Chronic otorrhea and osteomyelitis of the external auditory canal by Achromobacter xylosoxidans: an uncommon diagnosis

Purpose: Achromobacter xylosoxidans is an emerging pathogen mainly associated with resistant nosocomial infections. This bacteria had been isolated in the ear together with other pathogens in cultures from patients with chronic otitis media, but it had never been reported as a cause of osteomyelitis of the external auditory canal. Case presentation: We present a unique case of a healthy 81-year-old woman who presented with left chronic otorrhea refractory to topical and oral antibiotic treatment. Otomicroscopy revealed an erythematous and exudative external auditory canal (EAC) with scant otorrhea. The tympanic membrane was intact, but an area of bone remodeling with a small cavity anterior and inferior to the bony tympanic frame was observed. Otic culture isolated multi-drug-resistant A. xylosoxidans, only sensitive to meropenem and cotrimoxazole. Temporal bone computed tomography showed an excavation of the floor of the EAC compatible with osteomyelitis. Targeted antibiotherapy for 12 weeks was conducted, with subsequent resolution of symptoms and no progression of the bone erosion. Conclusions: Atypical pathogens such as A. xylosoxidans can be the cause of chronic otitis externa. Early diagnosis and specific antibiotherapy can prevent the development of further complications, such as osteomyelitis. In these cases, otic cultures play an essential role to identify the causal germ. This is the first case of EAC osteomyelitis due to A. xylosoxidans reported to dat

Optimizing prolog for small devices: A case study

In this paper we present the design and implementation of a wearable application in Prolog. The application program is a "sound spatializer." Given an audio signal and real time data from a head-mounted compass, a signal is generated for stereo headphones that will appear to come from a position in space. We describe high-level and low-level optimizations and transformations that have been applied in order to fit this application on the wearable device. The end application operates comfortably in real-time on a wearable computer, and has a memory foot print that remains constant over time enabling it to run on continuous audio streams. Comparison with a version hand-written in C shows that the C version is no more than 20-40% faster; a small price to pay for a high level description

Basaloid squamous cell carcinoma : report of five cases

Objectives: To document the clinical and histopathological characteristics of basaloid squamous cell carcinoma (BSCC). To add five new cases to the literature and compare them with another published series. Cases: retrospective review of five cases with the diagnosis of BSCC of the larynx. Results: all the patients were male. They were heavy smokers and drinkers. Most of the tumours were supraglottic. Three patients presented with stage-IV disease and the other two with stage-I disease. Surgery supplemented with radiation was used in three patients, partial surgery was used in another case and radiation and associated chemotherapy in the other one. Eight neck dissections were performed, six of them were functional and the other two radical dissections. Two cases were found to have metastatic lymph nodes. There were not any distant metastases but two patients had tumoral relapse. Conclusions: BSCC has well defined histological features. Central comedonecrosis within the cells nests, cell with nuclear palisading and high-grade dysplasia in overlaying mucosa are the main characteristics

High-level languages for small devices: A case study

In this paper we study, through a concrete case, the feasibility of using a high-level, general-purpose logic language in the design and implementation of applications targeting wearable computers. The case study is a "sound spatializer" which, given real-time signáis for monaural audio and heading, generates stereo sound which appears to come from a position in space. The use of advanced compile-time transformations and optimizations made it possible to execute code written in a clear style without efñciency or architectural concerns on the target device, while meeting strict existing time and memory constraints. The final executable compares favorably with a similar implementation written in C. We believe that this case is representative of a wider class of common pervasive computing applications, and that the techniques we show here can be put to good use in a range of scenarios. This points to the possibility of applying high-level languages, with their associated flexibility, conciseness, ability to be automatically parallelized, sophisticated compile-time tools for analysis and verification, etc., to the embedded systems field without paying an unnecessary performance penalty

An overview of the ciao multiparadigm language and program development environment and its design philosophy

We describe some of the novel aspects and motivations behind the design and implementation of the Ciao multiparadigm programming system. An important aspect of Ciao is that it provides the programmer with a large number of useful features from different programming paradigms and styles, and that the use of each of these features can be turned on and off at will for each program module. Thus, a given module may be using e.g. higher order functions and constraints, while another module may be using objects, predicates, and concurrency. Furthermore, the language is designed to be extensible in a simple and modular way. Another important aspect of Ciao is its programming environment, which provides a powerful preprocessor (with an associated assertion language) capable of statically finding non-trivial bugs, verifying that programs comply with specifications, and performing many types of program optimizations. Such optimizations produce code that is highly competitive with other dynamic languages or, when the highest levéis of optimization are used, even that of static languages, all while retaining the interactive development environment of a dynamic language. The environment also includes a powerful auto-documenter. The paper provides an informal overview of the language and program development environment. It aims at illustrating the design philosophy rather than at being exhaustive, which would be impossible in the format of a paper, pointing instead to the existing literature on the system