23 research outputs found
Recurrent neck abscesses due to cervical tuberculous lymphadenopathy in an elderly woman post-splenectomy: a case report
<p>Abstract</p> <p>Introduction</p> <p>There are approximately 7000 new cases of tuberculosis every year in the UK, the majority of which are pulmonary. Approximately 5% affect the lymph nodes in immunocompetent patients. Scrofula is an old term used to describe lymph nodes of the neck infected with tuberculosis</p> <p>Case presentation</p> <p>In the elderly population, growing neck lumps are always treated as red flags until a diagnosis is confirmed. Here, the case of an 89-year-old Caucasian woman is presented. She was reluctant to seek medical help as she feared the cause was sinister and did not want surgical intervention.</p> <p>Conclusion</p> <p>It is difficult to culture tuberculosis from superficial swabs, resulting in a high proportion of false negative results. Where there is a high degree of clinical suspicion for tuberculosis, it is important to consider a biopsy with culture. Patients over the age of 65 have waning immunity and are therefore a vulnerable group for acute infections as well as the re-activation of indolent organisms. Post-splenectomy patients are at a major disadvantage during sepsis and when a cellular immune response is required, such as when faced with a <it>Mycobacterium tuberculosis </it>infection. Scrofula is treated with a similar regime as pulmonary tuberculosis and has a near 100% success rate.</p
Constraints to Economic Development and Growth in the Middle East and North Africa
When comparing the speed and extent of economic development in different geographic
regions of the world over the past 20 years, the under-average performance of Arab countries
in general and Arab Mediterranean countries in particular is striking. This is despite
an overall favorable geo-strategic situation at the crossroads of three continents, with excellent
connections to sea and waterways and in direct proximity to the European Union,
one of the world’s economic hubs. It is also despite the minor importance of negative factors
such as a high-burden diseases or high levels of ethnic fractionalization.
In this paper, I focus on identifying the most important constraints on Arab Mediterranean
economic development. I use state-of-the-art econometric tools to quantify constraints that
have been identified through economic theory and studies of the political economy characteristics
of the region. The empirical results offer support for the central hypothesis that
limited technological capacities and political economy structures are the primary constraints
on economic development. With a view to international structural adjustment efforts,
my findings imply that the limited success of the Euro-Mediterranean policy to
stimulate the economic development of the Arab Mediterranean countries might be because
structural adjustment efforts do not tackle—or at least do not sufficiently tackle—
these constraints.Vergleicht man Geschwindigkeit und Umfang der wirtschaftlichen Entwicklung der verschiedenen
Weltregionen in den vergangenen zwanzig Jahren, so fällt insbesondere das
unterdurchschnittliche Abschneiden der arabischen Länder im Allgemeinen und der arabischen
Mittlemeerländer im Besonderen ins Auge, und dies trotz einer insgesamt vorteilhaften
geographischen Lage im Schnittpunkt dreier Kontinente mit exzellenten Anschlussmöglichkeiten
an See- und Wasserwege, trotz der direkten Nachbarschaft zum
Weltwirtschaftsdrehkreuz Europäische Union und trotz der relativ geringen Bedeutung
wichtiger entwicklungshemmender Faktoren, beispielsweise ethnische Zersplitterung oder
massive Ausbreitung von Krankheiten wie AIDS oder Malaria.
In diesem Aufsatz wird versucht, von den unterschiedlichen Hemmfaktoren wirtschaftlicher
Entwicklung, die in der wirtschaftstheoretischen Literatur und/oder in MENARegionalstudien
diskutiert werden, diejenigen herauszuarbeiten, die wirtschaftliche Entwicklung
am stärksten behindern oder möglicherweise stärker als andere. Dabei benutze
ich modernste ökonometrische Verfahren, um den Einfluss der verschiedenen erklärenden
Variablen zu quantifizieren. Die Ergebnisse stĂĽtzen die Eingangshypothese, dass insbesondere
mangelnde technologische Kapazitäten und Fähigkeiten sowie regionalspezifische
politökonomische Strukturen die wirtschaftliche Entwicklung in den arabischen Mittelmeerländern
behindern
100,000 Genomes Pilot on Rare-Disease Diagnosis in Health Care — Preliminary Report
BACKGROUND: The U.K. 100,000 Genomes Project is in the process of investigating the role of genome sequencing in patients with undiagnosed rare diseases after usual care and the alignment of this research with health care implementation in the U.K. National Health Service. Other parts of this project focus on patients with cancer and infection. METHODS: We conducted a pilot study involving 4660 participants from 2183 families, among whom 161 disorders covering a broad spectrum of rare diseases were present. We collected data on clinical features with the use of Human Phenotype Ontology terms, undertook genome sequencing, applied automated variant prioritization on the basis of applied virtual gene panels and phenotypes, and identified novel pathogenic variants through research analysis. RESULTS: Diagnostic yields varied among family structures and were highest in family trios (both parents and a proband) and families with larger pedigrees. Diagnostic yields were much higher for disorders likely to have a monogenic cause (35%) than for disorders likely to have a complex cause (11%). Diagnostic yields for intellectual disability, hearing disorders, and vision disorders ranged from 40 to 55%. We made genetic diagnoses in 25% of the probands. A total of 14% of the diagnoses were made by means of the combination of research and automated approaches, which was critical for cases in which we found etiologic noncoding, structural, and mitochondrial genome variants and coding variants poorly covered by exome sequencing. Cohortwide burden testing across 57,000 genomes enabled the discovery of three new disease genes and 19 new associations. Of the genetic diagnoses that we made, 25% had immediate ramifications for clinical decision making for the patients or their relatives. CONCLUSIONS: Our pilot study of genome sequencing in a national health care system showed an increase in diagnostic yield across a range of rare diseases. (Funded by the National Institute for Health Research and others.)
Vulnerability of the fetal primate brain to moderate reduction in maternal global nutrient availability
Moderate maternal nutrient restriction during pregnancy occurs in both developing and developed countries. In addition to poverty, maternal dieting, teenage pregnancy, and uterine vascular problems in older mothers are causes of decreased fetal nutrition. We evaluated the impact of global 30% maternal nutrient reduction (MNR) on early fetal baboon brain maturation. MNR induced major cerebral developmental disturbances without fetal growth restriction or marked maternal weight reduction. Mechanisms evaluated included neurotrophic factor suppression, cell proliferation and cell death imbalance, impaired glial maturation and neuronal process formation, down-regulation of gene ontological pathways and related gene products, and up-regulated transcription of cerebral catabolism. Contrary to the known benefits from this degree of dietary reduction on life span, MNR in pregnancy compromises structural fetal cerebral development, potentially having an impact on brain function throughout life