Bilateral Spontaneous Hyphaema in Juvenile Xanthogranuloma: A case report and literature review

Background: A four-month-old Nigerian male was presented with spontaneous hyphaema in both eyes initially thought to be due to trauma or possibly non accidental injury. There was associated secondary glaucoma and skin lesions typical of juvenile xanthogranuloma. This condition, to the best of our knowledge, has not yet been reported in Nigeria. Case report: There was redness in the right eye with no associated tearing or photophobia. On examination, there was visually directed reaching in both eyes, with central, steady and maintained fixation, corneal haze and 15% hyphaema. The left eye, which appeared normal, later also developed 10% hyphaema, upon which an impression of juvenile xanthogranuloma was entertained. Laboratory investigations, including a clotting profile, were all within normal limits. Examination under anaesthesia showed progressively increasing buphthalmos and vitreous haemorrhage in the left eye with high intraocular pressure and large cup disc ratios. Histology showed irregularly disposed spindle-shaped cells in the dermis that were intimately associated with small capillaries containing red blood cells. Occasional tuton-like giant cells were seen with hyperkeratosis and papillomatosis of the epidermis which is consistent with juvenile xanthogranuloma. Conclusion: Ocular complications provide the primary concern in this condition and could eventually lead to blindness. Therefore, a high index of suspicion is the key to the prevention of blindness. Keywords: juvenile xanthogranuloma, hyphaema, glaucomaNigerian Journal of Opthalmology Vol. 15 (2) 2007: pp. 61-6

COPD and cardiovascular disease

COPD is one of the major public health problems in people aged 40 years or above. It is currently the 4th leading cause of death in the world and projected to be the 3rd leading cause of death by 2020. COPD and cardiac comorbidities are frequently associated. They share common risk factors, pathophysiological processes, signs and symptoms, and act synergistically as negative prognostic factors. Cardiac disease includes a broad spectrum of entities with distinct pathophysiology, treatment and prognosis. From an epidemiological point of view, patients with COPD are particularly vulnerable to cardiac disease. Indeed, mortality due to cardiac disease in patients with moderate COPD is higher than mortality related to respiratory failure. Guidelines reinforce that the control of comorbidities in COPD has a clear benefit over the potential risk associated with the majority of the drugs utilized. On the other hand, the true survival benefits of aggressive treatment of cardiac disease and COPD in patients with both conditions have still not been clarified. Given their relevance in terms of prevalence and prognosis, we will focus in this paper on the management of COPD patients with ischemic coronary disease, heart failure and dysrhythmia.Novartis Portugal Novartisinfo:eu-repo/semantics/publishedVersio

Learning to nurse: combining simulation with key theory.

Following a recent Nursing and Midwifery Council revalidation of a university undergraduate nursing programme, simulation skills sessions and anatomy and physiology theory were integrated into one unit (module). This was done in order to integrate the basis for patient assessment and care provision with the anatomical and physiological theory and thereby enhance student learning and nursing practice. Students evaluated the new unit well and valued the close link between theory and practice simulation. Improvements were seen in the simulation skills sessions as students were better able to apply their underlying theory to their actions. Learning was enhanced as both simulation and theory were seen as more meaningful to practice and patient care

Macroscopic effects of the spectral structure in turbulent flows

Two aspects of turbulent flows have been the subject of extensive, split research efforts: macroscopic properties, such as the frictional drag experienced by a flow past a wall, and the turbulent spectrum. The turbulent spectrum may be said to represent the fabric of a turbulent state; in practice it is a power law of exponent \alpha (the "spectral exponent") that gives the revolving velocity of a turbulent fluctuation (or "eddy") of size s as a function of s. The link, if any, between macroscopic properties and the turbulent spectrum remains missing. Might it be found by contrasting the frictional drag in flows with differing types of spectra? Here we perform unprecedented measurements of the frictional drag in soap-film flows, where the spectral exponent \alpha = 3 and compare the results with the frictional drag in pipe flows, where the spectral exponent \alpha = 5/3. For moderate values of the Reynolds number Re (a measure of the strength of the turbulence), we find that in soap-film flows the frictional drag scales as Re^{-1/2}, whereas in pipe flows the frictional drag scales as Re^{-1/4} . Each of these scalings may be predicted from the attendant value of \alpha by using a new theory, in which the frictional drag is explicitly linked to the turbulent spectrum. Our work indicates that in turbulence, as in continuous phase transitions, macroscopic properties are governed by the spectral structure of the fluctuations.Comment: 6 pages, 3 figure

Fusion of colour contrasted images for early detection of oesophageal squamous cell dysplasia from endoscopic videos in real time

Standard white light (WL) endoscopy often misses precancerous oesophageal changes due to their only subtle differences to the surrounding normal mucosa. While deep learning (DL) based decision support systems benefit to a large extent, they face two challenges, which are limited annotated data sets and insufficient generalisation. This paper aims to fuse a DL system with human perception by exploiting computational enhancement of colour contrast. Instead of employing conventional data augmentation techniques by alternating RGB values of an image, this study employs a human colour appearance model, CIECAM, to enhance the colours of an image. When testing on a frame of endoscopic videos, the developed system firstly generates its contrast-enhanced image, then processes both original and enhanced images one after another to create initial segmentation masks. Finally, fusion takes place on the assembled list of masks obtained from both images to determine the finishing bounding boxes, segments and class labels that are rendered on the original video frame, through the application of non-maxima suppression technique (NMS). This deep learning system is built upon real-time instance segmentation network Yolact. In comparison with the same system without fusion, the sensitivity and specificity for detecting early stage of oesophagus cancer, i.e. low-grade dysplasia (LGD) increased from 75% and 88% to 83% and 97%, respectively. The video processing/play back speed is 33.46 frames per second. The main contribution includes alleviation of data source dependency of existing deep learning systems and the fusion of human perception for data augmentation

Synthesis of mild–hard AAO templates for studying magnetic interactions between metal nanowires

The sequential application of mild and hard anodization techniques in the fabrication of porous aluminamembranes allows one to decrease the number of continuous pores in anodized aluminium oxide (AAO) templates. Initially, standard mild anodization techniques were used to create porous templates with 100 nm interpore distances and 70 nm pore diameters. Hard anodization treatment on the same membrane then produced interpore distances of about 265 nm with diameters of 110 nm. At the interface between the two anodization steps, many of the mild-side pores were terminated to create a mild–hard membrane (Mi–Ha AAO) where the functional interpore distances were 200–300 nm. Growth (electrodeposition) of nickel and cobaltnanowires in the various pore structures of the mild and hard sides of the Mi–Ha AAO templates allows one to probe magnetic interactions between nanowires and compares them to wires grown in standard mild templates (Mi-AAO). The magnetic properties of nanowires in Mi–Ha AAO and Mi-AAO showed distinct differences in the squareness of hysteresis loops and coercivity both as a function of pore structure and magnetic component. In general, the squareness of the hysteresis loops increased with aspect ratio and greater interpore distance. Coercivity also showed an increase with aspect ratio, but varied differently with interpore distance for Ni and Co. These various magnetic behaviors are discussed with respect to crystalline structure, morphology, and interactions of adjacent sets of nanowires

New first trimester crown-rump length's equations optimized by structured data collection from a French general population

--- Objectives --- Prior to foetal karyotyping, the likelihood of Down's syndrome is often determined combining maternal age, serum free beta-HCG, PAPP-A levels and embryonic measurements of crown-rump length and nuchal translucency for gestational ages between 11 and 13 weeks. It appeared important to get a precise knowledge of these scan parameters' normal values during the first trimester. This paper focused on crown-rump length. --- METHODS --- 402 pregnancies from in-vitro fertilization allowing a precise estimation of foetal ages (FA) were used to determine the best model that describes crown-rump length (CRL) as a function of FA. Scan measures by a single operator from 3846 spontaneous pregnancies representative of the general population from Northern France were used to build a mathematical model linking FA and CRL in a context as close as possible to normal scan screening used in Down's syndrome likelihood determination. We modeled both CRL as a function of FA and FA as a function of CRL. For this, we used a clear methodology and performed regressions with heteroskedastic corrections and robust regressions. The results were compared by cross-validation to retain the equations with the best predictive power. We also studied the errors between observed and predicted values. --- Results --- Data from 513 spontaneous pregnancies allowed to model CRL as a function of age of foetal age. The best model was a polynomial of degree 2. Datation with our equation that models spontaneous pregnancies from a general population was in quite agreement with objective datations obtained from 402 IVF pregnancies and thus support the validity of our model. The most precise measure of CRL was when the SD was minimal (1.83mm), for a CRL of 23.6 mm where our model predicted a 49.4 days of foetal age. Our study allowed to model the SD from 30 to 90 days of foetal age and offers the opportunity of using Zscores in the future to detect growth abnormalities. --- Conclusion --- With powerful statistical tools we report a good modeling of the first trimester embryonic growth in the general population allowing a better knowledge of the date of fertilization useful in the ultrasound screening of Down's syndrome. The optimal period to measure CRL and predict foetal age was 49.4 days (9 weeks of gestational age). Our results open the way to the detection of foetal growth abnormalities using CRL Zscores throughout the first trimester

Resposta do capim-elefante (Pennisetum purpureum, Schum) a nitrogênio, fósforo e potássio em Tracuateua e Benevides, estado do Pará.

v.5 Pastagem e produção animal

Non-linearity of the collagen triple helix in solution and implications for collagen function

Collagen adopts a characteristic supercoiled triple helical conformation which requires a repeating (Xaa-Yaa-Gly)n sequence. Despite the abundance of collagen, a combined experimental and atomistic modelling approach has not so far quantitated the degree of flexibility seen experimentally in the solution structures of collagen triple helices. To address this question, we report an experimental study on the flexibility of varying lengths of collagen triple helical peptides, composed of six, eight, ten and twelve repeats of the most stable Pro-Hyp-Gly (POG) units. In addition, one unblocked peptide, (POG)10unblocked, was compared with the blocked (POG)10 as a control for the significance of end effects. Complementary analytical ultracentrifugation and synchrotron small angle X-ray scattering data showed that the conformations of the longer triple helical peptides were not well explained by a linear structure derived from crystallography. To interpret these data, molecular dynamics simulations were used to generate 50 000 physically realistic collagen structures for each of the helices. These structures were fitted against their respective scattering data to reveal the best fitting structures from this large ensemble of possible helix structures. This curve fitting confirmed a small degree of non-linearity to exist in these best fit triple helices, with the degree of bending approximated as 4–17° from linearity. Our results open the way for further studies of other collagen triple helices with different sequences and stabilities in order to clarify the role of molecular rigidity and flexibility in collagen extracellular and immune function and disease