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1
Fernandez, Jose, Dardo Riveros, Guy Garay, Reinaldo Campestri, Gonzalo Garate, Beatriz Grand, Juan Dupont, and Roberto Cacchione. "Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu Syndrome) with Transfusion Requirement. Effect of Danazol in 18 Patients with Long Follow-Up." Blood 104, no. 11 (November 16, 2004): 1036. http://dx.doi.org/10.1182/blood.v104.11.1036.1036.
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Abstract Hereditary hemorrhagic telangiectasia (HHT) is a relatively uncommon, autosomal dominant disorder characterized by telangiectases that develop in the skin, mucous membranes, and visceral organs. Mucous localization may seldom bleed profusely, especially epistaxis and upper gastrointestinal (GI) tract. Effective drug treatment is not well established, and multiple blood transfusions and endoscopic or surgical procedures may be the ultimate solution to the frequently bleeding HHT patient. Danazol (DZ) is a mild androgen that has been used in small series of HHT pts with ambiguous results. Its toxicity profile in long standing administration is now well known. Eighteen patients with HHT with transfusion requirements (TR) were treated with DZ at 400–600 mg/daily for the initial three months and 200–400 mg/daily thereafter as a maintenance treatment. At the time of initiation of DZ therapy, median age was 54 yr-old (32–73), nine were female and 9 male, and the median previous TR was 16 RBC units/yr. (2–46). All patients had epistaxis and oral cavity bleeding, with 2 additional upper gastrointestinal tract active bleeding that were detected in ten patients in which an upper GI endoscopy was performed. One patient had a cerebral angioma, surgically treated. None had pulmonary fistula. All patients had some kind of iron treatment. DZ was the first drug treatment intended to reduce the HHT bleeding in 10/18 pts. Median follow-up was 7 years (1.2–14) and two pts were lost to follow-up at 4 and 11 years respectively. At three months of DZ therapy, 12/18 pts (66.6%) showed a remarkable reduction of bleeding, and in 6 patients that showed no response, DZ treatment was stopped. In 7 pts (39%) TR dropped to none and in 5 pts median RT dropped from 22 RBC units/yr. to 10 units/yr. Two of responders had a relapse with upper GI tract bleeding and 1 pts with epistaxis within the first 2 years of DZ treatment. Attempts to reduce the maintenance dose below 200 mg/daily were related to new bleeding or worsening of the active sites. None of the long standing DZ therapy had any significant toxicity. DZ treatment have shown efficacy and safety in this cohort of HHT patients. Mecanism of action may involve the increase of synthesis or expression of ALK-1 dependent proteins and less likely of endoglin. We propose DZ as a first line treatment for the transfusion dependent HHT patients.
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Hayakawa, K., T. Shimizu, Y. Ohba, S. Tomioka, S. Takahasi, K. Amano, A. Yura, Y. Yokoyama, and Y. Hayakata. "Intrapair Differences of Physical Aging and Longevity in Identical Twins." Acta geneticae medicae et gemellologiae: twin research 41, no. 2-3 (July 1992): 177–85. http://dx.doi.org/10.1017/s0001566000002385.
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AbstractThe genetic and environmental contributions to physical aging (hair graying, balding, presbyopia) and longevity (age at death) were examined by within-pair comparison in monozygotic (MZ) and dizygotic (DZ) twins in later adulthood. Physical aging was investigated on 135 pairs of adult twins aged over 50. Hair graying and hair loss (baldness) showed significantly higher rates of concordance in the MZ twins than in the DZ twins. The intrapair difference of the degree of hair graying was negligible in 79%, slight in 15% and striking in 5% among the MZ pairs; while negligible in 40%, slight in 50% and striking in 10% among the DZ pairs. The intrapair difference of the degree of hair loss was negligible in 92%, slight in 8% (and striking in none) among the MZ pairs; while negligible in 69%, slight in 25% and striking in 6% among the DZ pairs. The age at onset of presbyopia showed a slightly higher rate of concordance in the MZ than in the DZ pairs. Longevity (age at death) was surveyed on 184 pairs of twins who died at over 40 years of age. The intrapair difference of longevity was 6.65 ± 5.6 years (maximum 18.0; minimum 0.04) in the MZ pairs, and 8.66 ± 7.2 years (maximum 18.6; minimum 2.9) in the DZ pairs. The MZ pairs showed a slightly smaller within-pair difference of longevity than the DZ pairs.
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De Berranger, E., G. Vaksmann, E. Thebaud-Leculee, I. Wyckaert, F. Mazingue, C. Francart, J. Dalle, and B. Nelken. "Results of randomized study on dexrazoxane administration in children with de novo acute leukemia." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 9037. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.9037.
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9037 Background: Anthracyclins and anthracenediones represent major drugs for both AML and ALL. Among other mechanisms, these drugs induce free radical production responsible of cardiac toxicity. It appeared very important to protect cardiomyocytes. Dexrazoxane (DZ) was developed in this goal. In adult patients, its efficiency was demonstrated both to protect heart and to respect anticancer therapy. We conducted a prospective single bind randomized study using DZ in pediatric acute leukemia. Methods: From Dec 00 to Sept 03, 16 patients (pts) were enrolled for receiving or not DZ (1g for 50mg of doxorubicin equivalent dose) with chemotherapy. Cardiac function was evaluated by echocardiogram before induction and after each chemotherapy course of either EORTC 58951 (arm VHR) or LAME01 trials and each year after treatment completion. The cardiologist operator did not know if child received DZ or not. The cumulative equivalent doxorubicin doses were 310 and 450mg/m2 for EORTC 58951 and LAME01, respectively. The primary end-point was cardiac function evolution. The secondary end points were OS, EFS and the respect of therapy schedule. Results: 16 pts (9M/7F, 11AML/5ALL), median age 8.5y (2.4 - 16.1) were enrolled. 5 AML and 3 ALL pts received DZ. Median f-up was 28.5 months (10–47). Mean left ventricular shortening fractions were 39 and 35% in pts without DZ and 40 and 39% in pts with DZ before chemotherapy and 1 year after diagnosis, respectively. Mean wall stress values were 50 and 50g/cm2 for patients without DZ and 39 and 38g/cm2 for pts with DZ. All these values were comparable. 12 pts were alive, 6 in each arm. 1 pt relapsed in DZ arm and 3 in the other arm. 2 pts died of disease and 2 from infection equally dispatched in the 2 arms. Mean time between successive chemotherapy courses was identical in different groups. 2 patients given DZ presented severe hepatic toxicity (≥grade 3 of WHO classification) followed by quick and spontaneous regression. None other toxicity > grade 1 were observed. Conclusions: DZ may be used safely in children receiving anthracycline. No difference in OS and DFS appear in our study. Median follow-up was probably too short for distinguishing any cardiac alteration, and patient number was low. No significant financial relationships to disclose.
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Gupta, Nidhi, Aalia S. Bano, Yogeshwar Sharma, Vikas Sood, and Akhil C. Banerjea. "Potent Intracellular Knock Down of Hepatitis B Virus X RNA by Catalytic Hammerhead Ribozymes or DNA-Enzymes with Antisense DNA-Oligonucleotides or 10-23 DNA-Enzymes that Powerfully Augment In Vitro Sequence-Specific Cleavage Activities." Open Biotechnology Journal 2, no. 1 (January 9, 2008): 1–12. http://dx.doi.org/10.2174/1874070700802010001.
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Novel antiviral approaches are needed to control Hepatitis B virus infection worldwide. X protein of this virus activates various promoters and is strongly associated with hepatocellular carcinoma. Although several groups, including ours, reported sequence-specific cleavage of X RNA by either ribozymes (Rzs) or DNA-enzymes (Dzs) earlier, but none of these studies reported 100% in vitro cleavage of the full-length X RNA. We reasoned that by melting the secondary structures near the Rz/Dz cleavage site with specific antisense DNA oligonucleotides (ODNs) or 10-23 Dz, it may be possible to achieve this objective. Hammerhead motif containing Rz-170 specific for X RNA was constructed by recombinant techniques and Dz-237 was synthesized using the 10-23 catalytic motif. When specific ODNs or 10-23 Dzs were included in the cleavage reaction with either Rz-170 or Dz-237, increased cleavage was observed in a dose-dependent manner which often resulted in almost complete in vitro cleavage of the target RNA. Rz-170 in combination with specific ODNs caused potent intracellular reduction of HBx RNA. Thus, the cleavage activity of catalytic nucleic acids (Rzs or Dzs) can be increased significantly by specific ODNs or Dzs and this treatment also results in potent intracellular target RNA reduction. These findings have important therapeutic implications.
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Luong, Hien T. T., Justin Chaplin, Allan F. McRae, Sarah E. Medland, Gonneke Willemsen, Dale R. Nyholt, Anjali K. Henders, et al. "Variation in BMPR1B, TGFRB1 and BMPR2 and Control of Dizygotic Twinning." Twin Research and Human Genetics 14, no. 5 (October 1, 2011): 408–16. http://dx.doi.org/10.1375/twin.14.5.408.
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Genes in the TGF9 signaling pathway play important roles in the regulation of ovarian follicle growth and ovulation rate. Mutations in three genes in this pathway, growth differentiation factor 9 (GDF9), bone morphogenetic protein 15 (BMP15) and the bone morphogenetic protein receptor B 1 (BMPRB1), influence dizygotic (DZ) twinning rates in sheep. To date, only variants in GDF9 and BMP15, but not their receptors transforming growth factor ß receptor 1 (TGFBR1), bone morphogenetic protein receptor 2 (BMPR2) and BMPR1B, have been investigated with respect to their roles in human DZ twinning. We screened for rare and novel variants in TGFBR1, BMPR2 and BMPR1B in mothers of dizygotic twins (MODZT) from twin-dense families, and assessed association between genotyped and imputed variants and DZ twinning in another large sample of MODZT. Three novel variants were found: a deep intronic variant in BMPR2, and one intronic and one non-synonymous exonic variant in BMPRB1 which would result in the replacement of glutamine by glutamic acid at amino acid position 294 (p.Gln294Glu). None of these variants were predicted to have major impacts on gene function. However, the p.Gln294Glu variant changes the same amino acid as a sheep BMPR1B functional variant and may have functional consequences. Six BMPR1B variants were marginally associated with DZ twinning in the larger case-control sample, but these were no longer significant once multiple testing was taken into account. Our results suggest that variation in the TGF9 signaling pathway type II receptors has limited effects on DZ twinning rates in humans.
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Mackey, Jason, Robert D. Brown, Laura Sauerbeck, Richard Hornung, Charles J. Moomaw, Daniel L. Koller, Tatiana Foroud, et al. "Affected Twins in the Familial Intracranial Aneurysm Study." Cerebrovascular Diseases 39, no. 2 (2015): 82–86. http://dx.doi.org/10.1159/000369961.
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Background and Purpose: Very few cases of intracranial aneurysms (IAs) in twins have been reported. Previous work has suggested that vulnerability to IA formation is heritable. Twin studies provide an opportunity to evaluate the impact of genetics on IA characteristics, including IA location. We therefore sought to examine IA location concordance, multiplicity, and rupture status within affected twin-pairs. Methods: The Familial Intracranial Aneurysm study was a multicenter study whose goal was to identify genetic and other risk factors for formation and rupture of IAs. The study required at least three affected family members or an affected sibling pair for inclusion. Subjects with fusiform aneurysms, an IA associated with an AVM, or a family history of conditions known to predispose to IA formation, such as polycystic kidney disease, Ehlers-Danlos syndrome, Marfan syndrome, fibromuscular dysplasia, or moyamoya syndrome were excluded. Twin-pairs were identified by birth date and were classified as monozygotic (MZ) or dizygotic (DZ) through DNA marker genotypes. In addition to zygosity, we evaluated twin-pairs by smoking status, major arterial territory of IAs, and rupture status. Location concordance was defined as the presence of an IA in the same arterial distribution (ICA, MCA, ACA, and vertebrobasilar), irrespective of laterality, in both members of a twin-pair. The Fisher exact test was used for comparisons between MZ and DZ twin-pairs. Results: A total of 16 affected twin-pairs were identified. Location concordance was observed in 8 of 11 MZ twin-pairs but in only 1 of 5 DZ twin-pairs (p = 0.08). Three MZ subjects had unknown IA locations and comprised the three instances of MZ discordance. Six of the 11 MZ twin-pairs and none of the 5 DZ twin-pairs had IAs in the ICA distribution (p = 0.03). Multiple IAs were observed in 11 of 22 MZ and 5 of 10 DZ twin-pairs. Thirteen (13) of the 32 subjects had an IA rupture, including 10 of 22 MZ twins. Conclusions: We found that arterial location concordance was greater in MZ than DZ twins, which suggests a genetic influence upon aneurysm location. The 16 twin-pairs in the present study are nearly the total of affected twin-pairs that have been reported in the literature to date. Further studies are needed to determine the impact of genetics in the formation and rupture of IAs.
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Allred, Isaac J., and Michael D. Blum. "Early Pennsylvanian sediment routing to the Ouachita Basin (southeastern United States) and barriers to transcontinental sediment transport sourced from the Appalachian orogen based on detrital zircon U-Pb and Hf analysis." Geosphere 18, no. 1 (November 22, 2021): 350–69. http://dx.doi.org/10.1130/ges02408.1.
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Abstract Carboniferous sediment dispersal from the Appalachian orogenic system (eastern United States) has become a topic of widespread interest. However, the actual pathways for continental-scale, east-to-west sediment transfer have not been documented. This study presents detrital zircon (DZ) U-Pb ages and Hf isotopic values from the Lower Pennsylvanian (Morrowan) Jackfork Group and Johns Valley Shale of the synorogenic Ouachita deepwater basin of Arkansas to document provenance and delineate the likely sediment-routing systems within the broader context of sediment dispersal across Laurentia. Twelve (12) DZ U-Pb age distributions are interpreted to indicate that sediments were derived from the Appalachians to the east and northeast, as well as the midcontinent region to the north. All samples display prominent ca. 500–400 Ma, 1250–950 Ma, 1550–1300 Ma, and 1800–1600 Ma grains, consistent with ultimate derivation from the Appalachian, Grenville, Midcontinent, and Yavapai-Mazatzal provinces. DZ Hf values obtained from the Ouachita Basin are similar to published Hf values from Pennsylvanian samples in the Appalachian and Illinois Basins. Age distributions are generally consistent for seven samples collected from the Jackfork Group and Johns Valley Shale in the southern Ouachita Mountains through ~2400 m of stratigraphic section and are interpreted to indicate little change in provenance during the Morrowan in this part of the system. However, samples from the most northern and most source-proximal site in Little Rock, Arkansas, exhibit modest percentages of Appalachian ages and elevated contributions of Yavapai-Mazatzal ages when compared with samples collected farther to the south and west. We interpret differences between DZ signatures to indicate distinct sediment-routing pathways to the Ouachita Basin. We infer the strong Appalachian and Grenville signals to represent an axial system flowing through the Appalachian foredeep, whereas the more diverse signals represent a confluence of rivers from the northeast through the backbulge of southern Illinois and western Kentucky and from the north across the Arkoma shelf. Collectively, the Ouachita Basin represents a terminal sink for sediments derived from much of the eastern and central United States.
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KENDLER, KENNETH S., and CHARLES O. GARDNER. "Twin studies of adult psychiatric and substance dependence disorders: are they biased by differences in the environmental experiences of monozygotic and dizygotic twins in childhood and adolescence?" Psychological Medicine 28, no. 3 (May 1998): 625–33. http://dx.doi.org/10.1017/s0033291798006643.
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Background. Twin studies have long been used to disentangle the role of genetic and environmental factors in the aetiology of psychiatric disorders. However, the validity of the twin method depends on the equal environment assumption – that monozygotic (MZ) and dizygotic (DZ) twins are equally correlated in their exposure to environmental factors of aetiological importance for the disorder under study.Methods. Both members of 822 female–female twin pairs from a population-based registry previously assessed for a range of psychiatric and substance use disorders were asked 12 questions assessing the similarity of their environmental experiences in childhood and adolescence. We examined whether the similarity of environmental experiences predicted concordance for psychiatric and substance abuse disorders by both a ‘pair-wise’ and ‘individual’ method utilizing logistic regression. We also examined smoking initiation, where prior evidence suggested a role for adolescent social environment.Results. Three factors were derived from these items: ‘Childhood treatment’, ‘Co-socialization’ and ‘Similitude’. Members of twin pairs agreed substantially in their recollections of these experiences. Compared with DZ twins, MZ twins reported comparable resemblance in their childhood treatment, but socialized together more frequently and reported that parents, teachers and friends more commonly emphasized their similarities. None of these three factors significantly predicted twin resemblance for major depression, generalized anxiety disorder, panic disorder, phobias, nicotine dependence or alcohol dependence. However, co-socialization significantly predicted twin resemblance for smoking initiation and perhaps for bulimia.Conclusion. Differential environmental experiences of MZ and DZ twins in childhood and adolescence are unlikely to represent a substantial bias in twin studies of most major psychiatric and substance dependence disorders but may influence twin similarity for the initiation of substance use.
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Tao, X., X. M. Men, B. Deng, and Z. W. Xu. "Effects of breed, postnatal development, and nutrition on mRNA expression of the FTO gene in porcine muscle and its relationship with intramuscular fat deposition." Czech Journal of Animal Science 58, No. 8 (July 30, 2013): 381–88. http://dx.doi.org/10.17221/6905-cjas.
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The effects of breed, development, and nutrition on mRNA expression of the fat mass and obesity-associated gene (FTO) and its relationship with intramuscular fat (IMF) content in porcine muscle (m. longissimus dorsi; m.l.d.) were estimated. Purebred Jinhua, Zhongbai, Yorkshire, Duroc, Duroc × Zhongbai (DZ), and Duroc × Yorkshire × Landrace (DYL) pigs were used to investigate the effect of breed. Pigs weighing 2.5, 10, 20, 40, 60, and 100 kg were selected to study the effects of different stages of development. To study the effect of nutrition, four diets were selected: corn-soybean (CS), CS with 1.2% conjugated linoleic acid (CLA) or 0.05% creatine monohydrate (CMH), and barley-soybean (BS). All eighty animals were slaughtered, and m.l.d. samples were collected to examine FTO mRNA expression and IMF content. Results showed that breed significantly affected FTO mRNA expression and IMF content. FTO mRNA expression in the studied pigs was in the order: Zhongbai and Yorkshire > Duroc and DZ > Jinhua and DYL. The IMF content ordered by breed was Duroc > DZ > DYL > Jinhua > Zhongbai > Yorkshire. Both FTO mRNA expression and IMF content increased with age of the pigs, with the greatest difference seen between 100 kg pigs and all other weights. In the study, none of the four diets had a significant effect (P > 0.05) on FTO mRNA expression or IMF content. The study demonstrated that FTO mRNA expression increased with increasing body weight and was significantly affected by the breed of pigs. The results showed that FTO mRNA expression had an inconsistent correlation with IMF content between breeds and developmental ages.
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Pelsmaekers, B., R. Loos, C. Carels, C. Derom, and R. Vlietinck. "The Genetic Contribution to Dental Maturation." Journal of Dental Research 76, no. 7 (July 1997): 1337–40. http://dx.doi.org/10.1177/00220345970760070201.
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It has been established in the literature that there is a major genetic impact on tooth size (Potter et al., 1976; Corruccini and Sharma, 1985; Sharma et al., 1985), tooth morphology (Kraus and Furr, 1952; Biggerstaff, 1970), and root formation (Garn et al., 1960; Green and Aszkler, 1970). None of the studies concerning root formation, however, used the more advanced method of path analysis and model fitting to estimate genetic influence. The aim of the present study was to determine the genetic and environmental influence on dental maturation. Dental age scores were determined on panoramic radiographs of 58 pairs of twins-26 monozygotic (MZ) and 32 dizygotic (DZ)-with the method of Demirjian et al. (1973). No mirror-image effect was found between the sides of the same individual or between twin members, so dental maturation seems to be symmetrical for both left and right sides of the mandible. Correlation coefficients were significantly higher in MZ than in DZ twins, which suggests a genetic influence. Model fitting showed that the variation in dental age was best explained by additive genetic influences (A-component) (43%) and by environmental factors common to both twins (C-component) (50%). The specific environment (E-component) added only 8% to the model. The importance of the common environmental factor can be explained by the fact that twins, being raised together, share the same prenatal, natal, and immediate post-natal conditions that are of importance for the formation of the teeth.
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Segal, Nancy L. "‘Biracial’-Looking Twins: A New Twin Type?/Twin Research: Twins with Cystic Teratomas; Sleep Quality and Body Mass Index; Previable Membrane Rupture/Print and Online Reports: Twins Born to a Sister Surrogate; NASA Twin Study; African-Cosmopolitan Twin Fashion Inspirations; Triplet Hockey Stars." Twin Research and Human Genetics 20, no. 3 (March 28, 2017): 260–65. http://dx.doi.org/10.1017/thg.2017.18.
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Dizygotic (DZ) co-twins born to mothers and fathers from different racial or ethnic backgrounds often resemble one parent much more than the other. As such, these pairs comprise a unique subset of twins for investigating how others’ responses to their different looks may affect their personalities and self-esteem. This article describes some of these twin pairs and some challenges of raising them, and suggests ways they may be used in research. Next, recent twin research on cystic teratomas, relations between sleep quality and body mass index, and previable membrane rupture is described. The final section concerns twins, twin studies, and related events in the media, namely: twins born to a sister surrogate, the NASA twin investigation, inspiring African-Cosmopolitan twins in fashion, and triplet Hockey Stars.
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Hankinson, R. J. "The Sceptical Inquirer." History of Philosophy and Logical Analysis 23, no. 1 (September 8, 2020): 74–99. http://dx.doi.org/10.30965/26664275-02301007.
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Abstract This article treats of whether scepticism, in particular Pyrrhonian scepticism, can be said to deploy a method of any kind. I begin by distinguishing various different notions of method, and their relations to the concept of expertise (section 1). I then (section 2) consider Sextus’s account, in the prologue to Outlines of Pyrrhonism, of the Pyrrhonist approach, and how it supposedly differs from those of other groups, sceptical and otherwise. In particular, I consider the central claim that the Pyrrhonist is a continuing investigator (section 3), who in spite of refusing to be satisfied with any answer (or none), none the less still achieves tranquillity, and whether this can avoid being presented as a method for so doing, and hence as compromising the purity of sceptical suspension of commitment (section 4). In doing so, I relate—and contrast—the Pyrrhonists’ account of their practice to the ‘Socratic Method’ (section 5), as well as to the argumentative practice of various Academics (section 6), and assess their claim in so doing to be offering a way of instruction (section 7). I conclude (section 8) that there is a consistent and interesting sense in which Pyrrhonian scepticism can be absolved of the charge that it incoherently, and crypto-dogmatically, presents itself as offering a method for achieving an intrinsically desirable goal.
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PICCIRILLO, PAUL, and CHARLES W. VAN ATTA. "The evolution of a uniformly sheared thermally stratified turbulent flow." Journal of Fluid Mechanics 334 (March 10, 1997): 61–86. http://dx.doi.org/10.1017/s002211209600434x.
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Experiments were carried out in a new type of stratified flow facility to study the evolution of turbulence in a mean flow possessing both uniform stable stratification and uniform mean shear.The new facility is a thermally stratified wind tunnel consisting of ten independent supply layers, each with its own blower and heaters, and is capable of producing arbitrary temperature and velocity profiles in the test section. In the experiments, four different sized turbulence-generating grids were used to study the effect of different initial conditions. All three components of the velocity were measured, along with the temperature. Root-mean-square quantities and correlations were measured, along with their corresponding power and cross-spectra.As the gradient Richardson number Ri = N2/(dU/dz)2 was increased, the downstream spatial evolution of the turbulent kinetic energy changed from increasing, to stationary, to decreasing. The stationary value of the Richardson number, Ricr, was found to be an increasing function of the dimensionless shear parameter Sq2/∈ (where S = dU/dz is the mean velocity shear, q2 is the turbulent kinetic energy, and ∈ is the viscous dissipation).The turbulence was found to be highly anisotropic, both at the small scales and at the large scales, and anisotropy was found to increase with increasing Ri. The evolution of the velocity power spectra for Ri [les ] Ricr, in which the energy of the large scales increases while the energy in the small scales decreases, suggests that the small-scale anisotropy is caused, or at least amplified, by buoyancy forces which reduce the amount of spectral energy transfer from large to small scales. For the largest values of Ri, countergradient buoyancy flux occurred for the small scales of the turbulence, an effect noted earlier in the numerical results of Holt et al. (1992), Gerz et al. (1989), and Gerz & Schumann (1991).
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Grace, R. F., and V. J. Roach. "Caesarean Section in a Patient with Paramyotonia Congenita." Anaesthesia and Intensive Care 26, no. 5 (October 1998): 534–37. http://dx.doi.org/10.1177/0310057x9802600511.
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This case report details spinal anaesthesia for an elective caesarean section in a patient with the rare condition of paramyotonia congenita. There are few case reports of anaesthesia in this condition and none in the Australian anaesthetic literature. This case highlights the need for the avoidance of hypothermia and depolarizing muscle relaxants, the safety of spinal anaesthesia and a conservative approach to the management of plasma potassium concentration. The subsequent review outlines the current literature and discusses other issues involved in the anaesthetic management of this disorder.
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Begum, Tahera, M. Jalal Uddin, and Ishrat Jabin. "Caesarean Section Without Indwelling Catheter." Chattagram Maa-O-Shishu Hospital Medical College Journal 14, no. 1 (April 4, 2015): 34–35. http://dx.doi.org/10.3329/cmoshmcj.v14i1.22878.
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Background: Many studies were conducted worldwide on the subject but there is none in Chittagong. To get our experience we had conducted the study. Methods: It was an experimental study. 70 cases were conveniently selected under certain inclusion and exclusion criteria. Cases were managed by the obstetricians unrelated to the study. All cases were meticulously observed by the investigators and findings were instantly recorded. All data were manually managed. A discussion was made and conclusion was drawn. Results: Total 70 cases were studied. 35 primae and 35 multipara. Mean age was 27 years +2.3 . All were literate and 86% were housewives. Cases were without medical, surgical complications and were uneventfully managed. First voiding time was 4.28 hours +0.45. 07% cases were evacuated with plain catheter after 7 hours for pain and bladder distention. Average hospital stay 2.3 days. There was no occurrence of urinary tract infection. Conclusion: Indwelling catheter should not be used unless it is strongly indicated. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22878 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 34-35
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Chowdhury, Liza, and Ishrat Jahan. "Cesarean Section without Urethral Catheterization." Journal of Armed Forces Medical College, Bangladesh 11, no. 1 (December 15, 2016): 3–6. http://dx.doi.org/10.3329/jafmc.v11i1.30658.
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Introduction: Urethral catheterization is done as a routine procedure in cesarean section. It is associated with great discomfort, high incidence of urinary tract infection, delayed ambulation and longer hospital stay.Objectives: To determine the feasibility and safety of cesarean section without urethral catheterization.Materials and Methods: A prospective, observational study was carried out from April 2012 to March 2013, in the Department of Obstetrics and Gynaecology, CMH Dhaka and IBN Sina Hospital Dhaka among 65 patients who had undergone cesarean section without catheterization. There were some limitations of this study. We had excluded previous cesarean from our study, so the results of this study cannot be generalized.Results: Firs void discomfort was not significantly associated without the use of indwelling catheter. Hospital stay was shorter (94% was discharged on 3rd post operative day). None of the patients had bladder injury. Mean duration of surgery was 45 minutes (44%) and ambulation time 11-14 hours (60%). Average estimated blood loss was 500 ml (41%) and time of 1st voiding was 5-8 hrs (58%). Need for catheterization was significantly low (3%).Conclusion: Cesarean section can be done safely without urethral catheterization with reduced morbidities.Journal of Armed Forces Medical College Bangladesh Vol.11(1) 2015: 3-6
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Julien, Carl. "PSXIII-21 Formulations of Vitamin K, Organic Acids, Essential Oils and Plant Hydroalcoholic Extracts Prevent Coccidiosis Impact on Growth Performances in Broilers." Journal of Animal Science 100, Supplement_3 (September 21, 2022): 319. http://dx.doi.org/10.1093/jas/skac247.582.
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Abstract The aim of this study was to evaluate the effect of formulations of vitamin K, organic acids, essential oils and plant hydroalcoholic extracts as anticoccidial alternatives in broilers. A 34-day cage trial with 10 replicates of 12 birds/cage was conducted. Male broilers (Ross 308) were randomly assigned to: 1) non-infected (NI); 2) Eimeria-infected (EI); 3) EI+decoquinate/zoalene shuttle program (DZ); 4) EI+2 kg/t Nutri-Gro® feed additive; 5) 3 L/1000 L Technocok® in drinking water from d14 to d20. The formulations were made by Synergie Eurobec International Ltd and contain 7.0 and 7.5 g/kg vitamin K. Eimeria infection was induced by an oral administration at d14 of 2x105 sporulated oocysts of mixed Eimeria species from field isolates. Data were analyzed by a mixed model including treatment and barn section as fixed and random effects, respectively, and by Kruskal-Wallis tests. As expected, the coccidian challenge (EI) reduced growth performances, increased total excreted oocyst counts (6.0 vs 3.0 log10, P < 0.0001) and E. acervulina (0.79 vs 0.21, P=0.0022) and E. tenella (2.04 vs 0.17, P < 0.0001) intestinal lesion scores (ILS) 6 days post infection (dpi, d20), compared to NI, whereas DZ palliated these infection impacts. The two formulation treatments increased d20 body weight (BW), compared to EI (0.980 and 0.939 vs 0.908 kg, P < 0.01), without improving the feed conversion ratio (FCR). The 2 kg/t Nutri-Gro® formulation increased (2.69 vs 2.61 kg, P=0.0486) and the Technocok® showed a trend to improve (2.68 vs 2.61 kg, P=0.1015) d34 BW, compared to EI birds. However, the formulations did not affect the oocyst excretion nor the ILS at 6 dpi (P>0.05). Overall, the additives showed beneficial effects on growth performance in a Eimeria-challenged broilers. These supplements may be involved in a strategy aimed at reducing the use of anticoccidials in broiler production.
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Gurung, Tara, Sangeeta Shrestha, Ujjwal Basnet, and Amirbabu Shrestha. "Awareness with Recall in General Anesthesia undergoing Cesarean Section." Nepal Journal of Obstetrics and Gynaecology 13, no. 1 (November 12, 2018): 18–22. http://dx.doi.org/10.3126/njog.v13i1.21611.
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Aims: To determine the incidence of awareness with recall in parturient undergoing cesarean section under general anesthesia in Paropakar Maternity and Women’s Hospital.Methods: Retrospective observational cohort study of the patients who underwent cesarean section under general anesthesia from April mid 2014 to April mid 2017 (Baishakh 2071 to Chaitra 2073 BS). Awareness questionnaires filled up through the modified Brice interview.Results: A total of 162 patients underwent Cesarean Section under general anesthesia and138 were included in the study. None of them had awareness and six patients had a dream.Conclusion: No awareness with recall found and prospective study is required to determine the condition.
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Varga, Gyorgy, and Ricardo Dias de Oliveira Brito. "The Cross-Section of Expected Stock Returns in Brazil." Brazilian Review of Finance 14, no. 2 (June 27, 2016): 151. http://dx.doi.org/10.12660/rbfin.v14n2.2016.60916.
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In a sample of the Brazilian stock market from 1999 to 2015, this paper shows that the book-to-market and momentum of individual firms capture some of the cross-sectional variation in average stock returns, while the market β and size do not play a role. The positive relation of cross-section of returns with book-to-market is more evident earlier, while the positive relation with momentum is stronger later in the sample. However, because none of these characteristics show explanatory power for all the subsamples studied, we are not fully convinced that they capture fundamental risk factors.
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Sharma, K. "The Twinning Rates and Epidemiological Characteristics of Births in Southeast Uttar Pradesh, India." Acta geneticae medicae et gemellologiae: twin research 46, no. 1 (January 1997): 47–56. http://dx.doi.org/10.1017/s000156600000074x.
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AbstractBirth statistics over a period of 5 years were analyzed to study epidemiological characteristics of twinning in Southeast Uttar Pradesh, India. The data revealed higher incidence of breech twins (11.84% of all cotwins) as compared to breech single births (2.18%). But the perinatal mortality and caesarean section rates were similar in both twin and singleton pregnancies. The cumulative twinning rate over the studied period was 11.70 per 1000 live births. The MZ and DZ twinning rates were estimated respectively as 3.67 and 8.03 per mill. The mean maternal age of sampled mothers was 26.42 years with one standard deviation of 5.30 years. The twinning rate for mothers over 35 years of age was about four times higher than that in mothers younger than 20 years. Incidently, the twinning rate was the highest at parity four and a non-linear curve could more appropriately be fitted to the series of data. Seasonal variations were observed for both twin and singleton births. The highest frequency of births was observed from August through October. But seasonal index for twinning rate showed a clear bimodal distribution with peaks in April (223) and September (167).
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Roy, Priyankur, Lakshmanan Jeyaseelan, and Jose Ruby. "Respiratory Morbidity in Term Infants delivered by Elective Cesarean Section at a Tertiary Care Hospital in India: A Randomized Controlled Trial." Journal of South Asian Federation of Obstetrics and Gynaecology 9, no. 4 (2017): 312–17. http://dx.doi.org/10.5005/jp-journals-10006-1520.
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ABSTRACT Objectives (1) To investigate the association between term elective cesarean sections and neonatal respiratory morbidity and the importance of timing of the cesarean. (2) To assess the maternal morbidity when emergency lower segment cesarean section (LSCS) was required. Participants All women with singleton term (37—41 + 6 weeks) pregnancies and planned for elective cesarean section in Christian Medical College, Vellore, India. Outcome measures The primary outcome measures were neonatal morbidities such as transient tachypnea of newborn (TTN) and respiratory distress syndrome (RDS). The secondary outcome measures were emergency cesarean section and maternal morbidities such as scar dehiscence, urinary tract infection (UTI), endometritis, peritonitis, and hemoperitoneum in the mother. Results The percentage of TTN in the infants in group I was 1.3% while there were none in group II. No infants were diagnosed to have RDS. Out of the 150 women who were planned for elective cesarean section, 55 women underwent emergency cesarean section. Among this, 19 (25.3%) of women were from group I as compared with 36 (48.0%) in group II. The difference in proportion between the two groups was –22.7 [95% confidence interval (CI): –37.7, –7.7], which was statistically significant (p < 0.01). The incidence of scar dehiscence, UTI, endometritis, and hemoperitoneum in the mothers of group II was marginally higher than that in the mothers of group I. There was one woman with peritonitis in group I while none was reported in the other group. All the maternal morbidities occurred to women who underwent emergency cesarean section. Out of the 19 women in group I and 36 women in group II who underwent emergency cesarean section, 1 (5.3%) and 6 (16.7%) women had morbidities. Conclusion Women requiring elective cesarean section can safely be done between 37 and 39 weeks with no further significant increase in the rates of neonatal morbidity such as TTN and RDS. How to cite this article Roy P, Jeyaseelan L, Ruby J, Garg R. Respiratory Morbidity in Term Infants delivered by Elective Cesarean Section at a Tertiary Care Hospital in India: A Randomized Controlled Trial. J South Asian Feder Obst Gynae 2017;9(4):312-317.
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Hamir, Amir N., and Charles E. Rupprecht. "Hepatic Capillariasis (Capillaria Hepatica) in Porcupines (Erethizon Dorsatum) in Pennsylvania." Journal of Veterinary Diagnostic Investigation 12, no. 5 (September 2000): 463–65. http://dx.doi.org/10.1177/104063870001200514.
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Tissues of 53 adult porcupines ( Erethizon dorsatum) from Pennsylvania were obtained for histopathologic examination. Hepatic capillariasis was recorded in 9% of the porcupines. An additional 11% of the liver sections showed lesions that were compatible with migration by Capillaria hepatica. Because only 1 section of the liver per animal was examined microscopically, the documented prevalence of C. hepatica in Pennsylvania is considered conservatively low. However, this condition was subclinical, because none of the infected animals showed clinical signs, and none revealed severe pathologic changes in the affected livers. This seems to be the only report of C. hepatica in porcupines.
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HASSAN, SAMIA, MISBAH KAUSAR JAVAID, and SADIA TARIQ. "EMERGENCY CAESAREAN SECTION." Professional Medical Journal 15, no. 02 (March 10, 2008): 211–15. http://dx.doi.org/10.29309/tpmj/2008.15.02.2772.
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Objective: Comparative analysis of problems encountered betweenpatients of elective caesarean section and patients for whom elective caesarean section was planned but ended upin emergency caesarean section. Design: Descriptive prospective analysis. Setting: Gynae Unit-II, Services Hospital,Lahore. Duration: One year, 1 January 2006 to 31 December 2006. Patients & Methods: A prospective study of st st100 patients who presented for antenatal care (ANC) and for whom elective caesarean section (CS) was planned wasdone. Patients evaluation was done on a designed performa that included demographic, social and obstetrical histories.Problems encountered in the preparatory stage, logistic problems, administrative problems, problems encounteredduring surgery, maternal, fetal mortality and morbidity were noted. Results: The patients were divided into twocategories. Categories I: included patients who had elective CS and category II: included patients who ended up inemergency CS. Numerous problems were encountered for category II patients. In the preparatory phase there wasdifficulty in arranging medicines for 32 patients. (59.2%), arranging blood for 28 patients (51.8%), obtaining consentfor 1 patient (1.85%). Logistic problems included non-availability of operation theatre for 15 patients (27.75%), nonavailability of anaesthetist for 9 patients (16.65%), and non-availability of paediatrician for 38 babies (17.3%). Noneof the emergency CS were done with in the recommended 30 minutes interval. Despite this, there was no significantcoloration between the decision delivery interval (DDI) and perinatal outcome. In our study like threatening cases wereoperative within 60 minutes. Intra operative problems in the category II patients included adhesions in 40 patients (74%)vs 10 patients (21.7%) of category I, partial dehiscence in 16 patients (29.6%) of category II vs 4 patients (8.68%) ofcategory I. Excessive hemorrhage in 8 patients (14.8%) of category II vs 2 patients (4.34%) of category I. Among thepost operative complications anemia was present in 20 patients (43.4%) of category I vs 45 patients (83.25%) ofcategory II patients. Blood transfusion was required for 16 patients (29.6%) of category II vs 4 patients (8.68%) ofcategory I and all patients were given iron supplement. Major wound infection were seen in 9 patients (16.65%) ofcategory II vs 2 patients (4.34%) of category I. Resuturing was done after appropriate antibiotic cover and dailyantiseptic dressing. Minor wound infections were seen in 22 patients (40.7%) of category II vs 12 patients (26.04%)of category I. Urinary Tract Infections (UTI) was seen in 6 patients (11.1%) of category II vs 1 patient (2.17%) ofcategory I. Respiratory Tract Infection (RTI) was seen in 5 patients (9.25%) of category II vs 2 patients (4.34%) ofcategory I. All these were treated by appropriate antibiotic cover. Regarding the neonatal outcome 16 babies (29.6%)of category II were kept under observation in neonatal nursery (NNU) as compared to 6 (13.02%) babies of categoryI. Admission for 2-10 days in NNU were 8 babies (14.96%) of category II vs 2 babies (4.34%) of category I. 2 babies(3.74%) of category II expired later while none of category I. Conclusion: Patients for whom elective CS was plannedbut who ended up in emergency CS, the DDI was prolonged and there was increase risk of maternal morbidity, fetalmorbidity and mortality as compared to those patients who had elective CS.
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Kakkar, Rakesh, and Pradeep Aggarwal. "Book Review: ‘Till We Win - India’s fight against the COVID-19 Pandemic’." Indian Journal of Community Health 32, no. 4 (December 31, 2020): 755–56. http://dx.doi.org/10.47203/ijch.2020.v32i04.028.
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‘Till We Win’ is a book which provides a comprehensive overview of India’s journey. It deliberates how India, as a nation, fought and continue to fight against the novel coronavirus, SARS CoV-2. It documents and analyses the COVID-19 pandemic responses and provides lessons for health systems strengthening.
The book has four section and eleven chapters. The first section focuses upon why viruses are likely to cause pandemic and how human activities are increasing the risks of outbreaks and epidemics. The next section deliberates on India’s pandemic response and how the policies had evolved with every new emerging condition. The authors argue that none of the country was fully prepared for the pandemic of the such a magnitude which eventually had disrupted even ‘so called’ better performing health system.
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Dybo, Anna V., Lidia F. Abubakirova, Zukhra K. Aibazova, Oleg R. Hisamov, Evgeniya V. Korovina, Vera S. Maltseva, Oleg A. Mudrak, et al. "Новые результаты в генеалогической классификации тюркских диалектов («случаи с аффрикатами»)." Oriental Studies 13, no. 3 (December 24, 2020): 696–713. http://dx.doi.org/10.22162/2619-0990-2020-49-3-696-713.
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Introduction. As is well known, the three Turkic dialectal continua — Tatar-Bashkir, Shor-Khakass-Chulym, and Karachay-Balkar ones — have developed quite distinctive reflexes of proto-Turkic palatal *j- and *č-, *-č(-). While compiling the Dialectological Atlas of Russia’s Turkic Languages, the authors were able to compose exact isoglosses of *j- and *č change in members of the mentioned continua, which made it also possible to partially reevaluate genetic clusterization on the basis of this data. Materials and Methods. Apart from the available publications and archival sources on the three areas in question, the analysis is based on the authors’ extensive field work that involves the use of a set of lexical questionnaires compiled in accordance with known aspects of the Turkic linguistic history. The source recordings for every speaker were turned into idiolectal audio-dictionaries and are linked to an electronic etymological database of the Turkic languages, each elicitation analyzed both with the comprehension method and the software for experimental phonetics. Results. As it turns out, this methodology of field work and post-analysis provides information crucial for detailed linguistic clusterization of dialectal continua in particular and any dialectal system in general. Traditionally, subtle problems of divergence and convergence, problems of archaic and innovative phenomena receive their solutions. The results are as follows. Palatal *j- and *č in the languages of the Khakass-Shor-Chulym group have changed by a strict series of rules none of which could be simultaneous, nor could follow each other in a different order. Thus, the two Middle Chulym dialects — Melet and Tutal ones — prove to lack an immediate linguistic ancestor, the Tutal ‘dialect’ is an archaic version of Mrassu Shor, while Melet is closely related to Kyzyl Khakass. Reflexes of *j- and *č are also principal isoglosses for a previously undocumented Khakass dialect, which does not have any specific affinity with Saghai, Kyzyl and Kachin dialects. Areal analysis of KarachayBalkar shows that dz < proto-Turkic *j- is a secondary development, while, on the other hand, it is finally proven that reflexes *j- > dz~dʑ and *j- > ʑ~z form a more significant isogloss. And for the Tatar-Bashkir dialectal continuum, there were identified three main types of proto-Turkic *jreflexation; a chronology for these three types intermixing during the early period of the continuum is also proposed.
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Burnside, Craig. "The Cross Section of Foreign Currency Risk Premia and Consumption Growth Risk: Comment." American Economic Review 101, no. 7 (December 1, 2011): 3456–76. http://dx.doi.org/10.1257/aer.101.7.3456.
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Lustig and Verdelhan (2007) argue that the excess returns to borrowing US dollars and lending in foreign currency “compensate US investors for taking on more US consumption growth risk,” yet the stochastic discount factor corresponding to their benchmark model is approximately uncorrelated with the returns they study. Hence, one cannot reject the null hypothesis that their model explains none of the cross sectional variation of the expected returns. Given this finding, and other evidence, I argue that the forward premium puzzle remains a puzzle. JEL: C58, E21, F31, G11, G12
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Sharma, K. "Sex Differences in Genetic Determinants of Craniofacial Variations - A Study Based on Twin Kinships." Acta geneticae medicae et gemellologiae: twin research 47, no. 1 (January 1998): 31–41. http://dx.doi.org/10.1017/s0001566000000350.
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AbstractRace, sex, nutritional status and cultural factors affect craniofacial morphogenesis. Out of these, sex is a major factor in craniofacial differentiation, because it can be stronger in one ethnic group and weaker in another. In this study, sex differences in genetic variance and heritability of 13 craniofacial traits are investigated. The study is based on a sample of 45 MZ and 101 DZ twin pairs and their 125 singleton siblings, 104 fathers and 103 mothers in 146 families drawn from an urban population of Chandigarh. Results of t'-tests for equality of the means reveal association of zygosity with the mean value of bigonial diameter in female twins and for none in males. Heterogeneity of variance is observed in about 50% traits in females as compared to 15% in males. This invalidates conventional within-pair genetic variance estimates for these traits. The revised genetic variance ratios are higher on an average in males than in females. However, there is greater MZ environmental covariance in male twins than their female counterparts. Family data indicate higher maternal effect for ear height, nasal height and frontal breadth, while greater paternal effect is seen in cranial traits. Sex-wise midparent-child regression coefficients show greater heritability in daughters for nasal traits and bigonial breadth, while sons show higher genetic component for head size measures.
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Hall, A. D., B. K. Puri, T. Stewart, and P. S. Grahame. "Doctors' Holding Power in Practice: Section 5(2) of the Mental Health Act 1983." Medicine, Science and the Law 35, no. 3 (July 1995): 231–36. http://dx.doi.org/10.1177/002580249503500310.
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Section 5(2) of the Mental Health Act 1983 (England and Wales) is a commonly used short term power of detention often implemented by junior medical staff, which has no statutory right of appeal. There is little published analysis of its use in clinical practice. A detailed case note study of its use in a psychiatric service with a large catchment area is presented. Fifty-seven per cent of the patients detained under s.5(2) were female. Affective psychosis was over-represented in detained females, while schizophrenia and paranoid states were over-represented in males. Eight per cent of s.5(2) detentions were initiated via the nurses' holding power, s.5(4). None of these patients were subsequently regraded to s.2 or 3, which may be accounted for by the finding that personality disorder and alcohol dependence were more commonly diagnosed in this subgroup. Of s.5(2) detainees, none of those with a non-psychotic disorder were regraded to s.2 or 3. Three patients had not accepted in-patient admission prior to implementation of s.5(2). Moreover, 38 per cent of all s.5(2) detentions took place within 24 hours of admission. Patients with a psychotic disorder were more likely to be detained within 24 hours of admission. Doubts regarding the validity of consent to voluntary admission in these patients are raised.
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Abboud, Therese K., Michael J. Moore, Jerry Jacobs, Kazushige Murakawa, Manoutchehr Soraya, and Jay Zhu. "Epidural Mepivacaine for Cesarean Section: Maternal and Neonatal Effects." Regional Anesthesia: The Journal of Neural Blockade in Obstetrics, Surgery, & Pain Control 12, no. 2 (April 1987): 76–79. http://dx.doi.org/10.1136/rapm-00115550-198712020-00003.
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The effects of epidural anesthesia using mepivacaine on maternal blood pressure, newborn Apgar scores, neonatal acid-base status, and the Early Neonatal Neurobehavioral Scale (ENNS) were studied in 21 pregnant women undergoing cesarean section. Maternal and neonatal blood levels of mepivacaine were also determined. Neonatal outcome was compared with a control group of 14 neonates of healthy mothers who received 3% 2-chloroprocaine for elective cesarean section. All patients had satisfactory anesthesia for cesarean section with an onset of 19 ± 1.8 minutes (mean ± SEM) and duration of 95 ± 11.9 minutes. Hypotension developed in two patients, and they were treated with intravenous ephedrine. All neonates had Apgar scores of 8 or more at 1 and 5 minutes and normal blood gases and acid-base status. None of the variables of the ENNS differed significantly between the mepivacaine and the chloroprocaine control group with the exception of truncal tone, which was significantly higher in the mepivacaine group ( p < 0.05). Mepivacaine was detected in all maternal and fetal samples, and the umbilical venous to maternal venous ratio was 0.57 ± 0.17 (mean ± SEM).
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Lowe-Ponsford, Francesca L., and Ayaz Begg. "Place of Safety and Section 136 at Gatwick Airport." Medicine, Science and the Law 36, no. 4 (October 1996): 306–12. http://dx.doi.org/10.1177/002580249603600406.
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Seventy-nine adults and nineteen children were arrested at Gatwick Airport under s.136 over the period of one year although not all were formally held under this section at the police station (i.e. not all were accepted by the custody police officer). Their notes at the police station were reviewed. None of the children and only half of the adults were eventually seen by a doctor. The police were able to deal with the others. Half of these latter were missing persons. Those referred to a doctor tended to be suicidal or confused compared with those who were dealt with solely by the police. In addition, the police station as a place of safety probably influenced management in that people were dealt with quickly. The phenomenon of ‘wanderers’ is commented upon. This study suggests that when reviewing people held by the police as a result of their behaviour, a more comprehensive study can be performed by considering those arrested under s.136, but needing a more informal approach, at the police station.
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Gupta, Nupur, Taru Gupta, and Ritu Singh. "Feto-maternal outcome in second versus first stage caesarean delivery in a tertiary medical care centre." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 12 (November 26, 2018): 5084. http://dx.doi.org/10.18203/2320-1770.ijrcog20184971.
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Background: The aim is to study neonatal and maternal outcomes of the caesarean sections performed in first stage versus second stage of labour. Methods: The retrospective analysis of data were done of caesarean section done at Department of Obstetrics and Gynaecology at ESI PGIMSR Basaidarapur New Delhi between January 2016 to December 2016. 45 women, who underwent second stage caesarean section were studied. For each case, two consecutive cases, who underwent caesarean delivery during the first stage of labour were taken as control for the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirement, urinary system injury and postoperative complications. Results: Out of 4477 deliveries, 1466 had caesarean section with a rate of 32%. The rate of second stage caesarean section was 3% of total caesarean section and 1% of total deliveries. Second stage caesarean section had higher maternal and perinatal morbidity like atonic PPH (33.3%), lower uterine segment extension (7%), febrile morbidity (10%), and need for blood transfusion (15%). There were 15.5% NICU admission in second stage caesarean group while none in first stage group. Conclusions: Caesarean section in the second stage of the labour is associated with increased maternal and neonatal morbidities. Special attention is required to the patients undergoing caesarean section in the second stage of the labour. They should be handled by senior and experienced obstetrician. Neonatologist should be present for every second stage caesarean section.
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Vaswani, Babita P., Aditi Trivedi, and Sriram Gopal. "Extraperitoneal versus transperitoneal cesarean section: a retrospective analysis." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 2 (January 28, 2020): 567. http://dx.doi.org/10.18203/2320-1770.ijrcog20200337.
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Background: Cesarean section is becoming a more common delivery type worldwide. The objective of this study was to compare surgical morbidity in extraperitoneal versus transperitoneal techniques of cesarean section.Methods: A total of 60 patients was included in this study out of which 30 underwent extraperitoneal cesarean section(ECS) and 30 patients underwent transperitoneal cesarean section (TCS) and compared both the techniques with respect to nausea or vomiting intra-operatively, pain score (as measured by visual analogue scale) post operatively, return of bowel function and blood loss.Results: Intra-operative nausea and vomiting was noted in 33.34% of patients in TCS group while none of the patients in ECS group had any such complaints. No difference was noted in average blood loss between the 2 groups. Post-operative pain in ECS was 4.13 as compared to 6.86 in TCS. Return of bowel sounds in ECS group was much earlier (5.46 hours) as compared to TCS group (11.33 hours).Conclusions: We conclude that extraperitoneal technique is advantageous over transperitoneal approach. Decreased nausea and vomiting, early return of bowel function in the post-operative period, decreased post-operative pain allowing early feeding and mobilization are definite benefits of this technique. This further helps in making a relatively smoother post-operative recovery.
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Li, Liang, Tianhua Zhou, Junwu Chen, and Jianfeng Chen. "A New Buckling-Restrained Brace with a Variable Cross-Section Core." Advances in Civil Engineering 2019 (December 26, 2019): 1–15. http://dx.doi.org/10.1155/2019/4620430.
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In this paper, a new type of buckling-restrained brace characterized by a variable cross-section core (BRB-VCC) is proposed and investigated. The practical design equations of the BRB-VCC are derived based on mechanical and mathematical theories. Six specimens are designed and tested to clarify the mechanical behaviours of the BRB-VCC and to validate the reliability of the proposed equations. The test results show that (1) none of the specimens buckle under compression, as expected, and their ductilities and energy dissipation capacities are satisfactory; (2) the derived formulas are reliable and can be conveniently used in engineering practice; and (3) the yielding displacement of the BRB-VCC is approximately 70% that of the traditional TJ-1 buckling-restrained brace (BRB-TJ-1), which may yield earlier than the BRB-TJ-1 in concrete structures under the action of an earthquake.
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Muthukrishnan, Dharini, and Prabha Janakiraman. "Successful conservative management of viable caesarean scar pregnancy with systemically administered methotrexate followed by ultrasound guided ethanol ablation of gestational sac: a rare case report." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 6 (May 26, 2022): 1782. http://dx.doi.org/10.18203/2320-1770.ijrcog20221459.
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The incidence and diagnosis of caesarean scar pregnancy is on rise because of rising caesarean section rates. Though many modalities are available for its management, none seems to be superior and data regarding them are also lacking. Here we are presenting a rare case report of successful conservative management of viable caesarean scar pregnancy with systemic methotrexate followed by ultrasound guided ethanol ablation of gestational sac.
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Steele, Russell W., James R. McConnell, Richard F. Jacobs, and John R. Mawk. "Recurrent Bacterial Meningitis: Coronal Thin-Section Cranial Computed Tomography to Delineate Anatomic Defects." Pediatrics 76, no. 6 (December 1, 1985): 950–53. http://dx.doi.org/10.1542/peds.76.6.950.
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Three patients with histories of recurrent bacterial meningitis were previously examined with skull and sinus radiographs, routine cranial computed tomography, intrathecal radioisotope tracer studies, and immunologic evaluation. None of these studies were diagnostic. Pneumococcal vaccine and prophylactic penicillin therapy were ineffective in preventing recurrent episodes in two cases. Thin-section (2-mm) direct coronal computed cranial tomography demonstrated anatomic defects in all three patients. The use of metrizamide cisternography was not necessary to diagnose the defects. All patients had basiethmoidal encephaloceles which were repaired surgically. Direct coronal computed tomography offers a relatively easy noninvasive method for delineating anatomic abnormalities in patients with recurrent meningitis.
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Cummings, James. "Strong ultrapowers and long core models." Journal of Symbolic Logic 58, no. 1 (March 1993): 240–48. http://dx.doi.org/10.2307/2275336.
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In his paper [7] Steel asked whether there can exist a normal measure U on a cardinal κ such thatWe use Reverse Easton forcing to show that this is consistent from a P2κ hypermeasure; we also show that the result is sharp, using the core model for nonoverlapping coherent extender sequences.The proof uses forcing technology due to Woodin.In this section we collect some facts that are useful in the forcing constructions of the next section. None of them are due to us, and we are unsure to whom they should be attributed for the most part. We give sketchy proofs; the reader who wants to see more details is referred to [2].
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LIU, RONGXIANG, TINGQUAN LEI, and LIXIN GUO. "STRATIFICATION MECHANISM AND INTERFACE CHARACTERIZATION OF (TiN), (TiC)/NiCrBSi COMPOSITE COATINGS SYNTHESIZED BY LASER REMELTING." Surface Review and Letters 11, no. 03 (June 2004): 291–95. http://dx.doi.org/10.1142/s0218625x04006190.
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TiC / TiN -reinforced composite coatings were fabricated on the substrate of Ti – 6Al – 4V alloy using laser remelting. X-ray diffraction (XRD) was used to identify the phases in the laser-clad composite coating; the interface characterization of the dilution zone-clad zone (IDC) and the dilution zone-heat-affected zone (IDH) was observed with a scanning electron microscope (SEM). The results show that the microstructure of a cross-section has stratification characterization, and consists of the clad zone (CZ), the dilution zone (DZ), the diffusion layer (DL) and the heat-affected zone (HAZ). The layer-by-layer microstructure results from the boundary layer phenomenon of viscous melt-fluid and diffusion. The kind of reinforced particle has an effect on the interface morphology, microstructure and flow characterization of the melt-fluid. The phase constitution in the clad zone consists of ( Cr – Ni – Fe ), TiC , Ni 4 B 3, Ti 2 Ni , Cr 2 B and M 23 C 6 for TiC + NiCrBSi coating, and ( Cr – Ni – Fe ), TiN , NiB , Cr 2 Ti and Ti 2 Ni for TiN + NiCrBSi coating. The interfaces of the IDC in the NiCrBSi -clad layer is clear and clean; those of TiC + NiCrBSi and TiN + NiCrBSi are illegible. Ti – Ni phases with acicular microstructure link dilution zone and clad zone, and two kinds of phase with acicular microstructure, are similar in composition and shape.
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van Gelderen, Elly. "The Northumbrian Old English glosses." NOWELE / North-Western European Language Evolution 72, no. 2 (December 10, 2019): 119–33. http://dx.doi.org/10.1075/nowele.00024.gel.
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Abstract The articles in this volume contribute to our understanding of Northumbrian Old English of the 10th century, of the nature of external influence, and of the authorship of the glosses. This introduction provides a background to these three areas. Most of the introduction and contributions examine the Lindisfarne Glosses with some discussion of the Rushworth and Durham Glosses. Section 2 shows that the Lindisfarne glossator often adds a (first and second person) pronoun where the Latin has none but allows third person null subjects. Therefore, although the Latin original has obvious influence, Old English grammar comes through. Section 3 reviews the loss of third person -th verbal inflection in favor of -s, especially in Matthew. This reduction may be relevant to the role of external (Scandinavian and British Celtic) influence and is also interesting when the language of the Lindisfarne and Durham Glosses is compared. In Section 4, the use of overt pronouns, relatives, and demonstratives shows an early use of th-pronouns, casting doubt on a Norse origin of they. Section 5 looks at negation mainly from a northern versus southern perspective and Section 6 sums up. Section 7 previews the other contributions and their major themes, namely possible external (Latin, Norse, or British Celtic) influence, the linguistic differences among glossators, the spacing of ‘prefixes’ as evidence for grammaticalization, and the role of doublets.
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OKUDAIRA, RYUJI, and ANDREW HUXLEY. "A Burmese tract on kingship: political theory in the 1782 manuscript of Manugye." Bulletin of the School of Oriental and African Studies 64, no. 2 (June 2001): 248–59. http://dx.doi.org/10.1017/s0041977x01000143.
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In 1782, the year of King Badon's coronation, someone close to the Burmese palace wrote a legal manuscript. This paper gives a translation of and commentary on that section of the manuscript dealing with kingship. By tracing the sources of the material used, it contributes to the debate about the sources of Burmese political philosophy. Was precolonial Burmese political thought primarily Hindu, primarily Buddhist, primarily Indian or none of the above?
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S., Bebincy D., and Chitra J. "Extraperitoneal versus transperitoneal cesarean section in surgical morbidity in a tertiary care centre." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 8 (July 26, 2017): 3397. http://dx.doi.org/10.18203/2320-1770.ijrcog20173450.
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Background: To test the advantages of extraperitoneal cesarean section over transperitoneal cesarean section.Methods: It is a single blinded prospective study. Women who were planned for emergency LSCS in the department of OG, Kanyakumari Government Medical College, Asaripallam were randomly allocated into extraperitoneal cesarean section (ECS) (n=80) or transperitoneal cesarean section (TCS) (n=80) from November 2015 to January 2017 and evaluated.Results: Even though the time taken to deliver the baby was more in ECS group (Average 4:57 minutes) than TCS group (Average 2:05 minutes, there is no change in Apgar score at 1 minute. The postoperative pain measured by VAS was lesser (4.28) in ECS than TCS (7.06). Bowel function returned early in ECS (8.687 hours) than in TCS (16.487 hours) group. None of the cases in ECS group had peroperative vomiting or post-operative wound infection.Conclusions: So, we can conclude that ECS is a better method in experienced hands than the TCS in selected cases.
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Gouvea, Rodrigo A. dos S. "Physicalism without identity." Trans/Form/Ação 43, no. 2 (June 2020): 253–80. http://dx.doi.org/10.1590/0101-3173.2020.v43n2.14.p253.
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Abstract This paper presents and discusses the most influential attempts to characterize physicalism without postulating relations of identity between the physical and the prima facie non-physical. The first section deals with a possible criticism that these attempts are misguided, since they contradict the physicalist slogan “everything there is physical.” In the second section, I elucidate the different formulations of the physicalist supervenience claim, and argue that none of them consists in an adequate characterization of physicalism. Three reasons are given in favor of this conclusion: their compatibility with forms of dualism (or pluralism); the fact that the supervenience relation is left unexplained; and Kim’s causal exclusion argument, which asserts that merely supervenient entities (i.e., ones that are not in identity relations with strictly physical entities) must be epiphenomenal. The third section presents the general features of another identity-independent attempt to characterize physicalism, namely realization physicalism. According to this view, tokens of prima facie non-physical types are realized by tokens of strictly physical types performing functional roles that specify the nature of the former. The third section also shows how realization physicalism deals with the objections that make physicalist supervenience claims inadequate for characterizing physicalism.
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Acharya, S., DK Uprety, HP Pokharel, R. Amatya, and R. Rai. "Cesarean Section without Urethral Catheterization: A Randomized Control Trial." Kathmandu University Medical Journal 10, no. 2 (January 3, 2013): 18–22. http://dx.doi.org/10.3126/kumj.v10i2.7337.
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Background Urethral catheterization is done as a routine procedure in cesarean section. It is associated with high incidence of urinary tract infections, discomfort, delayed ambulation and longer hospital stay. Objective To determine the feasibility and safety of cesarean section without urethral catheterization. Methods A prospective, randomized controlled trial was carried out from April 2008 to March 2009, in the Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences. Among 150 patients who had undergone cesarean section 75 were catheterized and 75 were uncatheterized. Results First void discomfort was significantly associated with the use of indwelling catheter (OR 6.95, CI 95 %, 3.74 to 12.95; P< 0.001).Significant number of patients with indwelling catheter had signs and symptoms of urinary tract infection (OR 6,CI 95%, 2.59 to 13. 86; P < 0.001). Positive urinalysis for urinary tract infection was high in catheterized group (P <0.001). Hospital stay was shorter in patients without catheter (p < 0.05). None of the patients had bladder injury. There were no significant differences in duration of surgery and ambulation time between two groups of patients. Conclusions Cesarean section can be done safely without urethral catheterization with reduced morbidities. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 18-22 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7337
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Khlebnikova, O. A., and Ya E. Terekhina. "New objects in section of the eastern Black Sea basin from 3D seismic data." Moscow University Bulletin. Series 4. Geology, no. 3 (June 28, 2020): 138–43. http://dx.doi.org/10.33623/0579-9406-2020-3-138-143.
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In the section of the eastern Black Sea basin and the Caucasus continental slope, according to 3D seismic data, unique objects were first discovered and described — vertical failure in the Upper Cretaceous — Lower Miocene deposits. An interesting feature of these structures is a close to isometric shape in plan. About 40 objects have been identified on an area of more than 1000 m2. «Bulls-eye» («multiphase») paleo-pockmarks [Andresen, Huuse, 2011], as well as karst collapse [Zuo et al., 2009] are proposed as world analogues with a similar wave pattern on seismic data. The corresponding genesis models are considered, but none of the theories allows drawing a conclusion. The discovered objects are unique and require further investigation.
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Ajaz, Muhammad, Irfan Khan, and M. K. Suleymanov. "Production cross-section of heavy flavored hadrons in pp collision at s = 7 TeV." Modern Physics Letters A 34, no. 19 (June 20, 2019): 1950150. http://dx.doi.org/10.1142/s0217732319501505.
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The transverse momentum distribution of the differential production cross-sections of heavy flavored charm hadrons [Formula: see text], [Formula: see text] in pp collisions at 7 TeV are simulated. Predictions of DPMJETIII.17-1, HIJING1.383 and Sibyll2.3c are compared to the differential cross-section measurements of the LHCb experimental data presented in the region of [Formula: see text] and [Formula: see text], where the pp center of mass frame is used to measure the transverse momentum and rapidity. The models reproduce only some regions of [Formula: see text] and/or bins of [Formula: see text] but none of them predict completely all the [Formula: see text] bins over the entire [Formula: see text] range.
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Nasreen, Shaikh Zinnatara, Safinaz Shahreen, Saleheen Huq, and Sabereen Huq. "Prevention of Postoperative Adhesions of Caesarean Section." Journal of Bangladesh College of Physicians and Surgeons 35, no. 2 (July 29, 2017): 86–90. http://dx.doi.org/10.3329/jbcps.v35i2.33369.
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Adhesions means fibrous or scar tissue that results from the healing process. Up to 95% of patients who have surgery develop adhesions. Adhesions formation and its long term sequel is a well known complication of the surgery but unfortunately very little is investigated about the prevention. The long term morbidities such as chronic pelvic pain, secondary infertility, hospital readmission, bowel obstruction, difficult repeat C/S with increased bleeding, longer operative time, injury to bowel ,bladder, ureters and placental accreta spectrum disorder from adhesions are the main concern. The cost for these adhesions is extreme burden for the developing countries. Several preventive agents against postoperative adhesions have been investigated. The proper surgical technique remains the cornerstone for good outcomes and risks reduction. Careful tissue handling, keeping tissue moist, meticulous homeostasis, minimization of tissue ishcaemia and avoiding excessive tissue desiccation, the use of micro and a traumatic instruments are very important to prevent the adhesive disorders. Several chemical agents, mechanical barriers and hydrofloatation are being used which seems to be promising. But all of them have some limitations. All these Barriers are being used widely but need to be properly evaluated, before its routine use. FDA approved Barrier Seprafilm, Hydrofloation Adept are popular but also CoSeal, SurgiWrap and Plasmax( not FDA approved ) are getting much popularity. Oxidized regenerated cellulose is promising but for C/S is not properly evaluated. The chemical barriers like NSAID, Steroids, antifibrinolytic agents and anticoagulant are being used since ancient period but they are not proved to be superior to adhesive barriers. In the current state of knowledge, none can replace the good surgical technique. Therefore along with the training of appropriate surgical technique, preclinical or clinical studies are still necessary to evaluate the effectiveness of the several proposed prevention strategies and more researches are time demanding to prevent postoperative adhesions.J Bangladesh Coll Phys Surg 2017; 35(2): 86-90
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C., T. E. "CAESAREAN SECTION BY AN OX (1885)." Pediatrics 84, no. 1 (July 1, 1989): 82. http://dx.doi.org/10.1542/peds.84.1.82.
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In scanning medical journals of the nineteenth century I have come across a number of bizarre anecdotal clinical reports. None, however, has yet equaled the case cited below. The following case is probably unique in the medical literature. My memory is refreshed from notes taken by DR. MEANS, who saw the case with me in consultation. Mrs. P, age 34, the mother of seven children and near full term in her eighth pregnancy, on November 16th. was gored by an infuriated ox. The horn of the beast entered at the anterior superior spinous process of the ilium, and made a rent extending to the umbilicus, and involving both the abdominal parietes and the walls of the uterus. The child was extruded through the wound in half an hour after the occurrence of the accident. When I arrived on the scene, I found the child fully delivered but remaining attached to the cord, which I ligatured and severed. There being no dilatation of either the os uteri or the vagina, I delivered the placenta through the rent and applied a bandage. The patient was almost lifeless from hemorrhage and shock, and I placed her on morphine and whisky. On the following day she was still alive and DR. MEANS was called in consultation at 9:30 a.m. The small intestines escaped from the wound on removal of the bandage, and were returned with much difficulty. The wound was now closed with interrupted sutures, a carbolized compress was applied, and the morphine and whisky continued internally. At 5:00 p.m. of the same day I found the pulse 130 and respiration 25 per minute; the abdomen was greatly distended, and the vital powers were fast becoming exhausted. On the following morning I found on my visit that the woman had expired at 10:00 o'clock of the previous night. SHAKESPEARE speaks of MACBETH as having been torn from his mother's womb by a wild boar, but probably the statement must be charged to poetic license. I believe the case I have above reported to be the only authentic case of Caesarian section performed by a beast on record. It may be interesting to know that the child suffered little or nothing from the violent and unusual method of delivery, and is alive to-day, a vigorous and thriving boy.
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Govardhanam, V., P. Tandon, and V. huang. "A181 CAUSES FOR C-SECTION IN IBD PATIENTS: A RETROSPECTIVE REVIEW." Journal of the Canadian Association of Gastroenterology 4, Supplement_1 (March 1, 2021): 195–96. http://dx.doi.org/10.1093/jcag/gwab002.179.
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Abstract Background Inflammatory bowel disease (IBD) is a group of chronic inflammatory conditions including ulcerative colitis (UC), Crohn’s disease (CD) or IBD-unclassified. Current expert guidelines recommend only two IBD-related reasons to consider C-section: perianal CD and ileal pouch-anal anastomosis (IPAA) history. However, the incidence of C section among IBD patients is higher than the non-IBD patients. There is a sparsity of literature on what other factors influence the decision to perform caesarean delivery among IBD patients. Aims To investigate IBD-related and non-IBD related reasons leading to C-section in IBD patients. Methods A retrospective chart review was performed on women with IBD, >18 years of age and/or older, who delivered at Mount Sinai Hospital, Toronto 2016–2019. OB records and OR records were reviewed to obtain information specific to C-section. Results A total of 119 deliveries were reviewed. 47 out of the 119 had C-section delivery. 42.9% (N=21) of C-section was in UC patients and 57.1% (N=28) was in CD patients. Maternal request comprised 2.1% (N=1) and arrest of cervical dilation 6.4% (N=3). 20.4% (N=10) patients failed vaginal delivery. Only 8.7% of C-section deliveries were Primiparous. 42.9% (N=12) of patients from the CD category that underwent C-section had fistulizing CD. 46.4% (N=13) of patients with CD had stricturing CD and underwent C-Section. 63.8% (N=30) of the patients that had C-section had planned C-Section. 26.6% (N=8) of the planned C-section was due to a history of the perianal disease and only 13.3% (N=4) had an active perianal disease. Other causes for planned C-section included J-pouch (10%, N=3) and active UC (2.1%, N=1). As per expert recommendation, we would anticipate 14% of patients to have C-section due to IBD related reasons however we found that 30% of the patients had C-section due to IBD related reasons. Conclusions Based on the preliminary data from our retrospective study we find that 30% of the C-sections were due to IBD related reasons and 70% C-sections were from non-IBD related reasons. Funding Agencies None
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Wilson, Trevor C., Barry J. Conn, and Murray J. Henwood. "Molecular phylogeny and systematics of Prostanthera (Lamiaceae)." Australian Systematic Botany 25, no. 5 (2012): 341. http://dx.doi.org/10.1071/sb12006.
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Prostanthera is the largest genus of Lamiaceae in Australia and was last comprehensively revised in 1870. To test the classification, and the homology of the morphological characters on which it is based, we analysed nuclear (ETS) and chloroplast (trnT–F and ndhF–rpl32) sequence data for 71 species of Westringieae (Lamiaceae) in separate and combined datasets by using maximum-parsimony and Bayesian-inference methods. Results supported the monophyly of the Westringieae, but indicated that Prostanthera is paraphyletic with respect to Wrixonia, requiring the latter to be synonymised with the former. Although combinations of datasets provided some degree of infrageneric resolution within Prostanthera sensu lato, none of its sections or series could be recovered unambiguously. Prostanthera section Prostanthera and P. section Klanderia (regarded as entomophilous and ornithophilous, respectively) did not form a sister relationship, and neither could be unequivocally resolved as monophyletic. However, all species of P. section Klanderia nested within P. section Prostanthera raising the possibility that P. section Prostanthera is paraphyletic. Similarly, the phylogeny of Prostanthera based on molecular data could not be reconciled with the morphological definition of the traditionally recognised series. We recommend abandoning Bentham’s series as a means of organising morphological variation within the genus, but acknowledge that it is premature to discard Bentham’s sections. The evolutionary and systematic implications of the lack of congruence between our molecular phylogeny and morphologically defined subgeneric taxa are discussed.
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Trafimow, David. "A Frequentist Alternative to Significance Testing, p-Values, and Confidence Intervals." Econometrics 7, no. 2 (June 4, 2019): 26. http://dx.doi.org/10.3390/econometrics7020026.
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There has been much debate about null hypothesis significance testing, p-values without null hypothesis significance testing, and confidence intervals. The first major section of the present article addresses some of the main reasons these procedures are problematic. The conclusion is that none of them are satisfactory. However, there is a new procedure, termed the a priori procedure (APP), that validly aids researchers in obtaining sample statistics that have acceptable probabilities of being close to their corresponding population parameters. The second major section provides a description and review of APP advances. Not only does the APP avoid the problems that plague other inferential statistical procedures, but it is easy to perform too. Although the APP can be performed in conjunction with other procedures, the present recommendation is that it be used alone.
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Magrini, Sara, and Anna Scoppola. "Cytological status of Viola kitaibeliana (Section Melanium, Violaceae) in Europe." Phytotaxa 238, no. 3 (December 16, 2015): 288. http://dx.doi.org/10.11646/phytotaxa.238.3.9.
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Viola kitaibeliana Schultes in Roemer & Schultes (1819: 383) was described for “Pannonia” as a small pansy with “caule erecto simplicissimo, foliis grosse crenatis, inferioribus subrotundis glabris, superioribus obovatis, stipulis similibus subintegerrimis, basive subpinnatis, petalo cornuto calycem glabrum aequante, reliquis brevioribus. Arvensi proxima, hac praecocior multo, (Aprili florens!) tenerior, et notis indicatis satis distincta. Flores 2, vel unicus, raro tres, oblique erecti in pedunculis folia excedentibus.” (Typus: M0112803; Fig. 1). Thereafter, many other names have been assigned to similar pansies described outside the Pannonian region: e.g. V. tricolor Linneus (1753: 935) var. nana De Candolle (1824: 304) and V. nemausensis Jordan (1846: 18) in France, V. tricolor subsp. minima Gaudin (1828: 210) in Switzerland, V. tricolor var. trimestris De Candolle (1824: 304), V. tricolor var. henriquesii Willk. ex Coutinho (1892: 36) and V. tricolor var. machadeana Coutinho (1892: 36) in the Iberian Peninsula. None of these taxa have been reported in Flora Europaea by Valentine et al. (1968) and later they have been included in V. kitaibeliana or placed in synonymy with it in the main floras (e.g. Muñoz Garmendia et al. 1993). According to Valentine et al. (1968) and to the updates of Magrini & Scoppola (2015b), in Europe V. kitaibeliana is widespread from Southwest to East, extending to Ukraine (Fig. 2).