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Ridgway, Jessica P., Jessica Schmitt, Ellen Almirol, Monique Millington, Erika Harding, and David Pitrak. "Electronic data sharing between public health department and clinical providers improves accuracy of HIV retention data." Open Forum Infectious Diseases 4, suppl_1 (2017): S421—S422. http://dx.doi.org/10.1093/ofid/ofx163.1059.
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Abstract Background Retention in care is critical for treatment and prevention of HIV. Many HIV care clinics measure retention rate, but data are often incomplete for patients who are classified as lost to follow-up but may be actually in care elsewhere, moved, or died. The Data to Care (D2C) initiative supports data sharing between health departments and HIV providers to confirm patient care status and facilitate reengagement efforts for out of care HIV patients. Methods The University of Chicago Medicine (UCM) provided an electronic list to the Chicago Department of Public Health (CDPH) of adult HIV-positive patients whose retention status was not certain. Retention in care was defined as at least 2 visits >90 days apart within the prior 12 months. CDPH matched this list of patients with data from the Chicago electronic HIV surveillance database. Matches were based on patient name, including alternative spellings and phonetics, and birth date. CDPH also cross-checked patient names with the CDC’s national enhanced HIV-AIDS Reporting System (eHARS) database. CDPH provided UCM with patient current care status, i.e., patient was in care elsewhere (as verified by lab data), moved out of state, or deceased. Results 780 HIV-positive patients received care in the UCM adult HIV clinic from January 1, 2013 to March 31, 2017. Of these, 360 were retained in care as of March 2017. We shared data with CDPH for 492 patients. Of these, 294 (59.8%) were matched, and 168 (34.1%) had a date of last medical care provided. See Table 1 for patient dispositions, before and after data sharing. 24 (13.4%) of patients believed to be lost to follow up according to UCM records were confirmed either transferred care or deceased according to health department data. Conclusion Data sharing between the health department and HIV providers can improve data accuracy regarding retention in care among people living with HIV. Disclosures J. P. Ridgway, Gilead FOCUS: Grant Investigator, Grant recipient; D. Pitrak, Gilead Sciences FOCUS: Grant Investigator, Grant recipient
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M, Logaraj, Sathiyanarayanan S, and Balaji R. "SYMPTOMATOLOGY OF FEMALE PATIENTS ATTENDING MOBILE MEDICAL CLINICS IN A RURAL BLOCK IN TAMILNADU." Asian Journal of Pharmaceutical and Clinical Research 11, no. 10 (October 7, 2018): 172. http://dx.doi.org/10.22159/ajpcr.2018.v11i10.20585.
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Objectives: The objectives of the study were to find out the prevalence of “symptoms not elsewhere classified” under the International Classification of Diseases, Tenth Revision, Clinical Modification among the female patients attending mobile medical clinics.Methods: A cross-sectional study was carried out among 7,124 female patients who attended weekly mobile medical clinics in a rural block in Tamil Nadu. Sociodemographic variables, symptomatology, patient history, and clinical examination details were collected using a pre-tested structured questionnaire.Results: The five common symptoms affecting the study population were myalgia (18.3%), nasal congestion (13.6%), headache (13.1%), lumbar pain (12.5%), and knee pain (9.3%). The systems commonly affected among the female patients were in the order of general symptoms and signs (R50-R69), circulatory and respiratory systems (R00-R09), and Nervous and Musculoskeletal Systems (R25-R29). In the age group of 10–19 years and 20–39 years, the most common symptom was headache (25.2% and 18.8%, respectively). In the age group of 40–59 years and 60 years and above, it was myalgia (24.2% and 32.3%, respectively).Conclusion: As pain being most common symptoms, an appropriate strategy and guidelines have to be developed to manage the problem of pain at primary care level.
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Noguera, Patricia, Campbell Pert, Catherine Collins, Nichola Still, and David Bruno. "Quantification and distribution ofAnisakis simplexsensu stricto in wild, one sea winter Atlantic salmon,Salmo salar, returning to Scottish rivers." Journal of the Marine Biological Association of the United Kingdom 95, no. 2 (October 7, 2014): 391–99. http://dx.doi.org/10.1017/s0025315414001374.
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Red vent syndrome (RVS) has previously been reported in returning wild Atlantic salmon,Salmo salarfrom Canada, Iceland, Ireland, Norway and the UK. Affected fish show reddening and swelling in the perianal/vent area, with scale loss, ulceration and bleeding in severe cases. Studies in the UK and elsewhere report the condition to be induced byAnisakis simplexsensu stricto (s.s.) larvae. This parasite, commonly reported in several marine fish species, is typically found in the body cavity and the skeletal muscle, but has recently been reported within the vent tissues of salmon. This latter finding may reflect greater efforts in examining this body portion due to current awareness of the parasite presence in this atypical location. Based on clinical observations, affected fish are classified into three categories according to the severity of the external lesions, but quantification of the vent parasite numbers in relation to the categories, and assessment of the relative importance of this area as a site of infestation, are missing to date. This investigation aimed to provide data on parasite number and distribution in the viscera, skeletal muscle, peduncle and vent area and to confirm the identity of the larvae found in the vent and the viscera. The study showed the perianal/vent region harbours the highest total number ofA. simplexlarvae per fish and, proportionally to fish biomass, is the most heavily infested body location irrespective of external severity levels of RVS.
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Atrash, Shebli, Qing Zhang, Xenofon Papanikolaou, Christoph Heuck, Aziz Bakhous, Jameel Muzaffar, Al-Ola Abdallah, and Bart Barlogie. "Characteristics and Prognosis Of IgM Multiple Myeloma." Blood 122, no. 21 (November 15, 2013): 1881. http://dx.doi.org/10.1182/blood.v122.21.1881.1881.
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Abstract Introduction Multiple Myeloma (MM) is considered a malignancy of post germinal center long-lived plasma cells. Nevertheless T-cell independent antigen stimulation before the exposure of the B-cell to the germinal center can happen and results to IgM secreting short lived plasma cells and lymphoplasmacytes representing thus a potential alternative normal counterpart for IgM plasma cell dyscrasias. IgM myeloma is an infrequent subtytpe of MM with an estimated prevalence of 0.5%. Due to its rarity little is known about its characteristics and prognosis in comparison with Waldestrom’s macroglobulinemia (WM) and the other MM subtypes. Purpose To identify the characteristics and the prognosis of IgM MM, and compare it predominantly with WM and subsequently with the rest of the MM subtypes. Methods We interogatted our Multiple Myeloma Data Base for cases of IgM MM and their respective Overall Survival (OS), Progression Free Survival (PFS), bone disease as defined by x-Rays, PET-CT and MRI, Gene Expression Profile (GEP), and common disease characteristics (anemia,calcium, creatinine) and compare it to the prognosis of WM and non-IgM MM. Diagnosis was based on the morphological and immunophenotypical findings of pathologically examined biopsy specimens along with the presence or not of typical clinical characteristics of MM (lytic bone lesions, hypercalcemia, renal failure) or typical clinical characteristics of WM (organomegaly, lymphadenopathy). Results There were 22 confirmed IgM MM cases. 14 of them presented at MIRT at initial diagnosis while 8 had previously been treated elsewhere. Osteolytic bone lesions and/or pathological fractures by x-ray and CT examination were evident in 16 cases. For the remaining 6 cases active bone focal lesions by either MRI or PET were identified in three. There was no organomegaly evident in cases with an available PET/CT at baseline, while only one had evidence of hilar and mediastinal lymphadenopathy along with calcified lung nodules. Elevated creatinine levels (>2.0 mg/dl) were evident in 4 cases at initial diagnosis. Their disease characteristics are depicted in the table 1. Median OS for IgM MM was 4.9 years while PFS could not be accurately estimated due to lack of data on patients treated elsewhere. Median OS for a historical control of 158 WM cases in MIRT was 9.2 years (Clin Lymphoma Myeloma Leuk. 11(1):139-42). Median OS of the WM group remained largely unaffected, even when the subgroup of the WM cases requiring treatment was analyzed (9.0 years).To further clarify if the IgM MM differs in terms of OS from the other isotypes of MM, we compared the IgM group to a group of 61 non-IgM MM cases which were matched by important prognostic clinical factors (age, creatinine> 2mg/dl, LDH>190u/L, b-2M >5.5mg/dl and Albumin<3.5gr/dl). No statistical difference was found for OS (p=0.846). Out of 22 cases, 14 of them had available GEP data on initial diagnosis. In 6 of these cases the cyclin D1 gene expression was high enough to be consistent with a t(11;14) translocation at FISH analysis, one case was consistent with a t(14;16) translocation, one with a t(4;14) translocation and two more were classified as belonging to the hyperdiploid subgroup. A comparative genomic analysis was performed on the IgM MM, the non-IgM MM and WM cases with available GEP data at initial diagnosis (14, 61 and 42 cases respectively). 1155 probesets that had expression level significantly different between WM and non IgM MM (FDR<3E-06) were identified. Then, the expression values of these 1155 probesets in all GEP samples, including WM, non IgM MM, and IgM MM, were used to build a clustering tree. We found that IgM MM mainly clustered with non IgM MM, supporting the findings of the clinical data. Conclusion IgM MM is a discrete clinical entity that should be distinguished from WM. Bone disease is evident in the majority of the cases, especially when specialized radiological techniques are incorporated at the initial work up. It holds a distinct prognosis from WM, while when balanced for prognostic factors that hold importance in MM it does not differ from the other MM isotypes. Finally analysis of the genetic data further supports the resemblance between IgM MM and the non IgM MM, and the difference with WM. Disclosures: Zhang: University of Arkansas for Medical Sciences: Co-inventor of the DNA probes for FISH of IGHC/IGHV (14q32), MMSET/FGFR3 (4p16), CCND3 (6p21), CCND1 (11q13), MAF (16q23), and MAFB (20q12) loci, sub. to the US Patent & Trademark Office as Prov. App# 61/726,327: Methods of Detecting 14q32 Translocations, Co-inventor of the DNA probes for FISH of IGHC/IGHV (14q32), MMSET/FGFR3 (4p16), CCND3 (6p21), CCND1 (11q13), MAF (16q23), and MAFB (20q12) loci, sub. to the US Patent & Trademark Office as Prov. App# 61/726,327: Methods of Detecting 14q32 Translocations Patents & Royalties.
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Burford, C., R. Laxton, Z. Sidhu, M. Aizpurua, A. King, I. Bodi, K. Ashkan, and S. Al-Sarraj. "ATRX immunohistochemistry can help refine ‘not elsewhere classified’ categorisation for grade II/III gliomas." British Journal of Neurosurgery 33, no. 5 (April 24, 2019): 536–40. http://dx.doi.org/10.1080/02688697.2019.1600657.
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Louis, David N., Pieter Wesseling, Werner Paulus, Caterina Giannini, Tracy T. Batchelor, J. Gregory Cairncross, David Capper, et al. "cIMPACT-NOW update 1: Not Otherwise Specified (NOS) and Not Elsewhere Classified (NEC)." Acta Neuropathologica 135, no. 3 (January 25, 2018): 481–84. http://dx.doi.org/10.1007/s00401-018-1808-0.
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Gangadhar, K., and D. Santhosh. "Primary Skull Osteosarcoma: MDCT Evaluation and Histopathological Correlation in Two Cases." Neuroradiology Journal 25, no. 2 (April 2012): 188–92. http://dx.doi.org/10.1177/197140091202500206.
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Osteosarcomas are typically long bone tumors and rarely affect the skull, with most articles reporting single cases. As elsewhere in the body, these lesions may be classified as primary or secondary, chiefly post-Paget and post-radiation therapy. We describe two cases of primary osteosarcoma of skull one presenting with cerebellar symptoms and another with giant skull swelling. Complete evaluation with 64 slice CT and histopathological correlation was carried out.
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WALTON, JOHN K., and DAVID TIDSWELL. "‘Classified at random by veritable illiterates’: the taking of the Spanish census of 1920 in Guipúzcoa province." Continuity and Change 20, no. 2 (August 2005): 287–313. http://dx.doi.org/10.1017/s0268416005005503.
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This article offers an approach through administrative and cultural history to the problems associated with gathering and processing data for the Spanish national census of 1920, and by implication for earlier Spanish censuses. It focuses on the Basque province of Guipúzcoa, making use of correspondence between the central statistical office in Madrid, the provincial jefe de estadística and the localities, and of reports on three problematic towns within the province. The issues that emerge regarding ‘undercounting’, the definition of administrative boundaries and the classification of demographic characteristics are set in the wider context of census-taking practices and problems elsewhere in Spain and in other cultures.
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Makino, Yasuhide, Takeshi Kawauchi, Yoshiki Arakawa, Tomoko Shofuda, Ema Yoshioka, Masahiro Tanji, Yohei Mineharu, Yonehiro Kanemura, and Susumu Miyamoto. "LGG-38. GENETIC ANALYSIS OF NEUROEPITHELIAL TUMORS IN THE PEDIATRIC AND ADOLESCENT AND YOUNG ADULT AGE IN A SINGLE INSTITUTE." Neuro-Oncology 22, Supplement_3 (December 1, 2020): iii373—iii374. http://dx.doi.org/10.1093/neuonc/noaa222.419.
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Abstract Molecular diagnosis in brain tumors has been widely spread after the publication of WHO 2016 classification. But it become a major problem that there are some tumors not to be classified on its criteria, especially in pediatric neuroepithelial tumors. To clarify the characteristics of gliomas in pediatric and adolescent and young adult age (AYA), we picked up 131 neuroepithelial tumors under 30-year-old at Kyoto University and analyze their molecular profiles. Hot spot mutations in IDH1/2, H3F3A, HIST1H3B, TERT promoter, and BRAF were analyzed by Sanger sequencing, and 1p/19q codeletion was examined by FISH or MLPA. With the pathohistological diagnosis and genetic information, all tumors were classified based on WHO 2016 classification. The terms “not otherwise specified” (NOS) and “not elsewhere classified” (NEC) were used based on cIMPACT-NOW. There were 25 glioblastomas and 34 pilocytic astrocytomas, which accounted for a larger percentage than in adult tumors. IDH-wild type gliomas accounted for 55% in diffuse astrocytomas and 69% in anaplastic astrocytomas. The percentages of gliomas with NEC were 50% of oligodendrogliomas and 20% in anaplastic oligodendrogliomas, respectively. Most pilocytic astrocytomas were under 20-year-old (27 patients) and located in infratentorial area (21 patients). Based on WHO 2016 classification, not a few neuroepithelial tumors in pediatric and AYA ages could be classified clearly. These tumors had more different genetic abnormalities than those in adult. Therefore, it may be important to evaluate these tumors with comprehensive genetic analysis.
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Fountoulakis, Konstantinos N. "The Contemporary Face of Bipolar Illness: Complex Diagnostic and Therapeutic Challenges." CNS Spectrums 13, no. 9 (September 2008): 763–79. http://dx.doi.org/10.1017/s1092852900013894.
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AbstractManic depression, or bipolar disorder, is a multifaceted illness with an inevitably complex treatment. The current article summarizes the current status of our knowledge and practice concerning its diagnosis and treatment. While the prototypic clinical picture concerns the “classic” bipolar disorder, today mixed episodes with incomplete recovery and significant psychosocial impairment are more frequent. The clinical picture of these mixed episodes is variable, eludes contemporary classification systems, and possibly includes a constellation of mental syndromes currently classified elsewhere. Treatment includes the careful combination of lithium, antiepileptics, atypical antipsychotics, and antidepressants, but not all of the agents in these broad categories are effective for the treatment of bipolar disorder.
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Sweeney, Vincent P., Adele D. Sadovnick, and Vilma Brandejs. "Prevalence of Multiple Sclerosis in British Columbia." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 13, no. 1 (February 1986): 47–51. http://dx.doi.org/10.1017/s0317167100035782.
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ABSTRACT:A province wide prevalence study on multiple sclerosis (MS) was conducted in British Columbia (B.C.). The prevalence date was July 1, 1982. The major portion of this study was a review of all the files of neurologists practicing in B.C. as this was judged to be the most accurate source for identifying MS patients. 239,412 neurologists' files were hand searched by one researcher using modified Schumacher criteria for classification. Other sources used during the study for identifying MS patients were the MS Clinic, general practitioners, ophthalmologists, urologists, specialized facilities such as long term care facilities and rehabilitation centres, and patient self-referrals.A total of 4,620 non-duplicated cases were identified and classified. 4,112 of these (89%) were classified according to information contained in neurologists' records.The prevalence estimate for definite/probable MS in B.C. was 93.3/100,000 population. This increased to 130.5/100,000 population if possible MS and optic neuritis were also included. These rates are among the highest reported in Canada or elsewhere. The cooperation of B.C. neurologists made this study unique in its scope and accuracy of diagnosis.
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el-Yazigi, A., K. Chaleby, and C. R. Martin. "A simplified and rapid test for acetylator phenotyping by use of the peak height ratio of two urinary caffeine metabolites." Clinical Chemistry 35, no. 5 (May 1, 1989): 848–51. http://dx.doi.org/10.1093/clinchem/35.5.848.
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Abstract We describe a simplified liquid-chromatographic test in which acetylator phenotype is determined by measuring the peak height ratio of two urinary caffeine metabolites, 5-acetylamino-6-formylamino-3-methyluracil and 1-methylxanthine. We applied this test to determine the acetylator phenotypes of 52 subjects who regularly drink coffee, tea, or caffeinated beverages. Also, we determined the acetylator phenotypes of these subjects according to a well-established sulfasalazine test, which yielded identical results. We established the reproducibility of the described test by determining the acetylator phenotypes of 10 additional subjects on two different days separated by a period of two to five weeks. Of the 52 subjects examined by both tests, 40 (76.9%) were classified as slow acetylators, which agrees well with the percentage reported elsewhere for 297 similar subjects from the Saudi population.
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BOWERS, WILLIAM J., DANIEL J. GIVELBER, and CAROLYN L. BLITCH. "How Did Tarasoff Affect Clinical Practice?" ANNALS of the American Academy of Political and Social Science 484, no. 1 (March 1986): 70–85. http://dx.doi.org/10.1177/0002716286484001006.
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The Tarasoff decisions of the California Supreme Court in 1974 and 1976 held that psychotherapists could be held liable for failing to protect the victims of their potentially violent patients. Our survey of psychiatrists, psychologists, and social workers in eight metropolitan areas showed that Californians were more likely to have heard of the case, to believe it required warning the likely victim, and actually to issue warnings in such cases than were psychotherapists from other jurisdictions. Therapists were more willing to take steps to protect victims in 1980 than in 1975, but willingness to warn increased more among Californians than among those in other states. We conclude that although Tarasoff has influenced therapists' attitudes and behavior more in California than elsewhere, the case has also affected psychotherapeutic practice nationally.
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Pogorzelczyk, Katarzyna, Joanna Synoweć, Andrzej Basiński, Daniel Ślęzak, Marlena Robakowska, Przemysław Żuratyński, and Wioletta Mędrzycka-Dąbrowska. "Cost analysis of treating pain patients on the example of the Clinical accident ward Of university Clinical Centre in Gdańsk." BÓL 20, no. 2 / Zjazd PTBB (September 17, 2019): 1–6. http://dx.doi.org/10.5604/01.3001.0013.4614.
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The cost analysis of pain treatment is not a topic often taken up by the health economists community. The subjective dimension and pain assessment by the patient is one of the main determinants of the lack of interest in this topic. Work carried out on this topic currently includes analysis accompanying the process of pharmacotherapy treatment, care provided by medical personnel as well as costs resulting from administrative services. The aim of the work is to present the cost analysis of care for a „pain” patient and to indicate the most optimal financial package of these activities. The study was performed on the basis of financial data of the Clinical Emergency Department of the University Clinical Center in Gdańsk for the last year. We analyzed the cases of patients complaining of pain who received pharmacotherapy. Results The total cost for 2017 amounted to 1.128.668 PLN. The largest amount of money was allocated to the group of patients qualified to the group R: „Symptoms, disease features and abnormal results of clinical trials not classified elsewhere” – 327.313.72 PLN. The symptom of pain is one of the most frequently indicated symptoms among patients who receive medical help at the Clinical Emergency Department of the University Clinical Center in Gdańsk, which should be associated with a greater degree of involvement in analgesic therapy in patients who require it.
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Rivera, Paola A., Akash Gupta, and Ninani Kombo. "Treatment of non-infectious retinal vasculitis." Therapeutic Advances in Ophthalmology 15 (January 2023): 251584142311527. http://dx.doi.org/10.1177/25158414231152761.
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Retinal vasculitis (RV) refers to an entity in which the retinal vasculature is inflamed, frequently with indications of inflammation elsewhere in the eye. Non-infectious RV can be idiopathic or associated with systemic disease, ocular conditions, and malignancy. It can also be classified based on the vessel affected: artery, vein, or both. Due to the lack of strong evidence-based treatment trials and algorithms for RV, physicians must often rely on their experience, which creates great variability in treating this entity. This article provides an overview of various treatment modalities used in the management of non-infectious RV, with a focus on immunomodulatory therapies. We outline a potential stepwise approach of starting with steroids to control the acute inflammation and subsequently changing to immunomodulatory therapy (IMT) for long-term treatment.
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Masaki, Motofumi, and Akira Koizumi. "Demographic characteristics and their genetic implications in a small island." Journal of Biosocial Science 20, no. 2 (April 1988): 225–34. http://dx.doi.org/10.1017/s0021932000017454.
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SummaryThe family registration records from a village population in a small island of Japan are used to assess the effect of demographic differentiation within a population on genetic measures. When the couples studied are classified by birth cohorts and origins, wives of the couples where one spouse came from elsewhere were older at marriage and had a shorter duration of marriage or registration than wives where both spouses were natives of the village. The mean number of offspring is statistically smaller in the former except for the latest cohort, due mainly to out-migration during the reproductive ages which also resulted in low rates of marriage among the offspring within the village. This leads to a small effective population size and an increased likelihood of genetic drift in the overall population.
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De Carlo, D., L. Dal Zotto, E. Perissinotto, L. Gallo, M. Gatta, U. Balottin, G. Mazzotta, et al. "Osmophobia in migraine classification: A multicentre study in juvenile patients." Cephalalgia 30, no. 12 (March 26, 2010): 1486–94. http://dx.doi.org/10.1177/0333102410362928.
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Aims: This study was planned to investigate the diagnostic utility of osmophobia as criterion for migraine without aura (MO) as proposed in the Appendix (A1.1) of the International Classification of Headache Disorders (ICHD-II, 2004). Methods: We analysed 1020 patients presenting at 10 Italian juvenile headache centres, 622 affected by migraine (M) and 328 by tension-type headache (TTH); 70 were affected by headache not elsewhere classified (NEC) in ICHD-II. By using a semi-structured questionnaire, the prevalence of osmophobia was 26.9%, significantly higher in M than TTH patients (34.6% vs 14.3%). Results: Osmophobia was correlated with: (i) family history of M and osmophobia; and (ii) other accompanying symptoms of M. By applying these ‘new’ criteria, we found an agreement with the current criteria for the diagnosis of migraine without aura (MO) in 96.2% of cases; 54.3% of previously unclassifiable patients received a ‘new’ diagnosis. Conclusions: In conclusion, this study demonstrates that this new approach, proposed in the Appendix (A1.1), appears easy to apply and should improve the diagnostic standard of ICHD-II in young patients too.
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Ruiz Jr, Facundo Burgos, Márcia Silva Santos, Helen Souto Siqueira, and Ulisses Correa Cotta. "Clinical features, diagnosis and treatment of acute primary headaches at an emergency center: why are we still neglecting the evidence?" Arquivos de Neuro-Psiquiatria 65, no. 4b (December 2007): 1130–33. http://dx.doi.org/10.1590/s0004-282x2007000700007.
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In order to analyze the clinical features, approach and treatment of patients with acute primary headaches seen at the Clinics Hospital of the Federal University of Uberlândia (HC-UFU) throughout 2005, the medical charts of 109 patients were evaluated through a standardized questionnaire as to age, gender, main diagnosis, characteristics of the headache attacks, diagnostic tests and treatment. Probable migraine was the most common type of primary headache (47.7%), followed by probable tension-type headache (37.6%), unspecified headache (11.9%), and headache not elsewhere classified (2.8%). As to characteristics of the crisis, the location of the pain was described in 86.2% of the patients. The most commonly used drugs for treatment of acute headache attacks were dipyrone (74.5%), tenoxicam (31.8%), diazepam (20.9%), dimenhydrate (10.9%), and metochlopramide (9.9%). The data collected are in agreement with those reported in literature. In most cases, treatment was not what is recommended by consensus or clinical studies with appropriate methodology. Therefore, we suggest the introduction of a specific acute headache management protocol which could facilitate the diagnosis, treatment and management of these patients.
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Matthews, Peter C. "Pathological Habit Disorder?" Canadian Journal of Psychiatry 33, no. 9 (December 1988): 826–29. http://dx.doi.org/10.1177/070674378803300908.
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This paper outlines a diagnostic entity called ‘Pathological Habit Disorder’ which is suggested for inclusion in the DSM as an Axis II option. Specific areas of concern, either mental (Axis I) or physical (Axis III), would delineate the syndrome. Pathological Habit Disorder (PHD) points to treatment options where the syndrome is wholly or partly habit-driven. Whether the syndrome is habit-driven or not will remain a clinical judgement even though many conditions, previously thought immutable except by medication, are proving accessible to behavioural engineering. In the ICD system, PHD seems to fit in “Special Symptoms or Syndromes not elsewhere Classified”. It is demonstrably useful to have a diagnosis such as PHD and to incorporate it into the body of medical classification, recognizing current practices for dealing with unwelcome or damaging habits.
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Khatri, R. "Basic Sciences: An Alternative career?" Kathmandu University Medical Journal 11, no. 1 (September 9, 2014): 78–80. http://dx.doi.org/10.3126/kumj.v11i1.11033.
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Career selection is a crucial and a complex process which is also true in the medical profession as well. In the context of our country, due to the limited opportunity and proper guidance, migration of medical graduates to foreign countries is increasing. Though, clinical subjects have a huge attraction, basic science field has failed to impress our medical graduates. In current scenario, basic science field seems to be a dumping site for the incompetent as the candidates who have failed trying their luck elsewhere stumble upon basic science careers though it is not true for all. Moreover, a very few medical graduates are interested in developing their career as a basic scientist. Therefore, to motivate today’s young medical graduates, there is a need of a good mentor along with a proper career guidance which can help them to understand the basic science field as an alternative career. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11033 Kathmandu University Medical Journal Vol.11(1) 2013: 78-80
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Rhee, Seongha, and Hyun Jung Koo. "Multifaceted gustation." Food and terminology 23, no. 1 (November 10, 2017): 38–65. http://dx.doi.org/10.1075/term.23.1.02rhe.
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Korean has a large number of taste terms and the paradigm is continuously expanding since the lexicalization operates systematically on a few robust principles. Based on the taste terms collected from lexicons, dictionaries, web-postings, and elsewhere, we classified the terms and analyzed the lexicalization patterns. In addition to the widely-known five classes of tastes, i.e., sweet, salty, sour, bitter and umami, Korean has three more classes in the basic category, i.e., pungent, fishy and bland. A large number of tactile sensory words to describe the touch sensations in the mouth at the tasting event and expressions denoting characteristic food texture and mastication also join in creating a rich taste vocabulary. The Korean taste lexicalization system is equipped with the means to signal diverse aspects of gustatory sensation, i.e., intensity, depth, purity and duration. Among such means are vowel polarity, consonantal sound symbolism, reduplication and onomatopoeia. The systematicity of taste lexicalization contributes to the plasticity of the paradigm, making the Korean taste vocabulary one of the most productive and elaborate paradigms.
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Giere, W., and J. Ingenerf. "Concept-oriented Standardization and Statistics-oriented Classification: Continuing the Classification versus Nomenclature Controversy." Methods of Information in Medicine 37, no. 04/05 (October 1998): 527–39. http://dx.doi.org/10.1055/s-0038-1634544.
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AbstractNowadays, most activities on controlled medical vocabularies focus on the provision of a sufficient atomic-level granularity for representing clinical data. Amongst others, clinical vocabularies should be concept oriented, compositional and should also reject “Not Elsewhere Classified” [1]. We strongly share the opinion that there is a need to deal with serious deficits of existing manually created vocabularies and with new demands for computer-based advanced processing and exchange of medical language data. However, we do not share the opinion that methodological requirements like observational and structural comparability needed for sound statistics should not be included in desiderata of controlled medical vocabularies. Statistical-oriented classifications are not developed for representing detailed clinical data but for providing purposedependent classes where cases of interest are assigned uniquely. Either statistical classifications are not included into the set of controlled medical vocabularies in the sense of Cimino, or his desiderata are misleading. We argue that statistical classifications should be linked to (formal) concept systems, but again this linkage does not change their different natures. With this article we continue the “classification versus nomenclature” controversy referring to Cote [2].
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Fisher, Michael, David Jones, Yimei Li, Xiaofan Guo, Poonam Sonawane, Angela Waanders, Joanna Phillips, et al. "LGG-06. COMPREHENSIVE GENOMIC CHARACTERIZATION AND INTEGRATED CLINICAL ANALYSIS OF LOW-GRADE GLIOMAS IN CHILDREN WITH NEUROFIBROMATOSIS TYPE 1." Neuro-Oncology 23, Supplement_1 (June 1, 2021): i32. http://dx.doi.org/10.1093/neuonc/noab090.130.
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Abstract Background Low-grade gliomas (LGGs) arising in children with neurofibromatosis type 1 (NF1) are usually not biopsied. To identify secondary genetic alterations or molecular features that may contribute to pathogenesis and correlate with clinical behavior, we initiated a comprehensive molecular and clinical analysis of pediatric NF1-LGGs. Methods NF1-LGGs were analysed by whole-genome sequencing (31), targeted gene panel sequencing (9), RNAseq transcriptomal profiling (33) and genome-wide DNA methylation analysis (67). Clinical annotation was available for 48 subjects. Results Most LGGs harbored bi-allelic NF1 inactivation as the sole genetic abnormality, but 11% had additional alterations (FGFR1 mutation, n=3; PIK3CA mutation, n=2; homozygous 9p21 deletion, n=2; MYB:QKI fusion, n=1; SETD2 mutation, n=1; EGFR amplification, n=1). FGFR1 mutation conferred additional growth advantage in multiple complementary murine Nf1 models. 88% of NF1-LGGs resembled sporadic pilocytic astrocytoma (PA) by methylation, higher than that based on histology. Non-PA methylation patterns included low-grade glial/glioneuronal tumors, rosette-forming glioneuronal tumors, MYB/MYBL1-altered glioma, and high-grade astrocytoma with piloid features (2 tumors histologically diagnosed as LGG). In total, 18% of samples were classified as non-PA and/or harbored an additional non-NF1 mutation. Non-PA methylation class tumors were more likely to harbor an additional non-NF1 mutation (p=0.005). 7.7% of optic pathway hypothalamic gliomas (OPHGs) had other mutations or were not classified by methylation as PA, compared with 20.6% of NF1-LGGs arising elsewhere. There was no difference based on age for the presence of an additional non-NF1 mutation or non-PA methylation class. Conclusions Given the overall low occurrence of non-NF1 mutations or non-PA methylation class tumors in this series, routine clinical biopsy of typically-appearing NF1-LGG may not be indicated, particularly for children with OPHG. Biopsy should be considered for non-OPHG tumors refractory to conventional treatment. As additional agents are developed and treatment strategies evolve, the rationale for biopsy of NF1-LGG may become stronger.
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DeVivo, Renée, Lauren Zajac, Asim Mian, Anna Cervantes-Arslanian, Eric Steinberg, Michael L. Alosco, Jesse Mez, Robert Stern, and Ronald Killany. "Differentiating Between Healthy Control Participants and Those with Mild Cognitive Impairment Using Volumetric MRI Data." Journal of the International Neuropsychological Society 25, no. 08 (May 27, 2019): 800–810. http://dx.doi.org/10.1017/s135561771900047x.
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AbstractObjective:To determine whether volumetric measures of the hippocampus, entorhinal cortex, and other cortical measures can differentiate between cognitively normal individuals and subjects with mild cognitive impairment (MCI).Method:Magnetic resonance imaging (MRI) data from 46 cognitively normal subjects and 50 subjects with MCI as part of the Boston University Alzheimer’s Disease Center research registry and the Alzheimer’s Disease Neuroimaging Initiative were used in this cross-sectional study. Cortical, subcortical, and hippocampal subfield volumes were generated from each subject’s MRI data using FreeSurfer v6.0. Nominal logistic regression models containing these variables were used to identify subjects as control or MCI.Results:A model containing regions of interest (superior temporal cortex, caudal anterior cingulate, pars opercularis, subiculum, precentral cortex, caudal middle frontal cortex, rostral middle frontal cortex, pars orbitalis, middle temporal cortex, insula, banks of the superior temporal sulcus, parasubiculum, paracentral lobule) fit the data best (R2= .7310, whole model test chi-square = 97.16,p< .0001).Conclusions:MRI data correctly classified most subjects using measures of selected medial temporal lobe structures in combination with those from other cortical areas, yielding an overall classification accuracy of 93.75%. These findings support the notion that, while volumes of medial temporal lobe regions differ between cognitively normal and MCI subjects, differences that can be used to distinguish between these two populations are present elsewhere in the brain.
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Zhang, Q., and LC Ang. "Epilepsy Related Death: the London Health Sciences Center Experience." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 46, s2 (September 2019): S62. http://dx.doi.org/10.1017/cjn.2019.261.
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Premature mortality among epilepsy patients is well recognized. Except a few identifiable causes of unnatural death, more than half of the epilepsy related death remains unexplained after extensive workup. These cases are classified as sudden unexpected death in epilepsy (SUDEP). SUDEP incidence varies significantly depending on the population, the methods documenting cause of death and the availability of Neuropathological examination. An accurate diagnosis of the cause of death is needed for epilepsy related death. The goal of this study is to present the relevant clinical data, the general autopsy and Neuropathology findings of epilepsy related death investigated in London Health Sciences Center during the period of 2000 to 2011. We identified 71 cases with known history of chronic epilepsy. In the 29 cases of epilepsy associated death, the causes of death have been classified as cardiac, pulmonary, accidental (e.g. drowning), toxic (e.g. drug overdose) and non-related causes. Forty two cases are considered to be SUDEP, and were categorized according to the recently proposed SUDEP Definition and Classification. Half of the SUDEP cases have no specific Neuropathological findings. The most common identifiable lesions in SUDEP cases are perinatal/neonatal destructive lesions (29%), hippocampal sclerosis (24%), and focal cortical dysplasia (20%). These are followed by neuronal heterotopia (9%), previous head trauma (9%), and cavernoma (5%).LEARNING OBJECTIVESThis presentation will enable the learner to:1.Review cause of death in epilepsy related deaths2.Discuss the practice guideline in neuropathology autopsy of epilepsy related deaths
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Herman, B., M. R. Pillai, S. Halabi, A. McKalip, A. Periasamy, P. Wodnicki, J. Gordon, and X. F. Wang. "Quantitative biomedical microscopy: a technology for both basic and clinical sciences." Proceedings, annual meeting, Electron Microscopy Society of America 53 (August 13, 1995): 788–89. http://dx.doi.org/10.1017/s0424820100140312.
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The development of quantitative optical microscopy has led to the ability to obtain accurate, highly sensitive spatial and temporal measurements of cell structure and function as well as the detection of low levels of pathogenic agents. One application of this capability has been in studies examining the role of high risk Human Papillomaviruses (HPV) in cervical cancer. Cervical cancer is the second most prevalent cancer in women worldwide, and epidemiological studies have strongly implicated the sexually transmitted HPV as a causative agent. So far, approximately 70 different genotypes have been identified, and those types associated with genital lesions have been classified as either “low-risk” or “high-risk” based on their association with benign or malignant lesions. The “high-risk” HPVs, such as HPV-16 and 18, have been found in approximately 84% of cervical carcinomas and are associated with cervical dysplasia and cervical intraepithelial neoplasia (CIN). HPV-16 is the most prevalent high-risk genotype and is present in about 50% of all genital lesions.
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Reeves, Analise Z., Patricia J. Campbell, Melisa J. Willby, and James E. Posey. "Disparities in Capreomycin Resistance Levels Associated with therrsA1401G Mutation in Clinical Isolates of Mycobacterium tuberculosis." Antimicrobial Agents and Chemotherapy 59, no. 1 (November 10, 2014): 444–49. http://dx.doi.org/10.1128/aac.04438-14.
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ABSTRACTAs the prevalence of multidrug-resistant and extensively drug-resistant tuberculosis strains continues to rise, so does the need to develop accurate and rapid molecular tests to complement time-consuming growth-based drug susceptibility testing. Performance of molecular methods relies on the association of specific mutations with phenotypic drug resistance and while considerable progress has been made for resistance detection of first-line antituberculosis drugs, rapid detection of resistance for second-line drugs lags behind. TherrsA1401G allele is considered a strong predictor of cross-resistance between the three second-line injectable drugs, capreomycin (CAP), kanamycin, and amikacin. However, discordance is often observed between therrsA1401G mutation and CAP resistance, with up to 40% ofrrsA1401G mutants being classified as CAP susceptible. We measured the MICs to CAP in 53 clinical isolates harboring therrsA1401G mutation and found that the CAP MICs ranged from 8 μg/ml to 40 μg/ml. These results were drastically different from engineered A1401G mutants generated in isogenicMycobacterium tuberculosis, which exclusively exhibited high-level CAP MICs of 40 μg/ml. These data support the results of prior studies, which suggest that the critical concentration of CAP (10 μg/ml) used to determine resistance by indirect agar proportion may be too high to detect all CAP-resistant strains and suggest that a larger percentage of resistant isolates could be identified by lowering the critical concentration. These data also suggest that differences in resistance levels among clinical isolates are possibly due to second site or compensatory mutations located elsewhere in the genome.
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Sarika, H.-L., A. Papathoma, M. Garofalaki, K. Saltiki, T. Pappa, K. Pazaitou-Panayiotou, E. Anastasiou, and M. Alevizaki. "Genetic screening of patients with medullary thyroid cancer in a referral center in Greece during the past two decades." European Journal of Endocrinology 172, no. 4 (April 2015): 501–9. http://dx.doi.org/10.1530/eje-14-0817.
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ObjectiveMutations in theRETgene are responsible for hereditary medullary thyroid cancer (MTC) and may vary between ethnic groups. We report the spectrum of mutations detected in patients with MTC in a referral center in Greece.Patients and methodsScreening forRETmutations was performed in 313 subjects from 188 unrelated families: 51 patients had clinical suspicion for familial disease, 133 were apparently sporadic, four patients had only C cell hyperplasia, and 125 were family members. Exons 8, 10, 11, and 13–16 were screened.ResultsA total of 58 individuals (30.85%) wereRETmutations carriers, 120 (63.8%) were finally classified as sporadic, 13 apparently sporadic cases (9.8%) were identified withRETmutation: ten carried the exon 8 at codon 533 mutation (previously reported), two the exon 14 at codon 804 mutation, and one the exon 13 at codon 768 mutation. Six patients (3.19%) with clinical features of multiple endocrine neoplasia type 2A and negative forRETmutations were classified as ‘unknown cause’. The mutations of hereditary cases were as follows: 21 cases (36.2%) in exon 8 codon 533, 19 (32.8%) in exon 11 codon 634, nine (15.5%) in exon 10, five (8.6%) in exon 16, three (5.2%) in exon 14 codon 804, and one in exon 13 codon 768 (1.7%).ConclusionThe spectrum ofRETmutations in Greece differs from that in other populations and the prevalence of familial cases is higher. The exon 8 (Gly533Cys) mutation was the most prevalent in familial cases unlike other series, followed by exon 11 (codon 634) mutations which are the most frequent elsewhere. The wide application of genetic screening in MTC reveals new molecular defects and helps to characterize the spectrum of mutations in each ethnic group.
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Telemi, Edvin, Nikolay L. Martirosyan, Mauricio J. Avila, Ashley L. Lukefahr, Christopher Le, and G. Michael Lemole. "Suprasellar pleomorphic xanthoastrocytoma: A case report." Surgical Neurology International 10 (April 24, 2019): 72. http://dx.doi.org/10.25259/sni-83-2019.
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Background: Pleomorphic xanthoastrocytoma (PXA) is a rare form of astrocytic neoplasm most commonly found in children and young adults. This neoplasm, which is classified as a Grade II tumor by the World Health Organization classification of tumors of the central nervous system, carries a relatively favorable outcome. It is usually found supratentorially in cortical regions of the cerebral hemispheres, and as such, presenting symptoms are similar to other supratentorial cortical neoplasms; with seizures being a common initial symptom. Due to the rarity of this type of neoplasm, PXA arising elsewhere in the brain is often not included in the initial differential diagnosis. Case Description: This report presents an extremely rare patient with PXA arising in the suprasellar region who presented with progressive peripheral vision loss. Magnetic resonance imaging of the brain demonstrated a heterogeneous suprasellar mass with cystic and enhancing components initially; the most likely differential diagnosis was craniopharyngioma. The patient underwent endoscopic endonasal resection of the tumor. Microscopically, the tumor was consistent with a glial neoplasm with variable morphology. Based on these findings along with further immunohistochemical workup, the patient was diagnosed with a PXA arising in the suprasellar region. At the 1-year follow-up, the patient remained free of recurrence. Although rare PXA originating in other uncommon locations, such as the spinal cord, cerebellum, the ventricular system, and the pineal region have been previously described. Conclusion: Although rare, PXA should be included in the differential diagnosis for solid-cystic tumors arising in the suprasellar region in young adults.
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Peschel, Nicolai, John T. Wright, Maranke I. Koster, Angus J. Clarke, Gianluca Tadini, Mary Fete, Smail Hadj-Rabia, et al. "Molecular Pathway-Based Classification of Ectodermal Dysplasias: First Five-Yearly Update." Genes 13, no. 12 (December 10, 2022): 2327. http://dx.doi.org/10.3390/genes13122327.
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To keep pace with the rapid advancements in molecular genetics and rare diseases research, we have updated the list of ectodermal dysplasias based on the latest classification approach that was adopted in 2017 by an international panel of experts. For this purpose, we searched the databases PubMed and OMIM for the term “ectodermal dysplasia”, referring mainly to changes in the last 5 years. We also tried to obtain information about those diseases on which the last scientific report appeared more than 15 years ago by contacting the authors of the most recent publication. A group of experts, composed of researchers who attended the 8th International Conference on Ectodermal Dysplasias and additional members of the previous classification panel, reviewed the proposed amendments and agreed on a final table listing all 49 currently known ectodermal dysplasias for which the molecular genetic basis has been clarified, including 15 new entities. A newly reported ectodermal dysplasia, linked to the gene LRP6, is described here in more detail. These ectodermal dysplasias, in the strict sense, should be distinguished from syndromes with features of ectodermal dysplasia that are related to genes extraneous to the currently known pathways involved in ectodermal development. The latter group consists of 34 syndromes which had been placed on the previous list of ectodermal dysplasias, but most if not all of them could actually be classified elsewhere. This update should streamline the classification of ectodermal dysplasias, provide guidance to the correct diagnosis of rare disease entities, and facilitate the identification of individuals who could benefit from novel treatment options.
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Conesa, Francesc C., Hector A. Orengo, Agustín Lobo, and Cameron A. Petrie. "An Algorithm to Detect Endangered Cultural Heritage by Agricultural Expansion in Drylands at a Global Scale." Remote Sensing 15, no. 1 (December 22, 2022): 53. http://dx.doi.org/10.3390/rs15010053.
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This article presents AgriExp, a remote-based workflow for the rapid mapping and monitoring of archaeological and cultural heritage locations endangered by new agricultural expansion and encroachment. Our approach is powered by the cloud-computing data cataloguing and processing capabilities of Google Earth Engine and it uses all the available scenes from the Sentinel-2 image collection to map index-based multi-aggregate yearly vegetation changes. A user-defined index threshold maps the first per-pixel occurrence of an abrupt vegetation change and returns an updated and classified multi-temporal image aggregate in almost-real-time. The algorithm requires an input vector table such as data gazetteers or heritage inventories, and it performs buffer zonal statistics for each site to return a series of spatial indicators of potential site disturbance. It also returns time series charts for the evaluation and validation of the local to regional vegetation trends and the seasonal phenology. Additionally, we used multi-temporal MODIS, Sentinel-2 and high-resolution Planet imagery for further photo-interpretation of critically endangered sites. AgriExp was first tested in the arid region of the Cholistan Desert in eastern Pakistan. Here, hundreds of archaeological mound surfaces are threatened by the accelerated transformation of barren lands into new irrigated agricultural lands. We have provided the algorithm code with the article to ensure that AgriExp can be exported and implemented with little computational cost by academics and heritage practitioners alike to monitor critically endangered archaeological and cultural landscapes elsewhere.
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Hughes, Kenneth V., Michael C. Bard, Jean E. Lewis, Jan L. Kasperbauer, and George W. Facer. "Hemangiopericytoma of the Nasal Cavity: A Review of 15 Cases over a 40-Year Period." American Journal of Rhinology 6, no. 6 (November 1992): 203–9. http://dx.doi.org/10.2500/105065892781976655.
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Hemangiopericytomas are rare tumors of vascular origin most commonly found in the extremities or retroperitoneal area. When they originate from the nasal cavity and paranasal sinuses, they tend to be less aggressive and generally do not metastasize. The term “hemangiopericytoma-like lesion” has been coined for sinonasal hemangiopericytomas that display more benign histologic and growth characteristics than do those located elsewhere. Fifteen cases of hemangiopericytoma of the nasal cavity and paranasal sinuses were reviewed over the period 1951 to 1990; included are follow-up data on cases reported earlier from this institution. The clinical course, management, and outcome was evaluated and correlated with the histologic characteristics of the tumors. The recurrence rate in our series was 13.3%; the mean follow-up was 11 years. No patients died of their disease or had evidence of metastatic disease. This clinicopathologic review suggests that sinonasal hemangiopericytomas should not be classified as “hemangiopericytoma-like” lesions; rather, they should be expected to have significant local recurrence rates with low rates of distant metastasis and mortality. Long-term follow-up is essential as there can be local recurrence after many years.
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Khalid, Hagar, Roy Schwartz, Luke Nicholson, Josef Huemer, Mohamed Hosny El-Bradey, Dawn A. Sim, Praveen J. Patel, et al. "Widefield optical coherence tomography angiography for early detection and objective evaluation of proliferative diabetic retinopathy." British Journal of Ophthalmology 105, no. 1 (March 19, 2020): 118–23. http://dx.doi.org/10.1136/bjophthalmol-2019-315365.
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PurposeTo evaluate the utility of widefield optical coherence tomography angiography (WF-OCTA) compared with clinical examination in grading diabetic retinopathy in patients diagnosed clinically with proliferative diabetic retinopathy (PDR) or severe non-proliferative diabetic retinopathy (NPDR).DesignThis retrospective observational case series included patients diagnosed clinically with PDR or severe NPDR. Patients underwent standard clinical examination and WF-OCTA imaging (PLEX Elite 9000, Carl Zeiss Meditec AG) using 12×12 montage scans between August 2018 and January 2019. Two trained graders identified neovascularisation at the disc (NVD) and neovascularisation elsewhere (NVE) on WF-OCTA which were compared with the clinical examination, and to ultra-widefield fluorescein angiography (UWFA) when available.ResultsSeventy-nine eyes of 46 patients were evaluated. Of those, 57 eyes were diagnosed clinically with PDR, and 22 with severe NPDR. NVD was detected on OCTA-B scan as preretinal hyperreflective material (PRHM) in 39 eyes (100%) with evident flow signals in 79.5% compared with 51.3% detected clinically. We further classified NVD on OCTA into four subtypes and found that subtypes 1 and 2 could not be seen on clinical examination alone. WF-OCTA detected NVE in 81% of the cases compared with 55.7% detected clinically. Using WF-OCTA resulted in a higher percentage of PDR grading (88.6%) than on clinical examination (72.2%). When available, UWFA confirmed the WF-OCTA diagnosis in the majority of cases.ConclusionThis study demonstrates that WF-OCTA has a higher detection rate of PDR than clinical examination. This suggests that this modality could be used non-invasively for the purpose of early detection and characterisation of neovascularisation.
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Asah, Cresta, Rune Frandsen, Rikke Ibsen, Jakob Kjellberg, and Poul Jennum. "Morbidity, Mortality, and Conversion to Neurodegenerative Diseases in Patients with REM Sleep Behavior Disorder and REM Sleep without Atonia." Neuroepidemiology 55, no. 2 (2021): 141–53. http://dx.doi.org/10.1159/000514175.
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<b><i>Introduction:</i></b> The underlying pathophysiology of idiopathic REM sleep behavior disorder (iRBD) is not fully understood, although the condition is currently recognized as an early-stage alpha-synuclein disorder. We evaluated the morbidity, mortality, and rate of conversion to a neurodegenerative disorder in a national group of patients. <b><i>Methods:</i></b> All patients in Denmark with a diagnosis of RBD between 2006 and 2013 were identified from the Danish National Patient Registry (NPR) records. We excluded patients who had received a diagnosis of narcolepsy or any of the following neurodegenerative diseases before their diagnosis of RBD: Parkinson’s disease, multiple system atrophy, progressive supranuclear paralysis, Alzheimer’s, and Lewy body dementia. We used randomly chosen controls matched for age, gender, and municipality. <b><i>Results:</i></b> In total, 246 iRBD patients and 982 matched controls were analyzed. The mortality rate was the same in both groups. The morbidity rate was significantly higher in the years before and after an RBD diagnosis, due to a wide variety of disorders in the following major disease groups: mental/behavioral disorders; endocrine/metabolic diseases; diseases of the eye; diseases of the nervous, digestive, musculoskeletal, circulatory, and respiratory systems; abnormal findings not classified elsewhere; external causes; and factors influencing health status. The conversion rate from RBD to a neurodegenerative disease was 13% over the 8 years after a diagnosis of RBD. <b><i>Conclusions:</i></b> A diagnosis of RBD is associated with increased morbidity several years before and after a diagnosis is made. Patients have a higher risk of converting to a neurodegenerative disorder than matched controls. Mortality rates are unchanged.
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Patten, Scott B., and Joel Paris. "The Bipolar Spectrum—A Bridge Too Far?" Canadian Journal of Psychiatry 53, no. 11 (November 2008): 762–68. http://dx.doi.org/10.1177/070674370805301108.
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Objectives: To review the literature evaluating outcomes resulting from expansion of the bipolar disorder (BD) diagnostic category. We were particularly interested in identifying high-level evidence for improved clinical outcomes as documented by randomized controlled trials (RCTs) or cohort studies. Methods: The English-language literature was searched using Ovid MEDLINE for studies of BD referenced against the key word spectrum. We used bibliographies and other databases to extend this search when no relevant RCTs or relevant cohort studies were identified. Results: In the MEDLINE searches, abstracts and titles of 86 studies were examined and 48 were found to be related to the topic of bipolar spectrum disorders (BSD). No RCTs or prospective cohort studies evaluating modified diagnostic or therapeutic practices were identified. The literature about the BSD consists mostly of expert opinion emphasizing: various links between bipolar and unipolar mood disorders; a proposal that a greater proportion of the population without a mood disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders should be diagnosed under the BD category; and, proposals that syndromes currently classified elsewhere should be subsumed under the BD category. Conclusions: Our search failed to uncover high-level evidence demonstrating the clinical utility of proposed diagnostic realignments. The widespread acceptance of the expanded spectrum concept appears to be based on interpretation of descriptive epidemiologic data by high-profile experts.
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Söderström, Lisa, Andreas Rosenblad, Eva Thors Adolfsson, and Leif Bergkvist. "Malnutrition is associated with increased mortality in older adults regardless of the cause of death." British Journal of Nutrition 117, no. 4 (February 28, 2017): 532–40. http://dx.doi.org/10.1017/s0007114517000435.
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AbstractMalnutrition predicts preterm death, but whether this is valid irrespective of the cause of death is unknown. The aim of the present study was to determine whether malnutrition is associated with cause-specific mortality in older adults. This cohort study was conducted in Sweden and included 1767 individuals aged ≥65 years admitted to hospital in 2008–2009. On the basis of the Mini Nutritional Assessment instrument, nutritional risk was assessed as well nourished (score 24–30), at risk of malnutrition (score 17–23·5) or malnourished (score <17). Cause of death was classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, into twenty different causes of death. Data were analysed using Cox proportional hazards regression models. At baseline, 55·1 % were at risk of malnutrition, and 9·4 % of the participants were malnourished. During a median follow-up of 5·1 years, 839 participants (47·5 %) died. The multiple Cox regression model identified significant associations (hazard ratio (HR)) between malnutrition and risk of malnutrition, respectively, and death due to neoplasms (HR 2·43 and 1·32); mental or behavioural disorders (HR 5·73 and 5·44); diseases of the nervous (HR 4·39 and 2·08), circulatory (HR 1·95 and 1·57) or respiratory system (HR 2·19 and 1·49); and symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (HR 2·23 and 1·43). Malnutrition and risk of malnutrition are associated with increased mortality regardless of the cause of death, which emphasises the need for nutritional screening to identify older adults who may require nutritional support in order to avoid preterm death.
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Cherian, Mathew, Pankaj Mehta, Shriram Varadharajan, Santosh Poyyamozhi, Elango Swamiappan, Jenny Gandhi, and Nithin Theckumparampil. "Retrospective Review and Proof of Concept of Asia’s First Mobile Stroke Unit Experience in Kovai Medical Center and Hospital." Journal of Stroke Medicine 3, no. 2 (December 2020): 116–23. http://dx.doi.org/10.1177/2516608520968418.
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Background: We review our initial experience of India’s and Asia’s first mobile stroke unit (MSU) following the completion of its first year of operation. We outline the clinical care pathway integrating the MSU services using a case example taking readers along our clinical care workflow while highlighting the challenges faced in organizing and optimizing such services in India. Methods: Retrospective review of data collected for all patients from March 2018 to February 2019 transported and treated within the MSU during the first year of its operation. Recent case example is reviewed highlighting complete comprehensive acute clinical care pathway from prehospital MSU services to advanced endovascular treatment with focus on challenges faced in developing nation for stroke care. Results: The MSU was dispatched and utilized for 14 patients with clinical symptoms of acute stroke. These patients were predominantly males (64%) with median age of 59 years. Ischemic stroke was seen in 7 patients, hemorrhagic in 6, and 1 patient was classified as stroke mimic. Intravenous tissue plasminogen activator was administered to 3 patients within MSU. Most of the patients’ treatment was initiated within 2 h of symptom onset and with the median time of patient contact (rendezvous) following stroke being 55 mins. Conclusion: Retrospective review of Asia’s first MSU reveals its proof of concept in India. Although the number of patients availing treatment in MSU is low as compared to elsewhere in the world, increased public awareness with active government support including subsidizing treatment costs could accelerate development of optimal prehospital acute stroke care policy in India.
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Lee, EunYoung, Anu Osinusi, Anand Chokkalingam, Diana M. Brainard, Tram Tran, Lauren Dau, Diogo Ferrinho, ChenYu Wang, and Kavita Juneja. "476. Gilead Sciences’ Commitment to the COVID-19 Pandemic." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S304—S305. http://dx.doi.org/10.1093/ofid/ofaa439.669.
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Abstract Background COVID-19 has spread rapidly: from the first case in Dec 2019, the declaration of a global pandemic in Mar 2020, to Jun 18, 2020 with >8 M confirmed cases and >400,000 deaths worldwide. Throughout this rapid spread, Gilead has focused on contributing antiviral expertise and resources to help patients (pts) and communities fighting COVID-19 Methods Gilead is supporting the efforts of governments, partnering with professionals, and community-based org., and collaborating with healthcare providers to accelerate research and access to remdesivir (RDV), the first medicine with demonstrated efficacy in treatment of COVID-19. This is a review of the programs initiated in RDV research, access, research grants and collaborative education Results In Jan 2020 Gilead began working with government and regulatory authorities to make RDV accessible to pts globally through the compassionate use and expanded access programs. These programs has treated >2000 COVID-19 pts. By Feb 2020, several phase 3 randomized trials on RDV were initiated. Based on trials completed and published data (n= >2000), RDV was granted emergency use authorization in the US on May 1, 2020 with full approval in 5 countries thereafter and several under review elsewhere. Collectively there will be >12,000 pts enrolled in RDV clinical programs by Dec 2020. Increasing manufacturing of RDV began at-risk in Jan 2020. By May 2020 Gilead has decreased production time, increased supply and committed to donating all its 1.5 M doses. Under the licensing agreements with generic drug manufacturers, RDV will be available in 127 countries upon approval. Gilead has committed to supporting research grants to enhance the understanding of the clinical course and outcomes in vulnerable population, long-term sequelae, and evaluate real world safety and effectiveness of COVID-19 therapies. Finally, Gilead has provided corporate grants to support the efforts of community-based orgs and public health entities to expand education on COVID-19 Conclusion Gilead has initiated a global, multifaceted rapid response that reflects the unprecedented emergency posed by SARS-COV-2. This includes increasing RDV production, access, timely initiation of phase 3 RDV trials, and establishment of grants programs for community projects, research and education Disclosures EunYoung Lee, PharmD, Gilead Sciences (Employee) Anu Osinusi, MD, Gilead Sciences (Employee) Anand Chokkalingam, PhD, Gilead Sciences (Employee) Diana M. Brainard, MD, Gilead Sciences (Employee) Tram Tran, MD, Gilead Sciences (Employee) Lauren Dau, PharmD, Gilead Sciences (Employee) Diogo Ferrinho, PharmD, Gilead Sciences (Employee) ChenYu Wang, PhD, Gilead Sciences (Employee) Kavita Juneja, MD, Gilead Sciences (Employee)Gilead Sciences (Employee)
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Wierzbik-Strońska, Magdalena, Klaudiusz Nadolny, Beniamin Oskar Grabarek, and Dariusz Boroń. "CHARACTERISTICS OF THE INTERVENTION OF EMERGENCY MEDICAL TEAMS IN THE SOUTHERN PART OF POLAND IN 12-MONTH OBSERVATION." Wiadomości Lekarskie 73, no. 8 (2020): 1632–36. http://dx.doi.org/10.36740/wlek202008108.
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The aim: The aim of this study was to characterize the general characteristics of the completed interventions by the Voivodeship Rescue Service of Katowice in the time period from 1st January 2018 to 31 December 2018. Material and methods: Analysis of the characteristics of the trips was done based on the information contained in the dispatch order cards and medical emergency services cards. In the statistical analysis the Chi-Square (p<0.05) test was utilized. Results: The total number of interventions was 211,548 cases. It is also worth observing, that the general number of interventions out of town amounted to 20,344 interventions, whereas, in town, there were 191,204 interventions. It can be observed that the most common decision made by the Emergency Medical Team was the decision to directly transported and received by the emergency department (126,553 cases; p<0.05). The definite most common reason for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (ICD-10 code : R; p<0.05). Conclusion: The largest number of interventions completed by the Voivodeship Rescue Service in Katowice in 2018 was due to injuries and poisonings, symptoms, diseases features and incorrect results of diagnostic tests, and in third place were cardiovascular diseases.
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Makhija, S., P.-Y. vod der Weid, J. Meddings, SJ Urbanski, and PL Beck. "Octreotide in Intestinal Lymphangiectasia: Lack of a Clinical Response and Failure to Alter Lymphatic Function in a Guinea Pig Model." Canadian Journal of Gastroenterology 18, no. 11 (2004): 681–85. http://dx.doi.org/10.1155/2004/176568.
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Intestinal lymphangiectasia, which can be classified as primary or secondary, is an unusual cause of protein-losing enteropathy. The main clinical features include edema, fat malabsorption, lymphopenia and hypoalbuminemia. Clinical management generally includes a low-fat diet and supplementation with medium chain triglycerides. A small number of recent reports advocate the use of octreotide in intestinal lymphangiectasia. It is unclear why octreotide was used in these studies; although octreotide can alter splanchnic blood flow and intestinal motility, its actions on lymphatic function has never been investigated. A case of a patient with intestinal lymphangiectasia who required a shunt procedure after failing medium chain triglycerides and octreotide therapy is presented. During the management of this case, all existing literature on intestinal lymphangiectasia and all the known actions of octreotide were reviewed. Because some of the case reports suggested that octreotide may improve the clinical course of intestinal lymphangiectasia by altering lymphatic function, a series of experiments were undertaken to assess this. In an established guinea pig model, the role of octreotide in lymphatic function was examined. In this model system, the mesenteric lymphatic vessels responded to 5-hydroxytryptamine with a decrease in constriction frequency, while histamine administration markedly increased lymphatic constriction frequency. Octreotide failed to produce any change in lymphatic function when a wide range of concentrations were applied to the mesenteric lymphatic vessel preparation. In conclusion, in this case, octreotide failed to induce a clinical response and laboratory studies showed that octreotide did not alter lymphatic function. Thus, the mechanisms by which octreotide induced clinical responses in the cases reported elsewhere in the literature remain unclear, but the present study suggests that it does not appear to act via increasing lymphatic pumping.
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Baiju, C. S., Karuna Joshi, Ria Virmani, Gunjan Gupta, and Pawandeep Kaur. "Surgical Techniques for Correcting Aberrant Frenal Attachment: A Clinical Review." Dental Journal of Advance Studies 09, no. 03 (October 18, 2021): 111–15. http://dx.doi.org/10.1055/s-0041-1736263.
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AbstractFrenum is a fold of mucous membrane, usually with enclosed muscle fibers, which attaches the lips and cheeks to the alveolar mucosa and/or gingival and underlying periosteum. Different types of frenal attachments have been observed and classified. Frenum with abnormal attachments may lead to mucogingival problems while hampering gingival health, as they cause an interference in the plaque control or may create a muscle pull. This condition may require management that can be usually performed with frenectomy and frenotomy procedures. Frenectomy is the complete removal of the frenum, while frenotomy is the incision and relocation of the frenal attachment. The present article is a compilation and review of a series of clinical cases of frenal excision through different surgical approaches.
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Bannister, Frank, and Dan Remenyi. "Acts of Faith: Instinct, Value and it Investment Decisions." Journal of Information Technology 15, no. 3 (September 2000): 231–41. http://dx.doi.org/10.1177/026839620001500305.
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Although well over 1000 journal articles, conference papers, books, technical notes and theses have been written on the subject of information technology (IT) evaluation, only a relatively small subset of this literature has been concerned with the core issues of what precisely is meant by the term ‘value’ and with the process of making (specifically) IT investment decisions. All too often, the problem and highly complex issue of value is either simplified, ignored or assumed away. Instead the focus of much of the research to date has been on evaluation methodologies and, within this literature, there are different strands of thought which can be classified as partisan, composite and meta approaches to evaluation. Research shows that a small number of partisan techniques are used by most decision makers with a minority using a single technique and a majority using a mixture of such techniques of whom a substantial minority use a formal composite approach. It is argued that, in mapping the set of evaluation methodologies on to what is termed the investment opportunity space, that there is a limit to what can be achieved by formal rational evaluation methods. This limit becomes evident when decision makers fall back on ‘gut feel’ and other non-formal/rigorous ways of making decisions. It is suggested that an understanding of these more complex processes and decision making, in IT as elsewhere, needs tools drawn from philosophy and psychology.
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Oviatt, Charles G., David B. Madsen, and Dave N. Schmitt. "Late Pleistocene and early Holocene rivers and wetlands in the Bonneville basin of western North America." Quaternary Research 60, no. 2 (September 2003): 200–210. http://dx.doi.org/10.1016/s0033-5894(03)00084-x.
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AbstractField investigations at Dugway Proving Ground in western Utah have produced new data on the chronology and human occupation of late Pleistocene and early Holocene lakes, rivers, and wetlands in the Lake Bonneville basin. We have classified paleo-river channels of these ages as “gravel channels” and “sand channels.” Gravel channels are straight to curved, digitate, and have abrupt bulbous ends. They are composed of fine gravel and coarse sand, and are topographically inverted (i.e., they stand higher than the surrounding mudflats). Sand channels are younger and sand filled, with well-developed meander-scroll morphology that is truncated by deflated mudflat surfaces. Gravel channels were formed by a river that originated as overflow from the Sevier basin along the Old River Bed during the late regressive phases of Lake Bonneville (after 12,500 and prior to 11,000 14C yr B.P.). Dated samples from sand channels and associated fluvial overbank and wetland deposits range in age from 11,000 to 8800 14C yr B.P., and are probably related to continued Sevier-basin overflow and to groundwater discharge. Paleoarchaic foragers occupied numerous sites on gravel-channel landforms and adjacent to sand channels in the extensive early Holocene wetland habitats. Reworking of tools and limited toolstone diversity is consistent with theoretical models suggesting Paleoarchaic foragers in the Old River Bed delta were less mobile than elsewhere in the Great Basin.
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Ozeki, Takaya, Michio Nagata, Takayuki Katsuno, Koji Inagaki, Kazunori Goto, Sawako Kato, Yoshinari Yasuda, Naotake Tsuboi, and Shoichi Maruyama. "Nephrotic syndrome with focal segmental glomerular lesions unclassified by Columbia classification; Pathology and clinical implication." PLOS ONE 16, no. 1 (January 5, 2021): e0244677. http://dx.doi.org/10.1371/journal.pone.0244677.
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Background The Columbia classification is widely used for diagnosis of focal segmental glomerulosclerosis (FSGS). In practice, we occasionally encounter segmental glomerular lesions unclassified as Columbia classification. We analyzed the clinical implication of unclassified segmental lesions comparing with Columbia-classified FSGS. Methods A retrospective cohort study from 13 local hospitals in Japan. From 172 biopsy cases diagnosed with FSGS or minimal change disease (MCD)/FSGS spectrum with unclassified segmental lesions, adult patients with nephrotic syndrome who received immunosuppressive therapies were included. The cases are classified by pathology, i.e., typical FSGS lesions sufficiently classified into subgroups of Columbia classification: collapsing (COL), tip (TIP), cellular (CEL), perihilar (PH), and not otherwise specified (NOS), and unclassified by the Columbia classification into three subgroups: “endothelial damage,”; “simple attachment,”; and “minor cellular lesion,”. The response to immunosuppressive treatment and 30% decline of eGFR were compared. Results Among 48 eligible cases, all were Japanese, 34 were typical FSGS; 13 TIP, 15 CEL, 6 NOS, and no COL or PH cases. Fourteen were unclassified cases: endothelial damage (n = 6), simple attachment (n = 5), and minor cellular lesion (n = 3). The median age of overall patients was 60 years old and the median of eGFR and urinary protein creatinine ratio was 51.5 mL/min/1.73m2 and 7.35, respectively. They received similar therapeutic regimen. Kaplan-Meier analysis revealed no significant difference in treatment response between typical FSGS and unclassified cases. Evaluating among the subgroups, endothelial damage, simple attachment and minor cellular lesion showed similar treatment response to TIP or CEL. No significant difference was also observed in the 30% decline of eGFR. Conclusions Japanese adult patients with nephrotic syndrome showing unclassified segmental lesions as Columbia classification may be equivalent clinical impact as Columbia classification of FSGS.
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Venyo, Anthony Kodzo-Grey. "Signet Ring Cell Carcinoma of the Prostate Gland: A Review and Update." Cancer Research and Cellular Therapeutics 5, no. 3 (July 26, 2021): 01–14. http://dx.doi.org/10.31579/2640-1053/082.
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Signet-ring cell carcinoma of the prostate gland (SRCCP) an uncommon and aggressive malignant tumour of the prostate gland which is characterized by histopathology examination features of compression of the nucleus into the form of a crescent by a large cytoplasmic vacuole. SRCCPs that have so far been reported have been either (a) primary tumours, metastatic tumours with the primary tumour elsewhere with the gastro-intestinal tract being the site of the primary tumour but the primary tumour could originate elsewhere, and additionally some reported SRCCPs have been classified as carcinoma of unknown primary. SRCCP could be a pure tumour or a tumour that is contemporaneously associated with other types of tumour including various variants of adenocarcinoma. SRCCP can manifest in various ways including: Incidental finding following prostatectomy that has been undertaken for a presumed benign prostatic hyperplasia, lower urinary tract symptoms, visible and non-visible haematuria, raised levels of serum PSA but some SRCCPs have been diagnosed with normal / low levels of serum PSA, there may be a history of dyspepsia in cases of metastatic signet-ring cell carcinoma in association with contemporaneous primary signet-ring cell carcinoma of the stomach or there may be a past history of surgical treatment for signet-ring cell carcinoma of the gastrointestinal tract, or bleeding from the gastrointestinal tract in cases of upper gastrointestinal tract and rectal bleeding as well as change in bowel habit for primary tumours of the anorectal region, retention of urine, and rarely a rectal mass in the case of SRCCP with an anorectal primary tumour. In order to exclude a primary signet ring cell carcinoma elsewhere, a detailed past medical history is required as well as radiology imaging including contrast – enhanced computed tomography (CECT) scan and contrast-enhanced magnetic resonance imaging (CEMRI) scan as well as upper gastrointestinal endoscopy and colonoscopy to exclude a primary lesion within the gastrointestinal tract. Diagnosis of SRCCP requires utilization of the histopathology and immunohistochemistry examination features of prostate biopsy, prostatic chips obtained from trans-urethral resection of prostate specimen or radical prostatectomy specimen. SRCCPs upon immunohistochemistry staining studies tend to show tumour that tend to exhibit positive staining for the following tumour markers as follows: PSA – positive staining for PSA has been variable in some studies, AE1/AE3, CAM 5.2, Ki-67 with a mean of 8%, PAS-diastase, Mucicarmine (50%), Alcian blue (60%), Alpha-methyl-acyl coenzyme A racemase (P504S), and Cytokeratin 5/6. SRCCPs also tend to exhibit negative staining for: Bcl2 (rare positive), and CEA (80%). Traditionally the treatment of Primary Signet-Ring Cell Carcinoma of the Prostate Gland has tended to be similar to the treatment of the traditional adenocarcinoma of the prostate gland which does include: hormonal treatment, radiotherapy, and surgery. Nevertheless, considering that primary SRCCPs and metastatic SRCCPs that have been reported in the literature have generally tended to be associated with an aggressive biological behaviour, even though there is no consensus opinion on the treatment of the disease it would be strongly recommended that these tumours that tend to be associated with rapid progress of the disease and poor survival there is an urgent need to treat all these tumours with aggressive surgery including radical prostatectomy plus adjuvant therapies including: radical radiotherapy, combination chemotherapy, selective prostatic angiography and super-selective embolization of the artery feeding the tumour including intra-arterial infusion of chemotherapy agents directly to the tumour, radiofrequency ablation of the tumour as well as irreversible electroporation of the tumour which should form part of a global multicentre study of various treatment options. With regard to metastatic signet-ring cell carcinomas of the prostate gland with a contemporaneous primary tumour elsewhere the primary tumour should also be treated by radical and complete excision of the primary tumour plus radical surgery and aggressive adjuvant therapy. Considering that SRCCPs have tendered not to respond well to available chemotherapy agents, there is need for urologists, oncologists, and pharmacotherapy research workers to identify new chemotherapy medicaments that would more effectively and safely destroy signet-ring cell tumours in order to improve upon the prognosis.
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Oliveira, Mirlany Mendes Maciel, Gabriel Sousa Lima, Daniela Meneses-Santos, Claudia Jordão Silva, Lívia Bonjardim Lima, and Luiz Fernando Barbosa de Paulo. "Considerations of Different Surgical Approaches to Lipoma in the Face: Clinical Case." ARCHIVES OF HEALTH INVESTIGATION 11, no. 3 (July 18, 2021): 554–58. http://dx.doi.org/10.21270/archi.v11i3.5331.
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Lipomas are benign mesenchymal neoplasms originating from mature adipose tissue, and frequently in clinical evaluation, they present as an increase in nodular volume, with a sessile or pedunculated base, smooth surface, and smooth consistency, asymptomatic and slow growth. Its color varies from yellowish to pink depending on the depth found in the tissues. In the oral cavity, its appearance is classified as rare. When present, their occurrence is greater in the cheek mucosa, lip, tongue, buccal sulcus, and buccal floor. The objective of this article is to report the clinical case of two lipomas in the mandibular region, where an excisional biopsy was performed, with different surgical modalities, but with effective treatment in both cases.
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Boaventura, Fernanda Moreira, Mariana Mussalem Santos, Mariana Tafner Perondini, Pedro Guimenti Ribeiro De Lima, and João Kleber de Almeida Gentile. "Inguinodynia after inguinal hernioplasty - clinical and surgical management: a literature review." Brazilian Journal of Case Reports 2, no. 3 (July 14, 2022): 90–105. http://dx.doi.org/10.52600/2763-583x.bjcr.2022.2.3.90-105.
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Inguinodynia (chronic inguinal pain) is one of the most feared complications for surgeons after inguinal hernia repair with prosthetic mesh placement. The biopsychosocial impact of this complication can lead to a considerable decrease in patients quality of life. Chronic inguinal pain can appear at varying periods after surgery, for weeks to years after the surgical procedure. The pain is classified as neuropathic and non-neuropathic related to nerve injury and mesh, respectively. The diagnosis and clinical management of this condition is a separate challenge for medical specialists in hernia surgery, requiring a thorough knowledge of inguinal anatomy, advanced surgical knowledge, and literature references on the subject are still limited. In this article we discuss the diagnostic and therapeutic tools as well as the surgical maneuvers for the intervention of inguinodynia.
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Melhado, Eliana M., Jayme A. Maciel, and Carlos A. M. Guerreiro. "Headache During Gestation: Evaluation of 1101 Women." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 34, no. 2 (May 2007): 187–92. http://dx.doi.org/10.1017/s0317167100006028.
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Objective:The purpose of this study was to evaluate the presence of headache in women with a previous history or new-onset headache during the current gestation, classify the findings, and describe the clinical characteristics and outcome of the headache.Methods:From January/1998 to June/2002 we prospectively evaluated 1101 pregnant women (12-45 years old), with a history of headache, at two prenatal clinics and an inpatient obstetric public hospital. Women were interviewed using a semi-structured questionnaire during the first, second, and third gestation trimesters and immediately after delivery. All interviews were conducted by one of the authors, using the International Headache Society Classification (IHSC-2004).Results:In 1029 women there was a history of headache prior to the current pregnancy, 36 (3.4%) women first experienced headache during this pregnancy and 40 patients experienced new types of headache. In these 76 patients with new onset headache during pregnancy, 40 had secondary headache (52.6%), 31 had primary headache (40.8%), and 5 had headache not classified elsewhere (6.6%). According to IHSC- 2004 criteria, we found migraine in 848/1029 women (82.4%), with pregestational headache.Conclusions:Most of the pregnant women presented with headache, mainly in migraine, prior to pregnancy, and most of the headaches improved or disappeared during the second and third gestation trimester. In a relatively small number of pregnant women, a new type of headache started during the gestation.
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Rus Makovec, Maja, Neli Vintar, and Samo Makovec. "Self – Reported Depression, Anxiety and Evaluation of Own Pain in Clinical Sample of Patients with Different Location of Chronic Pain / Samoocenjena Depresivnost in Anksioznost Ter Evalvacija Lastne Bolečine V Kliničnem Vzorcu Pacientov Z Različno Lokacijo Kronične Bolečine." Slovenian Journal of Public Health 54, no. 1 (March 1, 2015): 1–10. http://dx.doi.org/10.1515/sjph-2015-0001.
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Abstract Background. Depression, anxiety and chronic pain are frequent co-occurrent disorders. Patients with these mental disorders experience more intense pain that lasts for a longer time. Method. Questionnaire with 228 variables was applied to 109 randomly chosen patients that were treated at an outpatient clinic for treatment of chronic pain of the University Clinical Centre Ljubljana from March to June 2013. 87 patients responded to the questionnaire (79.8%). Location of pain considering diagnosis was the criterion in the discriminant analysis (soft tissue disorders; headache; symptoms not elsewhere classified; back pain) and following summative scores as predictors: level of depression and anxiety (The Zung Self-Rating Depression/Anxiety Scale), evaluation of pain and perceptions of being threatened in social relations. Results. Average age of participants was M = 52.7 years (SD 13.9), with 70.9% female, 29.1% male participants. 63% of respondents achieved clinically important level of depression and 54% clinically important level of anxiety. On univariate level, the highest level of depression and anxiety was found for back pain and the lowest for headache. No significant difference was found in evaluation of pain and perceptions of being threatened in social relations regarding location of pain. Self-evaluation of depression has, in the framework of discriminant analysis, the largest weight for prediction of differentiation between different locations of pain. Conclusion. Different locations of pain have different connections with mood levels. The results of research on a preliminary level indicate the need to consider mental experience in the treatment of chronic pain
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Bajwa, Awais, Neelam Nosheen, Khalid Iqbal Talpur, and Sheeraz Akram. "A Prospective Study on Diabetic Retinopathy Detection Based on Modify Convolutional Neural Network Using Fundus Images at Sindh Institute of Ophthalmology & Visual Sciences." Diagnostics 13, no. 3 (January 20, 2023): 393. http://dx.doi.org/10.3390/diagnostics13030393.
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Diabetic Retinopathy (DR) is the most common complication that arises due to diabetes, and it affects the retina. It is the leading cause of blindness globally, and early detection can protect patients from losing sight. However, the early detection of Diabetic Retinopathy is an difficult task that needs clinical experts’ interpretation of fundus images. In this study, a deep learning model was trained and validated on a private dataset and tested in real time at the Sindh Institute of Ophthalmology & Visual Sciences (SIOVS). The intelligent model evaluated the quality of the test images. The implemented model classified the test images into DR-Positive and DR-Negative ones. Furthermore, the results were reviewed by clinical experts to assess the model’s performance. A total number of 398 patients, including 232 male and 166 female patients, were screened for five weeks. The model achieves 92.71% accuracy, 91.89% sensitivity, and 92.90% specificity on the test data as labelled by clinical experts on Diabetic Retinopathy.