; Green, Peter H

    2013-11-01

    Anemia is considered to be an atypical or silent presentation of celiac disease, compared with the classic presentation with diarrhea. However, little information is available about how these groups compare in terms of disease severity. We compared the severity of celiac disease between patients who present with anemia vs those who present with diarrhea. The study cohort was selected from a database of patients with celiac disease who were evaluated at a tertiary referral center between 1990 and 2011. Severity of celiac disease was assessed by the degree of villous atrophy and clinical and serologic parameters. Patients were compared according to mode of presentation and sex. Multivariable analyses, adjusting for age and sex, were conducted to assess the association between the mode of celiac disease presentation and cholesterol level, bone density, severity of villous atrophy, erythrocyte sedimentation rate, and level of anti-tissue transglutaminase. Of 727 patients, 77% presented with diarrhea and 23% with anemia (92% iron deficient). On multiple regression analysis, presentation with anemia was associated with lower levels of total cholesterol (P = .02) and high-density lipoprotein (P = .002) and a higher erythrocyte sedimentation rate (P = .001) and level of anti-tissue transglutaminase (P = .01). Presentation with anemia was associated with lower level of cholesterol only in women. Anemic patients were more than 2-fold more likely to have severe villous atrophy and a low bone mass density at the time they were diagnosed with celiac disease than patients who presented with diarrhea. Celiac disease patients who present with anemia have more severe disease than those who present with diarrhea. There also appear to be sex-specific differences with regard to the association between anemia and the different features of celiac disease. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

  11. Clean Energy Solutions Center Services (Vietnamese Translation)

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    This is a Vietnamese translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

  12. Information Control: Preventing a Vietnamese Spring?

    Science.gov (United States)

    2013-11-01

    the people also were able to effect regime change. While a number of other regimes remained in power (Jordan, Morocco , Bahrain and Kuwait to name a...Company Brief – Vietnamese Government Weighs Up Free Internet Messaging App Ban.” August 23, 2013. Telecoms . (Accessed August 24, 2013). http

  13. Vietnamese traditional medicine from a pharmacist's perspective.

    NARCIS (Netherlands)

    Woerdenbag, H.J.; Nguyen, T.M.; Vu, D.V.; Tran, H.; Nguyen, D.T.; Tran, T.V.; Smet, P.A.G.M. de; Brouwers, J.R.B.J.

    2012-01-01

    Traditional medicine plays an important role in the healthcare system of Vietnam. Vietnamese traditional medicine (VTM) is underpinned by the oriental philosophy and theory of healing. VTM is largely influenced by traditional Chinese medicine, but differs to a certain extent. VTM is largely not

  14. Vietnamese traditional medicine from a pharmacist's perspective

    NARCIS (Netherlands)

    Woerdenbag, H.J.; Nguyen, T.M.; Vu, D.V.; Tran, Hung; Nguyen, D.T.; Tran, T.V.; De Smet, P.A.; Brouwers, J.R.

    Traditional medicine plays an important role in the healthcare system of Vietnam. Vietnamese traditional medicine (VTM) is underpinned by the oriental philosophy and theory of healing. VTM is largely influenced by traditional Chinese medicine, but differs to a certain extent. VTM is largely not

  15. Expressions Shared by Vietnamese in America.

    Science.gov (United States)

    Chan, Carole

    This document is a collection of a list of expressions shared by Vietnamese immigrants who have entered the United States. The expressions concern the following topics: names, formality, cultural influences, touching, tact and diplomacy, shared life, open houses, social standards, manual labor, fatalism, and adaptability. (Author/AM)

  16. Whole genome analysis of a Vietnamese trio

    Indian Academy of Sciences (India)

    2015-02-04

    Feb 4, 2015 ... We used standard and high-quality methods and software/ pipelines that had been used in the 1000 Genomes Project and other human genome projects to analyse our KHV trio genomic data. 3.1 Data production. The genomic DNA used in this study was from an anony- mous Kinh Vietnamese (KHV) trio ...

  17. Smoking Media Literacy in Vietnamese Adolescents

    Science.gov (United States)

    Page, Randy M.; Huong, Nguyen T.; Chi, Hoang K.; Tien, Truong Q.

    2011-01-01

    Background: Smoking media literacy (SML) has been found to be independently associated with reduced current smoking and reduced susceptibility to future smoking in a sample of American adolescents, but not in other populations of adolescents. Thus, the purpose of this study was to assess SML in Vietnamese adolescents and to determine the…

  18. Functional impairment and mental health functioning among Vietnamese children

    Science.gov (United States)

    Dang, Hoang-Minh; Weiss, Bahr; Trung, Lam T.

    2015-01-01

    Purpose Functional impairment is a key indicator of need for mental health services among children and adolescents, often a stronger predictor of service usage than mental health symptoms themselves. Functional impairment may be of particular importance in low and middle income countries (LMIC) because of its potential to focus policy on treatment of child mental health problems which is generally given low priority in LMIC. However, few studies have assessed functional impairment in LMIC. The present study assessed rates of functional impairment among children in Vietnam, as a case example of an LMIC, as well as effects of other risk/protective factors of particular relevance to LMIC (e.g., whether the family lived in an urban or rural area; family structure variables such as grandparents living with the family). Methods 1,314 parents of children 6–16 years old from 10 Vietnamese provinces were interviewed. Results The overall rate of functional impairment among Vietnamese children was 20%, similar to rates in high income countries such as Germany and the United States, suggesting that LMIC status may not be associated with dramatic increases in functional impairment in children. Functional impairment was significantly greater among mental health cases than non-cases, with increases of over 550% associated with mental health caseness. A number of other risk factors (e.g., marital status) had smaller but significant effects. Conclusions Mental health problems are a major but not the sole contributor to functional impairment among Vietnamese children. The pragmatic significance of this research lies in its potential to affect public awareness and policy related to child mental health in LMIC. PMID:26315942

  19. Medicine use of elderly Chinese and Vietnamese immigrants and attitudes to home medicines review.

    Science.gov (United States)

    White, Lesley; Klinner, Christiane

    2012-01-01

    There is a paucity of research into the perceptions of elderly Australian ethnic minorities towards public health services related to quality use of medicines. Among the six fastest growing ethnic groups in Australia, the Mandarin-speaking Chinese and Vietnamese constitute the largest elderly populations with poor English skills. This paper investigates the relationships of elderly Chinese and Vietnamese migrants with medicines, general practitioners and pharmacists, and how these relationships influence their awareness and attitudes of the home medicines review (HMR) program. Two semi-structured focus groups were held with a total of 17 HMR-eligible patients who have never received a HMR, one with Chinese and one with Vietnamese respondents, each in the respective community language. Confusion about medications and an intention to have a HMR were pronounced among all participants although none of them had heard of the program before participating in the focus groups. Respondents reported difficulties locating a pharmacist who spoke their native language, which contributed to an increased unmet need for medicine information. The Chinese group additionally complained about a lack of support from their general practitioners in relation to their medicine concerns and was adamant that they would prefer to have a HMR without the involvement of their general practitioner. Our results indicate a distinct HMR need but not use among elderly Chinese and Vietnamese eligible patients with poor English skills. Home medicines review service use and perceived medication problems are likely to improve with an increasing availability of bilingual and culturally sensitive health care providers.

  20. Glucose-6-phosphate dehydrogenase (G6PD mutations and haemoglobinuria syndrome in the Vietnamese population

    Directory of Open Access Journals (Sweden)

    Day Nick

    2009-07-01

    Full Text Available Abstract Background In Vietnam the blackwater fever syndrome (BWF has been associated with malaria infection, quinine ingestion and G6PD deficiency. The G6PD variants within the Vietnamese Kinh contributing to the disease risk in this population, and more generally to haemoglobinuria, are currently unknown. Method Eighty-two haemoglobinuria patients and 524 healthy controls were screened for G6PD deficiency using either the methylene blue reduction test, the G-6-PDH kit or the micro-methaemoglobin reduction test. The G6PD gene variants were screened using SSCP combined with DNA sequencing in 82 patients with haemoglobinuria, and in 59 healthy controls found to be G6PD deficient. Results This study confirmed that G6PD deficiency is strongly associated with haemoglobinuria (OR = 15, 95% CI [7.7 to 28.9], P G6PD variants were identified in the Vietnamese population, of which two are novel (Vietnam1 [Glu3Lys] and Vietnam2 [Phe66Cys]. G6PD Viangchan [Val291Met], common throughout south-east Asia, accounted for 77% of the variants detected and was significantly associated with haemoglobinuria within G6PD-deficient ethnic Kinh Vietnamese (OR = 5.8 95% CI [114-55.4], P = 0.022. Conclusion The primary frequency of several G6PD mutations, including novel mutations, in the Vietnamese Kinh population are reported and the contribution of G6PD mutations to the development of haemoglobinuria are investigated.

  1. Clinical utility of an optimised multiplex real-time PCR assay for the identification of pathogens causing sepsis in Vietnamese patients.

    Science.gov (United States)

    Tat Trung, Ngo; Van Tong, Hoang; Lien, Tran Thi; Van Son, Trinh; Thanh Huyen, Tran Thi; Quyen, Dao Thanh; Hoan, Phan Quoc; Meyer, Christian G; Song, Le Huu

    2018-02-01

    For the identification of bacterial pathogens, blood culture is still the gold standard diagnostic method. However, several disadvantages apply to blood cultures, such as time and rather large volumes of blood sample required. We have previously established an optimised multiplex real-time PCR method in order to diagnose bloodstream infections. In the present study, we evaluated the diagnostic performance of this optimised multiplex RT-PCR in blood samples collected from 110 septicaemia patients enrolled at the 108 Military Central Hospital, Hanoi, Vietnam. Positive results were obtained by blood culture, the Light Cylcler-based SeptiFast ® assay and our multiplex RT-PCR in 35 (32%), 31 (28%), and 31 (28%) samples, respectively. Combined use of the three methods confirmed 50 (45.5%) positive cases of bloodstream infection, a rate significantly higher compared to the exclusive use of one of the three methods (P=0.052, 0.012 and 0.012, respectively). The sensitivity, specificity and area under the curve (AUC) of our assay were higher compared to that of the SeptiFast ® assay (77.4%, 86.1% and 0.8 vs. 67.7%, 82.3% and 0.73, respectively). Combined use of blood culture and multiplex RT-PCR assay showed a superior diagnostic performance, as the sensitivity, specificity, and AUC reached 83.3%, 100%, and 0.95, respectively. The concordance between blood culture and the multiplex RT-PCR assay was highest for Klebsiella pneumonia (100%), followed by Streptococcus spp. (77.8%), Escherichia coli (66.7%), Staphylococcus spp. (50%) and Salmonella spp. (50%). In addition, the use of the newly established multiplex RT-PCR assay increased the spectrum of identifiable agents (Acintobacter baumannii, 1/32; Proteus mirabilis, 1/32). The combination of culture and the multiplex RT-PCR assay provided an excellent diagnostic accomplishment and significantly supported the identification of causative pathogens in clinical samples obtained from septic patients. Copyright © 2017 The

  2. "Like a Bird in a Cage." Vietnamese Women Survivors Talk About Domestic Violence

    Science.gov (United States)

    Shiu-Thornton, Sharyne; Senturia, Kirsten; Sullivan, Marianne

    2005-01-01

    In recent years, a growing literature has emerged that explores the role of culture in domestic violence for ethnic minority populations, including immigrants and refugees. This article presents qualitative data collected from Vietnamese refugee women through a research project in partnership with the Refugee Women's Alliance in Seattle,…

  3. Social Structures in the Economics of International Education: Perspectives from Vietnamese International Tertiary Students

    Science.gov (United States)

    Pham, Lien

    2013-01-01

    Drawing on the findings from in-depth interviews with Vietnamese international students studying at Australian universities, this article presents insights into the sociological influences that stem from international students' social networks, at home and abroad, and how they impact on students' aspirations and engagement in international…

  4. Pre-germinated brown rice reduced both blood glucose concentration and body weight in Vietnamese women with impaired glucose tolerance.

    Science.gov (United States)

    Bui, Thi Nhung; Le, Thi Hop; Nguyen, Do Huy; Tran, Quang Binh; Nguyen, Thi Lam; Le, Danh Tuyen; Nguyen, Do Van Anh; Vu, Anh Linh; Aoto, Hiromichi; Okuhara, Yasuhide; Ito, Yukihiko; Yamamoto, Shigeru; Kise, Mitsuo

    2014-01-01

    We have reported that newly diagnosed type 2 diabetes mellitus (DM) patients in Vietnam have a low body mass index (BMI) of around 23 and that the major factor for this is high white rice (WR) intake. Brown rice (BR) is known to be beneficial in the control of blood glucose levels; however, it has the property of unpleasant palatability. Pre-germinated brown rice (PGBR) is slightly germinated by soaking BR in water as this reduces the hardness of BR and makes it easier to eat. This study was designed to evaluate the effect of a 4-mo PGBR administration on various parameters in Vietnamese women aged 45-65 y with impaired glucose tolerance (IGT). Sixty subjects were divided into a WR or PGBR group. For the first 2 wk, WR was replaced by 50% PGBR, then for 2 wk by 75% PGBR and from the second month 100%. Before the beginning of the study and at the end of the study, 1) anthropometric measurements, 2) a nutrition survey for 3 nonconsecutive days by the 24 h recall method and 3) blood biochemical examinations were conducted. Fasting plasma concentrations of glucose and lipids and the obesity-related measurements and blood pressure were favorably improved only in the PGBR diet group. The present results suggest that replacing WR with PGBR for 4 mo may be useful in controlling body weight as well as blood glucose and lipid levels in Vietnamese women with IGT.

  5. Panic Disorder in Patients Presenting to the Emergency Department With Chest Pain: Prevalence and Presenting Symptoms.

    Science.gov (United States)

    Greenslade, Jaimi H; Hawkins, Tracey; Parsonage, William; Cullen, Louise

    2017-12-01

    Patients with panic disorder experience symptoms such as palpitations, chest pain, dizziness, and breathlessness. Consequently, they may attend the Emergency Department (ED) to be assessed for possible emergency medical conditions. Recognition of panic disorder within the ED is low. We sought to establish the prevalence of panic disorder in patients presenting for ED investigation of potential acute coronary syndrome. We also sought to characterise the cohort of patients with panic disorder in terms of presenting symptoms, risk factors, medical history and major adverse cardiac events (MACE). This was an observational study of 338 adult patients presenting to the Emergency Department of a tertiary hospital in Australia. Research nurses collected clinical data using a customised case report form. The outcome was panic disorder, assessed using the Mini International Neuropsychiatric Interview. The average age of participants was 50.2 years and 37.9% were female. Thirty-day MACE occurred in 7.7% of the cohort. The clinical diagnosis of panic disorder was made in 5.6% (95% CI: 3.4-8.6%) of patients. Compared to patients without panic disorder, patients with panic disorder were slightly more likely to report that their pain felt heavy (48.9% and 73.7% respectively, p=0.04). All other reported symptoms were similar in the two groups. The prevalence of panic disorder was low in patients presenting to an Australian ED with chest pain. Clinical signs or symptoms that are routinely collected as part of the chest pain workup cannot be used to distinguish patients with and without panic disorder. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

  6. Clinical utility of an optimised multiplex real-time PCR assay for the identification of pathogens causing sepsis in Vietnamese patients

    Directory of Open Access Journals (Sweden)

    Ngo Tat Trung

    2018-02-01

    Conclusion: The combination of culture and the multiplex RT-PCR assay provided an excellent diagnostic accomplishment and significantly supported the identification of causative pathogens in clinical samples obtained from septic patients.

  7. Adult patients in the pediatric emergency department: presentation and disposition.

    Science.gov (United States)

    Little, Wendalyn K; Hirsh, Daniel A

    2014-11-01

    Pediatric emergency departments (PEDs) are intended to care for acutely ill and injured children. Adult patients sometimes present to these facilities as well. Some of these are young adults still under the care of pediatric specialists, but older adults and those not under the care of specialists may seek care and may challenge pediatric care providers. Understanding the spectrum of adult illness encountered in the PED may help ensure optimum care for this patient population. This study aimed to describe the presentations of adult patients in 2 high-volume PEDs of a pediatric health care system. This is a retrospective review of electronic medical record to identify all visits for patients 21 years or older between 2008 and 2010. Patient demographics, reason for visit, diagnosis, and treatment details were identified. The combined PEDs recorded 417,799 total visits with 1097 patients 21 years or older; 188 of these were still followed by pediatric specialists. For the 907 remaining, the mean age was 36.5.years (range, 21-88 years); 73% were female. Fifty-one percent of the patients were triaged into the highest acuity levels. Fifty-seven percent of the patients were transferred to adult facilities for definitive care. There were no deaths among these patients at either PED, but 2 patients did require intubation and 1 received a period of chest compressions. Reason for presenting to the PED included on-site visitor (45%), mistakenly presented to children's hospital (34%), and hospital employee (21%). The most common presenting complaints were neurologic conditions, trauma/acute injuries, and chest pain. Adult patients in PEDs are rare but have relatively high acuity and often require transfer. Pediatric emergency department clinicians should have adequate, ongoing training to capably assess and stabilize adult patients across a spectrum of illness presentation.

  8. Sequence analysis of Vietnamese P[6] rotavirus strains suggests evidence of interspecies transmission.

    Science.gov (United States)

    Nguyen, Tuan Anh; Khamrin, Pattara; Trinh, Quang Duy; Phan, Tung Gia; Pham, Le Duc; Hoang, Le Phuc; Hoang, Kim Trong; Yagyu, Fumihiro; Okitsu, Shoko; Ushijima, Hiroshi

    2007-12-01

    Nucleotide and amino acid sequences of the VP8* gene of five Vietnamese P[6] rotavirus strains detected from hospitalized patients with acute gastroenteritis were analyzed and compared with other human and porcine P[6] rotaviruses. It is of interest that these strains had greatest identity with two Italian porcine rotavirus strains, 134/04-10 and 134/04-11. To our knowledge, these five Vietnamese rotaviruses are the rare P[6] rotavirus strains belonging to lineage I that cluster into sublineage Ic with porcine rotaviruses, and not into sublineage Ia, as other human P[6] rotaviruses have done so far. Sequence analysis of the VP7 gene of these P[6] rotavirus strains was also performed. The results showed that the Vietnamese G9P[6] strain had high similarity with other human G9 rotaviruses, confirming a human-animal reassortant virus, whereas other three G4P[6] strains had best identity with porcine G4 rotavirus strains, suggesting interspecies transmission of rotavirus between porcine and humans. This result provides the important data on molecular characteristics of Vietnamese rotaviruses, and highlights interspecies transmission events of rotaviruses in Vietnam as well as in Asia. (c) 2007 Wiley-Liss, Inc.

  9. Unusual presentation of mucocutaneous leishmaniasis in HIV-infected patient.

    Science.gov (United States)

    Bains, Anupama; Vedant, Deepak; Gupta, Priyanka; Tegta, G R

    2016-01-01

    Leishmaniasis is caused by protozoan parasite of genus leishmania. Visceral leishmaniasis, diffuse cutaneous leishmaniasis, and atypical forms of cutaneous leishmaniasis are common in HIV-infected patients. Our patient presented with an obstructive mass in nasal cavity and was diagnosed as a case of mucocutaneous leishmaniasis. Spontaneous healing of lesions in HIV-infected patients is rare rather they are unresponsive to treatment and have frequent relapses, especially in patients with low CD4 count. However, in our patient, the lesion improved significantly after 2 months of highly active antiretroviral therapy and co-trimoxazole prophylaxis.

  10. A Patient Presenting with Concurrent Testis Torsion and Epididymal Leiomyoma

    Directory of Open Access Journals (Sweden)

    E. Arpali

    2013-01-01

    Full Text Available Leiomyomas are the second most common tumors of epididymis. Patients with leiomyomas are sometimes misdiagnosed with testicular tumors. A Case of a patient with a scrotal mass presenting with testicular torsion is reported. Concurrent occurrence of testicular torsion and epididymal leiomyoma is an extremely rare condition.

  11. Delayed presentation of breast cancer patients | Otieno | East ...

    African Journals Online (AJOL)

    Objective: To determine the extent and nature of delayed presentation of patients treated for breast cancer at Kenyatta National Hospital (KNH). Setting: Kenyatta National Hospital (KNH) which is a tertiary, teaching and referral hospital in Nairobi, Kenya. Results: A total of 166 patients were recruited into the study. The mean ...

  12. Late Presentation for Care Among Patients With Chronic Hepatitis C

    DEFF Research Database (Denmark)

    Hansen, Janne Fuglsang; Hallager, Sofie; Øvrehus, Anne

    2018-01-01

    Patients with chronic hepatitis C may have advanced fibrosis at first evaluation. Using the European Association for the Study of the Liver (EASL) definition (FibroScan® >9.5 kPa) for "late presenter for care" (LP), we found that 32% (169 of 527) of patients were LP. Being a LP was associated...

  13. Management of patients presenting with diarrhoea to a regional ...

    African Journals Online (AJOL)

    Management of patients presenting with diarrhoea to a regional emergency department in KwaZulu-Natal: Call for clearer, more relevant guidance. ... management of acute diarrhoea in HIVinfected individuals, and that the lack of clear management strategies is likely to affect patient safety and increase antibiotic resistance.

  14. Diarrhoea among Vietnamese refugees in the Philippines.

    Science.gov (United States)

    Rodriguez, S V; Santos Ocampo, P D; Ka, E K; Tecson, L V

    1982-09-01

    A 6-month survey of diarrhoeas in Vietnamese refugee camp children was carried out and was responsible for 32.5% of pediatric consultations. One hundred twenty cases were studied and underwent laboratory work-up. Peak incidence was in the 4-6 years. Diarrhoea was observed to be at its peak in April and June which coincides with the increase in the number of transients and with the rainy season. Diarrhoea with fever and abdominal pain were the most prominent clinical symptoms. Only 8.3% grew bacterial pathogens' enteropathogenic E. coli being the most common followed by Staphylococcus aureus. It is apparent that a causative agent other than a bacterial pathogen such as a virus may play a major role in diarrhoeas in Vietnamese refugee infants and children. The lack of environmental sanitation and health education play a major role in the causation of diarrhoea in these refugee children.

  15. Patients presenting to an outpatient sport medicine clinic with concussion

    Science.gov (United States)

    Ouellet, Jérôme; Boisvert, Leslie; Fischer, Lisa

    2016-01-01

    Abstract Objective To describe the characteristics of patients who presented to outpatient sport and exercise medicine clinics with concussion. Design Retrospective chart review of electronic medical records. Setting Three specialized sport and exercise medicine clinics in London, Ont. Participants A total of 283 patients presenting with concussion. Main outcome measures Data collected included demographic variables (age and sex), sport participation at the time of injury, previous medical history (including history of concussion), Post-Concussion Symptom Scale (PCSS) scores, and return-to-play (RTP) variables (delay and outcome). Results The mean age of patients presenting for care was 17.6 years; 70.9% of patients were younger than 18 years of age (considered pediatric patients); 58.8% of patients were male; and 31.7% of patients had a previous history of concussion. The main sports associated with injury were hockey (40.0%), soccer (12.6%), and football (11.7%). Return to play was granted to 50.9% of patients before the 3-week mark and 80.2% of patients before 8 weeks. Total PCSS scores (maximum score was 132) and neck scores (part of the PCSS, maximum score was 6) were significantly higher in adults compared with pediatric patients (36.2 vs 27.6, P = .02, and 1.8 vs 1.2, P = .02, respectively). A significant difference was seen in RTP, with pediatric patients returning earlier than adults did (P = .04). This difference was not seen when comparing males with females (P = .07). Longer duration of follow-up did not influence RTP outcomes. Previous history of concussion was associated with restriction from contact or collision sports (P < .001). Conclusion Given the age and sex variability found in this study, as well as in previous published reports, it is important to manage each patient individually using current best available practice strategies to optimize long-term outcomes.

  16. Sex differences in clinical characteristics, hospital management practices, and in-hospital outcomes in patients hospitalized in a Vietnamese hospital with a first acute myocardial infarction.

    Science.gov (United States)

    Nguyen, Hoa L; Ha, Duc Anh; Phan, Dat Tuan; Nguyen, Quang Ngoc; Nguyen, Viet Lan; Nguyen, Nguyen Hanh; Nguyen, Ha; Goldberg, Robert J

    2014-01-01

    Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with acute myocardial infarction (AMI) at the Vietnam National Heart Institute in Hanoi. The objectives of this observational study were to examine sex differences in clinical characteristics, hospital management, in-hospital clinical complications, and mortality in patients hospitalized with an initial AMI. The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010. The average age of study patients was 66 years and one third were women. Women were older (70 vs. 64 years) and were more likely than men to have had hyperlipidemia previously diagnosed (10% vs. 2%). During hospitalization, women were less likely to have undergone percutaneous coronary intervention (PCI) compared with men (57% vs. 74%), and women were more likely to have developed heart failure compared with men (19% vs. 10%). Women experienced higher in-hospital case-fatality rates (CFRs) than men (13% vs. 4%) and these differences were attenuated after adjustment for age and history of hyperlipidemia (OR: 2.64; 95% CI: 1.01, 6.89), and receipt of PCI during hospitalization (OR: 2.09; 95% CI: 0.77, 5.09). Our pilot data suggest that among patients hospitalized with a first AMI in Hanoi, women experienced higher in-hospital CFRs than men. Full-scale surveillance of all Hanoi residents hospitalized with AMI at all Hanoi medical centers is needed to confirm these findings. More targeted and timely educational and treatment approaches for women appear warranted.

  17. Sex differences in clinical characteristics, hospital management practices, and in-hospital outcomes in patients hospitalized in a Vietnamese hospital with a first acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Hoa L Nguyen

    Full Text Available BACKGROUND: Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with acute myocardial infarction (AMI at the Vietnam National Heart Institute in Hanoi. The objectives of this observational study were to examine sex differences in clinical characteristics, hospital management, in-hospital clinical complications, and mortality in patients hospitalized with an initial AMI. METHODS: The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010. RESULTS: The average age of study patients was 66 years and one third were women. Women were older (70 vs. 64 years and were more likely than men to have had hyperlipidemia previously diagnosed (10% vs. 2%. During hospitalization, women were less likely to have undergone percutaneous coronary intervention (PCI compared with men (57% vs. 74%, and women were more likely to have developed heart failure compared with men (19% vs. 10%. Women experienced higher in-hospital case-fatality rates (CFRs than men (13% vs. 4% and these differences were attenuated after adjustment for age and history of hyperlipidemia (OR: 2.64; 95% CI: 1.01, 6.89, and receipt of PCI during hospitalization (OR: 2.09; 95% CI: 0.77, 5.09. CONCLUSIONS: Our pilot data suggest that among patients hospitalized with a first AMI in Hanoi, women experienced higher in-hospital CFRs than men. Full-scale surveillance of all Hanoi residents hospitalized with AMI at all Hanoi medical centers is needed to confirm these findings. More targeted and timely educational and treatment approaches for women appear warranted.

  18. Neuroimaging and other investigations in patients presenting with headache

    Directory of Open Access Journals (Sweden)

    Callum W Duncan

    2012-01-01

    Full Text Available Headache is very common. In the United Kingdom, it accounts for 4.4% of primary care consultations, 30% of referrals to neurology services and 0.5-0.8% of alert patients presenting to emergency departments. Primary headache disorders account for the majority of patients and most patients do not require investigation. Warning features (red flags in the history and on examination help target those who need investigation and what investigations are required. This article summarizes the typical presentations of the common secondary headaches and what neuroimaging and other investigations are appropriate for each headache type.

  19. Smoking media literacy in Vietnamese adolescents.

    Science.gov (United States)

    Page, Randy M; Huong, Nguyen T; Chi, Hoang K; Tien, Truong Q

    2011-01-01

    Smoking media literacy (SML) has been found to be independently associated with reduced current smoking and reduced susceptibility to future smoking in a sample of American adolescents, but not in other populations of adolescents. Thus, the purpose of this study was to assess SML in Vietnamese adolescents and to determine the association with smoking behavior and susceptibility to future smoking. A cross-sectional survey of 2000 high school students completed the SML scale, which is based on an integrated theoretical framework of media literacy, and items assessing cigarette use. Ordinal logistic regression was used to determine the association of SML with smoking and susceptibility to future smoking. Ordinal logistic regression was also to determine whether smoking in the past 30 days was associated with the 8 domains/core concepts of media literacy which comprise the SML. Smoking media literacy was lower among the Vietnamese adolescents than what has been previously reported in American adolescents. Ordinal logistic regression analysis results showed that in the total sample SML was associated with reduced smoking, but there was no association with susceptibility to future smoking. Further analysis showed that results differed according to school and grade level. There did not appear to be association of smoking with the specific domains/concepts that comprise the SML. The association of SML with reduced smoking suggests the need for further research involving SML, including the testing of media literacy training interventions, in Vietnamese adolescents and also other populations of adolescents. © 2011, American School Health Association.

  20. Normal Coronary Artery Patient Presenting with Left Ventricular Aneurysm

    Directory of Open Access Journals (Sweden)

    Hakan Altay

    2011-01-01

    Full Text Available Left ventricular aneurysm (LVA is one of the most important complications of myocardial infarction LVA is strictly defined as a distinct area of abnormal left ventricular diastolic contour with systolic dyskinesia or paradoxical bulging. LVA usually results from myocardial infarction. Other rare aetiologies of LVA include hypertrophic cardiomyopathy, Chagas' disease, sarcoidosis, congenital LVA, and idiopathic However, LVA formation in patients with idiopathic dilated cardiomyopathy is rarely reported, and the incidence, clinical features, and pathogenesis of LVA formation in patients with idiopathic dilated cardiomyopathy is not well understood. Here, we present a 45 years old, idiopathic dilated cardiomyopathy patient with LVA and normal coronary arteries The pathogenesis of LVA formation in patients with idiopathic dilated cardiomyopathy is not clear. One acceptable hypothesis is that coronary artery emboli originate from mural thrombi, present in some patients with idiopathic dilated cardiomyopathy, which develop due to local wall infarction and fibrosis. The local myocardial perfusion differences could be seen in idiopathic dilated cardiomyopathy and predominantly found in the anteroposterior axis of the left ventricle. Local fibrosis occurs more frequently on the anterior wall or posterior wall, and less frequently on the lateral or septal wall. In our patient, LVA existed in the septal segments.We could not define the exact mechanism of the septal aneurysm in our patient but we decided to present this abnormal case, which is different from cases thus far reported in the literature.

  1. Preoperative neuropsychological presentation of patients with refractory frontal lobe epilepsy.

    Science.gov (United States)

    Patrikelis, Panayiotis; Gatzonis, Stylianos; Siatouni, Anna; Angelopoulos, Elias; Konstantakopoulos, George; Takousi, Maria; Sakas, Damianos E; Zalonis, Ioannis

    2016-06-01

    This study investigated whether certain cognitive deficits are associated with frontal lobe epilepsy (FLE) aiming to contribute with localization data to the preoperative assessment of epilepsy surgery candidates. We evaluated 34 patients with refractory FLE, 37 patients with refractory medial temporal lobe epilepsy (MTLE), and 22 healthy individuals in attention, psychomotor speed, motor function, verbal memory span, verbal fluency, response inhibition/interference, concept formation and set shifting, anticipation and planning, global memory. Neuropsychological performances of FLE and MTLE were similar, with the only exception the WCST-number of categories index, measuring mental flexibility, in which MTLE patients performed significantly worse than FLE patients. Left-FLE patients presented more perseverative responding compared to both other patient groups and healthy controls (HCs), while left-MTLE patients showed worse sorting abilities than the other epilepsy groups. Our findings suggest a weak cognitive differentiation between FLE and MTLE, probably attributed to the intricate nature of fronto-temporal connectivity frequently resulting in overlapping deficits as well as the confounding effects of seizure-related variables. In clinical practice, a highly individualized (idiographic) neuropsychological approach along with the inclusion of concurrent EEG recordings (e.g., interictal coupling) may be of help for neuropsychologists in identifying FLE patients from those with medial temporal pathology presenting frontal dysfunction as a secondary cognitive symptom.

  2. Pseudohypertension-Like Presentation: An Exceptionally Rare Presentation in an Athletic Female Patient with Morphea

    Directory of Open Access Journals (Sweden)

    Ahmed Al-Imam

    2016-01-01

    Full Text Available Introduction. Pseudohypertension is a condition which mainly occurs due to thickening-calcification of tunica intima of the arterial wall, leading to a faulty measurement of the intra-arterial blood pressure. To the best of our knowledge, this is the first case report in literature, of a pseudohypertension-like presentation in association with Morphea en plaque. Case Presentation. This is a rare presentation of a young athletic female and a professional tennis player, with pseudohypertension-like presentation. The patient had a traumatic injury to the right elbow joint; the injury occurred during a professional tennis match. The injury was managed by immobilization, physiotherapy, and Low-Level Laser Therapy. Soon after that, the patient had a circumscribed sclerotic ivory plaque affecting the skin of the right cubital fossa. The histopathology analysis, together with the serological-hematological tests and the clinical picture, along with positive Osler’s signs, leads to the conclusive diagnosis of Morphea en plaque. The peculiar anatomic localization of the plaque anterior to the brachial artery leads to faulty blood pressure measurement as recorded by mercurial sphygmomanometer. Conclusion. This unique presentation of Morphea en plaque carries an important message in relation to the basic medical practice and in relation to the accurate measurement of the vital signs.

  3. Lateral sinus thrombosis patient presenting with headache and vomiting

    OpenAIRE

    Ayşenur Paç Kısaarslan; Yasemin Altuner Torun; Hümeyra Aslaner; Mehmet Somtaş; Ümmügülsüm Gümüş

    2013-01-01

    Lateral sinus thrombosis is rare intracranial complicationsof otitis media. A 12 years old girl patient presented withcomplaints of vomiting and headeche. Patient treated withceftriaxone had lost seven kilograms in ten days. Therewere complaints of frequent upper way infection andotitis media. Physical examination of right ear was painfuland right tympanic membrane was pale. Laboratorytests shuch as hemogram, blood smear, Brucellatube agglütination test, biochemistry tests, abdomenultrasaund ...

  4. Unique Presentation of Hematuria in a Patient with Arterioureteral Fistula

    Directory of Open Access Journals (Sweden)

    Tomas Mujo

    2016-01-01

    Full Text Available Active extravasation via an arterioureteral fistula (AUF is a rare and life-threatening emergency that requires efficient algorithms to save a patient’s life. Unfortunately, physicians may not be aware of its presence until the patient is in extremis. An AUF typically develops in a patient with multiple pelvic and aortoiliac vascular surgeries, prior radiation therapy for pelvic tumors, and chronic indwelling ureteral stents. We present a patient with a left internal iliac arterial-ureteral fistula and describe the evolution of management and treatment algorithms based on review of the literature.

  5. Among the Missing: The Experience of Vietnamese American Nursing Students

    Science.gov (United States)

    Wilby, Mary Lynn

    2013-01-01

    Non-traditional nursing students, including Vietnamese Americans often face challenges that differ from those of their white counterparts. These challenges have significant impact on academic success and contribute to underrepresentation of minorities in nursing. This study explored the lived experience of 12 Vietnamese American undergraduate…

  6. How Vietnamese Culture Influence on Learning and Teaching English

    Science.gov (United States)

    Huong, Phan Thi Thu

    2008-01-01

    Vietnamese has to face a cross-culture issue with the teaching and learning of English as Vietnamese culture is "villagers' culture" which considers relationships in village as family relations and an emphasis "on hierarchical, social order in their dealings with one another" (Ellis, 1995: 9) with a traditional teaching method…

  7. Lion and dragon: four centuries of Dutch-Vietnamese relations

    NARCIS (Netherlands)

    Kleinen, J.; van der Zwan, B.; Moors, H.; van Zeeland, T.

    2008-01-01

    Dutch-Vietnamese relations go back as far as the beginning of the seventeenth century. For a long time, relations between the Dutch lion and the Vietnamese dragon have been fragile and even violent. Although the relations were not continuously bad, they remained distant rather than warm. Today

  8. A Bilingual Vocabulary Size Test of English for Vietnamese Learners

    Science.gov (United States)

    Nguyen, Le Thi Cam; Nation, Paul

    2011-01-01

    This article describes the development and validation of a Vietnamese bilingual version of the Vocabulary Size Test--a test which measures written receptive vocabulary size. The test can be used to measure the English vocabulary size of Vietnamese learners of English. A learner's total vocabulary size is calculated by multiplying their test result…

  9. Effects of Vietnamese Sophora root on growth, adhesion, invasion ...

    African Journals Online (AJOL)

    Background: Vietnamese Sophora Root mainly contains active constituents such as alkaloids, and it has anti-tumour, antibacterial, and anti-inflammatory effects. The objective of the paper was to study the effects of Vietnamese Sophora Root on growth, adhesion, invasion and motility of mouse melanoma B16BL6 cells, and ...

  10. Life Science. A Handbook for Vietnamese Speaking Students.

    Science.gov (United States)

    Lindauer, Lawrence; And Others

    This bilingual glossary of the biological/life sciences is one in a series developed to help high school students who are literate in their native Vietnamese, but not in English, to meet graduation requirements. Major biological science concepts and definitions of important and commonly used terms are provided, first in Vietnamese and then in…

  11. Health Information in Vietnamese (Tiếng Việt)

    Science.gov (United States)

    ... Home - Tiếng Việt (Vietnamese) PDF Healthy Living Toolkit: Violence In the Home - Tiếng Việt (Vietnamese) MP3 U.S. Committee for Refugees and Immigrants Child Dental Health Early Childhood Caries - English PDF Early Childhood Caries - Tiếng Việt ( ...

  12. Voices of Dissent: Unpacking Vietnamese International Student Experience

    Science.gov (United States)

    Huong, Le; Koo, Fung Kuen; Arambewela, Rodney; Zutshi, Ambika

    2017-01-01

    Purpose: The purpose of this paper is to examine Vietnamese international students' experiences with the campus learning environment by analysing differences in staff and student perceptions. Design/Methodology/Approach: Two focus groups (n = 12) and ten in-depth interviews were conducted with Vietnamese students and four in-depth interviews with…

  13. Clinical Presentation and Outcome of Patients With Optic Pathway Glioma.

    Science.gov (United States)

    Robert-Boire, Viviane; Rosca, Lorena; Samson, Yvan; Ospina, Luis H; Perreault, Sébastien

    2017-10-01

    Optic pathway gliomas (OPGs) occur sporadically or in patients with neurofibromatosis type 1 (NF1). The purpose of this study was to evaluate the clinical presentation at diagnosis and at progression of patients with OPGs. We conducted a chart review of patients with OPGs diagnosed in a single center over a period of 15 years. Demographic data including age, sex, NF1 status, clinical presentation, and outcome were collected. Of the 40 patients who were identified, 23 had sporadic tumors (57.5%) and 17 had NF1-related tumors (42.5%). Among the children with NF1, there was a significant overrepresentation of girls (82.3%) (P = 0.02), while among the children without NF1, there were slightly more boys (56.5%) than girls (43.5%). The presence of nystagmus was strongly associated with sporadic optic pathway gliomas. Poor visual outcome was related to tumor affecting both optic pathways, hydrocephalus at diagnosis, and optic nerve atrophy. Of the 40 patients, five died of OPG complications (12.5%) and all had sporadic tumors. Our cohort is one of the largest with OPGs and a detailed description of the clinical presentation both at diagnosis and at progression. We observed a significant difference between sporadic and NF1 optic pathway gliomas in terms of demographics, clinical presentation, and outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. AETIOLOGICAL PROFILE OF PATIENTS PRESENTING WITH UPPER GASTROINTESTINAL BLEEDING

    Directory of Open Access Journals (Sweden)

    Amit Govind Kamat

    2017-06-01

    Full Text Available BACKGROUND In the recent years, the number of studies exclusively examining epidemiologic patterns of Upper Gastrointestinal Bleeding (UGIB has been quite limited. However, most epidemiologic studies have shown a decrease in the incidence of all causes of upper gastrointestinal bleeding. Although, the incidences of peptic ulcers have remained unchanged. Gastrointestinal bleeding is a very common emergency accounting for 7-8% of acute medical admissions. UGIB is 4-5 times more common than the lower GI haemorrhage. Acute erosive gastritis is the most common cause followed by oesophageal varices, peptic ulcer and reflux oesophagitis. Upper GI bleed is more common in men than women (ratio 3:2 and the frequency increases with age. Hence, the present study was designed to study the aetiological profile of patients presenting with upper gastrointestinal bleeding. MATERIALS AND METHODS This one year cross-sectional study was conducted from January 2013 to December 2013. Sample size of 50 was considered. Patients aged 18 years and above presenting with upper gastrointestinal bleeding and who are fit for endoscopy were selected. Endoscopy was performed in all patients within 24 hrs. of admission and data was plotted in terms of rates, ratios and percentages and continuous data was expressed as mean ± standard deviation. RESULTS In the present study, most of the patients reported past history of liver disease and intake of NSAIDs and aspirins. In the present study, on clinical examination, most of the patients had pallor followed by tenderness. In the present study, the commonest diagnosis was cirrhosis of liver due to alcohol-induced with portal hypertension. CONCLUSION Upper GI endoscopy revealed varices as most common cause of upper gastrointestinal bleeding.

  15. [Biological and evolutive spectrum of patients ANCA present].

    Science.gov (United States)

    Covic, A; Mutică, Camelia; Ignat, Anamaria; Boaru, Iulia; Veisa, G; Enea, Maria; Covic, Maria

    2004-01-01

    To analyse the immuno-biological profile of patients with antineutrophil cytoplasmic antibodies (ANCA) presents. This is a retrospective study of all ANCA positives cases from Nephrology Clinic Iasi during five years (1998-2003) on a cohort of 97 patients. pANCA was positive in 28, cANCA was positive in 60 and the others had pANCA and cANCA. The diseases ANCA associated were: systemic vasculitis, rapidly progressive glomerulonephritis (GNRP), chronic renal failure of an unknown etiology. ANCA presence was associated with inflammatory syndrome in 83.5%, anemic syndrome in 71.1%. From the patients with renal disfunction (71.1%), half of them presented an increased level of creatinine (>6 mg%). Renal biopsy proven especially crescentic glomerulonephritis. The complications and the diseases were more frequent in cANCA cases. cANCA presence is a negative prognosis factor in vasculitis; testing ANCA alone cannot be used to guide treatment.

  16. Perceptions of Vietnamese Fathers' Acculturation Levels, Parenting Styles, and Mental Health Outcomes in Vietnamese American Adolescent Immigrants

    Science.gov (United States)

    Nguyen, Peter V.

    2008-01-01

    Vietnamese adult and adolescent immigrants in the United States acculturate to the Western culture at different rates. Most Vietnamese parents tend to use the authoritarian parenting method in which dictatorial approaches are enforced, possibly leading to family conflicts and mental health issues. By means of the Suinn-Lew Asian Self-Identity…

  17. Patient with Takayasu arteritis presented as cardiogenic shock.

    Science.gov (United States)

    Tacoy, Gulten; Akyel, Ahmet; Tavil, Yusuf; Cengel, Atiye

    2010-11-01

    Takayasu arteritis is a chronic inflammatory disease involving the aorta, its main branches and affects particularly young women. Symptomatic coronary artery disease and cardiogenic shock are rare signs of Takayasu arteritis. We describe a 47-year-old male patient in whom cardiogenic shock was the initial presentation of Takayasu arteritis with coronary, subclavian, celiac and total abdominal aortic occlusion.

  18. Patients presenting with fresh trauma after interpersonal violence

    African Journals Online (AJOL)

    representative sample of patients presenting with fresh trauma to the Trauma Unit of Tygerberg Hospital was selected for study. Subjects were questioned about the nature of the trauma and breath alcohol concentrations were detennined. Blood and urine samples for analysis of alcohol and other substances were obtained ...

  19. Clinical presentation of Parkinson's disease among Sudanese patients

    African Journals Online (AJOL)

    Parkinson Disease (PD) is a neurodegenerative disorder affecting motor system. It is a chronic progressive disorder leading to long standing disability. Objective: To study the clinical presentation of PD among Sudanese patients seen at Elshaab Teaching Hospital during the period from May2004-April 2008. Methodology: ...

  20. The profile of the overdose patient presenting to Paarl Hospital ...

    African Journals Online (AJOL)

    Overdose is a common problem, often seen in emergency departments in South Africa. The aim of this study was to determine the profile of the overdose patient presenting to Paarl Hospital, the number of cases per day of the week and per month of the year, which drugs were most commonly used, as well as the ...

  1. Visual Morbidities among Elderly Patients Presenting at a Primary ...

    African Journals Online (AJOL)

    Visual Morbidities among Elderly Patients Presenting at a Primary Care Clinic in Nigeria. LA Adebusoye, ET Owoaje, MMA Ladipo, AO Adeniji. Abstract. Background: Visual challenges compromise mobility, increase dependency on family members and constitute a major health problem mainly seen by the primary care ...

  2. Surgical implications of abdominal pain in patients presenting to the ...

    African Journals Online (AJOL)

    Objective: To determine the local aetiological spectrum of surgically relevant causes of abdominal pain. Design: A prospective descriptive study was carried out. Setting: Kenyatta National Hospital, Nairobi, Kenya during the month of October 2002. Subjects: Patients aged 13 years and older presenting to the casualty ...

  3. Patients presenting with fresh trauma after interpersonal violence

    African Journals Online (AJOL)

    frequentty have evidence of substance abuse. Nevertheless ... Department of Nursing, University of the Western Cape, Bellville, ... substance use.l1·~. One window for research on interpersonal violence is provided by the study of patients presenting for treatment of fresh trauma. Studies of fresh trauma in South Africa have.

  4. Prevalence and presentation of spinal injury in patients with major

    African Journals Online (AJOL)

    dell

    Background: Spinal injury is a major cause of morbidity, mortality and long bed occupancy in patients admitted in Mulago Hospital. Several studies have reported different incidence and presentations of spinal injury 1-4. At Mulago hospital, road traffic crushes (RTC) is one of the most common causes of these injuries5.

  5. Prevalence and presentation of spinal injury in patients with major ...

    African Journals Online (AJOL)

    Background: Spinal injury is a major cause of morbidity, mortality and long bed occupancy in patients admitted in Mulago Hospital. Several studies have reported different incidence and presentations of spinal injury 1-4. At Mulago hospital, road traffic crushes (RTC) is one of the most common causes of these injuries5.

  6. Breast cancer patients' presentation for oncological treatment: a ...

    African Journals Online (AJOL)

    Introduction: Breast cancer patients are presenting at advanced stages for oncological treatment in Nigeria and World Health Organization predicted developing countries' breast cancer incidence and mortality to increase by year 2020. Methods: Prospective observational hospital based study that enrolled breast cancer ...

  7. Clinical presentation of patients and distribution of colonic ...

    African Journals Online (AJOL)

    Colonic diverticula disease is an acquired disease which affects adults and is frequently referred to as a western world disease. In Nigeria, studies on colonic diverticulosis are sparse and few of them are case reports. The aim was to describe the clinical presentation and distribution of colonic diverticulosis in patients who ...

  8. An Unusual Presentation of Lupus in a Pediatric Patient

    Directory of Open Access Journals (Sweden)

    Vimal Master Sankar Raj

    2013-01-01

    Full Text Available Systemic lupus erythematosus (SLE is an autoimmune disease causing inflammatory tissue damage. Multiple organ damage can ensue with renal and neurological involvement carrying the worse prognosis. In this case report we present a 10-year-old African American girl who presented with abnormal choreiform movements, headache, weight loss, and fatigue. Detailed clinical examination with laboratory and imaging studies clinched the diagnosis of SLE. Echocardiogram revealed the presence of Libman-sacks endocarditis. Patient showed rapid resolution of symptoms with steroid therapy. A brief discussion on childhood onset lupus along with the varied clinical presentation is discussed.

  9. Exploring the role of ethnic media and the community readiness to combat stigma attached to mental illness among Vietnamese immigrants: the pilot project Tam An (Inner Peace in Vietnamese).

    Science.gov (United States)

    Han, Meekyung; Cao, Lien; Anton, Karen

    2015-01-01

    Vietnamese Americans are at high risk for developing mental health disorders due to multiple risk factors such as trauma and acculturative stress. However, the utilization of mental health services has been low. The pilot project Tam An was implemented to raise mental health awareness by engaging community resources in the Vietnamese population. Informed by the Community Readiness Model and through local ethnic media sources, messages to destigmatize mental health and promote the willingness to initiate mental health treatment were presented. Using an exploratory perspective, findings from focus group data suggest that the project improved the community's stage of readiness.

  10. Supportive policies to promote high school completion for Vietnamese boys and young adults

    OpenAIRE

    Sharpe, Laura Judith

    2011-01-01

    This study examines ways to improve high school completion rates for Vietnamese-speaking boys in Vancouver. On average, English as a Second Language students have high school completion rates above the provincial average. However, for the past five years, Vietnamese-speaking boys have averaged completion rates 6.1 percentage points behind their non-Vietnamese-speaking peers and 14.4 percentage points behind Vietnamese-speaking girls, a gender gap twice that of non-Vietnamese speakers. Using a...

  11. Patients with Acromegaly Presenting with Colon Cancer: A Case Series

    Directory of Open Access Journals (Sweden)

    Murray B. Gordon

    2016-01-01

    Full Text Available Introduction. Frequent colonoscopy screenings are critical for early diagnosis of colon cancer in patients with acromegaly. Case Presentations. We performed a retrospective analysis of the incidental diagnoses of colon cancer from the ACCESS trial (ClinicalTrials.gov identifier: NCT01995734. Colon cancer was identified in 2 patients (4.5%. Case  1 patient was a 36-year-old male with acromegaly who underwent transsphenoidal surgery to remove the pituitary adenoma. After surgery, the patient underwent routine colonoscopy screening, which revealed a 40 mm tubular adenoma in the descending colon. A T1N1a carcinoma was surgically removed, and 1 of 22 lymph nodes was positive for metastatic disease, leading to a diagnosis of stage 3 colon cancer. Case  2 patient was a 50-year-old male with acromegaly who underwent transsphenoidal surgery to remove a 2 cm pituitary adenoma. The patient reported severe cramping and lower abdominal pain, and an invasive 8.1 cm3 grade 2 adenocarcinoma with signet rings was identified in the ascending colon and removed. Of the 37 lymph nodes, 34 were positive for the presence of tumor cells, and stage 3c colon cancer was confirmed. Conclusion. Current guidelines for colonoscopy screening at the time of diagnosis of acromegaly and at appropriate follow-up intervals should be followed.

  12. Cardiac asthma in elderly patients: incidence, clinical presentation and outcome

    Directory of Open Access Journals (Sweden)

    Ray Patrick

    2007-05-01

    Full Text Available Abstract Background Cardiac asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of cardiac asthma with that of classical congestive heart failure (CHF in elderly patients. Methods Prospective study in an 1,800-bed teaching hospital. Results Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years were included. Findings of cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137 and the cardiac asthma group (n = 75, differed for tobacco use (34% vs. 59%, p 2 (47 ± 15 vs. 41 ± 11 mmHg, p Conclusion Patients with cardiac asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.

  13. Body Dysmorphic Disorder in Patients Presenting for Cosmetic Treatment

    Directory of Open Access Journals (Sweden)

    Ebru Altintas

    2015-09-01

    Full Text Available Body dysmorphic disorder is an obsessive-compulsive related psychiatric disorder characterized by excessive preoccupation about an imagined or slight defect in appearance. Preoccupation of the appearance with the skin, hair and nose are most common. Impairment of the quality of life, comorbidity of the psychiatric and personality disorder are related with body dysmorphic disorder. Nowadays, cosmetic procedure has become increasingly popular especially among women. The prevalence of body dysmorphic disorder among patients seeking cosmetic treatment in surgery or dermatology clinics is higher than general population. As postoperatively some patients dissatisfied with the surgery, dermatologists and surgeons should be informed about body dysmorphic disorder. This aim of this review was to assess prevalance, clinical features, motivational factors of patients with body dysmorphic disorder presenting for cosmetic medical treatments. [Archives Medical Review Journal 2015; 24(3.000: 324-338

  14. Left atrial myoxma presenting as headache in the pediatric patient.

    Science.gov (United States)

    Xu, Jin; Gao, Yanxia; Li, Yi; Yu, Xuezhong; Guo, Shigong; Li, Meilin

    2015-02-01

    Cardiac myxomas rarely occur in children or adolescents. In addition, it is even more rare for the adolescent patient to present with neurological symptoms only. Early diagnosis is difficult because the symptoms of left atrial myxoma are frequently nonspecific. If delayed or left undiagnosed, severe and fatal complications, such as systemic embolism, heart failure, and pulmonary hypertension, may occur. A 13-year-old girl was admitted to our resuscitation room because of loss of consciousness for the preceding 2 h; she had a longstanding history of headache and dizziness for the previous 18 months. Repeated investigations at her local hospital did not reveal any abnormalities. During this admission, routine chest x-ray study found an abnormal bulge of a segment of the pulmonary artery and elevated cardiac enzymes. Emergency bedside echocardiography was performed and revealed a myxoma in the left atria. Subsequent computed tomography head revealed cardiogenic cerebral embolism. When her condition was stable, the patient was taken to the operating room, where a tumorectomy was performed successfully. The patient was then treated with oral anticoagulants and an uneventful recovery was made. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: In order to avoid delayed diagnosis and treatment of its potentially fatal complications, it is important for the emergency clinician to have a high level of suspicion for a cardiac myxoma when attending to young patients that present with syncope. We therefore recommend that, as routine practice, bedside echocardiography to be carried in the emergency department for young patients that present with syncope. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Disseminated lesions at presentation in patients with optic neuritis.

    OpenAIRE

    Ormerod, I E; McDonald, W I; du Boulay, G H; Kendall, B E; Moseley, I F; Halliday, A M; Kakigi, R; Kriss, A; Peringer, E

    1986-01-01

    Thirty five adults and two children with clinically isolated optic neuritis were examined by magnetic resonance imaging (MRI) to determine the presence of disseminated lesions within the brain at presentation and to compare these findings with the results of evoked potential studies. Of the adult patients, 61% showed lesions on the scans whereas the evoked potentials suggested the presence of lesions outside the visual system in 30%. MRI is a sensitive method for the demonstration of clinical...

  16. [Segmental neurofibromatosis in children. Presentation of 43 patients].

    Science.gov (United States)

    Pascual-Castroviejo, I; Pascual-Pascual, S I; Velázquez-Fragua, R; Viaño, J; López-Gutiérrez, J C

    It is known as segmental neurofibromatosis type 1 (NF1) a type of NF1 characterized by the features circumscribed to one or more body cutaneous and/or subcutaneous segments. This entity is recognized from recently and it is related with somatic mosaicism. 43 patients (29 females and 14 males) with ages below 16 years were retrospectively studied. Image study of the affected region of the body was performed in all patients to discard a subjacent organic disease, and a neurofibroma was histologically demonstrated in some cases. Somatic or gonosomal mosaicism was not investigated in any of the patients. Only 8 patients showed cutaneous lesion--7 with café-au-lait spots (3 of freckles type, 4 of large spots, of which, 3 were bilateral and 1 unilateral ) and 1 presented neurofibromas-. The other cases (81%) had cutaneous lesion with subjacent lesion (neurofibromas and bone dysplasia in most cases). The subcutaneous lesions were seen in all parts of the body without a preferent location. In cases with only cutaneous lesion, the clinical features were seen on the trunk skin. Segmental NF1 is considered to be the result of a somatic or gonosomal mosaicism and still is underdiagnosed. Features of segmental NF1 can be found in as many regions of the body as NF1 without mosaicism. The types of segmental NF1 that were seen less frequently in this series were those with only cutaneous features (café-au-lait spots and neurofibromas). Types with subcutaneous features that involved subjacent organs were seen in 81% of patients. Familial patients, with NF1 or segmental NF1 was shown in 15 patients (35%) and bilateral lesion in 4 cases (9.3%).

  17. Prognosis in patients presenting with non-traumatic coma.

    Science.gov (United States)

    Forsberg, Sune; Höjer, Jonas; Ludwigs, Ulf

    2012-03-01

    Studies of patients presenting with coma are limited, and little is known about the prognosis of these cases. The aim of this study was to investigate the acute and long-term prognosis after an episode of non-traumatic coma. Adults admitted consecutively to an emergency department in Stockholm, Sweden between February 2003 and May 2005 with a Glasgow Coma Scale (GCS) score of 10 or below were enrolled prospectively. All available data were used to explore the cause of the impaired consciousness on admission. Patients surviving hospitalization were followed-up for 2 years regarding survival. The final study population of 865 patients had the following eight different coma etiologies: poisoning (n = 329), stroke (n = 213), epilepsy (n = 113), circulatory failure (n = 60), infection (n = 56), metabolic disorder (n = 44), respiratory insufficiency (n = 33), and intracranial malignancy (n = 17). The hospital mortality rate among the 865 patients was 26.5%, varying from 0.9% for epilepsy to 71.7% for circulatory failure. The accumulated total 2-year mortality rate was 43.0%, varying from 13.7% for poisoning to 88.2% for malignancy. The level of consciousness on admission also influenced the prognosis: a GCS score of 3-6 was associated with a significantly higher hospital mortality rate than a GCS score of 7-10. The prognosis in patients presenting with non-traumatic coma is serious and depends largely on both the level of consciousness on admission and the etiology of the coma. Adding the suspected coma etiology to the routine coma grading of these emergencies may more accurately predict their prognosis. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. An unusual presentation of erythema multiforme in a paediatric patient.

    Science.gov (United States)

    BaniHani, A; Nazzal, H; Webb, L; Toumba, K J; Fabbroni, G

    2015-06-01

    Erythema multiforme (EM) is an acute, vesiculobullous disease of skin and mucous membranes with symptoms ranging from mild to severe. A complex interaction of different factors has been implicated the condition; the majority with a preceding herpes simplex infection. This report describes an unusual presentation of erythema multiforme affecting the lips and oral mucosa of a healthy 7-year-old boy in the form of lip adherence. Two weeks following eruption of oral ulcerations, a 7-year-old healthy boy developed severe erosive ulceration of both lips, causing complete lip adherence. This was accompanied by marked bilateral submandibular and cervical lymphadenopathy, tremor and sweating. Clinical and laboratory investigations led to a diagnosis of erythema multiforme. The patient was treated initially with gentle application of Vaseline between the lips using cotton buds in an attempt to release lip adhesion, followed by surgical release of the lips under general anaesthesia. Analgesics and topical steroid mouthwash were provided. Seven months later, the patient presented with a recurrence of his EM which included lesions on the skin. The patient was treated with antivirals, topical and systematic steroids to suppress the recurrent attacks of EM. Eighteen months following the initial presentation the patient and parent reported considerable decrease in the frequency, severity and duration of the occurrence of intra-oral ulcers, with no major episode of target lesions on the skin. Erythema multiforme is rare in children, however it should be considered in the differential diagnosis of recurrent erosive oral ulcerative lesions especially when the oral lesions resemble those of primary herpetic gingivostomatitis.

  19. Presentation

    Directory of Open Access Journals (Sweden)

    Eduardo Vicente

    2013-06-01

    Full Text Available In the present edition of Significação – Scientific Journal for Audiovisual Culture and in the others to follow something new is brought: the presence of thematic dossiers which are to be organized by invited scholars. The appointed subject for the very first one of them was Radio and the invited scholar, Eduardo Vicente, professor at the Graduate Course in Audiovisual and at the Postgraduate Program in Audiovisual Media and Processes of the School of Communication and Arts of the University of São Paulo (ECA-USP. Entitled Radio Beyond Borders the dossier gathers six articles and the intention of reuniting works on the perspectives of usage of such media as much as on the new possibilities of aesthetical experimenting being build up for it, especially considering the new digital technologies and technological convergences. It also intends to present works with original theoretical approach and original reflections able to reset the way we look at what is today already a centennial media. Having broadened the meaning of “beyond borders”, four foreign authors were invited to join the dossier. This is the first time they are being published in this country and so, in all cases, the articles where either written or translated into Portuguese.The dossier begins with “Radio is dead…Long live to the sound”, which is the transcription of a thought provoking lecture given by Armand Balsebre (Autonomous University of Barcelona – one of the most influential authors in the world on the Radio study field. It addresses the challenges such media is to face so that it can become “a new sound media, in the context of a new soundscape or sound-sphere, for the new listeners”. Andrew Dubber (Birmingham City University regarding the challenges posed by a Digital Era argues for a theoretical approach in radio studies which can consider a Media Ecology. The author understands the form and discourse of radio as a negotiation of affordances and

  20. Negotiations of distress between East Timorese and Vietnamese refugees and their family doctors in Melbourne.

    Science.gov (United States)

    Kokanovic, Renata; May, Carl; Dowrick, Christopher; Furler, John; Newton, Danielle; Gunn, Jane

    2010-05-01

    Recent critiques of depression have contested its coherence as a concept and highlighted its performance in medicalising distress. Studies of depression in a cross-cultural context have focused on language and belief systems as technical barriers to practice that need to be overcome in enacting depression work. This paper seeks to locate culture within the broader socio-structural context of depression care in general practice. The paper draws on interviews with five general practitioners (GPs), and 24 patients from Vietnamese and East Timorese backgrounds who predominantly have left their home as refugees. Each had been diagnosed with depression or prescribed antidepressants. These patients gave accounts of distress deeply embedded within, and inseparable from, lives fraught with frightening pre-migration experiences, traumatic escape and profound dislocation and alienation in their new 'home'. Fragmented lives were contrasted with the nourishing social fabric of homes left behind. GP participants were involved in a process of engaging with a profoundly communal and structural account of emotional distress while defending and drawing on an individualised notion of depression in performing their work and accounting for the pain presented to them.

  1. Monogenic autoinflammatory diseases: General concepts and presentation in adult patients.

    Science.gov (United States)

    Hernández-Rodríguez, José; Ruiz-Ortiz, Estíbaliz; Yagüe, Jordi

    2018-01-23

    Monogenic autoinflammatory diseases (AIFD) are rare disorders characterized by an uncontrolled increase of the systemic inflammatory response, which is caused by mutations in genes involved in inflammatory pathways. Over the last few years, new genes and proteins responsible for new monogenic AIFD have been identified and a substantial improvement in their treatment has been achieved. Monogenic AIFD manifestations typically begin during childhood, but they can also occur in adults. Compared to pediatric patients, adults usually present with a less severe disease and fewer long-term complications. In addition, patients with adult-onset disease carry low-penetrance mutations more often than pathogenic variants. A late-onset of AIFD may be occasionally associated with the presence of somatic mutations. In this study, we review the most frequent monogenic AIFD, and others recently described, which may occur during adulthood. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  2. Microproteinuria Predicts Organ Failure in Patients Presenting with Acute Pancreatitis

    DEFF Research Database (Denmark)

    Bertilsson, Sara; Swärd, Per; Håkansson, Anders

    2016-01-01

    with the presence of systemic inflammatory response syndrome as well as trauma, although its association with AP is not well understood. The aim of this study was to investigate the value of microproteinuria to predict development of organ failure in AP. Methods: Consecutive AP patients were prospectively enrolled......Background and Aims: The disease course of acute pancreatitis (AP) ranges from mild and self-limiting to severe inflammation, associated with significant morbidity and mortality. At present, there are no universally accepted and reliable predictors for severity. Microproteinuria has been associated...

  3. Impacts of geographical locations and sociocultural traits on the Vietnamese entrepreneurship.

    Science.gov (United States)

    Vuong, Quan Hoang

    2016-01-01

    This paper presents new results obtained from investigating the data from a 2015 Vietnamese entrepreneurs' survey, containing 3071 observations. Evidence from the estimations using multinomial logits was found to support relationships between several sociocultural factors and entrepreneurship-related performance or traits. Specifically, those relationships include: (a) Active participation in entrepreneurs' social networks and reported value of creativity; (b) CSR-willingness and reported entrepreneurs' perseverance; (c) Transforming of sociocultural values and entrepreneurs' decisiveness; and, (d) Lessons learned from others' failures and perceived chance of success. Using geographical locations as the control variate, evaluations of the baseline-category logits models indicate their varying effects on the outcomes when combined with the sociocultural factors that are found to be statistically significant. Empirical probabilities that give further detail about behavioral patterns are provided; and toward the end, the paper offers some conclusions with some striking insights and useful explanations on the Vietnamese entrepreneurship processes.

  4. Cultural Competence and Identity in Cross-Cultural Adaptation: The Role of a Vietnamese Heritage Language School

    Science.gov (United States)

    Maloof, Valerie Miller; Rubin, Donald L.; Miller, Ann Neville

    2006-01-01

    The present study examines the role of a Vietnamese heritage language school in cross-cultural adaptation, as operationalised by the confluence of two independent variables, language competence and integrated cultural identity. To characterise the students' language competencies and degree of integrated cultural identities, interview…

  5. Lateral sinus thrombosis patient presenting with headache and vomiting

    Directory of Open Access Journals (Sweden)

    Ayşenur Paç Kısaarslan

    2013-01-01

    Full Text Available Lateral sinus thrombosis is rare intracranial complicationsof otitis media. A 12 years old girl patient presented withcomplaints of vomiting and headeche. Patient treated withceftriaxone had lost seven kilograms in ten days. Therewere complaints of frequent upper way infection andotitis media. Physical examination of right ear was painfuland right tympanic membrane was pale. Laboratorytests shuch as hemogram, blood smear, Brucellatube agglütination test, biochemistry tests, abdomenultrasaund and chest X-ray were all normal. Besides aCRP was 65 mg/L and sedimantation rate was 26 mm/h.PT and PTT values were 15,1 and 29,8s respectively,fibrinogen was 280 mg/dl. In urine analysis +3 ketonbodies were observed. Homosistein level was normal,MTFHR gene polymorphism was heterozigot A1298C.Magnetic resonance imaging (MRI showed right chronicotitis media and thrombosis in both lateral and sigmoidsinuses. She was treated mastoidectomy and concurrentmiddle ear ventilation tubes. Enoxaparin was also startedin postoperative treatment. Intracranial problems must berapidly evaluated in patients with headache and vomiting.In this study we aimed to emphasize that lateral sinusthrombosis has to be taken into consideration in patientscomplainig intracranial problems with headache andvomiting.Key words: Otitis media, lateral sinus thrombosis,headache, vomiting

  6. Regional anesthesia in a patient presenting with varicella

    Directory of Open Access Journals (Sweden)

    Handan Gulec

    2012-06-01

    Full Text Available Varicella zoster virus (VZV is a DNA virus of herpes family. It is characterized by vesicular rash, fever and fatigue and it is a self-limiting disease. 22 years old male patient referred to ER with acute abdominal symptoms. We observed that the patient presenting with exanthema and fever for 10 days was diagnosed with varicella. In the preoperative examination, pulse was detected: 120 beats/minutes, blood pressure: 90/55 mmHg, Mallampathy score (Type 4 was high and neck joint could not manage extension, for this, regional anesthesia was decided to be performed. Detecting a small sized area without rashes between L4-5, 15 mg heavy marcain was injected to subarachnoid distance with 26 G spinal needle. When sensorial block grade was T8 incision was initiated. Intra operative vital results were stabile and the patient was referred to service without any PO problem. [J Contemp Med 2012; 2(2.000: 112-114

  7. Acculturation gaps in Vietnamese immigrant families: Impact on family relationships

    Science.gov (United States)

    Ho, Joyce; Birman, Dina

    2009-01-01

    Vietnamese immigrants in the United States face acculturation challenges involving the individual, family, and community. Experts suggest that immigrant family members acculturate at different rates resulting in an acculturation gap, which negatively influences family adjustment. In this study we examined the degree and patterns of acculturation differences between 104 first generation immigrant Vietnamese adolescents and their parents, and whether acculturation gap affected family relationships. Operationalizing the “gap” as both absolute value of differences in acculturation and interactions of parent and adolescent acculturation levels, we examined the impact of such gaps in Vietnamese and American language, identity, and behavioral acculturation on family relationships. Results revealed that family cohesion and satisfaction were predicted by gaps in Vietnamese identity acculturation, but not by gaps in other acculturation domains. PMID:20161537

  8. Occupational Adjustment of Refugees: The Vietnamese in the United States.

    Science.gov (United States)

    Stein, Barry N.

    1979-01-01

    This paper provides a detailed description of the pattern of occupational adjustment of the Vietnamese refugees to the United States and compares their experiences with other recent refugee and immigrant groups. (Author)

  9. Medical conditions and body pain in patients presenting orofacial pain.

    Science.gov (United States)

    Franco, Ana Lúcia; Runho, Gabriel Henrique Farto; Siqueira, José Tadeu Tesseroli de; Camparis, Cinara Maria

    2012-05-01

    To verify the frequency of self-reported medical conditions and pain areas in orofacial pain patients, comparing them with patients from the routine dental care. Data were collected from archives of the Orofacial Pain Clinic (Group A, n=319) and of the routine dental care clinics (Group B, n=84) at Faculdade de Odontologia de Araraquara, São Paulo, in Brazil. All individuals answered a standardized clinical questionnaire and completed a body map indicating their pain areas. The Mann-Whitney's test demonstrated that Group A presented a higher mean number of medical reports than Group B (p=0.004). In both groups, Pearson's correlation test showed that the highest frequencies of medical conditions were positively correlated to highest frequencies of painful areas (0.478, p=0.001 and 0.246, p=0.000, respectively). Group A tended to report more medical conditions and there was a positive correlation between the number of medical conditions and the one of pain areas for both groups.

  10. Psoriatic triad in a patient presenting with oligodontia

    Directory of Open Access Journals (Sweden)

    Rai P

    2010-01-01

    Full Text Available Psoriasis is a common dermatological disease. It can occur at any age but usually develops between 15 and 35 years of age and may persist throughout a person′s lifetime with periods of exacerbation and remission. The hyperproliferative state of the affected epidermis produces a turnover rate that is up to eight times greater than normal. Instead of being shed, the skin cells pile up, causing the visible lesions. Oral manifestations of psoriasis are rare clinical observations. Lesions have been reported on the lips, buccal mucosa, palate, gingiva, and floor of the mouth. We document a presentation of psoriasis showing a triad: skin lesions, arthritis, and oral manifestations (oligodontia being patient′s chief concern. Dental rehabilitation done was in the form of partial dentures. This was done to address the immediate concern of the patient, that is, inability to chew properly. As put forth through this case report, a potential link between psoriasis and oligodontia has scope for further study.

  11. Triple A syndrome presenting with myopathy: An Egyptian patient

    African Journals Online (AJOL)

    salah

    glucocorticoid deficiency with normal mineralocorticoid function, but defi- ciency has been reported in only 15% of patients.9. The orthostatic hypotension that was re- ported by our patient could be explained by abnormal cardiovascular reflexes. (progressive loss of cholinergic func- tion) due to autonomic dysfunction.10.

  12. Occurrence of crystal arthropathy in patients presenting with ...

    African Journals Online (AJOL)

    diagnosed, with 14.2%(n=37) having uric acid crystals and 4.6 % (n=12) having CPPD crystals. For the patients who had uric acid crystals (n=37), when gender was cross tabulated against microscopy, males (n=32; 86.5%) were noted to have more uric acid crystals than females (n=5; 13.5%). Among patients diagnosed ...

  13. (hiv) seropositivity in african patients presenting to the eye clinic

    African Journals Online (AJOL)

    %) patient each. These findings suggest that, patients with ocular disorders and who are otherwise healthy looking may infact be HIV seropositive and as such it may be necessary to observe all rules relating to HIV transmission so as to prevent ...

  14. HIV patients presenting common adverse drug events caused by ...

    African Journals Online (AJOL)

    Antiretroviral (ARV) drug toxicities pose treatment challenges and contribute to poor adherence. This study was carried out to document the commonly reported adverse reactions caused by ARV drugs in HIV patients in Tanzania. Information on drug induced adverse reactions (ADRs) in patients using ARV drugs was ...

  15. Pancytopenia in a surgical patient, a rare presentation of hyperthyroidism.

    Science.gov (United States)

    Jha, Prabhat; Singh, Yogendra Prasad; Ghimire, Bikal; Jha, Binit Kumar

    2014-12-15

    Pancytopenia is a rare complication of hyperthyroidism. Various mechanisms have been described such as immunological, bone marrow suppression. The possibility of hyperthyroidism should be considered in patients with unexplained pancytopenia. There are many case reports showing the association between hyperthyroidism and pancytopenia. All of these reports show association between Graves disease and pancytopenia but our case shows association between Multinodular goitre and pancytopenia. Besides it is uncommon to find such association in a surgical patient. This case report describes a 62 yr old hindu female with splenic injury and pancytopenia. On further investigations the patient was found to have hyperthyroidism. Though the definite mechanism regarding the association of pancytopenia with hyperthyroidism isn't clear, various cases have been described in the literature. This case shows the diagnostic dilemma that can occur in patients with pancytopenia. Any patient with unexplained pancytopenia should undergo thyroid function tests to rule out hyperthyroidism.

  16. Patients with multiple sclerosis present low levels of empathy

    Directory of Open Access Journals (Sweden)

    Marcos Barbosa de Almeida

    Full Text Available ABSTRACT Multiple sclerosis (MS is a chronic neuroimmunological disease that mainly affects young adults, leading to neurological disabilities over the course of their lives. Many psychiatric conditions have been reported in patients with MS, but there are remarkably few studies assessing empathy among these patients. Methods This is a single center, cross-sectional study, of 34 patients with MS and 34 matched control subjects. A specific questionnaire (empathy quotient was used. Results Patients with MS showed significantly lower levels of empathy. This finding was not correlated with disease duration, degree of disability, drugs for treating MS or lesion load on resonance magnetic imaging. Conclusion Decreased empathy is a frequent condition in patients with MS and should be addressed in order to diminish the psychosocial burden of this neurological disease.

  17. A review of patients with advanced cervical cancer presenting to ...

    African Journals Online (AJOL)

    , which has the highest rate of this disease in the world. Most cases are diagnosed at an advanced stage . Aim To describe the symptom burden, palliative care interventions, and outcomes of cervical cancer patients who entered care at ...

  18. Other Skin Conditions Often Present in Rosacea Patients

    Science.gov (United States)

    ... He noted that, while the incidence of skin cancer and seborrheic dermatitis is relatively high among rosacea patients answering the survey, the number who had ever experienced acne – if adolescence is ...

  19. DOES PRESENTING PATIENT'S BMI INCREASE DOCUMENTATION OF OBESITY?

    Directory of Open Access Journals (Sweden)

    Norm Clothier, MD, M. Kim Marvel, PhD, Courtney S. Cruickshank, MS

    2002-09-01

    Full Text Available Purpose: Despite the associated health consequences, obesity is infrequently documented as a problem in medical charts. The purpose of this study is to determine whether a simple intervention (routine listing of the BMI on the medical chart will increase physician documentation of obesity in the medical record. Methods: Participants were resident physicians in a family medicine residency program. Participants were randomly assigned to either an experimental group or a control group. For experimental group physicians, the Body Mass Index was listed alongside other vital signs of patients seen in an ambulatory setting. Physician documentation of patient obesity was assessed by chart review after patient visits. Documentation was defined as inclusion of obesity on the problem list or in the progress note. Results: The intervention did not significantly increase the rate of documentation of obesity in the medical chart. Several reasons for the lack of change are explored, including the difficulty of treating obesity successfully.

  20. Who presents satisfied? Non-modifiable factors associated with patient satisfaction among gynecologic oncology clinic patients.

    Science.gov (United States)

    Barber, Emma L; Bensen, Jeannette T; Snavely, Anna C; Gehrig, Paola A; Doll, Kemi M

    2016-08-01

    To examine associations between non-modifiable patient factors and patient satisfaction (PS) among women presenting to a gynecologic oncology clinic. This is a cross sectional analysis of patients presenting for surgical management by a gynecologic oncologist at a tertiary care academic medical center. The Patient Satisfaction Questionnaire (PSQ-18) that measures PS in seven domains of health care was administered. Scores were converted to "satisfied" versus "unsatisfied/equivocal". Demographic and medical factors were obtained from the medical record. Chi-square, t-tests, and multivariable logistic regression were used. 208 patients completed the baseline patient satisfaction questionnaire and the median PSQ-18 score was 70.5 (range: 42-90). Median age was 58years (range: 22-93). Several non-modifiable factors were associated with PS. White patients had higher interpersonal PS than minorities (86% v 65%, p=0.002). The uninsured had lower interpersonal (60% v 86%, p=0.003) and accessibility PS (33% v 67%, p=0.03). Increasing education and less time travelled to care were both associated with higher interpersonal (p=0.03, p=0.05) and accessibility PS (p=0.01, p=0.01). There was no association between clinical factors (BMI, comorbidities, cancer) and PS. In multivariable analysis, the strongest predictor of interpersonal PS was white race while the strongest predictors of accessibility PS were time travelled to care and insurance status. Patient satisfaction scores among patients presenting to a gynecologic oncology clinic are associated with non-modifiable demographic, financial and geographic factors. Pay for performance measures that use summed patient satisfaction scores may penalize hospitals for patient-mix driven differences. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. A LANGUAGE DEVELOPMENT PROFILE OF A VIETNAMESE LEARNER OF ENGLISH

    Directory of Open Access Journals (Sweden)

    Rohani Rohani

    2017-04-01

    Full Text Available This paper is a case study to a Vietnamese English learner. The main objective of the study was to describe how the English of a Vietnamese student developed. Interviews were conducted in order to collect the data. The interviews were tape recorded. The recorded data provided information about the learner’s background. Additionally the data served as a sample of the learner’s spoken English. The analysis of the sample revealed that the learner made several grammatical, syntactical, and phonological errors. With a contrastive analysis theory it could be concluded that one of the factors that might have triggered the errors were the difference between English and Vietnamese language. From a personality point of view, the subject of the study showed several positive personalities that supported the development of his English as a second language.

  2. Vietnamese Attitudes and Behavioural Patterns towards Counterfeit Brands

    Directory of Open Access Journals (Sweden)

    Giang Huynh

    2014-12-01

    Full Text Available This study examines Vietnamese female consumers’ attitudes towards counterfeit branded products; by investigating the influence of brand image, product involvement and price advantage towards decision-making processes associated with purchasing and ownership. An inductive anti-positivist approach was adopted, employing qualitative methods; drawing from in-depth interviews distilled and synthesized using Word Cloud software, as Geographic Information System (GIS based Spatial Analyses. Findings suggest that Price Advantage plays a determining and predominant role in encouraging consumers’ purchase intention of a counterfeit product. In addition, Brand Image has positive effect on the purchase intention as well; while product involvement plays no significant role in the process. Further observations point to there being paucity of literature that focuses on Vietnamese and ASEAN markets. With this is mind, a new conceptual framework was developed to reflect the nuances of the Vietnamese consumer experience; which it is suggested will be of value to scholars, practitioners and further studies.

  3. Characteristics of patients presenting with complications of abortion ...

    African Journals Online (AJOL)

    2012-05-25

    May 25, 2012 ... Most of the patients were aware of contraception, but usage, which mainly constituted emergency contraception, was low. Despite prophylactic antibiotics, sepsis was the most common .... such as the postcoital pill (levonorgestrel), with reported significant failure rates, especially at mid-cycle exposure.14.

  4. Surgical implications of abdominal pain in patients presenting to the ...

    African Journals Online (AJOL)

    The incidence of neoplasia found at laparatomy, for abdominal pain, on patients admitted to the general surgical ward was 3.0%. The incidence of neoplasia, as a cause of abdominal pain resulting in laparatomy was 3.3%. Conclusion: The results highlight the fact, with respects to abdominal pain, that there are significant ...

  5. Prevalence and predictors of anaemia among patients presenting ...

    African Journals Online (AJOL)

    Dr David Zadock Munisi

    Anaemia in CKD is associated with memory loss, disturbances in sleep, CKD progression,. CVD co-morbidities and higher ... Bedside isotope-dilution mass spectrometry (IDMS) traceable Schwartz GFR Calculator for Children was used to stage patients. ..... Tanzania: a 3-year prospective study. Journal of Hypertension 31: ...

  6. Characteristics of patients presenting with complications of abortion ...

    African Journals Online (AJOL)

    Objectives: Abortion is associated with significant healthproblem with short- and long-term complications that affect the quality of life of those who are fortunate enough to escape mortality. This study evaluated the population of patients with complications of abortion, identified the abortion providers and the pattern of ...

  7. Reasons and Pattern of Tooth Extraction Among Patients Presenting ...

    African Journals Online (AJOL)

    Background: Oral health is greatly influenced by health teeth. Objective: The study is to determine the reasons and pattern of tooth extraction in patients seeking care at the oral surgery/Dental clinic in Rasheed Shekoni Specialist Hospital, Dutse, Jigawa between January 2010 and December 2011. Methods: A retrospective ...

  8. Risk factors for asthma exacerbation in patients presenting to an ...

    African Journals Online (AJOL)

    Richard E Sanya, Bruce J Kirenga, William Worodria, Martin Okot-Nwang. Pulmonology unit, Department of Medicine, ... associated with exposure to irritants such as cigarette smoke exposure and diesel exhaust fumes .... patients seated, spirometry was done using an electronic spirometer (NDD EasyOne, Massachusetts, ...

  9. Management of older patients presenting after a fall - an accident ...

    African Journals Online (AJOL)

    Three-quarters of the patients were referred for further management: 52% to orthopaedic surgery, 12% to other surgical subspecialties, 6% to the general medical department, and 6% to other hospitals and clinics. No referrals were made to geriatric medicine, physiotherapy or occupational therapy. Conclusions.

  10. Neurocysticercosis in patients presenting with epilepsy at St ...

    African Journals Online (AJOL)

    Objective. To survey the prevalence of neurocysticercosis in patients treated for epilepsy in Lusikisiki, E Cape. Design. This was a descriptive study. Variables considered were age, gender, symptoms and type of seizure, serological data, electroencephalogram and computed tomography (CT) findings, treatment, and ...

  11. What doctors should look for in patients presenting with erectile ...

    African Journals Online (AJOL)

    Adele

    2003-12-10

    Dec 10, 2003 ... Dr Levinson's lecture is a compelling testimony to the chal- lenge of providing quality medical care in a culturally di- verse country such as South Africa. Therapy for sexual dys- function, in particular, calls for sensitivity and perception to ensure that the patient is managed appropriately in their par-.

  12. Oxidative Stress among Ghanaian Patients presenting with Chronic ...

    African Journals Online (AJOL)

    Dyslipidaemia and lipid peroxidation are known risk factors for chronic kidney disease (CKD). This study assessed the lipid profile and oxidative stress/lipid peroxidation in CKD patient, using the oxidative stress marker, Malondialdehyde (MDA) and antioxidants; Vitamins A and C, Cata-lase and Uric Acid. The study ...

  13. Medical nutrition therapy for a patient presenting with a chylothorax

    African Journals Online (AJOL)

    2013-08-26

    Aug 26, 2013 ... trauma. He reported that he drank occasionally at social events and exercised regularly. The patient complained of chest discomfort and shortness of .... composition of total parenteral nutrition prescription (Intravenous Therapeutic Nutrition® 5003A). Nutrient. Content per 2 620 ml. Dietary prescription.

  14. Socioeconomic factors affecting presentation of patients with post ...

    African Journals Online (AJOL)

    Background: As the etiological factors of burn injuries vary considerably in different communities, careful analysis of the epidemiological features in every community is needed to formulate a sound prevention programme. The present study attempts to analyze the demographic factors affecting the presentation of post burn ...

  15. Presentation and Intervention Time for Plastic Surgical Patients ...

    African Journals Online (AJOL)

    BACKGROUND: Data regarding time of presentation and intervention for trauma care in Nigeria and our centre is limited. A prospective study of presentation and intervention times at the trauma unit for the plastic surgical division was undertaken between November and December 2002. A questionnaire was provided the ...

  16. Dental extraction for patients presenting at oral surgery student clinic.

    Science.gov (United States)

    Baqain, Zaid H; Khraisat, Ameen; Sawair, Faleh; Ghanam, Sana; Shaini, Firas J; Rajab, Lamis D

    2007-03-01

    The aim of this study was to examine the reasons for dental extraction and to determine the pattern of tooth loss in patients seeking care at the oral surgery teaching clinics in the Faculty of Dentistry of the University of Jordan, Amman, Jordan, over a 3-year period. Data pertaining to the dental extractions of 2435 patients were analyzed. The results showed that 63.8% of the teeth included in this study were extracted because of dental caries, 22.9% because of periodontal disease, and 11.0% for prosthetic reasons. Pericoronitis, orthodontic treatment, trauma, and eruption problems accounted for 2.4% of the reported extractions. The upper premolars were the teeth most commonly extracted, and the lower first and second molars were the teeth most commonly extracted because of dental caries. The logistic regression test revealed that extraction because of dental caries occurred mostly in the group aged 21 to 30 years (P < .001). Periodontal disease was not likely the cause of extraction in patients younger than 40 years. Mandibular incisors were the teeth least likely extracted because of dental caries (P < .001), but they were the teeth most commonly extracted because of periodontal disease (P < .001). Extraction for orthodontic reasons mostly involved the premolars (P < .05) and occurred in patients 20 years of age or younger (P < .001). Men were less likely to lose teeth because of caries and periodontal disease (P < .05 and P < .001, respectively) and were more likely to lose teeth for prosthetic reasons and trauma. The information gained from this study is useful to shift oral health planning toward emphasizing the importance of maintaining natural dentition and preventing dental disease.

  17. Business Plan for a Vietnamese Restaurant & Coffee Shop in Helsinki

    OpenAIRE

    Pham Do, Thien Huong

    2014-01-01

    The objective of the thesis was to invent a practical business plan for setting up a combination of a Vietnamese Restaurant and Coffee Shop which is located in the capital city of Finland – Helsinki and in a very central area of the Antilla Shopping Mall. The main purpose of this study is to determine whether a very unique Vietnamese restaurant is viable to function without any coordination with other Asian cuisines such as Chinese, Thai, etc… This thesis also clarifies the constructive oppor...

  18. Splenic Infarct: A Rare Presentation in a Pediatric Patient

    Directory of Open Access Journals (Sweden)

    Palla Bhattarai

    2014-12-01

    Full Text Available A previously healthy 16-year-old male presented with a two day history of persistent epigastric pain. His physical examination was significant for tenderness in the left hypochondriac region with a palpable spleen 2cm below the left sub-costal margin. A CT scan of the abdomen showed a splenic infarct. Heterophile and EBV VCA IgM antibody test were positive. This is a rare case of infectious mononucleosis presenting with splenic infarct in an adolescent male without comorbidities. Keywords: infectious mononucleosis; splenic infarct.

  19. Giao-Trinh Huan-Luyen Phu-Huynk Goc Ngon-Ngu Thieu-So: Ban Viet-Ngu (Parenting Curriculum for Language Minority Parents: Vietnamese Guide).

    Science.gov (United States)

    Holt, Grace D.

    This guide for minority language parents whose primary language is Vietnamese presents parenting information to supplement a course in English as a Second Language. It focuses on topics parents must deal with in meeting the needs of their children. Vocabulary and practice drills are presented for activities in the following areas: (1) education…

  20. Adult Patients Presenting with Undescended Testis in Awareness ...

    African Journals Online (AJOL)

    Conclusion: Management of adults with undescended testis was challenging due to irreversible complications, psychological effects and poor outcome of treatment which shows the importance of awareness programs that will result in childhood presentation. Key Words: Undescended testis, cryptorchidism, infertility, adults, ...

  1. Application of Antigen Cross-Presentation Research into Patient Care

    NARCIS (Netherlands)

    The activation of adaptive immune responses requires the processing and presentation of protein antigens to lymphocytes. Especially dendritic cells are effective at display of antigen-derived peptides in the form of immunogenic peptide/MHC complexes to CD4 and CD8-positive T cells, and can stimulate

  2. Triple A syndrome presenting with myopathy: An Egyptian patient ...

    African Journals Online (AJOL)

    In this paper we report a 13 year old boy with Allgrove syndrome presenting with muscular weakness that was confi rmed by EMG studies. To our knowledge, muscle disease in Allogrove syndrome was not reported before. Keywords: Allgrove syndrome, triple A syndrome, alacrmia, cardiac achalasia, adrenal insufficiency.

  3. A review of patients with advanced cervical cancer presenting to ...

    African Journals Online (AJOL)

    100,000) of cervical cancer and mortality (50 per 100,000) from the disease.1 In Africa, for a variety of reasons, women with cancer of the cervix are often diagnosed late, requiring a palliative approach from the time of presentation. Opportunities for screening may be missed,2 and delivery of screening services is beset by ...

  4. Clinical presentation and mutations in Danish patients with Wilson disease

    DEFF Research Database (Denmark)

    Møller, Lisbeth Birk; Horn, Nina; Jeppesen, Tina Dysgaard

    2011-01-01

    consistently indicative of WND, with the exception of the 24-h urine-Cu test, which is always outside the normal range. Mutations were identified in 100% of the screened ATP7B alleles (70 unrelated), including five novel mutations: p.1021K; p.G1158V; p.L1304F; IVS20-2A>G; Ex5_6del. In all, 70% of mutations...... were found in exons 8, 14, 17, 18, and 20. The most frequent mutation, p.H1069Q, comprised 18%. We propose a new and simple model that correlates genotype and age of onset. By assuming that the milder of two mutations is 'functionally dominant' and determines the age of onset, we classified 25....../27 mutations as either severe (age of onset 20 years), and correctly predicted the age of onset in 37/39 patients. This method should be tested in other Wilson populations....

  5. An unusual presentation of erythema multiforme in a paediatric patient

    OpenAIRE

    Bani Hani, A; Nazzal, H; Webb, L; Toumba, KJ; Fabbroni, G

    2015-01-01

    Background: Erythema multiforme (EM) is an acute, vesiculobullous disease of skin and mucous membranes with symptoms ranging from mild to severe. A complex interaction of different factors has been implicated the condition; the majority with a preceding herpes simplex infection. This report describes an unusual presentation of erythema multiforme affecting the lips and oral mucosa of a healthy 7-year-old boy in the form of lip adherence. Case report: Two weeks following eruption of oral ulcer...

  6. Caretaker mental health and family environment factors are associated with adolescent psychiatric problems in a Vietnamese sample

    OpenAIRE

    Stratton, Kelcey Jane; Edwards, Alexis Christine; Overstreet, Cassie; Richardson, Lisa; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda Beth

    2014-01-01

    Little is known about risk factors for adolescent mental health in Vietnam. The present study investigated the relationship between caretaker mental health and adolescent mental health in a cross-sectional Vietnamese sample. Primary caretakers completed measures of their own mental distress and general health status using the Self-Reporting Questionnaire-20 (SRQ-20) as well as reports of adolescent mental health using the parent version of the Strengths and Difficulties Questionnaire (SDQ). M...

  7. A Study on the cardio-metabolic risk factors in vietnamese females with long-term vegan diet

    OpenAIRE

    Nguyen, Hai Quy Tram

    2017-01-01

    A study of the cardio- metabolic risk factors in Vietnamese females with vegan diet. Background. Numerous studies have shown that vegan diet has beneficial effects on the prevention of cardiovascular diseases. However, the effects of vegan diet on cardio-metabolic risk factors and the association between duration of vegan diet and those risk factors, are still unclear. Objectives. The present study aims to investigate the prevalence and influence of duration of vegan diet on cardio- me...

  8. What Factors Influence Vietnamese Students' Choice of University?

    Science.gov (United States)

    Dao, Mai Thi Ngoc; Thorpe, Anthony

    2015-01-01

    Purpose: The purpose of this paper is to report the factors that influence Vietnamese students' choice of university in a little researched context where the effects of globalization and education reform are changing higher education. Design/methodology/approach: A quantitative survey was completed by 1,124 current or recently completed university…

  9. Genetic variation within and between three Vietnamese pine ...

    African Journals Online (AJOL)

    Pinus merkusii is an important species in Vietnam with many economic and biological contributions. The information on diversity within and between populations of a species is necessary for plantation programs, breeding and conservation strategies. Genetic diversity of three Vietnamese populations (NA, QB and QN) was ...

  10. New report shows Vietnamese entrepreneurs are growth-oriented ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2015-06-30

    Jun 30, 2015 ... More than 70 of Vietnamese entrepreneurs choose to start a business to take advantage of opportunities. This is just one of many findings published in a new report that looks at entrepreneurship in Vietnam. The 2014 Vietnam Report, by the Global Entrepreneurship Monitor (GEM), was launched on June 9 ...

  11. The Vietnamese of New Orleans: Problems of America's Newest Immigrants.

    Science.gov (United States)

    Soberano, Rawlein

    New Orleans ranks as the city with the largest Vietnamese community in the nation. With their growing number, problems with the Plaquemines Parish community as well as with some black organizations have developed, particularly in the areas of employment and housing. Several individuals have argued that local businesses hired large numbers of…

  12. Experiments in Language Translation: Technical English-to-Vietnamese.

    Science.gov (United States)

    Sinaiko, H. Wallace; Brislin, Richard W.

    This paper documents the results of a series of experiments conducted by the Institute for Defense Analyses on translating technical material from English to Vietnamese. The work was accomplished in support of the Office of the Deputy Director, Research and Engineering, Deputy Director for Southeast Asia Matters. The paper addresses the question…

  13. Key factors driving corporate social responsibility of Vietnamese firms

    NARCIS (Netherlands)

    Kabir, Mohammed Rezaul; Thai Minh, H.

    2016-01-01

    We examine the impact of firm, corporate governance and managerial characteristics on the corporate social responsibility (CSR) activities of Vietnamese listed firms. Our results show that export-oriented firms engage in more CSR activities. As for corporate governance factors, we observe that

  14. Mental innovation space of Vietnamese agro-food firms

    NARCIS (Netherlands)

    De Koning, Jotte; Crul, Marcel; Engelen, van Johannes; Wever, Renee; Brezet, Johannes

    2016-01-01

    Purpose - Vietnamese agro-food firms are often small and have short value chains. They are facing increasing competition from multinationals to serve the consumers of the rising middle class. It is assumed that co-creation or open-innovation can be a competitive innovation strategy for the

  15. Silk for silver : Dutch-Vietnamese relations, 1637-1700

    NARCIS (Netherlands)

    Hoang Anh Tuan,

    2006-01-01

    Against the background of a regional crisis caused by dynastic change in China and the closure of Japan in the middle of the seventeenth century, the Vietnamese kingdom of Tonkin rose to the fore as the major silk producing and exporting region in East Asia. Based on a wealth of so far unused

  16. Vietnamese Women and Domestic Violence: A Qualitative Examination

    Science.gov (United States)

    Nguyen, Tuyen D.

    2004-01-01

    This grounded theory qualitative study investigated the major influencing factors in the United States that empowered six Vietnamese women who had been in abusive relationships to take actions, to make changes in their intimate relationships, unlike many of their abused counterparts in their homeland. Interviews of two focus group sessions,…

  17. Transnational Migration of Vietnamese Women in Asia | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Over the last decade, Asia has witnessed rapid growth in the feminization of migration. For example, during that period, more than 100 000 Vietnamese women migrated to other countries to work and a similar number to marry, through commercial arrangements. But, sending countries often lack the appropriate policies and ...

  18. Types of indirect compliments in Russian and Vietnamese communicative cultures

    Directory of Open Access Journals (Sweden)

    - Нгуен Тху Хыонг

    2014-12-01

    Full Text Available The article studies compliments as speech acts in Russian and Vietnamese communication and discusses the usage of some types of indirect compliments in the communicative cultures of the two. A comparison showing their similarities and differences and frequency in their usage in cross-cultural communication has also been undertaken.

  19. Chemistry: A Vietnamese Supplement. A High-School Bilingual Handbook for the Vietnamese Student. Indochinese High-School Supplement.

    Science.gov (United States)

    Tuan, Do Dinh; And Others

    This text is the first of a series of six bilingual handbooks especially designed for the Indochinese student in American high schools. Five of the supplements are in Vietnamese and each deals with a specific subject-area: chemisty, physics, biology, mathematics or U.S. history. The sixth book is in Khmer and is a supplement for U.S. history. The…

  20. The comparative study of resonance disorders for Vietnamese and Korean cleft palate speakers using nasometer

    OpenAIRE

    Shin, Yu-Jeong; Kim, Yongsoo; Kim, Hyun-Gi

    2017-01-01

    Background Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnoses using a nasometer. The aim of this study is to find the nasalance differences between Vietnamese cleft palate children and Korean cleft palate children by measuring the nasalance of five oral vowels. Methods Ten Vietnamese cleft palate children after surgery, three Vietnamese children for the control group, and ten Korean cleft palate children after surgery with the same age participated in this exp...

  1. AB103. Phenotype and genotype of urea cycle defect in a Vietnamese referral center

    Science.gov (United States)

    Nguyen, Khanh Ngoc; Bui, Huong Thi; Vu, Dung Chi; Can, Ngoc Thi Bich; Bui, Thao Phuong; Nguyen, Mai Chi; Daut, Hung Viet; Dang, Tuan Anh; Yamaguchi, Seiji; Kim, Gu-Hwan; Yoo, Han Wook

    2015-01-01

    Background and objective Urea cycle disorders (UCDs) are inborn errors of ammonia detoxification/arginine synthesis due to defects affecting the catalysts of the Krebs-Henseleit cycle. Clinical spectrum of UCDs is variant from mild to severe form. To describe clinical spectrum and genotype of UCDs in Vietnamese patients. Methods Case series report of 20 patients with UCDs from 2005 to 2014 at National Hospital of Pediatrics, Hanoi, Vietnam. Results During 10 years, we have 20 cases with UCDs including 2 case of argininosuccinic ciduria; 6 cases of citrullinemia type 1; 12 cases with ornithine transcarbamylase deficiency (OTC). Ten cases (two with argininosuccinic aciduria, five cases with citrullinemia type 1 and three cases with OTC) were newborn onset form. The remaining 10 cases were late onset form. All of newborn onset patients presented with poor feeding, irritability, then coma and dyspnea with hyperammonemia (415-1,254 µg/dL). Clinical symptoms of late onset patients were variant: acute encephalopathy (6/10), recurrent vomiting (5/10), convulsion (4/10), development delay (4/10), hemiplegia (3/10), elevated transaminase (10/10), coagulation disorders (10/10), hyperammonemia (200-1,200 µg/dL) with onset age from 4 to 18 months. Only one case of newborn onset form is survival with normal development (OTC deficiency—20 months old boy), 9/10 cases of late onset form is survival with normal development and mild development delay. Mutation Analysis was identified three causative hemizygote mutations c.77G > A (p.R26Q), c.298+5G>C (IVS3+5G > C) and c.422G > A (p.R141Q) of OTC in three probands and a nonsense homozygous mutation in exon 14 c.1030C > T (p.R344X) of ASS gene in one proband. Conclusions UCDs can occur at any age with non-specific neurological, hepatic—gastrointestinal, psychiatric symptoms. UCDs had good prognosis if early diagnosis and adequate management

  2. A study of the climate change impacts on fluvial flood propagation in the Vietnamese Mekong Delta

    Directory of Open Access Journals (Sweden)

    P. D. T. Van

    2012-12-01

    Full Text Available The present paper investigated the extent of the flood propagation in the Vietnamese Mekong Delta under different projected flood hydrographs, considering the 2000 flood event (the 20-yr return period event, T. V. H. Le et al., 2007 as the basis for computation. The analysis herein was done to demonstrate the particular complexity of the flood dynamics, which was simulated by the 1-D modelling system ISIS used by the Mekong River Commission. The floods of the year 2050 are simulated using a projected sea level rise of +30 cm. The future flood hydrograph changes at Kratie, Cambodia, were also applied for the upstream boundary condition by using an adjusted regional climate model. Two future flood hydrographs were applied at the upstream part of the delta, the first one in a scenario of climate change without considering developments in the Mekong Basin,and the second one in a scenario of climate change taking into account future development of the delta. Analyses were done to identify the areas sensitive to floods, considering the uncertainty of the projection of both the upstream and downstream boundary conditions. In addition, due to the rice-dominated culture in the Vietnamese Mekong Delta, possible impacts of floods on the rice-based farming systems were also analysed.

  3. A study of the climate change impacts on fluvial flood propagation in the Vietnamese Mekong Delta

    Science.gov (United States)

    Van, P. D. T.; Popescu, I.; van Griensven, A.; Solomatine, D. P.; Trung, N. H.; Green, A.

    2012-12-01

    The present paper investigated the extent of the flood propagation in the Vietnamese Mekong Delta under different projected flood hydrographs, considering the 2000 flood event (the 20-yr return period event, T. V. H. Le et al., 2007) as the basis for computation. The analysis herein was done to demonstrate the particular complexity of the flood dynamics, which was simulated by the 1-D modelling system ISIS used by the Mekong River Commission. The floods of the year 2050 are simulated using a projected sea level rise of +30 cm. The future flood hydrograph changes at Kratie, Cambodia, were also applied for the upstream boundary condition by using an adjusted regional climate model. Two future flood hydrographs were applied at the upstream part of the delta, the first one in a scenario of climate change without considering developments in the Mekong Basin,and the second one in a scenario of climate change taking into account future development of the delta. Analyses were done to identify the areas sensitive to floods, considering the uncertainty of the projection of both the upstream and downstream boundary conditions. In addition, due to the rice-dominated culture in the Vietnamese Mekong Delta, possible impacts of floods on the rice-based farming systems were also analysed.

  4. "Freedom. Money. Fun. Love.": the warlore of Vietnamese bargirls.

    Science.gov (United States)

    Gustafsson, Mai Lan

    2011-01-01

    Memories of the Vietnam War abound in the minds of those who survived it, be they veterans or civilians, Vietnamese or American. Vietnamese refugees, forced to flee their homeland after the war ended in 1975, tell particularly poignant stories of loss -- of country, of family, of tradition, and of identity. Not so the women featured in this article. During the war, they served as bargirls in Saigon, entertaining American soldiers. The stories they tell of the war paint an entirely different picture: one of good times, and camaraderie, and the exhilaration of being young and free in the city. They were able to break free from tradition and the expectations imposed on their gender because of the war, and because of that, remember the war as the best time of their lives.

  5. A STUDY OF RELATIONSHIP MARKETING IN THE VIETNAMESE BANKING SECTOR

    OpenAIRE

    Nguyen, Thi Thu Hien

    2006-01-01

    Relationship Marketing has been thought of as a new paradigm in marketing over the last few decades. It has been believed by academics and practitioners that companies can achieve success in the long run by maintaining relationship with their customers and business associates. However, much of the work and understanding of relationship or relational marketing to date focuses on the Western perspective, and hardly any work has been done in the Vietnamese or Asian context. The current literatur...

  6. Operational Art in the Sino-Vietnamese War

    Science.gov (United States)

    2014-12-04

    and internal political actions taken by Deng Xiaoping , one of the Chinese Vice Premier’s.53 Chinese Operational Effectiveness The final category...Vietnamese War? For China, the aim was to eliminate external vulnerabilities and to consolidate internal power around Deng Xiaoping , one of China’s...masterfully kept the war limited to ground operations between China and Vietnam. Deng Xiaoping shaped the strategic approach prior to combat operations

  7. Cultural influences on safety and health education among Vietnamese fishermen.

    Science.gov (United States)

    Carruth, Ann K; Levin, Jeffrey L; Gilmore, Karen; Bui, Thu; Gallardo, Gilbert; Evert, William; Sealey, Lorinda

    2010-10-01

    Every ethnic group has its own cultural background and history that influences how it views health behaviors. By virtue of their work history, many Vietnamese have pursued the fishing industry when migrating to the United States. Even though the fishing trades are among the most dangerous jobs in the world, there has been little attention in the literature to the significant role that culture plays in the expression and experience of occupational health practices among Vietnamese shrimp fishermen. Three focus group sessions were conducted to identify factors that hinder or facilitate receptivity to available training and to guide culturally appropriate content. Participants were recruited using purposive sampling among various Vietnamese shrimp fishermen communities in Texas. Utilizing a series of open-ended questions, sessions were conducted in their native language among owners/captains/deckhands; support infrastructure--adult family members and religious/community leaders; and industry management and insurance representatives. Translations of transcribed documents were compared with simultaneous translations to ensure thematic consistency. Conducting hands-on training among Vietnamese by experienced fishermen, specifically targeting captains, was considered key to safety culture on the vessels. Findings of the study support that training should occur in a variety of formats (hands-on), but should be periodic, current, practical, convenient, taught in the primary language of the audience by an experienced individual, culminate in a certificate of completion, and target captains first. These findings illustrate the importance of considering cultural factors in the design of workplace interventions that focus on changes in safety and occupational health behaviors.

  8. Antibiotic contaminants in coastal wetlands from Vietnamese shrimp farming.

    Science.gov (United States)

    Thuy, Hoang Thi Thanh; Nga, Le Phi; Loan, Tu Thi Cam

    2011-07-01

    Shrimp culture has been expanded rapidly in recent years in coastal wetland zone of Vietnam due to favorable natural conditions. However, this industry has caused several negative impacts to the environment. One of the critical issues is the excessive application of antibiotics including human medicines. These chemicals could be released from shrimp ponds and then accumulated and contaminated of the ecosystem. This review article discusses a whole range of findings that address various aspects of the usage, occurrence and potentially environmental risks of antibiotics released from shrimp farming, with emphasis on the South Vietnam coastal wetland. The published information on the usage and occurrence of antibiotics in Vietnamese shrimp farming has been reviewed. A global comparison was also carried out. This follows by a brief overview of the transport and fate of these antibiotics in the environment. Several antibiotics commonly used in Vietnamese shrimp culture have been detected in wastewater and sediment of the ponds, as well as in surrounding coastal wetlands, resulting in the existence of antibiotic-resistant bacteria. However, their transport and fate could not be clearly defined. The well-documented accumulation of antibiotics in mud and sediments in Vietnamese coastal wetlands potentially poses serious risks for the local wetland ecosystems. Thus, research on the transport and fate of antibiotics' residues from the ponds into the surrounding environment is urgently needed.

  9. Comparison of Vietnamese and European pig breeds using microsatellites.

    Science.gov (United States)

    Thuy, N T D; Melchinger-Wild, E; Kuss, A W; Cuong, N V; Bartenschlager, H; Geldermann, H

    2006-10-01

    This study characterized autochthonous pig breeds of Vietnam and compared them with breeds from other regions. A total of 343 animals were considered from 5 indigenous pig breeds of Vietnam (Muong Khuong, Co, Meo, Tap Na, and Mong Cai), 2 exotic breeds kept in Vietnam (Landrace and Yorkshire), 3 European commercial breeds (German Land-race, Piétrain, and Large White), the Chinese breed Meishan, and the European Wild Boar. Each individual was genotyped for 20 selected polymorphic microsatellite loci. The Vietnamese autochthonous breeds showed higher degrees of polymorphism, allelic diversity, and heterozygosity than the other pig breeds. Also, large genetic diversity was observed across the area of distribution, with village-specific subpopulations, which led to significant inbreeding coefficients. As expected, genetic distances showed large differences among European-based, Chinese, and Vietnamese indigenous breeds and reflected the geographical distribution of breeds. In comparison with the European breeds, the Vietnamese indigenous pig breeds harbored a considerable amount of genetic diversity and, therefore, will be of significance for livestock bioconservation.

  10. Vietnamese Domestic Tourism: An Investigation of Travel Motivations

    Directory of Open Access Journals (Sweden)

    Lee Jolliffe

    2011-01-01

    Full Text Available This article approaches domestic tourism in Vietnam from a native Asian perspective aiming to examine Vietnamese domestic travel motivations. This quantitative study is based on a self-administered questionnaire to survey 230 Vietnamese domestic travellers. Results highlight the significant roles of the employer sponsoring the trip, family, travel promotion, and favourable weather in determining travel, in addition to their motivations to seek time for leisure and recreation. Moreover, the study detected a perception gap between the tourist’s demand and the travel agent’s supply. The behaviour of Vietnamese domestic travellers reflects the characteristics of a transition economy and reveals certain aspects which are also peculiar to other Asian countries. --- Die hier präsentierte quantitative Studie untersucht Reisemotive vietnamesischer InlandstouristInnen mittels eines an 230 ProbandInnen gerichteten Fragebogens. Die Ergebnisse heben neben dem Motiv der Freizeitgestaltung und Erholung die signifikante Rolle der Reisefinanzierung durch Arbeit- geberInnen, der Familie, der Tourismuswerbung sowie der Wetterbedingungen für die Reiseentscheidung hervor. Außerdem ergab die Studie, dass sich die touristischen Motivationen vom Angebot der Reiseagenturen unterscheiden. Die Autorinnen argumentieren, dass das Urlaubsverhalten vietnamesischer InlandstouristInnen Charakteristika eines im wirtschaftlichen Umbruch befindenden Landes widerspiegelt sowie Aspekte aufzeigt, die auch in anderen asiatischen Ländern eine wichtige Rolle spielen.

  11. Homonegative Attitudes and their Correlates Among Vietnamese College Students.

    Science.gov (United States)

    Thanh Nguyen, Toan; Kimura, Kenichi; Morinaga, Yasuko

    2016-06-01

    This study investigated sex differences in homonegativity and their correlates among 197 Vietnamese college students (males = 49, females = 148, M = 20.9 years, SD = 2.9) in Ho Chi Minh City. The survey included Vietnamese-language versions of four scales measuring attitudes toward homosexuality (ATHS), traditional masculinity ideology, knowledge of homosexuality, and contact experiences with homosexuals. An exploratory factor analysis indicated a 3-factor structure for the ATHS: Homonegativity, Tolerance, and Positive Images. Male respondents reported significantly higher scores on homonegativity. Traditional masculinity ideology was positively related to females' homonegativity, but negatively correlated with tolerant attitudes of both males and females. Knowledge about homosexuality was negatively correlated with homonegativity. Media contact with homosexuals was negatively correlated with males' homonegativity, but positively correlated with both females and males' tolerant attitudes. Results suggest that future research develop a new scale to measure Vietnamese's homonegativity and that media contact as well as ample and accurate knowledge about homosexuality can alter homonegativity. © The Author(s) 2016.

  12. Relationship of time to presentation after onset of upper GI bleeding with patient characteristics and outcomes

    DEFF Research Database (Denmark)

    Laine, Loren; Laursen, Stig B; Dalton, Harry R

    2017-01-01

    BACKGROUND & AIMS: We performed a prospective multi-national study of patients presenting to the emergency department with upper gastrointestinal bleeding (UGIB) and assessed the relationship of time to presentation after onset of UGIB symptoms with patient characteristics and outcomes. METHODS...... of transfusion. Other outcomes are similar with rapid versus delayed presentation. Time to presentation should not be used as an indicator for poor outcome. Patients with delayed presentation should be managed with the same degree of care as those with rapid presentation.......: Consecutive patients presenting with overt UGIB (red-blood emesis, coffee-ground emesis and/or melena) from March 2014 to March 2015 at 6 hospitals were included. Multiple pre-defined patient characteristics and outcomes were collected. Rapid presentation was defined as ≤6 hours. RESULTS: Among 2944 patients...

  13. Legal Adaptation among Vietnamese Refugees in the United States: How International Migrants Litigate Civil Grievances during the Resettlement Process.

    Science.gov (United States)

    Hein, Jeremy; Beger, Randall R.

    2001-01-01

    Examines how Vietnamese refugees use the American legal system to address grievances arising during resettlement and how resettlement affects the pace of their legal adaptation. Data from state and federal civil cases involving Vietnamese litigants indicate that several aspects of Vietnamese litigation match their resettlement process, such as…

  14. Anti-inflammatory components of the Vietnamese starfish Protoreaster nodosus.

    Science.gov (United States)

    Thao, Nguyen Phuong; Luyen, Bui Thi Thuy; Koo, Jung Eun; Kim, Sohyun; Koh, Young Sang; Cuong, Nguyen Xuan; Nam, Nguyen Hoai; Van Kiem, Phan; Kim, Young Ho; Van Minh, Chau

    2015-02-20

    In the present study, we examined the inhibitory effects of a methanolic extract, dichloromethane fraction, water layer, and polyhydroxylated sterols (1-4) isolated from the Vietnamese starfish Protoreaster nodosus on pro-inflammatory cytokine (IL-12 p40, IL-6, and TNF-α) production in LPS-stimulated bone marrow-derived dendritic cells (BMDCs) using enzyme-linked immunosorbent assays (ELISA). The methanolic extract and dichloromethane fraction exerted potent inhibitory effects on the production of all three pro-inflammatory cytokines, with IC50 values ranging from 0.60 ± 0.01 to 26.19 ± 0.64 μg/mL. Four highly pure steroid derivatives (1-4) were isolated from the dichloromethane fraction and water layer of P. nodosus. Potent inhibitory activities were also observed for (25S) 5α-cholestane-3β,4β,6α,7α,8β,15α,16β,26-octol (3) on the production of IL-12 p40 and IL-6 (IC50s = 3.11 ± 0.08 and 1.35 ± 0.03 μM), and for (25S) 5α-cholestane-3β,6α,8β,15α,16β,26-hexol (1) and (25S) 5α-cholestane-3β,6α,7α,8β,15α,16β,26-heptol (2) on the production of IL-12 p40 (IC50s = 0.01 ± 0.00 and 1.02 ± 0.01 μM). Moreover, nodososide (4) exhibited moderate inhibitory effects on IL-12 p40 and IL-6 production. This is the first report of the anti-inflammatory activity from the starfish P. nodosus. The main finding of this study is the identification oxygenated steroid derivatives from P. nodosus with potent anti-inflammatory activities that may be developed as therapeutic agents for inflammatory diseases.

  15. What Teachers Say about Addressing Culture in Their EFL Teaching Practices: The Vietnamese Context

    Science.gov (United States)

    Nguyen, Long; Harvey, Sharon; Grant, Lynn

    2016-01-01

    This paper examines Vietnamese EFL teachers' beliefs about the role of culture in language teaching. It also considers how they address culture in their teaching practices in a Vietnamese university. Ethnographic data collected from semi-structured interviews indicated that opportunities for culture to find its way into EFL classroom activities…

  16. Code-Switching in Vietnamese University EFL Teachers' Classroom Instruction: A Pedagogical Focus

    Science.gov (United States)

    Grant, Lynn E.; Nguyen, Thi Hang

    2017-01-01

    This study examines the under-explored phenomenon in Vietnamese tertiary settings of code-switching practised by EFL (English as a foreign language) teachers in classroom instruction, as well as their awareness of this practice. Among the foreign languages taught and learned in Vietnamese universities, English is the most popular. The research…

  17. Credit Constraints and Determinants of the Cost of Capital in Vietnamese Manufacturing

    DEFF Research Database (Denmark)

    Rand, John

    2007-01-01

    This paper examines the extent to which borrowing constraints restrict firm access to credit and identifies individual, firm, and loan characteristics, which determine the cost of capital in Vietnamese manufacturing. Using direct information from a Vietnamese enterprise survey the paper shows...

  18. Exploring the Function of the Anti-communist Ideology in the Vietnamese American Diasporic Community

    Directory of Open Access Journals (Sweden)

    Long Le

    2011-01-01

    Full Text Available The anti-communist ideology in the Vietnamese American community is increasingly perceived as a destabilizing force. Specifically, there is a shift from a number of younger Vietnamese American scholars in imposing a “critical perspective” on particular formulas and narratives, such as immigrant assimilation, American exceptionalism, “we-win-even-when-we-lose,” and “refugees as a showcase for democracy.” From this perspective, the anti-communist ideology needs to be replaced by a new progressive ideology that can better promote the advancement of the Vietnamese people, here and elsewhere. In this article, the above call to cover the Vietnamese lives from more complex and critical perspectives is seen as an opportunity to revisit the function of the anti-communist ideology, which is embedded in the Vietnamese American diasporic community.

  19. Presenting features of primary angle-closure glaucoma in patients of ...

    African Journals Online (AJOL)

    closure glaucoma depends on their ethnic background. In order to examine the presenting features and effects of primary angle-closure glaucoma in people of mixed ethnicity, we reviewed all 'coloured' patients who presented to Groote Schuur ...

  20. Trauma patients who present in a delayed fashion: a unique and challenging population.

    Science.gov (United States)

    Kao, Mary J; Nunez, Hector; Monaghan, Sean F; Heffernan, Daithi S; Adams, Charles A; Lueckel, Stephanie N; Stephen, Andrew H

    2017-02-01

    A proportion of trauma patients present for evaluation in a delayed fashion after injury, likely due to a variety of medical and nonmedical reasons. There has been little investigation into the characteristics and outcomes of trauma patients who present delayed. We hypothesize that trauma patients who present in a delayed fashion are a unique population at risk of increased trauma-related complications. This was a retrospective review from 2010-2015 at a Level I trauma center. Patients were termed delayed if they presented >24 hours after injury. Patients admitted within 24 hours of their injury were the comparison group. Charts were reviewed for demographics, mechanism, comorbidities, complications and outcomes. A subgroup analysis was done on patients who suffered falls. During the 5-y period, 11,705 patients were admitted. A total of 588 patients (5%) presented >24 h after their injury. Patients in the delayed group were older (65 versus 55 y, P fashion have unique characteristics and are more likely to suffer negative outcomes including substance withdrawal. Future goals will include exploring strategies for early intervention, such as automatic withdrawal monitoring and social work referral for all patients who present in a delayed fashion. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Is ileoscopy with biopsy worthwhile in patients presenting with symptoms of inflammatory bowel disease?

    NARCIS (Netherlands)

    Geboes, K.; Ectors, N.; D'Haens, G.; Rutgeerts, P.

    1998-01-01

    To assess the value of adding ileoscopy with biopsy to colonoscopy, hence increasing the indications for ileoscopy in patients presenting with symptoms of inflammatory bowel disease. Two hundred fifty-seven patients with persistent diarrhea and 43 patients with sporadic colonic polyps were studied

  2. Patients' Self-presentational Tactics as Predictors of the Early Therapeutic Alliance.

    Science.gov (United States)

    Frühauf, Sarah; Figlioli, Patrick; Böck, Julian; Caspar, Franz

    2015-01-01

    The early therapeutic alliance is an important predictor for therapy outcome. However, knowledge about predictors of the therapeutic alliance is still limited. We examined if patients' self-presentational behaviors can predict the early therapeutic alliance. Videotaped intake interviews of 60 randomly selected patients were coded for patients' self-presentational tactics. The therapeutic alliance was measured with the Bern Post-Session Report. From the therapists' perspective, Agenda setting and Self-promotion were positively related and Supplication was negatively related to the therapeutic alliance. From the patients' perspective, Agenda setting was negatively related and Self-promotion was positively related to the therapeutic alliance. Provoking a response from the therapist was unrelated to the therapeutic alliance as judged from both therapist and patient perspectives. Correlations were of small-to-moderate size. These findings have important implications for building a constructive therapeutic alliance and identifying patients' needs. Patients' self-presentational behavior is a promising predictor of the early therapeutic alliance.

  3. Two cases of patients with renal transplants presenting with anuria due to an infarcted ileal conduit.

    Science.gov (United States)

    Coxon, Jonathan P; Jones, Chris R

    2002-10-01

    Transplanting kidneys into patients with an ileal conduit has become acceptable practice, and is usually well tolerated. We present the cases of two such patients who later presented as emergencies with anuria due to infarction of the ileal conduit. Both required operative intervention, and in both cases the renal function returned to its pre-operative level. The cases illustrate an important differential diagnosis of anuria in this group of transplant patients.

  4. Demographic survey of pediatric patients presenting to a chiropractic teaching clinic

    OpenAIRE

    Miller Joyce

    2010-01-01

    Abstract Background Considering the increasing use of alternative therapies for children, it is appropriate to determine the demographic profile of pediatric patients entering a chiropractic clinic. Methods Collection of demographic data including age, gender, condition at presentation, previous clinicians consulted and medical referral rates of pediatric patients presenting to a chiropractic teaching clinic between 2006 and 2010. Results Over-all, 20.5% of patients were aged between two days...

  5. Clinical presentation of geriatric polytrauma patients with severe pelvic fractures: comparison with younger adult patients.

    Science.gov (United States)

    Kanezaki, Shozo; Miyazaki, Masashi; Notani, Naoki; Tsumura, Hiroshi

    2016-12-01

    Elderly polytrauma patients with pelvic fractures are at higher risk than young adults for severe medical outcomes and/or death in the early post-trauma phase. The aim of our study was to identify predictive factors of medical severity among geriatric polytrauma patients. We conducted a retrospective cross-sectional study of polytrauma patients treated at our center, who had a pelvic fracture and at least two other injuries with an abbreviated injury score ≥3. Our study group included 15 geriatric (mean age, 65 years) and 13 young (mean age, 39 years) adults. Factors related to medical status on admission were compared between the groups to identify those predictive of a severe medical outcome, defined by massive transfusion (>10 units of red blood cells) within the first 24 h of admission and/or death. Groups were comparable in terms of injury severity score (mean, 29), systolic blood pressure, heart rate, shock index, hemoglobin level, the prothrombin time-to-international normalized ratio (PT-INR) and base deficit. Over two-third of geriatric patients required a massive transfusion, with two patients dying, compared with the death of one young patient. Among geriatric patients, predictors of a severe medical outcome were extravasation of contrast medium on computed tomography, a hemoglobin level 1.1 and a base deficit >2 mmol/l. Even with our aggressive treatment algorism of pelvic fractures, particularly for the elderly, most of the geriatric polytrauma patients with severe pelvic fractures were at a high risk of massive transfusion. Extravasation on enhanced computed tomography and abnormal levels of select blood serum markers could assist in the early identification of geriatric polytrauma patients at risk for a severe medical outcome.

  6. A note on clinical presentations of amebic liver abscess: an overview from 62 Thai patients

    Directory of Open Access Journals (Sweden)

    Wiwanitkit Viroj

    2002-07-01

    Full Text Available Abstract Background Amebic liver abscess is a tropical disease with a wide spectrum of clinical presentations. Given the often nonspecific nature of the complaints related to amebic abscess, a retrospective review of patients with confirmed disease to recognize the most common patterns of presentation is useful. Here, we study the clinical presentations of 62 Thai patients with amebic liver abscess. We also compare the clinical presentations of Anti HIV seronegative and Anti HIV seropositive patients. Methods A retrospective case review was carried out for 62 Thai patients who had been diagnosed with amebic liver abscess. Clinical information was collected, including symptoms and signs, location and number of abscesses. The Anti HIV serology laboratory investigation was also reviewed. Results According to our study, the common clinical symptoms and signs are abdominal pain (85.5 %, fever and chills (74.2 %, and abdominal tenderness (69.4 %. The location of the abscess was predominantly in the right lobe (74.2 %, and most of patients had a single abscess (77.4 %. Similar trends in clinical presentations were observed in both Anti HIV seropositive and Anti HIV seronegative subjects. Conclusions In conclusion, the clinical presentations of our amebic liver abscess patients were similar to those in previous reports. A similarity to those in the pyogenic liver abscess patients can be observed. Nevertheless, we could not detect important significant differences in the clinical presentations between Anti HIV seropositive and Anti HIV seronegative groups of patients.

  7. Critical successful factors for innovation in vietnamese firms

    Directory of Open Access Journals (Sweden)

    Tran Hoai Nam

    2017-09-01

    Full Text Available Purpose: Innovation is considered as a core element of sustainable competitive advantage in the rapidly changing environment. However, in Vietnam, researches on innovation are very rare, which are mostly general reports without underlying analyses of innovation in firms, especially determinants for innovation. Therefore, this paper focuses on analyzing critical successful factors for innovation in Vietnamese firms.  Design/methodology/approach: This study used primary data through questionnaire survey from November 2015 to February 2016. Respondents were senior managers of firms located mostly at Hanoi (Northern, Hochiminh (Southern and Danang city (Central. The questionnaire included multi-items designed to measure factors. Each item was measured by 5 point Likert scale: 1 (strongly disagree to 5 (strongly agree. Questionnaires were administerd to 500 firms belonging to list of Vietnam Chamber of Commerce and Industry (VCCI in these three cities with rate of 40% (Hochiminh city, 40% (Hanoi city and Danang (20%. However, there were 360 returned questionnaires and valid to next analyses. Analysis methodologies of reliability, factor analysis and regression are utilized in this paper.  Findings: We developed and tested a model of determinants for Innovation in Vietnamese firms. The major contribution of this study is testing six determinants for innovation in Vietnamese companies. The results showed that awareness of innovation, innovation strategy and policy, organization for innovation, HR for innovation and building capabilities have positive impact on innovation.  Originality/value: This study makes a contribution for both academics and practitioners. For academics, this study provided one more empirical evidence of the determinants for innovation. Regarding practical implications, this study suggests that Vietnamese companies have to strengthen capabilities for employees through training, encourage generation of new ideas, rule breaking

  8. VIETNAMESE MIGRATION IN THE CONTEXT OF CLIMATE CHANGE

    Directory of Open Access Journals (Sweden)

    Artem S. Lukyanetz

    2014-01-01

    Full Text Available The paper examines emigration from Vietnam in the context of global climate change. Vietnam is among the five countries, most vulnerable to water level rise in the oceans associated with global warming. The areas of potential flooding include territories with most dense population and are extremity important for the economy of Vietnam. The country has a significant demographic potential exceeding 90 mln people. Vietnamese migration has a relatively long history. Large Vietnamese communities have grown in the countries of Eastern Europe; these communities are relatively well integrated into the host countries. Increase in global mean temperatures could lead to severe storms, tsunamis, and flooding and force significant portion of the population out of the Mekong Delta regions and Central provinces of Vietnam. The paper discusses the potential of Atlas Information Systems (AISs for the assessment of social-economic and demographic consequences of climate change in Vietnam. The authors describe an AIS they are developing. This AIS consists of blocks that provide for a close link between socio-political, economic (production, natural resource, and environmental components for the integrated assessment of the provinces of Vietnam. Simulation of events shows that the flood zone could affect such populated provinces as An Giang, Kien Giang, Hau Giang, Dong Thap, Long An, Tien Giang, Vinh Long and Can Tho. To address this problem, the Vietnamese authorities, in 2008, approved the state target program to respond to climate change. The Ministry of Natural Resources and Environment was commissioned to create a scenario of climate change and sea level rise in Vietnam. However, the problem requires an immediate response at the international level, as the threat cannot be localized within the borders of Vietnam. Flooding may require mandatory relocation of the population in the country and, possibly, beyond its borders. If people are not relocated gradually

  9. The Consequences of the Vietnam War on the Vietnamese Population

    OpenAIRE

    Mizoguchi, Nobuko

    2010-01-01

    The purpose of this dissertation is to examine the demographic and socioeconomic consequences of wars, using the case of the Vietnam War and its effects on the Vietnamese population. Using mainly the 1989 and 1999 census microdata, it focuses on the effects of the last ten years of the Vietnam War (or the "American War") from 1965 to 1975, characterized by the escalation of the war with a large presence of American troops in Vietnam and extensive aerial bombings by the United States. The dis...

  10. The impact of minimum wage adjustments on Vietnamese wage inequality

    DEFF Research Database (Denmark)

    Hansen, Henrik; Rand, John; Torm, Nina

    Using Vietnamese Labour Force Survey data we analyse the impact of minimum wage changes on wage inequality. Minimum wages serve to reduce local wage inequality in the formal sectors by decreasing the gap between the median wages and the lower tail of the local wage distributions. In contrast, local...... wage inequality is increased in the informal sectors. Overall, the minimum wages decrease national wage inequality. Our estimates indicate a decrease in the wage distribution Gini coefficient of about 2 percentage points and an increase in the 10/50 wage ratio of 5-7 percentage points caused...

  11. A community-based participatory research approach to understanding pap testing adherence among Vietnamese American immigrants.

    Science.gov (United States)

    Nguyen-Truong, Connie K Y; Lee-Lin, Frances; Leo, Michael C; Gedaly-Duff, Vivian; Nail, Lillian M; Wang, Pei-Ru; Tran, Tri

    2012-01-01

    To explore factors potentially influencing Pap testing practices among Vietnamese American immigrant women (VIW, foreign-born) and describe their awareness of cervical cancer screening resources in their community. Descriptive study guided by the ecological model and community-based participatory research principles. Portland, Oregon, metropolitan area. Vietnamese American immigrant women (211) who were age 21 and older. We used descriptive statistics and logistic regression analyses to analyze a self-administered questionnaire that was pretested and translated using a team approach. Approximately 74% of VIW who completed the survey reported at least one Pap test, and 69% reported Pap testing history adherent to national guidelines. The factor most strongly associated with Pap testing receipt was suggestion from a friend, followed by longer residency in the United States, lower perceived common barriers, and lower perceived cultural barriers, for example, lack of family support and use of Eastern/Asian medicine. The factor most strongly associated with guideline adherence was having health insurance, followed by a recommendation from a physician or nurse practitioner. Only 11% of VIW knew where to obtain a free or low-cost Pap tests. Nurses can influence rates of Pap testing among VIW by providing health education through outreach programs targeted at lay health workers and their social networks, identifying at-risk patients such as recently immigrated women, reducing perceived common and cultural barriers to Pap testing, and helping women seek alternative payment options if they lack health insurance. Primary health care providers should be reminded of their essential role in increasing Pap testing adherence. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  12. [Nutritional management of patients with acute pancreatitis: when the past is present].

    Science.gov (United States)

    García Almansa, A; García Peris, P

    2008-05-01

    Patients with acute pancreatitis usually present nutritional status impairment. In alcoholic pancreatitis this impairment is usually presented before hospital admission. In patients with long-term complicated pancreatitis, malnutrition develops during the course of the disease. Besides, these patients present an increased stress and protein hypercatabolism. Treatment of acute pancreatitis usually maintains patients in a short period of starvation. In mild pancreatitis, starvation is needed for a few days, beginning progressively oral feeding. These patients don't need special nutritional support, unless they were previously malnourished. Patients with severe acute pancreatitis should always receive artificial nutritional support in order to preserve the nutritional status as starvation will be maintained for more than one week. In this paper, we review the nutritional treatment in these situations, trying to answer some different questions: type of nutritional support, when it should be started and when it is indicated to withdraw.

  13. Evaluation of New-Onset Diabetes in Patients Presenting Emergency Service with a Diabetic Ketoacidosis Attack

    Directory of Open Access Journals (Sweden)

    Yavuz Yiğit

    2013-12-01

    Full Text Available Aim: The aim of this study was to investigate the rate of new-onset diabetes mellitus (DM in patients presenting to our emergency department with diabetic ketoacidosis. Methods: We retrospectively evaluated hospital records of patients who presented to the Emergency Department at Istanbul Goztepe Research and Training Hospital between 01 April 2009 and 01 April 2011 and were diagnosed with diabetic ketoacidosis. 57 patients having complete clinical data were included in the study. Results: 45.6%of patients had type 1 DM, 33.3%- type 2 DM, and 21%of them were with new-onset DM. No statistically significant difference was found between type 1 DM, type 2 DM and new-onset DM patients with respect to arterial blood pH and HCO3 levels and serum sodium, potassium and plasma glucose levels at presentation as well as time of presentation (p>0.05, while HbA1c levels showed statistically significant difference in new-onset DM patients. Conclusion: No statistically significant difference was found between types of DM in patients diagnosed with diabetic ketoacidosis except for precipitating factors, age and HbA1c. Detecting high blood glucose levels in patients presenting to emergency room for reasons other than DM is not a rare condition. Cautious evaluation and recognition of these patients in emergency room for the possibility of undiagnosed DM is important for prevention of future diabetic ketoacidosis episodes. (The Medical Bulletin of Haseki 2013; 51: 168-72

  14. 2 Powerful Vietnamese Women Build Private Universities

    Science.gov (United States)

    Overland, Martha Ann

    2009-01-01

    Charismatic as well as politically astute, Ton Nu Thi Ninh is a patient woman--up to a point. As a high-ranking member of Vietnam's Communist Party, and regarded as the most powerful woman in the country, she had to be. But for far too long Ms. Ninh has watched the abysmal state of Vietnam's higher education handicap the country's future…

  15. The effect of presenting symptoms and patient characteristics on prehospital delay in MI patients presenting to emergency department by ambulance: a cohort study.

    Science.gov (United States)

    Coventry, Linda L; Bremner, Alexandra P; Williams, Teresa A; Celenza, Antonio

    2015-10-01

    There is little recent information about prehospital delay time for Australian patients with myocardial infarction (MI). This study: (1) describes prehospital delay time for patients with MI; (2) identifies variables and presenting symptoms which contribute to the delay. This retrospective cohort study identified patients with an Emergency Department (ED) discharge diagnosis of MI, transported by ambulance to one of the seven Perth metropolitan EDs, between January 2008 and October 2009. Prehospital delay times were analysed using linear regression models. Non-numeric (word descriptions) of delay time were categorised. Of 1,633 patients, symptom onset-time was available for 1,003. For 829 patients with a numeric onset-time, median delay was 2.2hours; decreased delay was associated with age prehospital delay times remain longer than is optimal, public awareness of MI symptoms should be enhanced in order to decrease prehospital delay. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  16. Profile of Patients Presenting for Cataract Surgery in a Public Hospital: A 15 Year Perspective.

    Science.gov (United States)

    Sommer, Adir; Belkin, Avner; Ofir, Shay; Assia, Ehud

    2017-02-01

    In recent decades cataract surgery has shifted slowly from public hospitals to ambulatory surgery centers, demonstrating changes in the profile of patients presenting to public hospitals for cataract surgery. These changes may potentially affect the complexity of surgeries, their volume, resident training, and perhaps also visual outcomes and patient satisfaction. To assess the changes in the medical and demographic characteristics of patients undergoing cataract surgery in a public hospital over a period of 15 years. We retrospectively reviewed the records of patients undergoing preoperative assessment before cataract surgery. Records for the period October 2000 to January 2001 (100 patients), October 2006 to January 2007 (100 patients), and October 2013 to January 2014 (150 patients) were assessed for demographic, systemic and ocular related parameters. There was a significant increase in the average age of patients (70.4, 72.4, 73.9 years, P = 0.026), with a significant increase in the percentage of patients of Arab ethnicity (17%, 11%, 28.7%, P = 0.002), and concomitant systemic co-morbidities (38%, 46%, 64.7%, P cataract (38%, 34.4%, 56.9%, P = 0.001), and a significant increase in the percentage of patients taking alpha-blocking medications (0%, 8%, 10.7 %, P = 0.004). Patients presenting for cataract surgery in 2013 compared to those in earlier periods are older, sicker and have more ocular conditions potentially affecting cataract surgery outcomes, patient satisfaction and residents' training.

  17. Patient advisory groups in practice improvement: sample case presentation with a discussion of best practices.

    Science.gov (United States)

    Angstman, Kurt B; Bender, Robert O; Bruce, Steven M

    2009-01-01

    Using patient advisory groups can affect practice changes and create a patient-centric focus for a primary care practice. A successful patient advisory group has been developed for our primary care clinics. Utilizing this group, we have implemented practice improvement changes that have had a significant impact in patient care. This will be demonstrated in a case presentation involving the implementation of depression care managers at our practice sites. We will review key "best practices," as defined by the group, regarding size, composition, and meeting frequency that can be used for the development of a clinical patient advisory group.

  18. Prevalence and presentation of tuberculosis among hemodialysis patients in Khartoum, Sudan.

    Science.gov (United States)

    Banaga, Amin S I; Siddiq, Nihad K; Alsayed, Randa T; Babiker, Rasha; Elmusharaf, Khalifa

    2016-01-01

    Tuberculosis (TB) is a major health problem in the developing countries. There are limited data about the prevalence of TB patients on maintenance hemodialysis (HD) in Sudan. The aim of this study is to identify the prevalence and presentation of TB among Sudanese maintenance HD patients. This is a hospital-based descriptive study. The participants of the study are all HD patients distributed in 13 HD centers in Khartoum and Khartoum North Provinces in Sudan. All patients attended the HD centers from November 1, 2014 to February 1, 2015, were interviewed by a questionnaire focused on personal and clinical data. Those who were diagnosed as having active TB were studied regarding their clinical presentation, presence of comorbidities, site of TB, and methods used on diagnosis. The total number of HD patients during the study period was 1328 patients. We found 19 patients who already diagnosed and treated for TB infection. The prevalence rate of TB among HD patients is 1.4%. The mean age of patient was 44.53±8.69 years, 89.5% of them were males. The majority of them have comorbidities: 31.6%% have hypertension and 21.1% have diabetes. Extrapulmonary TB was the major presentation (57.9%) mainly tuberculous lymphadenitis (26.3%). The pulmonary presentation was found to be 42.1%. The diagnosis of TB was supported by microbiological evidence of alcohol acid-fast Bacilli present in sputum smear (21%), histological diagnosis (31.6%), polymerase chain reaction (21%), and imaging in (26.3%). Patients on maintenance HD are at an increased risk of TB and diagnosis of TB among HD patients need a high index of suspicion. There is a great need for establishing a screening scheme for TB among HD patients and further epidemiological studies are needed to fully evaluate this problem.

  19. Is computerized tomography useful in identifying abdominal catastrophes in patients presenting with peritonitis?

    Science.gov (United States)

    Yehia, Maha; de Zoysa, Janak R; Collins, John F

    2008-01-01

    Peritonitis is a significant source of morbidity and mortality in patients on peritoneal dialysis (PD). Symptoms may persist, requiring an emergency laparotomy. Although increasingly used, we find that, in PD patients, abdominal computerized tomography (CT) is ineffective in determining significant pathology. This study was undertaken to assess the diagnostic utility of CT for the identification of intra-abdominal collections in PD patients presenting with peritonitis. A retrospective chart review was undertaken of all patients that underwent abdominal CT scanning in the context of severe PD peritonitis in the past 2 years. All of these patients had at least one CT scan preoperatively. 133 patients presented with PD peritonitis; 19 patients had a contrast CT procedure (12 females, 7 males). Average age was 59.2 years; mean duration on PD was 43.8 months. 13 of 19 patients had gram-negative bacillary peritonitis, 6 of whom had polymicrobial peritonitis; 4 patients had fungal peritonitis and 2 had Staphylococcus aureus peritonitis. 26 CT scans were done in 19 patients an average of 10 days after presentation. 21 of 26 scans revealed no collections of surgical interest. 12 laparotomies were performed, with an average delay of 10.4 days from presentation to laparotomy. Of the 12 laparotomies, 6 found a drainable collection not seen on CT. Seven of the 19 patients died (37%) and no patient was able to return to PD. PD patients requiring emergency laparotomy following PD peritonitis have a high mortality rate. A negative abdominal CT in the setting of ongoing symptoms should not be taken as reassuring, nor should it delay proceeding to emergency laparotomy.

  20. Seroprevalence of Helicobacter pylori in female Vietnamese immigrants to Korea.

    Science.gov (United States)

    Baik, Su Jung; Yi, Sun Young; Park, Hye Sook; Park, Bo Hyun

    2012-02-14

    To investigate the seroprevalence of Helicobacter pylori (H. pylori) and its relationship to nutritional factors in female Vietnamese immigrants to Korea. A total of 390 female immigrants from Vietnam and 206 Korean male spouses participated in the study. Blood samples from 321 female immigrants and 201 Korean male spouses were analyzed for H. pylori antibodies. Data on age, sex, alcohol consumption, smoking status, dietary nutritional factors and gastrointestinal symptoms were collected using questionnaires. The daily intakes of the following nutrients were estimated: energy, protein, niacin, lipid, fiber, calcium, iron, sodium, potassium, zinc, folate, cholesterol, and vitamins A, B1, B2, B6, C and E. The prevalence of H. pylori positivity was lower in the immigrants than in age-matched Korean females (55.7% vs 71.4%, respectively; P < 0.0001) and the domestic population of Vietnam. The prevalence of H. pylori positivity among married couples was 31.7% for both spouses. There were no statistically significant differences in the incidence of smoking, amount of alcohol consumed, or nutritional factors between the H. pylori-positive and negative groups. The prevalence of H. pylori positivity was lower among female Vietnamese immigrants than among Korean females. Nutritional factors did not differ between the H. pylori-positive and negative groups.

  1. Nutritional analysis of Vietnamese seaweeds for food and medicine.

    Science.gov (United States)

    Dang, Diem Hong; Hoang, Thi Minh Hien

    2004-01-01

    Vietnamese edible marine macro-algae (seaweed) are of interest because of their value in nutrition and medicine. Vietnamese living in the coastal have traditionally utilized seaweeds species as food supplement and herbal medicine. They consumed seaweed as food in various forms: raw as salad and vegetable, pickle with sauce or with vinegar, relish or sweetened jellies and also cooked for vegetable soup. As herbal medicine, seaweed is usually used for traditional comestics, treatments for cough, asthma, hemorrhoid, boils, goitres, stomach ailments, urinary diseases, reduce the incidence of tumors, ulcers and headaches. Although Vietnam has an abundance of algae floral with total number of species is estimated to be nearly 1000 spp. in which there are 638 species of marine algae identified. However, there have been no intense study regarding to changes in marine algal chemistry. The fifteen species of edible seaweeds studied in this paper include green, brown and red algae. The proximate compositions as ash, protein, lipid, carbohydrate, fatty acids, vitamins, pigments, macro and micro-elements were compared among different species examined and the genetic relationships among them by analyzing the species-specific differences in nucleotide sequences of ITS-1 region of the ribosomal DNA was identified.

  2. Toxoplasmosis of spinal cord in acquired immunodeficiency syndrome patient presenting as paraparesis: A rare entity

    Directory of Open Access Journals (Sweden)

    Sachin R Agrawal

    2014-01-01

    Full Text Available Although brain has been the most common site for toxoplasma infection in acquired immunodeficiency syndrome patients, involvement of spinal cord by toxoplasma has been rarely found. Spinal cord toxoplasmosis can present as acute onset weakness in both lower limbs associated with sensory and bladder dysfunction. A presumptive diagnosis can be made in patients with CD4 count <100/mm 3 based on a positive serum Toxoplasma gondii IgG antibodies, no recent prophylaxis against toxoplasmosis, intramedullary ring enhancing lesion in spinal cord supported by similar lesions in brain parenchyma. Institutions of antitoxoplasma treatment in such patients result in prompt clinical response and therefore avoiding the need of unnecessary invasive diagnostic tests. Here, we report a case of toxoplasmic myelitis in immunocompromised patient presenting as myelopathy who showed significant clinical improvement after starting antitoxoplasma treatment. Hence toxoplasmic myelitis should be considered in toxoplasma seropositive immunocompromised patients presenting as myelopathy and imaging studies showing ring enhancing intramedullary lesion.

  3. Mutations of the SBDS gene are present in most patients with Shwachman-Diamond syndrome.

    Science.gov (United States)

    Woloszynek, Jill R; Rothbaum, Robert J; Rawls, Amy S; Minx, Patrick J; Wilson, Richard K; Mason, Philip J; Bessler, Monica; Link, Daniel C

    2004-12-01

    Shwachman-Diamond Syndrome (SDS) is a rare multisystem disorder characterized by exocrine pancreatic insufficiency, bone marrow dysfunction, and metaphyseal chondrodysplasia. Recent studies show that mutations of SBDS, a gene of unknown function, are present in the majority of patients with SDS. In the present study, we show that most, but not all, patients classified based on rigorous clinical criteria as having SDS had compound heterozygous mutations of SBDS. Full-length SBDS protein was not detected in leukocytes of SDS patients with the most common SBDS mutations, consistent with a loss-of-function mechanism. In contrast, SBDS protein was expressed at normal levels in SDS patients without SBDS mutations. These data confirm the absence of SBDS mutations in this subgroup of patients and suggest that SDS is a genetically heterogeneous disorder. The presence (or absence) of SBDS mutations may define subgroups of patients with SDS who share distinct clinical features or natural history.

  4. Outcome in patients with bacterial meningitis presenting with a minimal Glasgow Coma Scale score

    Science.gov (United States)

    Lucas, Marjolein J.; Brouwer, Matthijs C.; van der Ende, Arie

    2014-01-01

    Objective: In bacterial meningitis, a decreased level of consciousness is predictive for unfavorable outcome, but the clinical features and outcome in patients presenting with a minimal score on the Glasgow Coma Scale are unknown. Methods: We assessed the incidence, clinical characteristics, and outcome of patients with bacterial meningitis presenting with a minimal score on the Glasgow Coma Scale from a nationwide cohort study of adults with community-acquired bacterial meningitis in the Netherlands from 2006 to 2012. Results: Thirty of 1,083 patients (3%) presented with a score of 3 on the Glasgow Coma Scale. In 22 of 30 patients (73%), the minimal Glasgow Coma Scale score could be explained by use of sedative medication or complications resulting from meningitis such as seizures, cerebral edema, and hydrocephalus. Systemic (86%) and neurologic (47%) complications occurred frequently, leading to a high proportion of patients with unfavorable outcome (77%). However, 12 of 30 patients (40%) survived and 7 patients (23%) had a good functional outcome, defined as a score of 5 on the Glasgow Outcome Scale. Patients presenting with a minimal Glasgow Coma Scale score on admission and bilaterally absent pupillary light responses, bilaterally absent corneal reflexes, or signs of septic shock on admission all died. Conclusions: Patients with community-acquired bacterial meningitis rarely present with a minimal score on the Glasgow Coma Scale, but this condition is associated with high rates of morbidity and mortality. However, 1 out of 5 of these severely ill patients will make a full recovery, stressing the continued need for aggressive supportive care in these patients. PMID:25340065

  5. Relationship between complaints presented by emergency patients and the final outcome

    OpenAIRE

    Helisamara Mota Guedes; Kesia Meiriele Souza; Patrícia de Oliveira Lima; José Carlos Amado Martins; Tânia Couto Machado Chianca

    2015-01-01

    AbstractObjective: to relate complaints presented by emergency room patients, classified using the Manchester Triage System, with the final outcome (discharge/death/transfer).Methods: prospective cohort study, involving 509 patients who were admitted to the emergency room and remained there for more than 24 hours after admission, being monitored to the final outcome. Data were analyzed with a statistical program using descriptive and analytical statistics.Results: the mean age of the patients...

  6. Insurance status is associated with complex presentation among emergency general surgery patients.

    Science.gov (United States)

    Scott, John W; Havens, Joaquim M; Wolf, Lindsey L; Zogg, Cheryl K; Rose, John A; Salim, Ali; Haider, Adil H

    2017-02-01

    The Affordable Care Act has the potential to significantly affect access to care for previously uninsured patients in need of emergency general surgical care. Our objective was to determine the relationship between insurance status and disease complexity at presentation among a national sample of emergency general surgical patients. Data from the National Emergency Department Sample from 2006-2009 were queried to identify all patients aged 18-64 years old admitted through the emergency department with a primary diagnosis of appendicitis, diverticulitis, inguinal hernia, or bowel obstruction. Primary outcome of complex presentation was defined as also presenting with generalized peritonitis, intra-abdominal abscess, perforated bowel, intestinal gangrene, or other disease-specific measures of complexity. We used multivariable logistic regression to determine the independent association between insurance status and complex presentation. Models accounted for patient- and hospital-level covariates. Counterfactual models were used to estimate the risk of complex presentation attributable to lack of insurance. A total of 1,373,659 patients were included, with an overall uninsured rate of 12.3%. Uninsured patients had significantly higher, unadjusted rates of complex presentation, and uninsured payer status was independently associated with complex presentation (odds ratio 1.38, 95% confidence interval: 1.34-1.42). Counterfactual models suggest that having insurance would result in a 22.37% (95% confidence interval: 22.35-22.39%) relative decline in risk of complex emergency general surgical presentation among the uninsured population. Insurance status is independently associated with severity of disease at presentation among emergency general surgical conditions nationally. In light of recently reaffirmed Affordable Care Act insurance expansion provisions, these results anticipate increased timely access to operative care for newly insured patients and a corresponding

  7. Profiling the clinical presentation of diagnostic characteristics of a sample of symptomatic TMD patients

    Directory of Open Access Journals (Sweden)

    e Silva Machado Luciana

    2012-08-01

    Full Text Available Abstract Background Temporomandibular disorder (TMD patients might present a number of concurrent clinical diagnoses that may be clustered according to their similarity. Profiling patients’ clinical presentations can be useful for better understanding the behavior of TMD and for providing appropriate treatment planning. The aim of this study was to simultaneously classify symptomatic patients diagnosed with a variety of subtypes of TMD into homogenous groups based on their clinical presentation and occurrence of comorbidities. Methods Clinical records of 357 consecutive TMD patients seeking treatment in a private specialized clinic were included in the study sample. Patients presenting multiple subtypes of TMD diagnosed simultaneously were categorized according to the AAOP criteria. Descriptive statistics and two-step cluster analysis were used to characterize the clinical presentation of these patients based on the primary and secondary clinical diagnoses. Results The most common diagnoses were localized masticatory muscle pain (n = 125 and disc displacement without reduction (n = 104. Comorbidity was identified in 288 patients. The automatic selection of an optimal number of clusters included 100% of cases, generating an initial 6-cluster solution and a final 4-cluster solution. The interpretation of within-group ranking of the importance of variables in the clustering solutions resulted in the following characterization of clusters: chronic facial pain (n = 36, acute muscle pain (n = 125, acute articular pain (n = 75 and chronic articular impairment (n = 121. Conclusion Subgroups of acute and chronic TMD patients seeking treatment can be identified using clustering methods to provide a better understanding of the clinical presentation of TMD when multiple diagnosis are present. Classifying patients into identifiable symptomatic profiles would help clinicians to estimate how common a disorder is within a population of

  8. Disability in Patients With Trapeziometacarpal Joint Arthrosis: Incidental Versus Presenting Diagnosis

    NARCIS (Netherlands)

    Becker, Stéphanie J. E.; Makarawung, Dennis J. S.; Spit, Silke A.; King, John D.; Ring, David

    2014-01-01

    Purpose To test the hypothesis that there is no difference in trapeziometacarpal (TMC) joint arthrosis-related symptoms and disability between patients seeking treatment for symptoms of TMC arthrosis and those with incidental TMC joint arthrosis. Methods We compared 64 patients presenting for care

  9. Utility Of Liver Biopsy In Hiv-Infected Patients Presenting With ...

    African Journals Online (AJOL)

    Objectives: To determine the utility of liver biopsy in providing a diagnosis in HIVinfected patients presenting with febrile illnesses and inconclusive initial investigative work up. Design: A retrospective descriptive study. Setting: The Aga Khan University Hospital, Nairobi. Subjects: Twelve in-patients with HIV disease who ...

  10. Outcomes of TB/HIV co-infected patients presenting with ...

    African Journals Online (AJOL)

    8% mortality at 6 months among the general population of patients with TB/HIV co-infection treated at the hospital.[9]. The aim of this article is to describe patient characteristics of an SA adult HIV-infected population presenting with TB DILI, determine the factors that impact on the reintroduction of a standard or modified TBT ...

  11. A look into colostomy in pediatric patients presented to Al Ribat ...

    African Journals Online (AJOL)

    Background: Colostomy is a very common procedure in pediatric pts. It has a lot of indications and complications. Objectives: 1) To observe the frequency of indications complications of colostomies between patients done in Al- Ribat university hospital and other patients done in other hospitals who presented there for ...

  12. An audit of pattern of patients' presentation at the periodontics clinic ...

    African Journals Online (AJOL)

    Objectives: This study is aimed at assessing the various reasons why patients present at the periodontics clinic of the University College Hospital, Ibadan. Materials and Methods: A six months retrospective review of patients treated in the periodontics clinic of the University College Hospital, Ibadan was conducted. Case file ...

  13. Community acquired pneumonia in diabetic and non-diabetic hospitalized patients: presentation, causative pathogens and outcome.

    Science.gov (United States)

    Saibal, M A A; Rahman, S H Z; Nishat, L; Sikder, N H; Begum, S A; Islam, M J; Uddin, K N

    2012-12-01

    Both community acquired pneumonia (CAP) and diabetes mellitus are common in Bangladesh. Though hospitalization of diabetic patients with CAP is increasing, data regarding their clinical presentation, microbial characteristics, antimicrobial susceptibility and outcome are lacking. This study was aimed at finding any difference in clinical presentation, bacterial causes, antimicrobial susceptibility pattern of isolated bacteria and outcome in diabetic and non-diabetic hospitalized patients with CAP. In this study total 47 diabetic and 43 non-diabetic adult hospitalized patients with CAP were enrolled. Clinical presentation of CAP differed in diabetics and non-diabetics. Frequency of atypical presentation and CURB-65 score were significantly higher in diabetics. Pleural effusion with multilobar infiltration was also common feature for CAP in diabetic patients. Klebsiella pneumoniae was the most frequent causative pathogen for CAP in diabetic patients, whereas Streptococcus pneumoniae was the most frequent causative agent for non-diabetic patients. Bacteria isolated from sputum sample of diabetic patients with CAP were resistant to almost all recommended antibiotics used for CAP but 100% of isolates were sensitive to Carbapenems. Pulmonary complications were relatively more in diabetics than in non-diabetics. Hospitalized diabetics with CAP required referral to intensive care unit more than that of non-diabetics. So, diabetic patients with CAP need extra attention.

  14. Ocular disease in patients with TB and HIV presenting with fever in ...

    African Journals Online (AJOL)

    Aims. To investigate ocular disease in Malawian patients with tuberculosis (TB) and HIV in presenting with fever, and to determine if indirect ophthalmoscopy is useful in the diagnosis of mycobacteraemia. Methods. A prospective study of all adult patients admitted with fever to Queen Elizabeth Central Hospital, Blantyre.

  15. Occult thyroid eye disease in patients presenting with dry eye symptoms.

    Science.gov (United States)

    Gupta, Anita; Sadeghi, Pooyan Badihian; Akpek, Esen Karamursel

    2009-05-01

    To describe the clinical presentation, laboratory features, and treatment outcomes in a series of patients with occult thyroid eye disease (TED). Retrospective observational case series. Among 539 patients who were referred for dry eye evaluation over 2 years, 21 were diagnosed with occult TED, based on typical findings in orbital echography. Medical records of these patients were reviewed to collect information on demographics, clinical findings, laboratory studies, and treatment response. All patients presented with symptoms of dry eye. Median age of patients was 57 years (range, 24 to 78 years), with the majority female (86%). No patients carried prior diagnosis of TED or had typical findings of TED such as proptosis, dysmotility, or diplopia. Suspicion of TED was based on conjunctival hyperemia with or without chemosis localized to extraocular muscles (100%), and subtle widening of interpalpebral fissure (48%). Clinical findings included corneal fluorescein staining (57%), rapid tear break-up time (31%), and abnormal Schirmer test (19%). Nineteen percent of patients had other rheumatologic disorders commonly associated with dry eye: Sjögren syndrome (n = 3), and rheumatoid arthritis (n = 1). Patients were treated topically using cyclosporine 0.05% 2 to 4 times a day, with or without steroid. Other treatments were also employed as necessary including warm compresses, artificial tears, and puntal plugs. Majority of patients (76%) had improvement of their symptoms. Occult TED is a potential cause of inflammatory ocular surface disease with dry eye symptomatology and should be considered in the differential diagnosis when evaluating dry eye patients.

  16. Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure.

    Science.gov (United States)

    Bachelot, Anne; Rouxel, Agnès; Massin, Nathalie; Dulon, Jérome; Courtillot, Carine; Matuchansky, Christine; Badachi, Yasmina; Fortin, Anne; Paniel, Bernard; Lecuru, Fabrice; Lefrère-Belda, Marie-Aude; Constancis, Elisabeth; Thibault, Elisabeth; Meduri, Géri; Guiochon-Mantel, Anne; Misrahi, Micheline; Kuttenn, Frédérique; Touraine, Philippe

    2009-07-01

    Premature ovarian failure (POF) encompasses a heterogeneous spectrum of conditions, with phenotypic variability among patients. The etiology of POF remains unknown in most cases. We performed a global phenotyping of POF women with the aim of better orienting attempts at an etiological diagnosis. We performed a mixed retrospective and prospective study of clinical, biological, histological, morphological, and genetic data relating to 357 consecutive POF patients between 1997 and 2008. The study was conducted at a reproductive endocrinology referral center. Seventy-six percent of the patients presented with normal puberty and secondary amenorrhea. Family history was present in 14% of the patients, clinical and/or biological autoimmunity in 14.3%. Fifty-six women had a fluctuating form of POF. The presence of follicles was suggested at ultrasonography in 50% of the patients, and observed in 29% at histology; the negative predictive value of the presence of follicles at ultrasonography was 77%. Bone mineral density alterations were found in 58% of the women. Eight patients had X chromosomal abnormalities other than Turner's syndrome, eight other patients evidenced FMR1 pre-mutation. Two other patients had autoimmune polyendocrine syndrome type 2 and 1. A genetic cause of POF was identified in 25 patients, i.e. 7% of the whole cohort. POF etiology remains most often undiscovered. Novel strategies of POF phenotyping are in such content mandatory to improve the rate of POF patients for whom etiology is identified.

  17. Thrombus Aspiration in Patients With ST-Segment Elevation Myocardial Infarction Presenting Late After Symptom Onset.

    Science.gov (United States)

    Desch, Steffen; Stiermaier, Thomas; de Waha, Suzanne; Lurz, Philipp; Gutberlet, Matthias; Sandri, Marcus; Mangner, Norman; Boudriot, Enno; Woinke, Michael; Erbs, Sandra; Schuler, Gerhard; Fuernau, Georg; Eitel, Ingo; Thiele, Holger

    2016-01-25

    The aim of this study was to examine whether manual thrombus aspiration reduces microvascular obstruction assessed by cardiac magnetic resonance imaging in patients with ST-segment elevation myocardial infarction (STEMI) presenting late after symptom onset. Thrombus aspiration is an established treatment option in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). However, there are only limited data on the efficacy of thrombus aspiration in patients with STEMI presenting ≥12 h after symptom onset. Patients with subacute STEMI presenting ≥12 and ≤48 h after symptom onset were randomized to primary PCI with or without manual thrombus aspiration in a 1:1 ratio. Patients underwent cardiac magnetic resonance imaging 1 to 4 days after randomization. The primary endpoint was the extent of microvascular obstruction. A total of 152 patients underwent randomization. The mean time between symptom onset and PCI was 28 ± 12 h. Baseline characteristics were comparable between groups. The majority of patients (60%) showed at least a moderate amount of viable myocardium in the affected region. Extent of microvascular obstruction was not significantly different between patients assigned to thrombus aspiration and the control group (2.5 ± 4.0% vs. 3.1 ± 4.4% of left ventricular mass, p = 0.47). There were also no significant differences in infarct size, myocardial salvage, left ventricular ejection fraction, and angiographic and clinical endpoints between groups. In this first randomized trial of thrombectomy in patients with STEMI presenting late after symptom onset, routine thrombus aspiration before PCI failed to show a benefit for markers of reperfusion success. (Effect of Thrombus Aspiration in Patients With Myocardial Infarction Presenting Late After Symptom Onset; NCT01379248). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  18. Characteristics and resource utilization of patients presenting to the emergency department from mass gathering events.

    Science.gov (United States)

    DeMott, Joshua M; Hebert, Charles L; Novak, Matthew; Mahmood, Sajid; Peksa, Gary D

    2017-11-06

    At many mass gathering events (MGEs), emergency medical services decrease the number of patient transfers to the hospital; however, little information is known regarding the characteristics of attendees presenting to or requiring transfer to the emergency department (ED). The purpose of this study is to describe the characteristics of patients presenting from MGEs to the ED. A secondary aim of this study is to describe ED resources utilized by these patients. This was a single-center, retrospective review evaluating patients attending MGEs who presented to the ED. Electronic medical records of patients seen in the ED of a tertiary academic medical center between October 13, 2013 and December 31, 2015 were reviewed and a descriptive analysis performed. We reviewed and included 209 patients. The majority of patients presenting to the ED were from large outdoor concerts (n=186, 89%), young (median age 20years), single (n=156, 87%) and had no past medical history (n=114, 63%). Alcohol use was reported in a majority (n=140, 78%) and polysubstance use in over a quarter of patients (n=55, 31%). The most frequently administered medications were intravenous fluids (n=94, 52%) and antiemetics (n=59, 33%). The majority of patients (n=161, 89%) were discharged directly from the ED, and median length of stay in the ED was 3.3h [IQR 2.3 to 5.3]. Patients presenting to the ED from MGEs generally required minimal medical care beyond supportive management with low rates of hospital admission. Further controlled studies are needed to confirm these findings. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Characteristics and acute outcomes of ICU patients with initial presentation of seizure.

    Science.gov (United States)

    Tobochnik, Steven; Gutierrez, Camilo; Jacobson, Mercedes P

    2015-03-01

    Seizures are a common cause of presentation to the emergency department (ED) but vary widely in severity and prognostic significance, with some cases requiring ICU management. Most evidence regarding seizure outcomes in the ICU comes from patients exclusively with status epilepticus (SE) or with new seizures detected after ICU admission. To aid in determining early prognosis of ICU patients with and without SE, we performed an analysis of patients initially presenting with any type of seizure and requiring ICU management. Analysis of hospital records of 247 consecutive patients presenting to the ED initially with seizure and directly admitted to the ICU between January 2010 and June 2013. The primary outcome was composite in-hospital death or discharge to hospice, and the secondary outcome was recurrent ICU seizures. The primary outcome occurred in 7.7% of patients. Both early mechanical ventilation and an acute intracranial process on neuroimaging were associated with a poor outcome. About half of this cohort presented with SE. Although SE was associated with recurrent seizures in the ICU, the primary outcome was similar between patients presenting with and without SE. Patients with SE had greater rates of early intubation in the ED and were treated more aggressively with medication, whereas patients without SE had greater rates of first ever seizure, acute intracranial disease including intracranial hemorrhage, and neurosurgical intervention. Patients presenting to the ED with and without SE requiring ICU admission may have similar acute outcomes, yet differ in risk factors and seizure etiologies. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  20. [The color test: psychodiagnostic opportunities for the patients presenting with chronic somatic diseases].

    Science.gov (United States)

    Aĭvazian, T A; Zaĭtsev, V P

    2014-01-01

    The objective of the present study was to estimate the diagnostic potential of the Luscher color test. A total of 1083 patients presenting with chronic somatic diseases were available for the psychodiagnostic examination. It was shown that the color test makes it possible to evaluate clinically significant psychological characteristics as well as dynamics of anxiety and stress-resistance in this group of patients. Specifically, in the cases of chronic somatic diseases, the test can be used as one of the psychodiagnostic methods especially for mass screening and in the situations when the application of the standard questionnaires encounters difficulties (for example, in the patients with disturbed cognitive functions).

  1. Posttransplantation malignancy in a patient presenting with weight loss and changed bowel habits: a case report

    Directory of Open Access Journals (Sweden)

    Luft Friedrich C

    2006-05-01

    Full Text Available Abstract Backround Advancements in immunosuppressive therapy have significantly improved patient and graft survival following renal transplantation. This is paralleled by an increasing occurrence of posttransplantation malignancy. Case presentation We report on a patient who presented with a history reminding of colon cancer seven years after receiving a kidney transplant. Initial diagnostic imaging seemed to confirm this diagnosis showing a constricting colonic lesion. To our surprise, colonoscopy findings were unremarkable. Review of the imaging studies revealed that the tumor-like picture was caused by the renal graft impressing the intestine. The following search for malignancy in other locations resulted in the diagnosis of glioblastoma multiforme of which the patient died several weeks later. Conclusion Follow-up of renal transplant patients must include screening tests directed at tumor detection. Imaging studies and other tests in this patient group should be interpreted by physicians who are familiar with transplant related peculiarities.

  2. Evaluation of sexual dysfunction in female patients presenting with faecal incontinence or defecation disorder.

    Science.gov (United States)

    Pellino, Gianluca; Ramage, Lisa; Simillis, Constantinos; Warren, Oliver; Kontovounisios, Christos; Tan, Emile; Tekkis, Paris

    2017-05-01

    Female patients with pelvic floor diseases may suffer from several sexual disorders and sexual life impairments. The aim of this manuscript was to evaluate sexual dysfunction in female patients presenting with faecal incontinence (FI) and defecation disorder (DD). A retrospective review was performed of a prospectively collected database of sexually active women referred to the pelvic floor clinic, who completed the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-12 (PISQ-12) at first visit. Statistical analysis was performed to evaluate and compare sexual dysfunction between patients with FI and DD and with published data on the general population. Regression analysis was used to identify predictors of sexual dysfunction and surgery. Three hundred thirteen patients were included, 192 (61%) with FI and 121 (39%) with DD. The patients with DD received more non-gynaecological surgical procedures (p = 0.023). More patients with DD received surgery for their current pelvic floor disease (p orgasm perception (item 13, OR = 2.1) were the strongest predictors of worse sexual function in patients with FI. Patients with DD were almost 15 times more likely to receive subsequent surgery (OR = 14.6, p < 0.001), whereas fear of urine leakage almost doubled the risk. Sexual dysfunction is prevalent among patients suffering from FI and DD, and questionnaires are useful in recognizing these patients. Subsequent surgery is more common for patients with DD compared to those with FI.

  3. Cytomegalovirus retinitis presenting as vasculitis in a patient with Wegener’s granulomatosis

    Directory of Open Access Journals (Sweden)

    Paris G Tranos

    2008-08-01

    Full Text Available Paris G Tranos1, Ilias Georgalas2, Panagiota Founti1, Ioannis Ladas21Papageorgiou University Hospital, Thessaloniki, Greece; 2Department of Ophthalmology, “G.Genimatas” Hospital, Athens, GreecePurpose: To present an unusual case of cytomegalovirus (CMV retinitis in a patient with Wegener’s granulomatosis.Results: A 54-year-old lady with Wegener’s granulomatosis presented with decreased vision in her left eye. Wegener’s retinal vasculitis was diagnosed initially and the patient received treatment with oral steroids. Three days later the patient developed typical CMV retinitis.Conclusion: The likelihood of CMV retinitis in patients with Wegener’s granulomatosis should not be overlooked. Increased awareness in such cases is very important since CMV retinitis may present with less typical manifestations, which makes the correct diagnosis more challenging.Keywords: cytomegalovirus retinitis, Wegener’s granulomatosis, ganciclovir

  4. Incidence of primary colorectal cancer from colonoscopy examinations in patients presenting with liver mass.

    Science.gov (United States)

    Sirikurnpiboon, Siripong; Awapittaya, Burin; Wannaprasert, Jerasak

    2013-03-01

    An in-patient presented with atypical primary liver mass and was suspected of having liver metastasis. One method of investigation is colonoscopy; however, there are currently no clear guidelines to indicate when this procedure should be performed. This was a retrospective review of 6 years' data from the surgical endoscopic unit in Rajavithi Hospital. The inclusion criteria were: (1) patient presented with liver mass, (2) radiological findings (mainly from CT scan or MRI) were not typicalfor hepatocellular carcinoma (HCC), intrahepatic cholagiocarcinoma (ICGC) and other primary liver tumors. The exclusion criteria were: (1) patients did not undergo the operation in Rajavithi Hospital, (2) there was loss of patient data during the follow-up period. A total of 1,532 cases underwent colonoscopy, of which 109 met the inclusion criteria. There were 24 cases of positive primary colorectal cancer and the incidence was 22% (95% CI 14.1-29.9), and 1 case of terminal ileum cancer. The final results after operation showed 40 cases of HCC, and 21 cases of intrahepatic cholangiocarcinoma. Risk factors for testing positive for colorectal cancer were: presenting with GI symptoms; abnormal CEA levels; and positive family history of colorectal cancer To increase the incidence of positive results for colorectal cancer and reduce unnecessary colonoscopy in patients who present with liver mass, the factors which indicate colonoscopy should be patients who present with GI symptom, abnormal CEA level, and whose family history raises concern.

  5. Peripheral Arterial Disease in Patients Presenting with Acute Coronary Syndrome in Six Middle Eastern Countries

    Directory of Open Access Journals (Sweden)

    Hassan A. Al-Thani

    2011-01-01

    Full Text Available To describe prevalence and impact of peripheral arterial disease (PAD in patients with acute coronary syndrome (ACS, data were collected over 5 months from 6 Middle Eastern countries. Patients were divided into 2 groups (with and without PAD. Out of 6705 consecutive ACS patients, PAD was reported in 177 patients. In comparison to non-PAD, PAD patients were older and more likely to have cardiovascular risk factors. They were more likely to have high Killip class, high GRACE risk score, and non-ST elevation ACS (NSTEACS at presentation. Thrombolytics, antiplatelet use, and coronary intervention were comparable in both groups. When presented with ST-elevation myocardial infarction (STEMI, patients with PAD had worse outcomes, while in NSTEACS; PAD was associated with higher rate of heart failure in comparison to non-PAD patients. In diabetics, PAD was associated with 2-fold increase in mortality when compared to non-PAD (P=0.028. After adjustment, PAD was associated with high mortality in STEMI (adjusted OR 2.6; 95% CI 1.23–5.65, P=0.01. Prevalence of PAD in ACS in the Gulf region is low. Patients with PAD and ACS constitute a high risk group and require more attention. PAD in patients with STEMI is an independent predictor of in-hospital death.

  6. Variable presentation of anaplastic large-cell lymphoma in patients with breast implants.

    Science.gov (United States)

    Locke, Michelle B; Lofts, Julian

    2017-10-01

    Anaplastic large-cell lymphoma (ALCL) has recently been reported in women with breast implants. The incidence of breast implant-related ALCL is extremely rare and most surgeons would not expect to see this disease in their career. However, the senior author has had three women present to his practice with ALCL over a 2-year period. The three patients and their presentation were reviewed to establish the presenting complaint in each case of subsequently diagnosed ALCL. Literature was reviewed to establish appropriate treatment protocols for any subsequent patients. The average time between first implant placement and presentation with breast implant-associated ALCL was 13.3 years (range: 10-16 years) and age at presentation was 49 years (range: 45-53 years). Each presentation was somewhat different, being a palpable mass, a painless seroma and a painful seroma. Both patients with seroma underwent ultrasound-guided aspiration of fluid which confirmed ALCL. All patients underwent implant removal and complete capsulectomy. The patient with a mass at presentation initially declined adjuvant treatment but subsequently developed an ALCL-associated seroma and was treated with surgery and post-operative chemotherapy. Patients with breast implant-associated ALCL can present with different clinical signs and symptoms. Late seroma is a relatively common presentation of breast implant-associated ALCL. While firm guidelines for the management of breast implant-related ALCL are lacking, we suggest that any late seroma in the absence of infection should be managed with aspiration and cytological analysis of the fluid. © 2015 Royal Australasian College of Surgeons.

  7. time of presentation of stroke patients for ct imaging in a nigerian ...

    African Journals Online (AJOL)

    Challenges in developing countries like Nigeria often lead to delayed presentation of stroke ... haemorrhagic stroke. However, 18 (21.7%) patients had apparently normal CT findings. The mean presentation time for CT imaging was 70 hours (SD ±94 hours). ..... Stroke Nursing; Council on Epidemiology and. Prevention ...

  8. Understanding the characteristics of patient presentations of young people at outdoor music festivals.

    Science.gov (United States)

    Hutton, Alison; Ranse, Jamie; Verdonk, Naomi; Ullah, Shahid; Arbon, Paul

    2014-04-01

    Outdoor music festivals are unique events given that they are, for the most part, bounded and ticketed, and alcohol is served. They frequently have a higher incidence of patient presentations when compared with similar types of mass gatherings. Often, however, single events are reported in the literature, making it difficult to generalize the findings across multiple events and limiting the understanding of the "typical" patient presentations at these mass gatherings. The aim of this paper was to understand the characteristics of young people who have presented as patients to on-site health care at outdoor music festivals in Australia, and the relative proportion and type of injury and illness presentations at these events. This research used a nonexperimental design, utilizing a retrospective review of patient report forms from outdoor music festivals. Data were collected from 26 outdoor music festivals across four States of Australia during the year 2010. Females presented at greater numbers than males, and over two-thirds presented with minor illnesses, such as headaches. Males presented with injuries, in particular lacerations to their face and their hands, and alcohol and substance use made up 15% of all presentations.

  9. Demographic survey of pediatric patients presenting to a chiropractic teaching clinic

    Directory of Open Access Journals (Sweden)

    Miller Joyce

    2010-12-01

    Full Text Available Abstract Background Considering the increasing use of alternative therapies for children, it is appropriate to determine the demographic profile of pediatric patients entering a chiropractic clinic. Methods Collection of demographic data including age, gender, condition at presentation, previous clinicians consulted and medical referral rates of pediatric patients presenting to a chiropractic teaching clinic between 2006 and 2010. Results Over-all, 20.5% of patients were aged between two days and 15 years and classified as pediatric patients. The most common presenting complaint was musculoskeletal (35%. Excess crying (30% was the most common complaint in the largest presenting age group which was under 12 weeks of age (62.3%. All children had previously presented for medical care for the same condition. Most (83% of the infant patients under 12 weeks of age were referred for care by a medical practitioner. Conclusion Parents commonly presented their child for care at this chiropractic clinic with a recommendation from a medical practitioner. The most common complaints were musculoskeletal and excessive crying conditions and the most prevalent age group was under 12 weeks of age.

  10. Endemic Burkitt Lymphoma: Long-term Outcome in 87 Patients Who Presented With Paraplegia in Cameroon.

    Science.gov (United States)

    Hesseling, P B; Mbah, G; Kouya, F; Kimbi, C; Nfor, P; Kaah, J; Kuruvilla, R; Best, A; Wharin, P

    2015-01-01

    The reported long-term outcome of endemic Burkitt lymphoma (eBL) patients who present with paraplegia is largely unknown. Records of BL patients treated with comparable short-interval cyclophosphamide chemotherapy schedules between 2004 and 2014 at three Baptist mission hospitals in Cameroon were reviewed. Survivors were followed up and examined at home or in hospital. Eighty-seven of 948 (9.2%) patients had paraplegia at diagnosis. The survival rate in eBL patients with paraplegia at diagnosis was 33% (n = 29) after follow-up of between 2 and 96 (median 40) months. Seven patients (24%) had neurological sequelae and needed rehabilitation. There was no relationship between the duration of symptoms (4 weeks) and the survival rate or the risk to have neurological sequelae. The survival rate and risk for sequelae were similar in patients with confirmed St. Jude stage III and IV diseases.

  11. IgA Nephropathy in a Patient Presenting with Pseudotumor Cerebri

    Directory of Open Access Journals (Sweden)

    Umair Syed Ahmed

    2016-01-01

    Full Text Available IgA nephropathy is the most common glomerulonephritis worldwide and typically has minimal signs for chronicity in histopathology at the time of initial presentation. Pseudotumor cerebri (PTC is characterized by increased intracranial pressure in the absence of any intracranial lesions, inflammation, or obstruction. PTC has been reported in renal transplant and dialysis patients, but we are unaware of any reports of pseudotumor cerebri in patients with IgA nephropathy. We report a case of a young female who presented with signs and symptoms of pseudotumor cerebri and was subsequently diagnosed with IgA nephropathy and end-stage renal disease. To our knowledge this is the first report of IgA nephropathy presenting as end-stage renal disease in a patient who presented with pseudotumor cerebri.

  12. Chinese Soot on a Vietnamese Soup

    Science.gov (United States)

    Mari, X.

    2015-12-01

    Black Carbon (BC) is an aerosol emitted as soot during biomass burning and fossil fuels combustion together with other carbonaceous aerosols such as organic carbon (OC) and polyaromatic hydrocarbons (PAHs). While the impacts of BC on health and climate have been studied for many years, studies about its deposition and impact on marine ecosystems are scares. This is rather surprising considering that a large fraction of atmospheric BC deposits on the surface of the ocean via dry or wet deposition. On a global scale, deposition on the ocean is about 45 Tg C per year, with higher fluxes in the northern hemisphere and in inter-tropical regions, following the occurrence of the hot-spots of concentration. In the present study conducted on shore, in Haiphong and Halong cities, North Vietnam, we measured the seasonal variations of atmospheric BC, OC and PAHs during a complete annual cycle. The presentation will discuss the atmospheric results in terms of seasonal variability and sources. Inputs to the marine system are higher during the dry season, concomitantly with the arrival of air masses enriched in BC coming from the North. However, the carbon fingerprint can significantly differ at shorter time periods depending on the air mass pathway and speed. Our work leads to the characterization and the determination of the relative contribution of more specific sources like local traffic, which includes tourism and fishing boats, coal dust emitted from the nearby mine, and long-range transported aerosols. This variable input of carbonaceous aerosols might have consequences for the cycling and the repartition of carbon and nutrients in the marine ecosystem of Halong Bay.

  13. Analysis of patients presenting to the emergency department with carbon monoxide intoxication

    Directory of Open Access Journals (Sweden)

    Selim Yurtseven

    2015-12-01

    Full Text Available Objectives: Carbon monoxide is a potentially fatal form of poisoning. The exact incidence is unclear, due to cases being undiagnosed or reported as fewer than the real number. Hyperbaric oxygen therapy (HBOT is of proven efficacy in the treatment of CO intoxication.The purpose of this study was to describe the general characteristics of carbon monoxide (CO intoxications presenting to the emergency department and to investigate troponin I values and the effectiveness of hyperbaric oxygen therapy (HBOT in these patients. Material and methods: Patients presenting to the emergency department with CO intoxication over one year and patients with such intoxications receiving HBOT were examined retrospectively. Results: One hundred seventy-one patients were included; 140 (81.9% were poisoned by stoves, 18 (10.5% by hot water boilers and 10 in (5.8% by fires. COHb levels were normal in 49 of the 163 patients whose values were investigated, and were elevated in 114 patients. Mean COHb value was 16.6. Troponin I values were investigated in 112 patients. These were normal in 86 patients and elevated in 26. Mean troponin I value was 0.38 ng/ml. One hundred twenty-three of the 171 patients in the study were discharged in a healthy condition after receiving normobaric oxygen therapy, while 48 patients received HBOT. Forty-two (87.5% of the patients receiving HBOT were discharged in a healthy condition while sequelae persisted in five (10.4%. One patient died after 15 session of HBOT. Conclusion: Although elevated carboxyhemoglobin confirms diagnosis of CO intoxication, normal levels do not exclude it. Troponin I levels may rise in CO intoxication. No significant relation was observed between carboxyhemoglobin and receipt of HBOT. A significant correlation was seen, however, between troponin I levels and receipt of HBOT. Keywords: Carbon monoxide intoxication, Hyperbaric oxygen, Troponin I, Echocardiography

  14. Hyperckemia and myalgia are common presentations of anoctamin-5-related myopathy in French patients.

    Science.gov (United States)

    Papadopoulos, Constantinos; LaforÊt, Pascal; Nectoux, Juliette; Stojkovic, Tanya; Wahbi, Karim; Carlier, Robert-Yves; Carlier, Pierre G; Leonard-Louis, Sarah; Leturcq, France; Romero, Norma; Eymard, Bruno; Behin, Anthony

    2017-12-01

    Patients with anoctamin-5 (ANO5) mutations may present not only with limb-girdle muscular dystrophy type 2L or adult-onset Miyoshi-type myopathy but also with asymptomatic hyperCKemia, exercise intolerance, or rhabdomyolysis. Data from 38 patients in France with ANO5 mutations with and without muscle weakness on first examination were compared. Twenty patients presented without muscle weakness. Median age at symptom onset or discovery of hyperCKemia was 23 years. Creatine kinase levels ranged from 200 to 40,000 U/L. Electromyography showed a myopathic pattern in 5 patients, and muscle imaging showed involvement of posterior calf muscles in 10 patients. Mild cardiac involvement was observed in 2 patients. Sixteen patients remain free of weakness after a median follow-up period of 5 years. Asymptomatic, sometimes mild hyperCKemia or exercise intolerance is a presentation of ANO5-related myopathy and may remain isolated or precede muscle weakness by many years. Muscle Nerve 56: 1096-1100, 2017. © 2017 Wiley Periodicals, Inc.

  15. The prognostic impact of chest pain in 1306 patients presenting with confirmed acute pulmonary embolism.

    Science.gov (United States)

    Wong, Christopher C Y; Ng, Austin C C; Lau, Jerrett K; Chow, Vincent; Sindone, Andrew P; Kritharides, Leonard

    2016-10-15

    The prognostic influence of chest pain in patients presenting with pulmonary embolism has not been well defined. We investigated whether the presence of chest pain at presentation affected the mortality of patients with acute pulmonary embolism. Retrospective cohort study of consecutive patients admitted to a tertiary hospital with confirmed acute pulmonary embolism from 2000 to 2012, with study outcomes tracked using a state-wide death registry. Of the 1306 patients included in the study, 771 (59%) had chest pain at presentation. These patients were younger with fewer comorbidities, and had lower 6-month mortality compared to patients without chest pain (5% vs 15%, PChest pain was consistently found to be an independent predictor of 6-month mortality in three separate multivariable models (range of hazard ratios 0.52-0.60, all with Pchest pain to a multivariable model that included the simplified pulmonary embolism severity index, haemoglobin, and sodium led to a significant net reclassification improvement of 18% (PChest pain is a novel, favourable prognostic marker in patients with acute pulmonary embolism. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Cultural and clinical factors associated with antihypertensive medication adherence in Vietnamese policemen

    Directory of Open Access Journals (Sweden)

    Wen-Wen Li

    2017-01-01

    Full Text Available The purpose of this study is to characterize Vietnamese policemen with hypertension, to report the proportion of hypertension control and medication adherence in Vietnamese policemen, and to explore cultural and clinical factors related to antihypertensive medication adherence. A cross-sectional study design was used. A convenience sample of 100 policemen with hypertension was recruited in Vietnam. A total score of 80% or more on the Medication Adherence scale was defined as medication adherence. Medication adherence was reported in 64% of the participants, but hypertension control was found in only 53%. Medication adherence was higher in the participants with higher perceived susceptibility to hypertension-related complications, higher perceived benefit of Western anti-hypertensive medications, longer duration of time since diagnosis, and fewer prescribed blood pressure lowering medications. Vietnamese policemen are at high risk for poor medication adherence and hypertension management. Culturally and clinically appropriate nursing interventions for hypertension management in Vietnamese policemen are needed.

  17. Modern and Traditional Medical Practices of Vietnam. Vietnamese Concepts of Illness and Treatment.

    Science.gov (United States)

    Rieu, Le Tai

    This paper discusses superstitious, folk, traditional, and modern medical practices of Vietnam. Concepts of illness, somatization, behavior labeling, diagnostic attempts, and attitudes toward treatment among Vietnamese are also reviewed. (APM)

  18. Burkitt's non-Hodgkins lymphoma presenting as facial nerve palsy in HIV-positive patients.

    Science.gov (United States)

    Woodcock, H; Nelson, M

    2011-02-01

    An isolated facial nerve palsy is rare as the presentation of a central nervous system lymphoma. In this case series, we present the clinical features of three HIV-positive patients presenting with facial nerve palsies due to HIV-associated Burkitt's lymphoma. These patients had a non-resolving facial paralysis, which occurred during a late stage of HIV. Magnetic resonance imaging (MRI) did not show leptomeningeal enhancement. Cerebrospinal fluid revealed a lymphocytosis with elevated protein and low glucose levels. The diagnosis of Burkitt's lymphoma was made on histology which showed the characteristic 'starry sky' appearance due to scattered tangible body-laden macrophages. The patients were commenced on the intensive chemotherapy regimen of CODOX-M/IVAC. Two patients died of disease progression and the third patient died of chemotherapy toxicity. This case series highlights the need for a high index of suspicion for underlying malignancy when a patient presents with a persistent facial paralysis in the later stages of HIV infection.

  19. STUDY OF CLINICAL PROFILE OF PATIENTS PRESENTING WITH SEXUAL PRECOCITY TO A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Binoy Kumar Mohanty

    2016-07-01

    Full Text Available BACKGROUND Precocious puberty is a common paediatric endocrine disorder seen in clinical practice. OBJECTIVE To study the various aetiologies and clinical presentations of patients presenting with sexual precocity to a tertiary care hospital. DESIGN Cross sectional study. MATERIAL AND METHODS We collected and analysed the clinical data including hormonal status of 24 consecutive patients who presented to our department from January 2014 to December 2015 for evaluation of sexual precocity. RESULTS Most of the patients presenting to us had evidence of precocious puberty (n=16, followed by premature adrenarche (n=5 and premature thelarche (n=3 respectively. The females outnumbered males in our study (68.75% of total cases. Females presenting with central precocious puberty had no appreciable cause (idiopathic in majority (85.72% of cases. While, males presenting with central precocious puberty had an organic cause (60% in majority of cases. CONCLUSIONS Precocious puberty is more common among females as compared to males. Organic lesion must be ruled out in all patients presenting with central precocious puberty especially in males.

  20. Genetic analysis of 55 northern Vietnamese patients with Wilson ...

    Indian Academy of Sciences (India)

    2017-12-19

    Dec 19, 2017 ... Center for Gene-Protein Research, Hanoi Medical University, Hanoi 100000, Vietnam; Department of Biochemistry, Hanoi Medical University, Hanoi 100000, Vietnam; Clinical Genetics Unit, Department of Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, 17176 Stockholm, Sweden ...

  1. Genetic analysis of 55 northern Vietnamese patients with Wilson ...

    Indian Academy of Sciences (India)

    Le Anh Tuan Pham

    2017-12-19

    Dec 19, 2017 ... It is a rare autosomal recessive genetic disorder of copper metabolism in which exces- sive amounts accumulate in the body, particularly in the liver, brain and eyes (Kayser–Fleischer ring in the cornea). Biochemical indicators for the disease include low serum concentrations of ceruloplasmin (<20 g/L) and ...

  2. Carcinoma involving the gallbladder in elderly patients presenting with acute cholecystitis.

    Science.gov (United States)

    Liu, K J; Richter, H M; Cho, M J; Jarad, J; Nadimpalli, V; Donahue, P E

    1997-10-01

    The unexpected intraoperative finding of a cancerous gallbladder has become particularly problematic, because cancer recurs rapidly after laparoscopic cholecystectomy. It would be desirable to identify the patients of greatest risk for gallbladder cancer before operation. After several elderly patients presenting with acute cholecystitis were found to have gallbladder cancer, we performed the following study. Records of patients (60 years of age or older, 1987 to 1995) with an admitting diagnosis of acute cholecystitis and symptoms including right upper quadrant pain, nausea, vomiting, fever, and leukocytosis were reviewed. Eighty patients were included in the study. Carcinoma involving the gallbladder was found in seven patients; six had primary and one had metastatic carcinoma. The 73 patients without cancer underwent cholecystectomy. The differences between the noncancer and cancer patients included age (68 +/- 7 versus 74 +/- 8 years, p < 0.05), total bilirubin (mg/dl, 1.5 +/- 1.5 versus 3.7 +/- 3.4, p < 0.01), alkaline phosphatase (IU/L, 179 +/- 132 versus 369 +/- 226, p < 0.01), and aspartate aminotransferase (IU/L, 77 +/- 93 versus 158 +/- 157, p < 0.05). Additional work-up and open cholecystectomy should be considered in elderly patients presenting with apparent acute cholecystitis, especially when liver functions are abnormal.

  3. [The algorithm for rehabilitation of the patients presenting with laryngeal cancer following open functionally sparing operations].

    Science.gov (United States)

    Kozhanov, L G; Sdvizhkov, A M; Reshetov, I V; Kryukov, A I; Kravtsov, S A; Kozhanov, A L; Bekov, M T

    2016-01-01

    The objective of the present study was to increase the efficiency of the treatment of the patients presenting with laryngeal cancer by the enhancement of the functional reserve of the preserved portion of the larynx and the prevention of the narrowing of its lumen. Another objective was to develop an algorithm for the rehabilitation of the patients with laryngeal localization of the tumour following open functionally sparing operations that consists of the operative and postoperative stages. During the period from 2006 to 2014, a total of 71 patients underwent functionally sparing operations. 66 of them were operated for laryngeal cancer, 1 for thyroid cancer spreading over trachea and larynx, 3 for papillomatosis. Resection of the larynx in the vertical and horizontal planes was performed in 62 and 9 patients respectively. Vertical plane surgery included the following procedures: fronto-lateral resection of the larynx in 51 patients, extended fronto-lateral resection in 10, and combined resection in 1 patient. It is concluded that the systemic approach to the treatment of the patients with laryngeal cancer and the proposed algorithm for their rehabilitation made it possible to restore the laryngeal function in 68 of the 71 patients (95.8%).

  4. Chest Pain as a presenting complaint in patients with acute myocardial infarction (AMI).

    Science.gov (United States)

    Malik, Muhammad Ajmal; Alam Khan, Shahzad; Safdar, Sohail; Taseer, Ijaz-Ul-Haque

    2013-04-01

    To study various characteristics of chest pain in acute myocardial infarction patients. A total of 331 patients of AMI admitted at Cardiology unit Nishtar Hospital Multan and Chaudhry Pervez Elahi Institute of Cardiology Multan, irrespective of the age and gender, were included in this study. The study duration was one year starting from June 2011 to June 2012. Non-probability purposive sampling technique was used in this descriptive study. Informed consent to participate in this study was taken. Data were entered and analyzed using SPSS-11. A total number of 331 patients with AMI were included in the study. Mean age was 54.99±11.25 years with minimum age 20 years and maximum age 90 years. It included 264(79.8%) male and 67(20.2%) female patients with male to female ratio of 3.9:1. Out of these 331 patients 308 (93.1%) patients reported chest pain as the presenting complaint. Remaining 23(6.9%) presented with clinical features other than chest pain. There were 127(38.4%) patients with pre-cordial chest pain, 115(34.7%) had retrosternal chest pain, 58(17.5%) were having epigastric pain. Severe chest pain was seen in 281(84.9%) patients while 26(7.9%) had only mild chest discomfort. Radiation of the pain to shoulder, neck and jaw was seen in 75 (22.7%) patients. In 42(12.7%) patients, pain radiated to both sides of chest. Another 55(16.6%) patients had pain radiation to chest, shoulder, upper arm and ulnar side of left forearm. Chest pain radiation to interscapular region along with both sides of chest was present in 10(3.0%) patients. In 11(3.3%) patients' pain radiated only to left side of chest. Pain persisting for >20 minutes was reported by 298 (90%) patients while only 10(3.1%) had pain persisting for chest pain of cardiac as well as non cardiac causes. However, vigilant evaluation of characteristics of chest pain in history taking may help to overcome this dilemma. Severe and prolonged precordial chest pain in a male patient between the age of 41-70 years

  5. Colon cancer: association of histopathological parameters and patients' survival with clinical presentation.

    Science.gov (United States)

    Alexiusdottir, Kristin K; Snaebjornsson, Petur; Tryggvadottir, Laufey; Jonasson, Larus; Olafsdottir, Elinborg J; Björnsson, Einar Stefan; Möller, Pall Helgi; Jonasson, Jon G

    2013-10-01

    Available data correlating symptoms of colon cancer patients with the severity of the disease are very limited. In a population-based setting, we correlated information on symptoms of colon cancer patients with several pathological tumor parameters and survival. Information on all patients diagnosed with colon cancer in Iceland in 1995-2004 for this retrospective, population-based study was obtained from the Icelandic Cancer Registry. Information on symptoms of patients and blood hemoglobin was collected from patients' files. Pathological parameters were obtained from a previously performed standardized tumor review. A total of 768 patients entered this study; the median age was 73 years. Tumors in patients presenting at diagnosis with visible blood in stools were significantly more likely to be of lower grade, having pushing border, conspicuous peritumoral lymphocytic infiltration, and lower frequency of vessel invasion. Patients with abdominal pain and anemia were significantly more likely to have vessel invasion. Logistic regression showed that visible blood in stools was significantly associated with protecting pathological factors (OR range 0.38-0.83, p < 0.05). Tumors in patients presenting with abdominal pain were strongly associated with infiltrative margin and scarce peritumoral lymphocytic infiltration (OR = 1.95; 2.18 respectively, p < 0.05). Changes in bowel habits were strongly associated with vessel invasion (OR = 2.03, p < 0.05). Cox regression showed that blood in stools predicted survival (HR = 0.54). In conclusion, visible blood in stools correlates significantly with all the beneficial pathological parameters analyzed and with better survival of patients. Anemia, general symptoms, changes in bowel habits, acute symptoms, and abdominal pain correlate with more aggressive tumor characteristics and adverse outcome for patients. © 2013 APMIS Published by Blackwell Publishing Ltd.

  6. Systolic blood pressure at Emergency Department presentation and 1-year mortality in acute chest pain patients.

    Science.gov (United States)

    Irfan, Affan; Haaf, Philip; Meissner, Julia; Twerenbold, Raphael; Reiter, Miriam; Reichlin, Tobias; Schaub, Nora; Zbinden, Anina; Heinisch, Corinna; Drexler, Beatrice; Winkler, Katrin; Mueller, Christian

    2011-10-01

    High blood pressure at rest has been an established risk factor for cardiovascular disease. However the relationship between Systolic Blood Pressure (SBP) and 1-year-mortality among acute chest pain patients presenting to Emergency Department (ED); and effects of preexisting renal insufficiency, hemodynamic stress - as quantified by Brain Natriuretic Peptide (BNP) and chest pain duration, on this relationship is unknown. Data was used from APACE (Advantageous Predictors of Acute Coronary Syndrome Evaluation), a prospective observational multicenter study of 1240 ED chest pain patients. SBP at presentation was categorized into quartiles: Q1≤127mmHg; Q2 128-142mmHg; Q3 143-160mmHg; Q4≥161mmHg. 60 deaths occurred during 1-year. One-year-mortality-rate showed lower Hazard Ratios for Q2, Q3 and Q4 vs Q1 (HR [95% CI]; 0.39 (0.19-0.78), 0.34 (0.17-0.70), 0.35 (0.17-0.72); pPatients showed progressively better prognosis from Q2 through Q4 vs Q1 only in patients who presented to ED with for more than 12h of chest pain duration. Patients with renal insufficiency had lower SBP at presentation than others (p=0.001). There was no association between the outcome and interaction variable of SBP quartiles and BNP (p=0.27). Acute chest pain patients presenting to ED exhibit an inverse association between SBP at presentation and 1-year-mortality; a relationship which appears stronger in those who present with chest pain of greater than 12h duration. Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  7. Strategic Options for Vietnamese Tea Processors in the Global Value Chain

    DEFF Research Database (Denmark)

    Sørensen, Olav Jull; Luong Thi Ngoc, Oanh; Nguyen Thi Hai, Yen

    2009-01-01

    The aim of the chapter is to study the position of Vietnamese tea producers, processors and traders in the Global Value CHain for tea and analyse the strategic options at various levels of the chain. The dominant governance at the Vietnamese level is found to be the market and this puts constraints...... on the possibilities for upgrading and for identifying a local driver of the chain. A few transnational companies dominate the global value chain for tea....

  8. Solvent Free Preparation of p-Cymene from Limonene Using Vietnamese Montmorillonite

    DEFF Research Database (Denmark)

    Nguyen, Thao-Tran Thi; Duus, Fritz; Le, Thach Ngoc

    2013-01-01

    p-Cymene, an important intermediate in industrial chemistry, has been prepared in good yields by thermally induced dehydrogenation of limonene under solvent-free reaction conditions using Vietnamese montmorillonite as an efficient green catalyst.......p-Cymene, an important intermediate in industrial chemistry, has been prepared in good yields by thermally induced dehydrogenation of limonene under solvent-free reaction conditions using Vietnamese montmorillonite as an efficient green catalyst....

  9. Persistent hiccups in cancer patient: A presentation of syndrome of inappropriate antidiuretic hormone induced hyponatremia

    Directory of Open Access Journals (Sweden)

    Alka Goyal

    2013-01-01

    Full Text Available Hyponatremia is quite common in cancer patients, but the presentation as persistent hiccups is not common. Literature over hiccups development due to hyponatremia is quite scant. Hiccups are of various types, persistent hiccups are those that last more than 48 h and remains less than 1 month. Hiccups lasting more than 24 h require investigation for an underlying organic etiology, with hyponatremia included in the differential diagnosis. This paper discusses a carcinoma lip patient presented with the persistent hiccups and unconsciousness post-operatively. The patient was initially responded with trials of both metoclopramide and Ryle′s tube insertion, but eventually, his hiccups resolved only after treatment of hyponatremia. Patient′s clinical course and investigations suggest an etiology of syndrome of inappropriate antidiuretic hormone (SIADH secretion behind the hyponatremia. Study suggested that SIADH linked hyponatremia should be considered in the differential diagnosis of cancer patients with refractory hiccups.

  10. Axillary sentinel node identification in breast cancer patients: degree of radioactivity present at biopsy is critical

    DEFF Research Database (Denmark)

    Nielsen, Kristina R; Oturai, Peter S; Friis, Esbern

    2011-01-01

    The radioactivity present in the patient (Act(rem) ) at sentinel node (SN) biopsy will depend on injected activity amount as well as on the time interval from tracer injection to biopsy, which both show great variations in the literature. The purpose of this study was to analyse the influence...... of varying Act(rem) levels on the outcome of axillary SN biopsy in patients with breast cancer (BC)....

  11. A Patient Presenting with Bilateral Lung Lesions, Pleural Effusion, and Proteinuria

    OpenAIRE

    Katerina D. Samara; Giorgos Papadogiannis; Nicholson, Andrew G; Eleutherios Magkanas; Konstantinos Stylianou; Nikolaos Siafakas; Antoniou, Katerina M.

    2013-01-01

    Diagnosis and management of a systemic vasculitis are among the most demanding challenges in clinical medicine. A patient with a past history of cryptogenic organizing pneumonia presents with new bilateral lung lesions, unilateral pleural effusion, and significant proteinuria. The patient tested p-ANCA and anti-MPO positive but c-ANCA negative. A diagnosis of granulomatosis with polyangiitis GPA was reached after performing both renal and lung biopsies. Step-by-step differential diagnosis and...

  12. A Patient Presenting with Bilateral Lung Lesions, Pleural Effusion, and Proteinuria

    Directory of Open Access Journals (Sweden)

    Katerina D. Samara

    2013-01-01

    Full Text Available Diagnosis and management of a systemic vasculitis are among the most demanding challenges in clinical medicine. A patient with a past history of cryptogenic organizing pneumonia presents with new bilateral lung lesions, unilateral pleural effusion, and significant proteinuria. The patient tested p-ANCA and anti-MPO positive but c-ANCA negative. A diagnosis of granulomatosis with polyangiitis GPA was reached after performing both renal and lung biopsies. Step-by-step differential diagnosis and management are discussed.

  13. Profiling acute presenting symptoms of geriatric patients attending an urban hospital emergency department.

    Science.gov (United States)

    Foo, Chik Loon; Chan, Kim Chai; Goh, Hsin Kai; Seow, Eillyne

    2009-06-01

    To study the profile of geriatric patients warded to the emergency department (ED) of an Asian acute care general hospital and determine if they are 'more ill', more likely to have atypical presentations and have a higher utilisation of healthcare resources when compared to a younger group of patients. This is a retrospective chart review of consecutive patients aged 45 years and above presenting to the study ED over a period of 4 weeks from 4 June 2006 to 1 July 2006. The following data were obtained: (i) demographics, (ii) mode of arrival and triage acuity, (iii) presence of co-morbidities, (iv) investigations ordered in the ED, (v) clinical symptoms and diagnoses, (vi) disposition, (vii) length of hospital stay, (viii) injuries and outcomes of elderly fallers. The study population was divided into 2 groups--a study group with patients aged 65 years and above, and a control group with patients aged 45 to 64. There were 2847 patients in the study group and these were compared against 2875 in the control group. Those 65 years and above had greater representation in the ED population compared to the general population. In the study group, the proportion of females, the number arriving by ambulance and the likelihood of having a higher triage acuity increased with age. The elderly had higher rates of co-morbidities. They also had a higher resource utilisation rate. Falls was their commonest presenting complaint. It is crucial that EDs recognise the special needs of elderly patients due to the growing ageing population. Healthcare policy makers when allocating resources should take into account the profile of elderly patients presenting to an ED and their resource utilisation.

  14. Prevalence and predictors of prior antibacterial use among patients presenting to hospitals in Northern Uganda.

    Science.gov (United States)

    Ocan, Moses; Manabe, Yukari C; Baluku, Hannington; Atukwase, Esther; Ogwal-Okeng, Jasper; Obua, Celestino

    2015-09-25

    Human antibacterial exposure occur in different ways including consumption of animal and agricultural products as well as use of prescribed and non-prescribed agents. We estimated the prevalence and explored the predictors of antibacterial use among patients presenting to hospitals in northern Uganda. Four hundred fifty (450) patients were randomly selected and antibacterial use prior to hospital visit measured using a questionnaire and urine antibacterial activity assay. Urine antibacterial bioassays were performed using American type culture collections of Escherichia coli, Bacillus subtilis and Streptococcus pyogenes. Data were analysed using STATA 12.0 at 95% confidence level. Of 450 patients interviewed, 62.2% had used antibacterial agents. Urine antibacterial activity was detected in 30.4% of the samples tested. Of the 85 patients who reported not taking any antibacterial at home, 16 (18.8%) had urine with antibacterial activity. Most test bacteria, E. coli (74.5%), B. subtilis (72.6%) and S. pyogens (86.7%) were sensitive to urine of patients who reported using antibacterial drugs before hospital visit. From the interview, metronidazole 15.6% (70/450), amoxicillin 12% (54/450), and ciprofloxacin 10.4% (47/450) were the most used antibacterial agents. Patient age (OR, 2.45: 95% CI: 1.02-5.91: P = 0.024), time-lag between last drug intake and hospital visit (OR: 3.18: 95% CI: 1.44-7.0: P antibacterial agents before hospital visit. Community antibacterial use continues to take place in an unregulated manner. In addition, physiciansrarely seek to ascertain prior use of antibacterial agents among patients presenting to hospitals. This couldhave a bearing on patient treatment outcomes. Knowledge of prior antibacterial use among patients presenting to hospitals is useful to physicians in ensuring antibacterial stewardship.

  15. Incidence and risk factors for developing infection in patients presenting with uninfected diabetic foot ulcers.

    Science.gov (United States)

    Jia, Limin; Parker, Christina N; Parker, Tony J; Kinnear, Ewan M; Derhy, Patrick H; Alvarado, Ann M; Huygens, Flavia; Lazzarini, Peter A

    2017-01-01

    There is a paucity of research on patients presenting with uninfected diabetic foot ulcers (DFU) that go on to develop infection. We aimed to investigate the incidence and risk factors for developing infection in a large regional cohort of patients presenting with uninfected DFUs. We performed a secondary analysis of data collected from a validated prospective state-wide clinical diabetic foot database in Queensland (Australia). Patients presenting for their first visit with an uninfected DFU to a Diabetic Foot Service in one of thirteen Queensland regions between January 2012 and December 2013 were included. Socio-demographic, medical history, foot disease history, DFU characteristics and treatment variables were captured at the first visit. Patients were followed until their DFU healed, or if their DFU did not heal for 12-months, to determine if they developed a foot infection in that period. Overall, 853 patients were included; mean(standard deviation) age 62.9(12.8) years, 68.0% male, 90.9% type 2 diabetes, 13.6% indigenous Australians. Foot infection developed in 342 patients for an overall incidence of 40.1%; 32.4% incidence in DFUs healed infection were: DFUs healed between 3-12 months (2.3 (1.6-3.3)), deep DFUs (2.2 (1.2-3.9)), peripheral neuropathy (1.8 (1.1-2.9)), previous DFU history (1.7 (1.2-2.4)), foot deformity (1.4 (1.0-2.0)), female gender (1.5 (1.1-2.1)) and years of age (0.98 (0.97-0.99)) (all pinfection prior to healing. To prevent infection clinicians treating patients with uninfected DFUs should be particularly vigilant with those presenting with deep DFUs, previous DFU history, peripheral neuropathy, foot deformity, younger age, female gender and DFUs that have not healed by 3 months after presentation.

  16. Peer-level patient presenters decrease pharmacy students' social distance from patients with schizophrenia and clinical depression.

    Science.gov (United States)

    Buhler, Amber V; Karimi, Reza M

    2008-10-15

    To create a doctor of pharmacy curricular experience that will decrease students' social barriers to interaction with and treatment of mentally-ill patients. We created a survey instrument to measure 4 aspects of students' conceptions of schizophrenia and clinical depression: (1) understanding of the medical nature of each disease, (2) understanding of patient behavior, (3) belief in the efficacy of treatment, and (4) social distance. We delivered this instrument before and after a neuropsychiatry curriculum including "peer-level patient presenters" in addition to the traditional first-year pharmacy curriculum. Social-distance scores significantly decreased in first-year pharmacy students who attended peer-level patient presentations, indicating increased willingness to interact with persons with schizophrenia and clinical depression. In addition, students' understanding of the causes of illness, behavior of patients, and most importantly, efficacy of drug counseling for these diseases increased. Changes to the curriculum including the addition of peer-level patient presentations can quantitatively decrease pharmacy students' social barriers to the treatment of mentally-ill patients.

  17. [The psychological characteristics of the patients presenting with Meniere's disease and their psycho-social adaptation].

    Science.gov (United States)

    Iaroslavskaia, M A; Petrovskaia, A N

    2013-01-01

    The objective of the present work was to highlight and systematize the current scientific concepts of the role of psychological factors in the psycho-social adaptation of the patients presenting the Meniere's disease. The authors analysed the data concerning the psycho-social adaptation of the patients presenting with this condition that were published in the scientific literature during many years. The detailed analysis of the psychological characteristics of the patients allowed to reveal peculiarities of their psychological response to the disease and conserved personal-environmental resources that can be used in the development of stress-adaptation models for the psychological correction and psychotherapeutic treatment with a view to their subsequent introduction into the routine clinical practice of healthcare service institutions.

  18. Pleural and pericardial effusion in a patient with polymyalgia rheumatica: a case presentation.

    Science.gov (United States)

    Sánchez Ruiz-Granados, Elena; del Castillo Madrigal, Matilde; Romero Jiménez, Manuel Jesús

    2013-01-01

    Polymyalgia rheumatica is an inflammatory rheumatic disease that presents with bilateral pain and stiffness affecting mainly proximal muscles. It affects individuals over 50 years of age and it is usually associated with a raised erythrocyte sedimentation rate. Classically, treatment with low-dose corticosteroids results in a dramatic improvement in both symptoms and laboratory findings. We report the case of an 80 years old patient presenting polymyalgia rheumatica coinciding with pleuropericardial effusion. The patient had a very good response to treatment with rapid improvement in the symptomatology and laboratory findings. Polymyalgia Rheumatica is a common disease but it is rarely associated to pleuropericardial effusion. It should be considered in the differential diagnostic in patients presenting with pericardial effusion over 50 of age years due to the good response to treatment. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  19. Comparison of antifungal activities of Vietnamese citrus essential oils.

    Science.gov (United States)

    Van Hung, Pham; Chi, Pham Thi Lan; Phi, Nguyen Thi Lan

    2013-03-01

    Citrus essential oils (EOs) are volatile compounds from citrus peels and widely used in perfumes, cosmetics, soaps and aromatherapy. In this study, inhibition of citrus EOs extracted from Vietnamese orange (Citrus sinensis), mandarin (Citrus reticulata Blanco), pomelo (Citrus grandis Osbeck) and lime (Citrus aurantifolia Swingle) on the growth of plant pathogenic fungi, Mucor hiemalis, Penicillium expansum and Fusarium proliferatum was investigated. The EOs of the citrus peels were obtained by cold-pressing method and the antifungal activity of EOs was evaluated using the agar dilution method. The results show that the EOs had significant antifungal activity. Lime EO was the best inhibitor of M. hiemalis and F. proliferatum while pomelo EO was the most effective against P. expansum. These results indicate that citrus EOs can be used as antifungal natural products in the food, pharmaceutical and cosmetic industries.

  20. The impact of minimum wage adjustments on Vietnamese wage inequality

    DEFF Research Database (Denmark)

    Hansen, Henrik; Rand, John; Torm, Nina

    Using Vietnamese Labour Force Survey data we analyse the impact of minimum wage changes on wage inequality. Minimum wages serve to reduce local wage inequality in the formal sectors by decreasing the gap between the median wages and the lower tail of the local wage distributions. In contrast, local...... wage inequality is increased in the informal sectors. Overall, the minimum wages decrease national wage inequality. Our estimates indicate a decrease in the wage distribution Gini coefficient of about 2 percentage points and an increase in the 10/50 wage ratio of 5-7 percentage points caused...... by the adjustment of the minimum wages from 2011to 2012 that levelled the minimum wage across economic sectors....

  1. Diversity and taxonomy of Vietnamese Pollicaria (Gastropoda, Pupinidae

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    Russell L. Minton

    2017-02-01

    Full Text Available Species in the genus Pollicaria (Gastropoda: Pupinidae are conspicuous members of the southeast Asian land snail fauna. Originally erected in 1856, both the genus and its constituent species have been reorganized multiple times with the most recent treatment published in 2013. Collections of Vietnamese Pollicaria during 2014 and 2015 raised questions of the utility of currently used diagnostic shell characters and identification keys in species identification. An examination of the authors’ collections, combined with museum specimens, suggested that at least three species of Pollicaria occur or have historically occurred in Vietnam. It is suggested that P. rochebruni is a senior synonym of P. crossei and treat both taxa as conspecific. A second species, P. mouhoti, was believed to only occur in Cambodia, Laos, and Thailand. A possible third species, based only on previous karyotypic work, is discussed. Our data further suggest that shell features such as color and size lack consistent utility in species-level identifications in Pollicaria.

  2. Further Highly Hydroxylated Steroids from the Vietnamese Starfish Archaster typicus.

    Science.gov (United States)

    Hanh, Tran Thi Hong; Vien, Le Thi; Vinh, Le Ba; Thanh, Nguyen Van; Cuong, Nguyen Xuan; Nam, Nguyen Hoai; Thung, Do Cong; Kiem, Phan Van; Minh, Chau Van

    2016-01-01

    Eight highly hydroxylated steroids (1-8), including three new compounds as sodium salts of (24S)-5α-cholestane-3β,4β,5,6α,7β,8,14,15α,24-nonaol 6-sulfate (1), (24E)-5α-cholest-24-ene-26-yde-3β,6α,8,14,15α-pentaol 15-sulfate (2), and 5α-cholest-3β,6α,8,14,15α,24,25,26-octaol 15-sulfate (3), were isolated and elucidated from the methanol extract of the Vietnamese starfish Archaster typicus. The structure elucidation was done by spectroscopic methods including one and two dimensional (1D-, 2D-)NMR and Fourier transform ion cyclotron resonance (FT-ICR)-MS. The isolated compounds can be used as chemical markers for taxonomic identification of the starfish A. typicus.

  3. Gender matters: Private sector training in Vietnamese SMEs

    DEFF Research Database (Denmark)

    Trifkovic, Neda; Bjerge, Benedikte Alkjærsig; Torm, Nina

    In many developing countries the skill base is a cause of concern with respect to international competition. Firm-provided training is generally seen as an important tool for bridging the skills gap between labour force and private sector demand. Yet little is known about how successful such trai......In many developing countries the skill base is a cause of concern with respect to international competition. Firm-provided training is generally seen as an important tool for bridging the skills gap between labour force and private sector demand. Yet little is known about how successful...... such training may be in closing the gender wage gap. We use a matched employer–employee panel dataset to assess why firms train and whether formal training affects wage outcomes in Vietnamese SMEs. Training is generally found to be firm-sponsored and specific in nature. We find that training is associated...

  4. Hepatitis B Stigma and Knowledge among Vietnamese in Ho Chi Minh City and Chicago

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    Lan Dam

    2016-01-01

    Full Text Available Stigma regarding viral hepatitis and liver disease has psychological and social consequences including causing negative self-image, disrupting relationships, and providing a barrier to prevention, testing, and treatment. The aim of this study was to characterize and compare HBV knowledge and stigma in Vietnamese in Ho Chi Minh City and Chicago and to begin to evaluate the cultural context of HBV stigma. Methods. A written survey including knowledge questions and a validated HBV stigma questionnaire was distributed to Vietnamese in Ho Chi Minh City and Chicago. 842 surveys from Ho Chi Minh City and 170 from Chicago were analyzed. Results. Vietnamese living in Chicago had better understanding of HBV transmission and that HBV can cause chronic infection and liver cancer. Vietnamese in Chicago had higher stigma scores on a broad range of items including guilt and shame about HBV and were more likely to feel that persons with HBV can bring harm to others and should be isolated. Conclusions. Vietnamese in Ho Chi Minh City and Chicago have knowledge deficits about HBV, particularly regarding modes of transmission. Persons in Ho Chi Minh City expressed lower levels of HBV stigma than Vietnamese living in Chicago, likely reflecting changing cultural attitudes in Vietnam. Culturally appropriate educational initiatives are needed to address the problem of HBV stigma.

  5. Triple negative breast cancer patients presenting with low serum vitamin D levels: a case series

    Science.gov (United States)

    Khan, Yasir; Tisman, Glenn

    2009-01-01

    Introduction Serum vitamin D levels measured as 25-hydroxyvitamin D have been shown to be low in cancer patients, including breast cancer patients. However, the vitamin D status has yet to be studied in different breast cancer phenotypes: luminal A, luminal B, HER2+/ER-, and triple negative comprising the majority of basal-like. Case presentation Fifteen triple-negative breast cancer patients have presented to our medical oncology office in the last five years. Thirteen of these fifteen patients (87%) were found to be vitamin D deficient, defined as serum 25(OH)D less than 80 nmol/L, prior to initiation of adjuvant therapy. Ninety-one breast cancer patients from our office were classified as: luminal A (ER+ &/or PR+ and HER2-), luminal B (ER+ &/or PR+ and HER2+), HER2+/ER- (ER-, PR-, and HER2+), and triple-negative or basal-like (ER-, PR-, and HER2-). A normal mean was found from 78 volunteers. The breast cancer patients were found to be statistically different than the normal population. The triple-negative phenotype was found to be the most statistically different than the normal population. Conclusion The triple-negative breast cancer phenotype has the lowest average vitamin D level and the highest percentage of patients that are vitamin D deficient. These data suggests that low vitamin D levels are characteristic of the triple-negative phenotype. PMID:19830074

  6. Urgent penectomy in a patient presenting with epidermoid carcinoma of the penis associated to myiasis

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    Antonio J. Tavares

    2007-08-01

    Full Text Available The objective of this study is to describe the case of a patient presenting advanced epidermoid carcinoma of the penis associated to myiasis. A 41-year-old patient presenting with a necrotic lesion of the distal third of the penis infested with myiasis was attended in the emergency room of our hospital and was submitted to an urgent penectomy. This is the first case of penile cancer associated to myiasis described in the literature. This case reinforces the need for educative campaigns to reduce the incidence of this disease in developing countries.

  7. An unusual case of a patient with extreme fixed neck flexion presenting for emergency abdominal surgery.

    Science.gov (United States)

    Oleyar, Michael; Neustein, Steven M

    2009-10-01

    Patients with a known difficult airway for intubation who present with intestinal obstruction are at an increased risk for receiving general anesthesia. It may be necessary to perform an awake fiberoptic intubation, or possibly a tracheostomy if an awake intubation cannot be performed. In some cases, an awake tracheostomy may not be possible due to the anatomy. We report a case in which a patient with extreme fixed neck flexion deformity in whom a tracheostomy would not have been possible, presented for emergency abdominal surgery.

  8. When pacemakers fail: an analysis of clinical presentation and risk in 120 patients with failed devices.

    Science.gov (United States)

    Nanthakumar, K; Dorian, P; Ham, M; Lam, P; Lau, C; Nishimura, S; Newman, D

    1998-01-01

    Although pacemaker recalls are common, the optimal mechanism for risk assessment and triage of patients at risk for sudden loss of device system function is unknown. A retrospective chart review of 120 patients with factory proven failed devices was performed. Logistic regression analysis was used to determine clinical correlates of emergency room versus outpatient clinic presentation at time of device failure. Twenty-two patients (18%) presented to emergency and 98 (82%) to clinic. Sixty-three devices had no device output at the time of presentation. Multivariate logistic regression analysis revealed that antiarrhythmic drug use (odds ratio: 7.4, 95% CI: 2.0-28.0), atrioventricular nodal disease as an indication for pacing (odds ratio: 2.8, 95% CI: 1.2-3.0), and female gender (odds ratio: 2.2, 95% CI: 1.0-4.5) were the only significant correlates of emergency room presentations. Pacemaker dependency (escape heart rate < 40 beats/min) did not correlate with location of presentation even though no device output at the time of presentation was associated with emergency room presentation (odds ratio: 2.5, 95% CI: 1.1-5.8). Neither the presence of structural heart disease nor symptoms at the time of device implantation (syncope or presyncope) were correlated with location of presentation upon unexpected device failure. Although there were no deaths in the 120 failed devices studied, there were 26 deaths in the total group of 227 patients with recalled devices that could not be studied. Antiarrhythmic drug use, electrocardiographic pacing indication, and female gender may be more sensitive predictors of emergency room presentation and significant symptoms in the event of unanticipated pacemaker failure. The inability of any retrospective analysis to accurately assess mortality in the setting of pacemaker system failure underscores the need for prospective databases in recall situations.

  9. Endobronchial Enigma: A Clinically Rare Presentation of Nocardia beijingensis in an Immunocompetent Patient

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    Nader Abdel-Rahman

    2015-01-01

    Full Text Available Nocardiosis is an opportunistic infection caused by the Gram-positive weakly acid-fast, filamentous aerobic Actinomycetes. The lungs are the primary site of infection mainly affecting immunocompromised patients. In rare circumstances even immunocompetent hosts may also develop infection. Diagnosis of pulmonary nocardiosis is usually delayed due to nonspecific clinical and radiological presentations which mimic fungal, tuberculous, or neoplastic processes. The present report describes a rare bronchoscopic presentation of an endobronchial nocardial mass in a 55-year-old immunocompetent woman without underlying lung disease. The patient exhibited signs and symptoms of unresolving community-acquired pneumonia with a computed tomography (CT scan that showed a space-occupying lesion and enlarged paratracheal lymph node. This patient represents the unusual presentation of pulmonary Nocardia beijingensis as an endobronchial mass. Pathology obtained during bronchoscopy demonstrated polymerase chain reaction (PCR confirmation of nocardiosis. Symptoms and clinical findings improved with antibiotic treatment. This patient emphasizes the challenge in making the diagnosis of pulmonary nocardiosis, especially in a low risk host. A literature review presents the difficulties and pitfalls in the clinical assessment of such an individual.

  10. Factors associated with mortality in patients presenting to the emergency department with severe hypernatremia.

    Science.gov (United States)

    Ates, Ihsan; Özkayar, Nihal; Toprak, Güvenç; Yılmaz, Nisbet; Dede, Fatih

    2016-04-01

    Hypernatremia is a common electrolyte disorder associated with prolonged hospitalization and death. Severe hypernatremia is defined as a serum sodium (Na(+)) concentration >160 mmol/L. To the best of our knowledge, there is little information on patients with severe hypernatremia, Na(+) >160 mmol/L. Therefore, in this study, we aimed to determine the frequency, demographic and clinical characteristics, comorbid conditions and treatment strategies in patients presenting to the emergency department with severe hypernatremia, and also to evaluate the effects of these factors on mortality. A retrospective chart review was performed on patients presenting to the emergency department between January 2011 and June 2014. Patients with Na(+) >160 mmol/L were screened retrospectively via the hospital electronic information management system and patient medical record files. During the 3.5 years of screening, 256 patients (0.04 %) with Na(+) >160 mmol/L presented to the emergency department. The mean age of the patients included in the study was 74.4 ± 15.2 years, mean Na(+) level was 168.7 ± 7.4 mmol/L and, mean mortality was 49.5 % during the hospitalization. Multivariable Cox regression analysis showed that low systolic blood pressure, low pH, Na(+) >166 mmol/L, increased plasma osmolarity, mean sodium reduction rate ≤-0.134 mmol/L/h, dehydration, and, pneumonia to be independently associated with mortality. This study describes the demographic and clinical characteristics of patients with Na(+) >160 mmol/L in a large population along with comorbid conditions, incidence, treatment strategies and, its association with mortality.

  11. Long-Term Cardiovascular Outcomes In Patients With Angina Pectoris Presenting With Bundle Branch Block

    Science.gov (United States)

    Bansilal, Sameer; Aneja, Ashish; Mathew, Verghese; Reeder, Guy S.; Smars, Peter A.; Lennon, Ryan J.; Wiste, Heather J.; Traverse, Kay; Farkouh, Michael E.

    2011-01-01

    The long-term outcomes of unselected patients with angina pectoris and a bundle branch block (BBB) on the initial electrocardiogram are not well established. The Olmsted County Chest Pain Study is a community-based cohort of 2271 consecutive patients presenting to three Olmsted County emergency departments with angina from 1985 to 1992. Patients were followed for major adverse cardiovascular events (MACE) including death, myocardial infarction, stroke and revascularization at 30 days and over a median follow-up period of 7.3 years and for mortality only through a median of 16.6 years. Cox models were used to estimate the associations between bundle branch block and cardiovascular outcomes. The mean age of the cohort on presentation was 63 years, with 58% men. MACE at 30 days occurred in 11% with RBBB, 8.8 % with LBBB and 6.4 % in patients without BBB (p=0.17). Over a median follow-up of 7.3 years, patients with BBB were at higher risk for MACE (RBBB HR 1.85, 95% CI 1.44–2.38; p<0.001 and LBBB HR 2.04, 95% CI 1.62–2.56; p<0.001) compared to those without BBB. Over a median of 16.6 years, both BBB groups had lower survival rates than patients without BBB (RBBB HR 2.19, 95% CI 1.73–2.78; p<0.001 and LBBB HR 3.32, 95% CI 2.67–4.13; p ≤ 0.001), but after adjustment for multiple risk factors, an increased risk of mortality for LBBB remained significant. In conclusion, the appearance of LBBB or RBBB in patients presenting with angina predicts adverse long-term cardiovascular outcomes compared to patients without BBB. PMID:21439535

  12. Magnetic resonance imaging findings in patients presenting with (sub)acute cerebellar ataxia

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Tanja [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Neuroradiology, Hamburg (Germany); The Johns Hopkins Hospital School of Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Neuroradiology, Baltimore, MD (United States); Thomalla, Goetz [University Medical Center Hamburg-Eppendorf, Department of Neurology, Hamburg (Germany); Goebell, Einar [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Neuroradiology, Hamburg (Germany); Piotrowski, Anna [The Johns Hopkins University School of Medicine, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD (United States); Yousem, David Mark [The Johns Hopkins Hospital School of Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Neuroradiology, Baltimore, MD (United States)

    2015-02-17

    Acute or subacute cerebellar inflammation is mainly caused by postinfectious, toxic, neoplastic, vascular, or idiopathic processes and can result in cerebellar ataxia. Previous magnetic resonance (MR) studies in single patients who developed acute or subacute ataxia showed varying imaging features. Eighteen patients presenting with acute and subacute onset of ataxia were included in this study. Cases of chronic-progressive/hereditary and noncerebellar causes (ischemia, multiple sclerosis lesions, metastasis, bleedings) were excluded. MR imaging findings were then matched with the clinical history of the patient. An underlying etiology for ataxic symptoms were found in 14/18 patients (postinfectious/infectious, paraneoplastic, autoimmune, drug-induced). In two of five patients without MR imaging findings and three of eight patients with minimal imaging features (cerebellar atrophy, slight signal alterations, and small areas of restricted diffusion), adverse clinical outcomes were documented. Of the five patients with prominent MR findings (cerebellar swelling, contrast enhancement, or broad signal abnormalities), two were lost to follow-up and two showed long-term sequelae. No correlation was found between the presence of initial MRI findings in subacute or acute ataxia patients and their long-term clinical outcome. MR imaging was more flagrantly positive in cases due to encephalitis. (orig.)

  13. Tuberculosis and pulmonary candidiasis co-infection present in a previously healthy patient.

    Science.gov (United States)

    Fontalvo, Dilia Mildret; Jiménez Borré, Gustavo; Gómez Camargo, Doris; Chalavé Jiménez, Neylor; Bellido Rodríguez, Javier; Cuadrado Cano, Bernarda; Navarro Gómez, Shirley

    2016-06-30

    The coexistance among fungal pathogens and tuberculosis pulmonary is a clinical condition that generally occurs in immunosuppressive patients, however, immunocompetent patients may have this condition less frequently. We report the case of an immunocompetent patient diagnosed with coinfection Mycobacterium tuberculosis and Candida albicans. A female patient, who is a 22-years old, with fever and a new onset of hemoptysis. Diminished vesicular breath sounds in the apical region and basal crackling rales in the left lung base were found in the physical examination. Microbiological tests include: chest radiography and CAT scan pictograms in high resolution, Ziehl-Neelsen stain, growth medium for fungus and mycobacteria through Sabouraudís agar method with D-glucose. Medical examinations showed Candida albicans fungus and Mycobacterium tuberculosis present in the patient. Patient was treated with anti-tuberculosis and anti-fungal medications, which produced good responses. Pulmonary tuberculosis and fungal co-infection are not common in immunocompetent patients. However, we can suspect that there is a presence of these diseases by detecting new onset of hemoptysis in patients.

  14. Patients with worsening chronic heart failure who present to a hospital emergency department require hospital care

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    Shafazand Masoud

    2012-03-01

    Full Text Available Abstract Background Chronic heart failure (CHF is a major public health problem characterised by progressive deterioration with disabling symptoms and frequent hospital admissions. To influence hospitalisation rates it is crucial to identify precipitating factors. To characterise patients with CHF who seek an emergency department (ED because of worsening symptoms and signs and to explore the reasons why they are admitted to hospital. Method Patients (n = 2,648 seeking care for dyspnoea were identified at the ED, Sahlgrenska University Hospital/Östra. Out of 2,648 patients, 1,127 had a previous diagnosis of CHF, and of these, 786 were included in the present study with at least one sign and one symptom of worsening CHF. Results Although several of the patients wanted to go home after acute treatment in the ED, only 2% could be sent home. These patients were enrolled in an interventional study, which evaluated the acute care at home compared to the conventional, in hospital care. The remaining patients were admitted to hospital because of serious condition, including pneumonia/respiratory disease, myocardial infarction, pulmonary oedema, anaemia, the need to monitor cardiac rhythm, pathological blood chemistry and difficulties to communicate. Conclusion The vast majority of patients with worsening CHF seeking the ED required hospital care, predominantly because of co-morbidities. Patients with CHF with symptomatic deterioration may be admitted to hospital without additional emergency room investigations.

  15. Utility of penicillin allergy testing in patients presenting with a history of penicillin allergy.

    Science.gov (United States)

    Sagar, Priyanka S; Katelaris, Constance H

    2013-04-01

    Current statistics show that approximately 10% of patients claim to be allergic to penicillin yet only 10% of these have demonstrable allergy. The most appropriate and cost-effective antibiotics are sometimes withheld on the basis of patient history of drug allergy. Investigation of IgE hypersensitivity and delayed hypersensitivity in patients with a history of penicillin allergy to a teaching hospital allergy clinic. Patients underwent skin prick and intradermal testing (IDT) with major and minor penicillin determinants. Those with negative skin tests were administered a three-day oral challenge. Demographic and clinical details about the reactions were noted. One hundred twenty eight patients underwent testing, of these, one hundred and ten had self-reported histories of penicillin allergy and eighteen were referred because of other antibiotic allergies. Seventeen patients with self-reported penicillin allergy had either positive skin tests or oral challenge results, corresponding to 15% of patients having proven allergy. None reacted on skin prick testing, four reacted to IDT, thirteen reacted to oral challenge (five immediate and eight delayed). Analysis of clinical histories showed that patients with a well-defined history of allergy and a history of anaphylaxis were more likely to have a positive test compared to patients with vague histories. Skin testing proved to be less sensitive than oral challenge. A minority of patients presenting with a history of penicillin allergy have evidence of immune-mediated hypersensitivity (17/110, 15%) in this study. Of these, eight out of seventeen (47%) had delayed reactions, demonstrating the usefulness and discriminating power of objective testing, which must include three-day oral challenge. Discriminating factors for immune-mediated allergy from patient history were a clear description of the original reaction and a history of anaphylaxis. Negative allergy testing enables the use of penicillin as first-line treatment

  16. How Cardiologists Present the Benefits of Percutaneous Coronary Interventions to Patients With Stable Angina

    Science.gov (United States)

    Goff, Sarah L.; Mazor, Kathleen M.; Ting, Henry H.; Kleppel, Reva; Rothberg, Michael B.

    2015-01-01

    Importance Patients with stable coronary artery disease (CAD) attribute greater benefit to percutaneous coronary interventions (PCI) than indicated in clinical trials. Little is known about how cardiologists' presentation of the benefits and risks may influence patients' perceptions. Objectives To broadly describe the content of discussions between patients and cardiologists regarding angiogram and PCI for stable CAD, and to describe elements that may affect patients' understanding. Design, Setting, and Participants Qualitative content analysis of encounters between cardiologists and patients with stable CAD who participated in the Verilogue Point-of-Practice Database between March 1, 2008, and August 31, 2012. Transcripts in which angiogram and PCI were discussed were retrieved from the database. Patients were aged 44 to 88 years (median, 64 years); 25% were women; 50% reported symptoms of angina; and 6% were taking more than 1 medication to treat angina. Main Outcomes and Measures Results of conventional and directed qualitative content analysis. Results Forty encounters were analyzed. Five major categories and subcategories of factors that may affect patients' understanding of benefit were identified: (1) rationale for recommending angiogram and PCI (eg, stress test results, symptoms, and cardiologist's preferences); (2) discussion of benefits (eg, accurate discussion of benefit [5%], explicitly overstated benefit [13%], and implicitly overstated benefit [35%]); (3) discussion of risks (eg, minimization of risk); (4) cardiologist's communication style (eg, humor, teach-back, message framing, and failure to respond to patient questions); and (5) patient and family member contributions to the discussion. Conclusions and Relevance Few cardiologists discussed the evidence-based benefits of angiogram and PCI for stable CAD, and some implicitly or explicitly overstated the benefits. The etiology of patient misunderstanding is likely multifactorial, but if future

  17. A Prospective Analysis of Patients Presenting for Medical Attention at a Large Electronic Dance Music Festival.

    Science.gov (United States)

    Friedman, Matt S; Plocki, Alex; Likourezos, Antonios; Pushkar, Illya; Bazos, Andrew N; Fromm, Christian; Friedman, Benjamin W

    2017-02-01

    Mass-Gathering Medicine studies have identified variables that predict greater patient presentation rates (PPRs) and transport to hospital rates (TTHRs). This is a descriptive report of patients who presented for medical attention at an annual electronic dance music festival (EDMF). At this large, single EDMF in New York City (NYC; New York, USA), the frequency of patient presentation, the range of presentations, and interventions performed were identified. This descriptive report examined consecutive patients who presented to the medical tent of a summertime EDMF held at an outdoor venue with an active, mobile, bounded crowd. Alcohol was available for sale. Entry was restricted to persons 18 years and older. The festival occurred on three consecutive days with a total cumulative attendance of 58,000. Medical staffing included two Emergency Medicine physicians, four registered nurses, and 86 Emergency Medical Services (EMS) providers. Data collected included demographics, past medical history, vital signs, physical exam, drug and alcohol use, interventions performed, and transport decisions. Eighty-four patients were enrolled over 2.5 days. Six were transported and zero died. The ages of the subjects ranged from 17 to 61 years. Forty-three (51%) were male. Thirty-eight (45%) initially presented with abnormal vital signs; four (5%) were hyperthermic. Of these latter patients, 34 (90%) reported ingestions with 3,4-methylenedioxymethamphetamine (MDMA) or other drugs. Eleven (65%) patients were diaphoretic or mydriatic. The most common prehospital interventions were intravenous normal saline (8/84; 10%), ondansetron (6/84; 7%), and midazolam (3/84; 4%). Electronic dance music festivals are a growing trend and a new challenge for Mass-Gathering Medicine as new strategies must be employed to decrease TTHR and mortality. Addressing common and expected medical emergencies at mass-gathering events through awareness, preparation, and early, focused medical interventions may

  18. Functional Imaging Signature of Patients Presenting with Polycythemia/Paraganglioma Syndromes.

    Science.gov (United States)

    Janssen, Ingo; Chen, Clara C; Zhuang, Zhenping; Millo, Corina M; Wolf, Katherine I; Ling, Alexander; Lin, Frank I; Adams, Karen T; Herscovitch, Peter; Feelders, Richard A; Fojo, Antonio T; Taieb, David; Kebebew, Electron; Pacak, Karel

    2017-08-01

    Pheochromocytoma/paraganglioma (PPGL) syndromes associated with polycythemia have previously been described in association with mutations in the von Hippel-Lindau gene. Recently, mutations in the prolyl hydroxylase gene (PHD) 1 and 2 and in the hypoxia-inducible factor 2 α (HIF2A) were also found to be associated with multiple and recurrent PPGL. Such patients also presented with PPGL and polycythemia, and later on, some presented with duodenal somatostatinoma. In additional patients presenting with PPGL and polycythemia, no further mutations have been discovered. Because the functional imaging signature of patients with PPGL-polycythemia syndromes is still unknown, and because these tumors (in most patients) are multiple, recurrent, and metastatic, the goal of our study was to assess the optimal imaging approach using 4 different PET radiopharmaceuticals and CT/MRI in these patients. Methods: Fourteen patients (10 women, 4 men) with confirmed PPGL and polycythemia prospectively underwent (68)Ga-DOTATATE (13 patients), (18)F-FDG (13 patients), (18)F-fluorodihydroxyphenylalanine ((18)F-FDOPA) (14 patients), (18)F-fluorodopamine ((18)F-FDA) (11 patients), and CT/MRI (14 patients). Detection rates of PPGL lesions were compared between all imaging studies and stratified between the underlying mutations. Results:(18)F-FDOPA and (18)F-FDA PET/CT showed similar combined lesion-based detection rates of 98.7% (95% confidence interval [CI], 92.7%-99.8%) and 98.3% (95% CI, 90.9%-99.7%), respectively. The detection rates for (68)Ga-DOTATATE (35.3%; 95% CI, 25.0%-47.2%), (18)F-FDG (42.3; 95% CI, 29.9%-55.8%), and CT/MRI (60.3%; 95% CI, 48.8%-70.7%) were significantly lower (P < 0.01), irrespective of the mutation status. Conclusion:(18)F-FDOPA and (18)F-FDA are superior to (18)F-FDG, (68)Ga-DOTATATE, and CT/MRI and should be the radiopharmaceuticals of choice in this rare group of patients. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  19. Clinical predictors of psychological distress in patients presenting for evaluation of a spinal disorder.

    Science.gov (United States)

    Daubs, Michael D; Hung, Man; Adams, Jacob R; Patel, Alpesh A; Lawrence, Brandon D; Neese, Ashley M; Brodke, Darrel S

    2014-09-01

    Psychological distress has been shown to adversely affect the treatment outcomes of many spinal disorders. Most physicians do not routinely use psychological screening questionnaires. Additionally, physicians have not performed well when assessing patients for psychological distress while using clinical impression alone. The purpose of our study was to evaluate the clinical factors that most accurately predict the presence of psychological distress in patients presenting for the evaluation of a spinal disorder. This is a retrospective study. Three hundred eighty-eight consecutive patients presented for an initial evaluation of a spinal disorder at a tertiary spine clinic. Oswestry disability index (ODI), visual analog scale (VAS), and distress risk assessment method (DRAM). Three hundred eighty-eight consecutive patients presenting for the evaluation of a spinal disorder with a completed DRAM, ODI, and VAS were evaluated. The DRAM was used to classify the patients' level of psychological distress. Clinical variables such as history of depression, use of antidepressants, use of other psychotropic medications, history of surgery, and history of chronic pain syndromes along with ODI and VAS scores were used to develop a model to predict a patient's level of psychological distress. Our model was highly accurate (92%), sensitive (92%), and specific (95%) in predicting a patient's level of psychological distress. If patients' VAS is 4 or 5, their ODI is less than 45, and they are not on any psychotropic medications, they likely will fall into the normal group. Patients with a VAS greater than 7, currently taking antidepressants or other psychotropic medications, an ODI greater than 58, and a history of surgery are likely to fall into the higher distressed categories of distressed depressive or distressed somatic. A patient's clinical history, ODI, and VAS scores can predict their level of psychological distress. In general, patients with higher VAS pain scores, higher

  20. Variations in the Presentation of Aphasia in Patients with Closed Head Injuries

    OpenAIRE

    Kavanagh, Dara Oliver; Lynam, Conor; Düerk, Thorsten; Casey, Mary; Eustace, Paul W.

    2010-01-01

    Impairments of speech and language are important consequences of head injury as they compromise interaction between the patient and others. A large spectrum of communication deficits can occur. There are few reports in the literature of aphasia following closed head injury despite the common presentation of closed head injury. Herein we report two cases of closed head injuries with differing forms of aphasia. We discuss their management and rehabilitation and present a detailed literature rev...

  1. A Case Report of a Neurobrucellosis Patient Presenting Prolonged Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    Sheikholeslami N

    2011-01-01

    Full Text Available Background and Objectives: Brucellosis is a zoonotic disease with various misleading clinical manifestations. One of them is the involvement of central nervous system which has a broad range of clinical manifestations. Improvement of knowledge among medical professionals about its different clinical presentation can lead them to better diagnosis and treatment. Case Report: In this report, we presented a neurobrucellosis patient with chief complaint of 4 month-nausea and vomiting.

  2. ANMCO-SIMEU Consensus Document: in-hospital management of patients presenting with chest pain

    OpenAIRE

    Zuin, Guerrino; Parato, Vito Maurizio; Groff, Paolo; Gulizia, Michele Massimo; Di Lenarda, Andrea; Cassin, Matteo; Cibinel, Gian Alfonso; Del Pinto, Maurizio; Di Tano, Giuseppe; Nardi, Federico; Rossini, Roberta; Ruggieri, Maria Pia; Ruggiero, Enrico; Scotto di Uccio, Fortunato; Valente, Serafina

    2017-01-01

    Abstract Chest pain is a common general practice presentation that requires careful diagnostic assessment because of its diverse and potentially serious causes. However, the evaluation of acute chest pain remains challenging, despite many new insights over the past two decades. The percentage of patients presenting to the emergency departments because of acute chest pain appears to be increasing. Nowadays, there are two essential chest pain-related issues: (i) the missed diagnoses of acute co...

  3. Outcome and Risk Factors Presented in Old Patients Above 80 Years of Age Versus Younger Patients After Ischemic Stroke

    DEFF Research Database (Denmark)

    Bentsen, Line; Christensen, Louisa; Christensen, Anders

    2014-01-01

    . METHODS: The analysis was based on consecutive patients admitted within 6 hours after stroke onset and discharged with ischemic stroke, surviving at least 3 months after ictus. To prevent bias, the analysis was based on a registry from before implementation of tissue plasminogen activator treatment; all...... of age or older presented with significantly more severe strokes than younger patients, median Scandinavian Stroke Scale score 39 vs 42 (P = .003). Median mRS score before stroke was significantly higher in patients aged 80 years or older (P ictus (P...

  4. Halogenated organics in Vietnamese and in Vietnam food. Dioxins, dibenzofurans, PCBs, polybrominated diphenyl ethers and selected pesticides

    Energy Technology Data Exchange (ETDEWEB)

    Schecter, A.; Tung, K.C. [Univ. of Texas School of Public Health at Dallas, TX (United States); Quynh, Hong Trong [Oncology Institute, Ha Noi, Vietnam (Viet Nam); Paepke, O. [ERGO Research Laboratory, Hamburg (Germany); Malisch, R. [State Laboratory for Chemical and Veterinary Analysis, Freiburg (Germany); Constable, J.D. [Harvard Medical School, Boston, MA (United States)

    2004-09-15

    Vietnam is frequently thought of as the location of the world's largest dioxin contamination, with over 400 pounds of 2,3,7,8-TCDD from Agent Orange defoliant sprayed from 1962 to 1971. Although this is true, distribution of dioxin from Agent Orange is far from ubiquitous in Vietnam. The north was never sprayed and only certain areas of central and south Vietnam were sprayed. Dioxins have been found in very high levels in human milk and in food in some select areas of Vietnam from the 1970s to the present. Other pesticides including DDT and metabolites, {alpha}, {beta}, and {gamma} HCH, and HCB have also been found in humans and in food. We review dioxin ''hot spots'' studied in the past with current suspect hot spots and also add to the chemicals studied in Vietnamese by measuring polybrominated diphenyl ether (PBDE) flame retardants in nursing Vietnamese women's milk and compare these to levels from other countries.

  5. Wernicke encephalopathy: MR findings at clinical presentation in twenty-six alcoholic and nonalcoholic patients.

    Science.gov (United States)

    Zuccoli, G; Gallucci, M; Capellades, J; Regnicolo, L; Tumiati, B; Giadás, T Cabada; Bottari, W; Mandrioli, J; Bertolini, M

    2007-08-01

    Wernicke encephalopathy is a severe neurologic disorder that results from a dietary vitamin B1 deficiency. It is characterized by changes in consciousness, ocular abnormalities, and ataxia. This study was undertaken to analyze and compare findings on MR imaging and neurologic symptoms at clinical presentations of patients with Wernicke encephalopathy with and without a history of alcohol abuse. A multicenter study group retrospectively reviewed MR brain imaging findings, clinical histories, and presentations of 26 patients (14 female, 12 male) diagnosed between 1999 and 2006 with Wernicke encephalopathy. The age range was 6-81 years (mean age, 46 .6+/-19 years). Fifty percent of the patients had a history of alcohol abuse, and 50% had no history of alcohol abuse. Eighty percent showed changes in consciousness, 77% had ocular symptoms, and 54% had ataxia. Only 38% of the patients showed the classic triad of the disease at clinical presentation. At MR examination, 85% of the patients showed symmetric lesions in the medial thalami and the periventricular region of the third ventricle, 65% in the periaqueductal area, 58% in the mamillary bodies, 38% in the tectal plate, and 8% in the dorsal medulla. Contrast enhancement of the mamillary bodies was statistically positively correlated with the alcohol abuse group. Our study confirms the usefulness of MR in reaching a prompt diagnosis of Wernicke encephalopathy to avoid irreversible damage to brain tissue. Contrast enhancement in the mamillary bodies is a typical finding of the disease in the alcoholic population.

  6. ANMCO-SIMEU Consensus Document: in-hospital management of patients presenting with chest pain.

    Science.gov (United States)

    Zuin, Guerrino; Parato, Vito Maurizio; Groff, Paolo; Gulizia, Michele Massimo; Di Lenarda, Andrea; Cassin, Matteo; Cibinel, Gian Alfonso; Del Pinto, Maurizio; Di Tano, Giuseppe; Nardi, Federico; Rossini, Roberta; Ruggieri, Maria Pia; Ruggiero, Enrico; Scotto di Uccio, Fortunato; Valente, Serafina

    2017-05-01

    Chest pain is a common general practice presentation that requires careful diagnostic assessment because of its diverse and potentially serious causes. However, the evaluation of acute chest pain remains challenging, despite many new insights over the past two decades. The percentage of patients presenting to the emergency departments because of acute chest pain appears to be increasing. Nowadays, there are two essential chest pain-related issues: (i) the missed diagnoses of acute coronary syndromes with a poor short-term prognosis; and (ii) the increasing percentage of hospitalizations of low-risk cases. It is well known that hospitalization of a low-risk chest pain patient can lead to unnecessary tests and procedures, with an increasing trend of complications and burden of costs. Therefore, the significantly reduced financial resources of healthcare systems induce physicians and administrators to improve the efficiency of care protocols for patients with acute chest pain. Despite the efforts of the Scientific Societies in producing statements on this topic, in Italy there is still a significant difference between emergency physicians and cardiologists in managing patients with chest pain. For this reason, the aim of the present consensus document is double: first, to review the evidence-based efficacy and utility of various diagnostic tools, and, second, to delineate the critical pathways (describing key steps) that need to be implemented in order to standardize the management of chest pain patients, making a correct diagnosis and treatment as uniform as possible across the entire country.

  7. [ANMCO/SIMEU Consensus document: In-hospital management of patients presenting with chest pain].

    Science.gov (United States)

    Zuin, Guerrino; Parato, Vito Maurizio; Groff, Paolo; Gulizia, Michele Massimo; Di Lenarda, Andrea; Cassin, Matteo; Cibinel, Gian Alfonso; Del Pinto, Maurizio; Di Tano, Giuseppe; Nardi, Federico; Rossini, Roberta; Ruggieri, Maria Pia; Ruggiero, Enrico; Scotto Di Uccio, Fortunato; Valente, Serafina

    2016-06-01

    Chest pain is a common general practice presentation that requires careful diagnostic assessment because of its diverse and potentially serious causes. However, the evaluation of acute chest pain remains challenging, despite many new insights over the past two decades. The percentage of patients presenting to the emergency departments because of acute chest pain appears to be increasing. Nowadays, there are two essential chest pain-related issues: 1) the missed diagnoses of acute coronary syndromes with a poor short-term prognosis; 2) the increasing percentage of hospitalizations of low-risk cases.It is well known that hospitalization of a low-risk chest pain patient can lead to unnecessary tests and procedures, with an increasing trend of complications and burden of costs. Therefore, the significantly reduced financial resources of healthcare systems induce physicians and administrators to improve the efficiency of care protocols for patients with acute chest pain. Despite the efforts of the Scientific Societies in producing statements on this topic, in Italy there is still a significant difference between emergency physicians and cardiologists in managing patients with chest pain. For this reason, the aim of the present consensus document is double: first, to review the evidence-based efficacy and utility of various diagnostic tools, and, second, to delineate the critical pathways (describing key steps) that need to be implemented in order to standardize the management of chest pain patients, making a correct diagnosis and treatment as uniform as possible across the entire country.

  8. Metastatic adenocarcinoma of the colon presenting as a monarthritis of the hip in a young patient

    Directory of Open Access Journals (Sweden)

    Cobiella Carlos

    2006-12-01

    Full Text Available Abstract Background Malignant arthritis is a rare manifestation of metastatic disease. We describe the case of a previously well 28 year old man in whom hip pain was the presenting symptom of disease. We describe the case and discuss the aetiology of colorectal cancer in young patients. We then review the literature and discuss the investigation and management of malignant joint arthritis. Case presentation We present the case of a 28 year old man who presented to the emergency department with an acute monoarthritis of the hip. He had an unremarkable past medical history and was systemically well. A diagnosis of malignant joint effusion was reached after a heightened index of clinical suspicion, magnetic resonance imaging and cytological evaluation of the synovial fluid. Computed tomography and bone scan confirmed widespread metastatic disease from a primary colonic adenocarcinoma. The patient tolerated three cycles of oxaliplatin and capecitabine but died 4 months after presentation. Conclusion The metastatic spread of cancer to the joint and the synovium is one of the rarest manifestations of malignant disease and has not been previously reported as the presenting symptom of disease. The diagnosis is a difficult one to reach and is associated with a poor prognosis. This case illustrates the importance of thorough investigation in reaching this diagnosis and entertaining the possibility in individuals who do not respond to conventional management of acute monoarthritis, even in young patients and individuals who do not display any other symptoms of disease.

  9. Acute management and outcomes of patients with diabetes mellitus presenting to Canadian emergency departments with hypoglycemia.

    Science.gov (United States)

    Rowe, Brian H; Singh, Mira; Villa-Roel, Cristina; Leiter, Lawrence A; Hramiak, Irene; Edmonds, Marcia L; Lang, Eddy; Sivilotti, Marco; Scheuermeyer, Frank; Worster, Andrew; Riley, Jennifer; Afilalo, Marc; Stiell, Ian; Yale, Jean-Francois; Woo, Vincent C; Campbell, Samuel

    2015-02-01

    This retrospective chart audit examined the demographics, investigations, management and outcomes of adult patients with diabetes mellitus presenting to Canadian emergency departments (EDs). All sites conducted a search of their electronic medical records using International Classification of Diseases, Tenth Revision, codes to identify ED visits for hypoglycemia between 2008 and 2010. Patient characteristics, demographics, ED management, ED resources and outcome are reported. A total of 1039 patients over the age of 17 years were included in the study; 347 (33.4%) were classified as type 1 diabetes and 692 (66.6%) were classified as type 2 diabetes. Type 2 diabetes patients were significantly older (73 vs. 49 years; pdiabetes required admission (30.3 vs. 8.8%). Discharge instructions were documented in only 55.5% of patients, and referral to diabetes services occurred in fewer than 20% of cases. Considerable variation existed in the management of hypoglycemia across EDs. Patients with diabetes presenting to an ED with hypoglycemia consume considerable healthcare resources, and practice variation exists. Emergency departments should develop protocols for the management of hypoglycemia, with attention to discharge planning to reduce recurrence. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  10. An atypical presentation of sinus mucopyocele in a pediatric cystic fibrosis patient

    Directory of Open Access Journals (Sweden)

    Horesh E

    2015-05-01

    Full Text Available Elan Horesh, Andrew A Colin, Roy Casiano, Sara T WesterBascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USAAbstract: This case report details an association of chronic allergic conjunctivitis and respiratory tract colonization in a cystic fibrosis (CF patient due to an ethmoidal mucocele infected with Escherichia coli. A 3-year-old CF patient presented for evaluation with complaints of chronic periocular erythema, conjunctival injection, and irritation for 2 years. He was treated for presumed allergic conjunctivitis with no improvement and continued to have overall worsening of symptoms on the right greater than the left eye in a waxing and waning pattern. On presentation to the Bascom Palmer Eye Institute, he was noted to have telecanthus and prominent erythema in the region of the medial canthus. Orbital imaging disclosed a mucocele in the right ethmoid sinus. The patient underwent functional endoscopic sinus surgery, with successful marsupialization of the ethmoidal mucocele, which was found on culture to be infected with E. coli. Post-operatively with continuous pulmonary care, the patient remains free of allergic conjunctivitis and E. coli colonization of the upper airway. This case highlights the importance of analyzing the adjacent sinus in patients with chronic, relapsing allergic conjunctivitis refractory to medical management, particularly in patients with underlying systemic diseases such as CF.Keywords: allergic conjuncitivitis, Escherichia Coli, cystic fibrosis, mucocele

  11. Incidence and risk factors for developing infection in patients presenting with uninfected diabetic foot ulcers.

    Directory of Open Access Journals (Sweden)

    Limin Jia

    Full Text Available There is a paucity of research on patients presenting with uninfected diabetic foot ulcers (DFU that go on to develop infection. We aimed to investigate the incidence and risk factors for developing infection in a large regional cohort of patients presenting with uninfected DFUs.We performed a secondary analysis of data collected from a validated prospective state-wide clinical diabetic foot database in Queensland (Australia. Patients presenting for their first visit with an uninfected DFU to a Diabetic Foot Service in one of thirteen Queensland regions between January 2012 and December 2013 were included. Socio-demographic, medical history, foot disease history, DFU characteristics and treatment variables were captured at the first visit. Patients were followed until their DFU healed, or if their DFU did not heal for 12-months, to determine if they developed a foot infection in that period.Overall, 853 patients were included; mean(standard deviation age 62.9(12.8 years, 68.0% male, 90.9% type 2 diabetes, 13.6% indigenous Australians. Foot infection developed in 342 patients for an overall incidence of 40.1%; 32.4% incidence in DFUs healed <3 months, 55.9% in DFUs healed between 3-12 months (p<0.05. Independent risk factors (Odds Ratio (95% confidence interval for developing infection were: DFUs healed between 3-12 months (2.3 (1.6-3.3, deep DFUs (2.2 (1.2-3.9, peripheral neuropathy (1.8 (1.1-2.9, previous DFU history (1.7 (1.2-2.4, foot deformity (1.4 (1.0-2.0, female gender (1.5 (1.1-2.1 and years of age (0.98 (0.97-0.99 (all p<0.05.A considerable proportion of patients presenting with an uninfected DFU will develop an infection prior to healing. To prevent infection clinicians treating patients with uninfected DFUs should be particularly vigilant with those presenting with deep DFUs, previous DFU history, peripheral neuropathy, foot deformity, younger age, female gender and DFUs that have not healed by 3 months after presentation.

  12. Time of presentation of stroke patients for CT imaging in a Nigerian ...

    African Journals Online (AJOL)

    Background: Neuroimaging is the cornerstone for guiding thrombolytic and interventional therapy for stroke. Beneficial outcome can only be obtained within a rather short time of less than 3-4.5 hours of symptom onset. Challenges in developing countries like Nigeria often lead to delayed presentation of stroke patients in ...

  13. Two simultaneous autoimmune processes in a patient presenting with respiratory insufficiency.

    Science.gov (United States)

    Troy, Lauren; Hamor, Paul; Bleasel, Jane; Corte, Tamera

    2014-03-01

    The idiopathic inflammatory myopathies, including dermatomyositis, are uncommon acquired autoimmune diseases, sometimes associated with interstitial lung disease. Myasthenia gravis, a separate autoimmune disorder involving the neuromuscular junction, has some overlapping clinical features but has only rarely been reported to occur simultaneously within the same patient. Here we present the first reported case of concomitant dermatomyositis, myasthenia gravis, and interstitial lung disease.

  14. Descending colon interposition in a patient presenting with abdominal pain and acute appendicitis

    Directory of Open Access Journals (Sweden)

    Eiref SD

    2010-09-01

    Full Text Available Interposition of the descending colon between the kidney and the psoas major muscle is a rare hindgut anatomic variant. Presented herein is a case of descending colon interposition in a patient admitted with abdominal pain and acute appendicitis. Internal hernia was ruled out by laparoscopy.

  15. A patient with a noninvasive mucinous ovarian borderline tumor presenting with late pleural metastases

    NARCIS (Netherlands)

    Simons, M.; Nagtegaal, I.D.; Overbeek, L.I.H.; Flucke, U.E.; Massuger, L.F.A.G.; Bulten, J.

    2015-01-01

    We describe a patient diagnosed with a noninvasive intestinal-type mucinous ovarian borderline tumor presenting with pleural metastases 4 yr later. This was confirmed by an identical mutation in TP53 in both tumors. Metastases of ovarian borderline tumors outside the pelvis or abdominal cavity are

  16. Pattern of Presentation of Patients with Leukaemia in the Niger Delta ...

    African Journals Online (AJOL)

    Results: Acute myeloid leukaemia (AML) occurred mainly in adolescent (<19 years) while chronic myeloid leukaemia (CML) occurred predominantly in young adulthood (20-39 years). Granulocytic sarcoma was absent in the leukaemias. Majority of the patients presented in the advanced stage of the disease. The earliest ...

  17. Secondary Leukemia in a non-Hodgkin's Lymphoma Patient Presenting as Myeloid Sarcoma of the Breast

    OpenAIRE

    Pitini, Vincenzo; Arrigo, Carmela; Sauta, Maria Grazia; Altavilla, Giuseppe

    2011-01-01

    As defined by the World Health Organization classification of tumors of hematopoietic and lymphoid tissue, myeloid sarcoma (MS) is a tumor mass of myeloblasts or immature myeloid cells that can arise before, concurrent with, or following acute myeloid leukaemia. We describe a case of secondary leukemia presenting itself as MS of the breast in a patient previously treated for a non-Hodgkin's Lymphoma.

  18. Axillary sentinel node identification in breast cancer patients: degree of radioactivity present at biopsy is critical

    DEFF Research Database (Denmark)

    Nielsen, Kristina R; Oturai, Peter S; Friis, Esbern

    2011-01-01

    The radioactivity present in the patient (Act(rem) ) at sentinel node (SN) biopsy will depend on injected activity amount as well as on the time interval from tracer injection to biopsy, which both show great variations in the literature. The purpose of this study was to analyse the influence...

  19. Surgical management of colonic basidiobolomycosis among adolescent and adult patients: presentation and outcome.

    Science.gov (United States)

    Abd El Maksoud, Walid M; Bawahab, Mohammed A; Ashraf, Tarique H; Al Shehri, DaferM; Mirza, Nihal I

    2017-10-23

    The aim of this study was to review retrospectivelythe clinical presentations, indications for surgery and surgical outcomes of adolescent and adult patients who were diagnosed with colonic basidiobolomycosis in the last 10years. The study was carried out in Aseer Central Hospital, Abha, Saudi Arabia by reviewing the medical files of all patients in the last 10 yearswho were diagnosed with colonic basidiobolomycosis and required surgical intervention. There were twenty two patients. Common findings in all patients were weight loss, abdominal pain, and an abdominal mass. The right colon was affected in 21 patients. The initial diagnosis was correct in 7 patients while 9 were thought to be malignant. All patients underwent colonic resection followed byat least one year of antifungal medical treatment. Intraoperatively, all patients had moderate or dense adhesions, an abdominal mass and lymphadenopathy. Most surgeons'had the impression intraoperatively that the diagnosis was inflammatory rather than malignant. Postoperatively, 3 patients died within 6 months of the operation due to progression of the disease. Four patients developed severe wound infections, 3 of whom had abdominal dehiscence and required re-closure. Colonic basidiobolomycosis is alife-threatening fungal infection that should be considered a surgical condition. A high index of suspicion including basidiobolomycosis in the differential diagnosis for the acute abdomen with a colonic mass is required for a proper diagnosis. Early aggressive surgical management followed bya prolonged course of itraconazolepostoperatively could improve the outcome of the condition. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  20. Characteristics of cancer patients presenting to an integrative medicine practice-based research network.

    Science.gov (United States)

    Edman, Joel S; Roberts, Rhonda S; Dusek, Jeffery A; Dolor, Rowena; Wolever, Ruth Q; Abrams, Donald I

    2014-09-01

    To assess psychosocial characteristics, symptoms and reasons for seeking integrative medicine (IM) care in cancer patients presenting to IM clinical practices. A survey of 3940 patients was conducted at 8 IM sites. Patient reported outcome measures were collected and clinicians provided health status data. This analysis compares 353 participants self-identified as cancer patients with the larger noncancer cohort. Mean age of the cancer cohort was 55.0 years. Participants were predominantly white (85.9%), female (76.4%), and well educated (80.5% completed college). For 15.2% of cancer patients, depression scores were consistent with depressive symptoms, and average scores for perceived stress were higher than normal, but neither were significantly different from noncancer patients. The most prevalent comorbid symptoms were chronic pain (39.8%), fatigue (33.5%), and insomnia (23.3%). In the cancer cohort, perceived stress was significantly associated with depression, fatigue, insomnia, pain, and QOL. Cancer patients who chose an IM clinical practice "seeking healthcare settings that address spirituality as an aspect of care" had significantly higher levels of perceived stress, depression, and pain than those not selecting this reason. Demographic characteristics, depression scores, perceived stress scores, and reasons for seeking integrative cancer care were not significantly different between cancer patients and noncancer patients. Perceived stress may be an important indicator of QOL. The association of perceived stress, depression and pain with seeking spirituality suggests that providing IM interventions, such as effective stress management techniques and pastoral or spiritual counseling, may be helpful to patients living with cancer. © The Author(s) 2014.

  1. Dioxins and related compounds in Vietnamese, Vietnamese food and the environment. Potential relevance of hot spots from recent findings

    Energy Technology Data Exchange (ETDEWEB)

    Paepke, O. [ERGO Research, Hamburg (Germany); Quynh, Hoang Trong [Institute for Oncology, Ha Noi (Viet Nam); Schecter, A. [Univ. of Texas School of Public Health, Dallas Regional Campus, Dallas, TX (United States)

    2004-09-15

    Agent Orange, a phenoxyherbicide mixture of 2,4,5-trichlorophenoxyaceticacid (2,4,5-T) and 2,4- dichlorophenoxyacetic acid (2,4-D) was sprayed for reasons of defoliation in large amounts on about 10 % of southern Vietnam during the Vietnam war between 1962-1971. 2,4,5-T was contaminated with the highly toxic and persistent 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in the low ppm-range (mg/kg). In samples collected between 1970 and 1973 Baughman et al., 1973 documented elevated levels of TCDD from Agent Orange in milk samples from southern Vietnamese woman as well as in fish and shrimp samples from sprayed areas in this region. Studies have documented the intake of 2,3,7,8-TCDD from Agent Orange in Vietnamese and in among US war veterans. This paper gives an overview on recent findings for PCDDs/Fs and dioxin-like PCBs and in various environmental compartments, in humans and in food. Due to the fact that 2,3,7,8-TCDD is the major dioxin congener in 2,4,5-T, many investigators focused mainly on TCDD. We found from our own investigations, that TCDD in case of dioxin contamination is still the predominant dioxin congener, but in certain instances we also found other elevated congeners as well. In some cases mixed chemical contamination of food or humans was found - originating from Agent Orange and other sources. The paper will explain the potential origin of some of the other contaminations found.

  2. Characteristics and outcomes of injured patients presenting by private vehicle in a state trauma system.

    Science.gov (United States)

    Johnson, Nicholas J; Carr, Brendan G; Salhi, Rama; Holena, Daniel N; Wolff, Catherine; Band, Roger A

    2013-02-01

    Previous studies have demonstrated lower mortality among patients transported to single urban trauma centers by private vehicle (PV) compared with Emergency Medical Services (EMS). We sought to describe the characteristics and outcomes of injured patients transported by PV in a state trauma system compared to patients transported by EMS. We performed a retrospective cohort study of state trauma registry data for patients admitted to all Pennsylvania trauma centers over 5 years (1/2003 to 12/2007). Our primary exposure of interest was prehospital mode of transport and our primary outcome of interest was in-hospital mortality. Unadjusted analyses were performed as were adjusted analyses controlling for injury severity. Data are presented as percents, odds ratios (ORs), and 95% confidence intervals. Of the 91132 patients analyzed, 9.6% were transported to the emergency department by PV and 90.4% by EMS. Overall Injury Severity Score (ISS) was 13.3 ± 11.0 (ISS for EMS 13.7 ± 11.3, PV 9.2 ± 7.1, P 15, ISS >25) subgroups. Nearly 10% of injured patients arrive at trauma centers by private vehicle. Transport of injured patients by EMS was associated with higher mortality than PV transport. This may reflect the effects of prehospital time, prehospital interventions, or other confounders. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Clinical predictors for Legionella in patients presenting with community-acquired pneumonia to the emergency department

    Directory of Open Access Journals (Sweden)

    Frei Reno

    2009-01-01

    Full Text Available Abstract Background Legionella species cause severe forms of pneumonia with high mortality and complication rates. Accurate clinical predictors to assess the likelihood of Legionella community-acquired pneumonia (CAP in patients presenting to the emergency department are lacking. Methods We retrospectively compared clinical and laboratory data of 82 consecutive patients with Legionella CAP with 368 consecutive patients with non-Legionella CAP included in two studies at the same institution. Results In multivariate logistic regression analysis we identified six parameters, namely high body temperature (OR 1.67, p Legionella CAP. Using optimal cut off values of these six parameters, we calculated a diagnostic score for Legionella CAP. The median score was significantly higher in Legionella CAP as compared to patients without Legionella (4 (IQR 3–4 vs 2 (IQR 1–2, p Legionella pneumonia. Conversely, of the 73 patients (16% with ≥4 points, 66% of patients had Legionella CAP. Conclusion Six clinical and laboratory parameters embedded in a simple diagnostic score accurately identified patients with Legionella CAP. If validated in future studies, this score might aid in the management of suspected Legionella CAP.

  4. Clinical Presentation of Pediatric Patients at Risk for Sudden Cardiac Arrest.

    Science.gov (United States)

    Dalal, Aarti; Czosek, Richard J; Kovach, Joshua; von Alvensleben, Johannes C; Valdes, Santiago; Etheridge, Susan P; Ackerman, Michael J; Auld, Debbie; Huckaby, Jeryl; McCracken, Courtney; Campbell, Robert

    2016-10-01

    To identify the clinical presentation of children and adolescents affected by 1 of 4 cardiac conditions predisposing to sudden cardiac arrest: hypertrophic cardiomyopathy, long QT syndrome (LQTS), catecholaminergic polymorphic ventricular tachycardia (CPVT), and anomalous origin of the left coronary artery from the right sinus of Valsalva (ALCA-R). This was a retrospective review of newly diagnosed pediatric patients with hypertrophic cardiomyopathy, LQTS, CPVT, and ALCA-R referred for cardiac evaluation at 6 US centers from 2008 to 2014. A total of 450 patients (257 male/193 female; median age 10.1 years [3.6-13.8 years, 25th-75th percentiles]) were enrolled. Patient age was ≤13 years for 70.4% of the cohort (n = 317). Sudden cardiac arrest was the initial presentation in 7%; others were referred on the basis of abnormal or suspicious family history, personal symptoms, or physical findings. Patients with LQTS and hypertrophic cardiomyopathy were referred most commonly because of family history concerns. ALCA-R was most likely to have abnormal signs or symptoms (eg, exercise chest pain, syncope, or sudden cardiac arrest). Patients with CPVT had a high incidence of syncope and the greatest incidence of sudden cardiac arrest (45%); 77% exhibited exercise syncope or sudden cardiac arrest. This study demonstrated that suspicious or known family history plays a role in identification of many patients ultimately affected by 1 of the 3 genetic disorders (hypertrophic cardiomyopathy, LQTS, CPVT). Important patient and family history and physical examination findings may allow medical providers to identify many pediatric patients affected by 4 cardiac disorders predisposing to sudden cardiac arrest. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Management and outcomes of severe dengue patients presenting with sepsis in a tropical country.

    Directory of Open Access Journals (Sweden)

    Prapit Teparrukkul

    Full Text Available Dengue is a common cause of infection in adults in tropical countries. Sepsis is a syndrome of systemic manifestations induced by infection of any organisms; including bacterial, fungal and viral agents. Here, we investigated the diagnosis, management and outcomes of dengue patients presenting with sepsis in a prospective study of community-acquired sepsis in Thailand.From June to December 2015, 874 adult patients (age≥18 years with suspected or documented community-acquired infection, with ≥3 diagnostic criteria for sepsis according to the Surviving Sepsis Campaign 2012, and within 24 hours of admission were evaluated. Serum was stored and later tested for dengue PCR assays.A total of 126 patients had dengue PCR assays positive (2 DENV-1, 12 DENV-2, 24 DENV-3 and 88 DENV-4, and 5 of them (4% died. We found that attending physicians suspected dengue infection on admission in 84 patients (67%, and recorded dengue infection as the final diagnosis in 96 patients (76%. Four of five fatal cases were diagnosed and treated as septic shock not due to dengue. In multivariable analysis, there was a trend showing that age≥60 years, hypoxemia and misdiagnosis of dengue by attending physicians were associated with 28-day mortality.A number of adult patients who died of dengue are misdiagnosed as severe sepsis and septic shock. Diagnosis of dengue based on clinical features alone is difficult. Rapid diagnostic tests for dengue may need to be routinely used in adult patients presenting with sepsis and septic shock in tropical countries. This approach could improve diagnosis and management of those patients.

  6. Chronic Constipation in the Elderly: An Unusual Presentation of Colonic Dysmotility in an Elderly Patient

    Directory of Open Access Journals (Sweden)

    R. Peravali

    2013-01-01

    Full Text Available Introduction. Chronic constipation is common in the elderly, and often no underlying pathology is found. Primary colonic dysmotility has been described in children but is rare in the elderly. Case report. We present an 82-year-old female with long standing constipation presenting acutely with large bowel obstruction. Laparotomy and Hartman’s procedure was performed, and a grossly distended sigmoid colon was resected. Histology revealed a primary myopathic process. Conclusion. Primary colonic myopathy should be considered in elderly patients presenting with large bowel obstruction and a long preceding history of constipation, particularly when previous endoscopic examinations were normal.

  7. Visual impairment and delay in presentation for surgery in chinese pediatric patients with cataract.

    Science.gov (United States)

    You, Caiyun; Wu, Xiaoming; Zhang, Yingying; Dai, Yunhai; Huang, Yusen; Xie, Lixin

    2011-01-01

    To report visual impairment and blindness and delay in presentation for surgery in Chinese pediatric patients with cataract. Retrospective case series. A total of 196 children (309 eyes) with congenital or developmental cataract. Surgery was performed in all patients. Visual impairment and blindness were defined as best-corrected visual acuity visual acuity, and time delay to surgery of these children were evaluated. Incidence of visual impairment and blindness, ages at disease recognition and at surgery, and duration of delay in presentation for surgery. Visual acuity was 20/25 or better in 22 eyes (7.1%), between 20/25 and 20/40 in 72 eyes (23.3%), and between 20/40 and 20/60 in 87 eyes (28.2%). Visual impairment and blindness occurred in 41.4% of eyes, 52.0% of patients, 35.4% of patients with bilateral cataract, and 74.7% of patients with unilateral cataract. The frequency of visual impairment and blindness in eyes with combined nystagmus, combined strabismus, total cataract, nuclear cataract, and posterior polar cataract was 84.4%, 75%, 63.8%, 48%, and 48.3%, respectively. Severe postoperative complications resulted in 14.8% of visual impairment and blindness. The mean ages at disease recognition and at surgery were 22.6 ± 30.4 months and 68.3 ± 40.0 months, respectively. The mean delay of presentation for surgery was 49.6 ± 39.8 months in all patients and 35.7 ± 32.2 months in the patients with congenital cataract. The disease was recognized within 6 months of age in 46 children (40.7%) with bilateral cataract and 10 children (12.0%) with unilateral cataract. Among these children, only 18 (15.9%) with bilateral cataract and 1 (1.2%) with unilateral cataract underwent surgery between 3 and 6 months of age. No patients received surgical intervention within 3 months. Severe visual impairment is common in pediatric patients with cataract in China. Delayed presentation to the hospital and late surgical treatment are the major reasons and deserve greater

  8. Telling the patient's story: using theatre training to improve case presentation skills.

    Science.gov (United States)

    Hammer, Rachel R; Rian, Johanna D; Gregory, Jeremy K; Bostwick, J Michael; Barrett Birk, Candace; Chalfant, Louise; Scanlon, Paul D; Hall-Flavin, Daniel K

    2011-06-01

    A medical student's ability to present a case history is a critical skill that is difficult to teach. Case histories presented without theatrical engagement may fail to catch the attention of their intended recipients. More engaging presentations incorporate 'stage presence', eye contact, vocal inflection, interesting detail and succinct, well organised performances. They convey stories effectively without wasting time. To address the didactic challenge for instructing future doctors in how to 'act', the Mayo Medical School and The Mayo Clinic Center for Humanities in Medicine partnered with the Guthrie Theater to pilot the programme 'Telling the Patient's Story'. Guthrie teaching artists taught storytelling skills to medical students through improvisation, writing, movement and acting exercises. Mayo Clinic doctors participated and provided students with feedback on presentations and stories from their own experiences in patient care. The course's primary objective was to build students' confidence and expertise in storytelling. These skills were then applied to presenting cases and communicating with patients in a fresher, more engaging way. This paper outlines the instructional activities as aligned with course objectives. Progress was tracked by comparing pre-course and post-course surveys from the seven participating students. All agreed that the theatrical techniques were effective teaching methods. Moreover, this project can serve as an innovative model for how arts and humanities professionals can be incorporated for teaching and professional development initiatives at all levels of medical education.

  9. Atypical Presentation of Herpes Zoster Duplex Bilateralis in a Renal Transplanted Patient

    Directory of Open Access Journals (Sweden)

    Ana Isabel Gouveia

    2013-12-01

    Full Text Available Viral infections in renal transplant patients are an important cause of morbidity and mortality. In most cases, the clinical presentation of herpes zoster allows the diagnosis to be made only by history and physical examination. However, patients who are immunosuppressed may have uncommon presentations, and require a high index of suspicion and additional diagnostic testing for proper management. We report a rare presentation of herpes zoster duplex bilateralis involving symmetrical dermatomes over the lower limbs occurring in a woman with a recent history of renal transplantation. The skin lesions were also atypical representing a diagnostic challenge. This infection should be part of differential diagnosis of cutaneous manifestations in organ transplant recipients.

  10. Pericarditis as the Presenting Feature of Graves Disease in a Pediatric Patient.

    Science.gov (United States)

    Cullen, Danielle; Munjal, Neil; Chalal, Hannah; Ramgopal, Sriram; Tas, Emir; Witchel, Selma

    2017-04-01

    Pericarditis is a rare presentation of thyrotoxicosis associated with Graves disease. This association has not been previously described in the pediatric literature. We report a 17-year-old male patient who presented with chest pain, dyspnea, and tachycardia. He was found to have diffuse ST-segment elevation consistent with pericarditis. At presentation, he was noted to have bilateral proptosis. Abnormal thyroid function studies and an elevated thyroid-stimulating hormone receptor antibody level confirmed the diagnosis of Graves thyrotoxicosis. The patient was treated with anti-inflammatory and antithyroid agents and improved in time. We discuss previously reported cases of Graves disease-associated pericarditis in adults, potential etiologies, and management strategies.

  11. Clinical presentation of hypernatremia in elderly patients: a case control study.

    Science.gov (United States)

    Chassagne, Philippe; Druesne, Laurent; Capet, Corinne; Ménard, Jean François; Bercoff, Eric

    2006-08-01

    To assess early clinical signs and their prognostic value in elderly patients with hypernatremia. Prospective, case control study of 150 patients with hypernatremia matched to 300 controls. Multicenter study including seven short- and long-term geriatric care facilities. Clinical assessment of hydration status at bedside, such as abnormal skin turgor or dry oral mucosa. 30-day mortality rate and clinical indicators (assessed at the peak of natremia) associated with mortality. Patients and controls were comparable in terms of drugs and underlying diseases, except for history of dementia, which was more frequent in patients than in controls. Patients were significantly more likely than controls to have low blood pressure, tachycardia, dry oral mucosa, abnormal skin turgor, and recent change of consciousness. Only three clinical findings were found in at least 60% of patients with hypernatremia: orthostatic blood pressure and abnormal subclavicular and forearm skin turgor. The latter two signs were significantly more frequent in patients with hypernatremia. Four other signs (tachycardia, abnormal subclavicular skin turgor, dry oral mucosa, and recent change of consciousness) had a specificity of greater than 79%. Using logistic regression, four signs were significantly and independently associated with hypernatremia: abnormal subclavicular and thigh skin turgor, dry oral mucosa, and recent change of consciousness. The mortality rate was 41.5% and was significantly higher in patients with hypernatremia. The status of consciousness when hypernatremia was diagnosed was the single prognostic indicator associated with mortality (odds ratio=2.3, 95% confidence interval=1.01-5.2). Most of the classical signs of dehydration are irregularly present in patients with hypernatremia. Caregivers should carefully screen any variations in consciousness, because they may reveal severe hypernatremia.

  12. Disability in patients with trapeziometacarpal joint arthrosis: incidental versus presenting diagnosis.

    Science.gov (United States)

    Becker, Stéphanie J E; Makarawung, Dennis J S; Spit, Silke A; King, John D; Ring, David

    2014-10-01

    To test the hypothesis that there is no difference in trapeziometacarpal (TMC) joint arthrosis-related symptoms and disability between patients seeking treatment for symptoms of TMC arthrosis and those with incidental TMC joint arthrosis. We compared 64 patients presenting for care of TMC joint arthrosis with 64 with incidental TMC joint arthrosis. For both groups, the diagnosis was based on crepitation on examination. Bivariate and multivariate analyses assessed factors associated with symptoms and disability related to TMC joint arthrosis. In bivariate analysis, patients presenting for care of TMC joint arthrosis had significantly more symptoms and disability from TMC joint arthrosis than those with incidental TMC joint arthrosis. The best multivariate linear regression model for fewer TMC joint arthrosis-related symptoms and disability included patients with incidental TMC joint arthrosis, male sex, no other painful conditions, less catastrophic thinking, and fewer depressive symptoms and explained 74% of the variability. Having incidental TMC joint arthrosis (25%) and more adaptive coping strategies (less catastrophic thinking; 5%) were the most important contributors to fewer symptoms and less disability. Future studies are merited to determine whether training in better coping strategies (eg, less catastrophic thinking and fewer depressive symptoms) can decrease symptoms and disability in patients with TMC joint arthrosis. Prognostic III. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  13. Polyvascular Disease in Patients Presenting with Acute Coronary Syndrome: Its Predictors and Outcomes

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    Hassan Al Thani

    2012-01-01

    Full Text Available We evaluated prevalence and clinical outcome of polyvascular disease (PolyVD in patients presenting with acute coronary syndrome (ACS. Data for 7689 consecutive ACS patients were collected from the 2nd Gulf Registry of Acute Coronary Events between October 2008 and June 2009. Patients were divided into 2 groups (ACS with versus without PolyVD. All-cause mortality was assessed at 1 and 12 months. Patients with PolyVD were older and more likely to have cardiovascular risk factors. On presentation, those patients were more likely to have atypical angina, high resting heart rate, high Killip class, and GRACE risk scoring. They were less likely to receive evidence-based therapies. Diabetes mellitus, renal failure, and hypertension were independent predictors for presence of PolyVD. PolyVD was associated with worse in-hospital outcomes (except for major bleedings and all-cause mortality even after adjusting for baseline covariates. Great efforts should be directed toward primary and secondary preventive measures.

  14. Presentation and outcomes of hepatocellular carcinoma patients at a western centre.

    Science.gov (United States)

    Kitisin, Krit; Packiam, Vignesh; Steel, Jennifer; Humar, Abhinav; Gamblin, T Clark; Geller, David A; Marsh, J Wallis; Tsung, Allan

    2011-10-01

    The present study examines the presentation and outcomes of hepatocellular carcinoma (HCC) at a Western centre over the last decade. Between January 2000 and September 2009, 1010 patients with HCC were evaluated at the University of Pittsburgh Medical Center (UPMC). Retrospectively, four treatment groups were classified: no treatment (NT), systemic therapy (ST), hepatic artery-based therapy (HAT) and surgical intervention (SI) including radiofrequency ablation, hepatic resection and transplantation. Kaplan-Meier analysis assessed survival between groups. Cox regression analysis identified factors predicting survival. Patients evaluated were 75% male, 87% Caucasian, 84% cirrhotic, and predominantly diagnosed with hepatitis C. In all, 169 patients (16.5%) received NT, 25 (2.4%) received ST, 529 (51.6%) received HAT and 302 (29.5%) received SI. Median survival was 3.6, 5.6, 8.8, and 83.5 months with NT, ST, HAT and SI, respectively (P= 0.001). Transplantation increased from 9.5% to 14.2% after the model for end-stage liver disease (MELD) criteria granted HCC patients priority points. Survival was unaffected by bridging transplantation with HAT or SI (P= 0.111). On multivariate analysis, treatment modality was a robust predictor of survival after adjusting for age, gender, AFP, Child-Pugh classification and cirrhosis (P < 0.001, χ(2) = 460).   Most patients were not surgical candidates and received HAT alone. Surgical intervention, especially transplantation, yields the best survival. © 2011 International Hepato-Pancreato-Biliary Association.

  15. Clinicopathologic Presentation and Natural History of Anorectal Melanoma: A Case Series of 18 Patients.

    Science.gov (United States)

    Hicks, Caitlin W; Pappou, Emmanouil P; Magruder, Jonathan T; Gazer, Benny; Fang, Sandy; Wick, Elizabeth C; Gearhart, Susan L; Ahuja, Nita; Efron, Jonathan E

    2014-06-01

    Anorectal melanoma is a rare malignant neoplasm with variable natural history and nonspecific presentation. We describe the clinicopathologic and prognostic parameters of a series of 18 patients (16 [88.9%] white; 10 [55.6%] male; median age, 64.0 years [interquartile range, 45.8-74.3 years]) with histologically proven anorectal melanoma treated at our institution during a 21-year period between October 1991 and August 2012. Late diagnosis was common (44.5% of patients had stage II disease or worse at diagnosis), likely owing to a delay in presentation, nonspecific presenting symptoms, and frequent incorrect diagnoses (16 cases [88.9%]). Overall disease-specific mortality was 66.7% (12 of 18 patients), with a median time to death of 15.5 months (interquartile range, 7.3-25.5 months). Disease-specific survival was significantly better following wide local excision vs abdominoperineal resection (P = .04), although patients undergoing the former tended to have fewer rectal lesions (P = .04), smaller lesions (P = .02), and a trend toward less advanced stage (P = .06). Larger studies assessing optimal medical and surgical management for anorectal melanoma are needed to improve outcomes.

  16. Hoarding behaviour in Xhosa patients with schizophrenia - prevalence and clinical presentation

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    T Ameer

    2007-12-01

    Full Text Available Objective:Hoarding is commonly defined as the acquisition ofand failure to discard possessions of little use or value, and isincluded as a symptom in the diagnostic criteria for obsessivecompulsive personality disorder (OCPD and obsessivecompulsive disorder (OCD. However, it has also beenobserved in other clinical syndromes including schizophrenia.This study was conducted to investigate the prevalence andclinical presentation of hoarding behaviour in schizophreniaamong Xhosa patients.Method:The sample consisted of 102 patients, recruited aspart of a larger genetic study in the Cape Town metropolebetween November 2004 and January 2005, diagnosed withschizophrenia or schizoaffective disorders according to theDiagnostic and Statistical Manual of Mental Disorders(DSM-IVcriteria. They were screened for clinically significant hoardingsymptoms. If these were present, additional information onthe phenomenology was obtained by means of a structuredquestionnaire. The Mini International Neuropsychiatric Interview(MINI (screen and full version, the Yale Brown ObsessiveCompulsive Scale (Y-BOCS Checklist, Y-BOCS, Clutter ImageRating Scale (CIRS and a structured questionnaire on hoardingwere administered.Results:Only four patients with schizophrenia were classifiedas hoarders. Although their clinical presentation resembled thatof hoarders described elsewhere in the literature, they had lowY-BOCS scores and did not report other obsessive-compulsivesymptoms.Conclusion:Our results suggest that hoarding behaviour isnot common in Xhosa patients with schizophrenia. Furtherinvestigation of protective factors for hoarding behaviour in theXhosa population is warranted.

  17. Validating a pragmatic definition of shock in adult patients presenting to the ED.

    Science.gov (United States)

    Li, Yan-ling; Chan, Cangel Pui-yee; Sin, King-keung; Chan, Stewart S W; Lin, Pei-yi; Chen, Xiao-hui; Smith, Brendan E; Joynt, Gavin M; Graham, Colin A; Rainer, Timothy H

    2014-11-01

    The importance of the early recognition of shock in patients presenting to emergency departments is well recognized, but at present, there is no agreed practical definition for undifferentiated shock. The main aim of this study was to validate an a priori clinical definition of shock against 28-day mortality. This prospective, observational, cross-sectional, single-center study was conducted in Hong Kong, China. Data were collected between July 1, 2012, and January 31, 2013. An a priori definition of shock was designed, whereby patients admitted to the resuscitation room or high dependency area of the emergency department were divided into 1 of 3 groups-no shock, possible shock, and shock. The primary outcome was 28-day mortality. Secondary outcomes were in-hospital mortality or admission to the intensive or coronary care unit. A total of 111 patients (mean age, 67.2 ± 17.1 years; male = 69 [62%]) were recruited, of which 22 were classified as no shock, 54 as possible shock, and 35 as shock. Systolic blood pressure, mean arterial pressure, lactate, and base deficit correlated well with shock classifications (P definition of undifferentiated shock has been proposed and validated in a group of patients presenting to an emergency department in Hong Kong. This definition needs further validation in a larger population and other settings. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Malignant peripheral nerve sheath tumor presenting as pathological fracture of femur in neurofibromatosis patient

    Directory of Open Access Journals (Sweden)

    Roobina Khan

    2017-01-01

    Full Text Available Malignant peripheral nerve sheath tumors (MPNSTs are rare soft tissue sarcomas that arise from a peripheral nerve or cells associated with the nerve sheath, such as Schwann cells, perineural cells, or fibroblasts. MPNSTs account for 5%–10% of all soft tissue sarcomas. Neurofibromas in Neurofibromatosis-1 (NF-1 may undergo malignant transformation in 2%–5% of patients. We are reporting a very rare case in NF-1 patient who, presented with pathological intertrochanteric fracture of femur and liver metastasis. X-ray from left hip joint shows lytic lesion which on histopathology turned out to be MPNST. S-100 was positive confirming its neural origin. Elbow lesion which was excised later, also showed similar features with S-100 positivity. Ultrasonography abdomen showed target lesions in liver. Fine-needle aspiration cytology from liver showed scattered malignant spindle cells. A final diagnosis of metastatic MPNST was made. Although malignant transformation in neurofibromas is extremely rare when it occurs, it is associated with NF-1 in 75% of patients. This case highlights the possibility of fracture femur as the presenting complains, in patients of NF with malignant transformation. The case is unique with regard to its presentation and rarity of metastatic sites.

  19. Never giving up: outcomes and presentation of emergency general surgery in geriatric octogenarian and nonagenarian patients.

    Science.gov (United States)

    Shah, Adil A; Zafar, Syed Nabeel; Kodadek, Lisa M; Zogg, Cheryl K; Chapital, Alyssa B; Iqbal, Aftab; Greene, Wendy R; Cornwell, Edward E; Havens, Joaquim; Nitzschke, Stephanie; Cooper, Zara; Salim, Ali; Haider, Adil H

    2016-08-01

    Aging of the population necessitates consideration of the increasing number of older adults requiring emergency care. The objective of this study was to compare outcomes and presentation of octogenarian and/or nonagenarian emergency general surgery (EGS) patients with younger adults. Based on a standardized definition of EGS, patients in the 2007 to 2011 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample were queried for primary EGS diagnoses. Included patients were categorized into older (≥80 years) vs younger (<80 years) adults based on a marked increase in mortality around aged 80 years. Using propensity scores, risk-adjusted differences in major morbidity, mortality, length of stay (LOS), and cost were compared. Of 3,707,465 included patients, 17.2% (n = 637,588) were ≥80 years. Relative to younger adults, older patients most frequently presented for gastrointestinal-bleeding (odds ratio [95% confidence intervals]: 2.81 [2.79 to 2.82]) and gastrostomy care (2.46 [2.39 to 2.53]). Despite higher odds of mortality (1.67 [1.63 to 1.69]), older adults exhibited lower risk-adjusted odds of morbidity (.87 [.86 to .88]), shorter LOS (4.50 vs 5.14 days), and lower total hospital costs ($10,700 vs $12,500). Octogenarian and/or nonagenarian patients present differently than younger adults. Reductions in complications, LOS, and cost among surviving older adults allude to a "survivorship tendency" to never give up, despite collectively higher mortality risk. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Coping with oral pain: lay management strategies adopted by patients prior to presentation.

    Science.gov (United States)

    Sofola, Oyinkansola O; Uti, Omolara G

    2009-01-01

    To identify lay measures taken by patients in response to oral pain before seeking professional care and to determine factors leading to demand for professional oral health care. A cross-sectional survey of patients aged 16 years and above who presented with oral pain at the oral diagnosis clinics of the Lagos University Teaching Hospital and the Lagos State University Teaching Hospital was carried out. Data was collected by means of questionnaires which sought information on onset and duration of pain, character, aggravating and relieving factors and actions taken by the patients before presentation at the dental clinic. A total of 215 patients participated. More than half of them described their pain as severe to very severe with 106 (49.3%) and 21 (9.8%) reporting sleep disruptions and severe agony respectively. Delay in presentation range from over a month in 56 (26%) patients to years in 85 (39.5%). Responses to pain symptoms included, communication with different persons for advice in 192 (89.3%) and application of at least one lay measure in 183 (85.1%) patients. Duration and persistence of pain was associated significantly with the use of more than one measure. There was no association between gender or age and the use of lay measures. Use of measures with possible adverse effects like petrol and acid was reported in 5 (2.7%) of the respondents. Lay strategies in response to oral pain are common in this Nigerian population and appear to be used as an alternative to professional oral health care.

  1. Outcome of poor initial TIMI flow in patients presenting with acute coronary syndrome.

    Science.gov (United States)

    Nammas, Wail; Pietilä, Mikko; Romppanen, Hannu; Sia, Jussi; DeBelder, Adam; Karjalainen, Pasi P

    2017-10-01

    We explored the predictors and outcome of poor, versus good, initial TIMI flow in patients with acute coronary syndrome (ACS). We performed post-hoc analysis of a randomized trial of patients presenting with ACS who received 2 comparative stents. Poor initial TIMI flow was defined as baseline TIMI flow grade 0/1 at the initial coronary angiography. The primary endpoint was major adverse cardiac events (MACE): a composite of cardiac death, non-fatal myocardial infarction or ischemia-driven target lesion revascularization. Stent thrombosis (ST) was adjudicated according to the criteria of definite ST described by the Academic Research Consortium. Propensity score-matched analysis was performed. We report data after 5-year follow-up. Of 827 patients enrolled, 279 (33.7%) had initial TIMI 0/1 flow. Median follow-up duration was 5.0 years. Presentation by ST-elevation myocardial infarction and target vessel other than left anterior descending artery predicted initial TIMI 0/1 flow. MACE rate was comparable between the 2 subgroups (14% versus 15.9%, in patients with poor versus good initial TIMI flow, respectively, p = .46). Individual endpoints were comparable (p > .05 for all). Definite ST was more frequent in patients with initial TIMI 0/1 flow (3.6% versus 1.5%, respectively, p = .048). This was driven by more frequent early events (30 days) (p = .036); late/very late events were comparable (p = 1.0). Predictors of poor initial TIMI flow included presentation by ST-elevation myocardial infarction, and target vessel other than left anterior descending artery. Definite ST occurred more in patients with poor, versus good, initial TIMI flow, mainly driven by difference in early events.

  2. Atypical systemic leishmaniasis to be considered in the differential of patients presenting with depressed immunity.

    Directory of Open Access Journals (Sweden)

    Nuha Nuwayri-Salti

    Full Text Available Systemic leishmaniasis has been known to present with prolonged fever, hepatosplenomegaly and wasting. Beside this classical form, a sub-clinical form has been identified. It is described with either one or two of the above symptoms missing; other findings have been reported instead, such as lymphadenopathy and anemia. In this report, we reveal a third unsuspected form which we are referring to as "atypical".Patients suspected to be immune-deficient were referred to our immunology specialized laboratory to study some aspects of their immune functions (not normally covered in the general laboratory. Multiple specialized tests were performed, including microscopic examinations using appropriate stains, and mainly cultures of biopsies on several types of specialized media. 19·4% of 160 patients were found to have close to normal laboratory profiles, but exhibited dysfunctional macrophages laden with Leishmania parasites.Findings such as the ones we obtained allowed us to uncover the presence of patients with an atypical form of systemic leishmaniasis. It presents with symptoms masquarading a condition in which the immune system is non functional. This predisposes patients to recurrent secondary infections resulting in clinical pictures with a great variety of signs and symptoms. These findings alerted us to the fact that systemic leishmaniasis presents with a much wider spectrum of signs and symptoms than so far suspected and is far more common than diagnosed to date. Furthermore, among these 31 patients was a number of adults. This proved that in our area systemic leishmaniasis is surely not limited to the pediatric age group. Our recommendation is to entertain the diagnosis of atypical systemic leishmaniasis in any patient with an unexplained depressed immunity state and in whom no obvious immunologic defect can be identified.

  3. Health care utilization among adenosine-sensitive supraventricular tachycardia patients presenting to the emergency department.

    Science.gov (United States)

    Dewland, Thomas A; Oesterle, Adam; Stein, John; Marcus, Gregory M

    2017-08-01

    Although adenosine-sensitive supraventricular tachycardia (SVT) is generally curable, it remains an important cause of healthcare utilization. We sought to determine predictors of health care utilization among SVT patients presenting to the emergency department (ED). We studied consecutive patients evaluated in an urban, academic ED for adenosine-sensitive SVT. The primary study outcomes were (1) ambulance transportation to the index ED visit, (2) hospital admission from the index ED encounter, and (3) recurrent SVT-associated ED encounters. Among 100 patients with adenosine-sensitive SVT, 35 were transported to the ED by ambulance. Prior electrophysiologist evaluation was associated with a significant 87% reduced odds of ambulance utilization (OR 0.13, 95% CI 0.03-0.67, p = 0.015). A total of 62 patients were subsequently admitted to the hospital. All patients with coronary artery disease, diabetes, syncope, and wide complex SVT were admitted. Similarly, individuals with an elevated troponin had a significantly greater odds of hospital admission (OR 16.8, 95% CI 1.9-148.4, p = 0.011). After the index ED visit, 60 patients were seen by an electrophysiologist, and 47 underwent catheter ablation. Individuals treated with catheter ablation had a significant 75% reduction in the risk of a recurrent ED visit for SVT (HR 0.25, 95% CI 0.10-0.62, p = 0.003). Readily modifiable clinical factors, including a previous visit to an electrophysiologist and treatment with catheter ablation, are associated with reduced health care utilization among patients presenting to the ED with SVT.

  4. Epidemiology, clinical presentation, diagnosis and treatment of autoimmune pancreatitis: A retrospective analysis of 53 patients.

    Science.gov (United States)

    Rasch, Sebastian; Phillip, Veit; Schmid, Roland M; Algül, Hana

    2016-01-01

    Most of the data about epidemiology, clinical presentation and treatment of autoimmune pancreatitis (AIP) is based on case series or small study groups. We therefore analyzed all cases of AIP treated at our clinic retrospectively. We searched our clinical database for the diagnosis pancreatitis between January 2007 and June 2014, selected patients with AIP and entered all relevant information in a database for statistical analysis. In total 53 patients with AIP were treated at our institution, 62% with type 1 and 23% with type 2 AIP. Gender distribution was male/female 3.1:1 for type 1 and 1:1.2 for type 2 AIP. The median age was 63.0 and 32.5 years for type 1 and type 2 AIP, respectively. The most common symptom is abdominal pain particular in patients with type 2 AIP whereas jaundice was only apparent in patients with type 1 AIP. The international diagnostic criteria seem to facilitate diagnosis of AIP as unnecessary pancreatic surgery in patients with AIP decreases. In 62.6% of the patients therapy was indicated and 84.8% showed a response to initial therapy with steroids. Recurring disease occurred in 28.3% of the cases but only 3.8% suffered a second relapse. Permanent maintenance therapy with steroids or additional therapy with immunomodulatory drugs is successful in recurring disease. Our data further corroborate previous findings on epidemiology, clinical presentation and treatment of AIP. AIP is a well manageable autoimmune disease in most patients. Better biopsy techniques and simplified diagnostic criteria might further alleviate diagnosis of AIP. Copyright © 2015 IAP and EPC. Published by Elsevier India Pvt Ltd. All rights reserved.

  5. Sex-based differences in prevalence and clinical presentation among pericarditis and myopericarditis patients.

    Science.gov (United States)

    Laufer-Perl, Michal; Havakuk, Ofer; Shacham, Yacov; Steinvil, Arie; Letourneau-Shesaf, Sivan; Chorin, Ehud; Keren, Gad; Arbel, Yaron

    2017-02-01

    Sex differences in heart diseases, including acute coronary syndrome, congestive heart failure, and atrial fibrillation, have been studied extensively. However, data are lacking regarding sex differences in pericarditis and myopericarditis patients. The purpose of the study was to evaluate whether there are sex differences in pericarditis and myopericarditis patients as well. We performed a retrospective, single-center observational study that included 200 consecutive patients hospitalized with idiopathic pericarditis or myopericarditis from January 2012 to April 2014. Patients were evaluated for sex differences in prevalence, clinical presentation, laboratory variables, and outcome. We excluded patients with a known cause for pericarditis. Among 200 consecutive patients, 55 (27%) were female. Compared with men, women were significantly older (60±19 years vs 46±19 years, P<.001) and had a higher rate of chronic medical conditions. Myopericarditis was significantly more common among men (51% vs 25%, P=.001). Accordingly, men had significantly higher levels of peak troponin (6.8±17 ng/mL vs 0.9±2.6 ng/mL, P<.001), whereas women presented more frequently with pericardial effusion (68% vs 45%, P=.006). Interestingly, women had a significantly lower rate of hospitalization in the cardiology department (42% vs 63%, P=.015). Overall, there were no significant differences in ejection fraction, type of treatment, complications, or in-hospital mortality. Most patients admitted with acute idiopathic pericarditis are male. In addition, men have a higher prevalence of myocardial involvement. Significant sex differences exist in laboratory variables and in hospital management; however, the outcome is similar and favorable in both sexes. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. [Presentation, staging, and outcome of patients with hepatocellular carcinoma at a center in Veracruz, Mexico].

    Science.gov (United States)

    Martinez-Mier, G; Esquivel-Torres, S; Medina Granados, J P; Luna-Castillo, M; Castillo-Chiquete, R; Calzada-Grijalva, J F; Gonzalez-Velazquez, F

    2014-01-01

    Hepatocellular carcinoma (HCC) staging provides a basis for calculating disease prognosis and therapeutic guidance. Liver resection and transplantation are curative options, and ablation therapies are applied to patients that are not candidates for curative treatment. Survival after liver resection or ablation therapies varies. To describe the presentation, staging, management, and outcome in patients with HCC in our center. Forty-two patients had a 7-year prospective follow-up. Survival was calculated with the Kaplan-Meier analysis and the log-rank test was used for its comparison between the staging systems (Okuda, BCLC, and CLIP) and types of treatment (liver resection, radiofrequency ablation, and no surgical treatment). The mean age of the patients was 68.9 ± 9.5 years; 57% were women. A total of 54% of the patients presented with cirrhosis and 31% were infected with hepatitis C virus (HCV). The mean tumor size was 6.48 ± 2.52cm. The CLIP 0, Okuda I, and BCLC A stages had better survival rates than the other stages (P<0.05). Survival with resection was superior (median of 32 months and survival at 1, 3, and 5 years of 83, 39, and 19.7%, respectively) to that of both radiofrequency ablation (median of 25 months and survival at 1 and 3 years of 90 and 17.2%, respectively) and no surgical treatment (1 year < 5%) (P<0.05). The patients at our center were diagnosed at late stages of HCC, as is the case in other Mexican populations. Outcome in relation to CLIP and BCLC was similar to the prognoses reported in the literature. The best results were observed in the patients with early stage disease and those that underwent HCC resection surgery. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  7. From Complication to Diagnosis: Prostate Cancer in an Acetabular Fracture Patient Presenting with Hip Pain

    Directory of Open Access Journals (Sweden)

    Rana Terlemez

    2017-04-01

    Full Text Available According to the Turkish Public Health Institution data, prostate cancer is the 2nd most common cancer in men. Advanced stage patients may apply with pain in the lower back, hips, or upper thighs. In this case report, a 66 year-old man who has hip pain referred to our rheumatology department with sacroiliitis is presented. Further investigations revealed that hip pain was the result of acetabular fracture due to osteoblastic bone metastases. Significant pain palliation was achieved in the patient who is diagnosed with primer prostate carcinoma after radiation therapy.

  8. The psychological well-being and appearance concerns of patients presenting with ptosis.

    Science.gov (United States)

    Richards, H S; Jenkinson, E; Rumsey, N; White, P; Garrott, H; Herbert, H; Kalapesi, F; Harrad, R A

    2014-03-01

    Ptosis affects both the function and appearance of the eyes and face, because of drooping of the eyelids. Previous research has focused on functional impairment; however, similar appearance altering eye conditions have been demonstrated to have major impacts on psychosocial functioning. This study examines the psychological well-being and appearance concerns of patients presenting with ptosis recruited from Bristol Eye Hospital using validated questionnaires focusing on demographics and psychosocial factors before surgery. Patients reported higher levels of anxiety, depression, and appearance concern than population norms, with scores comparable to previous research examining the impact of other disfiguring eye conditions. Gender differences were observed, with almost half of females experiencing significant psychosocial issues related to appearance concern about their ptosis compared with 20% of males. Linear regressions revealed that the main predictor of poor adjustment to the appearance of ptosis was the level of concern an individual had regarding the negative perceptions of other people. These results implicate psychosocial factors and demographics as predictors of the development of appearance-related distress and compromised psychological well-being for patients with ptosis who are currently seeking surgery. This study provides clinicians with a greater understanding of the concerns of affected patients, and treatment motivations. The findings may also inform the development of patient reported outcome measures and support for patients, which targets the psychosocial impact of the condition.

  9. Patients With Type A Acute Aortic Dissection Presenting With an Abnormal Electrocardiogram.

    Science.gov (United States)

    Costin, Nathaniel I; Korach, Amit; Loor, Gabriel; Peterson, Mark D; Desai, Nimesh D; Trimarchi, Santi; de Vincentiis, Carlo; Ota, Takeyoshi; Reece, T Brett; Sundt, Thoralf M; Patel, Himanshu J; Chen, Edward P; Montgomery, Dan G; Nienaber, Christoph A; Isselbacher, Eric M; Eagle, Kim A; Gleason, Thomas G

    2018-01-01

    The electrocardiogram (ECG) is often used in the diagnosis of patients presenting with chest pain to emergency departments. Because chest pain is a common manifestation of type A acute aortic dissection (TAAAD), ECGs are obtained in much of this population. We evaluated the effect of particular ECG patterns on the diagnosis and treatment of TAAAD. TAAAD patients (N = 2,765) enrolled in the International Registry of Acute Aortic Dissection were stratified based on normal (n = 1,094 [39.6%]) and abnormal (n = 1,671 [60.4%]) findings on presenting ECGs and further subdivided according to specific ECG findings. Time data are presented in hours as medians (quartile 1 to quartile 3). Patients with ECGs with abnormal findings presented to the hospital sooner after symptom onset than those with ECGs with normal findings (1.4 [0.8 to 3.3] vs 2.0 [1.0 to 3.3]; p = 0.005). Specifically, this was seen in patients with infarction with new Q waves or ST elevation (1.3 [0.6 to 2.7] vs 1.5 [0.8 to 3.3]; p = 0.049). Interestingly, the time between symptom onset and diagnosis was longer with infarction with old Q waves (6.7 [3.2 to 18.4] vs 5.0 [2.9 to 11.8]; p = 0.034) and nonspecific ST-T changes (5.8 [3.0 to 13.8] vs 4.5 [2.8 to 10.5]; p = 0.002). Surgical mortality was higher in patients with abnormal ECG findings (20.6% vs 11.9%, p < 0.001), especially in those with ischemia by ECG (25.7% vs 16.8%, p < 0.001) and infarction with new Q waves or ST elevation (30.1% vs 17.1%, p < 0.001). TAAAD patients presenting with abnormal ECG results are sicker, have more in-hospital complications, and are more likely to die. The frequency of nonspecific ST-T abnormalities and its association with delay in diagnosis and treatment presents an opportunity for practice improvement. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Male genitoplasty for 46 XX congenital adrenal hyperplasia patients presenting late and reared as males

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    Shilpa Sharma

    2012-01-01

    Full Text Available Aim: To evaluate the clinical profile and management of 46 XX Congenital Adrenal Hyperplasia (CAH patients presenting with severe virilization and assigned a male gender. Materials and Methods: Of 173 children diagnosed with CAH at the Pediatric Intersex Clinic since 1980, seven children with CAH presented late with severe virilization and were reared as males. All of them were assigned the male sex with removal of the female adnexa. Six were treated with male genitoplasty. Appropriate hormonal supplementation was offered after puberty. Results: The mean age at presentation was 14.2 years (7 - 21. Six patients had presented after puberty, only one at seven years of age. Staged male genitoplasty comprising of chordee correction, male urethroplasty, and bilateral testicular prosthesis was performed. The female adnexa (uterus, ovaries, most of the upper vagina, and the fallopian tubes were removed. The mental makeup was masculine in six and bigender in one. Bilateral mastectomy was performed at puberty in all. Hormonal treatment comprised of glucocorticoids and testosterone. Six patients were comfortable with the outcome of the masculinizing genitoplasty. One had a short-sized phallus. One had repeated attacks of urinary tract infection arising from the retained lower vaginal pouch. Social adjustments were good in all, except in one who had a bigender mental makeup. Conclusion: CAH patients with severe virilization presenting late and reared as males are extremely rare. However, the assigned gender can be retained adequately as males, meeting the socioeconomic compulsions of the society. The results are satisfactory following appropriate surgical procedures and hormonal supplementation.

  11. Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

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    Matheus F. Oliveira

    2014-06-01

    Full Text Available Normal pressure hydrocephalus (NPH is characterized by gait disturbance, dementia and/or urinary incontinence associated with dilation of ventricular system with normal opening cerebrospinal fluid pressure. Wide scientifical evidence confirms association between NPH and psychiatric symptoms. We selected 35 patients with idiopathic normal pressure hydrocephalus from January 2010 to January 2012 in a Brazilian tertiary hospital and performed a formal psychiatric evaluation to identify psychiatric disorders. Psychiatric disorders were present in 71% of these patients, especially anxiety, depression and psychotic syndromes. NPH patients may develop symptoms with frontal dominance, such as personality changes, anxiety, depression, psychotic syndromes, obsessive compulsive disorder, Othello syndrome; shoplifting and mania. Unusual appearances of NPH symptoms may hinder early diagnosis and consequently proper treatment.

  12. Analysis of Patients Presenting to a Pediatric Emergency Department with Acute Limping

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    Sabiha Şahin

    2017-08-01

    Full Text Available Introduction: Limping is a common presenting complaint to a pediatric emergency department among children. The differential diagnosis of acute limp includes transient synovitis, trauma, infections, neoplasia, and congenital neuromuscular and developmental disorders. We aimed to evaluate patients presenting with acute limp to our pediatric emergency department and to analyze the clinical characteristics of the disease. In addition, we aimed to investigate the value of several laboratory parameters in early identification of septic and aseptic conditions. Methods: We retrospectively analyzed children under 18 years of age who were admitted to our emergency department with acute limping in a two-year period. Patients with any chronic diseases, any history of trauma, coagulopathy (as documented by blood clotting tests and any history of intramuscular injections within the previous week were excluded. The patients’ complete blood count, erythrocyte sedimentation rate (ESR, C-reactive protein (CRP levels, plain pelvic radiographs and ultrasonography reports were evaluated. The patients were classified as septic or aseptic according to their white blood cells (WBC, CRP and ESR values. Totally 120 patients were included in the study. The upper limit for WBC, ESR and CRP was accepted as 9000 cells/mm3, 20 mm/h and 0.8 mg/dL, respectively. Results: Of the total of 86 patients in the aseptic group, 81 had normal WBC, ESR and CRP levels and were diagnosed with transient synovitis, 2 female patients received the diagnosis of slipped upper femoral epiphysis, and 3 patients were diagnosed with Legg-Calvé-Perthes disease during clinical follow-up. The remaining 34 patients with high ESR, WBC and CRP levels were included in the septic group in whom the following diagnoses were established during the follow-up: septic arthritis (n=12, Familial Mediterranean Fever (n=4, juvenile rheumatoid arthritis (n=4, Guillain-Barré syndrome (n=3, osteomyelitis (n=3, acute

  13. [Fever as the presenting manifestation of colon cancer: a case series of 11 patients].

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    Lecoules, S; Carmoi, T; Klotz, C; Rapp, C; Perrot, G; Galeano, C; Algayres, J-P

    2013-03-01

    Fever happens frequently in colon cancer but it is rarely the presenting manifestation. We report a case series of patients with colon cancer revealed by fever in the three military hospitals in Paris. Of the 11 patients studied, seven were men and four were women, and their mean age was 70 years. Cancer was localized in the sigmoid colon (n=6), left colon (n=3) and right colon (n=2). Cancer staging (UICC TNM classification 2002) was respectively pTis (n=1), I (n=4), II (n=3) and III (n=3). Fever was the only reason for admission and two patients had a recurrent fever of unknown origin. All patients but one had bacterial infection. Blood cultures grew up in six cases, Escherichia coli (n=3), Streptococcus gallolyticus (ex bovis) (n=2) and anaerobic bacteria (n=1). There was one case of infective endocarditis caused by S. gallolyticus. Imaging showed a liver abscess (n=3) and a colon cancer complicated by an abscess (n=3). In seven patients, a familial history of colon cancer and symptoms of underlying colic disease were present (neglected rectal bleeding, iron deficiency anaemia, clinical evidence of an abdominal mass). Fever may reveal colon cancer at an early stage. Its main cause is a bacterial infection, such as bacteremia or abscess. Fever of unknown origin is a rare presentation. Detailed history, careful clinical examination and analysis of imaging contribute to recommend the prescription of colonoscopy. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  14. New report of two patients with mosaic trisomy 9 presenting unusual features and longer survival

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    Paulo Ricardo Gazzola Zen

    Full Text Available CONTEXT: Mosaic trisomy 9 is considered to be a rare chromosomal abnormality with limited survival. Our objective was to report on two patients with mosaic trisomy 9 presenting unusual findings and prolonged survival. CASE REPORTS: The first patient was a boy aged six years and five months presenting weight of 14.5 kg (< P3, height of 112 cm (P10, head circumference of 49 cm (P2, prominent forehead, triangular and asymmetric face, thin lips, right microtia with overfolded helix, small hands, micropenis (< P10, small testes and hallux valgus. His lymphocyte karyotype was mos 47,XY,+9 [4 ]/46,XY [50 ]. Additional cytogenetic assessment of the skin showed normal results. The second patient was a two-year-old girl who was initially assessed at five months of age, when she presented weight of 5.3 kg (< P3, height of 61.5 cm (P2-P10, head circumference of 40.5 cm (P25, sparse hair, micrognathia, right ear with overfolded helix and preauricular pit, triphalangeal thumbs and sacral dimple. She also had a history of congenital heart disease, hearing loss, hypotonia, delayed neuropsychomotor development and swallowing disorder. Her lymphocyte karyotype was mos 47,XX,+9 [3 ]/46,XX [69 ]. Both patients had unusual clinical findings (the first, hemifacial hypoplasia associated with microtia, with a phenotype of oculo-auriculo-vertebral spectrum, and the second, triphalangeal thumbs and hearing loss and survival greater than what is usually described in the literature (< 1 year. Further reports will be critical for delineating the clinical features and determining the evolution of patients with mosaic trisomy 9

  15. The role of sonography in patients with breast cancer presenting as an axillary mass

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    Park, Sun Young; Kim, Eun Kyung; Oh, Ki Keun; Lee, Kyong Sik; Park, Byeong Woo [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2002-09-01

    To compare sonography and mammography in terms of their diagnostic value in breast cancer cases which initially presented as an axillary mass without a palpable mass or other clinical symptoms. Seven patients with enlarged axillary lymph nodes who first presented with no evidence of palpable breast lesions and who underwent both mammography and sonography were enrolled in this study. In six of the seven, the presence of metastatic adenocarcinoma was confirmed preoperatively by axillary needle aspiration biopsy; in four, subsequent sonographically guided breast core biopsy performed after careful examination of the primary site indicated that primary breast cancer was present. In each case, the radiologic findings were evaluated by both breast sonography and mammography. Breast lesions were detected mammographically in four of seven cases (57%); in three of the four, the lesion presented as a mass, and in one as microcalcification. In three of these four detected cases, fatty or scattered fibroglandular breast parenchyma was present; in one, the parenchyma was dense. In the three cases in which lesions were not detected, mammography revealed the presence of heterogeneously dense parenchyma. Breast sonography showed that lesions were present in six of seven cases (86%); in the remaining patient, malignant microcalcification was detected at mammography. Final pathologic examination indicated that all breast lesions except one, which was a ductal carcinoma in situ, with microinvasion, were infiltrating ductal carcinomas whose size ranged from microscopic to greater than 3 cm. At the time of this study, all seven patients were alive and well, having been disease free for up to 61 months after surgery. In women with a palpable axillary mass confirmed as metastatic adenocarcinoma, breast sonography may be a valuable adjunct to mammography.

  16. VARIATION OF VALGUS ANGLE IN PATIENTS PRESENTING FOR TOTAL KNEE ARTHROPLASTY

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    Abhinav Bhatnagar

    2017-04-01

    Full Text Available BACKGROUND Total Knee Arthroplasty (TKA nowadays is a commonly used treatment for patients suffering from severe osteoarthritis. The success of TKA is influenced by a complex interaction between the bony anatomy, the geometry of the components and the soft tissue balancing. Valgus angle subtended between the mechanical and anatomical axis of femur is one of the major factors influencing the alignment of implants. The objective of this study is to determine the variation of this valgus angle using a scannogram in patients with severe osteoarthritis presenting for TKA. MATERIALS AND METHODS 150 consecutive patients of osteoarthritis of the knee joint presenting for total knee arthroplasty participated in our study. All patients underwent a preoperative scannogram, the mechanical and anatomical axis were drawn and the valgus angle was measured on the PACS (picture archiving and communication system software. RESULTS The mean age of patients undergoing TKA was 63.62±8.38 years. Although, the mean valgus angle for the patients was 6.009±0.89 degrees, only 45 (30% of 150 had valgus angle between 6-7 degrees. 72 (48% had valgus angle in the range of 5-6 degrees and 9 (6% had valgus angle in the range of 4-5 degrees. In 21 (14% knees, valgus angle was more than 7 degrees, while in 3 (2% knees, it was less than 4 degrees. CONCLUSION Fixed valgus angle resection is not reliable in restoring mechanical axis in total knee arthroplasty. A proper preoperative planning to determine the accurate valgus angle is a must to maintain alignment while performing total knee arthroplasty and thereby improve the long-term results. Scannogram is an easy, reliable and cost-effective method to determine the valgus angle.

  17. Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study.

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    Leonardo Gil-Santana

    Full Text Available The rising prevalence of diabetes mellitus (DM worldwide, especially in developing countries, and the persistence of tuberculosis (TB as a major public health issue in these same regions, emphasize the importance of investigating this association. Here, we compared the clinical profile and disease outcomes of TB patients with or without coincident DM in a TB reference center in Brazil.We performed a retrospective analysis of a TB patient cohort (treatment naïve of 408 individuals recruited at a TB primary care center in Brazil between 2004 and 2010. Data on diagnosis of TB and DM were used to define the groups. The study groups were compared with regard to TB disease presentation at diagnosis as well as to clinical outcomes such as cure and mortality rates upon anti-tuberculosis therapy (ATT initiation. A composite score utilizing clinical, radiological and microbiological parameters was used to compare TB severity between the groups.DM patients were older than non-diabetic TB patients. In addition, diabetic individuals more frequently presented with cough, night sweats, hemoptysis and malaise than those without DM. The overall pattern of lung lesions assessed by chest radiographic examination was similar between the groups. Compared to non-diabetic patients, those with TB-diabetes exhibited positive acid-fast bacilli in sputum samples more frequently at diagnosis and at 30 days after ATT initiation. Notably, higher values of the TB severity score were significantly associated with TB-diabetes comorbidity after adjustment for confounding factors. Moreover, during ATT, diabetic patients required more frequent transfers to TB reference hospitals for complex clinical management. Nevertheless, overall mortality and cure rates were indistinguishable between the study groups.These findings reinforce the idea that diabetes negatively impacts pulmonary TB severity. Our study argues for the systematic screening for DM in TB reference centers in endemic

  18. Arteriojejunal Fistula Presenting with Recurrent Obscure GI Hemorrhage in a Patient with a Failed Pancreas Allograft

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    Nirmit Desai

    2013-01-01

    Full Text Available We present a case of a patient with a failed pancreaticoduodenal allograft with exocrine enteric-drainage who developed catastrophic gastrointestinal (GI hemorrhage. Over the course of a week, she presented with recurrent GI bleeds of obscure etiology. Multiple esophago-gastro-duodenoscopic (EGD and colonoscopic evaluations failed to reveal the source of the hemorrhage. A capsule endoscopy and a technetium-labeled red blood cells (RBC imaging study were similarly unrevealing for source of bleeding. She subsequently developed hemorrhagic shock requiring emergent superior mesenteric arteriography. Run off images revealed an external iliac artery aneurysm with fistulization into the jejunum. Coiled embolization was attempted but abandoned because of hemodynamic instability. Deployment of a covered endovascular stent into the right external iliac artery over the fistula site resulted in immediate hemodynamic stabilization. A high index of suspicion for arterioenteric fistulae is needed for diagnosis of this uncommon but eminently treatable form of GI hemorrhage in this patient population.

  19. Leukemia cutis in a patient with chronic lymphocytic leukemia presenting as bilateral helical nodules

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    Ali Raufi

    2016-12-01

    Full Text Available Chronic lymphocytic leukemia, the most common adult leukemia worldwide, is considered an indolent but incurable non-Hodgkin lymphoma. Leukemia cutis is an uncommon manifestation of chronic lymphocytic leukemia. We present a case of an adult patient who presented with skin lesion of bilateral ears, which led to the diagnosis of chronic lymphocytic leukemia. We also reviewed the cases of auricular involvement in chronic lymphocytic leukemia patients reported in the literature. Local treatment is indicated in case of leukemia cutis; however, systemic treatment is recommended when there are systemic signs and symptoms. Better awareness of disease evolution and prompt diagnosis of this leukemia cutis of chronic lymphocytic leukemia will improve the effectiveness and outcome of its management.

  20. Patient with metastatic breast cancer presenting as acute cholecystitis with one-year survival on hormonotherapy.

    Science.gov (United States)

    Zamkowski, Mateusz; Kąkol, Michał; Makarewicz, Wojciech; Ropel, Jerzy; Bobowicz, Maciej

    2017-08-31

    Breast cancer has high metastatic potential with distant metastases involving mainly lungs, liver and bones. Less frequently it gives distant spread to other organs. Herein we would like to present a very rare case of an acute cholecystitis which turned out to be a metastatic breast cancer in previously healthy woman. A female patient, 64-years old, presented to the emergency department with symptoms of biliary colic and acute abdomen. During the emergency cholecystectomy, we diagnosed the gallbladder empyema with thickened wall. There were also multiple metastatic nodules in the peritoneal cavity and an excessive amount of free fluid. The emergency physicians diagnosing female patient with the acute abdominal symptoms and a breast cancer history might suspect malignant spread into abdominal organs including gallbladder. On the other hand, acute cholecystitis symptoms might be the first symptoms of metastatic process in the gallbladder from the unknown primary source, which may be breast.

  1. Age and clinical outcomes in patients presenting with acute coronary syndromes☆

    Science.gov (United States)

    Ahmed, Emad; AlHabib, Khalid F.; El-Menyar, Ayman; Asaad, Nidal; Sulaiman, Kadhim; Hersi, Ahmad; Almahmeed, Wael; Alsheikh-Ali, Alawi A.; Amin, Haitham; Al-Motarreb, Ahmed; Al Saif, Shukri; Singh, Rajvir; Al-Lawati, Jawad; Al Suwaidi, Jassim

    2013-01-01

    Context Elderly patients have more cardiovascular risk factors and a greater burden of ischemic disease than younger patients. Aims To examine the impact of age on clinical presentation and outcomes in patients presenting with acute coronary syndrome (ACS). Methods and material Collected data from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2), which is a prospective multicenter study from six adjacent Arab Middle Eastern Gulf countries. Patients were divided into 3 groups according to their age: ≤50 years, 51–70 years and >70 years and their clinical characteristics and outcomes were analyzed. Mortality was assessed at one and 12 months. Statistical analysis used One-way ANOVA test for continuous variables, Pearson chi-square (X2) test for categorical variables and multivariate logistic regression analysis for predictors were performed. Results Among 7930 consecutive ACS patients; 2755 (35%) were ≤50 years, 4110 (52%) were 51–70 years and 1065 (13%) >70 years old. The proportion of women increased with increasing age (13% among patients ≤50 years to 31% among patients > 70 years). The risk factor pattern varied with age; younger patients were more often obese, smokers and had a positive family history of CAD, whereas older patients more likely to have diabetes mellitus, hypertension, and dyslipidemia. Advancing age was associated with under-treatment evidence-based therapies. Multivariate logistic regression analysis after adjusting for relevant covariates showed that old age was independent predictors for re-ischemia (OR 1.29; 95% CI 1.03–1.60), heart failure (OR 2.8; 95% CI 2.17–3.52) and major bleeding (OR 4.02; 95% CI 1.37–11.77) and in-hospital mortality (age 51–70: OR 2.67; 95% CI 1.86–3.85, and age >70: OR 4.71; 95% CI 3.11–7.14). Conclusion Despite being higher risk group, elderly are less likely to receive evidence-based therapies and had worse outcomes. Guidelines adherence is highly recommended in elderly. PMID

  2. Decreasing Stroke Code to CT Time in Patients Presenting with Stroke Symptoms.

    Science.gov (United States)

    Kalnins, Aleksandrs; Mickelsen, L Jake; Marsh, Daisha; Zorich, Christoph; Casal, Stephanie; Tai, Waimei Amy; Vora, Nirali; Olalia, Gennette; Wintermark, Max; Larson, David B

    2017-01-01

    Guided quality improvement (QI) programs present an effective means to streamline stroke code to computed tomography (CT) times in a comprehensive stroke center. Applying QI methods and a multidisciplinary team approach may decrease the stroke code to CT time in non-prenotified emergency department (ED) patients presenting with symptoms of stroke. The aim of this project was to decrease this time for non-prenotified stroke code patients from a baseline mean of 20 minutes to one less than 15 minutes during an 18-week period by applying QI methods in the context of a structured QI program. By reducing this time, it was expected that the door-to-CT time guideline of 25 minutes could be met more consistently. Through the structured QI program, we gained an understanding of the process that enabled us to effectively identify key drivers of performance to guide project interventions. As a result of these interventions, the stroke code to CT time for non-prenotified stroke code patients decreased to a mean of less than 14 minutes. This article reports these methods and results so that others can similarly improve the time it takes to perform nonenhanced CT studies in non-prenotified stroke code patients in the ED. ©RSNA, 2017.

  3. Unusual Presentation of Central Diabetes Insipidus in a Patient With Neurosarcoidosis

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    Vedha Sanghi MBBS

    2016-09-01

    Full Text Available Hypernatremia is a frequent cause of intensive care unit admission. The patient presented in this article had hypernatremia refractory to D5W (dextrose 5% water therapy, which led to a complex investigation. Workup revealed central diabetes insipidus most likely secondary to flare up of neurosarcoidosis. The challenge in terms of diagnosis was a presentation with low urine output in the setting of hypernatremia resistant to treatment with desmopressin. This case unfolded the role of hypothyroidism causing secondary renal dysfunction and hence needed continued treatment with thyroxine in addition to treatment for hypernatremia.

  4. Adrenal Insufficiency in a Cancer Patient Presenting as Acute Hypotension During Induction of Anaesthesia

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    Shilpi Singhal

    2008-01-01

    Full Text Available A 54 year-old-male, a case of squamous cell carcinoma of right pyriform fossa, treated with radical radiotherapy & chemo-therapy in 2004, presented in January 2007, with difficulty in swallowing. He was diagnosed to have squamous cell carcinoma of upper third of oesophagus & surgery was planned. Patient had history of recurrent blackouts which were attributed to general-ized weakness and diarrhoea. During induction, he developed Hypotension & on evaluation, was diagnosed to have primary adrenal insufficiency.

  5. Progressive multifocal leukoence-phalopathy presenting as homonymous hemianopia in a patient with acquired immunodeficiency syndrome

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    Amit Pandey

    2012-01-01

    Full Text Available We present a case of a Human Immunodeficiency Virus (HIV positive patient who was referred for retinal evaluation to rule out ophthalmic manifestations of Acquired Immunodeficiency Syndrome (AIDS. She complained of some disturbance in vision in both eyes. Fundus examination showed no abnormality. Perimetry, done to rule out optic nerve pathology, showed a left homonymous hemianopia. Magnetic Resonance Imaging (MRI scan showed features of Progressive Multifocal Leukoencephalopathy (PML. She had no other neurological symptoms or signs.

  6. Secondary Leukemia in a non-Hodgkin's Lymphoma Patient Presenting as Myeloid Sarcoma of the Breast

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    Vincenzo Pitini

    2011-01-01

    Full Text Available As defined by the World Health Organization classification of tumors of hematopoietic and lymphoid tissue, myeloid sarcoma (MS is a tumor mass of myeloblasts or immature myeloid cells that can arise before, concurrent with, or following acute myeloid leukaemia. We describe a case of secondary leukemia presenting itself as MS of the breast in a patient previously treated for a non-Hodgkin's Lymphoma.

  7. Intersecting Homeliness: Vietnamese Australian Reflections of a Suburban Home (Strathfield, NSW

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    Helary Ngo

    2015-09-01

    my family still resides in that has happened 10 years ago and has not escaped the memories of any of us. I hope to capture, in a self-reflexive way, the merging of the past and the present within the Vietnamese migrant experience living in the Australian landscape, with its dark history of the forced displacement of Indigenous peoples. I wish to mourn and acknowledge that the land that has given my refugee family opportunity to begin life safely and freely, and my birthplace is a stolen land. And that we are always both grateful and in mourning with our homeland.

  8. Patients With Ice Hockey Injuries Presenting to US Emergency Departments, 1990–2006

    Science.gov (United States)

    Deits, Jeff; Yard, Ellen E.; Collins, Christy L.; Fields, Sarah K.; Comstock, R. Dawn

    2010-01-01

    Abstract Context: Although the number of US ice hockey participants doubled from 1990 to 2006, no nationally representative studies have examined US ice hockey injuries among participants of all ages during this period. Objective: To describe patients with ice hockey injuries presenting to a representative sample of US emergency departments (EDs) from 1990 through 2006. Design: Prospective injury surveillance study. Setting: The US Consumer Product Safety Commission collects data from 100 nationally representative EDs via the National Electronic Injury Surveillance System (NEISS). Patients or Other Participants: Individuals injured while playing ice hockey and presenting to a NEISS-affiliated ED from 1990 through 2006. Main Outcome Measure(s): Incidence and patterns of ice hockey–related injuries. Results: From 1990 through 2006, 8228 patients with ice hockey–related injuries presented to NEISS-affiliated EDs, representing an estimated 302 368 ice hockey–related injuries sustained nationally during this time. Injuries occurred predominantly among males (93.5%). More than half of the injured were aged 9 to 14 years (28.9%) or 15 to 18 years (30.1%), and injury incidence in these age groups increased over the study period (P  =  .009 and P Ice hockey injury patterns vary by age and sex. Our findings indicate that many trips to the ED might be prevented by using protective equipment appropriately. PMID:20831391

  9. Nocardia yamanashiensis in an immunocompromised patient presenting as an indurated nodule on the dorsal hand.

    Science.gov (United States)

    Anzalone, C Lane; Cohen, Philip R; Tarrand, Jeffrey J; Diwan, Abdul H; Prieto, Victor G

    2013-01-01

    Nocardia are ubiquitous, aerobic, gram-positive actinomycetes. Nocardiosis typically occurs in immunocompromised patients, although immunocompetent individuals can also be affected. The purpose of this case study is to review the clinical characteristics and treatments of a unique form of cutaneous nocardiosis. We retrospectively reviewed the medical literature using PubMed, searching the terms cutaneous, host, immunocompromised, Nocardia, primary, yamanashiensis. Patient reports and previous reviews of the subject were critically assessed and the salient features are presented. Cutaneous nocardiosis typically presents as pustular nodules and the lesions may progress to become abscesses, cellulitis, granulomas or keloid-like tumors. N. brasiliensis is the predominant species involved in primary cutaneous nocardiosis; other common Nocardia species involved in human disease are N. farcinica, N. abscessus, N. cyriacigeorgica, and N. nova. Only two individuals (including the patient presented here) with primary cutaneous infection by N. yamanashiensis have been described in the literature; a third clinical isolate was recovered from a lung biopsy. Nocardia yamanashiensis is a rare clinical form of primary cutaneous nocardiosis. 16S ribosomal gene sequencing, as well as Gram stain and modified Fite acid-fast stain, play a vital role in identifying this clinical variant.

  10. Profile of injured patients presenting to a tertiary hospital in a developing country.

    Science.gov (United States)

    Musharrafieh, Umayya; Rahi, Amal C; Taha, Assaad; Shamseddine, Wael; Steitieh, Suzanne; Jamali, Faek; Tamim, Hala

    2011-01-01

    In most developing countries including Lebanon, trauma research is lacking and warranted. Objectives of the current study were to describe trauma patients referred to a tertiary care center during one year and identify outcomes and patterns of injury. Review of hospital charts of every 12th consecutive patient presenting to the emergency unit (ED) after a traumatic event during the year 2001-2002. Data collected include: demographics, injury description, and hospital data. A total of 736 patients were included, 212 pediatric, 455 young, and 62 geriatric patients. The most common body regions injured were the extremities followed by the face. The most encountered mechanism of injury was fall from less than 15 feet (38.2%) followed by penetrating/gunshot injury (14.8%), and road traffic accidents (11.8%). The rates of hospital admission and surgical intervention were highest among geriatric patients (p = 0.03 and p < 0.001). Most injuries occurred during the evening shift and the average time spent in the ED was 86 minutes. The police was informed in 6.6% of the cases. Falls represent a worrisome mechanism across all age groups. This may be an indication for unaddressed occupational hazards for the working young and lack of awareness about the need for more children supervision. More rigorous investigation of intentional and unintentional firearm injuries, and their predisposing factors are needed.

  11. Three patients presenting with severe macrosomia and congenital hypertrophic cardiomyopathy: a case series.

    Science.gov (United States)

    Vincent, Marie; Benbrik, Nadir; Romefort, Bénédicte; Colombel, Agnès; Bézieau, Stéphane; Isidor, Bertrand

    2017-03-24

    Macrosomia and hypertrophic cardiomyopathy are two features often associated in neonates of diabetic mothers. We report the cases of three patients with severe macrosomia and critical hypertrophic cardiomyopathy without severely unbalanced maternal diabetes. Only three patients with those two features and no uncontrolled maternal diabetes have been previously reported. The first patient was a 39-week-old girl, the second patient was a 39-week-old girl, and the third patient was a 41-week-old boy. The two French girls and the French boy had severe macrosomia and hypertrophic cardiomyopathy, leading to the death of the boy. The outcome of the two girls was favorable, with a standardization of growth curves and ventricular hypertrophy. Their mothers presented with high body mass index but no severe documented maternal diabetes; glycemic imbalance was only suspected on postnatal analyses. There was no hydramnios during pregnancy and no other environmental factor, especially toxic exposure. Their parents are from Mayotte, Guadeloupe, and Guinea-Conakry. The usual genetics causes, Beckwith-Wiedemann syndrome, and chromosomal copy number variation, were also excluded. This report suggests the implication of other factors in addition to glycemic disorders, including genetic factors, in the occurrence of macrosomia and severe hypertrophic cardiomyopathy in neonates. These three original observations indicate that gynecologists and neonatologists should pay attention to neonates from mothers with a high body mass index and when maternal diabetes is not documented.

  12. A pilot cross-sectional study of patients presenting with cellulitis to emergency departments.

    LENUS (Irish Health Repository)

    Quirke, M

    2014-11-01

    To characterise the Emergency Department (ED) prevalence of cellulitis, factors predicting oral antibiotic therapy and the utility of the Clinical Resource Efficiency Support Team (CREST) guideline in predicting patient management in the ED setting, a prospective, cross-sectional study of consecutive adult patients presenting to 3 Irish EDs was performed. The overall prevalence of cellulitis was 12 per 1,000 ED visits. Of 59 patients enrolled, 45.8% were discharged. Predictors of treatment with oral antibiotics were: CREST, Class 1 allocation (odds ratio (OR) 6.81, 95% Cl =1.5-30.1, p=0.012), patient self-referral (OR= 6.2, 95% Cl 1.9- 20.0, p=0.03) and symptom duration longer than 48 hours (OR 1.2, 95% Cl = 1.0-1.5,p=0.049). In conflict with guideline recommendation, 43% of patients in CREST Class 1 received IV therapy. Treatment with oral antibiotics was predicted by CREST Class 1 allocation, self-referral, symptom duration of more than 48 hours and absence of pre-EO antibiotic therapy.

  13. Campylobacter concisus pathotypes are present at significant levels in patients with gastroenteritis.

    Science.gov (United States)

    Underwood, Alexander P; Kaakoush, Nadeem O; Sodhi, Nidhi; Merif, Juan; Seah Lee, Way; Riordan, Stephen M; Rawlinson, William D; Mitchell, Hazel M

    2016-03-01

    Given that Campylobacter jejuni is recognized as the most common cause of bacterial gastroenteritis worldwide, recent findings showing comparable levels of Campylobacter concisus in patients with gastroenteritis would suggest that this bacterium is clinically important. The prevalence and abundance of Campylobacter concisus in stool samples collected from patients with acute gastroenteritis was examined using quantitative real-time PCR. The associated virulence determinants exotoxin 9 and zonula occludens toxin DNA were detected for Campylobacter concisus-infected samples using real-time PCR. Campylobacter concisus was detected at high prevalence in patients with gastroenteritis (49.7 %), higher than that observed for Campylobacter jejuni (∼5 %). The levels of Campylobacter concisus were putatively classified into clinically relevant and potentially transient subgroups based on a threshold developed using Campylobacter jejuni levels, as the highly sensitive real-time PCR probably detected transient passage of the bacterium from the oral cavity. A total of 18 % of patients were found to have clinically relevant levels of Campylobacter concisus, a significant number of which also had high levels of one of the virulence determinants. Of these patients, 78 % were found to have no other gastrointestinal pathogen identified in the stool, which strongly suggests a role for Campylobacter concisus in the aetiology of gastroenteritis in these patients. These results emphasize the need for diagnostic laboratories to employ identification protocols for emerging Campylobacter species. Clinical follow-up in patients presenting with high levels of Campylobacter concisus in the intestinal tract is needed, given that it has been associated with more chronic sequelae.

  14. Chromatic multifocal pupillometry for objective perimetry in patients with Best's vitelliform macular dystrophy (Conference Presentation)

    Science.gov (United States)

    Rotenstreich, Ygal; Ben-Ner, Daniel; Chibel, Ron; Mahajna, Mohamad O.; Sher, Ifat

    2017-02-01

    Purpose: Objective pupilloperimetry in healthy subjects and patients with Best's Vitelliform Macular Dystrophy using a chromatic multifocal pupillometer (CMP). Methods: A CMP (Accutome Inc) was used to record pupillary responses (PR) of 17 healthy subjects and 5 Best's patients. Red and blue light stimuli were presented at 76 locations of a 16.2 degree VF. The PR of patients were compared with their findings on Humphrey's 24-2 perimetry, Optical Coherence Tomography (OCT) and with the PR of healthy subjects. Percentage of Pupil Constriction (PPC), maximal constriction velocity (MCV) and the latency of MCV (LMCV) were determined. Results: In response to red light, Best's patients demonstrated reduced PPC and slower MCV compared with healthy subjects in nearly all test point locations. Severity of defects in PPC in responses to red light correlated with reduced thickness of photoreceptor layer as determined by OCT in the central, superior, nasal and temporal areas of the central retina (Pearson's r= -0.93, -0.91, -0.92, -0.85, respectively). By contrast, in response to blue light stimuli, the PPC and MCV of patients were lower than normal only in several central points. Surprisingly, the latency of MCV was shorter in patients compared with healthy subjects in response to red and blue stimuli. Conclusions: This study demonstrates the potential feasibility of using pupillometer-based chromatic perimetry for objectively assessing VF defects in patients with Best's macular dystrophy. Our findings also suggest that chromatic pupilloperimetry may differentiate between PR mediated by cones or rods, and can specifically detect defects in macular cones.

  15. Development of the First Language Is Not a Barrier to Second-Language Acquisition: Evidence from Vietnamese Immigrants to the United States.

    Science.gov (United States)

    Nguyen, Anne; Shin, Fay; Krashen, Stephen

    2001-01-01

    Elementary and middle school children in California who speak Vietnamese as a first language reported high levels of oral competence in Vietnamese and a desire to maintain Vietnamese language and culture. There was no evidence that the development of the first language was a barrier to second language acquisition. (Author/VWL)

  16. Clinical Features and Outcome in Newly Diagnosed Hodgkin Lymphoma Patients Presenting with PET/CT-Ascertained Focal Skeletal Lesions

    DEFF Research Database (Denmark)

    El-Galaly, Tarec Christoffer; Hutchings, Martin; Juul Mylam, Karen

    Clinical Features and Outcome in Newly Diagnosed Hodgkin Lymphoma Patients Presenting with PET/CT-Ascertained Focal Skeletal Lesions......Clinical Features and Outcome in Newly Diagnosed Hodgkin Lymphoma Patients Presenting with PET/CT-Ascertained Focal Skeletal Lesions...

  17. Domestic Minor Sex Trafficking Patients: A Retrospective Analysis of Medical Presentation.

    Science.gov (United States)

    Goldberg, Amy P; Moore, Jessica L; Houck, Christopher; Kaplan, Dana M; Barron, Christine E

    2017-02-01

    To describe the clinical characteristics of patients referred for domestic minor sex trafficking (DMST) to improve identification and intervention. Retrospective cohort study. The Lawrence A. Aubin, Sr Child Protection Center at Hasbro Children's Hospital where patients are evaluated by child abuse pediatricians in outpatient, emergency department, and inpatient settings. A total of 41 patients younger than the age of 18 years referred for the evaluation of DMST involvement between August 1, 2013 and March 30, 2015. We collected demographic, social-environmental, medical, and psychiatric variables from the medical records of patients referred for evaluation who have self-disclosed, been reported with evidence, and/or have histories that place them at high risk for DMST involvement. Children had frequent contact with medical providers, with 81% seen in the year before referral for DMST. Childhood maltreatment and family dysfunction were identified (sexual abuse, 21/37 or 57%; parental substance abuse, 22/37 or 60%) in the 41 patients. Children had medical problems (eg, sexually transmitted infection, 13/41 or 32%), psychiatric needs (eg, acute suicidality, 8/41 or 20%; at least 1 previous psychiatric admission, 19/41 or 46%), and substance use (36/41 or 88%). Although 26/41 (63%) had runaway and 17/41 (42%) lived in a group home placement, 28/41 (68%) currently lived at home and 29/41 (71%) presented with a parent/guardian or relative. Children referred for DMST present frequently to physicians and have complex medical and psychiatric needs. Medical providers' increased awareness of this health issue would inform victim identification and intervention. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  18. Uncommon Presentation of Idiopathic Intracranial Hypertension in a Patient with Polycystic Ovary Syndrome: A Case Report

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    Anas Mohammad Albarrak

    2017-03-01

    Full Text Available Introduction: Idiopathic intracranial hypertension is a rare condition characterized by increased intracranial pressure without clinical, laboratory, or radiological evidence of intracranial pathology. Early management could prevent irreversible outcomes. Case Presentation: A 17-year-old single Arabian female of Arab origin presented with a 2-day complaint of horizontal diplopia and transient visual obscurations. She denied any history of headache or decreased vision. The patient was diagnosed with polycystic ovary syndrome a year prior to presentation. Examination revealed bilateral moderate papilledema and limited left eye abduction. However, visual acuity and fields were normal. Increased intracranial pressure was confirmed by lumbar puncture opening pressure (550 mm H2O. The cerebrospinal fluid composition and imaging of brain and cerebral venous system were normal. The diagnosis of idiopathic intracranial hypertension was confirmed and the patient was treated with acetazolamide 500 mg twice per day. The symptoms totally resolved within 3 days and the papilledema disappeared after 2 months. Conclusion: Awareness of such uncommon presentation of idiopathic intracranial hypertension emphasizes the critical importance of detailed ophthalmic examination and shows the good prognosis of early management.

  19. [Physical condition and work capacity of Vietnamese workers in the People's Republic of Bulgaria].

    Science.gov (United States)

    Ch'ong, N V

    1983-01-01

    The expansion of integration processes on economics between P.R. of Bulgaria and S.R. of Vietnam during the eight 5-year plan period and the increased number of Vietnamese workers in Bulgaria determine the actuality and significance of the problem of the studies on their physical state and working capacity. One hundred sixty newly-come Vietnamese workers, aged between 20 and 35 were examined as well as 89 subjects, working as miners in Madan mines, with three years average length or service and average age 20-30. The following indices were used in the determination of the physical state and working capacity: height, body weight, chest measurements, vital capacity, muscular strength and hand muscular strength, time of simple and complicated visual-motor reaction. The results revealed that the group of workers, with a 3-year stay in Bulgaria, had statistically significant, higher values of the majority of the indices as compared with those of the newly-come Vietnamese. The Vietnamese workers manifested lower values of the indices for physical development (with 5 to 25%) as compared with the Bulgarians, the difference being considerably smaller in the miners' group. The future longitudinal studies on the physical state and working capacity of the Vietnamese workers will be the grounds for the elaboration of norms for physical loading, weight lifting, etc.

  20. A Character Level Based and Word Level Based Approach for Chinese-Vietnamese Machine Translation

    Directory of Open Access Journals (Sweden)

    Phuoc Tran

    2016-01-01

    Full Text Available Chinese and Vietnamese have the same isolated language; that is, the words are not delimited by spaces. In machine translation, word segmentation is often done first when translating from Chinese or Vietnamese into different languages (typically English and vice versa. However, it is a matter for consideration that words may or may not be segmented when translating between two languages in which spaces are not used between words, such as Chinese and Vietnamese. Since Chinese-Vietnamese is a low-resource language pair, the sparse data problem is evident in the translation system of this language pair. Therefore, while translating, whether it should be segmented or not becomes more important. In this paper, we propose a new method for translating Chinese to Vietnamese based on a combination of the advantages of character level and word level translation. In addition, a hybrid approach that combines statistics and rules is used to translate on the word level. And at the character level, a statistical translation is used. The experimental results showed that our method improved the performance of machine translation over that of character or word level translation.

  1. A Character Level Based and Word Level Based Approach for Chinese-Vietnamese Machine Translation.

    Science.gov (United States)

    Tran, Phuoc; Dinh, Dien; Nguyen, Hien T

    2016-01-01

    Chinese and Vietnamese have the same isolated language; that is, the words are not delimited by spaces. In machine translation, word segmentation is often done first when translating from Chinese or Vietnamese into different languages (typically English) and vice versa. However, it is a matter for consideration that words may or may not be segmented when translating between two languages in which spaces are not used between words, such as Chinese and Vietnamese. Since Chinese-Vietnamese is a low-resource language pair, the sparse data problem is evident in the translation system of this language pair. Therefore, while translating, whether it should be segmented or not becomes more important. In this paper, we propose a new method for translating Chinese to Vietnamese based on a combination of the advantages of character level and word level translation. In addition, a hybrid approach that combines statistics and rules is used to translate on the word level. And at the character level, a statistical translation is used. The experimental results showed that our method improved the performance of machine translation over that of character or word level translation.

  2. Vietnamese Migrant Workers in Thailand - Implications for Leveraging Migration for Development

    Directory of Open Access Journals (Sweden)

    Nancy HUYEN NGUYEN

    2014-05-01

    Full Text Available A greater flow of people to and from each of the Mekong countries is catching the attention of the general public and academic researchers. As one of the fastest growing countries in the GMS, Thailand is attracting the majority of migrant workers from its neighbours. At a smaller scale, when compared with those from Lao PDR, Cambodia and Myanmar, Vietnamese workers are also joining this increasing trend in immigration to Thailand. By analyzing information from secondary data sources, this research paper attempts to provide further insights into the social and economic impacts generated by the Vietnamese migrant workers in Thailand both at home and the host country. The study discovers that moving to Thailand for work has eased the pressures of rural unemployment and underemployment that have plagued Vietnam recently. Meanwhile, Vietnamese workers are helping soothe the stress caused by the increasing demand for unskilled and low skilled labourers in Thailand. The study further learns that the long-established community of Vietnamese migrants in Thailand is encouraging the increasing movement of Vietnamese workers to Thailand. The study findings suggest meaningful implications for future policies in leveraging labour migration for development.

  3. Powerpoint as a Potential Tool to Learners' Vocabulary Retention: Empirical Evidences from a Vietnamese Secondary Education Setting

    Science.gov (United States)

    Nam, Ta Thanh; Trinh, Lap Q.

    2012-01-01

    In Vietnamese secondary education, translation and visuals are traditionally used as major techniques in teaching new English lexical items. Responding to the Vietnamese government policy issued in 2008 on using IT for a quality education, the application of PowerPoint has been considered the most prevalent type of technology used in the…

  4. "This Is Not Representation!": A Study of Urbanization, Alienation, and Tolerance through a Vietnamese Heritage Language and Culture Program

    Science.gov (United States)

    Nguy?n, Thu Suong Th?; Anderson, Jantina

    2017-01-01

    This case centers on a Vietnamese language and culture program situated within an urban context. It illustrates how sociohistorical and geopolitical contexts interplay in understanding relations within schools as well as school-community relations. A new ethnoburb creates both opportunities and challenges for the Vietnamese community related to…

  5. A Narrative Engagement Framework to Understand HPV Vaccination among Latina and Vietnamese Women in a Planned Parenthood Setting

    Science.gov (United States)

    Hopfer, Suellen; Garcia, Samantha; Duong, Huong T.; Russo, Jennefer A.; Tanjasiri, Sora P.

    2017-01-01

    Disparities in cervical cancer and human papillomavirus (HPV) vaccination persist among Vietnamese and Latina women. Through a partnership with Planned Parenthood of Orange and San Bernardino Counties (PPOSBC) in Southern California, we conducted in-depth interviews with young adult Latina (n = 24) and Vietnamese (n = 24) women, and PPOSBC staff…

  6. Recognizing the Effects of Comprehension Language Barriers and Adaptability Cultural Barriers on Selected First-Generation Undergraduate Vietnamese Students

    Science.gov (United States)

    Phan, Christian Phuoc-Lanh

    2009-01-01

    This investigation is about recognizing the effects of comprehension language barriers and adaptability cultural barriers on selected first-generation Vietnamese undergraduate students in the Puget Sound region of Washington State. Most Vietnamese students know little or no English before immigrating to the United States; as such, language and…

  7. Cultural Identity and Allegiance among Vietnamese Students and Their Organizations at the University of California, Irvine: 1980-1990

    Science.gov (United States)

    Nguyen, Thai-Huy; Gasman, Marybeth

    2015-01-01

    Background: Within the canon of Asian American histories and histories of student activism, little attention is given to the Vietnamese students at the University of California at Irvine, who came together to advocate for the well-being of Vietnamese refugees after the end of the Vietnam War. This study examines this history and discusses the…

  8. Impetigo presenting as an acute necrotizing swelling of the lower lip in an adult patient.

    Science.gov (United States)

    Ghafoor, Mohammed; Halsnad, Moorthy; Fowell, Christopher; Millar, Brian G

    2012-06-01

    The authors present an unusual case of an acute swelling of the lower lip and septicemia in a 35-year-old, recent immigrant male arriving from India. The patient presented in our emergency department with a 48-hour history of a worsening, painful swelling of the lower lip. On presentation, he was pyrexial and the lip was found to be acutely inflamed with honey-colored crusting, pustular lesions, and induration . A diagnosis of impetigo leading to necrosis of the lip was established, a rare phenomenon potentially resulting in significant tissue destruction. Appropriate medical management achieved a good outcome and prevented disabling tissue loss of the orofacial region. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Incidental detection of hyperfunctioning thyroid cancer metastases in patients presenting with thyrotoxicosis

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    Nishikant A Damle

    2012-01-01

    Full Text Available Thyrotoxicosis due to functioning metastases from thyroid cancer is rare. It also presents a therapeutic challenge, as both the metastatic cancer and thyrotoxicosis need to be treated. We present here two cases of thyrotoxicosis which on a routine 99m Tc-pertechnetate thyroid scan showed extrathyroidal foci of uptake. Two patients who initially presented with thyrotoxicosis underwent a routine thyroid scan. Abnormal uptake in the shoulder was incidentally noted, which prompted us to do a whole body pertechnetate scan in the same sitting, which revealed extensive hyperfunctioning metastases in the lungs and bones. We also discuss the ′Flip Flop′ phenomenon in thyroid cancer, which was seen in our case. This report emphasizes the importance of evaluating the abnormal foci of uptake seen on a routine thyroid scan.

  10. Aphasic Dystextia as Presenting Feature of Ischemic Stroke in a Pediatric Patient

    Directory of Open Access Journals (Sweden)

    Arpita Lakhotia

    2016-01-01

    Full Text Available Aphasia is an important presenting symptom of acute stroke. With increasing reliance on electronic communication, incoherent texting or “dystextia,” which is a subset of aphasia that is reflected in text messages, can be a useful tool for symptom recognition and analysis. It can be a red flag for the family and therefore can help in early identification of an acute neurological deficit. It is also useful for providers to reliably analyze the deficit as well as establish a timeline of evolution of symptoms. There have been case reports where dystextia has been the presenting feature of stroke or complicated migraine and in one case of meningioma. We present the case of a teenage patient that in our knowledge is the youngest reported case of dystextia, whose aphasia recorded in a text message assisted with stroke localization. This also adds to the literature of dystextia which so far has only seven other cases reported.

  11. Artificial neural networks to predict presence of significant pathology in patients presenting to routine colorectal clinics.

    Science.gov (United States)

    Maslekar, S; Gardiner, A B; Monson, J R T; Duthie, G S

    2010-12-01

    Artificial neural networks (ANNs) are computer programs used to identify complex relations within data. Routine predictions of presence of colorectal pathology based on population statistics have little meaning for individual patient. This results in large number of unnecessary lower gastrointestinal endoscopies (LGEs - colonoscopies and flexible sigmoidoscopies). We aimed to develop a neural network algorithm that can accurately predict presence of significant pathology in patients attending routine outpatient clinics for gastrointestinal symptoms. Ethics approval was obtained and the study was monitored according to International Committee on Harmonisation - Good Clinical Practice (ICH-GCP) standards. Three-hundred patients undergoing LGE prospectively completed a specifically developed questionnaire, which included 40 variables based on clinical symptoms, signs, past- and family history. Complete data sets of 100 patients were used to train the ANN; the remaining data was used for internal validation. The primary output used was positive finding on LGE, including polyps, cancer, diverticular disease or colitis. For external validation, the ANN was applied to data from 50 patients in primary care and also compared with the predictions of four clinicians. Clear correlation between actual data value and ANN predictions were found (r = 0.931; P = 0.0001). The predictive accuracy of ANN was 95% in training group and 90% (95% CI 84-96) in the internal validation set and this was significantly higher than the clinical accuracy (75%). ANN also showed high accuracy in the external validation group (89%). Artificial neural networks offer the possibility of personal prediction of outcome for individual patients presenting in clinics with colorectal symptoms, making it possible to make more appropriate requests for lower gastrointestinal endoscopy. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.

  12. PREVALENCE OF MEIBOMIAN GLAND DISEASE IN TYPE II DIABETIC PATIENTS & ITS CLINICAL PRESENTATIONS

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    Reshma Pathan

    2015-01-01

    Full Text Available AIMS : To study the prevalence of the meibomian gland disease in typ e 2 diabetic patients and its clinical presentations. SETTING AND DESIGN : A hospital based cross sectional descriptive study of 100 type 2 diabetic patients attending a medical college was conducted. METHODS : Detailed diabetic history was recorded. Assessment of ocular surface i.e. the lid margins , conjunctiva , corneal surface was done via slit lamp biomicroscopy. Meibomian gland disease (MGD severity was assessed by the quality and expressibility of the meibomian secretion. Dry eye tests like schir mer’s test and tear film breakup time were done. STATISTICAL ANALYSIS USED : SPSS statistical software version 17 was used. RESULTS : 56% of the patients out of 100 diabetic patients had MGD. The most common symptom was burning (46.9% , followed by dryness ( 23.5% , 5.6% had conjunctival injection , 7.14% had corneal erosions , 25% had mucus debris , 53.65% had dry eye which was statistically significant (p=0.001 , 56.25% males and 72.2% females had the disease which was not statistically significant. CONCLUSION : The prevalence of Meibomian gland disease in the diabetic population was 56% which is more than the general population prevalence. Apart from other disorders diabetics are also more prone for ocular surface diseases like Meibomian gland disease. MGD is an important pre disposer for severe diseases like Dry eye in this subgroup of patients which can lead to complications like conjunctival keratinisations , corneal erosions and perforations. Careful examination of these patients for ocular surface disease and prompt treatment is required.

  13. Effect of music on pain, anxiety, and patient satisfaction in patients who present to the emergency department in Turkey.

    Science.gov (United States)

    Parlar Kilic, Serap; Karadag, Gulendam; Oyucu, Serpil; Kale, Ozlem; Zengin, Suat; Ozdemir, Emine; Korhan, Esra Akin

    2015-01-01

    The objective of this study is to evaluate the effect of music therapy on pain, anxiety, and patient satisfaction in patients who present to the emergency department in Turkey. This controlled and experimental study was conducted in the emergency department of a hospital in Turkey between July and October 2012. The study sample consisted of 200 patients in total, 100 forming the intervention group and 100 being the control group, who fell under color code green in the triage system and came with complaints of pain due to nausea/vomiting and diarrhea, abdominal pain, headaches, and joint pain. A questionnaire, the State Anxiety Scale, and the Visual Analog Scale to measure the patients' level of pain were used in the study. The questionnaires of the intervention group were administered after playing the music. When the intervention and control groups were compared, it was observed that there was a significant decrease in the VASP and STAI-S scores in favor of the intervention group. It was observed that 21.0% of the patients in the intervention group were very pleased to hear music in the emergency department, 58% of them were moderately or at least a little pleased, and 21.0% were not pleased at all. The results showed that music therapy had a positive effect in terms of reducing the severity of pain and the level of anxiety in patients, that only a very small portion of the patients were not pleased to listen to music in the emergency department. © 2014 The Authors. Japan Journal of Nursing Science © 2014 Japan Academy of Nursing Science.

  14. Static balance in patients presenting diabetes mellitus type 2 with and without diabetic polyneuropathy.

    Science.gov (United States)

    Palma, Felipe H; Antigual, Diego U; Martínez, Sergio F; Monrroy, Manuel A; Gajardo, Rubén E

    2013-12-01

    To contrast the static balance in patients presenting diabetes mellitus type 2 (DM2) with and without polyneuropathy (DPN); and to correlate the rates from the scale Diabetic Neuropathy Examination (DNE) with the mean ratio of the center of pressure (CoP). Twenty patients, aged between 40 and 54, presenting DM2 and classified, according to DNE scale, in groups with (n = 10) and without (n = 10) DPN, were compared. Static balance was evaluated by means of the CoP mean ratio on a Wii Balance Board® under the conditions of open and closed eyes. After normality verification (Shapiro-Wilk), balance between both groups was compared by means of the Student t test and Mann-Whitney U test, as applicable. DNE rating was correlated with the mean ratio of CoP in the group with DPN, considering a significance level p static balance than patients without DPN in the closed eyes condition. Furthermore, the higher the rating in DNE, the stronger the displacement of CoP, which may be associated with higher risk of falls.

  15. [The analysis of the effectiveness of the combined treatment of the patients presenting with laryngeal papillomatosis].

    Science.gov (United States)

    Svistushkin, V M; Starostina, S V; Egorov, V I; Ragimov, A A; Mustafaev, D M; Matveev, A V; Volkova, K B

    The objective of the present work was to evaluate the effectiveness of the application of the inducer of endogenous interferon synthesis in the course of the combined treatment of the adult patients presenting with laryngeal papillomatosis. A total of 50 patients with this pathology were admitted and examined at the ENT Clinics of I.M. Sechenov First Moscow State Medical University and M.F. Vladimirsky Moscow Regional Research Clinical Institute during 24 months. The patients comprising group 1 (n=25) were treated with the use of cold plasma surgery and the inducer of endogenous interferon synthesis while those included in group 2 (n=25) received only surgical treatment. It was shown that the combined treatment including the surgical step (cold plasma surgery) followed by the treatment with the inducer of endogenous interferon synthesis to prevent relapses makes it possible to reduce the number of secondary surgical interventions, increase the duration of the intervals between relapses, and decrease the content of types 6 and 11 human papilloma virus in the saliva.

  16. Hashimoto encephalopathy in pediatric patients: Homogeneity in clinical presentation and heterogeneity in antibody titers.

    Science.gov (United States)

    Lee, Jiwon; Yu, Hee Joon; Lee, Jeehun

    2018-01-01

    Hashimoto encephalopathy is an autoimmune encephalopathy characterized by elevated antithyroid antibodies and a favorable response to corticosteroid. This study delineated the clinical characteristics of pediatric Hashimoto encephalopathy and the significance of low antithyroid antibody titers in diagnosis and treatment. Clinical manifestations, antibody titers, and treatment responses were retrospectively reviewed in six consecutive children diagnosed with Hashimoto encephalopathy between August 2008 and July 2016. Age at diagnosis was 10-17years. Presenting symptoms were seizures, altered consciousness, behavioral changes, psychosis, tremor, and dystonia. Thyroid function was normal in five patients, and one had hypothyroidism prior to the encephalopathy. Antithyroid antibody titer was increased at presentation in five patients and one week later in the other. Antibody levels were extremely varied (anti-thyroglobulin, 20.5-2318.0U/ml; anti-thyroid peroxidase, 12.5-2231.0U/ml; reference range, Hashimoto encephalopathy were similar, irrespective of antithyroid antibody titer. Because the initial antithyroid antibody titers can be normal or mildly-elevated, follow-up testing of antithyroid antibodies is required in patients who are clinically suspect for Hashimoto encephalopathy. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  17. THE STUDY OF MICRONUCLUES INDEX IN PATIENTS PRESENTING WITH MALIGNANT LESIONS

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    Archana

    2015-08-01

    Full Text Available Micronucleus is the nucleus that expresses the genotypic alterations caused in the process of malignancy. It is characteristically seen in exfoliated epithelial cells like Buccal Mucosa and urinary bladder wall during pre - cancerous and cancerous conditions in less and large proportions respectively. It is commonly used as a Biomarker to assess the stage and severity of neoplasm. Aim of our study is to observe the micronucleus Index in patients presenting with malignant oral lesions. 30 patients with maligna nt lesions from the Department of oral medicine, Vydehi Institute of Dental Sciences and Research Centre were screened for the presence of micronucleus . The buccal scrapings were obtained from the site of the lesion in the oral cavity by conventional metho ds. The obtained slides were stained by using Haematoxylin& Eosin stains and the micronucleus index was calculated. The results showed that the alteration of micronucleus count was observed in malignant conditions with respect to age and gender. Hence it c an be concluded that the micronucleus index can be used as a biomarker or as a screening test in patients presenting with pre malignant conditions

  18. Epidemiology of benign eyelid lesions in patients presenting to a teaching hospital

    Science.gov (United States)

    Al-Faky, Yasser H.

    2011-01-01

    Purpose This study evaluates the relative frequency of benign eyelid lesions presented to a teaching hospital in Saudi population. Patients and methods Charts of patients with benign eyelid lesions were retrospectively reviewed from January 2003 to December 2008. Clinical details included demographic data, symptoms and signs, surgical findings, primary diagnosis, and indication for biopsy were analyzed in a histopathologically confirmed benign eyelid lesions. Eyelid lesions were arranged according to their order of frequencies. Results A total of 222 biopsies were evaluated from 181 patients (male 39.2% and female 60.8%). The age of the patient at the time of biopsy ranged from 2 to 87 years old. The most common benign eyelid lesion encountered in our practice was sweat gland hidrocystoma followed by chalazion, skin tag, epidermal cyst, nevus, seborrheic keratosis, xanthelasma, and molluscum contagiosum respectively. Histopathological studies confirmed the clinical diagnosis in 95.9% (213/222) of specimens and was different from the clinical diagnosis in 4.1% (9/222) of the lesions which included seborrheic keratosis (n = 3), pilomatrixoma, steatocystoma, hemangioendothelioma, juvenile xanthogranuloma, calcinosis cutis, and syringocystadenoma papilliferum. No malignant lesion was labeled as benign. Conclusion Epidemiology of benign eyelid lesions in Saudi population is different from Far East or Western populations. Sweat gland hidrocystoma with classical clinical features and straightforward diagnosis is the most frequent lesion in our series which could be due to characteristic dry climate. PMID:23960994

  19. Psychological comorbidities predicting prescription opioid abuse among patients in chronic pain presenting to the emergency department.

    Science.gov (United States)

    Wilsey, Barth L; Fishman, Scott M; Tsodikov, Alexander; Ogden, Christine; Symreng, Ingela; Ernst, Amy

    2008-11-01

    We attempted to identify psychological comorbidities that are associated with the propensity for prescription opioid abuse. Patients presenting to an emergency department seeking opioid refills for chronic pain were evaluated with five validated self-report instruments and structured clinical interviews. The potential for prescription opioid abuse was modeled with multiple regression analysis using depression, anxiety disorders, personality disorder, and addiction as independent variables. Of the 113 patients studied, 91 (81%) showed a propensity for prescription opioid abuse as determined by scores on the Screener and Opioid Assessment for Patients with Pain instrument. Depression, anxiety, and a history of substance were common and panic attacks, posttraumatic stress disorder, and personality disorders were also found, albeit less frequently. Panic attacks, trait anxiety, and the presence of a personality disorder accounted for 38% of the variance in the potential for prescription opioid abuse. Patients in chronic pain should be assessed for psychological and addiction disorders because they are at increased risk for abusing opioids. They should also be referred for psychosocial treatment as part of their care, where appropriate.

  20. Clinical presentation of inhalational anthrax following bioterrorism exposure: report of 2 surviving patients.

    Science.gov (United States)

    Mayer, T A; Bersoff-Matcha, S; Murphy, C; Earls, J; Harper, S; Pauze, D; Nguyen, M; Rosenthal, J; Cerva, D; Druckenbrod, G; Hanfling, D; Fatteh, N; Napoli, A; Nayyar, A; Berman, E L

    2001-11-28

    The use of anthrax as a weapon of biological terrorism has moved from theory to reality in recent weeks. Following processing of a letter containing anthrax spores that had been mailed to a US senator, 5 cases of inhalational anthrax have occurred among postal workers employed at a major postal facility in Washington, DC. This report details the clinical presentation, diagnostic workup, and initial therapy of 2 of these patients. The clinical course is in some ways different from what has been described as the classic pattern for inhalational anthrax. One patient developed low-grade fever, chills, cough, and malaise 3 days prior to admission, and then progressive dyspnea and cough productive of blood-tinged sputum on the day of admission. The other patient developed progressively worsening headache of 3 days' duration, along with nausea, chills, and night sweats, but no respiratory symptoms, on the day of admission. Both patients had abnormal findings on chest radiographs. Non-contrast-enhanced computed tomography of the chest showing mediastinal adenopathy led to a presumptive diagnosis of inhalational anthrax in both cases. The diagnoses were confirmed by blood cultures and polymerase chain reaction testing. Treatment with antibiotics, including intravenous ciprofloxacin, rifampin, and clindamycin, and supportive therapy appears to have slowed the progression of inhalational anthrax and has resulted to date in survival.

  1. A DEFICIENCY OF ANTIGEN-PRESENTING CELLS IN PATIENTS WITH PULMONARY TUBERCULOSIS

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    L. V. Sakhno

    2009-01-01

    Full Text Available Abstract. The phenotype and functional properties of antigen-presenting cells (APCs: blood monocytes and in vitro generated macrophages/dendritic cells were investigated in patients with pulmonary tuberculosis (TB, n = 192 with different levels of proliferative response to M. tuberculosis antigens (PPD-responsive vs PPD - anergic patients, n = 118 and 74, respectively. A functional deficiency of all 3 types of APCs was revealed in patients with TB. I.e., a monocyte disfunction was displayed by low CD86 and HLA-DR expression, 2-fold increase of CD14+CD16+ subset, high level of FasL+ and IL-10+ cells, and enhanced IL-10 and IL-6 production upon LPS-stimulation. The in vitro generated macrophages from blood monocytes challenged with GM-CSF, were characterized by shifted Th1/Th2 balance (down-regulated production of IFNγ and IL-18 combined with up-regulation of IL-6 and IL-10, and reduced allostimulatory activity in mixed lymphocyte culture. The dendritic cells were characterized by decrease of mature, activated CD25+ cells, low level of IFNγ production in conjunction with enhanced capacity to produce IL - 10 and IL-6, and profound reduction of functional (allostimulatory activity. The APC disfunction of were most prominent in PPD-anergic patients. A possible role of APC disfunctions in disturbed antigen-specific T-cell response to M. tuberculosis is discussed.

  2. Development of a partial Balint's syndrome in a congenitally deaf patient presenting as pseudo-aphasia.

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    Drane, Daniel L; Lee, Gregory P; Huthwaite, Justin S; Tirschwell, David L; Baudin, Brett C; Jurado, Miguel; Ghodke, Basavaraj; Marchman, Holmes B

    2009-05-01

    We present a 56 year-old, right-handed, congenitally deaf female who exhibited a partial Balint's syndrome accompanied by positive visual phenomena restricted to her lower right visual quadrant (e.g., color band, transient unformed visual hallucinations). Balint's syndrome is characterized by a triad of visuo-ocular symptoms that typically occur following bilateral parieto-occipital lobe lesions. These symptoms include the inability to perceive simultaneous events in one's visual field (simultanagnosia), an inability to fixate and follow an object with one's eyes (optic apraxia), and an impairment of target pointing under visual guidance (optic ataxia). Our patient exhibited simultanagnosia, optic ataxia, left visual field neglect, and impairment of all complex visual-spatial tasks, yet demonstrated normal visual acuity, intact visual fields, and an otherwise normal neurocognitive profile. The patient's visuo-ocular symptoms were noticed while she was participating in rehabilitation for a small right pontine stroke. White matter changes involving both occipital lobes had been incidentally noted on the CT scan revealing the pontine infarction. As the patient relied on sign language and reading ability for communication, these visuo-perceptual limitations hindered her ability to interact with others and gave the appearance of aphasia. We discuss the technical challenges of assessing a patient with significant barriers to communication (e.g., the need for a non-standardized approach, a lack of normative data for such special populations), while pointing out the substantial contributions that can be made by going beyond the standard neuropsychological test batteries.

  3. Making Curricula Competence-oriented at Vietnamese Universities

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    Bosma, RH.

    2016-01-01

    Full Text Available Many academic curricula suffer from a teacher-centred focus on knowledge transfer and do not consider the societal needs for competences. This paper reflects on the transformation from theory-centred towards competency-oriented curricula at three Vietnamese Agriculture Universities with support of a Netherlands-funded project. Experts guided the implementation, from analysis of labour market to evaluation of new courses. Based on students' evaluation and lecturers' experiences, both types of respondents reported that after having been exposed to a series of trainings and hands-on experience in and outside classrooms, they gained new sets of knowledge and skills. However, some issues emerged in the process. Among these are the lack of competence among lecturers to design curricula based on outcomes, particularly addressing competence of students' knowledge, skills and attitudes; lack of staff to develop and implement a competence-based curricula; non- aggregation of closely related courses in modules that avoid repetitions and provides time for training of skills and attitudes. There is also a need to train students for competency in performing more complex learning outcomes, such as critical thinking. For this change to happen, lecturers need continuous training in didactics for active teaching, and Universities need to provide means for participative learning.

  4. Encouraging Vietnamese Household Recycling Behavior: Insights and Implications

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    The Ninh Nguyen

    2017-01-01

    Full Text Available This research aims to provide new insights into various determinants affecting household recycling. By focusing on Vietnam, this research also extends knowledge about sustainable behavior in emerging markets, which are the major culprits in terms of greenhouse gas emissions. Hypotheses were developed as a result of the critical review of relevant studies in the fields of marketing, psychology, and economics, and then tested using a quantitative survey data. Structured questionnaires were administered to Vietnamese respondents which yielded 486 usable responses. Multivariate statistics reveal that all the determinants influenced their recycling behavior except for moral norms. Attitude towards the importance of recycling exerted the strongest influence, followed by subjective norms and warm glow respectively. On the other hand, attitude towards the inconvenience of recycling significantly reduced recycling behavior. The research findings have important implications for strategies aimed at promoting recycling behavior. Communication and education programs should emphasize how household recycling contributes to environmental protection, as well as stress intrinsic rewards when recycling. Public media campaigns should feature opinion leaders and attractive communicators, who can effectively apply social pressure to perform recycling behavior. Organizations should also make every effort to make recycling more convenient.

  5. Batrachochytrium salamandrivorans is the predominant chytrid fungus in Vietnamese salamanders.

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    Laking, Alexandra E; Ngo, Hai Ngoc; Pasmans, Frank; Martel, An; Nguyen, Tao Thien

    2017-03-13

    The amphibian chytrid fungi, Batrachochytrium dendrobatidis (Bd) and B. salamandrivorans (Bsal), pose a major threat to amphibian biodiversity. Recent evidence suggests Southeast Asia as a potential cradle for both fungi, which likely resulted in widespread host-pathogen co-existence. We sampled 583 salamanders from 8 species across Vietnam in 55 locations for Bsal and Bd, determined scaled mass index as a proxy for fitness and collected environmental data. Bsal was found within 14 of the 55 habitats (2 of which it was detected in 2013), in 5 salamandrid species, with a prevalence of 2.92%. The globalized pandemic lineage of Bd was found within one pond on one species with a prevalence of 0.69%. Combined with a complete lack of correlation between infection and individual body condition and absence of indication of associated disease, this suggests low level pathogen endemism and Bsal and Bd co-existence with Vietnamese salamandrid populations. Bsal was more widespread than Bd, and occurs at temperatures higher than tolerated by the type strain, suggesting a wider thermal niche than currently known. Therefore, this study provides support for the hypothesis that these chytrid fungi may be endemic to Asia and that species within this region may act as a disease reservoir.

  6. Relapsed Colon Cancer Patient Presenting With Hematuria 13 Years After Primary Tumor Resection: A Case Report

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    Yu-Ho Huang

    2010-04-01

    Full Text Available We report a rare case of postoperative colon cancer recurrence who presented with hematuria 13 years after resection of the primary colonic cancer. The patient was 72 years of age and underwent surgical resection of sigmoid colon cancer at another regional hospital in 1994. Since June 2007, this patient has complained of hematuria and bloody stool. On physical examination, tenderness and a hard, indurated mass was palpable in the lower mid-abdomen. Abdominal computed tomography showed a metastatic tumor at the lower midline peritoneum with invasion of the adjacent abdominal wall. Her serum carcinoembryonic antigen level was elevated to 32 ng/dL. Histopathology revealed metastatic colonic adenocarcinoma in the jejunum and abdominal wall.

  7. Premenstrual Dysphoric Disorder in a Patient With Traumatic Brain Injury: A Case Presentation.

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    Omura, Jaclyn; Osorio, Marisa

    2017-09-04

    We present a case of a 17-year-old girl who developed premenstrual dysphoric disorder (PMDD) after sustaining a severe traumatic brain injury (TBI), and we review the diagnosis of PMDD. The patient developed symptoms of severe depression surrounding her menses months after sustaining severe TBI and was diagnosed with PMDD by a psychiatrist. She ultimately required antipsychotics for optimal symptom resolution. PMDD is a severe form of premenstrual syndrome with symptoms including irritability, anxiety, and nonfatal suicidal behavior. We discuss other potential causes of mood disturbance that are important to screen for after TBI, including depression, anxiety, and hypothalamic-pituitary axis disorders. Rehabilitation medicine providers need to be aware of PMDD in postpubertal female patients with TBI because it can lead to nonfatal suicidal behaviors. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  8. Bilious pericardial effusion at initial presentation in a patient with lung cancer.

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    Kotoulas, Christophoros S; Foroulis, Christophoros; Letsas, Konstantinos; Kostikas, Konstantinos; Konstantinou, Marios

    2003-11-08

    BACKGROUND: Cardiac tamponade as the initial manifestation of metastatic cancer is a rare clinical entity. Furthermore, a thoraco-biliary fistula is another rare complication of echinococcosis due to rupture of hydatid cysts located at the upper surface of the liver to the pleural or pericardial cavity. We report a case of non-small cell lung cancer with a coexisting hepatic hydatid cyst presenting as a bilious pericardial effusion. CASE REPORT: A 66-year-old patient presented with cardiac tamponade of unknown origin. Chest CT-scan demonstrated a left central lung tumor, a smaller peripheral one, bilateral pleural effusions and a hydatid cyst on the dome of the liver in close contact to the diaphragm and pericardium. Pericardiotomy with drainage was performed, followed by bleomycin pleurodesis. The possible mechanism for the bilious pericardial effusion might be the presence of a pericardio-biliary fistula created by the hepatic hydatid cyst. CONCLUSIONS: This is the first case of a bilious pericardial effusion at initial presentation in a patient with lung cancer with coexisting hepatic hydatid cyst.

  9. Bilious pericardial effusion at initial presentation in a patient with lung cancer

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    Kostikas Konstantinos

    2003-11-01

    Full Text Available Abstract Background Cardiac tamponade as the initial manifestation of metastatic cancer is a rare clinical entity. Furthermore, a thoraco-biliary fistula is another rare complication of echinococcosis due to rupture of hydatid cysts located at the upper surface of the liver to the pleural or pericardial cavity. We report a case of non-small cell lung cancer with a coexisting hepatic hydatid cyst presenting as a bilious pericardial effusion. Case report A 66-year-old patient presented with cardiac tamponade of unknown origin. Chest CT-scan demonstrated a left central lung tumor, a smaller peripheral one, bilateral pleural effusions and a hydatid cyst on the dome of the liver in close contact to the diaphragm and pericardium. Pericardiotomy with drainage was performed, followed by bleomycin pleurodesis. The possible mechanism for the bilious pericardial effusion might be the presence of a pericardio-biliary fistula created by the hepatic hydatid cyst. Conclusions This is the first case of a bilious pericardial effusion at initial presentation in a patient with lung cancer with coexisting hepatic hydatid cyst.

  10. Uncommon Presentation of Idiopathic Intracranial Hypertension in a Patient with Polycystic Ovary Syndrome: A Case Report.

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    Albarrak, Anas Mohammad; Kojan, Suleiman

    2017-01-01

    Idiopathic intracranial hypertension is a rare condition characterized by increased intracranial pressure without clinical, laboratory, or radiological evidence of intracranial pathology. Early management could prevent irreversible outcomes. A 17-year-old single Arabian female of Arab origin presented with a 2-day complaint of horizontal diplopia and transient visual obscurations. She denied any history of headache or decreased vision. The patient was diagnosed with polycystic ovary syndrome a year prior to presentation. Examination revealed bilateral moderate papilledema and limited left eye abduction. However, visual acuity and fields were normal. Increased intracranial pressure was confirmed by lumbar puncture opening pressure (550 mm H2O). The cerebrospinal fluid composition and imaging of brain and cerebral venous system were normal. The diagnosis of idiopathic intracranial hypertension was confirmed and the patient was treated with acetazolamide 500 mg twice per day. The symptoms totally resolved within 3 days and the papilledema disappeared after 2 months. Awareness of such uncommon presentation of idiopathic intracranial hypertension emphasizes the critical importance of detailed ophthalmic examination and shows the good prognosis of early management.

  11. E. coli Meningitis Presenting in a Patient with Disseminated Strongyloides stercoralis

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    Juliana B. Gomez

    2013-01-01

    Full Text Available Introduction. Spontaneous Escherichia coli meningitis is an infrequent condition in adults and is associated with some predisposing factors, including severe Strongyloides stercoralis (SS infections. Case Presentation. A 43-year-old Hispanic man, with history of travelling to the jungle regions of Peru and Brazil two decades ago, and who received prednisone due to Bell’s palsy for three weeks before admission, presented to the Emergency Department with diarrhea, fever, and hematochezia. A week after admission he developed drowsiness, meningeal signs, abdominal distension, and constipation. A cerebrospinal fluid culture showed extended spectrum β-lactamase producing E. coli. A colonoscopy was performed and showed pancolitis. Three days after the procedure the patient became unstable and developed peritoneal signs. He underwent a laparotomy, which ended up in a total colectomy and partial proctectomy due to toxic megacolon. Three days later the patient died in the intensive care unit due to septic shock. Autopsy was performed and microscopic examination revealed the presence of multiple Strongyloides larvae throughout the body. Conclusion. Strongyloides stercoralis infection should be excluded in adults with spontaneous E. coli meningitis, especially, if gastrointestinal symptoms and history of travelling to an endemic area are present. Even with a proper diagnosis and management, disseminated strongyloidiasis has a poor prognosis.

  12. [Lacrimal sac tumors presenting as lacrimal obstruction. Retrospective study in Mexican patients 2007-2012].

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    Coloma-González, I; Flores-Preciado, J; Ceriotto, A; Corredor-Casas, S; Salcedo-Casillas, G

    2014-06-01

    To determine the demographic and clinical data of primary tumors of the lacrimal sac presenting as lacrimal obstruction. Retrospective and descriptive study was conducted between the years 2007 to 2012 on all patients undergoing surgery for low lacrimal obstruction at Dr. Luis Sanchez Bulnes Hospital, an Association for the prevention of blindness in Mexico IAP. Primary tumors of the lacrimal sac represented 2.5% of all lacrimal obstructions, being more common in women than in men (8:1). The large majority (89%) of the cases were non-epithelial, with lymphoid lesions being the most frequent. Benign tumors were presented at a younger age (50 years old) than malignant (70 years old). One-third (33%) of cases were unexpected findings during surgery (100% benign). Just over half (55%) were malignant tumors (1.4% of obstructions), all of them lymphoproliferative lesions. The most frequent clinical tumor was in the inner edge, either with or without epiphora. The progression time varied according to the degree of aggressiveness of the lymphoma (3 months-10 years). Lacrimal sac tumors are rare, but they must be taken into account in patients with an unusual clinical presentation of lacrimal obstruction. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  13. Patients with ice hockey injuries presenting to US emergency departments, 1990-2006.

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    Deits, Jeff; Yard, Ellen E; Collins, Christy L; Fields, Sarah K; Comstock, R Dawn

    2010-01-01

    Although the number of US ice hockey participants doubled from 1990 to 2006, no nationally representative studies have examined US ice hockey injuries among participants of all ages during this period. To describe patients with ice hockey injuries presenting to a representative sample of US emergency departments (EDs) from 1990 through 2006. Prospective injury surveillance study. The US Consumer Product Safety Commission collects data from 100 nationally representative EDs via the National Electronic Injury Surveillance System (NEISS). Individuals injured while playing ice hockey and presenting to a NEISS-affiliated ED from 1990 through 2006. Incidence and patterns of ice hockey-related injuries. From 1990 through 2006, 8228 patients with ice hockey-related injuries presented to NEISS-affiliated EDs, representing an estimated 302 368 ice hockey-related injuries sustained nationally during this time. Injuries occurred predominantly among males (93.5%). More than half of the injured were aged 9 to 14 years (28.9%) or 15 to 18 years (30.1%), and injury incidence in these age groups increased over the study period (P  =  .009 and P Ice hockey injury patterns vary by age and sex. Our findings indicate that many trips to the ED might be prevented by using protective equipment appropriately.

  14. The Patient Educator Presentation in Dental Education: Reinforcing the Importance of Learning About Rare Conditions.

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    Edwards, Paul C; Graham, Jasmine; Oling, Rebecca; Frantz, Kate E

    2016-05-01

    The aim of this study was to determine whether a patient educator presentation (PEP) on pemphigus vulgaris would increase second-year dental students' awareness of the importance of learning about rare conditions and improve their retention of rare disease knowledge. The study involved students' subjective assessments of a PEP experience at two U.S. dental schools. In this mixed methods study, cross-sectional data were obtained by surveys and in-depth interviews. Questions focused on students' assessment of the messages acquired from the PEP and its likely impact on their future clinical care. At University 1, students completed paper surveys with open-ended questions and participated in a focus group. At University 2, students completed an online survey consisting of rating scale and open-ended questions. Responses to open-ended questions were categorized into themes. At University 1, 79 students (out of a possible 102; response rate 77.5%) completed the survey, and an additional ten students participated in a focus group. At University 2, 30 students (out of a possible 104; response rate 28.8%) completed the survey. At Universities 1 and 2, 88% and 100%, respectively, of respondents stated the PEP would influence their future clinical decision making. The vast majority of respondents (94% and 100% at University 1 and University 2, respectively) were of the opinion that the personal testimonial from a patient would help them recall information about pemphigus vulgaris in five years' time. Respondents from both universities commented that the PEP emphasized the importance of not dismissing a patient's concerns. These results suggest that a presentation by a patient with a rare condition can be an effective educational tool for preclinical dental students.

  15. Lung cancer in symptomatic patients presenting in primary care: a systematic review of risk prediction tools.

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    Schmidt-Hansen, Mia; Berendse, Sabine; Hamilton, Willie; Baldwin, David R

    2017-06-01

    Lung cancer is the leading cause of cancer deaths. Around 70% of patients first presenting to specialist care have advanced disease, at which point current treatments have little effect on survival. The issue for primary care is how to recognise patients earlier and investigate appropriately. This requires an assessment of the risk of lung cancer. The aim of this study was to systematically review the existing risk prediction tools for patients presenting in primary care with symptoms that may indicate lung cancer DESIGN AND SETTING: Systematic review of primary care data. Medline, PreMedline, Embase, the Cochrane Library, Web of Science, and ISI Proceedings (1980 to March 2016) were searched. The final list of included studies was agreed between two of the authors, who also appraised and summarised them. Seven studies with between 1482 and 2 406 127 patients were included. The tools were all based on UK primary care data, but differed in complexity of development, number/type of variables examined/included, and outcome time frame. There were four multivariable tools with internal validation area under the curves between 0.88 and 0.92. The tools all had a number of limitations, and none have been externally validated, or had their clinical and cost impact examined. There is insufficient evidence for the recommendation of any one of the available risk prediction tools. However, some multivariable tools showed promising discrimination. What is needed to guide clinical practice is both external validation of the existing tools and a comparative study, so that the best tools can be incorporated into clinical decision tools used in primary care. © British Journal of General Practice 2017.

  16. A STUDY OF THE OCULAR MANIFESTATIONS OF RHEUMATOID ARTHRITIS AMONG PATIENTS PRESENTING TO A TERTIARY CENTRE

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    Dhanya Sukumaran

    2017-08-01

    Full Text Available BACKGROUND Rheumatoid Arthritis (RA is a chronic inflammatory disease of unknown aetiology marked by a symmetric peripheral polyarthritis. It is the most common form of chronic inflammatory arthritis and often results in joint damage and physical disability. The name is based on the term "rheumatic fever", an illness, which includes joint pain and is derived from the Greekword ῥεύμα-rheuma (nom., ῥεύματος-rheumatos (gen. ("flow, current". The suffix oid ("resembling" gives the translation as joint inflammation that resembles rheumatic fever. The first recognised description of rheumatoid arthritis was made in 1800 by Dr. Augustin Jacob Landré-Beauvais (1772-1840 of Paris. Because, it is a systemic disease, RA may result in a variety of extra-articular manifestations including fatigue, subcutaneous nodules, lung involvement, pericarditis, peripheral neuropathy, vasculitis and haematologic abnormalities. MATERIALS AND METHODS Patients who were diagnosed cases of rheumatoid arthritis attending the rheumatology clinic were referred to the Ophthalmology OPD in Government Medical College, Thrissur, for detailed eye examination. RESULTS The study was conducted in 100 patients (88 females and 12 males. Rheumatoid Factor (RF was found to be positive in 60 patients (60%, presence of dry eye did not correlate with rheumatoid positivity (Fishers exact test- the two-tailed P value = 0.4256. Through various tests, we concluded that there was aqueous deficiency in 61% and mucin deficiency in 46% of the patients. Other ocular manifestations present were- scleritis (2%, episcleritis (2% and keratomalacia (2%. CONCLUSION From the present study, we found out that extra-articular involvement of organs in rheumatoid arthritis is significant. The main ocular manifestations in rheumatoid arthritis found in our study were keratoconjunctivitis sicca, episcleritis, scleritis and keratomalacia. Though keratoconjunctivitis sicca was the most common, it did

  17. Comparison of buying behavior in depressed patients presenting with or without compulsive buying.

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    Lejoyeux, M; Haberman, N; Solomon, J; Adès, J

    1999-01-01

    Compulsive buying is defined as repetitive impulsive and excessive buying leading to personal and familial distress. This study compares the buying behavior of depressed patients presenting with or without compulsive buying. The weight of promotional factors such as sales and advertising campaigns was systematically assessed. The impulsive nature of compulsive buying and the choice of items purchased were also investigated. For this purpose, we studied buying behavior among 52 inpatients diagnosed for major depressive episode with DSM-IV criteria. None of the patients presented mania or hypomania, obsessive-compulsive disorder, or alcohol or drug abuse or dependence disorder. We assessed the prevalence of compulsive buying and compared the "buying style" among patients with (CB+) and without (CB-) compulsive buying. The diagnosis of depression was assessed with the Mini International Neuropsychiatric Interview (MINI). The diagnosis of compulsive buying was made using standardized criteria and a specific rating scale. All patients answered a specific questionnaire assessing the phenomenology of the buying behavior. Twenty-one of 52 depressives presented with compulsive buying. The CB+ group was not more sensitive to promotional factors. They did not seek sales or use loans significantly more than others. Upon entering a shop, the CB+ subjects did not change their choice more often than others. CB+ subjects were significantly more often alone while shopping (85% of cases v61% of CB- group, p = .05). Most purchases from the CB+ group were self-gifts or gifts to others (50.4% v 23.5%, p = .003); 14.4% of purchases in the CB+ group (v 2.2% in CB- group, P = .045) were made because the patients believed their social status requires acquisition. Items to be bought were more often considered by CB+ subjects as occasions not to be missed (31.4% v15.1%, P = .03). Purchases were significantly (57% v 16%) less often used than expected by the CB+ group (P = .002). Most

  18. Presenting Symptoms and Dysphagia Screen Predict Outcome in Mild and Rapidly Improving Acute Ischemic Stroke Patients.

    Science.gov (United States)

    Gadodia, Gaurav; Rizk, Nibal; Camp, Deborah; Bryant, Katja; Zimmerman, Susan; Brasher, Cynthia; Connelly, Kerrin; Dunn, Joshua; Frankel, Michael; Ido, Moges Seymour; Lugtu, James; Nahab, Fadi

    2016-12-01

    There are limited data on which patients not treated with intravenous (IV) tissue-type plasminogen activator (tPA) due to mild and rapidly improving stroke symptoms (MaRISS) have unfavorable outcomes. Acute ischemic stroke (AIS) patients not treated with IV tPA due to MaRISS from January 1, 2009 to December 31, 2013 were identified as part of the Georgia Coverdell Acute Stroke Registry. Multivariable regression analysis was used to identify factors associated with a lower likelihood of favorable outcome, defined as discharge to home. There were 1614 AIS patients who did not receive IV tPA due to MaRISS (median National Institutes of Health stroke scale [NIHSS] 1], of which 305 (19%) did not have a favorable outcome. Factors associated with lower likelihood of favorable outcome included Medicare insurance status (odds ratio [OR]: .53, 95% confidence interval [CI]: .34-.84), arrival by emergency medical services (OR: .46, 95% CI: .29-.73), increasing NIHSS score (per unit OR: .89, 95% CI: .84-.93), weakness as the presenting symptom (OR: .50, 95% CI: .30-.84), and a failed dysphagia screen (OR: .43, 95% CI: .23-.80). During the study period, dysphagia screen identify a subgroup of patients who are more likely to have an unfavorable outcome. Whether IV tPA treatment can improve the outcome in this subgroup of patients needs to be evaluated in a randomized placebo-controlled trial. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  19. Value of ultrasonography in the diagnosis of gout in patients presenting with acute arthritis.

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    Pattamapaspong, Nuttaya; Vuthiwong, Withawat; Kanthawang, Thanat; Louthrenoo, Worawit

    2017-06-01

    To evaluate the value of ultrasonographic features of crystal deposition for diagnosing gout in patients presenting with acute arthritis. Ultrasound scanning of the most inflamed joint was performed on 89 consecutively enrolled patients with acute arthritis. Two radiologists independently reviewed the ultrasound images, and a consensus was achieved with a third radiologist when the interpretations of four key ultrasound features of gout differed. Arthrocentesis and crystal analysis using compensated polarized light microscopy of aspirates are considered the gold standards for gout diagnosis. Fifty-three (60%) patients had gout, whereas the remaining 36 (40%) had non-gout arthritis. The mean serum uric acid level was 7.1 mg/dl in patients with gout and 4.7 mg/dl in patients with non-gout arthritis. Three US features differed significantly (p gout and non-gout arthritis: the double contour sign (42 vs. 8%, respectively), intra-articular aggregates (58 vs. 8%), and tophi (40 vs. 0%). No statistically significant differences in detecting intra-tendinous aggregates (32 vs. 17%, p = 0.14) were observed. The sensitivity and specificity of the double contour sign were 42 and 92%, respectively; those of the intra-articular aggregates were 58 and 92%; and those of tophi were 40 and 100%. The positive predictive values for these three features ranged from 88 to 100%, whereas the negative predictive values ranged from 52 to 60%. When the prevalence is high, these three ultrasound features may be a useful adjunct in the diagnosis of acute gout, particularly when specialized microscopic techniques are not available.

  20. Opportunities and barriers to public health nutrition education in Vietnamese universities.

    Science.gov (United States)

    Pham, Quynh Th; Worsley, Anthony; Lawrence, Mark; Marshall, Bernie

    2017-05-01

    A core challenge for low- and middle-income countries (LMICs) in combating the negative effects of the nutrition transition is to implement appropriate prevention strategies to halt the increasing prevalence of obesity and non-communicable diseases (NCDs), against a background of prevailing under nutrition. There have been several proposals for the enhancement of university nutrition education for future health and related professionals who are expected to communicate knowledge of health risks to the broad community. However, little is known about university nutrition education in LMICs. The present study aimed to investigate professional development opportunities and barriers for university nutrition lecturers to teach public health nutrition (PHN). An online survey was conducted among 242 Vietnamese health and education professionals and university nutrition lecturers across Vietnam. Purposive sampling was used to recruit participants. Comparisons of between the groups' responses were examined via SPSS Crosstabs. The structures of the perceived barriers and desired PHN training topics were examined via factor analyses. Multiple linear regression examined the influences on lecturers' learning interests in nutrition areas. The lecturers' learning interests spanned four areas: basic nutrition, basic food, food policy and 'new' trends (e.g. food policy, marketing). Major impediments to nutrition teaching in universities divided into two groups: resource limitations and professional constraints (e.g. lack of relevant training opportunities). The lecturers' perceptions of professional constraints influenced their interest in learning about 'new' trends. The results highlighted the need and opportunities to enhance PHN professional development for nutrition lecturers in Vietnam.

  1. Chemical Composition and α-Glucosidase Inhibitory Activity of Vietnamese Citrus Peels Essential Oils

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    Nguyen Hai Dang

    2016-01-01

    Full Text Available Background. Inhibition of α-glucosidase is an important factor to control postprandial hyperglycemia in type 2 diabetes mellitus. Citrus essential oils (CEO are among the most widely used essential oils, and some of them exhibited promising antidiabetic effect. However, the α-glucosidase inhibition of CEO has not been investigated so far. The present work aims to evaluate the α-glucosidase inhibition of essential oils from six Vietnamese Citrus peels. Methods. The chemical composition of essential oils obtained by hydrodistillation from six Citrus peels was analyzed by GC-MS. All essential oils were tested for their inhibitory activity on α-glucosidase using p-nitrophenyl-α-D-glucopyranoside as substrate. Results. In Buddha’s hand and lime peels, the major components were limonene (59.0–61.31% and γ-terpinene (13.98–23.84% while limonene (90.95–95.74% was most abundant in pomelo, orange, tangerine, and calamondin peels. Among the essential oils, the Buddha’s hand oil showed the most significant α-glucosidase inhibitory effect with the IC50 value of 412.2 μg/mL. The combination of the Buddha’s hand essential oil and the antidiabetic drug acarbose increased the inhibitory effect. Conclusions. The results suggested the potential use of Buddha’s hand essential oil as an alternative in treatment of type 2 diabetes mellitus.

  2. STATE AND PROSPECTS OF RUSSIAN-VIETNAMESE COOPERATION IN NUCLEAR ENERGY

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    Gordeev-Burgvits Mikhail Alekseevich

    2014-12-01

    Full Text Available In 2010 the Vietnam government arrived at a decision to build the first nuclear power plant in the country Ninh Thuan 1 according to Russian project and with the help of Russian specialists. The construction of NPP in Vietnam will essentially relieve the deficit in energy production. The political leaders of Vietnam reckon upon the further growth of the economy. Energy of Vietnam is now generally held on big HPPs and TPPs. Small hydropower and such renewable energy sources as sun and wind play an important role in energy production. Because of the small amount of falls in the recent years in spite of monsoon climate, HPPs in Vietnam produce energy using not their full capacity. In TPP coal, diesel oil and gas is used as energy resources. The share of coal is still quite big (around 18 % and coal TPPs have a serious negative impact on the environment. That’s why the specialists count on the development of nuclear energy. The paper presents the plans for the construction of a nuclear power plant "Ninh Thuan" in Vietnam, the alleged NPP project, its advantage over other projects, prerequisites and prospects for cooperation between the Russian and Vietnamese governments in this field.

  3. Governance conditions for adaptive freshwater management in the Vietnamese Mekong Delta

    Science.gov (United States)

    Ha, T. P.; Dieperink, Carel; Dang Tri, Van Pham; Otter, Henriëtte S.; Hoekstra, Piet

    2018-02-01

    The Vietnamese Mekong Delta (VMD) is a region of utmost importance to Vietnam's national food security. However, the availability of required freshwater resources (from both surface and groundwater sources) is currently under great threats due to dry season salinity intrusion, surface water pollution, and over-exploitation of groundwater. Global climate change, sea level rise, and upstream and in situ development activities may worsen the situation. Assuming that adaptive management could be a promising strategy to address the increasingly complex and unpredictable water-related problems in the VMD, we design and apply a framework to identify the extent to which the governance regime in this region exhibits conditions that are likely to promote adaptive freshwater management. Using both primary and secondary data, our analysis reveals that the prospects for adaptive water management in the study area are limited since several conditions were not present. We observe among others limitations in vertical and horizontal integration and public participation, restraints in knowledge and information sharing, inadequate policy development and implementation, and insufficient diversification of financial resources. Following our findings, we conclude the paper with recommendations both for national, regional and local policy interventions and for future research.

  4. The Vietnamese State and Administrative Co-Management of Nature Reserves

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    Nguyen KimDung

    2016-03-01

    Full Text Available The Vietnamese government has introduced co-management in its national system of special-use forests (SUFs to improve the effectiveness of nature and biodiversity conservation. One of the major challenges is to allow flexibility and local adaptability of co-management coordinated by SUF management boards within the overall still-rigid structure of vertical state networks. Using a critical institutional perspective, this paper examines the influence of the vertical and horizontal linkages that underline the form and function of SUF co-management. Data is presented from a nation-wide survey of 113 SUFs, 22 random in-depth interviews, and four in-depth case studies of SUFs. The results show that the success of co-management in centralized states like Vietnam depends on the greater devolution of allocative power from central to district governments to facilitate horizontal networked collaboration with local communities. Yet the results also indicate that the central state maintains an important role in setting the conditions that allow for the success of these networked collaborations. Based on these findings the conclusions reflect on the need to further develop a critical institutional approach for understanding the purpose, interests, and resources of co-management in the context of centralized states.

  5. Preparation and Characterization of Polyurethane Nanocomposites Using Vietnamese Montmorillonite Modified by Polyol Surfactants

    Directory of Open Access Journals (Sweden)

    C. N. Ha Thuc

    2014-01-01

    Full Text Available This study focuses on the preparation of thermoplastic polyurethane (TPU nanocomposite using Vietnamese montmorillonite (MMT as the reinforced phase. The MMT was previously modified by intercalating polyethylene oxide (PEO and polyvinyl alcohol (PVA molecules between the clay layers. X-ray diffraction (XRD results of organoclays revealed that galleries of MMT were increased to 18.2 Å and 27 Å after their intercalation with PEO and PVA, respectively. Thermoplastic polyurethane (TPU nanocomposites composed of 1, 3, 5, and 7%wt organoclays were synthesized. The result of XRD and transmission electron microscopic (TEM analyses implied that the PEO modified MMT was well dispersed, at 3%wt, in polyurethane matrix. Fourier Transform Infrared Spectroscopic (FTIR has confirmed this result by showing the hydrogenous interaction between the urethane linkage and OH group on the surface of silicate layer. Thermogravimetric (TG showed that the organoclay samples also presented improved thermal stabilities. In addition, the effects of the organoclays on mechanical performance and water absorption of the PU nanocomposite were also investigated.

  6. A Study on Astrazon Black AFDL Dye Adsorption onto Vietnamese Diatomite

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    Bui Hai Dang Son

    2016-01-01

    Full Text Available In the present paper, the adsorption of Astrazon Black AFDL dye onto Vietnamese diatomite has been demonstrated. The diatomite was characterized by XRD, SEM, TEM, EDS, and nitrogen adsorption/desorption isotherms. The results show that diatomite mainly constituted centric type frustules characterized by pores as discs or as cylindrical shapes. The adsorption kinetics and isotherms of dye onto Vietnam diatomite were investigated. The experimental data were fitted well to both Freundlich and Langmuir in the initial concentration range of 400–1400 mg L−1. The average value of maximum adsorption capacity, qm, calculated from Freundlich equation is statistically similar to the average value of maximum monolayer adsorption capacity calculated from Langmuir equation. The thermodynamic parameters evaluated from the temperature dependent on adsorption isotherms in the range of 303–343 K show that the adsorption process was spontaneous and endothermic. The Webber and pseudo-first/second-order kinetic models were used to analyze the mechanism of adsorption. The piecewise linear regression and Akaike’s Information Criterion were used to analyze experimental data. The results show that the dye adsorption onto diatomite was film diffusion controlled and the goodness of fit of experimental data for kinetics modes was dependent on the initial concentration.

  7. Septic shoulder presenting as a shoulder dislocation in the pediatric patient: a case report.

    Science.gov (United States)

    Maguire, Kathleen J; Otsuka, Norman Y

    2017-05-01

    Shoulder dislocation is relatively uncommon in the younger pediatric population. Because of the relative strength of the surrounding soft tissue structures of the shoulder compared with the proximal humeral physis, subluxation or dislocation resulting from a traumatic event or application of force is rare and instead a proximal humeral physeal injury occurs. Case presentation - We present a 5-year-old male who presented to the office with post-traumatic left shoulder pain for about 1 week. Radiographs of the left shoulder indicated inferior subluxation of the humeral head. He was ultimately diagnosed and treated for a septic shoulder. Septic arthritis of the glenohumeral joint accounts for about 3% of all septic arthritis cases. About half of the pediatric patients with a septic arthritis will present with a concomitant osteomyelitis about the joint involved. Widening of the glenohumeral joint and subluxation clinically as well as radiographically have been described in cases of large joint effusions because of an increase in intra-articular fluid in adults. This inferior subluxation is often noted without a frank dislocation. The case described in this report is unique in that this is the first to describe a pediatric septic shoulder presenting as a shoulder subluxation. Given the rarity of pediatric shoulder dislocations and subluxations, the pediatric orthopaedist and pediatrician should maintain a suspicion for a septic joint. Level V.

  8. Infectious Endocarditis Presenting as Intracranial Hemorrhage in a Patient Admitted for Lumbar Radiculopathy

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    David Ethan Kahn

    2011-01-01

    Full Text Available Infectious endocarditis is frequently found in the neurologic intensive care unit and may rarely be the cause of intracranial hemorrhage. In such instances, further diagnostic imaging to search for an underlying structural lesion is prudent. Well-known causes of these hemorrhages include cardioembolism with hemorrhagic transformation, septic emboli, and mycotic aneurysms. We present a case of a patient who was admitted for routine evaluation and pain management of lumbar radiculopathy, who developed a large intraparenchymal hemorrhage and was found to have bacterial endocarditis. This was diagnosed retrospectively from positive hematoma cultures and a vegetation on transesophageal echocardiogram. Further evaluation revealed a mycotic aneurysm.

  9. Pseudotumoral presentation of fungating mycetoma caused by Phaeoacremonium fuscum in a renal transplant patient.

    Science.gov (United States)

    McGrogan, D; David, M D; Roberts, C; Borman, A M; Nath, J; Inston, N G; Mellor, S

    2015-12-01

    Eumycetoma is an unusual infection in immunocompromised patients outside the tropics, caused by a variety of fungal pathogens. We describe the case of a 51-year-old renal transplant recipient who presented with a large pseudotumoral foot lesion necessitating complete surgical excision of the lesion. Cultures and molecular diagnosis confirmed Phaeoacremonium fuscum. This is the first case, to our knowledge, of fungating mycetoma caused by this fungal species in a solid organ transplant recipient. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Bilateral Intracavernous Carotid Artery Aneurysms Presenting as Diplopia in a Young Patient

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    Nikolaos Kopsachilis

    2013-01-01

    Full Text Available Introduction. Bilateral intracavernous carotid artery aneurysms (ICAAs are extremely rare and difficult to treat. Case Report. A 26-year-old female presented in our clinic with acute diplopia due to oculomotor nerve palsy on the left side. Magnetic resonance imaging of the brain showed two heterogeneously enhanced masses indicating bilateral ICAA. An endovascular coil embolization was performed on the left side successfully, resulting in resolution of her symptoms. Conclusion. Thorough systemic evaluation in young patients with diplopia can reveal life-threatening underlying pathology and prevent major complications.

  11. Case presentation of an intranasal ectopic tooth in a pediatric patient.

    Science.gov (United States)

    Yu, Chao; Gu, Deying; An, Junnan; Tang, Yuedi

    2015-01-01

    An ectopic tooth in the nasal cavity is a rare phenomenon, especially on the inferior turbinate. In most of the reported cases, no etiological explanation of the intranasal teeth has been suggested or found. In children, intranasal ectopic teeth are usually associated with cleft lip and alveolus. Here, we report a rare case of a pediatric patient with unilateral nasal obstruction due to an intranasal ectopic tooth originating from the inferior turbinate without any facial and dental deformities. This case is unique due to the unusual location of the ectopic tooth and its presentation in a child without facial and dental deformities. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Neurofibromatosis Type 1 Presenting with Plexiform Neurofibromas in Two Patients: MRI Features

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    Ahmet Mesrur Halefoglu

    2012-01-01

    Full Text Available Neurofibromatosis type 1 (NF1, also known as peripheral neurofibromatosis or von Recklinghausen’s disease, is one of the most common genetic disorders. It is inherited in an autosomal dominant pattern. Multiple cutaneous neurofibromas are hallmark lesions of NF1. Localized and plexiform neurofibromas of the paraspinal and sacral region are the most common abdominal neoplasms in NF1. Herein, we report two patients with a known history of NF1 presenting with multiple, extensive localized and plexiform neurofibromas. We describe the important distinguishing features of these tumors as seen on magnetic resonance imaging (MRI, including very bright signal intensity and target sign on T2 weighted images.

  13. Patients radiation protection in medical imaging. Conference proceedings; Radioprotection des patients en imagerie medicale. Recueil des presentations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-12-15

    This document brings together the available presentations given at the conference organised by the French society of radiation protection about patients radiation protection in medical imaging. Twelve presentations (slides) are compiled in this document and deal with: 1 - Medical exposure of the French population: methodology and results (Bernard Aubert, IRSN); 2 - What indicators for the medical exposure? (Cecile Etard, IRSN); 3 - Guidebook of correct usage of medical imaging examination (Philippe Grenier, Pitie-Salpetriere hospital); 4 - Radiation protection optimization in pediatric imaging (Hubert Ducou-Le-Pointe, Aurelien Bouette (Armand-Trousseau children hospital); 5 - Children's exposure to image scanners: epidemiological survey (Marie-Odile Bernier, IRSN); 6 - Management of patient's irradiation: from image quality to good practice (Thierry Solaire, General Electric); 7 - Dose optimization in radiology (Cecile Salvat (Lariboisiere hospital); 8 - Cancer detection in the breast cancer planned screening program - 2004-2009 era (Agnes Rogel, InVS); 9 - Mammographic exposures - radiobiological effects - radio-induced DNA damages (Catherine Colin, Lyon Sud hospital); 10 - Breast cancer screening program - importance of non-irradiating techniques (Anne Tardivon, Institut Curie); 11 - Radiation protection justification for the medical imaging of patients over the age of 50 (Michel Bourguignon, ASN); 12 - Search for a molecular imprint for the discrimination between radio-induced and sporadic tumors (Sylvie Chevillard, CEA)

  14. Use of Vietnamese in English Language Teaching in Vietnam: Attitudes of Vietnamese University Teachers

    Science.gov (United States)

    Anh, Kieu Hang Kim

    2012-01-01

    Drawing upon the literature on the history of the language teaching methods focusing on the use of L1 in L2 teaching, the debate surrounding the role of L1 in the L2 classroom in general and in the English classroom in particular and recent studies of the issue, this article presents at its core a study that investigated the attitudes of…

  15. Cross-Border Brides: Vietnamese Wives, Chinese Husbands in a Border-Area Fishing Village

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    Nguyễn Thị Phương Châm

    2014-06-01

    Full Text Available This article traces the lives of a group of Vietnamese women driven by poverty and loss of marriageability to cross the border into China to marry men from the fishing village of Wanwei. Wanwei’s location, only 25 kilometers from the border with Vietnam, enables these women to make fairly regular trips back to their native villages to visit their birth families. Yet, despite the fact that they now live in a designated Jing (ethnic Vietnamese village, where a significant proportion of the population shares their ethnicity, their illegal residential status and recent arrival excludes them from the community of villagers who claim descent from Vietnamese immigrants in the sixteenth century. Despite the hardships these women face as a result of continuing poverty, lack of emotional intimacy in their marriages, and marginal social status, few see themselves as victims of human trafficking. Instead, most take pride in their agency and achievements.

  16. Chain Migration through Social Networks: Case Study of Vietnamese Migrants in Thailand

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    Anh Tuan NGUYEN

    2016-11-01

    Full Text Available The paper aims to investigate the relationship between the recent increasingly pattern of Vietnamese migrants in Thailand and migration networks. By surveying 50 Vietnamese migrants in Bangkok, Thailand, the study confirms that migration networks have played a critical role in facilitating migration flows, especially irregular flows from Vietnam to Thailand over the years. It can be reflected by reducing the cost of migration, coping with new working environment and risks during working in Thailand and ensuring the return process for Vietnamese migrants. Moreover, forms of social networks includes personal networks (kinship and friendship networks, and community network (ngườidẫnđường’s network, social media has been also discussed. The study also implies that the người dẫn đường’s networks might contribute to recently emerging issues such as human trafficking and smugglings, which require further research.

  17. Variations in the Presentation of Aphasia in Patients with Closed Head Injuries

    Directory of Open Access Journals (Sweden)

    Dara Oliver Kavanagh

    2010-01-01

    Full Text Available Impairments of speech and language are important consequences of head injury as they compromise interaction between the patient and others. A large spectrum of communication deficits can occur. There are few reports in the literature of aphasia following closed head injury despite the common presentation of closed head injury. Herein we report two cases of closed head injuries with differing forms of aphasia. We discuss their management and rehabilitation and present a detailed literature review on the topic. In a busy acute surgical unit one can dismiss aphasia following head injury as behaviour related to intoxication. Early recognition with prolonged and intensive speech and language rehabilitation therapy yields a favourable outcome as highlighted in our experience. These may serve as a reference for clinicians faced with this unusual outcome.

  18. Variations in the presentation of aphasia in patients with closed head injuries.

    Science.gov (United States)

    Kavanagh, Dara Oliver; Lynam, Conor; Düerk, Thorsten; Casey, Mary; Eustace, Paul W

    2010-01-01

    Impairments of speech and language are important consequences of head injury as they compromise interaction between the patient and others. A large spectrum of communication deficits can occur. There are few reports in the literature of aphasia following closed head injury despite the common presentation of closed head injury. Herein we report two cases of closed head injuries with differing forms of aphasia. We discuss their management and rehabilitation and present a detailed literature review on the topic. In a busy acute surgical unit one can dismiss aphasia following head injury as behaviour related to intoxication. Early recognition with prolonged and intensive speech and language rehabilitation therapy yields a favourable outcome as highlighted in our experience. These may serve as a reference for clinicians faced with this unusual outcome.

  19. An Unusual Presentation of Frontal Bony Defect with Pneumocephalus and its Management in an Elderly Patient

    Directory of Open Access Journals (Sweden)

    Shih-Tong Chen

    2015-03-01

    Full Text Available Pneumocephalus can be caused by neurosurgical procedures, endoscopic sinus surgery, craniofacial trauma, tumors of the skull base, frontal sinus cranialization, and can rarely occur spontaneously. The treatment options are conservative treatment, craniotomy, osteoplastic flap surgery of the frontal sinus, and endoscopic endonasal surgery. We herein present the case of a 61-year-old man with a frontal sinus bony defect with pneumocephalus caused by craniotomy who presented atypically with left facial cellulitis, followed by meningitis and seizures. This bony defect was successfully repaired with endoscopic modified Lothrop procedure (EMLP. At 18 months' follow-up after the surgery, neither obvious postoperative complications nor signs of pneumocephalus were noted. EMLP offered a less invasive, safer, and effective way to repair the frontal bony defect in our elderly patient.

  20. Variations in the presentation of aphasia in patients with closed head injuries.

    LENUS (Irish Health Repository)

    Kavanagh, Dara Oliver

    2012-01-31

    Impairments of speech and language are important consequences of head injury as they compromise interaction between the patient and others. A large spectrum of communication deficits can occur. There are few reports in the literature of aphasia following closed head injury despite the common presentation of closed head injury. Herein we report two cases of closed head injuries with differing forms of aphasia. We discuss their management and rehabilitation and present a detailed literature review on the topic. In a busy acute surgical unit one can dismiss aphasia following head injury as behaviour related to intoxication. Early recognition with prolonged and intensive speech and language rehabilitation therapy yields a favourable outcome as highlighted in our experience. These may serve as a reference for clinicians faced with this unusual outcome.

  1. Large Scale Integration of Renewable Power Sources into the Vietnamese Power System

    Science.gov (United States)

    Kies, Alexander; Schyska, Bruno; Thanh Viet, Dinh; von Bremen, Lueder; Heinemann, Detlev; Schramm, Stefan

    2017-04-01

    The Vietnamese Power system is expected to expand considerably in upcoming decades. Power capacities installed are projected to grow from 39 GW in 2015 to 129.5 GW by 2030. Installed wind power capacities are expected to grow to 6 GW (0.8 GW 2015) and solar power capacities to 12 GW (0.85 GW 2015). This goes hand in hand with an increase of the renewable penetration in the power mix from 1.3% from wind and photovoltaics (PV) in 2015 to 5.4% by 2030. The overall potential for wind power in Vietnam is estimated to be around 24 GW. Moreover, the up-scaling of renewable energy sources was formulated as one of the priorized targets of the Vietnamese government in the National Power Development Plan VII. In this work, we investigate the transition of the Vietnamese power system towards high shares of renewables. For this purpose, we jointly optimise the expansion of renewable generation facilities for wind and PV, and the transmission grid within renewable build-up pathways until 2030 and beyond. To simulate the Vietnamese power system and its generation from renewable sources, we use highly spatially and temporally resolved historical weather and load data and the open source modelling toolbox Python for Power System Analysis (PyPSA). We show that the highest potential of renewable generation for wind and PV is observed in southern Vietnam and discuss the resulting need for transmission grid extensions in dependency of the optimal pathway. Furthermore, we show that the smoothing effect of wind power has several considerable beneficial effects and that the Vietnamese hydro power potential can be efficiently used to provide balancing opportunities. This work is part of the R&D Project "Analysis of the Large Scale Integration of Renewable Power into the Future Vietnamese Power System" (GIZ, 2016-2018).

  2. Clinical and Psychological Variables Present in Patients with Chronic Back Pain

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    Ahmed José Pomares Avalos

    2016-03-01

    Full Text Available Background: chronic back pain is regarded as a major public health problem with a substantial socio-economic impact. Objective: to determine the main clinical and psychological variables present in patients with chronic back pain. Methods: a case series study including the comparison of variables was conducted from July to December 2015 at the Dr. Gustavo Aldereguía Lima Hospital in Cienfuegos. The study variables were: age, sex, educational level, occupation, origin, characteristics of pain (intensity, frequency, duration, type of treatment used for its relief, anxiety, depression, anger and hostility as personality traits, and anxiety, depression and stress as negative emotional states. A non-probability sample of patients with chronic back pain was used. The information was obtained through a questionnaire and various psychological instruments. Results: predominant psychological variables were pathological stress as negative emotional state, as well as trait anxiety and depression. The prevailing clinical variables were moderate intensity of pain, episodic occurrence, duration longer than 2 years and medical treatment as the most frequent type of treatment used.Conclusions: high trait anxiety and pathological stress as negative emotional state coexist in patients with chronic back pain. These psychological aspects may be influencing the presence and clinical characteristics of pain.

  3. Management strategies for neoplastic and vascular brain lesions presenting during pregnancy: A series of 29 patients

    Science.gov (United States)

    Pereira, Celestino Esteves; Lynch, Jose Carlos

    2017-01-01

    Background: The occurrence of a brain tumor or intracranial vascular lesion during pregnancy is a rare event, but when it happens, it jeopardizes the lives of both the mother and infant. It also creates challenges of a neurosurgical, obstetric, and ethical nature. A multidisciplinary approach should be used for their care. Methods: Between 1986 and 2015, 12 pregnant women diagnosed with brain tumors and 17 women with intracranial vascular lesion underwent treatment at the Neurosurgery Department of the Servidores do Estado Hospital and Rede D’Or/São Luis. The Neurosurgery Department teamed up with Obstetrics Anesthesiology Departments in establishing the procedures. The patients’ records, surgical descriptions, imaging studies, and histopathological material were reviewed. Results: Among 12 patients presenting with brain tumors, there were neither operative mortality nor fetal deaths. Among the vascular lesions, aneurysm rupture was responsible for bleeding in 6 instances. Arteriovenous malformation was diagnosed in 7 patients. In this subgroup, the maternal and fetal mortality rates were 11.7% and 23.7%, respectively. Conclusions: We can assert that the association between a brain tumor and vascular lesions with pregnancy is a very unusual event, which jeopardizes both the lives of the mother and infant. It remains incompletely characterized due to the rare nature of these potentially devastating events. Knowing the exact mechanism responsible for the interaction of pregnancy and with these lesions will improve the treatment of these patients. PMID:28303207

  4. Imaging findings of paediatric oncology patients presenting with acute neurological symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Chu, W.C.W. E-mail: winnie@med.cuhk.edu.hk; Lee, V.; Howard, R.G.; Roebuck, D.J.; Chik, K.W.; Li, C.K

    2003-08-01

    Paediatric oncology patients are prone to central nervous system (CNS) complications due to multiple factors including disorders of the blood cell counts (which include neutropenia, thrombocytopenia or hyperleukocytosis), immunosuppression, neurotoxicity of the treatment, CNS dysfunction due to failure of other organ systems, disease progression of the primary malignancy or metastases. Imaging plays an important role in the management of paediatric oncology patients presenting with acute neurological symptoms. This pictorial review is from our institutional experience on imaging children who are under the care of the Child Cancer Centre. The review consists of a spectrum of neurological complications in paediatric oncology patients. The complications can be classified as (1) cerebrovascular complications, (2) treatment-elated complications, (3) opportunistic infections and (4) tumoural involvement of the CNS. Computed tomography (CT) is the initial choice of investigation, which is easily available and helps to exclude major intracranial abnormality such as haemorrhage. If the CT is negative, magnetic resonance imaging (MRI) should be performed, which is more sensitive for detection of CNS lesions.

  5. Sex differences in clinical presentation, management and outcome in emergency department patients with chest pain.

    Science.gov (United States)

    Hess, Erik P; Perry, Jeffery J; Calder, Lisa A; Thiruganasambandamoorthy, Venkatesh; Roger, Veronique L; Wells, George A; Stiell, Ian G

    2010-09-01

    We sought to assess sex differences in clinical presentation, management and outcome in emergency department (ED) patients with chest pain, and to measure the association between female sex and coronary angiography within 30 days. We conducted a prospective cohort study in an urban academic ED between Jul. 1, 2007, and Apr. 1, 2008. We enrolled patients over 24 years of age with chest pain and possible acute coronary syndrome (ACS). Among the 970 included patients, 386 (39.8%) were female. Compared with men, women had a lower prevalence of known coronary artery disease (21.0% v. 34.2%, p women as having a low (stress testing between sexes, there was a lower rate of acute myocardial infarction (AMI) (4.7% v. 8.4%, p = 0.03) and positive stress test results (4.4% v. 7.9%, p = 0.03) in women. Women were less frequently referred for coronary angiography (9.3% v. 18.9%, p Women had a lower rate of AMI and a lower rate of positive stress test results despite similar rates of testing between sexes. Although women were less frequently referred for coronary angiography, these data suggest that sex differences in management were likely appropriate for the probability of disease.

  6. Duodenal Histoplasmosis Presenting with Upper Gastrointestinal Bleeding in an AIDS Patient

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    Michael A. Spinner

    2012-01-01

    Full Text Available Gastrointestinal histoplasmosis (GIH is common in patients with disseminated disease but only rarely comes to clinical attention due to the lack of specific signs and symptoms. We report the unusual case of a 33-year-old Caucasian male with advanced AIDS who presented with upper GI bleeding from diffuse erosions throughout the duodenum. Biopsy of the lesions revealed small bowel mucosa with granulomatous inflammation and macrophages with small intracellular yeasts consistent with disseminated histoplasmosis. The patient demonstrated significant clinical improvement following a two-week course of liposomal amphotericin B. To our knowledge, this is the first case report of duodenal histoplasmosis leading to clinically significant bleeding, manifesting with worsening anemia and melanotic stools. Given our findings, we maintain that GIH should be considered on the differential diagnosis for GI bleeding in AIDS patients at risk, specifically those with advanced immunosuppression (i.e., CD4+ cell counts  cells/mm3 who reside in endemic areas (Ohio or Mississippi river valleys and/or have a prior history of histoplasmosis. For diagnostic evaluation, we recommend checking a urine Histoplasma quantitative antigen EIA as well as upper and/or lower endoscopy with biopsy. We recommend treatment with a two-week course of liposomal amphotericin B followed by indefinite itraconazole.

  7. A patient with metastatic melanoma presenting with gastrointestinal perforation after dacarbazine infusion: a case report

    Directory of Open Access Journals (Sweden)

    Hospers Geke AP

    2010-01-01

    Full Text Available Abstract Introduction We report a rare case of gastrointestinal perforation following dacarbazine infusion for metastatic melanoma. The condition is attributed to a responding malignant melanoma in the gastrointestinal tract. Case presentation A 52-year-old Caucasian man presented with abdominal pain and distension, malaise, night sweats, dysphagia and early satiety. A computed tomography scan showed massive ascites, lymphadenopathy and liver lesions suspect for metastases. An upper gastrointestinal endoscopy was performed and revealed multiple dark lesions of 5 mm to 10 mm in his stomach and duodenum. When his skin was re-examined, an irregular pigmented lesion over the left clavicle measuring 15 mm × 8 mm with partial depigmentation was found. Histological examination of a duodenal lesion was consistent with a diagnosis of metastatic melanoma. The patient deteriorated and his level of lactate dehydrogenase rapidly increased. The patient was started on systemic treatment with dacarbazine 800 mg/m2 every three weeks and he was discharged one day after the first dose. On the sixth day he was readmitted with severe abdominal pain. A chest X-ray showed the presence of free intraperitoneal air that was consistent with gastrointestinal perforation. His lactate dehydrogenase level had fallen from 6969U/L to 1827U/L, supporting the conclusion that the response of gastrointestinal metastases to dacarbazine had resulted in the perforation of the patient's bowel wall. A laparotomy was discussed with the patient and his family but he decided to go home with symptomatic treatment. He died 11 days later. Conclusion Melanoma can originate in, as well as metastasize to, the gastrointestinal tract. Gastrointestinal perforations due to responding tumors are a well-known complication of systemic treatment of gastrointestinal lymphomas. However, as the response rate of metastatic melanoma to dacarbazine is only 10% to 20%, and responses are usually only partial

  8. Stroke prevention by direct revascularization for patients with adult-onset moyamoya disease presenting with ischemia.

    Science.gov (United States)

    Kim, Tackeun; Oh, Chang Wan; Kwon, O-Ki; Hwang, Gyojun; Kim, Jeong Eun; Kang, Hyun-Seung; Cho, Won-Sang; Bang, Jae Seung

    2016-06-01

    OBJECT Moyamoya disease (MMD) is a progressive disease that can cause recurrent stroke. The authors undertook this retrospective case-control study with a large sample size in an attempt to assess the efficacy of direct or combined revascularization surgery for ischemia in adults with MMD. METHODS The authors investigated cases involving patients with moyamoya disease presenting with ischemia who visited Seoul National University Bundang Hospital and Seoul National University Hospital between 2000 and 2014. Among 441 eligible patients, 301 underwent revascularization surgery and 140 were treated conservatively. Variables evaluated included age at diagnosis, sex, surgical record, Suzuki stage, and occurrence of stroke. Patients were stratified into 2 groups based on whether or not they had undergone revascularization surgery. Actuarial 1-, 5-, and 10-year stroke rates were calculated using the life table method. Risk factor analysis for 5-year stroke occurrence was conducted with multivariate regression. RESULTS Of the 441 patients, 301 had been surgically treated (revascularization group) and 140 had not (control group). The mean follow-up durations were 45 and 77 months, respectively. The actuarial 10-year cumulative incidence rate for any kind of stroke was significantly lower in the revascularization group (9.4%) than in the control group (19.6%) (p = 0.041); the relative risk reduction (RRR) was also superior (52.0%) in the revascularization group, and the number needed to treat was 10. The 10-year rate of ischemic stroke was greater (13.3%) in the control group than in the revascularization group (3.9%) (p = 0.019). The RRR for ischemic stroke in the revascularization group was 70.7%, and the number needed to treat was 11. However, the actuarial 1- and 5-year rates of ischemic stroke did not significantly differently between the groups. Overall, revascularization surgery was shown to be an independent protective factor, as revealed by multivariate analysis

  9. Fatal HHV6 infection in an immunocompromised patient presenting with skin involvement.

    Science.gov (United States)

    Galan, Anjela; McNiff, Jennifer M; Choi, Jennifer Nam; Lazova, Rossitza

    2010-02-01

    Infection with human herpesvirus-6 (HHV6) has a broad distribution in the human population, with a seroprevalence approaching 100% worldwide. Primary infection takes place during childhood, after which the virus remains latent mostly in lymphocytes and monocytes at various sites. Immunosuppression can result in viral reactivation, associated with clinical sequelae and even death. We report a case of a disseminated HHV6 infection in a 53-year-old patient, who was immunocompromised after allogeneic bone marrow transplant treatment for acute lymphocytic leukemia. Initially, he presented with a macular eruption of the skin, followed by involvement of other sites. Histopathologic analysis of skin biopsies revealed superficial perivascular large atypical mononuclear cells with intranuclear and intracytoplasmic inclusions. Most affected cells labeled with antibodies to CD3 and CD43 as lymphocytes, and some labeled with CD68 as macrophages. Polymerase chain reaction (PCR) studies of the blood, skin, liver, colon, cerebrospinal fluid and brain were positive for HHV6 virus. Additionally, the serologic titers for HHV6 were high. Viral particles were also detected by electron microscopy (EM) in the colon. Although rare, HHV6 virus may be an important pathogen in immunocompromised patients, and may present initially in the skin. Awareness of this infection is critical to diagnosis in acute settings.

  10. Caring for the dying patient in the ICU--the past, the present and the future.

    Science.gov (United States)

    Fridh, Isabell

    2014-12-01

    The aim of this paper is to present the state of the science concerning issues in end-of-life (EOL) care which have an impact on intensive care nurses possibilities to provide nursing care for dying patients and their families. The perspective of families is also illuminated and finally ethical challenges in the present and for the future are discussed. The literature review revealed that the problem areas nurses report concerning EOL care have been the same over three decades. Most problems are related to inter-disciplinary collaboration and communication with the medical profession about the transition from cure to comfort care. Nurses need enhanced communication skills in their role as the patient's advocate. Education in EOL care and a supportive environment are prerequisites for providing EOL care. Losing a loved one in the ICU is a stressful experience for close relatives and nursing care has a profound impact on families' memories of the EOL care given to their loved ones. It is therefore important that ICU nurses are aware of families' needs when a loved one is dying and that follow-up services are appreciated by bereaved family members. Ethical challenges are related to changed sedation practices, organ donation, globalisation and cultural sensitivity. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. A rare presentation of adult onset Still’s disease in an elderly patient

    Directory of Open Access Journals (Sweden)

    Mariya Apostolova

    2011-10-01

    Full Text Available Adult onset Still’s disease (AOSD is a rare inflammatory disorder of unknown etiology that usually affects young adults. Very few patients older than 70-year-old have been reported. Clinical features include quotidian fevers, arthralgias, arthritis, pharyngitis, lymphadenopathy and an evanescent rash. AOSD should be considered in the differential diagnosis of fever of unknown origin. Early diagnosis is often difficult since it is a diagnosis of exclusion and the presence of infectious, neoplastic and autoimmune conditions needs to be ruled out before the diagnosis is made. No specific laboratory tests are available to aid in the diagnosis of AOSD. As a result, a set of diagnostic criteria that define the clinical features of this condition, termed the Yamaguchi criteria, have been most commonly used to establish the diagnosis. We describe the case of a 72-year-old Caucasian male with past medical history significant for generalized anxiety disorder, depression, BPH, and hypertriglyceridemia, who presented to a tertiary institution complaining of profound generalized weakness and weight loss that started three weeks prior to presentation. Initial laboratory studies showed leukocytosis, elevated ESR, CRP, ferritin and liver dysfunction. Cultures, ANA and rheumatoid factor studies were negative. The patient underwent further extensive workup that excluded the presence of infectious, neoplastic and autoimmune disorders and was subsequently diagnosed with AOSD and new onset diabetes mellitus. For the management of AOSD he was started on prednisone with significant improvement in markers of inflammation, symptoms and level of function.

  12. Male patients presenting with rapidly progressive puberty associated with malignant tumors

    Directory of Open Access Journals (Sweden)

    Soo Jung Kim

    2016-03-01

    Full Text Available In males, precocious puberty (PP is defined as the development of secondary sexual characteristics before age 9 years. PP is usually idiopathic; though, organic abnormalities including tumors are more frequently found in male patients with PP. However, advanced puberty in male also can be an important clinical manifestation in tumors. We report 2 cases of rapidly progressive puberty in males, each associated with a germ-cell tumor. First, an 11-year-old boy presented with mild fever and weight loss for 1 month. Physical examination revealed a pubertal stage of G3P3 with 10-mL testes. Investigations revealed advanced bone age (16 years with elevated basal luteinizing hormone and testosterone levels. An anterior mediastinal tumor was identified by chest radiography and computed tomography, and elevated α-fetoprotein (AFP and β-human chorionic gonadotropin (β-hCG levels were noted. Histopathologic analysis confirmed a yolk-sac tumor. Second, a 12-year-old boy presented with diplopia, polydipsia, and polyuria for 4 months. Physical examination revealed a pubertal stage of G3P3 with 8-mL testes. Bone age was advanced (16 years and laboratory tests indicated panhypopituitarism with elevated testosterone level. A mixed germ-cell tumor was diagnosed with elevated AFP and β-hCG levels. Of course, these patients also have other symptoms of suspecting tumors, however, rapidly progressive puberty can be the more earlier screening sign of tumors. Therefore, in male patients with accelerated or advanced puberty, malignancy should be considered, with evaluation of tumor markers. In addition, advanced puberty in male should be recognized more widely as a unique sign of neoplasm.

  13. Mass-gathering Medicine: Risks and Patient Presentations at a 2-Day Electronic Dance Music Event.

    Science.gov (United States)

    Lund, Adam; Turris, Sheila A

    2015-06-01

    Music festivals, including electronic dance music events (EDMEs), increasingly are common in Canada and internationally. Part of a US $4.5 billion industry annually, the target audience is youth and young adults aged 15-25 years. Little is known about the impact of these events on local emergency departments (EDs). Drawing on prospective data over a 2-day EDME, the authors of this study employed mixed methods to describe the case mix and prospectively compared patient presentation rate (PPR) and ambulance transfer rate (ATR) between a first aid (FA) only and a higher level of care (HLC) model. There were 20,301 ticketed attendees. Seventy patient encounters were recorded over two days. The average age was 19.1 years. Roughly 69% were female (n=48/70). Forty-six percent of those seen in the main medical area were under the age of 19 years (n=32/70). The average length of stay in the main medical area was 70.8 minutes. The overall PPR was 4.09 per 1,000 attendees. The ATR with FA only would have been 1.98; ATR with HLC model was 0.52. The presence of an on-site HLC team had a significant positive effect on avoiding ambulance transfers. Twenty-nine ambulance transfers and ED visits were avoided by the presence of an on-site HLC medical team. Reduction of impact to the public health care system was substantial. Electronic dance music events have predictable risks and patient presentations, and appropriate on-site health care resources may reduce significantly the impact on the prehospital and emergency health resources in the host community.

  14. Atypical presentation of acute idiopathic megacolon in a 14-year-old patient

    Directory of Open Access Journals (Sweden)

    B. Barakat

    2012-12-01

    Full Text Available In clinical practice the term “megacolon” is used to indicate a marked dilatation of the cecum and the sigmoid colon (>12 and 6.5 cm, respectively (1. From a clinical standpoint, a megacolon can be classified as chronic or acute depending on its clinical presentation. Chronic megacolon typically refers to a congenital disorder in which the enteric nervous system (ENS supplying the colon does not develop properly, thereby leaving the distal segments of the viscus without myenteric and submucosal ganglia (i.e. Hirschsprung’s disease (2. Other cases of non-aganglionic chronic megacolon can be secondary to variety of conditions such as Chagas’ disease and neurodegenerative diseases (e.g. Parkinson’s and Alzheimer’s diseases, leading to or associated with ENS abnormalities (3. The acute form of megacolon, also referred to as Ogilvie’s syndrome, is characterized by a predominant involvement of the cecum and right colon usually affecting elderly patients undergoing surgery (e.g. orthopedic procedures or taking medications altering gut motility (e.g. opioids or antidepressants (4. Some forms of acute megacolon, however, can be idiopathic in origin since no underlying etiology can be identified. Patients with acute idiopathic megacolon usually have a longstanding history of constipation, often accompanied by laxative abuse, and their clinical presentation is characterized by abdominal distension and severe pain with radiological evidence of stool impacted in the colon and rectum (1, 4. The case herein reported represents an unusual form of acute idiopathic megacolon characterized by massive descending and sigmoid colon distension complicated with a volvulus in a 14-year-old boy with no Hirschsprung’s disease. In addition, just to increase the peculiarity of this case report, the patient had an unremarkable clinical record, and never suffered from chronic constipation in the past.

  15. Peroxynitrite modified DNA presents better epitopes for anti-DNA autoantibodies in diabetes type 1 patients.

    Science.gov (United States)

    Tripathi, Prashant; Moinuddin; Dixit, Kiran; Mir, Abdul Rouf; Habib, Safia; Alam, Khursheed; Ali, Asif

    2014-07-01

    Peroxynitrite (ONOO(-)), formed by the reaction between nitric oxide (NO) and superoxide (O2(-)), has been implicated in the etiology of numerous disease processes. Peroxynitrite interacts with DNA via direct oxidative reactions or via indirect radical-mediated mechanism. It can inflict both oxidative and nitrosative damages on DNA bases, generating abasic sites, resulting in the single strand breaks. Plasmid pUC 18 isolated from Escherichiacoli was modified with peroxynitrite, generated by quenched flow process. Modifications incurred in plasmid DNA were characterized by ultraviolet and fluorescence spectroscopy, circular dichroism, HPLC and melting temperature studies. Binding characteristics and specificity of antibodies from diabetes patients were analyzed by direct binding and inhibition ELISA. Peroxynitrite modification of pUC 18 plasmid resulted in the formation of strand breaks and base modification. The major compound formed when peroxynitrite reacted with DNA was 8-nitroguanine, a specific marker for peroxynitrite induced DNA damage in inflamed tissues. The concentration of 8-nitroguanine was found to be 3.8 μM. Sera from diabetes type 1 patients from different age groups were studied for their binding to native and peroxynitrite modified plasmid. Direct binding and competitive-inhibition ELISA results showed higher recognition of peroxynitrite modified plasmid, as compared to the native form, by auto-antibodies present in diabetes patients. The preferential recognition of modified plasmid by diabetes autoantibodies was further reiterated by gel shift assay. Experimentally induced anti-peroxynitrite-modified plasmid IgG was used as a probe to detect nitrosative lesions in the DNA isolated from diabetes patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Unusual presentation of a severely ill patient having severe fever with thrombocytopenia syndrome: a case report.

    Science.gov (United States)

    Kaneko, Masahiko; Maruta, Masaki; Shikata, Hisaharu; Asou, Kengo; Shinomiya, Hiroto; Suzuki, Tadaki; Hasegawa, Hideki; Shimojima, Masayuki; Saijo, Masayuki

    2017-02-03

    Severe fever with thrombocytopenia syndrome is an emerging infectious disease caused by a novel phlebovirus belonging to the family Bunyaviridate. Emergence of encephalitis/encephalopathy during severe fever with thrombocytopenia syndrome progression has been identified as a major risk factor associated with a poor prognosis. Here we report the case of a severely ill patient with severe fever with thrombocytopenia syndrome virus-associated encephalitis/encephalopathy characterized by a lesion of the splenium, which resolved later. A 56-year-old Japanese man presented with fever and diarrhea, followed by dysarthria. Diffusion-weighted magnetic resonance imaging demonstrated high signal intensity in the splenium of the corpus callosum. The severe fever with thrombocytopenia syndrome virus genome was detected in our patient's serum, and the clinical course was characterized by convulsion, stupor, and hemorrhagic manifestations, with disseminated intravascular coagulation and hemophagocytic lymphohistiocytosis. Supportive therapy not including administration of corticosteroids led to gradual improvement of the clinical and laboratory findings, and magnetic resonance imaging demonstrated resolution of the splenial lesion. The serum severe fever with thrombocytopenia syndrome viral copy number, which was determined with the quantitative reverse-transcription polymerase chain reaction, rapidly decreased despite the severe clinical course. Our patient's overall condition improved, allowing him to be eventually discharged. Patients with encephalitis/encephalopathy due to severe fever with thrombocytopenia syndrome virus infection may have a favorable outcome, even if they exhibit splenial lesions and a severe clinical course; monitoring the serum viral load may be of value for prediction of outcome and potentially enables the avoidance of corticosteroids to intentionally cause opportunistic infection.

  17. Coping patterns as a valid presentation of the diversity of coping responses in schizophrenia patients.

    Science.gov (United States)

    Ritsner, Michael S; Gibel, Anatoly; Ponizovsky, Alexander M; Shinkarenko, Evgeny; Ratner, Yael; Kurs, Rena

    2006-11-15

    This study aimed to identify coping patterns used by schizophrenia inpatients in comparison with those used by healthy individuals, and to explore their association with selected clinical and psychosocial variables. The Coping Inventory for Stressful Situations (CISS) was used to assess coping strategies among 237 inpatients who met DSM-IV criteria for schizophrenia and 175 healthy individuals. Severity of psychopathology and distress, insight into illness, feelings of self-efficacy and self-esteem (self-construct variables), social support, and quality of life were also examined. Factor analysis, analysis of covariance and correlations were used to examine the relationships between the parameters of interest. Using dimensional measures, we found that emotion-oriented coping style and emotional distress were significantly higher in the schizophrenia group, whereas the task-oriented coping style, self-efficacy, perceived social support and satisfaction with quality of life were lower compared with controls. When eight CISS coping patterns were defined, the results revealed that patients used emotion coping patterns 5.5 times more frequently, and task and task-avoidance coping patterns significantly less often than healthy subjects. Coping patterns have different associations with current levels of dysphoric mood and emotional distress, self-construct variables, and satisfaction with quality of life. Thus, the identified coping patterns may be an additional useful presentation of the diversity of coping strategies used by schizophrenia patients. Coping patterns may be considered an important source of knowledge for patients who struggle with the illness and for mental health professionals who work with schizophrenia patients.

  18. Pattern of dyslipidaemia among the Bangladeshi type 2 diabetic patients presented with acute coronary syndrome.

    Science.gov (United States)

    Hoque, M H; Mahmood, M; Haque, M A; Salim, M A

    2014-10-01

    Increasing prevalence of diabetes and its complications in the developing communities would pose a threat in respect to their existing health care service. An increased incidence of atherosclerosis in insulin-dependent diabetic patients has long been recognized. Hyperlipidaemia, a common finding in these patients, may be one of the contributing factors. The objective of our study is to find out the patterns of dyslipidaemia among the Bangladeshi patients with type-2 diabetes mellitus presented with acute coronary syndrome. This study was conducted in the department of cardiology of BIRDEM and Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period of January 2009 to December 2009. A total of 100 patients were included in this study, according to the inclusion and exclusion criteria. Diabetes Mellitus and Acute Coronary Syndrome was diagnosed according to the guideline of American Diabetic Association and American College of Cardiology respectively. Among the respondents Mean±SD of fasting blood sugar and 2 hours ABF were 9.23±3.6mmol/L and 12.61±8.52mmol/L respectively. Mean±SD of HbA1C of the respondents was 7.23±2.12. Total cholesterol level 200mg/dl were 27.0%, 42.0% and 31.0% respectively. HDL cholesterol 40mg/dl were 76.0% and 24.0% respectively. LDL cholesterol 150mg/dl were 43.0% and 57.0% respectively. TG within 40 to 160mg/dl and >160mg/dl were 73.0% and 27.0% respectively, Mean±SD of Total Cholesterol, HDL Cholesterol, LDL Cholesterol and Triglyceride were 162.43±38.62, 37.41±8.59, 137.43±22.73 and 156.43±41.92mg/dl respectively.

  19. Clinical presentation and management practice of systemic mastocytosis. A survey on 460 Italian patients.

    Science.gov (United States)

    Pieri, Lisa; Bonadonna, Patrizia; Elena, Chiara; Papayannidis, Cristina; Grifoni, Federica Irene; Rondoni, Michela; Girlanda, Stefania; Mauro, Marina; Magliacane, Diomira; Elli, Elena Maria; Iorno, Maria Loredana; Almerigogna, Fabio; Scarfì, Federica; Salerno, Roberto; Fanelli, Tiziana; Gesullo, Francesca; Corbizi Fattori, Giuditta; Bonifacio, Massimiliano; Perbellini, Omar; Artuso, Anna; Soverini, Simona; De Benedittis, Caterina; Muratori, Simona; Pravettoni, Valerio; Cova, Vittoria; Cortellini, Gabriele; Ciceri, Fabio; Cortelezzi, Agostino; Martinelli, Giovanni; Triggiani, Massimo; Merante, Serena; Vannucchi, Alessandro Maria; Zanotti, Roberta

    2016-07-01

    Systemic mastocytosis is a rare heterogeneous myeloproliferative neoplasm characterized by abnormal proliferation and activation of mast cells. We describe a large multicentre series of 460 adult patients with systemic mastocytosis, with a diagnosis based on WHO 2008 criteria, in a "real-life" setting of ten Italian centers with dedicated multidisciplinary programs. We included indolent forms with (n = 255) and without (n = 165) skin lesions, smouldering (n = 20), aggressive (n = 28), associated with other hematological diseases mastocytosis (n = 21) and mast cell leukemia (n = 1). This series was uniquely characterized by a substantial proportion of patients with low burden of neoplastic mast cells; notably, 38% of cases were diagnosed using only minor diagnostic criteria according to WHO 2008 classification, underlying the feasibility of early diagnosis where all diagnostic approaches are made available. This has particular clinical relevance for prevention of anaphylaxis manifestations, that were typically associated with indolent forms. In multivariate analysis, the most important features associated with shortened overall survival were disease subtype and age at diagnosis >60 years. Disease progression was correlated with mastocytosis subtype and thrombocytopenia. As many as 32% of patients with aggressive mastocytosis suffered from early evolution into acute leukemia. Overall, this study provides novel information about diagnostic approaches and current presentation of patients with SM and underlines the importance of networks and specialized centers to facilitate early diagnosis and prevent disease-associated manifestations. Am. J. Hematol. 91:692-699, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. An Extremely Uncommon Case of Parasitic Infection Presenting as Eosinophilic Ascites in a Young Patient

    Directory of Open Access Journals (Sweden)

    Kemal Oncu

    2011-04-01

    Full Text Available We report the case of a 24-year-old male patient admitted for recent ascites and splenomegaly of unknown origin. The patient was referred to our institution with complaints of diarrhea, epigastric pain, abdominal cramping and weight loss over the past three weeks. The acute onset presented with colicky abdominal pain and peritoneal effusion. History revealed reduced appetite and weight gain of 7 kg over the last one month. His past medical history and family history was negative. He had no history of alcohol abuse or viral hepatitis infection. Laboratory data revealed normal transaminases and bilirubin levels, and alkaline phosphatase and gammaglutamyltransferase were within normal range. A diagnostic laparoscopy was performed which showed free peritoneal fluid and normal abdominal viscera. Upper gastrointestinal system endoscopy performed a few days later revealed diffuse severe erythematous pangastritis and gastroduodenal gastric reflux. Duodenal biopsies showed chronic nonspecific duodenitis. Antrum and corpus biopsies showed chronic gastritis. The ascitic fluid was straw-colored and sterile with 80% eosinophils. Stool exam was negative for parasitic infection. Treatment with albendazole 400 mg twice daily for 5 days led to the disappearance of ascites and other signs and symptoms. Three months after albendazole treatment the eosinophilic cell count was normal. The final diagnosis was consistent with parasitic infection while the clinical, sonographic and histological findings suggested an eosinophilic ascites. We emphasize the importance of excluding parasitic infection in all patients with eosinophilic ascites. We chose an alternative way (albendazole treatment to resolve this clinical picture. With our alternative way for excluding this parasitic infection, we treated the patient and then found the cause.

  1. The value of daily platelet counts for predicting dengue shock syndrome: Results from a prospective observational study of 2301 Vietnamese children with dengue.

    Directory of Open Access Journals (Sweden)

    Phung Khanh Lam

    2017-04-01

    Full Text Available Dengue is the most important mosquito-borne viral infection to affect humans. Although it usually manifests as a self-limited febrile illness, complications may occur as the fever subsides. A systemic vascular leak syndrome that sometimes progresses to life-threatening hypovolaemic shock is the most serious complication seen in children, typically accompanied by haemoconcentration and thrombocytopenia. Robust evidence on risk factors, especially features present early in the illness course, for progression to dengue shock syndrome (DSS is lacking. Moreover, the potential value of incorporating serial haematocrit and platelet measurements in prediction models has never been assessed.We analyzed data from a prospective observational study of Vietnamese children aged 5-15 years admitted with clinically suspected dengue to the Hospital for Tropical Diseases in Ho Chi Minh City between 2001 and 2009. The analysis population comprised all children with laboratory-confirmed dengue enrolled between days 1-4 of illness. Logistic regression was the main statistical model for all univariate and multivariable analyses. The prognostic value of daily haematocrit levels and platelet counts were assessed using graphs and separate regression models fitted on each day of illness. Among the 2301 children included in the analysis, 143 (6% progressed to DSS. Significant baseline risk factors for DSS included a history of vomiting, higher temperature, a palpable liver, and a lower platelet count. Prediction models that included serial daily platelet counts demonstrated better ability to discriminate patients who developed DSS from others, than models based on enrolment information only. However inclusion of daily haematocrit values did not improve prediction of DSS.Daily monitoring of platelet counts is important to help identify patients at high risk of DSS. Development of dynamic prediction models that incorporate signs, symptoms, and daily laboratory measurements

  2. FDI Spill‑Overs, Absorptive Capacity and Domestic Firms’ Technical Efficiency in Vietnamese Wearing Apparel Industry

    Directory of Open Access Journals (Sweden)

    Hoang Duong Vu

    2017-01-01

    Full Text Available This study empirically examines relationship between FDI spill-overs and technical efficiency of domestic firms and role of the absorptive capacity of domestic firms. Data on Vietnamese Annual Enterprises Survey are exploited to build a firm-level panel data on the Vietnamese wearing apparel industry from 2009 to 2013. By applying stochastic production frontier model, this paper shows that there are positive vertical spill-over effects but no horizontal effects. Moreover, this study finds the negative impact of the absorptive capacity of domestic firms on benefits reaped from FDI externalities.

  3. Vietnamese Garment Enterprises After the Termination of the Multi-Fiber Agreement

    DEFF Research Database (Denmark)

    Schaumburg-Müller, Henrik

    in the basic institutional international trade arrangements. The focus is on Vietnam and the Vietnamese garment suppliers looking at how they have performed after the removal of the quota systems and what kind of strategies they have pursued. The results show that Vietnamese suppliers have been able to compete...... internationally after the quota removals although many of them appear to be locked in the low value end of the chain. The data show, however, that they are not only able to compete and grow but also to change between buyers and markets, which provides them with the flexibility of shifting between chains....

  4. Improved meal presentation increases food intake and decreases readmission rate in hospitalized patients.

    Science.gov (United States)

    Navarro, Daniela Abigail; Boaz, Mona; Krause, Ilan; Elis, Avishay; Chernov, Karina; Giabra, Mursi; Levy, Miriam; Giboreau, Agnes; Kosak, Sigrid; Mouhieddine, Mohamed; Singer, Pierre

    2016-10-01

    Reduced food intake is a frequent problem at a hospital setting, being a cause and/or consequence of malnutrition. Food presentation can affect food intake and induce nutritional benefit. To investigate the effect of improved meal presentation supported by gastronomy expertise on the food intake in adults hospitalized in internal medicine departments. Controlled before and after study. Two hundred and six newly hospitalized patients in internal medicine departments were included and divided in two groups, a) control: receiving the standard lunch from the hospital and b) experimental: receiving a lunch improved in terms of presentation by the advices received by the Institut Paul Bocuse, Ecully, Lyon, France together with the hospital kitchen of the Beilinson Hospital, without change in the composition of the meal. The amount of food left at the participants' plates was estimated using the Digital Imaging Method, which consisted in photographing the plates immediately to previous tray collection by the researcher. In addition, the nutritionDay questionnaire was used to measure other variables concerned to their food intake during hospitalization. Charlson Comorbidity Index was calculated. There was no significant difference between the groups regarding demography or Charlson Comorbidity Index. Patients who received the meal with the improved presentation showed significantly higher food intake than those who received the standard meal, despite reported loss in appetite. Participants from the experimental group left on their plate less starch (0.19 ± 0.30 vs. 0.52 + 0.41) (p  0.05). Both of the groups were asked how hungry they were before the meal and no significance was shown. More participants from the experimental group reported their meal to be tasty in comparison to those in the control group (49.5% vs. 33.7% p < 0.005). Length of stay was not different but readmission rate decreased significantly in the study group (p < 0.02) from 31.2% to 13

  5. Multiple Bilateral Unerupted Supplemental Premolars: An Unusual Presentation in a Nonsyndromic Patient

    Science.gov (United States)

    Panda, Suman; Maganur, Prabhadevi; Ahmed, Ather

    2017-01-01

    Supernumerary teeth are one of the routinely encountered developmental disturbances representing one or more extra teeth in the jaws. These may resemble the teeth of the group to which it belongs, i.e., molars, premolars, or incisors, or it may bear little or no resemblance. Based on the morphologic appearance, it is classified as supplemental teeth or rudimentary teeth. The supplemental teeth are those that resemble the teeth to which it is associated and rudimentary teeth are those that do not resemble the teeth. Supplemental teeth, most of the times, are associated with syndromes and they can also be present in the absence of systemic pathology. Literature reveals predilection of the presence of supplemental premolars of 2:1 in males. This is the case report of a 14-year-old male who presented with multiple unerupted bilateral supplemental premolars on both the arches. How to cite this article Satish V, Panda S, Maganur P, Ahmed A. Multiple Bilateral Unerupted Supplemental Premo-lars: An Unusual Presentation in a Nonsyndromic Patient. Int J Clin Pediatr Dent 2017;10(2):217-222. PMID:28890628

  6. Chest CT examinations in patients presenting with acute chest pain: a pictorial review.

    Science.gov (United States)

    Hammer, Sebastiaan; Kroft, Lucia J; Hidalgo, Alberto L; Leta, Ruben; de Roos, Albert

    2015-12-01

    Acute chest pain (ACP) is one of the most common presenting symptoms at the emergency department. The differential diagnosis is vast. To exclude life-threatening causes, radiologists encounter an increasing amount of thoracic computed tomography (CT) examinations including CT angiography of the heart and great vessels. The dual- and triple-rule CT examinations are currently implemented in clinical practice. We retrospectively identified chest CT examinations in the setting of acute chest pain in our hospitals and collected a variety of common and uncommon cases. In this pictorial essay, we present the most educative cases from patients who presented with acute chest pain in the emergency department of our hospitals and for whom a thoracic CT was ordered. When aortic emergencies, acute coronary syndrome, and pulmonary embolism are excluded, these cases may help the radiologist to suggest alternative diagnoses in the diagnostic challenge of acute chest pain. Teaching Points • The number of chest CT examinations for ACP is increasing.• Chest CT examinations may help suggesting alternative diagnosis in ACP.• Radiologists should be aware of the differential diagnosis of ACP.

  7. Internet addiction and sleep quality among Vietnamese youths.

    Science.gov (United States)

    Zhang, Melvyn W B; Tran, Bach Xuan; Huong, Le Thi; Hinh, Nguyen Duc; Nguyen, Huong Lan Thi; Tho, Tran Dinh; Latkin, Carl; Ho, Roger C M

    2017-08-01

    Internet addiction has been a major behavioral disorder over the past decade. Prior meta-analytic review has demonstrated the association between Internet addiction and psychiatric disorders, as well as sleep related disorders. There remains a paucity of literature about Internet addiction and sleep related disorders in low and middle income countries like Vietnam. It is the aim of this exploratory study to determine the association. An online cross-sectional study was conducted between August through to October 2015. Respondent drive sampling technique was utilized in the recruitment of participants. The short form version of the Young's Internet addiction test was administered and sleep related disorders was ascertained by means of a self-report questionnaire. Chi-squared, t-test and ANOVA were used to determine whether there were any significant differences amongst the variables considered. Multivariate logistic regressions were also used in the analysis, in order to identify factors associated with Internet addiction. 21.2% Of the participants were diagnosed with Internet addiction. 26.7% of those with Internet addiction also reported that they have had sleep related difficulties. 77.2% of these participants were receptive towards seeking medical treatment. Our current study also highlighted that being single and those who were using tobacco products were not at heightened risk of developing associated sleep related issues. Our current study is largely a cross-sectional exploratory study that has shown that there is a significant prevalence of both Internet addiction and sleep related disorders amongst Vietnamese youth. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Trafficking of Vietnamese women and girls for marriage in China.

    Science.gov (United States)

    Stöckl, Heidi; Kiss, Ligia; Koehler, Jobst; Dong, Dung Thuy; Zimmerman, Cathy

    2017-01-01

    Bride-trafficking has been a growing phenomenon in Southeast Asia, particularly in China, where one-child policies have resulted in demographic imbalances favoring males. Yet, empirical evidence about women and girls sold into marriage in China remains sparse. This study describes the experiences of 51 Vietnamese women and girls as young as 14 in post-trafficking services who were sold into marriage in China. A consecutive sample of individuals from five services in Vietnam were invited to be interviewed within the first 2 weeks of admission. It is part of a wider dataset for research on the health of men, women, and children in post-trafficking services in Cambodia, Thailand, and Vietnam, the largest study to date on human trafficking and health. We calculated proportions for all variables and conducted bivariate analyses using Fisher Exact Tests for their associations with mental health disorders symptoms. Before leaving home, 31% ( n  = 15) participants were married. Participants reported high levels of sexual violence ( n  = 43; 86%) while trafficked and59% ( n  = 30) spent time in detention before returning to Vietnam. Once in post-trafficking care 52.9% ( n  = 27) reported probable depression, anxiety or post-traumatic stress disorders (PTSD), two women (4%) attempted suicide in the past month and 38 (75%) remained afraid of their trafficker. Ten (22%) became pregnant while trafficked, and seven (16%) were pregnant at the interview. The cross-border bride trade between Vietnam and China raises complex policy issues, including questions about detention and immigration rights and strategies for supported return processes, including maternal and child health services. As the repercussions of China's absent female population will persist, Vietnam and China must grapple with the political and social conditions to implement prevention strategies, and resources for women who fall prey to this cross-border bride trade.

  9. [Examination of clinical presentation in terminal-phase lung cancer patients at a single palliative care unit].

    Science.gov (United States)

    Kambayashi, Takatoyo; Nakatsukasa, Hironobu; Kawashima, Ichiro

    2013-10-01

    To study the clinical presentation of lung cancer patients at our palliative care unit (PCU). We examined the clinical presentation of lung cancer patients at our PCU and compared it with the clinical presentation of patients with malignant tumors besides those indicative of lung cancer. The PCU occupancy ratio of lung cancer patients to inpatients was 24%, which was dependent on the type of carcinoma. Lung cancer patients in need of oxygen inhalation and/or terminal sedation were more in number than those with other types of malignant tumors. On the other hand, few patients needed treatment. Dyspnea is the major reason for the terminal sedation of lung cancer patients. Severe dyspnea appeared to be the typical clinical presentation of terminal-phase lung cancer patients.

  10. Anal phyllodes tumor in a male patient: a unique case presentation and literature review.

    Science.gov (United States)

    Ho, Szu-pei; Tseng, Hui-hwa; King, T M; Chow, Philip-C

    2013-03-26

    Lesions of anogenital mammary-like glands are rare, and only 44 female cases have been reported. Herein, we describe a particularly rare case of phyllodes tumor of anogenital mammary-like glands in a 41-year-old male presenting anal bleeding. Papillectomy was performed. The excised tumor was circumscribed in shape, and after it was sliced into sections, it was noted that there were leaf-like slits on the surface of cut side. Under the microscope, the tumor was found to be biphasic, with a bland glandular epithelium and low-to-intermediate cellular stroma, which together created the leaf-like slits. Gynecomastoid hyperplasia was evident at the periphery. The epithelium showed immuno-activity for ER, PR(focal), AR, and GCDFP-15. The stromal cells showed positive staining for CD34 and vimentin. The morphology and immunophenotype were similar to benign phyllodes tumors of breast. To the best of our knowledge, this case report represents the first case of phyllodes tumor of anogenital mammary-like glands with gynecomastoid hyperplasia at the periphery in a male patient. To make a diagnosis, we had to differentiate this lesion from hidradenoma papilliferum of skin appendage, phyllodes tumor of ectopic prostatic tissue, and other tumors of anogenital mammary-like glands analogous to the breast tumor (e.g., fibroadenoma phyllodes, periductal stromal sarcoma, and spindle cell carcinoma). While gynecomastia of male breast is usually a result of hormone imbalance, our patient's tumor did not seem to be related to peripheral hormone status in the anogenital mammary-like glands. Nevertheless, because hormone imbalance has been strongly related to male breast cancer, hormone levels may need to be followed in male patients who have this rare malady. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1509145815899177.

  11. Combinations of Genetic Data Present in Bipolar Patients, but Absent in Control Persons

    DEFF Research Database (Denmark)

    Mellerup, Erling; Andreassen, Ole A; Bennike, Bente

    2015-01-01

    The main objective of the study was to find combinations of genetic variants significantly associated with bipolar disorder. In a previous study of bipolar disorder, combinations of three single nucleotide polymorphism (SNP) genotypes taken from 803 SNPs were analyzed, and four clusters...... of combinations were found to be significantly associated with bipolar disorder. In the present study, combinations of four SNP genotypes taken from the same 803 SNPs were analyzed, and one cluster of combinations was found to be significantly associated with bipolar disorder. Combinations from the new cluster...... and from the four previous clusters were identified in the genomes of 209 of the 607 patients in the study whereas none of the 1355 control participants had any of these combinations in their genome....

  12. Evaluation of the Burn Patients Presenting to Emergency Clinic of a Education Hospital

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    Enver İlhan

    2012-07-01

    Full Text Available Aim: Burn is a significant cause of morbidity and mortality in all age groups. Its treatment requires a multidisciplinary approach. In this study we aimed to evaluate burn cases and discuss the relevant literature. Material and Method: 449 burn patients presenting to the Emergency Clinic in January 2008-2009 were retrospectively evaluated accompanied by the literature.Results: Most of the burns occurred in summer months. The most age group suffering from burns was between 25 and 34 years. Flame-type burns were more frequent than scald-type burns. Burns most often occurred at workplaces, which was followed by homes. The upper extremities were most often afflicted by burns. Discussion: Burns are an important social health issue. Imprudence and ac-cidents facilitate burn occurrence. Prevention is the most significant treat-ment method.

  13. Clinical Presentation and Frequency of Risk Factors in Patients with Breast Carcinoma in Pakistan.

    Science.gov (United States)

    Memon, Zahid Ali; Qurrat-ul-Ain; Khan, Ruba; Raza, Natasha; Noor, Tooba

    2015-01-01

    Breast cancer is known to be one of the most prevalent cancers among women in both developing and developed countries .The incidence of breast cancer in Pakistan has increased dramatically within the last few years and is the second country after Israel in Asia to have highest proportional cases of breast cancer. However, there are limited data for breast cancer available in the literature from Pakistan. The study was conducted to bring to light the common clinical presentation of breast cancer and to evaluate the frequency of established risk factors in breast carcinoma patients and furthermore to compare the findings between premenopausal and postmenopausal women in Pakistan. A 6 months (from July 2012 to Dec 2012) cross sectional survey was conducted in Surgical and Oncology Units of Civil Hospital, Karachi. Data were collected though a well developed questionnaire from 105 female patients diagnosed with carcinoma of breast and analyzed using SPSS version 17. Institutional ethical approval was obtained prior to data collection. Out of 105 patients, 43 were premenopausal and 62 were postmenopausal, 99 being married. Mean age at diagnosis was 47.8 ± 12.4 years. A painless lump was the most frequent symptom, notived by 77.1%(n=81). Some 55.2% (n=58) patients had a lump in the right breast and 44.8%(n=47) in the left breast. In the majority of cases, the lump was present in upper outer quadrant 41.9% (n=44). Mean period of delay from appearance of symptoms to consulting a doctor was 5.13 ± 4.8 months, from the shortest 1 month to the longest 36 months. Long delay (> 3 months) was the most frequent figure 41.9%. Considering overall risk factors most frequent were first pregnancy after 20 years of age (41%), physical breast trauma (28.6%), lack of breast feeding(21.9%), and early menarche breast cancer or any other cancer in first degree relatives (9.5% and 13.3%, respectively). Some of the less common factors were late menopause >54 years (8.6%), use of oral

  14. Anaesthetic management of patients with congenital heart disease presenting for non-cardiac surgery.

    Directory of Open Access Journals (Sweden)

    Mohindra R

    2002-01-01

    Full Text Available The incidence of congenital heart disease is about one percent of all live births in the United States. Treatment is being performed at a younger age and these children are showing improved survival. It is not unusual for children with congenital heart disease to present for non-cardiac surgery. Their management depends on their age, type of lesion, extent of corrective procedure, the presence of complications and other congenital anomalies. Each patient needs a detailed pre-operative evaluation to understand the abnormal anatomy and physiology, and related anaesthetic implications. No anaesthetic agent is an absolute contraindication, although drugs beneficial for one lesion may be detrimental for another. Regional anaesthesia has also been safely used in children with congenital heart disease. However the anaesthesiologist must have a detailed understanding of the pathophysiology of the lesion and the pharmacology of drugs being used to be able to provide safe anaesthesia for children with congenital heart disease.

  15. Atypical presentation of syphilis in an HTLV-I infected patient

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    Carnaúba Jr Dimas

    2003-01-01

    Full Text Available We report the case of a 44 year-old female, who presented a long-lasting, clinically atypical, secondary syphilis ("malignant syphilis" in the right foot, which started six months before medical evaluation. The patient had a serological diagnosis of HTLV-I infection and syphilis two years before the onset of the skin lesions, following a blood donation. As she believed she was allergic to penicillin, she initially received sulfamethoxazole + trimethoprim, without any improvement of the clinical picture. After failure of this first treatment regimen, she was given penicillin, which promoted complete healing of the lesion. We found evidence that infection by HTLV-I is capable of modifying the clinical course of secondary syphilis.

  16. Rhabdomyolysis presenting with severe hypokalemia in hypertensive patients: a case series.

    Science.gov (United States)

    Wen, Zhang; Chuanwei, Li; Chunyu, Zeng; Hui, Huang; Weimin, Li

    2013-04-17

    Rhabdomyolysis presenting with severe hypokalemia as the first manifestation of primary hyperaldosteronism is extremely rare. Two middle-aged Chinese females were admitted to our emergency department for muscular weakness and limb pain, and both have the history of early onset hypertension. Laboratory test showed elevated creatinine phosphokinase (4, 907 and 8, 531 IU/L) and extremely low serum potassium (1.38 mmol/L and 1.98 mmol/L). Rhabdomyolysis and severe hypokalemia were established as first diagnosis. Hypokalemic rhabdomyolysis was confirmed after nervous system disorders, autoimmune diseases and trauma were excluded. Adrenal computerized tomography scan and postural stimulation test revealed aldosterone-producing adenomas. They both received laparoscopic adrenalectomy and were stable at the 2-year follow-up visit. The two cases remind physicians to bear in mind the risk of hypokalemia-induced rhabdomyolysis among patients with primary hyperaldosteronism.

  17. A rare presentation of subcutaneous granuloma annulare in an adult patient; A case report

    Directory of Open Access Journals (Sweden)

    Waleed Alajroush

    2016-07-01

    Full Text Available We are reporting a 33-year old woman with multiple skin-colored, firm, non-tender nodules of varying sizes (ranging between 1 and 1.5 cm, with limited mobility and normal overlying skin. They were distributed mainly on the palmer side of the fingers. History and laboratory examination indicated lack of systemic diseases such as diabetes, rheumatoid arthritis, and tuberculosis. Histopathologic examination confirmed the subcutaneous granuloma annulare (SGA diagnosis by showing a normal epidermis with palisading granulomas (histocytes and giant cells surrounding small areas of connective tissue degeneration (central necrobiosis and mucin accumulation in the reticular dermis and subcutaneous tissues. The patient responded well to two-session course of intra-lesional steroid injections. SGA should be considered by dermatologists in the differential diagnosis of subcutaneous nodules even without concomitant systemic disease and with rare presentation.

  18. The role of urgent transthoracic echocardiography in the evaluation of patients presenting with acute chest pain.

    Science.gov (United States)

    Shah, Benoy Nalin; Ahmadvazir, Shahram; Pabla, Jatinder Singh; Zacharias, Kostas; Senior, Roxy

    2012-10-01

    Chest pain is one of the most frequent reasons for presentation to the Emergency Department. The possible causes of chest pain are numerous and diverse, but importantly, several conditions, such as acute coronary syndrome, pulmonary embolism and aortic dissection, require urgent management and, in some cases, may be life-threatening. In such situations, a prompt and accurate diagnosis is vital. Two-dimensional echocardiography is a safe, painless and rapid test that can be performed in the Emergency Department and ensure a correct diagnosis as well as identify other complications and help institute appropriate management strategies swiftly. We review the current indications for urgent echocardiography in this article, with reference to international management guidelines where available, when managing patients with suspected acute coronary syndrome, acute pulmonary embolism, acute aortic dissection, acute pericarditis and trauma. We also discuss the differences between comprehensive and FOcussed Cardiac UltraSound (FOCUS) echocardiography studies, along with the associated quality control and medicolegal implications.

  19. [The distribution of intestinal parasites in patients presenting at the Parasitology Laboratory of the Cumhuriyet University.].

    Science.gov (United States)

    Değerlı, Serpil; Ozçelık, Semra; Celıksöz, Ali

    2005-01-01

    This study is concerned with the distribution of intestinal parasites detected in patients who presented at the routine Parasitology Laboratory of the Cumhuriyet University Faculty of Medicine from May 2002-November 2004. A total of 5057 stool specimens from 2305 (45.6%) males and 2752 (54.4%) females were examined for intestinal parasites using direct examination and flotation methods. Intestinal parasites were found in 231 (4.5%) females and 301(5.9%) males. A total of 1313 cellophane tape specimens from 646 (49.2%) females and 667 (50.8%) males were examined. Parasites were detected in 34 (2.6%) female and 48 (3.6%) male patients. The distribution of intestinal parasites detected in stool specimens was as follows: 189 (3.7%) Giardia intestinalis, 124 (2.4%) E. histolytica/dispar, 128 (2.5%) Entamoeba coli, 29 (0.6%) Iodamoeba butschlii, 21(0.4%) Blastocystis hominis, 2 (0.03%) Chilomastix mesnili, 1 (0.01%) Trichomonas hominis, 1 (0.01%) Hymenolepis nana, 33 (0.6%) Taenia saginata, 3 (0.05%) Ascaris lumbricoides, and 1 (0.01%) Trichuris trichiura. Parasites detected in cellophane tape specimens included 71 (5.4%) Enterobius vermicularis and 11 (0.8%) Taenia saginata.

  20. Hydatid cyst presenting as a breast lump in a male patient.

    Science.gov (United States)

    Limaiem, F; Bouslama, S; Haddad, I; Bouraoui, S; Lahmar, A; Mzabi, S

    2013-06-01

    The breast is a rare primary site of hydatid disease and accounts for only 0.27% of cases. Mammary hydatidosis generally occurs in females and has never been described in male patients. In this paper, the authors report a new case of isolated hydatid cyst of the breast in a 35-year-old previously healthy man, who presented with a left breast painless lump of one year duration. Physical examination showed a non-tender and immobile mass in the upper lateral quadrant of the left breast, with normal overlying skin and nipple. There was no palpable lymph node in the left axilla and the contralateral breast was normal. Ultrasonography showed a 2.7 x 1.5 cm cystic lesion in the left breast. The patient underwent total excision of the mass, and histopathological examination confirmed the diagnosis of hydatid cyst. The authors conclude that although hydatid cyst of the breast is rare, it should be considered in the differential diagnosis of breast lumps especially in endemic areas.