Ossifying fibroma of the maxillary sinus at the Kara (Togo) Teaching Hospital

SummaryIntroductionOssifying fibroma of the jaw is a benign tumorous disease, somewhat rare and aggressive. It frequently targets the mandible, but seldom the maxillary.Case studyThe present study reports the first case of left maxillary sinus fibroma treated at the Kara Teaching Hospital in North Togo. It occurred in a 29-year-old patient who experienced slow-growing tumefaction of the left maxillary sinus, resulting in deformation of the left side of the face in the maxillary region and ipsilateral nasal obstruction. Orthopantomography showed a displacement of teeth 21, 22, and 23 with an abnormal degree of opacity at the dental roots. The CT scan of the nose and sinuses revealed a tumorous lesion of expanding bony density increasing in volume at the outer wall of the left maxillary sinus, of regular shape that contained microscopic calcifications, extending into the ipsilateral orbital floor and pushing the surrounding soft tissues forward without invading them. The histopathological examination of the tumor confirmed the diagnosis of ossifying fibroma.DiscussionOssifying fibroma or fibrous osteoma is a rare and benign lesion developing insidiously with a polymorphous aspect. Of unknown etiology, most frequently located in the mandible, it is differentiated from other types of fibroma in its clinical, radiological, and histological aspects. However, only examination of the gross specimen can provide the final diagnosis. Treatment requires surgery.ConclusionSurgical treatment entailed the complete macroscopic enucleoresection. Recovery has been favorable at 2 years of follow-up

Methods for coastal monitoring and erosion risk assessment: two Portuguese case studies

Coastal zones are naturally dynamic and mobile systems exposed to natural (river flows, waves and storms) as well as human interventions that continuously reshape their morphology. Erosion phenomena related to extreme weather events and sediment scarcity are common, threatening buildings and infrastructures, as well as beaches, ecosystems and valuable wetland; conditions that pose challenges to coastal security and defence. Regular monitoring of coastal areas, assessment of their morphodynamics and identification of the processes influencing sediment transport are thus increasingly important for a better understanding of changes and evolutionary trends in coastal systems. This demands a multi-disciplinary approach involving researchers with expertise in coastal processes and state-of-the-art observation technologies. In this paper state-of-the-art surveying methods for an efficient quantification of changes in coastal environments are described and evaluated, and two NW-Portuguese case studies are presented. Survey methods included: topographic surveys based on terrestrial videogrammetric mobile mapping and aerial photogrammetry; sub-tidal bathymetry with sonar imagery using an Autonomous Surface Vehicle (ASV); as well as field observations, with sediment sampling and beach characterisation. In the first case study erosion/accretion patterns in the Douro estuary sand spit are analysed, considering its breakwater, river flow, wave and wind effects. Prior to the construction of a detached breakwater, the spitâ s morphodynamics was related to extreme river flow events, wave and wind conditions; afterwards the spit stabilized its shape and increased its area and volume. In the second case study the coast of Vila Nova de Gaia was broadly analysed, including the shoreface, foreshore and dunes, the characterization of major features and a short-period analysis of installed dynamics. Results obtained from field data, topographical surveys and numerical wave models were combined for the erosion risk assessment, using a methodology specifically developed for the study area. Both monitoring programs achieved their proposed objectives and provided valuable information to the local authorities, as gathered and processed information constitutes a valuable database for coastal planning and for ICZM purposes. They demonstrate the potential of several approaches, supported by advanced technologies, for the study of complex coastal morphodynamic processes.Zonas costeiras são sistemas naturalmente dinâmicos e móveis, expostos a fatores naturais (fluxos de rios, ondas e tempestades) e intervenções humanas, que alteram continuamente a sua morfologia. Fenómenos de erosão relacionados com temporais e escassez de sedimentos são comuns. Eles ameaçam construções e infraestruturas, praias, ecossistemas e zonas húmidas, o que constitui um desafio para a segurança e defesa costeiras. Uma monitorização regular de áreas costeiras, com avaliação da sua morfodinâmica e identificação dos processos que influenciam o transporte de sedimentos, visando uma melhor compreensão das alterações e tendências evolutivas nos sistemas costeiros, torna-se portanto cada vez mais importante. Para tal necessita-se de uma abordagem multidisciplinar e investigadores especializados em processos costeiros e tecnologias de observação de ponta. O presente trabalho descreve e avalia métodos de monitorização de última geração para uma quantificação eficiente de alterações em ambientes costeiros e apresenta dois estudos de caso Portugueses. Os métodos de observação incluem: levantamentos topográficos terrestres em modo cinemático baseados em videogrametria; levantamentos topográficos aéreos baseados em fotogrametria; batimetria sub-tidal e imagens de fundo obtidas com sonar a partir de um veículo autónomo de superfície; e observações de campo com análise de sedimentos e caracterização de praias. O primeiro caso de estudo referese à análise de padrões de erosão e acreção na restinga do estuário do Douro, tendo em conta efeitos causados pelo molhe, o caudal do rio, ondas e vento. Antes da construção de um molhe destacado, a morfodinâmica da restinga estava relacionada com eventos extremos de caudal, agitação marítima e vento. Após a construção, a forma da restinga estabilizou e observou-se um aumento da sua área e do seu volume. No segundo caso de estudo, a costa de Vila Nova de Gaia foi amplamente estudada, incluindo shoreface, foreshore e dunas, com a caracterização dos principais atributos e uma análise de curto-período da dinâmica instalada. Os resultados obtidos a partir de dados de campo, dos levantamentos topográficos e de modelos numéricos de ondas foram combinados numa análise de risco com métodos especificamente desenvolvidos para a área de estudos. Ambos os programas de monitorização atingiram os seus objetivos e geraram informação relevante para as autoridades locais. A informação recolhida e processada constitui uma base de dados valiosa para o planeamento costeiro e a Gestão Integrada de Zonas Costeiras. Os estudos demonstram o potencial das diversas abordagens, apoiadas por tecnologias avançadas, para o estudo dos processos complexos de morfodinâmica costeira.This research was partially supported by the European Regional Development Fund (ERDF) through the COMPETE – Operational Competitiveness Programme and national funds through FCT – Foundation for Science and Technology, under the project “Pest-C/ MAR/LA0015/2013”, and partially funded by the Project ECORISK (reference NORTE-07-0124-FEDER- 000054), co-financed by the North Portugal Regional Operational Programme (ON.2 – O Novo Norte), under the National Strategic Reference Framework (NSRF), through the European Regional Development Fund (ERDF). Wave climate analyses were supported by the FCT-funded RAP project (PTDC/MAR/111223/2009)

mPSQed: A Software for the Design of Multiplex Pyrosequencing Assays

Molecular-based diagnostic assays are the gold standard for infectious diseases today, since they allow a rapid and sensitive identification and typing of various pathogens. While PCR can be designed to be specific for a certain pathogen, a subsequent sequence analysis is frequently required for confirmation or typing. The design of appropriate PCR-based assays is a complex task, especially when conserved discriminating polymorphisms are rare or if the number of types which need to be differentiated is high. One extremely useful but underused method for this purpose is the multiplex pyrosequencing technique. Unfortunately there is no software available to aid researchers in designing multiplex pyrosequencing assays. Here, we present mPSQed (Multiplex PyroSeQuencing EDitor), a program targeted at closing this gap. We also present the design of an exemplarily theoretical assay for the differentiation of human adenovirus types A–F using two pyrosequencing primers on two distinct PCR products, designed quickly and easily using our software

Trust, Nostalgia and Narrative Accounts of Blood Banking in England in the 21st Century

Historically, cultural accounts and descriptions of blood banking in Britain have been associated with notions of altruism, national solidarity and imagined community. While these ideals have continued to be influential, the business of procuring and supplying blood has become increasingly complex. Drawing on interview data with donors in one blood centre in England, this article reports that these donors tend not to acknowledge the complex dynamics of production and exchange in modern blood systems. This, it is argued, is congruent with nostalgic narratives in both popular and official accounts of blood services, which tend to bracket these important changes. A shift to a more open institutional narrative about modern blood services is advocated, as blood services face current and future challenges

LICAVAL: combination therapy in acute and maintenance treatment of bipolar disorder

<p>Abstract</p> <p>Background</p> <p>The challenge of Bipolar Disorder (BD) treatment is due to the complexity of the disease. Current guidelines represent an effort to help clinicians in their everyday practice but still have limitations, specially concerning to long term treatment. LICAVAL (e<it>fficacy and tolerability of the combination of <b>LI</b>thium and <b>CA</b>rbamazepine compared to lithium and <b>VAL</b>proic acid in the treatment of young bipolar patients</it>) study aim to evaluate acute and maintenance phase of BD treatment with two combined drugs.</p> <p>Methods</p> <p>LICAVAL is a single site, parallel group, randomized, outcome assessor blinded trial. BD I patients according to the DSM-IV-TR, in depressive, manic,/hypomanic or mixed episode, aged 18 to 35 years are eligible. After the diagnostic assessments, the patients are allocated for one of the groups of treatment (lithium + valproic acid or lithium + carbamazepine). Patients will be followed up for 8 weeks in phase I (acute treatment), 6 months in phase II (continuation treatment) and 12 months in phase III (maintenance treatment). Outcome assessors are blind to the treatment. The main outcome is the evaluation of changes in mean scores on CGI-BP-M between baseline and endpoint at the end of each phase of the study.</p> <p>Results</p> <p>LICAVAL is currently in progress, with patients in phase I, II or III. It will extended until august 2012.</p> <p>Conclusions</p> <p>Trials comparing specific treatments efficacy in BD (head to head) can show relevant information in clinical practice. Long term treatment is an issue of great important and should be evaluated carefully in more studies as long as BD is a chronic disease.</p> <p>Trial registration</p> <p>ClinicalTrials.gov Identifier: NCT00976794</p

An impact assessment for urban stormwater use

The adoption of stormwater collection and use for a range of non-potable applications requires that the perceived risks, particularly those associated with public health, are addressed. Pollutant impacts have been assessed using E. coli and a scoring system on a scale of 0 to 5 to identify the magnitude of impacts and also the likelihood of exposure to stormwater during different applications. Combining these identifies that low or medium risks are generally predicted except for domestic car washing and occupational irrigation of edible raw food crops where the predicted high risk would necessitate the introduction of remedial action

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- A nd middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs