Addison's disease symptoms - a cross sectional study in urban South Africa

BACKGROUND: Addison's disease is a potentially life-threatening disorder, and prompt diagnosis, and introduction of steroid replacement has resulted in near normal life-expectancy. There are limited data describing the clinical presentation of Addison's disease in South Africa. It is hypothesised that patients may present in advanced state of ill-health, compared to Western countries. Patients A national database of patients was compiled from primary care, referral centres and private practices. 148 patients were enrolled (97 white, 34 mixed ancestry, 5 Asian and 12 black). METHODS: Demographic and clinical data were elicited using questionnaires. Biochemical data were obtained from folder reviews and laboratory archived results. RESULTS: The majority of the cohort was women (62%). The median and inter-quartile age range (IQR) of patients at enrolment was 46.0 (32.0-61.0) years, with a wide range from 2.8-88.0 years. The median and IQR age at initial diagnosis was 34.0 (20.0-45.0) years (range 0.02-77.0) years, indicating that at the time of enrolment, the patients, on average, were diagnosed with Addison's disease 12 years previously. Hyperpigmentation was observed in 76%, nausea and vomiting occurred in more than 40%, and weight loss was noted in 25%. Loss of consciousness as a presenting feature was recorded in 20 %. with a 95% confidence interval [CI] of (14-28%) and shock occurred in 5% CI (1.5-8.5%). Case-finding was recorded at 3.1 per million. CONCLUSIONS: The usual constellation of hyperpigmentation, nausea, vomiting and weight loss suggests Addison's disease, but a significant proportion present with an advanced state of ill-health and Addisonian crises. A lower prevalence rate, compared to Western countries is suggested

A User Centric Virtual Network Function Orchestration for Agile 5G Cloud-RAN

International audienc

On the use of the thermal step method as a tool for study of space charge in semiconductor gallium nitride: GaN

International audienceThermal step method (TSM) is a non destructive technique which measures the distribution of electric field and the space charge density across a solid insulators. In this paper, we report the experimental results obtained by the Thermal step method (TSM) and The capacitive voltage (C-V) characterisations of the gallium nitride films grown by the Metal Organic Vapour Phase Epitaxy on silicon substrate. The C-V curves shows a MOS structure behaviours, this was attributed to the existence of an SiO2 insulator between silicon and GaN. Experimental results were in good accordance with TSM measurements. These where performed under different applied bias voltage, remnant saturation current indicate a sign inversion above -75 m

The impact of environmental regulations on exports: Case study results from Cyprus, Jordan, Morocco, Syria, Tunisia, and Turkey

Concern about the effects of environmental policies on trade competitiveness continues to grow in the non-EU Mediterranean regions (e.g., North Africa, the Middle East, Turkey, Cyprus). While the impact of environmental regulations on exports is widely discussed in the region, there has been little empirical analysis of how more stringent environmental regulations might affect exports of key sectors in the future. This paper summarizes the results of six case studies that estimate the impact of potential changes in environmental regulations on exports from a key sector in each country. These case studies, which are based on a theoretically consistent yet empirically tractable modeling approach, suggest that a range of outcomes is likely and depends on a fairly small set of specific information. For some of the cases, expected regulatory changes would probably have little impact on exports, while in other cases the impacts could be substantially larger. In some countries, the range of potential outcomes is largely due to the magnitude of the policy change, the importance of various inputs in production, and the lack of information on international market conditions. © 2002 Elsevier Science Ltd. All rights reserved

Examination of the flexion relaxation phenomenon in erector spinae muscles during short duration slumped sitting

Objective. The purpose of this study was to examine the myoelectric activity of the erector spinae muscles of the back in order to determine if the flexion relaxation phenomenon occurs in seated forward flexion or slumped postures. Background. The flexion relaxation phenomenon during standing forward flexion is well documented. However, flexion relaxation in seated forward flexion has not been studied. It is possible that flexion relaxation could be linked with low back pain that some individuals experience during seated work. Methods. Twenty-two healthy subjects (11 males, 11 females) participated in the study. Surface electromyography was used to measure the level of muscle activity at the thoracic and lumbar levels of the erector spinae muscles. An electromagnetic tracking device measured the three-dimensional movement of the lumbar spine. Five trials each of standing and seated forward flexion were performed. Results. A slumped sitting posture yielded flexion relaxation of the thoracic erector spinae muscles, whereas the lumbar erector spinae muscle group remained at relatively constant activation levels regardless of seated posture. Thoracic erector spinae silence occurred at a smaller angle of lumbar flexion during sitting than the flexion relaxation angle observed during standing flexion relaxation. Conclusions. Since the myoelectric activity of the lumbar erector spinae did not increase, it is likely that the passive tissues of the vertebral column were loaded to support the moment at L4/L5. Ligaments contain a large number of free nerve endings which act as pain receptors and therefore could be a potential source of low back pain during seated work. Relevance. Examination of flexion relaxation during seated postures may provide insight into the association between low back pain and seated work. © 2002 Elsevier Science Ltd. All rights reserved