\ud Case Report: Unsuspected Uterine Choriocarcinoma with Lung Metastasis\ud

Choriocarcinoma is a rare form of cancer which commonly occurs in women of reproductive age, rarely in post-menopausal women and in women under 20 years of age. Methods & Results: We report an unsuspected case of uterine choriocarcinoma with lung metastasis in a 27 year-old woman who presented to a medical ward with a history of prominent respiratory, but also genital and gastrointestinal symptoms. Conclusions: The presented case report emphasizes the need for sophisticated diagnostic technology to enable early diagnosis and correct treatment. Furthermore the case highlights the need for healthcare workers to consider rare causes of respiratory signs and symptoms

Design and calibration of percolation samplers for measuring polyacrylamide-amended furrow-irrigation effects on drainage water quality

Amending irrigation furrow inflows with polyacrylamide (PAM) at low concentrations (10 mg L -1 ) reduces irrigation-induced erosion by 94% and increases infiltration by 15%, relative to untreated furrows. We hypothesized that PAM erosion-control technology would allow irrigation managers to increase furrow inflows to speed furrow-stream advance, produce a more uniform water distribution down field, and reduce the leaching hazard at the upper end (due to reduced infiltration opportunity time and/or shorter sets). We developed, tested, and installed instruments in a furrow irrigated Portneuf silt loam (Co-Si, mixed, mesic, Durixerollic Calciorthids with 1.6% slope) to investigate this premise. Soils were instrumented with repeating pulse multivibrator (CS-615) soil water sensors, thermocouples, tensiometers, and percolation soil water samplers at upper and lower ends of the furrows. Percolation samplers consisted of a 23-cm-deep, 20-cm-dia. stainless-steel beaker with a 1 7-cm-long, 4-cm-dia., 0.5 bar air-entry ceramic cup imbedded in a 5-cm-deep silica flour layer, slurried into the beaker bottom. Water was collected under suction (~ 1.4x ambient) via teflon tubes. Percolation sampler design and testing, field installation, and study experimental design are discussed

Fate and efficacy of polyacrylamide applied in furrow irrigation: Full-advance and continuous treatments

Polyacrylamide (PAM) is applied to 400 000 irrigated hectares annually in the USA to control irrigation-induced erosion, yet the fate of dissolved PAM applied in irrigation water is not well documented. We determined the fate of PAM added to furrow streams under two treatments: Initial-10, 10 mg L-1 PAM product applied only during the initial hours of the irrigation, and Cont-1, 1.0 mg L—1 PAM product applied continuously during the entire irrigation. The study measured PAM concentrations in 167-m-long PAM-treated furrow streams and along a 530-m tail ditch that received this runoff. Soil was Portneuf silt loam (coarse-silty, mixed, superactive, mesic Durinodic Xeric Haplocalcid) with 1.5% slope. Samples were taken at three times during the irrigations, both during and after PAM application. Polyacrylamide was adsorbed to soil and removed from solution as the streams traversed the soil-lined channels. The removal rate increased with stream sediment concentration. Stream sediment concentrations were higher when PAM concentrations were <2 mg L-1 a.i., for early irrigations, and when untreated tributary ?ows combined with the stream. In these cases, PAM concentration decreased to undetectable levels over the ?ow lengths used in this study. When in?ows contained >6 mg L-1 PAM a.i., stream sediment concentrations were minimal and PAM concentrations did not change down the furrow, though they decreased to undetectable levels within 0.5 h after application ceased. One percent of applied PAM was lost in tail-ditch runoff. This loss could have been eliminated by treating only the furrow advance or not treating the last two irrigations

Capital flows, long term bond yields and fiscal stance : the Eurozone policy trilemma

The paper aims at estimating the existence of a trilemma in the Eurozone, i.e., to assess to what extent the net capital flows, the volatility of bond yields and the fiscal stance are strictly linked to each other constraining countries’ ability to manage the internal policy goals. The existence of constraints on policy alternatives is estimated for 11 Eurozone countries from 2002 till 2012. The sample is then divided into pre- (2002–2008) and post-crisis (2009–2012) periods. A further division between the PIIGS and the non-PIIGS is then applied. The results show the validity of the trilemma for the whole Euro area and for the whole period but with some distinction between the pre- and post-crisis periods and between the PIIGS and the non-PIIGS countries. The existence of the trilemma underlines the presence of national constraints and suggests, for the future of the Eurozone, to push towards centralized fiscal policy instruments.info:eu-repo/semantics/publishedVersio

Clinical profile and outcome of surgical treatment of perforated peptic ulcers in Northwestern Tanzania: A tertiary hospital experience

\ud \ud Perforated peptic ulcer is a serious complication of peptic ulcers with potential risk of grave complications. There is paucity of published reports on perforated peptic ulcer disease in our local environment. This study was conducted to evaluate the clinical presentation, management and outcome of patients with peptic ulcer perforation in our setting and to identify predictors of outcome of these patients. This was a combined retrospective and prospective study of patients who were operated for perforated peptic ulcers at Bugando Medical Centre between April 2006 and March 2011. Data were collected using a pre-tested and coded questionnaire and analyzed using SPSS computer software version 15.0. Ethical approval to conduct the study was obtained from relevant authority before the commencement of the study. A total of 84 patients were studied. Males outnumbered females by a ratio of 1.3: 1. Their median age was 28 years and the modal age group was 21-30 years. The median duration of illness was 5.8 days. The majority of patients (69.0%) had no previous history of treatment for peptic ulcer disease. The use of non-steroidal anti-inflammatory drugs, alcohol and smoking was reported in 10.7%, 85.7% and 64.3% respectively. Eight (9.5%) patients were HIV positive with a median CD4 count of 220 cells/μl. Most perforations were located on the duodenum {90.4%) with the duodenal to gastric ulcers ratio of 12.7: 1. Graham's omental patch (Graham's omentopexy) of the perforations was performed in 83.3% of cases. Complication and mortality rates were 29.8% and 10.7% respectively. The factors significantly related to complications were premorbid illness, HIV status, CD 4 count < 200 cells/μl, treatment delay and acute perforation (P < 0.001). Mortality rate was high in patients who had age ≥ 40 years, delayed presentation (>24 hrs), shock at admission (systolic BP < 90 mmHg), HIV positivity, low CD4 count (<200 cells/μl), gastric ulcers, concomitant diseases and presence of complications (P < 0.001). The median overall length of hospital stay was 14 days. Excellent results using Visick's grading system were obtained in 82.6% of surviving patients. Perforation of peptic ulcer remains a frequent clinical problem in our environment predominantly affecting young males not known to suffer from PUD. Simple closure with omental patch followed by Helicobacter pylori eradication was effective with excellent results in majority of survivors despite patients' late presentation in our center

Oesophageal varices, schistosomiasis, and mortality among patients admitted with haematemesis in Mwanza, Tanzania: a prospective cohort study.

BACKGROUND: Upper gastrointestinal bleeding (UGIB) is a common cause of hospital admissions worldwide. Aetiologies vary by sociodemographics and geography. Retrospective studies of endoscopies in much of Africa have documented oesophageal varices as a leading cause of UGIB. Prospective studies describing outcomes and associations with clinical factors are lacking. METHODS: We conducted a prospective cohort study at a referral hospital in Mwanza, Tanzania where schistosomiasis is endemic. Adults admitted with haematemesis underwent laboratory workup, schistosomiasis antigen testing and elective endoscopy, and were followed for two months for death or re-bleeding. We assessed predictors of endoscopic findings using logistic regression models, and determined prediction rules that maximised sensitivity and positive predictive value (PPV). RESULTS: Of 124 enrolled patients, 13 died within two months (10%); active schistosomiasis prevalence was 48%. 64/91(70%) patients had oesophageal varices. We found strong associations between varices and numerous demographic or clinical findings, permitting construction of simple, high-fidelity prediction rules for oesophageal varices applicable even in rural settings. Portal vein diameter ≥ 13 mm or water sourced from the lake yielded sensitivity, specificity, PPV and NPV >90% for oesophageal varices; presence of splenomegaly or water sourced from the lake maintained sensitivity and PPV >90%. CONCLUSIONS: Our results guide identification of patients, via ultrasound and clinical examination, likely to have varices for whom referral for endoscopy may be life-saving. Furthermore, they support empiric anti-schistosome treatment for patients with UGIB in schistosome-endemic regions. These interventions have potential to reduce UGIB-related morbidity and mortality in Africa

Polyacrylamide as an organic nitrogen source for soil microorganisms with potential effects on inorganic soil nitrogen in agricultural soil

Linear polyacrylamide (PAM) is gaining considerable acceptance as an effective anti-erosion additive in irrigation water. The potential effects of repeated PAM application on soil microbial ecology and the potential for biotransformation of this polymer in soils are not completely known. Untreated and PAM-treated soils (coarse-silty, mixed, mesic Durixerollic Calciorthids) were collected from agricultural fields near Kimberly, ID. Soils were analyzed to determine the effects of PAM treatment on bacterial counts and inorganic N concentrations and the potential for PAM biotransformation. Culturable heterotrophic bacterial numbers were significantly elevated in PAM-treated soil for the plot planted to potatoes; this effect was not observed in the plot planted to dry pink beans. Total bacterial numbers, determined by AODC, were not altered by PAM treatment in any of the soils sampled. Polyacrylamide-treated soil planted to potatoes contained significantly higher concentrations of NO3 and NH 3 (36.7 ± 2.20 and 1.30 ± 0.3 mg kg-1 , respectively) than did untreated soil (10.7 ± 2.30 and 0.50 ± 0.02 mg kg-1, respectively). For bean field soil there was no difference between treated and untreated soil inorganic N concentrations. Enrichment cultures generated from PAM-treated and untreated soils utilized PAM as sole N source, but not as sole C source. While the monomeric constituents of PAM, acrylamide and acrylic acid, both supported bacterial growth as sole C source, the PAM polymer did not. Enrichment cultures that used PAM for N exhibited amidase activity specific for PAM as well as smaller aliphatic amides. Utilization of PAM for N, but not for C, indicates that ultimately PAM may be converted into long chain polyacrylate, which may be further degraded by physical and biological mechanisms or be incorporated into organic matter

Soil amidase activity in polyacrylamide-treated soils and potential activity toward common amide-containing pesticides

t Polyacrylamide (PAM) is currently used as an irrigation water additive to significantly reduce the amount of soil erosion that occurs during furrow irrigation of crops. Elevated soil amidase activity specific toward the large PAM polymer has been reported in PAM-treated field soils; the substrate specificity of the induced amidase is uncertain. PAM-treated and untreated soils were assayed for their capacity to hydrolyze the amide bond in carbaryl (Sevin), diphenamid (Dymid), and naphthalene acetamide. Based on results obtained with a soil amidase assay, there was no difference between PAM-treated and untreated soils with respect to the rate of amide bond hydrolysis of any of the agrochemicals tested. It appears that under these assay conditions the PAM-induced soil amidase is not active toward the amide bonds within these molecules. However, carbaryl was hydrolyzed by a different soil amidase. To our knowledge, this is the first soil enzyme assay-based demonstration of the hydrolysis of carbaryl by a soil amidase