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Tkachenko, Anastasiia Yevhenivna, Liudmyla Olehivna Kyrychenko, and Tamara Anatoliivna Radyvylova. "Clustering Noisy Time Series." System technologies 3, no. 122 (October 10, 2019): 133–39. http://dx.doi.org/10.34185/1562-9945-3-122-2019-15.
Повний текст джерелаАнотація:
One of the urgent tasks of machine learning is the problem of clustering objects. Clustering time series is used as an independent research technique, as well as part of more complex data mining methods, such as rule detection, classification, anomaly detection, etc.A comparative analysis of clustering noisy time series is carried out. The clustering sample contained time series of various types, among which there were atypical objects. Clustering was performed by k-means and DBSCAN methods using various distance functions for time series.A numerical experiment was conducted to investigate the application of the k-means and DBSCAN methods to model time series with additive white noise. The sample on which clustering was carried out consisted of m time series of various types: harmonic realizations, parabolic realizations, and “bursts”.The work was carried out clustering noisy time series of various types.DBSCAN and k-means methods with different distance functions were used. The best results were shown by the DBSCAN method with the Euclidean metric and the CID function.Analysis of the results of the clustering of time series allows determining the key differences between the methods: if you can determine the number of clusters and you do not need to separate atypical time series, the k-means method shows fairly good results; if there is no information on the number of clusters and there is a problem of isolating non-typical rows, it is advisable to use the DBSCAN method.
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Oesterreich, Maciej. "On the method of identification of atypical observations in time series." Econometrics 24, no. 2 (2020): 1–16. http://dx.doi.org/10.15611/eada.2020.2.01.
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Shahid, SMA, MN Ali, M. Ahmed, SS Islam, and SB Hossain. "Diaphragmatic Hernia with Atypical Presentation - A Case Series." Journal of Bangladesh College of Physicians and Surgeons 32, no. 1 (November 30, 2014): 45–50. http://dx.doi.org/10.3329/jbcps.v32i1.21050.
Повний текст джерелаАнотація:
Congenital Diaphragmatic Hernia is one of the most challenging diagnosis faced by pediatric surgeons. From the time of its first anatomic description more than 300 years ago, CDH has carried a high mortality rate. We aimed to review patients who presented with hernia of diaphragm during the last six months. In this retrospective study, the medical records of three patients treated for diaphragmatic hernias who were admitted to Rajshahi Medical College Hospital between July 2012 and December 2012 were analyzed. Three patients with age of 45 days to 7 years were included in the study. Male to female ratio was 1:2. All patients had left-sided diaphragmatic hernia. Chest X-ray was obtained from all patients which was diagnostic. One patient needed thoracotomy incision. No patient required mesh repair. The mean hospitalization time was 14 days. There was no postoperative death. Diaphragmatic hernia is an uncommon and challenging situation for the surgeon. Prompt diagnosis and treatment prevent serious morbidity and mortality associated with complications such as gangrene and perforation of herniated organ. DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21050 J Bangladesh Coll Phys Surg 2014; 32: 45-50
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Rutkowski, Martin J., Ryan M. Alward, Rebecca Chen, Jeffrey Wagner, Arman Jahangiri, Derek G. Southwell, Sandeep Kunwar, Lewis Blevins, Han Lee, and Manish K. Aghi. "Atypical pituitary adenoma: a clinicopathologic case series." Journal of Neurosurgery 128, no. 4 (April 2018): 1058–65. http://dx.doi.org/10.3171/2016.12.jns162126.
Повний текст джерелаАнотація:
OBJECTIVEIn 2004, the WHO classified atypical pituitary adenoma as a distinct adenoma subtype. However, the clinical significance of this distinction remains undetermined. The authors sought to define patient characteristics, tumor features, and treatment outcomes associated with atypical pituitary adenoma.METHODSThe authors reviewed records of patients who underwent resection of pituitary adenoma at the University of California, San Francisco, between 2007 and 2014. Per institutional protocol, adenomas exhibiting mitotic activity underwent evaluation for all 3 markers of atypicality (mitotic index, extensive p53 staining, and MIB-1 index ≥ 3%). Statistical analyses were performed using χ2, Fisher’s exact test, t-test, log-rank, and logistic regression.RESULTSBetween 2007 and 2014, 701 patients underwent resection for pituitary adenoma. Among these patients, 122 adenomas exhibited mitotic activity and therefore were evaluated for all 3 markers of atypicality, with 36 tumors (5%) proving to be atypical. There were 21 female patients (58%) and 15 male patients (42%) in the atypical cohort, and 313 female patients (47%) and 352 male patients (53%) in the nonatypical cohort (p = 0.231). The mean age of patients in the atypical cohort was 37 years (range 10–65 years), which was significantly lower than the mean age of 49 years (range 10–93 years) for patients in the nonatypical cohort (p < 0.001). The most common presenting symptoms for patients with atypical adenomas were headaches (42%) and visual changes (33%). Atypical adenomas were more likely to be functional (78%) than nonatypical adenomas (42%; p < 0.001). Functional atypical adenomas were significantly larger than functional nonatypical adenomas (mean diameter 2.2 vs 1.4 cm; p = 0.009), as were nonfunctional atypical adenomas compared with nonfunctional nonatypical adenomas (mean diameter 3.3 vs 2.3 cm; p = 0.01). Among the entire adenoma cohort, larger presenting tumor size was associated with cavernous sinus invasion (p < 0.001), and subtotal resection was associated with cavernous sinus invasion (p < 0.001) and larger size (p < 0.001) on binomial multivariate regression. The median time until recurrence was 56 months for atypical adenomas, 129 months for functional nonatypical adenomas, and 204 months for nonfunctional nonatypical adenomas (p < 0.001). Functional atypical adenomas recurred more frequently and significantly earlier than functional nonatypical adenomas (p < 0.001). When accounting for extent of resection, cavernous sinus invasion, size, age, sex, and functional subtype, atypicality remained a significant predictor of earlier recurrence among functional adenomas (p = 0.002).CONCLUSIONSWhen compared with nonatypical pituitary adenomas, atypical adenomas are more likely to present in younger patients at a larger size, are more often hormonally hypersecretory, and are associated with earlier recurrence. These features lend credence to atypical pituitary adenomas being a distinct clinical entity in addition to a discrete pathological diagnosis.
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Bedard, Thomas, Mujtaba Mohammed, Serenella Serinelli, and Timothy A. Damron. "Atypical Enostoses—Series of Ten Cases and Literature Review." Medicina 56, no. 10 (October 13, 2020): 534. http://dx.doi.org/10.3390/medicina56100534.
Повний текст джерелаАнотація:
Bone islands (BI; enostoses) may be solitary or occur in the setting of osteopoikilosis (multiple bone islands) and are sometimes associated with Gardner’s Syndrome (osteopoikilosis and colonic polyposis). Characteristic features of bone islands are (1) absence of pain or local tenderness, (2) typical radio dense central appearance with peripheral radiating spicules (rose thorn), (3) Mean CT (computerized tomography) attenuation values above 885 Hounsfield units (HU) (4) absence of uptake on bone scan and (5) radiographic stability over time. However, when enostoses display atypical features of pain, unusual radiographic appearance, aberrant HU, increased radiotracer uptake, and/or enlargement, they can be difficult to differentiate from more sinister bony lesions such as osteoblastic metastasis, low grade central osteosarcoma, osteoid osteoma and osteoblastoma. In this retrospective case series, the demographic, clinical, radiographic, treatment and outcome for ten patients with eleven atypical bone islands (ABI) are presented, some showing associated pain (5), some with atypical radiographic appearance (3), some with increased activity on BS (4), some with documented enlargement over time (7), one with abnormal CT attenuation value, some in the setting of osteopoikilosis (2), one in the setting of Gardner’s Syndrome and one osteoid osteoma simulating a bone island. This series represents the spectrum of presentations of ABI. Comprehensive review of the literature reveals that the previous largest series of ABI showing enlargement as the atypical feature was in younger patients with jaw BI. Hence, this represents one of the largest series reported of ABI of all types in adults.
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Ghosh, Arindam, Subhankar Chakravorty, Somak Krishna Biswas, and Sumitra Kumar Biswas. "Series of rare diagnosis and presentations of abdominal mass in children: a great learning experience." International Journal of Contemporary Pediatrics 7, no. 5 (April 24, 2020): 1184. http://dx.doi.org/10.18203/2349-3291.ijcp20201658.
Повний текст джерелаАнотація:
Abdominal mass is a common finding in children, either palpable or radiologically evident surprisingly. Some of them are rare tumors. Functional active tumors are rarely palpable but present with varied arrays of symptoms. In this series authors are discussing few rare cases with atypical presentations such as- teratoma arising from adrenal gland, teratoma presenting with hypertension, fetus in fetu (Girl and Boy child), adrenocortical tumor presenting as precocious puberty and adrenal pheochromocytoma with features of cushing’s syndrome. These atypical presentations may have pose a challenge in diagnosis and management for the treating team with first time occurrence specifically if they are handling them for first time.
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Marucci, G., M. Faustini-Fustini, A. Righi, E. Pasquini, G. Frank, R. Agati, and M. P. Foschini. "Thyrotropin-secreting pituitary tumours: significance of “atypical adenomas” in a series of 10 patients and association with Hashimoto thyroiditis as a cause of delay in diagnosis." Journal of Clinical Pathology 62, no. 5 (December 19, 2008): 455–59. http://dx.doi.org/10.1136/jcp.2008.061523.
Повний текст джерелаАнотація:
Background:Thyrotropin-secreting adenomas (TSH-As) are rare and, according to the World Health Organization criteria (WHO 2004), a significant proportion of them present features of atypical adenomas at the time of diagnosis.Aims:To determine the frequency of “atypical adenomas” and the significance of this definition as regards follow-up. To investigate their possible association with Hashimoto thyroiditis, leading to a delay in diagnosis.Methods:Case notes for patients who underwent trans-sphenoidal surgery between 1992 and 2006 were retrieved. Follow-up ranged from 6 to 180 months.Results:Ten cases of TSH-As out of 908 pituitary adenomas were selected. Before surgery, eight patients had hyperthyroidism, one was euthyroid and another one showed hypothyroidism associated with Hashimoto thyroiditis. All cases were macroadenomas; six of them were invasive. Three cases met the criteria for classification as atypical. In none of the cases, including the three “atypical adenomas”, were clinical or radiological signs of recurrence observed.Conclusions:The three cases with features of atypical adenoma did not recur or metastasise, suggesting that, at least in the present series, a strict relationship between the morphological criteria for diagnosing atypical adenomas and biological behaviour may be sometimes lacking. Furthermore, the casual association of TSH-As with Hashimoto thyroiditis may led to an adjunctive delay in diagnosis, because of low thyroid hormone levels.
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Komotar, Ricardo J., J. Bryan Iorgulescu, Daniel M. S. Raper, Eric C. Holland, Kathryn Beal, Mark H. Bilsky, Cameron W. Brennan, et al. "The role of radiotherapy following gross-total resection of atypical meningiomas." Journal of Neurosurgery 117, no. 4 (October 2012): 679–86. http://dx.doi.org/10.3171/2012.7.jns112113.
Повний текст джерелаАнотація:
Object Atypical (WHO Grade II) meningiomas comprise a heterogeneous group of tumors, with histopathology delineated under the guidance of the WHO and a spectrum of clinical outcomes. The role of postoperative radiotherapy for patients with atypical meningiomas who have undergone gross-total resection (GTR) remains unclear. In this paper, the authors sought to clarify this role by reviewing their experience over the past 2 decades. Methods The authors retrospectively analyzed all patients at their institution who underwent GTR between 1992 and 2011 with a final histology demonstrating atypical meningioma. Information regarding patients, tumor characteristics, and postoperative adjuvant therapy was gleaned from medical records. Time to recurrence and overall survival were analyzed using univariate, multivariate, and Kaplan-Meier survival analyses. Results Forty-five patients who met the inclusion criteria underwent GTR for atypical meningiomas. By a median follow-up of 44.1 months, 22% of atypical meningiomas had recurred. There was no recurrence in 12 (92%) of 13 patients who received postoperative radiotherapy or in 19 (59%) of 32 patients who did not undergo postoperative radiotherapy (p = 0.085), demonstrating a strong trend toward improved local control with postoperative radiotherapy. No other factors were significantly associated with recurrence in univariate or multivariate analyses. Conclusions This retrospective series supports the observation that postoperative radiotherapy likely results in lower recurrence rates of gross totally resected atypical meningiomas. Although a multicenter prospective trial will ultimately be needed to fully define the role of radiotherapy in managing gross totally resected atypical meningiomas, the authors' results contribute to a growing number of series that support routine postoperative radiotherapy as an adjuvant treatment for these lesions.
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Bogdan, Yelena, and Juan de Dios Robinson. "Healing time and complications in operatively treated atypical femur fractures associated with bisphosphonate use: A multicentre series." Injury 46, no. 8 (August 2015): 1430. http://dx.doi.org/10.1016/j.injury.2015.06.011.
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Morokoff, Andrew P., Jacob Zauberman, and Peter M. Black. "SURGERY FOR CONVEXITY MENINGIOMAS." Neurosurgery 63, no. 3 (September 1, 2008): 427–34. http://dx.doi.org/10.1227/01.neu.0000310692.80289.28.
Повний текст джерелаАнотація:
ABSTRACT OBJECTIVE Meningiomas that occur over the convexity of the brain are the most common meningiomas, but little has been published about their contemporary management. We aimed to analyze a large series of convexity meningiomas with respect to surgical technique, complication rates, and pathological factors leading to recurrence. METHODS We retrospectively reviewed 163 cases of convexity meningiomas operated on in our institution by the senior author (PMB) between 1986 and 2005. The median follow-up time was 2.3 years (range, 1–13 yr). RESULTS Convexity tumors represented 22% of all meningiomas operated on. There was a female:male ratio of 2.7:1. Median age was 57 years (range, 20–89 yr). Image-guided surgery was used on all cases in the last 5 years. The 30-day mortality rate was 0%. The incidence of new neurological deficits was 1.7%, and the overall complication rate was 9.4%. The pathology of the tumors was benign in 144 (88.3%), atypical in 16 (9.8%), and anaplastic/malignant in 3 (1.8%). In six of the cases designated “benign,” there were borderline atypical features. The 5-year recurrence rate for benign meningiomas was 1.8%, atypical meningiomas 27.2%, and anaplastic meningiomas 50%. The two cases of benign tumor recurrences involved tumors with borderline atypia and high MIB-1 indices. The borderline atypical cases had a 5-year recurrence-free survival rate of only 55.9%, more closely approximating that of tumors designated “atypical.” CONCLUSION Convexity meningiomas can be safely removed using modern image-guided minimally invasive surgical techniques with a very low operative mortality. Benign convexity meningiomas having a Simpson Grade I complete excision have a very low recurrence rate. The recurrence rates of atypical and malignant tumors are significantly higher, and borderline atypical tumors should be considered to behave more like atypical rather than benign lesions. Longer-term follow-up data are needed to more accurately determine the recurrence rates of benign meningiomas.
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Cappellesso, Rocco, Filippo Nozzoli, Federica Zito Marino, Sara Simi, Francesca Castiglione, Vincenzo De Giorgi, Carlo Cota, et al. "NTRK Gene Fusion Detection in Atypical Spitz Tumors." International Journal of Molecular Sciences 22, no. 22 (November 15, 2021): 12332. http://dx.doi.org/10.3390/ijms222212332.
Повний текст джерелаАнотація:
Atypical Spitz tumors (AST) deviate from stereotypical Spitz nevi for one or more atypical features and are now regarded as an intermediate category of melanocytic tumors with uncertain malignant potential. Activating NTRK1/NTRK3 fusions elicit oncogenic events in Spitz lesions and are targetable with kinase inhibitors. However, their prevalence among ASTs and the optimal approach for their detection is yet to be determined. A series of 180 ASTs were screened with pan-TRK immunohistochemistry and the presence of NTRK fusions was confirmed using FISH, two different RNA-based NGS panels for solid tumors, and a specific real time RT-PCR panel. Overall, 26 ASTs showed pan-TRK immunostaining. NTRK1 fusions were detected in 15 of these cases showing cytoplasmic immunoreaction, whereas NTRK3 was detected in one case showing nuclear immunoreaction. Molecular tests resulted all positive in only two ASTs (included the NTRK3 translocated), RNA-based NGS and real time RT-PCR were both positive in three cases, and FISH and real time RT-PCR in another two cases. In seven ASTs NTRK1 fusions were detected only by FISH and in two cases only by real time RT-PCR. The frequency of NTRK fusions in ASTs is 9%, with a clear prevalence of NTRK1 compared to NTRK3 alterations. Pan-TRK immunohistochemistry is an excellent screening test. Confirmation of NTRK fusions may require the use of different molecular techniques.
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Carvalho, Marcela de Marillac, Luiz Otávio de Oliveira Pala, and Thelma Sáfadi. "Volatilidade de dados intradiários: comportamento multiescala do Ibovespa frente à pandemia COVID-19." Semina: Ciências Exatas e Tecnológicas 42, no. 1 Supl (April 29, 2021): 25. http://dx.doi.org/10.5433/1679-0375.2021v42n1suplp25.
Повний текст джерелаАнотація:
In financial markets, volatility modeling has been a strategy widely used because it reflects uncertainties about changes in asset prices. Incorporating peculiarities of financial series, this study estimated the volatility for the intraday index of the Brazilian stock market (Ibovespa) using ARIMA-APARCH models in different time frequencies with the aid of the wavelet MODWT decomposition technique. This work proposes an analysis of the impacts of the frequency components on the behavior of the volatility of intraday returns using the series of details wavelet in different time horizons, in an atypical period in the global financial markets, generated by the COVID-19 pandemic. The empirical results suggest low unconditional volatility and strong signs of persistence in all analyzed frequencies. The asymmetry in volatility is evidenced in the higher frequencies, the leverage effect being present only in the series of details with variations of 15-120 min., which is corroborated with the results obtained with the reconstructed series. The evidenced behaviors have an impact on the elaboration of short-term investment strategies and risk management, since the positive and negative shocks, such as those given by the world pandemic of COVID-19, have different impacts on the volatility of returns in shorter periods. The information obtained can contribute to the analysis of future atypical events in the Brazilian stock market, supporting the decision-making of economic agents.
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Fuehrer, Neil, Lynn Hartmann, Amy Degnim, Teresa Allers, Robert Vierkant, Marlene Frost, and Daniel Visscher. "Atypical Apocrine Adenosis of the Breast: Long-term Follow-up in 37 Patients." Archives of Pathology & Laboratory Medicine 136, no. 2 (February 1, 2012): 179–82. http://dx.doi.org/10.5858/arpa.2011-0225-oa.
Повний текст джерелаАнотація:
Context.—Atypical apocrine adenosis is a rare breast lesion in which the cellular population demonstrates cytologic alterations that may be confused with malignancy. The clinical significance and management of atypical apocrine adenosis are unclear because of the lack of long-term follow-up studies. Objective.—To determine the breast cancer risk in a retrospective series of patients with atypical apocrine adenosis diagnosed in otherwise benign, breast excisional biopsies. Design.—We identified 37 atypical apocrine adenosis cases in the Mayo Benign Breast Disease Cohort (9340 women) between 1967 and 1991 with a blinded pathology rereview. Breast cancer diagnoses subsequent to initial atypical apocrine adenosis biopsy were identified (average follow-up, 14 years). Results.—The mean age at diagnosis of atypical apocrine adenosis in the group was 59 years. Breast carcinoma subsequently developed in 3 women (8%) with atypical apocrine adenosis, diagnosed after follow-up intervals of 4, 12, and 18 years. The tumor from 1 of the 3 cases (33%) was ductal carcinoma in situ, contralateral to the original biopsy, and the other 2 cases (66%) were invasive carcinoma. Ages at the time of diagnosis of atypical apocrine adenosis were 55, 47, and 63 years for those that developed in situ or invasive carcinoma. Conclusions.—(1) Atypical apocrine adenosis was a rare lesion during the accrual era of our cohort (<1% of cases); (2) women found to have atypical apocrine adenosis were, on average, older than were other patients with benign breast disease, however, there does not seem to be an association with age and risk for developing carcinoma in patients diagnosed with atypical apocrine adenosis, as previously suggested; and (3) atypical apocrine adenosis does not appear to be an aggressive lesion and should not be regarded as a direct histologic precursor to breast carcinoma.
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Salib, Christian, Pallavi Khattar, Jinjun Cheng, and Julie Teruya-Feldstein. "Atypical Peripheral Blood Cell Morphology in COVID-19 (Sars-CoV-2) Patients from Mount Sinai Health System in New York City." Blood 136, Supplement 1 (November 5, 2020): 26–27. http://dx.doi.org/10.1182/blood-2020-142581.
Повний текст джерелаАнотація:
INTRODUCTION Coronavirus disease 2019 (COVID-19) is a respiratory disease caused by a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recent studies have suggested that COVID-19 positive patients present with leukopenia, lymphopenia, neutrophilia, thrombocytopenia, and higher neutrophil: lymphocyte ratio (NLR) and monocyte: lymphocyte ratio (MLR). More recently, we reported hypersegmented granulocytes and COVID-19 infection in Blood. 2020 Jun 11;135(24):2196. Neutrophil hypersegmentation has been closely associated with vitamin B12, folate and iron deficiencies, as well as methotrexate use, chemotherapy toxicity, uremia, heat stroke, myelodysplasia and Boucher-Neuhäuser Syndrome. Initially, these cytomorphologic changes may easily be overlooked or dismissed as non-specific reactive changes. In this study, we expand our initial observation on our index case to a larger case series. To the best of our knowledge, this is the largest case series to describe the concurrent lymphocyte and unique granulocyte atypia associated with SARS-CoV-2 infection. METHODS Study Design 2,199 patients were hospitalized in the Mount Sinai Health System from Feb 27 to April 2, 2020 with confirmed COVID-19 positivity. Data obtained for this study was covered under an Institutional Review Board (IRB) waiver, HS#:12-00133 GCO#1:12-036(0001-08) Inclusion criteria 50 peripheral blood smears flagged for Pathologist review from March 13 - April 20, 2020 at Mount Sinai Hospital Clinical Hematology Laboratory were included in this study. All suspected COVID-19 cases were confirmed using real-time polymerase chain reaction (RT-PCR) assay to test nasal and pharyngeal swab specimens, per WHO guidelines. Of the 50 COVID-19 positive peripheral blood smears, 39 slides were scanned and imaged with Scopio Labs X100 Full Field Digital Microscope. The X100 provided high resolution oil-immersion level images of large scanned areas. https://scopiolabs.com/hematology/ 19 peripheral blood smears were blindly and independently reviewed by 4 Hematopathologists (CS, PK, JC, JTF), with particular emphasis on granulocyte cytomorphology and percent of hypersegmented neutrophils present (defined as neutrophils with 5 or more nuclear lobes in at least 3% of cells or presence of 6 or more lobes). Atypical lymphocyte morphology was also evaluated and categorized as Downey type I, II, III or plasmacytoid, while monocyte morphology was assessed for unusual nuclear folds and features. Evaluation of platelets and other abnormalities were noted. The presence and degree of significant cytologic atypia was recorded and compared to 20 COVID-19 negative blood smears. RESULTS 16 of the 19 (84%) COVID-19 positive cases showed hypersegmented neutrophils, and all 19 harbored atypical lymphocytes and monocyte morphology, with giant platelets. In contrast, 5 of the 20 (25%) COVID-19 negative cases showed hypersegmented neutrophils, with 2 patients displaying atypical monocytes; none showed atypical lymphocytes or giant platelets (p = 0.022). Concurrent laboratory values showed no evidence of vitamin B12 or folate deficiency. Representative images are summarized in Figure 1 (A-C, 5-6 lobed neutrophils; D-E atypical plasmacytoid lymphocytes, G-I atypical monocytes, J-L giant platelets). CONCLUSION We report atypical hypersegmented neutrophils with toxic cytoplasmic change, atypical monocytes, plasmacytoid lymphocytes, and giant platelets in peripheral blood smears of COVID-19 patients which are significantly higher than in control COVID-19 negative patients. Figure 1 Disclosures Teruya-Feldstein: Edge Anthem: Consultancy.
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Aggarwal, Srishti, Monika Jindal, and Santosh Minhas. "Case series on uterine rupture depicting the atypical presentations in the labour room." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 12 (November 25, 2021): 4549. http://dx.doi.org/10.18203/2320-1770.ijrcog20214658.
Повний текст джерелаАнотація:
Uterine rupture is the complete division of all the three layers of uterus. Most uterine ruptures occur during labor in pregnant women, most commonly seen in previously scarred myometrium. Consequences of uterine rupture depend on the time between diagnosis of uterine rupture and intervention, and can be as grave as fetal and maternal death. Vigilance and avid action by the obstetrician can lead to better outcomes. Case 1 represented a 28-year-old moderately anemic G4P2L2A1 having previous 2 LSCS at POG 39 weeks 1 day presented in COVID emergency in active labour and was found to have a uterine scar rupture (5 cm rent) extending towards bladder wall with shoulder presenting on rent. A live female baby with thick meconium staining was delivered and uterine repair along with bilateral tubectomy was performed. Case 2 represented a 21-year-old primigravida with breech presentation at a gestation of 34 weeks 6 days with preterm labour pains who had been referred to our centre. Decision for LSCS was taken and on entering the abdomen rupture uterus with an inverted T-shaped rent in the upper segment extending up to the fundus was seen. A stillborn male fetus was delivered through the rent, followed by successful uterine repair. In spite of massive blood loss, the mother had survived. Case 3 represented a 30-year-old grand multipara at a gestation of 38 weeks 3 days with ultrasound documented fetal demise with fetal hydrocephalus and holoprosencephaly with labour pains was taken up for laparotomy due to suspicion of uterine rupture based on examination findings. Intra-operatively, baby was found lying in the peritoneal cavity with an unsalvageable uterus with a rupture in lower uterine segment and left lateral wall extending upto round ligament above and cervix below. A stillborn male fetus was delivered and peripartum subtotal hysterectomy with left salpingoophorectomy and right salpingectomy was done with a good maternal outcome. The above series suggest that the signs and symptoms of uterine rupture are usually variable and nonspecific, hence posing a challenge for the diagnosis. Early diagnosis and timely intervention by the obstetrician, can help us to improve the fetal and maternal outcome drastically.
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Palma, Lucio, Paolo Celli, Carmine Franco, Luigi Cervoni, and Giampaolo Cantore. "Long-term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases." Neurosurgical Focus 2, no. 4 (April 1997): E5. http://dx.doi.org/10.3171/foc.1997.2.4.6.
Повний текст джерелаАнотація:
To contribute to a better understanding of the prognostic differences between atypical and malignant meningiomas as defined by the World Health Organization (WHO) and the influence of the grade of initial surgical excision on postoperative course, 42 cases of atypical and 29 of malignant meningioma were studied, along with long-term follow up. The two groups were compared with respect to long-term survival, recurrence-free survival, and median time to recurrence. The prognostic significance of the Simpson grade of surgical resection and tumor location was also considered. Survival at 5 and 10 years was recorded in 95% and 79%, respectively, of patients with atypical meningioma and in 64.3% and 34.5% of patients with malignant meningioma (p = 0.001). Recurrence-free survival and median time to recurrence were also significantly longer in patients with atypical than in those with malignant meningiomas: 11.9 versus 2 years (p = 0.001) and 5 versus 2 years (p < 0.0041), respectively. Six (26%) of the 23 recurring atypical meningiomas became malignant. Simpson Grade I resection and location in the cerebral convexity, which were closely related, were found to be associated with a significantly better clinical course in the entire series (p ¾ 0.0016). Patients with atypical meningiomas fared better than those with malignant meningiomas after incomplete surgical excision (Simpson Grades II-III), but the difference was not statistically significant. Multivariate analysis using the Cox model indicated that radical extirpation (Simpson Grade I vs. II-III) and histological findings (atypical meningioma vs. malignant meningioma) were significantly related to prolonged survival (p < 0.0003 and p < 0.0388, respectively). In conclusion, the current study shows that for most patients with atypical meningioma the prognosis was less severe than for those with malignant meningioma, but the risk of a downhill course resulting from malignancy after incomplete resection and recurrence was not negligible (26%). In addition, the WHO classification was found to be inadequate for a minority of the atypical meningioma cases, which currently have the same unfavorable course as cases of malignant meningioma. The results also indicate that objective Simpson Grade I extirpation of convexity meningiomas can be successful despite histological findings of malignancy.
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Palma, Lucio, Paolo Celli, Carmine Franco, Luigi Cervoni, and Giampaolo Cantore. "Long-term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases." Journal of Neurosurgery 86, no. 5 (May 1997): 793–800. http://dx.doi.org/10.3171/jns.1997.86.5.0793.
Повний текст джерелаАнотація:
✓ To contribute to a better understanding of the prognostic differences between atypical and malignant meningiomas as defined by the World Health Organization (WHO) and the influence of the grade of initial surgical excision on postoperative course, 42 cases of atypical and 29 of malignant meningioma were studied, along with long-term follow up. The two groups were compared with respect to long-term survival, recurrence-free survival, and median time to recurrence. The prognostic significance of the Simpson grade of surgical resection and tumor location was also considered. Survival at 5 and 10 years was recorded in 95% and 79%, respectively, of patients with atypical meningioma and in 64.3% and 34.5% of patients with malignant meningioma (p = 0.001). Recurrence-free survival and median time to recurrence were also significantly longer in patients with atypical than in those with malignant meningiomas: 11.9 versus 2 years (p = 0.001) and 5 versus 2 years (p < 0.0041), respectively. Six (26%) of the 23 recurring atypical meningiomas became malignant. Simpson Grade I resection and location in the cerebral convexity, which were closely related, were found to be associated with a significantly better clinical course in the entire series (p ≤ 0.0016). Patients with atypical meningiomas fared better than those with malignant meningiomas after incomplete surgical excision (Simpson Grades II–III), but the difference was not statistically significant. Multivariate analysis using the Cox model indicated that radical extirpation (Simpson Grade I vs. II–III) and histological findings (atypical meningioma vs. malignant meningioma) were significantly related to prolonged survival (p < 0.0003 and p < 0.0388, respectively). In conclusion, the current study shows that for most patients with atypical meningioma the prognosis was less severe than for those with malignant meningioma, but the risk of a downhill course resulting from malignancy after incomplete resection and recurrence was not negligible (26%). In addition, the WHO classification was found to be inadequate for a minority of the atypical meningioma cases, which currently have the same unfavorable course as cases of malignant meningioma. The results also indicate that objective Simpson Grade I extirpation of convexity meningiomas can be successful despite histological findings of malignancy.
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Martin, David E., and Ralph H. Raasch. "Rifabutin: A New Rifamycin for the Prevention of Atypical Mycobacterial Infection." Journal of Pharmacy Technology 10, no. 5 (September 1994): 197–203. http://dx.doi.org/10.1177/875512259401000503.
Повний текст джерелаАнотація:
Objective: To discuss the chemistry, mechanism of action, in vitro activity, pharmacology, clinical efficacy, and toxicity of rifabutin, a new rifamycin, in the prevention and treatment of disseminated mycobacterial infection in patients with AIDS. Data Sources: The English-language literature was searched from 1980 through October 1993 using MEDLINE, International Pharmaceutical Abstracts (IPA), Index Medicus, and bibliographic reviews of relevant textbooks and review articles. Study Selection: One published report of two identical randomized, prospective, double-blind trials of rifabutin to prevent disseminated mycobacteremia is available. Other literature reviewed included a clinical case series of patients treated with rifabutin for documented or presumed mycobacterial infection. Data Extraction: Clinical trial and case series were evaluated for study design, efficacy, and toxicity. Data Synthesis: In two trials, rifabutin has been shown to prolong the onset of mycobacteremia (caused by Mycobacterium avium-intracellulare or M. avium complex) in adult AIDS patients with CD4-lymphocyte counts <200 cells/mm3. The prolongation of time to bacteremia is significant compared with placebo as the CD4 count declines. However, overall survival is not prolonged by rifabutin prophylaxis in these patients. No blind, randomized studies are available evaluating the efficacy of rifabutin in treating documented mycobacteremia in AIDS patients, or in treating pulmonary infections caused by Mycobacterium tuberculosis. Conclusions: Rifabutin should be added to the prophylactic regimens of HIV-positive patients with CD4 counts <100 cells/mm3. Prophylactic treatment prolongs the period of time before dissemination of mycobacterial infection occurs (bacteremia), with associated delays in onset of fever and fatigue, decline in performance score, and hospitalization. Rifabutin is usually well tolerated in patients given 300 mg/d. Rifabutin is a weaker enzyme inducer than rifampin, but drug interactions with rifabutin should be monitored under circumstances of concomitant therapy with anticoagulants or anticonvulsants.
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Chen, Longwen, Christine N. Booth, Julie A. Shorie, Jennifer A. Brainard, and Matthew A. Zarka. "Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations." CytoJournal 11 (November 14, 2014): 29. http://dx.doi.org/10.4103/1742-6413.144686.
Повний текст джерелаАнотація:
The 2001 Bethesda system recommends further classifying atypical glandular cells (AGCs) as either endocervical or endometrial origin. Numerous studies have investigated the clinical significance of AGC. In this study, we investigated the incidence of clinically significant lesions among women with liquid-based Papanicolaou cervicovaginal (Pap) interpretations of atypical endometrial cells (AEMs) or AGC favor endometrial origin (AGC-EM). More importantly, we correlated patients of AEM or AGC-EM with their clinical presentations to determine if AEM/AGC-EM combined with abnormal vaginal bleeding is associated with a higher incidence of significant endometrial pathology. All liquid-based Pap tests with an interpretation of AEM and AGC-EM from July, 2004 through June, 2009 were retrieved from the database. Women with an interpretation of atypical endocervical cells, AGC, favor endocervical origin or AGC, favor neoplastic were not included in the study. The most severe subsequent histologic diagnoses were recorded for each patient. During this 5-year period, we accessioned 332,470 Pap tests of which 169 (0.05%) were interpreted as either AEM or AGC-EM. Of the 169 patients, 133 had histologic follow-up within the health care system. The patients ranged in age from 21 to 71 years old (mean 49.7). On follow-up histology, 27 (20.3%) had neoplastic/preneoplastic uterine lesions. Among them, 20 patients were diagnosed with adenocarcinoma (18 endometrial, 1 endocervical, and 1 metastatic colorectal), 3 with atypical endometrial hyperplasia, and 4 with endometrial hyperplasia without atypia. All patients with significant endometrial pathology, except one, were over 40 years old, and 22 of 25 patients reported abnormal vaginal bleeding at the time of endometrial biopsy or curettage. This study represents a large series of women with liquid-based Pap test interpretations of AEM and AGC-EM with clinical follow-up. Significant preneoplastic or neoplastic endometrial lesions were identified in 20.3% of patients. Patients with Pap test interpretations of AEM or AGC-EM and the clinical presentation of abnormal vaginal bleeding should be followed closely.
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ALVARENGA, Lucas Rocha, Natascha Silva SANDY, Gabriela Souza GOMEZ, Gabriel HESSEL, Adriana Maria Alves DE TOMMASO, and Maria Ângela BELLOMO-BRANDÃO. "SYMPTOMATIC CHOLELITHIASIS AS THE PRESENTATION OF PEDIATRIC PRIMARY SCLEROSING CHOLANGITIS - CASE SERIES AND LITERATURE REVIEW." Arquivos de Gastroenterologia 58, no. 2 (June 2021): 227–33. http://dx.doi.org/10.1590/s0004-2803.202100000-41.
Повний текст джерелаАнотація:
ABSTRACT BACKGROUND: Primary sclerosing cholangitis (PSC) is a rare hepatobiliary disorder, whose etiology remains not fully elucidated. Given how rare PSC is in childhood, until the recent publication of a multicenter international collaboration, even data on its characteristics and natural history were scarce. Symptomatic cholelithiasis has not been previously reported as the presentation of PSC. OBJECTIVE: The aim of this study was the diagnosis of PSC following the initial unusual presentation with symptomatic cholelithiasis, that followed an atypical clinical course that could not be explained by cholelithiasis alone. A literature review was also conducted. METHODS: We conducted a retrospective chart review of three patients, who were diagnosed and/or followed at the Clinics Hospital, University of Campinas - Sao Paulo/ Brazil, between 2014 and 2020. Data analyzed included gender, age of presentation, past medical history, imaging findings, laboratory results, endoscopic evaluation, response to medical therapy and follow-up. RESULTS: Age at time of presentation with cholelithiasis varied from 10 to 12 years. In two of the cases reported, a more subacute onset of symptoms preceded the episode of cholelithiasis. Two patients were managed with cholecystectomy, not followed by any surgical complications, one patient was managed conservatively. Percutaneous liver biopsy was performed in all three cases, showing histological findings compatible with PSC. Associated inflammatory bowel disease (IBD) was not seen in any of the patients. The patients have been followed for a mean time of 3.4 years. CONCLUSION: PSC and cholelithiasis are both rare in the pediatric population. This study reports on symptomatic cholelithiasis as a presentation of PSC and raises the importance of suspecting an underlying hepatobiliary disorder in children with cholelithiasis without any known predisposing factors and/or that follow an atypical clinical course for cholelithiasis alone.
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Shetty, Shishir, and Shrihari Guddadararangiah. "Case Report: unilateral condylar hyperplasia." F1000Research 10 (January 25, 2021): 46. http://dx.doi.org/10.12688/f1000research.48499.1.
Повний текст джерелаАнотація:
Case: This report describes a clinical case of unilateral condylar hyperplasia (CH) with unique, atypical morphology. An important feature of this report is the documentation of a series of clinical photographs of the patient, showing a gradual increase in facial asymmetry associated with the CH. The main symptom reported in this case was facial asymmetry. The main intraoral clinical features observed in the patient were contralateral crossbite and ipsilateral open bite associated with CH. Surgical reshaping of the condyle was the treatment plan for this case. Conclusions: The main take away point from this case is the importance of obtaining previous photographs of the patient at different ages during case diagnosis, which helps the clinician to determine the approximate time of commencement of CH. This case also highlights the imaging features of rarely observed atypical shape of the hyperplastic condyle.
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Mahran, Ayman, Mohamed Allam, Hiba Ahmed, Alaa Ghazally, and Asmaa M Ahmed. "Generalized Granuloma Annulare Can Be Presented With Different Clinical Morphologies In The Same Patient: A Case Report." Dermatology and Dermatitis 4, no. 2 (October 30, 2019): 01–04. http://dx.doi.org/10.31579/2578-8949/090.
Повний текст джерелаАнотація:
The term granuloma annulare (GA) appropriately describes the classic type characterized by ringed erythematous plaques with histological palisaded granulomatous inflammation. However, GA now includes a range of disease. Over time, more atypical, rare types have been reported in isolated case reports or small case series. Here, we describe a unique case of generalized GA presented by two morphologically different lesions in a 52 years old diabetic man. To the best of our knowledge, this association has never been reported in the literature.
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Li, Daphne, Daniel M. Heiferman, Hasan R. Syed, João Gustavo Santos, Robin M. Bowman, Arthur J. DiPatri, Tadanori Tomita, Nitin R. Wadhwani, and Tord D. Alden. "Pediatric primary spinal atypical teratoid rhabdoid tumor: a case series and review of the literature." Journal of Neurosurgery: Pediatrics 24, no. 3 (September 2019): 267–83. http://dx.doi.org/10.3171/2019.4.peds19113.
Повний текст джерелаАнотація:
Atypical teratoid rhabdoid tumors (ATRTs) are rare malignant central nervous system tumors, commonly occurring before 3 years of age. Median overall survival (OS) of patients with these tumors is about 1 year, despite aggressive multimodal therapy. Pediatric primary spinal ATRTs are even more rare, with fewer than 50 cases reported. The authors present a series of four patients who were treated at Ann and Robert H. Lurie Children’s Hospital of Chicago in the period from 1996 to 2017.These patients, with ages 2–11 years, presented with pain and a decline in motor functions. They were found to have lesions in the lumbar, thoracic, and/or cervical spine. One patient’s tumor was intramedullary with exophytic components, while another patient’s tumor had both intra- and extradural components. All patients underwent resection followed by chemotherapy (systemic and intrathecal). Two patients had fractionated radiation therapy and one had an autologous stem cell transplant. Three patients are known to be deceased (OS 8.5–45 months). The fourth patient was in remission 19 years after her initial diagnosis. To the authors’ knowledge, this is the largest series of pediatric primary spinal ATRTs documented at a single institution. These cases illustrate a variety of presentations of spinal ATRT and add to the body of literature on this aggressive pathology.A systematic MEDLINE search was also conducted using the keywords “atypical teratoid rhabdoid tumor,” “pediatric spinal rhabdoid tumor,” and “malignant rhabdoid tumor spine.” Reports were included for patients younger than 21 years, without evidence of intracranial or systemic disease at the time of diagnosis. Clinical characteristics and outcomes of the four institutional cases were compared to those in the literature. This review yielded an additional 48 cases of primary pediatric spinal ATRTs reported in the English-language literature. Patients (ages 2 months to 19 years) presented with symptoms of pain, regression of motor function, and spinal cord compression. The majority of tumors were intradural (14 extramedullary, 8 intramedullary, 1 both). Eleven cases in the literature described tumors limited to extradural structures, while 10 tumors involved the intra- and extradural spine. Four reports did not specify tumor location. Although rare, spinal ATRT should be considered in the differential diagnosis of pediatric patients presenting with a new spinal mass.
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VEITCH, D., A. GORST-RASMUSSEN, and A. GEFFERTH. "WHY FARIMA MODELS ARE BRITTLE." Fractals 21, no. 02 (June 2013): 1350012. http://dx.doi.org/10.1142/s0218348x13500126.
Повний текст джерелаАнотація:
The FARIMA models, which have long-range-dependence (LRD), are widely used in many areas. Through the derivation of a precise characterization of the spectrum and variance time function, we show that this family is very atypical among LRD processes, being extremely close to the fractional Gaussian noise in a precise sense which results in ultra-fast convergence to fGn under rescaling. Furthermore, we show that this closeness property is not robust to additive noise. We argue that the use of FARIMA, and more generally fractionally differenced time series, should be reassessed in some contexts, in particular when convergence rate under rescaling is important and noise is expected.
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Lynrah, Zareen A., and Gopika Kalsotra. "Invasive Sino-aspergillosis in Immunocompetent Individuals: Atypical Presentations." An International Journal Clinical Rhinology 2, no. 3 (2009): 27–32. http://dx.doi.org/10.5005/jp-journals-10013-1006.
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ABSTRACT Aims To describe the demographic, clinical and radiological findings of invasive aspergillosis of the orbit and paranasal sinuses in immunocompetent individuals that presented without any nasal symptoms and to review the role of voriconazole in such cases. Materials and methods A series of 13 cases is being reported with review of literature. All these cases except one underwent complete surgical debridement of the disease at the time of biopsy. On histopathological confirmation of invasive aspergillosis, the cases with sphenoid sinus involvement were given 2.5 gm of intravenous Amphotericin B (1 mg/kg/day) followed by oral itraconazole in a dose of 10 mg/kg/day for 6 months. The cases where there were lesser chances of intracranial involvement or the cases that refused for intravenous Amphotericin B were started on voriconazole 200 mg twice a day for six to twelve months. All these cases were followed up with the help of radiology, clinical improvement in symptoms and signs and fungal serology. Results We found isolated sphenoid sinus involvement in 10 (76.92%) cases, isolated maxillary sinus involvement 2 (15.38%) cases and isolated orbital involvement 1 (7.69%). Our protocol was successful in 11 (84.61%) cases, one patient was lost to follow-up while one died due to intracranial complications during the third week of therapy. Conclusion This study showcased the atypical presentations of invasive aspergillosis in immunocompetent individuals and the high degree of suspicion required to diagnose this entity. An aggressive, effective and optimal management protocol has been suggested and the role of voriconazole has been highlighted.
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Ware, Marcus L., David A. Larson, Penny K. Sneed, William W. Wara, and Michael W. McDermott. "Surgical Resection and Permanent Brachytherapy for Recurrent Atypical and Malignant Meningioma." Neurosurgery 54, no. 1 (January 1, 2004): 55–64. http://dx.doi.org/10.1227/01.neu.0000097199.26412.2a.
Повний текст джерелаАнотація:
Abstract OBJECTIVE Recurrent atypical and malignant meningiomas are difficult to treat successfully. Chemotherapy to date has been unsuccessful, and radiosurgery is limited to smaller tumors. Reoperation alone provides limited tumor control and limited prolonged survival. The addition of brachytherapy at the time of operation is an option. Here, we report the results of our series of patients with recurrent malignant meningioma treated with resection and brachytherapy with permanent low-dose 125I. METHODS The charts of patients in our database with recurrent atypical and malignant meningiomas treated by surgical resection and permanent 125I brachytherapy at the University of California, San Francisco, between 1988 and 2002 were selected for this study. Calculations of disease-free survival and overall survival curves were made by the Kaplan-Meier actuarial method. Univariate analysis between Kaplan-Meier curves was based on the log-rank statistic, with a significance level set at a value of P ≤ 0.05. RESULTS Seventeen patients had recurrent malignant meningioma, and four had recurrent atypical meningioma. The median number of sources implanted after surgical resection was 30 (range, 4–112 sources), with a median total activity of 20 mCi (range, 3.3–85.9 mCi). The median time to progression after brachytherapy was 11.6 months for patients with malignant meningioma and 10.4 months for the combined group. There was a trend toward longer disease-free survival time in patients after gross total resection versus subtotal resection and in patients with tumors located at the convexity and parasagittally versus at the cranial base. These differences did not reach statistical significance. The median overall survival after diagnosis was 9.4 years for patients with atypical meningioma, 6.6 years for those with malignant meningioma, and 8.0 years for all patients combined. Survival from the time of resection and implantation of 125I was 1.6 years for patients with atypical meningioma, 2.4 years for patients with malignant meningioma, and 2.4 years for the combined group. Thirty-three percent of patients had complications requiring surgical intervention. Radiation necrosis occurred in 27% of patients; 13% underwent surgery for radiation necrosis. In addition, 27% had a wound breakdown and required surgical intervention. CONCLUSION The options for patients with recurrent atypical or malignant meningiomas are limited. Our results suggest that for tumors not suitable for radiosurgery, resection followed by permanent brachytherapy should be considered as a potential salvage treatment. However, this approach results in a relatively high complication rate in these heavily treated patients and requires meticulous surgical technique and medical therapies to assist with wound healing after surgery.
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du Fossé, Nadia A., E. Margo Lutke Holzik, and Cor H. de Kroon. "Three atypical presentations of choriocarcinoma, occurring during and shortly after a coexistent viable pregnancy." BMJ Case Reports 14, no. 6 (June 2021): e242381. http://dx.doi.org/10.1136/bcr-2021-242381.
Повний текст джерелаАнотація:
Gestational choriocarcinoma is a malignant tumour originating from the trophoblastic tissue that can arise during or after any type of pregnancy, but most of the time follows a molar pregnancy. Characteristic for this tumour is its rapid haematogenous spread to various organs, causing atypical presentations often attributable to metastatic disease. We review three cases that occurred during and shortly after a coexistent intrauterine pregnancy. The patient of Case 1 presented with neurological symptoms due to hypercalcaemia, in Case 2 there was initially suspicion of appendicitis and the third patient presented with acute respiratory insufficiency. This case series illustrates that, although highly effective chemotherapy is available, choriocarcinoma can be life-threatening and accurate diagnosis is challenging but critical.
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Brady, Miranda J., and Melodie Cardin. "Your Typical Atypical Family: Streaming Apolitical Autism on Netflix." TOPIA: Canadian Journal of Cultural Studies 42 (May 2021): 96–116. http://dx.doi.org/10.3138/topia-42-008.
Повний текст джерелаАнотація:
Using Critical Disability Studies and Critical Autism Studies lenses, this article examines the first season of the Netflix series Atypical, a comedy/drama coming of age story centred on an autistic teenager and his family. Atypical promotes heightened visibility for autistic people in popular culture. However, in its first season, its construction of autism reveals a broader cultural valuation of particular forms of disability that can be managed and reformed, reflecting a medical model. It also does not engage the intense invisibility and bias against non-speaking autistic people, which in turn bolsters ideals of normality ( Mitchell & Snyder 2000 ; Darke 1998 ). Notably, the show’s main character is played by an actor who is not autistic and who can control and manage his autistic characteristics, and its first season only included one small part for an autistic actor, a part that was created retroactively to fit with the show; this made it exemplary of a retrofit ( Dolmage 2017 ). At the same time, normality is reproduced through the deployment of conventional and gendered family roles to illustrate how autism should be managed primarily by women. Ultimately, through the processes of playing autistic, retrofitting, moralizing conformity, and reproducing conventional family roles, the show’s first season promoted a very palatable and normalized form of autism. However, reception of the first season and the backlash it received led to changes in the second and third seasons, providing an excellent example of how autistic advocacy can shape popular culture.
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Xu, Chengcheng, Zhibin Li, and Wei Wang. "SHORT-TERM TRAFFIC FLOW PREDICTION USING A METHODOLOGY BASED ON AUTOREGRESSIVE INTEGRATED MOVING AVERAGE AND GENETIC PROGRAMMING." TRANSPORT 31, no. 3 (September 21, 2016): 343–58. http://dx.doi.org/10.3846/16484142.2016.1212734.
Повний текст джерелаАнотація:
The accurate short-term traffic flow forecasting is fundamental to both theoretical and empirical aspects of intelligent transportation systems deployment. This study aimed to develop a simple and effective hybrid model for forecasting traffic volume that combines the AutoRegressive Integrated Moving Average (ARIMA) and the Genetic Programming (GP) models. By combining different models, different aspects of the underlying patterns of traffic flow could be captured. The ARIMA model was used to model the linear component of the traffic flow time series. Then the GP model was applied to capture the nonlinear component by modelling the residuals from the ARIMA model. The hybrid models were fitted for four different time-aggregations: 5, 10, 15, and 20 min. The validations of the proposed hybrid methodology were performed by using traffic data under both typical and atypical conditions from multiple locations on the I-880N freeway in the United States. The results indicated that the hybrid models had better predictive performance than utilizing only ARIMA model for different aggregation time intervals under typical conditions. The Mean Relative Error (MRE) of the hybrid models was found to be from 4.1 to 6.9% for different aggregation time intervals under typical conditions. The predictive performance of the hybrid method was improved with an increase in the aggregation time interval. In addition, the validation results showed that the predictive performance of the hybrid model was also better than that of the ARIMA model under atypical conditions.
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Choi, Clara Y. H., Scott G. Soltys, Iris C. Gibbs, Griffith R. Harsh, Paul S. Jackson, Robert E. Lieberson, Steven D. Chang, and John R. Adler. "Cyberknife Stereotactic Radiosurgery for Treatment of Atypical (Who Grade II) Cranial Meningiomas." Neurosurgery 67, no. 5 (November 1, 2010): 1180–88. http://dx.doi.org/10.1227/neu.0b013e3181f2f427.
Повний текст джерелаАнотація:
Abstract BACKGROUND: The optimal management of subtotally resected atypical meningiomas is unknown. OBJECTIVE: To perform a retrospective review of patients with residual or recurrent atypical meningiomas treated with stereotactic radiosurgery (SRS). METHODS: Twenty-five patients were treated, either immediately after surgery (n = 15) or at the time of radiographic progression or treatment failure (n = 10). SRS was delivered to with a median marginal dose of 22 Gy (range, 16-30) in 1 to 4 fractions (median, 1), targeting a median tumor volume of 5.3 cm3 (range, 0.3-26.0). RESULTS: With a median follow-up time of 28 months (range, 3-67), the 12-, 24-, and 36-month actuarial local and regional control rates for all patients were 94%, 94%, 74%, and 90%, 90%, 62%, respectively. There were 2 cases of radiation toxicity. On univariate analysis, the number of recurrences before SRS (P = .046), late SRS (ie, waiting until tumor progression to initiate treatment) (P = .03), and age at treatment ≥60 years (P = .01) were significant predictors of recurrence. Of the 20 radiation-naïve patients, 2 patients failed with the targeted lesion and 3 elsewhere in the resection bed, resulting in 12-, 24- and 36-month actuarial local and regional control rates of 100%, 100%, 73% and 93%, 93%, 75%, respectively. The overall locoregional control rates at 12, 24, and 36 months were 93%, 93%, and 54%, respectively. CONCLUSION: Irradiation of the entire postoperative tumor bed may not be necessary for the majority of patients with subtotally resected atypical meningiomas. Patients in this series achieved outcomes comparable to that of historical control rates for larger volume, conventionally fractionated radiotherapy.
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Park, Joon Hong, Yoon Je Cho, Young-Soo Chun, and Kee Hyung Rhyu. "A Novel Surgical Method for Treating Symptomatic Incomplete Atypical Femoral Fracture using Percutaneous Elastic Intramedullary Nailing." Geriatric Orthopaedic Surgery & Rehabilitation 12 (January 1, 2021): 215145932110151. http://dx.doi.org/10.1177/21514593211015104.
Повний текст джерелаАнотація:
Purpose: To introduce the principles and procedure of percutaneous elastic intramedullary nailing (PEIN) as a treatment for symptomatic incomplete atypical femoral fracture (SIAFF). Methods: From October 2014 to April 2019, 6 cases of SIAFF were treated with PEIN. Two pre-bent 4-mm stainless-steel nails were used to apply compressive force to the fracture site. The antegrade method was used for proximal fractures and the retrograde method for middle and distal femoral fractures. The femoral bowing angle in the coronal and sagittal planes, and the time required for callus formation and union, were evaluated on plain radiographs in both planes. Thigh pain, tenderness, and complications were also assessed. Results: The mean operating time was 65.00 ± 22.64 min. No case progressed to complete atypical fracture. In one case, fracture occurred around the point of nail entry after the patient fell from a chair on postoperative day 7. The incomplete fracture lines were united in 5 cases, after excluding one case with a complication. The time taken to confirm endocortical callus formation, fracture line disappearance, and clinical union was 2.11 ± 0.53, 6.45 ± 4.10, and 6.45 ± 3.65 months, respectively. Conclusions: PEIN is a quick, simple but effective treatment for SIAFF that considers the fracture mechanism and is applicable to cases with severe femoral bowing. Level of evidence: Level IV, case series.
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Khan, Sarfaraz Alam, and Nazeem Ishrat Siddiqui. "Pathophysiology of COVID-19 and its potential therapeutics." International Journal of Basic & Clinical Pharmacology 10, no. 2 (January 25, 2021): 201. http://dx.doi.org/10.18203/2319-2003.ijbcp20210193.
Повний текст джерелаАнотація:
A series of acute and atypical serious respiratory illnesses were reported in December 2019 from Wuhan, a city of China. It spread to other places and became a global pandemic involving more than 200 countries of the world. Soon, it was discovered that this atypical respiratory illness was caused by a novel corona virus. It was named as the severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) and the disease caused by it as corona virus disease-19 (COVID-19). Since COVID-19 is a new viral disease, world is still struggling to find out a permanent remedy to control this serious health problem. It seems prudent to study or have a look on the pathophysiology of SARS CoV-2 in the light of available research. Further, a review on pathophysiology may give an insight on the potential therapeutic options. Being a new virus and having potential to cause significant morbidity and mortality in short span of time various approved drugs are being repurposed for the treatment of COVID-19.
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Mack, Ellen E., and Charles B. Wilson. "Meningiomas induced by high-dose cranial irradiation." Journal of Neurosurgery 79, no. 1 (July 1993): 28–31. http://dx.doi.org/10.3171/jns.1993.79.1.0028.
Повний текст джерелаАнотація:
✓ Although meningiomas are known to be induced by low doses of cranial irradiation, such as those given to treat tinea capitis, little experience has been reported on the induction of meningiomas by high-dose cranial irradiation. The authors describe a series of 10 patients with meningiomas and a previous history of high-dose radiation therapy, usually given for a primary brain tumor. Of the 10 patients, eight were female, three had multiple meningiomas, and the majority had other stigmata of previous radiation therapy. Eight meningiomas were examined pathologically and one-half were classified as either aggressive or atypical, or were noted to have a high bromodeoxyuridine labeling index. The average time from radiation therapy to diagnosis of a meningioma was 24 years (range 5 to 40 years), a shorter interval than that previously reported for meningiomas induced by lower doses of irradiation. Within this series, patient age at irradiation was significantly correlated with tumor latency; individuals who were younger at the time of radiation therapy had a shorter time to meningioma formation. The latency of meningioma formation is therefore influenced by both the radiation dose and the age of the patient at irradiation.
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Leon-Medina, Jersson X., Jaiber Camacho, Camilo Gutierrez-Osorio, Julián Esteban Salomón, Bernardo Rueda, Whilmar Vargas, Jorge Sofrony, Felipe Restrepo-Calle, Cesar Pedraza, and Diego Tibaduiza. "Temperature Prediction Using Multivariate Time Series Deep Learning in the Lining of an Electric Arc Furnace for Ferronickel Production." Sensors 21, no. 20 (October 18, 2021): 6894. http://dx.doi.org/10.3390/s21206894.
Повний текст джерелаАнотація:
The analysis of data from sensors in structures subjected to extreme conditions such as the ones used in smelting processes is a great decision tool that allows knowing the behavior of the structure under different operational conditions. In this industry, the furnaces and the different elements are fully instrumented, including sensors to measure variables such as temperature, pressure, level, flow, power, electrode positions, among others. From the point of view of engineering and data analytics, this quantity of data presents an opportunity to understand the operation of the system under normal conditions or to explore new ways of operation by using information from models provided by using deep learning approaches. Although some approaches have been developed with application to this industry, it is still an open research area. As a contribution, this paper presents an applied deep learning temperature prediction model for a 75 MW electric arc furnace, which is used for ferronickel production. In general, the methodology proposed considers two steps: first, a data cleaning process to increase the quality of the data, eliminating both redundant information as well as atypical and unusual data, and second, a multivariate time series deep learning model to predict the temperatures in the furnace lining. The developed deep learning model is a sequential one based on GRU (gated recurrent unit) layer plus a dense layer. The GRU + Dense model achieved an average root mean square error (RMSE) of 1.19 °C in the test set of 16 different thermocouples radially distributed on the furnace.
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Amaya, Juan Pablo, and Juan Ignacio Areta. "Ontogeny of long-range vocalizations in a Neotropical fossorial rodent: the Anillaco Tuco-Tuco (Ctenomys sp.)." PeerJ 6 (February 14, 2018): e4334. http://dx.doi.org/10.7717/peerj.4334.
Повний текст джерелаАнотація:
Tuco-tucos (Ctenomys spp.) are subterranean rodents that produce territorial, high intensity long-range vocalizations (LRVs) of broadband and low frequency that are essential for long-distance communication between individuals in different tunnel systems. Despite their importance, the development of LRVs remains poorly understood. In adult Anillaco Tuco-Tucos (Ctenomys sp.) the LRV is composed by two types of syllables (series and individual notes) that are repeated a variable number of times. We studied the development of the LRVs in eight juveniles of the Anillaco Tuco-Tuco ranging from 14–28 to 104–118 days after birth. We (1) tested whether the syllables followed any of three alternative developmental modes (retention of juvenile vocalizations, modification of juvenile precursors or de novo appearance in adults), (2) evaluated the development of structural and acoustic features of syllables, and (3) tested the prediction that juveniles should produce a greater proportion of atypical series in precursors of the LRV than adults, due to lack maturation and/or precise coupling of neuromuscular and anatomical structures. The LRV of the Anillaco Tuco-Tuco exhibited a mixed developmental mode: while series developed from juvenile precursors whose acoustic features gradually approached those of adults, individual notes appeared later in the ontogeny and de novo with acoustic features indistinguishable from those of adults. The number of series per vocalization increased through development and varied from one to 25 in juvenile males and from one to six in juvenile females. The structure of the most common series type (triad) did not exhibit ontogenetic changes and was present as such at the onset of the emission of vocalizations. On the contrary, acoustic features of juvenile triad notes changed with age in both sexes (duration 90% increased through development, while bandwidth 90% and peak frequency decreased). Furthermore, juveniles emitted a higher proportion of atypical series than adults (7.4% vs. 0.3%), as expected in the development of any complex behavior that requires practice to be mastered. The maturation of the LRV occurred well before the sexual maturation, presumably due to the protracted time needed to acquire or build a burrow system long before mating is possible. We propose that protracted vocal development is another component in the slow developmental strategy of Ctenomys and subterranean rodents in general.
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Casazza, Geoffrey, M. Elise Graham, Douglas Nelson, David Chaulk, David Sandweiss, and Jeremy Meier. "Pediatric Bacterial Tracheitis—A Variable Entity: Case Series with Literature Review." Otolaryngology–Head and Neck Surgery 160, no. 3 (October 23, 2018): 546–49. http://dx.doi.org/10.1177/0194599818808774.
Повний текст джерелаАнотація:
Objective To review the presentation and treatment of children diagnosed with bacterial tracheitis at our institution and to review the available literature focusing on key presenting symptoms and clinical outcomes of children diagnosed with bacterial tracheitis. Study Design Case series with literature review. Setting Tertiary children’s hospital and available literature. Subjects and Methods Case series of children with bacterial tracheitis retrospectively reviewed at a tertiary children’s hospital. Those with a tracheostomy or those who developed bacterial tracheitis as a complication of prolonged intubation were excluded. Results Thirty-six children were identified (mean ± SD age, 6.7 ± 4.5 years). The most common presenting symptom was cough (85%), followed by stridor (77%) and voice changes/hoarseness (67%). A concurrent viral illness was found for 55%, and the most common bacteria cultured was methicillin-sensitive Staphylococcus aureus. Pediatric intensive care admission occurred for 69%, and 43% required intubation. No patient required tracheostomy. One patient (2.7%) died secondary to airway obstruction and subsequent respiratory arrest. Four patients had recurrence of bacterial tracheitis 4 to 12 months following their initial presentation. Conclusion Bacterial tracheitis is an uncommon condition with an atypical presentation and variable clinical course but serious consequences if left unrecognized. Staphylococcus is the most common bacteria identified, and many patients will have a prodromal viral illness. Changes in patient epidemiology and presentation may have occurred over time.
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Itoh, Naoya, Nana Akazawa, Eri Kanawaku, Hiromi Murakami, Yuichi Ishibana, Daichi Kawamura, Takanori Kawabata, Keita Mori, Eiichi N. Kodama, and Norio Ohmagari. "Effects of infectious disease consultation and antimicrobial stewardship program at a Japanese cancer center: An interrupted time-series analysis." PLOS ONE 17, no. 1 (January 25, 2022): e0263095. http://dx.doi.org/10.1371/journal.pone.0263095.
Повний текст джерелаАнотація:
In cancer patients, appropriate diagnosis and management of infection are frequently challenging owing to subtle or atypical presentation. We investigated the effectiveness of infectious disease (ID) consultations and the Antimicrobial Stewardship Program (ASP) in a Japanese cancer center. This 36-month-period, single-institution, interrupted time series analysis was retrospectively conducted during April 1, 2018–March 31, 2021, to evaluate a two-phase intervention: Phase 1 (notification of antimicrobials by the infection control team) and Phase 2 (establishing an ID consultation service and implementing ASP). Among 32,202 patients hospitalized, 22,096 and 10,106 hospitalizations occurred at baseline and during intervention period, respectively. The Antimicrobial Stewardship Team (AST) provided feedback on specific broad-spectrum antimicrobials in 913 instances (347 appropriate [38%]; 566 inappropriate [62%]), and 440 ID consultations were completed, with a 75% overall acceptance rate for AST suggestions. In Phase 2, monthly carbapenem days of therapy (CAR-DOT) decreased significantly, and narrow-spectrum antibiotic usage increased significantly in both trend and level; monthly DOT of antipseudomonal agents decreased significantly in trend. The results of these analyses of antimicrobial use are consistent with the DOT-based data based on antimicrobial use density (AUD). The total number of inpatient specimens increased significantly; the trend of multidrug-resistant Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus infections decreased, without changes in the incidence of other resistant organisms, all-cause in-hospital mortality, and length of stay. Actual and adjusted CAR purchase costs per patient-day decreased without significant changes in the actual and adjusted purchase cost per patient-day for all intravenous antimicrobials. Combining ID consultation and ASP reduced carbapenem use without negative patient outcomes. Their implementation could facilitate establishment of safe cancer treatment facilities in Japan and improve prognosis in cancer patients.
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Refinetti, Ana Paula, Richard Shapiro, Joan Cangiarella, and Amber Azniv Guth. "Atypical vascular lesion after radiation therapy for breast cancer." Journal of Clinical Oncology 30, no. 27_suppl (September 20, 2012): 184. http://dx.doi.org/10.1200/jco.2012.30.27_suppl.184.
Повний текст джерелаАнотація:
184 Background: Atypical vascular lesions (AVLs) are known to occur in the setting of radiation therapy after breast conserving surgery for treatment of breast cancer. Their relationship with potential secondary angiosarcoma has yet not been fully characterized. AVLs typically present as single or multiple pink papules in the skin of the breast. Histologic examination reveals proliferation of dilated vascular channels in the dermis with IHC reactive for CD31, CD34 and D2-40. Management consists of local excision to rule out angiosarcoma. Methods: The pathology records of the NYU Langone Medical Center were queried for patients who were diagnosed with atypical vascular lesions. Results: A total of 3 patients with previous history of breast cancer treated with breast conserving therapy (BCT) and radiation therapy were included in this case series. Two patients were diagnosed with DCIS and one was diagnosed with Invasive ductal carcinoma. The median time between the cancer diagnosis and the development of AVL was 5 years (3-9 years). Presentation was an erythematous skin nodule in two patients and progressive telangectasia in one. Diagnosis was made initially by punch biopsy and it was followed by excisional biopsy in all three cases. Only one patient had residual atypical vascular lesion in the excisional biopsy especimen. Conclusions: AVL is a pathological entity with growing importance over the years due to its questionable progression to angiosarcoma. The improvement in survival of patients diagnosed with breast cancer as well as the widespread use of lumpectomy with breast irradiation for the treatment of the disease have caused an exponential increase in the number of patients seen in daily practice after BCT. Clinicians must implement high surveillance of these patients and have a low threshold for further work up of skin changes in the radiated breast in order to early diagnose these lesions since it is yet unknown which ones will progress to angiosarcoma. There are ongoing studies in the development of immunophenotypical markers such as MYC that will be a useful diagnostic tool to differentiate AVL from its malignant counterpart.
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Bando, Daniel Hideki, Hommenig Scrivani, Pedro Alberto Morettin, and Chei Tung Teng. "Seasonality of suicide in the city of Sao Paulo, Brazil, 1979-2003." Revista Brasileira de Psiquiatria 31, no. 2 (June 2009): 101–5. http://dx.doi.org/10.1590/s1516-44462009000200004.
Повний текст джерелаАнотація:
OBJECTIVE: To evaluate suicide seasonality in the city of São Paulo within an urban area and tropical zone. METHOD: Suicides were evaluated using the chi-square test and analysis of variance (ANOVA) by comparing monthly, quarterly and half-yearly variations, differentiating by gender. Analyses of time series were carried out using the autocorrelation function and periodogram, while the significance level for seasonality was confirmed with the Fisher's test. RESULTS: The suicides of the period between 1979 and 2003 numbered 11,434 cases. Differences were observed in suicides occurring in Spring and Autumn for the total sample (ANOVA: p-value = 0.01), and in the male sample (ANOVA: p-value = 0.02). For the analysis of time series, seasonality was significant only for the period of 7 months in the male sample (p-value = 0.04). DISCUSSION: In this study, no significant seasonal differences were observed in the occurrences of suicides, with the exception of the male sample. The differences observed did not correspond with the pattern described in studies carried out in temperate zones. Some of the climatic particularities of the tropical zone might explain the atypical pattern of seasonality of suicides found in large populations within an urban area and tropical zone.
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Khan, Hashim Ali, Qaim Ali Khan, Muhammad Aamir Shahzad, Muhammad Amer Awan, Naeemullah Khan, Smaha Jahangir, Fiza Shaheen, et al. "Comprehensive overview of IRVAN syndrome: a structured review of Case Reports and Case Series." Therapeutic Advances in Ophthalmology 14 (January 2022): 251584142110708. http://dx.doi.org/10.1177/25158414211070880.
Повний текст джерелаАнотація:
Idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome is a rare spectrum of retinal vasculitis, aneurysms, and neuroretinitis affecting young individuals in their third decade. Most of our current knowledge is based on case reports, case series, and a handful of collaborative studies. There is much diversity in treatment approaches and outcomes in the reported literature. We have aggregated published case reports and case series into quantitative and narrative synthesis to draw evidence-based conclusions toward clinical features, atypical and rare findings, systemic associations, disease course, and treatment outcomes. The analysis suggested the disease mostly affects young individuals with a female predilection. Anterior chamber and vitreous inflammation are common than previously believed. The most prevalent pattern of retinal vasculitis in IRVAN eyes is mixed vasculitis, followed by arteritis and phlebitis. Most eyes at the time of presentation have capillary nonperfusion and require treatment. Most eyes retain good visual acuity; however, treatment is required to maintain visual function. Intravitreal antivascular endothelial growth factors administered as an adjunct to retinal laser photocoagulation are more likely to improve visual outcomes. Besides, we have discussed the different hypotheses on the etiopathogenesis of the disease and stronger evidence suggests an inflammatory origin of the disease.
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Meta, Rahmina, Henning B. Boldt, Bjarne W. Kristensen, Felix Sahm, Wenche Sjursen, and Sverre H. Torp. "The Prognostic Value of Methylation Signatures and NF2 Mutations in Atypical Meningiomas." Cancers 13, no. 6 (March 12, 2021): 1262. http://dx.doi.org/10.3390/cancers13061262.
Повний текст джерелаАнотація:
Background: Due to the solely subjective histopathological assessment, the WHO 2016 classification of human meningiomas is subject to interobserver variation. Consequently, the need for more reliable and objective markers are highly needed. The aim of this pilot study was to apply genome-wide DNA methylation analysis on a series of atypical meningiomas to evaluate the practical utility of this approach, examine whether prognostic subclasses are achieved and investigate whether there is an association between the methylation subclasses with poor prognosis and time to recurrence. NF1/2 mutation analyses were also performed to explore the prognostic value of such mutations in these atypical meningiomas. Methods: Twenty intracranial WHO grade II atypical meningiomas from adult patients were included. They consisted of 10 cases with recurrence (group I), and 10 cases without recurrence (group II). The formalin-fixed and paraffin-embedded tissues underwent standardized genome-wide DNA methylation analysis, and the profiles were matched with the reference library and tumor classifier from Heidelberg. NF1/2 somatic mutation analyses were performed using the CNSv1panel from Düsseldorf. Results: Eighteen out of 20 cases matched to the meningioma class using the common brain tumor classifier (v11b4). Four of these cases matched to a methylation subclass related to a prognostic subgroup based on a cut-off of 0.9. NF2 mutations were detected in 55% of cases across both groups, and the most prominent copy number alterations were chromosomal losses of 22q, 1p and 14q. No significant NF1 mutations were identified. Conclusions: Genome-wide DNA methylation profiling represents a useful tool in the diagnostics of meningiomas, however, methodological adjustments need to be addressed.
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Joseph, Rufina, Bhavani Deepthi Perumalla, Giridhar Sethuraman, and Usha Devi. "Acute Febrile Illness as a Manifestation of Cytomegalovirus Infection in Extremely Low-Birth Weight Babies—A Case Series." Journal of Neonatology 35, no. 4 (October 24, 2021): 234–37. http://dx.doi.org/10.1177/09732179211054092.
Повний текст джерелаАнотація:
Cytomegalovirus (CMV) infection in extremely low-birth weight infants (ELBW) is associated with significant morbidity and mortality. Our case series elaborates the profile and outcomes of 5 ELBW neonates with likely postnatal CMV infection. All babies were on mothers’ own milk and had a history of receiving leuko-reduced packed red blood cells. The mean age at diagnosis was 64 days. Hepatosplenomegaly was present in 4 cases. Along with other features warranting testing for CMV, unusually all the 5 neonates had fever spikes at the time of deterioration. Three cases had thrombocytopenia. Atypical clinical feature in the form of papular lesions, which healed with hyperpigmentation, was noted in a neonate. The fever subsided after starting treatment with valganciclovir. All babies developed bronchopulmonary dysplasia requiring prolonged respiratory support. Two babies expired. Duration of treatment with valganciclovir ranged from 6 weeks to 6 months. Survivors were developmentally normal on follow-up with normal hearing and ophthalmic examination. Febrile spikes with worsening of pre-existing morbidities could be an important clue to acquired CMV infection.
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Kim, Daniel, Andrzej Niemierko, William L. Hwang, Anat O. Stemmer-Rachamimov, William T. Curry, Fred G. Barker, Robert L. Martuza, Kevin S. Oh, Jay S. Loeffler, and Helen A. Shih. "Histopathological prognostic factors of recurrence following definitive therapy for atypical and malignant meningiomas." Journal of Neurosurgery 128, no. 4 (April 2018): 1123–32. http://dx.doi.org/10.3171/2016.11.jns16913.
Повний текст джерелаАнотація:
OBJECTIVEPatients with atypical and malignant (WHO Grade II and III) meningiomas have a worse prognosis than patients with benign (WHO Grade I) meningiomas. However, there is limited understanding of the pathological risk factors that affect long-term tumor control following combined treatment with surgery and radiation therapy. Here, the authors identify clinical and histopathological risk factors for the progression and/or recurrence (P/R) of high-grade meningiomas based on the largest series of patients with atypical and malignant meningiomas, as defined by the 2007 WHO classification.METHODSPatients diagnosed with WHO Grade II and III meningiomas between 2007 and 2014 per the WHO 2007 criteria and treated with both surgery and external beam radiation therapy were retrospectively reviewed for clinical and histopathological factors at the time of diagnosis and assessed for P/R outcomes at the last available follow-up.RESULTSA total of 76 patients met the inclusion criteria (66 Grade II meningiomas, 10 Grade III meningiomas). Median follow-up from the time of pathological diagnosis was 52.6 months. Three factors were found to predict P/R: Grade III histology, brain and/or bone invasion, and a Ki-67 proliferation rate at or above 3%. The crude P/R rate was 80% for patients with Grade III histology, 40% for those with brain and/or bone involvement (regardless of WHO tumor grade), and 20% for those with a proliferative index ≥ 3% (regardless of WHO tumor grade). The median proliferation index was significantly different between patients in whom treatment failed and those in whom it did not fail (11% and 1%, respectively).CONCLUSIONSIn patients with atypical or malignant meningiomas, the presence of Grade III histology, brain and/or bone involvement, and a high mitotic index significantly predicted an increased risk of treatment failure despite combination therapy. These patients can be stratified into risk groups predicting P/R. Patients with high-risk features may benefit from more treatment and counseling than is typically offered currently.
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Sono, Takashi, Alisha D. Ware, Edward F. McCarthy, and Aaron W. James. "Chondromyxoid Fibroma of the Pelvis: Institutional Case Series With a Focus on Distinctive Features." International Journal of Surgical Pathology 27, no. 4 (December 23, 2018): 352–59. http://dx.doi.org/10.1177/1066896918820446.
Повний текст джерелаАнотація:
Chondromyxoid fibroma (CMF) is a relatively uncommon benign bone tumor of cartilaginous differentiation. The primary pitfall in the histopathologic diagnosis of CMF is confusion with a high-grade chondrosarcoma, owing to the atypical stellate and spindled cells set within a chondromyxoid background. CMF is particularly challenging to diagnose within the pelvis, where clinical suspicion for chondrosarcoma is high and benign lesions may grow to a large size to occupy the pelvic bones. In our practice, we noted this difficulty in several consecutive cases, especially when older patients presented with CMF within the pelvis. This prompted an institutional retrospective case review of all CMF within the pelvis. In 10 cases, we found overall that CMF of pelvis occurred in an older age range (mean age = 48.6 years), was larger in size (mean size = 6.0 cm), and showed a higher rate of soft tissue extension (50%) as compared with prior reports of nonpelvic CMF. Typical histologic features of CMF were seen in all cases; however, a high frequency of dystrophic calcification (50%) and necrosis (30%) was observed. Of interest, these aggregate demographic, radiologic, and histologic findings are all consistent with a benign neoplasm that has grown undetected within the pelvis over a long period of time. Recognition of these differences between pelvic CMF and tumors involving other sites will aid in avoiding misdiagnosis of this uncommon entity.
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Pfau, David, Akina Tamaki, Kathryn R. Hoppe, Kord Honda, Rod Rezaee, and Chad A. Zender. "Sentinel Node Biopsy in Young Patients with Atypical Melanocytic Tumors of the Head and Neck." OTO Open 3, no. 2 (April 2019): 2473974X1985075. http://dx.doi.org/10.1177/2473974x19850752.
Повний текст джерелаАнотація:
Objective To examine the diagnostic value of the sentinel lymph node biopsy in pediatric through young adult head and neck melanocytic tumors of unknown malignant potential. Study Design Retrospective case series. Setting Single academic institution. Subjects and Methods Demographics, histology, and outcomes were examined in 14 patients aged 4 to 24 years with head and neck melanocytic tumors of unknown malignant potential. Information on age at diagnosis, primary lesion characteristics, and sentinel lymph node biopsy were compared. Results Of 14 patients meeting criteria for head and neck melanocytic tumors of unknown malignant potential, 8 patients underwent sentinel lymph node biopsy (57%). Of those, 4 biopsies (50%) had positive sentinel nodes. All patients undergoing sentinel lymph node biopsy had primary lesions greater than 1 mm depth or mitotic rate of at least 1 mitosis per mm2. No patients had recurrence of their primary lesion at time of follow-up. Conclusion Our data show a high rate of node-positive sentinel lymph node biopsy for pediatric and young adult head and neck patients with melanocytic tumors of unknown malignant potential, supporting the value of sentinel lymph node biopsy in this population.
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Hartmuth, Maximilian. "Mosque-Building on the Ottoman-Venetian Frontier, circa 1550–1650: The Phenomenon of Square-Tower Minarets Revisited." Muqarnas Online 35, no. 1 (October 3, 2018): 175–91. http://dx.doi.org/10.1163/22118993_03501p008.
Повний текст джерелаАнотація:
Abstract In the Balkan region of Herzegovina is found a series of Ottoman-period mosques distinguished by minarets of an atypical form: unlike standard Ottoman designs with cylindrical or polygonal minaret shafts, the square plan of these minarets makes them more reminiscent of bell towers. Despite this salient and unusual feature, the “campanile minarets,” as some scholars choose to call them, remain little studied as a historical phenomenon; outside the former Yugoslavia, they are still practically unknown. The current article aims to establish the reasons for the popularity and dissemination of this curious architectural feature in a particular region and time. It discusses two hypotheses that link square-tower minarets morphologically to the Catholic Adriatic and Arab world, but ultimately offers a different interpretation of their formal origins and their establishment as a type.
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Hall, J. A., T. N. Solie, H. B. Seim, and D. C. Twedt. "Gastric myoelectric and motor activity in dogs with gastric dilatation-volvulus." American Journal of Physiology-Gastrointestinal and Liver Physiology 265, no. 4 (October 1, 1993): G646—G653. http://dx.doi.org/10.1152/ajpgi.1993.265.4.g646.
Повний текст джерелаАнотація:
Electrical and contractile properties of the stomach were assessed in six adult dogs after recovery from surgical treatment for gastric dilatation-volvulus (GDV), a disorder characterized by delayed gastric emptying of the solid phase. Electrodes and strain-gauge force transducers were sutured to the serosa of the antrum and pylorus at the time of surgical intervention for GDV. Ten days after implantation, electrical and mechanical activities were recorded before and after a standardized meal. The analog FM tape recordings of the electrical and mechanical signals were converted to digital time series for analysis by computer. Recordings from dogs after GDV showed increased slow wave propagation velocity in both the fasting and the fed states compared with controls. In addition, the GDV dogs had atypical fasting state phase III activity fronts. We found no difference in gastric slow wave frequency, dysrhythmia, or electromechanical coupling between the two groups. These results indicate that delayed gastric emptying in this syndrome is associated with increased gastric slow wave propagation velocity.
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Celesia, Benedetto Maurizio, Bruno Cacopardo, Daniela Massimino, Maria Gussio, Salvatore Tosto, Giuseppe Nunnari, and Marilia Rita Pinzone. "Atypical Presentation of PKDL due toLeishmania infantumin an HIV-Infected Patient with Relapsing Visceral Leishmaniasis." Case Reports in Infectious Diseases 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/370286.
Повний текст джерелаАнотація:
We describe the case of an Italian patient with HIV infection who developed an atypical rash resembling post-kala-azar dermal leishmaniasis (PKDL) when receiving liposomal Amphotericin B (L-AMB) for secondary prophylaxis of visceral leishmaniasis (VL). At the time of PKDL appearance, the patient was virologically suppressed but had failed to restore an adequate CD4+ T-cell count. Histology of skin lesions revealed the presence of a granulomatous infiltrate, with lymphocytes, plasma cells, and macrophages, most of which containedLeishmaniaamastigotes. Restriction fragment length polymorphism-polymerase chain reaction was positive forLeishmania infantum. Paradoxically, cutaneous lesions markedly improved when a new relapse of VL occurred. The patient received meglumine antimoniate, with a rapid clinical response and complete disappearance of cutaneous rash. Unfortunately, the patient had several relapses of VL over the following years, though the interval between them has become wider after restarting maintenance therapy with L-AMB 4 mg/kg/day once a month. Even if rare, PKDL due toLeishmania infantummay occur in Western countries and represents a diagnostic and therapeutic challenge for physicians. The therapeutic management of both PKDL and VL in HIV infection is challenging, because relapses are frequent and evidence is often limited to small case series and case reports.
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Bleiker, M. A. "Epidemiological Trends of Tuberculosis in Low and High Prevalence Countries." Paediatrica Indonesiana 15, no. 11-12 (May 29, 2017): 273. http://dx.doi.org/10.14238/pi15.11-12.1975.273-83.
Повний текст джерелаАнотація:
The study of the epidemiology of tuberculosis and the need for a rational approach to the problem of tuberculosis control require a sound knowledge of the risk of transmission of tuberculosis infection from host to host. This knowledge is required today both in countries with a high prevalence and in those with a low prevalence of the disease. The risk of transmission of tuberculosis infection in a given community during a particular period of time is most reliably expressed numerically in terms of a series of average annual infection risks in successive calender years.The infection risk indicates the proportion of the population which will be primarily infected, or reinfected, with tubercle bacilli in the course of one year. The risk is usually expressed as a percentage or as a rate. The annual trend (decrease) in the risk of infection is even more important than the actual level of this risk.Tuberculin surveys in schoolchildren, which are repeated, say every five years, in the same area provide us with the necessary information to make estimates for the annual infection risk. In areas where infections with the socalled atypical mycobacteriae are frequent, simultaneous testing with two "Sensitins", one prepared from human tubercle bacilli and one from atypical mycobacteriae will be of value for estimating the proportion of those infected with virulent bacilli and those infected with other mycobacteriae.
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Weronska, Anna, Daniel P. Potaczek, Julia Oto, Pilar Medina, Anetta Undas, and Ewa Wypasek. "A Series of 14 Polish Patients with Thrombotic Events and PC Deficiency-Novel c.401-1G>A PROC Gene Splice Site Mutation in a Patient with Aneurysms." Genes 13, no. 5 (April 22, 2022): 733. http://dx.doi.org/10.3390/genes13050733.
Повний текст джерелаАнотація:
Objectives: Protein C (PC) deficiency is an inherited thrombophilia with a prevalence of 0.5% in the general population and 3% in subjects with a first-time deep vein thrombosis (DVT). Here we report a series of 14 PC-deficient Polish patients with comprehensive clinical and molecular characteristics, including long-term follow-up data and a deep mutational analysis of the PROC gene. Patients and Methods: Fourteen unrelated probands (mean ± SD age 43.8 ± 13.0 years) with suspicion of PC deficiency, who experienced thromboembolic events and a majority of whom received anticoagulants (92.8%), were screened for PROC mutations by sequencing the nine PROC exons and their flanking intron regions. Results: Ten probands (71.4%) had missense mutations, two patients (14.3%) carried nonsense variants, and the other two subjects (14.3%) had splice-site mutations, the latter including the c.401-1G>A variant, reported here for the very first time. The proband carrying the c.401-1A allele had a hepatic artery aneurysm with a highly positive family history of aneurysms and the absence of any mutations known to predispose to this vascular anomaly. Conclusion: A novel detrimental PROC mutation was identified in a family with aneurysms, which might suggest yet unclear links of thrombophilia to vascular anomalies, including aneurysms at atypical locations in women. The present case series also supports data indicating that novel oral anticoagulants (NOACs) are effective in PC deficient patients.