Fat Embolism Syndrome in Duchenne Muscular Dystrophy Patients: Early Recognition and Aggressive Therapy

We describe two pediatric patients with Duchenne muscular dystrophy that presented with acute neurologic deterioration and hypoxic respiratory failure requiring mechanical ventilation. These cases fulfill the clinical criteria for Fat Embolism Syndrome. Early recognition and aggressive supportive therapy with mechanical ventilation, right ventricular afterload reduction, and blood transfusion led to survival without any residual effects from the event. Fat Embolism Syndrome needs to be considered early in the course of patients with Duchenne muscular dystrophy who present with respiratory and neurological symptoms

Rancang Bangun Sistem Informasi Mylibrary Telkomsel Berbasis Website (Studi Kasus: PT. Telekomunikasi Selular)

Information is important for companies, especially in the field of services in order to help the customer. Information on PT. Telekomunikasi Selular services mainly in the division at the moment still uses the way of deploying and managing the information manually. To help the process of document management at PT. Mobile telecommunications are still using manual method and data storage is still in the archive, he built MyLibrary Information Systems Telkomsel. The research methodology used is the waterfall methodology. By using the modeling language UML design as a system to be built, Class Diagram as a data model that consists of entities and relationships (relations) between objects. The system is built using the PHP programming language implementation phase and a database using MySQL database and information system testing plan using techniques Black Box. The system is built based Website that is accessible only to employees of PT. Telekomunikasi Selular. Based on the results of the implementation is done, it can be concluded that the information system is to facilitate employees in the process of document management, employee data and data reports. This information system is also expected to be developed to provide mobile-based applications for mobile devices such as mobile phones and tablet computers

A Novel Domain Transfer-Based Approach for Unsupervised Thermal Image Super-Resolution

This paper presents a transfer domain strategy to tackle the limitations of low-resolution thermal sensors and generate higher-resolution images of reasonable quality. The proposed technique employs a CycleGAN architecture and uses a ResNet as an encoder in the generator along with an attention module and a novel loss function. The network is trained on a multi-resolution thermal image dataset acquired with three different thermal sensors. Results report better performance benchmarking results on the 2nd CVPR-PBVS-2021 thermal image super-resolution challenge than state-of-the-art methods. The code of this work is available online

Brain Death Secondary to Rocky Mountain Spotted Fever Encephalitis

A two-year-old female presented with acutely altered mental status following eight days of fever and rash. She had been camping at an Indiana campground 11 days prior to the onset of illness and was evaluated twice for her fever and rash prior to admission. Laboratory evaluation on admission revealed thrombocytopenia, hyponatremia, and elevated transaminases. The patient developed diffuse cerebral edema, and despite intensive care, the edema led to brain death from Rocky Mountain spotted fever (RMSF). We present this case to highlight the importance of considering RMSF and other tick-borne illnesses in a child with prolonged fever and rash in a nonendemic area and also the difficulty of diagnosis in early stages of disease. A detailed travel history, evaluation of key laboratory findings (white blood count, platelet count, and transaminases), and close follow-up if rash and fevers persist may help to improve detection of RMSF. If a tick-borne illness such as RMSF is suspected, empiric doxycycline therapy should be started immediately, as lab confirmation may take several days and mortality increases greatly after five days of symptoms

Resource utilization in patients with schizophrenia who initiated risperidone long-acting therapy: results from the Schizophrenia Outcomes Utilization Relapse and Clinical Evaluation (SOURCE)

<p>Abstract</p> <p>Background</p> <p>Schizophrenia is a chronic mental health disorder associated with increased hospital admissions and excessive utilization of outpatient services and long-term care. This analysis examined health care resource utilization from a 24-month observational study of patients with schizophrenia initiated on risperidone long-acting therapy (RLAT).</p> <p>Methods</p> <p>Schizophrenia Outcomes Utilization Relapse and Clinical Evaluation (SOURCE) was a 24-month observational study designed to examine real-world treatment outcomes by prospectively following patients with schizophrenia initiated on RLAT. At baseline visit, prior hospitalization and ER visit dates were obtained for the previous 12 months and subsequent hospitalization visit dates were obtained at 3-month visits, if available. The health care resource utilization outcomes measures observed in this analysis were hospitalizations for any reason, psychiatric-related hospitalizations, and emergency room (ER) visits. Incidence density analysis was used to assess pre-event and postevent rates per person-year (PY).</p> <p>Results</p> <p>The primary medical resource utilization analysis included 435 patients who had a baseline visit, ≥1 postbaseline visits after RLAT initiation, and valid hospitalization dates. The number of hospitalizations and ER visits per PY declined significantly (<it>p </it>< .0001) after initiation with RLAT. A 41% decrease (difference of -0.29 hospitalizations per PY [95% CI: -0.39 to -0.18] from baseline) in hospitalizations for any reason, a 56% decrease (a difference of -0.35 hospitalizations per PY [95% CI: -0.44 to -0.26] from baseline) in psychiatric-related hospitalizations, and a 40% decrease (-0.26 hospitalizations per PY [95% CI: -0.44 to -0.10] from baseline) in ER visits were observed after the baseline period. The percentage of psychiatric-related hospitalizations decreased significantly after RLAT initiation, and patients had fewer inpatient hospitalizations and ER visits (all <it>p </it>< .0001).</p> <p>Conclusion</p> <p>The results suggest that treatment with RLAT may result in decreased hospitalizations for patients with schizophrenia.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00246194">NCT00246194</a></p