Valproate in Conversion Disorder: A Case Report

Few data are in literature about the pharmacological treatment of conversion disorder and there are not any studies about the use of Valproate extended release (ER) in treating conversion disorder. In this article, we are reporting a case of an Italian woman with a diagnosis of conversion disorder treated effectively and quickly by Valproate ER

Quetiapine Sustained Release in Treatment of Delirium Induced by Cerebral Metastasis

While haloperidol represents the first-line treatment of delirium, some studies have shown that atypical antipsychotics could be used as an efficacious treatment in delirium management. This article reports a case of a delirious patient, treated effectively and quickly with Quetiapine sustained release with negligible side effects

Change Point Problem for Censored Data

Department of Probability and Mathematical StatisticsKatedra pravděpodobnosti a matematické statistikyMatematicko-fyzikální fakultaFaculty of Mathematics and Physic

Coexistence of diffuse large B-cell lymphoma and papillary thyroid carcinoma in a patient affected by Hashimoto's thyroiditis.

SUMMARY Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. On the contrary, primary thyroid lymphoma (PTL) is a rare disease, accounting for 2% to 5% of all thyroid malignancies. Despite several cases in which both PTC and PTL arise in the setting of Hashimoto's thyroiditis (HT), the coexistence of both tumors in HT patients is very rare. Herein we report the case of a 66-year-old woman with long-standing nodular HT under replacement therapy, who presented with a fast, painless enlargement in the right anterior side of the neck. Thyroid ultrasonography demonstrated increased growth of a hypoechoic nodule in the right lobe measuring 32 × 20 mm. A total thyroidectomy was performed, and histology revealed a diffuse large B-cell lymphoma (DLBCL) on a background of florid HT. Moreover, a unifocal papillary microcarcinoma, classical variant (7 mm, pT1aNxMx), was discovered. The patient was then treated with chemotherapy for the PTL, but she did not undergo radioactive iodine ablation treatment for the microPTC as per guidelines. Two years after surgery, the patient had no evidence of recurrence of either malignancy. This rare case highlights the importance of monitoring HT patients with nodular lesions, especially if they have long-standing disease. In addition, PTL should be considered for differential diagnosis in elder HT patients who present with sudden thyroid enlargement

Lateral resistance of pipes on rocky seabeds: comparison between measurements and models based on synthetic seabeds

The behavior of pipelines, cables and umbilicals on rocky seabeds has to date received little research attention. This is despite the marine renewable energy and oil and gas industries relying on these 'pipes' to cross a variety of rocky seabed types in the presence of extreme metocean conditions. Present design solutions are challenging and costly, yet there remains a track record of in-service failures. This paper forms part of a wider research effort being undertaken by the University of Western Australia (UWA) into pipe behavior on rocky seabeds. This work includes the effects intermittent gaps have on hydrodynamic forces, the effect of seabed roughness on enhanced boundary layer thickness and the validity of existing hydrodynamic force models for small diameter cables. In this paper, the lateral resistance of pipes on rocky seabeds is investigated using both physical and numerical testing of model pipes over artificially-created rocky seabeds. Four model pipes of varying diameter have been displaced laterally over 1 m square model rocky seabeds, with a range of pipe to rock diameters. The lateral resistance of the physical pipe tests were recorded using load cells and a digital data-logger. Analysis of the physical test results has enabled comparison to (and refinement of) numerical models as well as improved understanding of the importance of different parameters. Our results show peak frictions above 6 arising under conditions where interface friction is only about 0.3, which contrasts dramatically with the friction value of 0.6 nominated in F109. This work contributes towards generation of new design methods suitable for application to field conditions.</p

Improved stability design of subsea pipelines on mobile seabeds: Learnings for the STABLEpipe JIP

The on-bottom stability design of subsea pipelines is important to ensure safety and reliability but is challenging to achieve, particularly in Australia due to onerous metocean and seabed conditions, and the prevalence of light gas pipelines. This challenge has been amplified by the fact that industry design guidelines have given no guidance on how to incorporate the potential benefits of seabed mobility, which can lead to lowering and self-burial of the pipeline on a sandy seabed. In this paper, we review the learnings of the STABLEpipe Joint Industry Project (JIP), which was initiated with the aim of developing newdesign guidelines to assess the on-bottom stability of pipelines on mobile seabeds. The paper summarises the new research undertaken within the STABLEpipe JIP to better predictsedimentation and scour, pipe-fluid interaction and pipe-soil interaction. New design methods to assess the on-bottom stability are also outlined, which have been developed based onthe new research. These methods have been adopted in a DNVGL guideline authored by the JIP researchers in collaboration with DNVGL and presently available for use by the JIP participants. Finally, applications of the STABLEpipe JIP outcomes and focus areas for further work are discusse

Pipeline and cable stability: updated state of the art

At OMAE in 2008 the ‘state of the art’in pipeline on-bottom stability engineering was summarized, providing an overview of the current available knowledge for addressing pipeline stability. The aim of that work was to summarise key aspects of the pipeline stability design process and to include some historical perspective. The paper discusses the advantage and shortfalls of the different design approaches with a view to consolidate understanding, rather than to provide a ready-made solution to a complex design problem [1]. Since that time, a decade of research and further methodology refinement has extended the boundaries of the industry's knowledge and understanding of the behaviour of subsea pipelines and cables, including geotechnics, hydrodynamics, oceanography and structural response modelling. In particular, progress has been made in: • The response of pipelines to sediment transport and scour; • Understanding the behaviour of small diameter pipelines and cables within wave and current boundary layers; and • The behaviour of cables on rocky seabeds in high energy marine environments. This paper summarises these innovations to enable the application of new paradigms in engineering practice and improved outcomes for initial project capital cost, reliability and operational integrity, as well as better models to predict the longterm behaviour where pipes are decommissioned in-situ. While a relatively widely studied field of engineering, there remain areas of active ongoing research to improve our understanding and ability to model and predict subsea pipeline on-bottom behavior, with<br/

Observed changes to the stability of a subsea pipeline caused by seabed mobility

High resolution bathymetry combined with structural modelling is used to estimate changes in the on-bottom stability of an offshore pipeline due to scour and sedimentation over an 11 year period. Detailed observations of post-lay embedment changes have been combined with the pipeline structural characteristics and an elastic-plastic model of soil resistance to estimate the vertical and horizontal stability of the pipeline using a finite difference solution to the beam bending equation. Application of the design approach indicates that post-lay increases to the critical (break-out) velocity of 1 – 2 m/s occur along the full 19 km of surveyed pipeline due to scour and sedimentation, which act to reduce load and increase soil resistance. The rate at which this increase in stability occurs with time is found to vary along the pipeline, and is dependent on the mechanism of pipeline lowering (i.e. whether the pipe lowered due to sagging into widely spaced scour holes, or by sinking into the shoulders between many closely spaced scour holes). By incorporating sediment transport into the pipeline design, the present results suggest potential for significant improvements in pipeline on-bottom stability and associated reductions in minimum required specific gravity and/or secondary stabilisation

Lateral resistance of "rigid" pipelines and cables on rocky seabeds

Accurate assessment of lateral resistance is critical to ensure the on-bottom stability and integrity of subsea pipelines and cables in the oil/gas and marine renewable energy industries. However, on rocky seabeds recommend practices provide limited recommendations on pipe/seabed interaction, suggesting only a single value for the friction coefficient of 0.6. This paper reports on a programme of physical experiments and theoretical modelling investigating the lateral resistance of pipes on rocky seabeds. It is shown that the peak and mean effective friction can significantly exceed the interface (or Coulomb) friction coefficient when the pipe diameter (D) is similar to the median rock diameter (dn50). Only when the pipe diameter becomes large compared to the rock size does the mean effective friction approach the interface friction. The effective friction coefficient was found to vary with variability in rock size and shape, as well as the length of pipe relative to median rock diameter. Each of these findings is reproduced well using the theoretical model and demonstrating that the effective lateral friction coefficient maybe higher than 0.6 for mean friction, and significantly higher for peak friction. This implies that inaccuracy may exist in current design, which may be rectified using the theoretical model