Surgical Treatment of Intestinal Perforation in Behçet Syndrome: an Unusual Presentation

Behçet syndrome is a chronic, recurring, systemic disorder characterized by the histopathologic finding of nonspecific vasculitis in multiple organs. Behçet syndrome involves the gastrointestinal tract in 10-50% of patients; The main sites of involvement are the terminal ileum and cecum. In patients with Behçet syndrome, CT is advocated for early detection of complications as well as for exclusion of other abdominal pathologic conditions but there is no specific exam. The report of histology in conjunction with the clinical history and the presence of oral ulcers, uveitis and suspected cutaneous lesions suggests the diagnosis. The optimal medical treatment of Behçet syndrome has not yet been well established. In rare cases surgery must be required to control the disease. The authors report one case of Behcet Syndrome presenting with intestinal perforation.info:eu-repo/semantics/publishedVersio

Effect of anisotropy on the formation of active particle films

Active colloids belong to a class of non-equilibrium systems where energy uptake, conversion and dissipation occurs at the level of individual colloidal particles, which can lead to particles' self-propelled motion and surprising collective behaviour. Examples include coexistence of vapour-and liquid-like steady states for active particles with repulsive interactions only, phenomena known as motility induced phase transition. Similarly to motile unicellular organisms, active colloids tend to accumulate at confining surfaces forming dense adsorbed films. In this work, we study the structure and dynamics of aggregates of self-propelled particle near confining solid surfaces, focusing on the effects of the particle anisotropic interactions. We performed Langevin dynamics simulations of two complementary models for active particles: ellipsoidal particles interacting through Gay-Berne potential, and rod-like particles composed of several repulsive Lennard-Jones beads. We observe a non-monotonic behavior of the structure of clusters formed along the confining surface as a function of the particle aspect ratio, with a film spreading when particles are near spherical, compact clusters with hedgehog-like particle orientation for more elongated active particles, and a complex dynamical behavior for intermediate aspect ratio. The stabilization time of cluster formation along the confining surface also displays a non-monotonic dependence on the aspect ratio, with a local minimum at intermediate values. Additionally, we demonstrate that the hedgehog-like aggregates formed by Gay-Berne ellipsoids exhibit higher structural stability as compared to the ones formed by purely repulsive active rods, which are stable due to the particle activity only

Wetting of a solid surface by active matter

A lattice model is used to study repulsive active particles at a planar surface. A rejection-free Kinetic Monte Carlo method is employed to characterize the wetting behaviour. The model predicts a motility-induced phase separation of active particles, and the bulk coexistence of dense liquid-like and dilute vapour-like steady states is determined. An “ensemble”, with a varying number of particles, analogous to a grand canonical ensemble in equilibrium, is introduced. The formation and growth of the liquid film between the solid surface and the vapour phase is investigated. At constant activity, as the system is brought towards coexistence from the vapour side, the thickness of the adsorbed film exhibits a divergent behaviour regardless of the activity. This suggests a complete wetting scenario along the full coexistence curve

Time to go global: a consultation on global health competencies for postgraduate doctors

BACKGROUND: Globalisation is having profound impacts on health and healthcare. We solicited the views of a wide range of stakeholders in order to develop core global health competencies for postgraduate doctors. METHODS: Published literature and existing curricula informed writing of seven global health competencies for consultation. A modified policy Delphi involved an online survey and face-to-face and telephone interviews over three rounds. RESULTS: Over 250 stakeholders participated, including doctors, other health professionals, policymakers and members of the public from all continents of the world. Participants indicated that global health competence is essential for postgraduate doctors and other health professionals. Concerns were expressed about overburdening curricula and identifying what is 'essential' for whom. Conflicting perspectives emerged about the importance and relevance of different global health topics. Five core competencies were developed: (1) diversity, human rights and ethics; (2) environmental, social and economic determinants of health; (3) global epidemiology; (4) global health governance; and (5) health systems and health professionals. CONCLUSIONS: Global health can bring important perspectives to postgraduate curricula, enhancing the ability of doctors to provide quality care. These global health competencies require tailoring to meet different trainees' needs and facilitate their incorporation into curricula. Healthcare and global health are ever-changing; therefore, the competencies will need to be regularly reviewed and updated

Phase structure of black branes in grand canonical ensemble

This is a companion paper of our previous work [1] where we studied the thermodynamics and phase structure of asymptotically flat black $p$-branes in a cavity in arbitrary dimensions $D$ in a canonical ensemble. In this work we study the thermodynamics and phase structure of the same in a grand canonical ensemble. Since the boundary data in two cases are different (for the grand canonical ensemble boundary potential is fixed instead of the charge as in canonical ensemble) the stability analysis and the phase structure in the two cases are quite different. In particular, we find that there exists an analog of one-variable analysis as in canonical ensemble, which gives the same stability condition as the rather complicated known (but generalized from black holes to the present case) two-variable analysis. When certain condition for the fixed potential is satisfied, the phase structure of charged black $p$-branes is in some sense similar to that of the zero charge black $p$-branes in canonical ensemble up to a certain temperature. The new feature in the present case is that above this temperature, unlike the zero-charge case, the stable brane phase no longer exists and `hot flat space' is the stable phase here. In the grand canonical ensemble there is an analog of Hawking-Page transition, even for the charged black $p$-brane, as opposed to the canonical ensemble. Our study applies to non-dilatonic as well as dilatonic black $p$-branes in $D$ space-time dimensions.Comment: 32 pages, 2 figures, various points refined, discussion expanded, references updated, typos corrected, published in JHEP 1105:091,201

Power grip, pinch grip, manual muscle testing or thenar atrophy - which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review

<p>Abstract</p> <p>Background</p> <p>Objective assessment of motor function is frequently used to evaluate outcome after surgical treatment of carpal tunnel syndrome (CTS). However a range of outcome measures are used and there appears to be no consensus on which measure of motor function effectively captures change. The purpose of this systematic review was to identify the methods used to assess motor function in randomized controlled trials of surgical interventions for CTS. A secondary aim was to evaluate which instruments reflect clinical change and are psychometrically robust.</p> <p>Methods</p> <p>The bibliographic databases Medline, AMED and CINAHL were searched for randomized controlled trials of surgical interventions for CTS. Data on instruments used, methods of assessment and results of tests of motor function was extracted by two independent reviewers.</p> <p>Results</p> <p>Twenty-two studies were retrieved which included performance based assessments of motor function. Nineteen studies assessed power grip dynamometry, fourteen studies used both power and pinch grip dynamometry, eight used manual muscle testing and five assessed the presence or absence of thenar atrophy. Several studies used multiple tests of motor function. Two studies included both power and pinch strength and reported descriptive statistics enabling calculation of effect sizes to compare the relative responsiveness of grip and pinch strength within study samples. The study findings suggest that tip pinch is more responsive than lateral pinch or power grip up to 12 weeks following surgery for CTS.</p> <p>Conclusion</p> <p>Although used most frequently and known to be reliable, power and key pinch dynamometry are not the most valid or responsive tools for assessing motor outcome up to 12 weeks following surgery for CTS. Tip pinch dynamometry more specifically targets the thenar musculature and appears to be more responsive. Manual muscle testing, which in theory is most specific to the thenar musculature, may be more sensitive if assessed using a hand held dynamometer – the Rotterdam Intrinsic Handheld Myometer. However further research is needed to evaluate its reliability and responsiveness and establish the most efficient and psychometrically robust method of evaluating motor function following surgery for CTS.</p