The accuracy rate of Alvarado score, ultrasonography, and computerized tomography scan in the diagnosis of acute appendicitis in our center

Objective: In this study, we aim to compare the relationship between the Alvarado score, ultrasonography, and multislice computerized tomography (CT) findings used for the diagnosis of the patients who presented to our emergency unit with clinical features suggestive of acute appendicitis.Materials and Methods: Seventy.four patients operated with the diagnosis of acute appendicitis were included in the study. The demographic  characteristics of the patients, physical findings, blood parameters,  Alvarado scores, the radiological method used for the diagnosis, the  surgical methods (open or laparoscopic) and the pathology results wererecorded on the standard proforma. The collected data were analyzed with Statistical Package for Social Sciences (SPSS 15 for Windows, SPSS Inc., Chicago, Illinois, USA) computer program.Results: During study period, the sensitivity of ultrasonography was found to be as 71.2%, specificity as 46.7%, the positive predictive value (PPV) as 82.2%, the negative predictive value (NPV) as 31.8%, and the accuracy  rate was determined as 65.7%. The sensitivity of tomography was  determined as 97.2%, the specificity as 62.5%, PPV as 92.1%, and NPV as 83.3%, and the accuracy rate was determined as 90%. The sensitivity of  the Alvarado score was calculated as 54%, the specificity as 73.3%, the PPV as 88.2% and the NPV as 29.7%, and the accuracy rate was determined as 57.7%.Conclusion: In conclusion, computerized tomography (CT) was found to have higher specificity and sensitivity than Alvarado score and USG which are not sufficient on their own for taking the decision for surgery. We also found that CT scan had lower negative laparotomy rate when compared with the other two modalities.Key words: Alvarado score, appendicitis, computerized tomography, ultrasonograph

Project PROMETHEUS: Design and Construction of a Radio Frequency Quadrupole at TAEK

The PROMETHEUS Project is ongoing for the design and development of a 4-vane radio frequency quadrupole (RFQ) together with its H+ ion source, a low energy beam transport (LEBT) line and diagnostics section. The main goal of the project is to achieve the acceleration of the low energy ions up to 1.5 MeV by an RFQ (352 MHz) shorter than 2 meter. A plasma ion source is being developed to produce a 20 keV, 1 mA H+ beam. Simulation results for ion source, transmission and beam dynamics are presented together with analytical studies performed with newly developed RFQ design code DEMIRCI. Simulation results shows that a beam transmission 99% could be achieved at 1.7 m downstream reaching an energy of 1.5 MeV. As the first phase an Aluminum RFQ prototype, the so-called cold model, will be built for low power RF characterization. In this contribution the status of the project, design considerations, simulation results, the various diagnostics techniques and RFQ manufacturing issues are discussed.Comment: 4 pages, 8 figures, Proceedings of the 2nd International Beam Instrumentation Conference 2013 (IBIC'13), 16-19 Sep 2013, WEPC02, p. 65

Microstructural analysis with graded and non-graded indium in InGaN solar cell

In this study are graded and non graded InGaN/GaN samples grown on c-oriented sapphire substrate using the Metal Organic Chemical Vapour Deposition (MOCVD) technique. The structural and morphological properties of the grown InGaN/GaN solar cell structures are analyzed using High Resolution X-ray Diffraction (HRXRD), atomic force microscopy (AFM). Each structures c and a lattice parameters strain, biaxial strain, hydrostatic strain, stress, lattice relax, tilt angle, mosaic crystal size, dislocation densities of GaN and InGaN layers are determined by XRD measurements. In accordance with these calculations, the effect of graded structure on the defects, are discussed. As a dramatic result; although values of full width at half maximum (FWHM) are broad, a considerable decrease at dislocations is noticed. The AFM observations have revealed that the two dimensional growth of the graded sample is more significant and its roughness value is lower. JV measurements shown that the performance of the graded structure is higher. It is determined that all test results are consistent with each other. © Copyright 2017 by American Scientific Publishers. All rights reserved

Intra-anal imiquimod cream against human papillomavirus infection in men who have sex with men living with hiv: A single-arm, open-label pilot study

Men who have sex with men (MSM) living with HIV have a high prevalence and incidence of anal high-risk human papillomavirus (hrHPV) and anal cancer. We conducted an open-label, single-arm pilot study to examine the tolerability of imiquimod cream among MSM aged ≥18 years, living with HIV, who tested positive for anal hrHPV at Melbourne Sexual Health Centre between April 2018 and June 2020. We instructed men to apply 6.25 mg imiquimod intra-anally and peri-anally 3 doses per week for 16 weeks (period 1) and then one dose per week for a further 48 weeks (period 2). Twenty-seven MSM enrolled in period 1 and 24 (86%) applied at least 50% of doses. All men reported adverse events (AEs), including 39.5% grade 1, 39.5% grade 2, and 21% grade 3 AEs on at least one occasion. Eighteen MSM (67%) temporarily stopped using imiquimod during period 1, most commonly due to local AEs (n = 11) such as irritation and itching. Eighteen MSM continued in period 2 and all applied at least 50% of doses with no treatment-limiting AEs reported. Imiquimod 3 doses per week caused local AEs in most men and was not well tolerated. In contrast, once-a-week application was well tolerated over 48-weeks with no treatment-limiting AEs

Examination of the temperature related structural defects of InGaN/GaN solar cells

In this study the effects of the annealing temperature on the InGaN/GaN solar cells with different In-contents grown on sapphire substrate by the Metal Organic Chemical Vapor Deposition (MOCVD) are analyzed by High Resolution X-ray Diffraction (HRXRD) and an Atomic Force Microscope (AFM). The plane angles, mosaic crystal sizes, mixed stress, dislocation intensities of the structure of the GaN and InGaN layers are determined. According to the test results, there are no general characteristic trends observed due to temperature at both structures. There are fluctuating failures determined at both structures as of 350 °C. The defect density increased on the GaN layer starting from 350 °C and reaching above 400 °C. A similar trend is observed on the InGaN layer, too. © 2015 Elsevier Ltd. All rights reserved

Preconditioning-induced ischemic tolerance: a window into endogenous gearing for cerebroprotection

Ischemic tolerance defines transient resistance to lethal ischemia gained by a prior sublethal noxious stimulus (i.e., preconditioning). This adaptive response is thought to be an evolutionarily conserved defense mechanism, observed in a wide variety of species. Preconditioning confers ischemic tolerance if not in all, in most organ systems, including the heart, kidney, liver, and small intestine. Since the first landmark experimental demonstration of ischemic tolerance in the gerbil brain in early 1990's, basic scientific knowledge on the mechanisms of cerebral ischemic tolerance increased substantially. Various noxious stimuli can precondition the brain, presumably through a common mechanism, genomic reprogramming. Ischemic tolerance occurs in two temporally distinct windows. Early tolerance can be achieved within minutes, but wanes also rapidly, within hours. Delayed tolerance develops in hours and lasts for days. The main mechanism involved in early tolerance is adaptation of membrane receptors, whereas gene activation with subsequent de novo protein synthesis dominates delayed tolerance. Ischemic preconditioning is associated with robust cerebroprotection in animals. In humans, transient ischemic attacks may be the clinical correlate of preconditioning leading to ischemic tolerance. Mimicking the mechanisms of this unique endogenous protection process is therefore a potential strategy for stroke prevention. Perhaps new remedies for stroke are very close, right in our cells

In Vivo Near-Infrared Imaging of Fibrin Deposition in Thromboembolic Stroke in Mice

imaging of activated factor XIII (FXIIIa), an important mediator of thrombosis or fibrinolytic resistance. The present study was to investigate the fibrin deposition in a thromboembolic stroke mice model by FXIIIa–targeted near-infrared fluorescence (NIRF) imaging., which were correlated with histology after animal euthanasia. NIRF images and lesion volume.Non-invasive detection of fibrin deposition in ischemic mouse brain using NIRF imaging is feasible and this technique may provide an in vivo experimental tool in studying the role of fibrin in stroke

Translational Stroke Research Using a Rabbit Embolic Stroke Model: A Correlative Analysis Hypothesis for Novel Therapy Development

Alteplase (tissue plasminogen activator, tPA) is currently the only FDA-approved treatment that can be given to acute ischemic stroke (AIS) patients if patients present within 3 h of an ischemic stroke. After 14 years of alteplase clinical research, evidence now suggests that the therapeutic treatment window can be expanded 4.5 h, but this is not formally approved by the FDA. Even though there remains a significant risk of intracerebral hemorrhage associated with alteplase administration, there is an increased chance of favorable outcome with tPA treatment. Over the last 30 years, the use of preclinical models has assisted with the search for new effective treatments for stroke, but there has been difficulty with the translation of efficacy from animals to humans. Current research focuses on the development of new and potentially useful thrombolytics, neuroprotective agents, and devices which are also being tested for efficacy in preclinical and clinical trials. One model in particular, the rabbit small clot embolic stroke model (RSCEM) which was developed to test tPA for efficacy, remains the only preclinical model used to gain FDA approval of a therapeutic for stroke. Correlative analyses from existing preclinical translational studies and clinical trials indicate that there is a therapeutic window ratio (ARR) of 2.43-3 between the RSCEM and AIS patients. In conclusion, the RSCEM can be used as an effective translational tool to gauge the clinical potential of new treatments