Cerebrovascular Accident Caused by Embolic Atrial Myxoma

Background: Atrial myxomas, the most common type of cardiac tumors, can cause life-threatening complications. As most cardiac myxomas are surgically curable, early diagnosis is crucial. Cardiac tumors can present with cardiac and embolic manifestations, and should be considered in the differential diagnosis of patients presenting with such symptoms. In this case report, we describe a young, healthy patient who presented with stroke symptoms secondary to embolic atrial myxoma. Case Presentation: Case Presentation A 45-year-old male with no past medical history presented with an acute onset of dysarthria, described as garbled speech. He also experienced weakness and heaviness of his right hand, which impaired his ability to brush his teeth and write. He denied left-handed or lower extremity weakness, head trauma, facial droop, dysphagia, migraines, diplopia/visual changes, confusion, or memory loss. He denied tobacco, alcohol, or drug use. Review of systems was otherwise negative, although the patient reported that whenever he participated in strenuous physical activity over the past few years, he would become nauseated

Hematemesis, a Distended Abdomen, and Pulseless Electrical Activity – An Unusual Presentation of Boerhaave’s Syndrome

Case Presentation An 82-year-old male with a past medical history significant for coronary artery disease with three stents placed over the last 15 months, diastolic heart failure with preserved EF, atrial fibrillation on warfarin, colon cancer status-post sigmoid resection and prostate cancer status-post prostatectomy who presented with three episodes of melena, hematemesis, and weakness. The patient was in his usual state of health prior to these symptoms. He had no history of gastrointestinal (GI) bleeding or other GI pathology and was a non-drinker and non-smoker. He denied frequent use of non-steroidal anti-inflammatory medications

Opportunities for Quality Improvement in a Smoking Cessation Program for Patients with Lung Cancer

Background Smoking cessation improves mortality in patients with lung cancer Low rates of smoking cessation have been observed and are rarely effective in absence of formal interventions (counseling, nicotine replacement, medication, etc.) Referrals to formal counseling can significantly impact cessation. Particularly in patients with lung cancer, cancer centers have the opportunity to serve as a central actor for referrals In this study we aimed to assess the efficacy of the Tobacco Cessation Program at the Sidney Kimmel Cancer Center and to identify opportunities for quality improvement to improve smoking cessation rates in these patient

Evaluating Component Migration: Comparing Two Generations of the INBONE(®) Total Ankle Replacement.

Although total ankle replacement (TAR) designs have radically evolved, the compressive forces at the ankle can cause aseptic loosening, talar subsidence, and implant failure. The purpose of the present report was to compare the implant migration associated with the INBONE(®) I, a TAR system with a stemmed talar component, and the newer generation INBONE(®) II, a TAR system without a stemmed talar component (Wright Medical Technology, Inc., Arlington, TN). Because core decompression could weaken the integrity of the talus, we hypothesized that the stemmed component would result in greater implant migration. A total of 35 consecutive patients (age 58.2 ± 12.1 years; 23 men) were included. Of these 35 patients, 20 (57.1%) had been treated with the INBONE(®) I and 15 (42.9%) with the INBONE(®) II. To assess implant migration, using anteroposterior radiographs, the distance from the apex of the tibial component to the most distal aspect of the talar stem or to the mid-saddle of the nonstemmed component was measured. The measurements were recorded from the immediate postoperative radiographs and the 12-month postoperative radiographs. Implant migration was quantified as the difference between the 12-month and the immediate postoperative measurements. Despite our hypothesis, no significant difference was found in implant migration between the INBONE(®) I (0.7 ± 1.2 mm) and INBONE(®) II (0.6 ± 1.3 mm, p = .981). However, previously published data have suggested that implant migration can continue for ≥2 years after surgery. Therefore, additional investigations with larger sample sizes and longer follow-up periods are needed to draw definitive conclusions

Modeling Emerging Semiconductor Devices for Circuit Simulation

Circuit simulation is an indispensable part of modern IC design. The significant cost of fabrication has driven researchers to verify the chip functionality through simulation before submitting the design for final fabrication. With the impending end of Moore’s Law, researchers all over the world are looking for new devices with enhanced functionality. A plethora of promising emerging devices has been proposed in recent years. In order to leverage the full potential of such devices, circuit designers need fast, reliable models for SPICE simulation to explore different applications. Most of these new devices have complex underlying physical mechanism rendering the model development an extremely challenging task. For the models to be of practical use, they have to enable fast and accurate simulation that rules out the possibility of numerically solving a system of partial differential equations to arrive at a solution. In this chapter, we show how different modeling approaches can be used to simulate three emerging semiconductor devices namely, silicon- on- insulator four gate transistor(G4FET), perimeter gated single photon avalanche diode (PG-SPAD) and insulator-metal transistor (IMT) device with volatile memristance. All the models have been verified against experimental /TCAD data and implemented in commercial circuit simulator

A Knob for Changing Light Propagation from Subluminal to Superluminal

We show how the application of a coupling field connecting the two lower metastable states of a lambda-system can produce a variety of new results on the propagation of a weak electromagnetic pulse. In principle the light propagation can be changed from subluminal to superluminal. The negative group index results from the regions of anomalous dispersion and gain in susceptibility.Comment: 6 pages,5 figures, typed in RevTeX, accepted in Phys. Rev.

The information needs of people living with ankylosing spondylitis: a questionnaire survey

<p>BACKGROUND:Today, health care is patient-centred with patients more involved in medical decision making and taking an active role in managing their disease. It is important that patients are appropriately informed about their condition and that their health care needs are met. We examine the information utilisation, sources and needs of people with ankylosing spondylitis (AS).</p> <p>METHODS: Participants in an existing AS cohort study were asked to complete a postal or online questionnaire containing closed and open-ended questions, regarding their information access and needs. Participants were stratified by age and descriptive statistics were performed using STATA 11, while thematic analysis was performed on open-ended question narratives. Qualitative data was handled in Microsoft Access and explored for emerging themes and patterns of experiences.</p> <p>RESULTS: Despite 73% of respondents having internet access, only 49% used the internet to access information regarding AS. Even then, this was only infrequently. Only 50% of respondents reported accessing written information about AS, which was obtained mainly in specialist clinics. Women were more likely than men to access information (63% (women) 46% (men)) regardless of the source, while younger patients were more likely to use online sources. The main source of non-written information was the rheumatologist. Overall, the respondents felt there was sufficient information available, but there was a perception that the tone was often too negative. The majority (95%) of people would like to receive a regular newsletter about AS, containing positive practical and local information. Suggestions were also made for more information about AS to be made available to non-specialist medical professionals and the general public.</p> <p>CONCLUSIONS: There appears to be sufficient information available for people with AS in the UK and this is mostly accessed by younger AS patients. Many patients, particularly men, choose not to access AS information and concerns were raised about its negative tone. Patients still rely on written and verbal information from their specialists. Future initiatives should focus on the delivery of more positive information, targeting younger participants in particular and increasing the awareness in the general population and wider non-specialist medical community.</p&gt

Patient perspectives of managing fatigue in ankylosing spondylitis, and views on potential interventions: a qualitative study

<p>Background: Fatigue is a major component of living with ankylosing spondylitis (AS), though it has been largely over-looked, and currently there are no specific agreed management strategies.</p> <p>Methods: This qualitative exploratory study involved participants who are members of an existing population-based ankylosing spondylitis (PAS) cohort. Participants residing in South West Wales were invited to participate in a focus group to discuss; (1) effects of fatigue, (2) self-management strategies and (3) potential future interventions. The focus groups were audio-recorded and the transcripts were analysed using thematic analysis.</p> <p>Results: Participants consisted of 3 males/4 females (group 1) and 4 males/3 females (group 2), aged between 35 and 73 years (mean age 53 years). Three main themes were identified: (1) The effects of fatigue were multi-dimensional with participants expressing feelings of being ‘drained’ (physical), ‘upset’ (emotional) and experiencing ‘low-mood’ (psychological); (2) The most commonly reported self-management strategy for fatigue was a balanced combination of activity (exercise) and rest. Medication was reluctantly taken due to side-effects and worries over dependency; (3) Participants expressed a preference for psychological therapies rather than pharmacological for managing fatigue. Information on Mindfulness-Based Stress Reduction (MBSR) was received with interest, with recommendations for delivery in a group format with the option of distance-based delivery for people who were not able to attend a group course.</p> <p>Conclusions: Patients frequently try and manage their fatigue without any formal guidance or support. Our research indicates there is a need for future research to focus on psychological interventions to address the multi-faceted aspects of fatigue in AS.</p&gt

Hemozoin produced by mammals confers heme tolerance

Free heme is cytotoxic as exemplified by hemolytic diseases and genetic deficiencies in heme recycling and detoxifying pathways. Thus, intracellular accumulation of heme has not been observed in mammalian cells to date. Here we show that mice deficient for the heme transporter SLC48A1 (also known as HRG1) accumulate over ten-fold excess heme in reticuloendothelial macrophage lysosomes that are 10 to 100 times larger than normal. Macrophages tolerate these high concentrations of heme by crystallizing them into hemozoin, which heretofore has only been found in blood-feeding organisms. SLC48A1 deficiency results in impaired erythroid maturation and an inability to systemically respond to iron deficiency. Complete heme tolerance requires a fully-operational heme degradation pathway as haplo insufficiency of HMOX1 combined with SLC48A1 inactivation causes perinatal lethality demonstrating synthetic lethal interactions between heme transport and degradation. Our studies establish the formation of hemozoin by mammals as a previously unsuspected heme tolerance pathway

Persistence and Availability of Web Services in Computational Biology

We have conducted a study on the long-term availability of bioinformatics Web services: an observation of 927 Web services published in the annual Nucleic Acids Research Web Server Issues between 2003 and 2009