Outcomes of patients with rodenticide poisoning at a far east poison center

BACKGROUND: Rodenticide poisoning remains a major public health problem in Asian countries. Nevertheless, very few data are available in world literature regarding the outcomes of these patients. Therefore, the purpose of this study was to investigate the clinical outcomes of rodenticide poisonings in our hospital and to compare these data with published reports from other international poison centers. FINDINGS: We retrospectively examined the records of 20 patients with rodenticide poisoning (8 brodifacoum, 12 bromadiolone) who were referred to Chang Gung Memorial Hospital between 2000 and 2011. It was found that most of the rodenticide patients were middle-aged adults. Both genders were equally affected and many patients had a past history of major depressive disorder or schizophrenia. Nevertheless, patients with bromadiolone were referred significantly sooner than patients with brodifacoum poisoning (0.1 ± 0.1 versus 5.5 ± 10.5, P < 0.001). Furthermore, it was found that patients with brodifacoum suffered higher incidences of ecchymosis (50.0% versus 0%, P = 0.006) and hematuria (50.0% versus 0%, P = 0.006) than patients with bromadiolone poisoning. Laboratory analysis also demonstrated a poorer hemostatic profile of patients with brodifacoum [prothrombin time (PT), international normalized ratio (INR), 4.3 ± 4.8 versus 1.0 ± 0.1, P = 0.032; PT prolongation, 50.0% versus 0%, P = 0.006; activated partial thromboplastin time (aPTT) prolongation, 50.0% versus 0%, P = 0.006] than patients with bromadiolone poisoning. At the end of analysis, no patient died of the poisoning. CONCLUSION: The favorable outcome (zero mortality rate) is comparable to the published reports from other international poison centers. Further studies are warranted

Genome-Wide Gene Expression Analysis Implicates the Immune Response and Lymphangiogenesis in the Pathogenesis of Fetal Chylothorax

Fetal chylothorax (FC) is a rare condition characterized by lymphocyte-rich pleural effusion. Although its pathogenesis remains elusive, it may involve inflammation, since there are increased concentrations of proinflammatory mediators in pleural fluids. Only a few hereditary lymphedema-associated gene loci, e.g. VEGFR3, ITGA9 and PTPN11, were detected in human fetuses with this condition; these cases had a poorer prognosis, due to defective lymphangiogenesis. In the present study, genome-wide gene expression analysis was conducted, comparing pleural and ascitic fluids in three hydropic fetuses, one with and two without the ITGA9 mutation. One fetus (the index case), from a dizygotic pregnancy (the cotwin was unaffected), received antenatal OK-432 pleurodesis and survived beyond the neonatal stage, despite having the ITGA9 mutation. Genes and pathways involved in the immune response were universally up-regulated in fetal pleural fluids compared to those in ascitic fluids. Furthermore, genes involved in the lymphangiogenesis pathway were down-regulated in fetal pleural fluids (compared to ascitic fluid), but following OK-432 pleurodesis, they were up-regulated. Expression of ITGA9 was concordant with overall trends of lymphangiogenesis. In conclusion, we inferred that both the immune response and lymphangiogenesis were implicated in the pathogenesis of fetal chylothorax. Furthermore, genome-wide gene expression microarray analysis may facilitate personalized medicine by selecting the most appropriate treatment, according to the specific circumstances of the patient, for this rare, but heterogeneous disease

Вихретоковый анизотропный термоэлектрический первичный преобразователь лучистого потока

Представлена оригинальная конструкция первичного преобразователя лучистого потока, который может служить основой для создания приемника неселективного излучения с повышенной чувствительностью

An Adaptive Supervisory Sliding Fuzzy Cerebellar Model Articulation Controller for Sensorless Vector-Controlled Induction Motor Drive Systems

This paper presents the implementation of an adaptive supervisory sliding fuzzy cerebellar model articulation controller (FCMAC) in the speed sensorless vector control of an induction motor (IM) drive system. The proposed adaptive supervisory sliding FCMAC comprised a supervisory controller, integral sliding surface, and an adaptive FCMAC. The integral sliding surface was employed to eliminate steady-state errors and enhance the responsiveness of the system. The adaptive FCMAC incorporated an FCMAC with a compensating controller to perform a desired control action. The proposed controller was derived using the Lyapunov approach, which guarantees learning-error convergence. The implementation of three intelligent control schemes—the adaptive supervisory sliding FCMAC, adaptive sliding FCMAC, and adaptive sliding CMAC—were experimentally investigated under various conditions in a realistic sensorless vector-controlled IM drive system. The root mean square error (RMSE) was used as a performance index to evaluate the experimental results of each control scheme. The analysis results indicated that the proposed adaptive supervisory sliding FCMAC substantially improved the system performance compared with the other control schemes

A Diagnostic System for Speed-Varying Motor Rotary Faults

This study proposed an intelligent rotary fault diagnostic system for motors. A sensorless rotational speed detection method and an improved dynamic structural neural network are used. Moreover, to increase the convergence speed of training, a terminal attractor method and a hybrid discriminant analysis are also adopted. The proposed method can be employed to detect the rotary frequencies of motors with varying speeds and can enhance the discrimination of motor faults. To conduct the experiments, this study used wireless sensor nodes to transmit vibration data and employed MATLAB to write codes for functional modules, including the signal processing, sensorless rotational speed estimation, neural network, and stochastic process control chart. Additionally, Visual Basic software was used to create an integrated human-machine interface. The experimental results regarding the test of equipment faults indicated that the proposed novel diagnostic system can effectively estimate rotational speeds and provide superior ability of motor fault discrimination with fast training convergence

Late Termination of Pregnancy: Experience From an East Asian Population and Report of a Novel Technique for Feticide

We report our experience of late feticide in Taiwan as well as a novel technique, fetal cardiac tamponade, which can be used in the late termination of pregnancy. Twenty-six patients who elected to undergo feticide were enrolled in this study (among 40 pregnancies with fetal abnormalities diagnosed late in gestation during 2005–2008 in a tertiary referral center in Taiwan). The fetal abnormalities in these patients included structural malformations and/or genetic defects. This study conformed strictly to the regulation of law and was approved by the Institutional Review Board/Ethics Committee of the Changhua Christian Hospital. Two methods were used to perform feticide: intracardiac injection of potassium chloride (6 mmol) and intracardiac injection of lidocaine (10 mL in 2% preparation). If fetal asystole was not achieved 3 minutes after initial injection, fetal cardiac tamponade was then performed by instilling normal saline into the fetal pericardium. Permanent cessation of fetal heart activity was regarded as successful feticide. The gestational age of the feticide group ranged from 24 to 38 weeks (mean, 30.85 ± 3.77 weeks). The body weight of the aborted fetuses ranged from 675 g to 2,860 g (mean, 1,618.1 ± 590.7 g). The use of lidocaine was successful in six of the seven cases (85.7% success rate). The use of potassium chloride was successful in 11 of the 19 cases (57.9% success rate). Fetal cardiac tamponade as a salvage technique was performed in nine cases, including eight cases in which pumping of the fetal heart resumed following potassium chloride administration and in one case when lidocaine alone failed to achieve permanent cessation of fetal heart activity. The success rate of fetal cardiac tamponade as a salvage technique was therefore 100%. No maternal complications were noted in our series. Fetal cardiac tamponade is a useful and safe supplementary technique in late feticide when cardiac depressing agents fail to cease fetal cardiac activity

Hepatitis B Virus Reactivation After 23 Months of Rituximab-based Chemotherapy in an HBsAg-negative, Anti-HBs-positive Patient With Follicular Lymphoma

A 72-year-old female negative for hepatitis B surface antigen (HBsAg) and positive for antibody to hepatitis B surface antigen (anti-HBs) was diagnosed to have follicular lymphoma in 2006. Seventeen cycles of rituximab-based chemotherapy were administered over 23 months. Twelve days after the last cycle of chemotherapy, serum aminotransferase levels were elevated, and hepatitis serology tests revealed reappearance of HBsAg and hepatitis B e antigen (HBeAg), loss of anti-HBs, and positivity for hepatitis B virus (HBV) DNA. Antiviral treatment with entecavir was administered immediately, and the hepatitis flare was controlled. Rituximab-based chemotherapy can induce HBV reactivation even in HBsAg-negative, anti-HBs-positive patients. Early recognition and prompt antiviral treatment is crucial for patients with HBV reactivation during anticancer therapy

The Application of EUS-guided FNA in the Diagnosis of Pancreatic Neoplasms in the Elderly

Summary: Background: Endoscopic ultrasound guided fine needle aspiration has become a standard procedure in diagnosis of pancreatic neoplasms with a high diagnosis yield. However, the clinical application focusing on the elderly population is scanty. Methods: Consecutive procedures for EUS-FNA diagnosis of pancreatic neoplasms at a tertiary referral center from March 2014 to December 2015 were analyzed retrospectively. The procedures were divided into two groups according to their age, the control group consisted of patients ≤60 years old and the elderly groups consisted of patients >60 years old. The primary outcome is the accuracy of the diagnosis in the two groups. The secondary outcome is the safety during the procedure. Results: A total of 28 EUS-FNA procedures were performed. The mean age of the control group was 48.7 years (n = 14) versus 70.2 years (n = 14) for the elderly cohort. Diagnostic accuracy of the EUS-FNA procedure in detecting malignant (true positive) and benign (true negative) lesions were higher in the control group (nonelderly: 85.7% vs. elderly: 50%; P = 0.046). There were two mild acute pancreatitis associated to the EUS-FNA procedures in the control group. Conclusion: Although EUS-FNA is safe and well tolerated in the elderly patients, our study showed a lower EUS-FNA diagnosis accuracy in this group. Focal fibrotic changes in the pancreas associated with the elderly patients resembled that of chronic pancreatitis microscopically. Keywords: EUS-FNA, pancreatic neoplasms, elderly, endoscopy, diagnosi

Dynamic Cross-Linking of Catalytically Synthesized Poly(Aminonorbornenes)

Amine-functionalized polymeric materials have a wide variety of applications; however, the preparation of these materials is often plagued by laborious, multistep synthetic routes. Herein, a modified and improved synthetic protocol utilizes the hydroaminoalkylation reaction to catalytically assemble aminefunctionalized monomers on a gram scale with 100% atom economy. Combined with ring-opening metathesis polymerization (ROMP), amine-functionalized polymers with varying electronic properties have been synthesized. Extensive rheological characterizations show that modification of the electronic properties of the amine substituent influences the bulk material properties through modification of hydrogen bonding and π-stacking interactions to afford dynamic cross-linking within the polymeric material. Tertiary amine-containing polymers display distinct rheological properties that differ from those of polymers with pendant hydrogen-bond-donating secondary amines. The profound viscoelastic effects that result from the incorporation of tunable dynamic interactions are presented