A case of probable Amiodarone-induced pancreatitis in the treatment of atrial fibrillation: a literature review and case report.

Amiodarone is an effective medication used in the treatment of several different arrhythmias. Its most well-known adverse effects include pulmonary fibrosis, thyroid dysfunction, and hepatotoxicity. A less common side effect is acute pancreatitis. A 67-year-old male being treated for atrial fibrillation in rapid ventricular response with Amiodarone developed acute epigastric abdominal pain 24 hours after initiation of therapy. He was diagnosed as having acute pancreatitis based on characteristic findings seen on an abdominal CT scan. Commonly encountered etiologies of pancreatitis were ruled out through a combination of the history, laboratory values, and imaging results. Based on the temporal association of the acute presentation and initiation of Amiodarone therapy, in conjunction with a lack of support for any other etiology, the diagnosis of Amiodarone-induced pancreatitis was made. Within 7 days following the cessation of Amiodarone therapy, the patient\u27s symptoms had completely resolved. Amiodarone-induced pancreatitis is an often overlooked medication association and is one that has been infrequently reported throughout the literature. Given the substantial morbidity and mortality associated with acute pancreatitis, and the ease of treatment (withdrawing Amiodarone), this is a critical side effect that should be recognized in the appropriate clinical setting

Pathogenic mutations in TULP1 responsible for retinitis pigmentosa identified in consanguineous familial cases.

PurposeTo identify pathogenic mutations responsible for autosomal recessive retinitis pigmentosa (arRP) in consanguineous familial cases.MethodsSeven large familial cases with multiple individuals diagnosed with retinitis pigmentosa were included in the study. Affected individuals in these families underwent ophthalmic examinations to document the symptoms and confirm the initial diagnosis. Blood samples were collected from all participating members, and genomic DNA was extracted. An exclusion analysis with microsatellite markers spanning the TULP1 locus on chromosome 6p was performed, and two-point logarithm of odds (LOD) scores were calculated. All coding exons along with the exon-intron boundaries of TULP1 were sequenced bidirectionally. We constructed a single nucleotide polymorphism (SNP) haplotype for the four familial cases harboring the K489R allele and estimated the likelihood of a founder effect.ResultsThe ophthalmic examinations of the affected individuals in these familial cases were suggestive of RP. Exclusion analyses confirmed linkage to chromosome 6p harboring TULP1 with positive two-point LOD scores. Subsequent Sanger sequencing identified the single base pair substitution in exon14, c.1466A>G (p.K489R), in four families. Additionally, we identified a two-base deletion in exon 4, c.286_287delGA (p.E96Gfs77*); a homozygous splice site variant in intron 14, c.1495+4A>C; and a novel missense variation in exon 15, c.1561C>T (p.P521S). All mutations segregated with the disease phenotype in the respective families and were absent in ethnically matched control chromosomes. Haplotype analysis suggested (p<10(-6)) that affected individuals inherited the causal mutation from a common ancestor.ConclusionsPathogenic mutations in TULP1 are responsible for the RP phenotype in seven familial cases with a common ancestral mutation responsible for the disease phenotype in four of the seven families

A methodology for flexibility analysis of pipeline systems

Pipeline systems serve a crucial role in an effective transport of fluids to the designated location for medium to long span of distances. Owing to its paramount economic significance, pipeline design field have undergone extensive development over the past few years for enhancing the optimization and transport efficiency. This research paper attempts to propose a methodology for flexibility analysis of pipeline systems through employing contemporary computational tools and practices. A methodical procedure is developed, which involves modeling of the selected pipeline system in CAESAR II followed by the insertion of pipe supports and restraints. The specific location and selection of the inserted supports is based on the results derived from the displacement, stress, reaction, and nozzle analysis of the concerned pipeline system. Emphasis is laid on the compliance of the design features to the leading code of pipeline transportation systems for liquid and slurries, ASME B31.4. The discussed procedure and approach can be successfully adjusted for the analysis of various other types of pipeline system configuration. In addition to the provision of systematic flow in analysis, the method also improves efficient time-saving practices in the pipeline stress analysis

Is there such a thing as agile IT program management?

This paper presents early evidence of agile methods in IT enabled transformational programs of high strategic significance and substantial complexity in large organisations. Based on interviews of top management, and program and project managers, we discuss the key drivers that lead to agile IT enabled programs and some of the barriers encountered while managing IT enabled programs in an agile manner. In addition to the need for fast response to environmental changes, strong IT-business collaboration, and efficient resource use by minimising governance burden, we found that organisations are adopting agile practices in program management as transitory step towards achieving enterprise agility. In doing so agile and non-agile projects co-exist within a program thus creating new coordination challenges. Programs with high degree of agile methods adoption face similar challenges in coordinating with the rest of the organisation which operates in non-agile manner. The paper aims to contribute to fostering scholarly discussion on implementation of agile practices in major projects and programs, an emerging area of research with scarce academic literature

Loss of function mutations in RP1 are responsible for retinitis pigmentosa in consanguineous familial cases.

PurposeThis study was undertaken to identify causal mutations responsible for autosomal recessive retinitis pigmentosa (arRP) in consanguineous families.MethodsLarge consanguineous families were ascertained from the Punjab province of Pakistan. An ophthalmic examination consisting of a fundus evaluation and electroretinography (ERG) was completed, and small aliquots of blood were collected from all participating individuals. Genomic DNA was extracted from white blood cells, and a genome-wide linkage or a locus-specific exclusion analysis was completed with polymorphic short tandem repeats (STRs). Two-point logarithm of odds (LOD) scores were calculated, and all coding exons and exon-intron boundaries of RP1 were sequenced to identify the causal mutation.ResultsThe ophthalmic examination showed that affected individuals in all families manifest cardinal symptoms of RP. Genome-wide scans localized the disease phenotype to chromosome 8q, a region harboring RP1, a gene previously implicated in the pathogenesis of RP. Sanger sequencing identified a homozygous single base deletion in exon 4: c.3697delT (p.S1233Pfs22*), a single base substitution in intron 3: c.787+1G>A (p.I263Nfs8*), a 2 bp duplication in exon 2: c.551_552dupTA (p.Q185Yfs4*) and an 11,117 bp deletion that removes all three coding exons of RP1. These variations segregated with the disease phenotype within the respective families and were not present in ethnically matched control samples.ConclusionsThese results strongly suggest that these mutations in RP1 are responsible for the retinal phenotype in affected individuals of all four consanguineous families

Percutaneous Mitral Valve Repair versus Optimal Medical Therapy in Patients with Functional Mitral Regurgitation: A Systematic Review and Meta-Analysis

Objectives. To compare percutaneous mitral valve repair (PMVR) with optimal medical therapy (OMT) in patients with heart failure (HF) and severe functional mitral regurgitation (FMR). Background. Many patients with HF and FMR are not suitable for surgical valve replacement and remain symptomatic despite maximal OMT. PMVR has recently emerged as an alternative solution. Methods. We performed a systematic review and a meta-analysis to address this question. Cochrane CENTRAL, MEDLINE, and Scopus were searched for randomized (RCT) and nonrandomized studies comparing PMVR with OMT in patients with HF and FMR. Primary endpoint was all-cause midterm mortality (at 1 and 2 years). Secondary endpoints were 30-day mortality and cardiovascular mortality and HF hospitalizations, at maximum follow-up. Studies including mixed cohort of degenerative and functional MR were allowed initially but were excluded in a secondary sensitivity analysis for each of the study’s end points. This meta-analysis was performed following the publication of two RCTs (MITRA-FR and COAPT). Results. Eight studies (six observational, two RCTs) comprising 3,009 patients were included in the meta-analysis. In comparison with OMT, PMVR significantly reduced 1-year mortality (RR: 0.70 [0.56, 0.87]; p=0.002; I2=47.6%), 2-year mortality (RR: 0.63 [0.55, 0.73]; p\u3c0.001; I2=0%), and cardiovascular mortality (RR: 0.32 [0.23, 0.44]; p\u3c0.001; I2=0%). No significant difference between PMVR+OMT and OMT was noted in HF hospitalization (HR: 0.69 [0.40, 1.20]; p=0.19; I2=85%) and 30-day mortality (RR: 1.13 [0.68, 1.87]; p=0.16; I2=0%). Conclusions. In comparison with OMT, PMVR significantly reduces 1-year mortality, 2-year mortality, and cardiovascular mortality in patients with HF and severe MR

Učinak duljine skladištenja na kvalitetu jaja i valivost kokoši Rhode Island Red.

In this research study, hatchability results and some internal egg quality characteristics of 0, 2, 3, 5, 7 and 9 d stored eggs in RIR were examined. It was determined that the effect of storage time on hatchability, hatchability of fertile eggs, embryonic mortality, chick weight, albumen weight, yolk weight, albumen index, yolk index and Haugh unit was significant (P<0.05). There was no positive or negative effect of storage time on the fertility rates, but there was a negative effect of storage time on egg weight, hatchability, embryonic development and chick weight on d 3 (P<0.05). It was determined that prolonged storage time caused a decrease in the albumen weight, yolk weight, albumen index, yolk index and Haugh unit value of Rhode Island Red eggs. Rhode Island Red eggs should not be stored more than 3 d.U radu su istraženi valivost i karakteristike jaja pasmine Rhode Island Red u uvjetima različite duljine skladištenja od 0, 2, 3, 5, 7 i 9 dana. Duljina skladištenja statistički je značajno (P<0,05) utjecala na valivost, valivost oplođenih jaja, smrtnost embrija, masu pilića, masu bjelanjka, masu žumanjka, indeks bjelanjka, indeks žumanjka te na vrijednost Haughove jedinice. Nije utvrđen ni pozitivan ni negativan učinak duljine skladištenja na stopu plodnosti, ali je duljina skladištenja od 3 dana značajno utjecala (P<0,05) na masu jaja, valivost, razvoj embrija i masu pilića. Ustanovljeno je da u jaja Rhode Island Red kokoši produženo vrijeme skladištenja dovodi do smanjenja mase bjelanjka, mase žumanjka, indeksa bjelanjka, indeksa žumanjka i vrijednost Haughove jedinice. Zaključeno je da jaja kokoši Rhode Island Red ne bi trebalo skladištiti dulje od 3 dana

The shifting sand of program coordination effort: lessons from IT-enabled transformation programs

Set in the context of an Australian software vendor for a global enterprise product, this paper explores the roles and practices that have evolved as the company scales from its already well established agile software teams, to agility at the enterprise level. With a focus on roles and practices at the program level within a Disciplined Agile Delivery framework, this study adds to the limited body of research into the process and impact of scaled agile approaches in software vendor environments