Anterior segment intraocular metallic foreign body causing chronic hypopyon uveitis

Intraocular foreign body (IOFB) is a common association of penetrating ocular trauma. Early diagnosis and removal of IOFBs especially if they are metallic is very important to determine further management and the final result of treatment. Missed IOFB may present in different clinical aspects that may limit its detection and symptoms may only become apparent after a prolonged period of time. We report a case of a missed metallic intraocular foreign body in the anterior chamber over a 2-year period without causing severe inflammatory reaction and presented with uveitis later. A 42-year-old man presented with a progressive blurring of vision, pain, photophobia, and redness in the left eye for 3 months. He had a history of traffic accident 2 years ago and he was accepted to intensive care unit for 3 days. Three months ago, in another center, he was admitted to hospital for 1 week and intravitreal antibiotics and medical treatment were given for pain, photophobia, and redness in his left eye. In five o’ clock meridian of the angle, there was an IOFB coated with hypopyon was observed under biomicrocopic magnification. Plain X-ray and computed tomography confirmed the foreign body in the left eye. After obtaining informed consent from the patient, the foreign body was removed under local anesthesia

Segmenting Markets by Bagged Clustering: Young Chinese Travelers to Western Europe.

Market segmentation is ubiquitous in marketing. Hierarchical and nonhierarchical methods are popular for segmenting tourism markets. These methods are not without controversy. In this study, we use bagged clustering on the push and pull factors of Western Europe to segment potential young Chinese travelers. Bagged clustering overcomes some of the limitations of hierarchical and nonhierarchical methods. A sample of 403 travelers revealed the existence of four clusters of potential visitors. The clusters were subsequently profiled on sociodemographics and travel characteristics. The findings suggest a nascent young Chinese independent travel segment that cannot be distinguished on push factors but can be differentiated on perceptions of the current independent travel infrastructure in Western Europe. Managerial implications are offered on marketing and service provision to the young Chinese outbound travel market

Nutritionist’s Variation in Counseling Style and the Effect on Weight Change of Patients Attending a Community Based Lifestyle Modification Program

Information concerning the nature of nutritionist-patient relationships is very limited. This qualitative and quantitative study examined nutritionist’s skills, attributes, and beliefs towards nutrition counseling during a lifestyle modification intervention program, and whether this affected the patient’s weight outcome. 24 nutrition consultations were observed during the program and the nutritionists were interviewed for their perception on practice (n = 4). A statistically significant difference was observed between the nutritionists in regard to patient’s weight change after adjustment for age and baseline weight (p < 0.001). Key nutritionist skills identified that influenced weight outcome were meticulous investigation of the underlying obesity cause, identification of the subject’s stage of change, and psychological support

Psoriasis and Hypertension Severity: Results from a Case-Control Study

BACKGROUND: Epidemiologic studies have provided new insights into the association between psoriasis and cardiovascular diseases. Previous population studies have examined hypertension frequency in psoriasis patients. However, the relationship between severity of hypertension and psoriasis has not been characterized. OBJECTIVE: We sought to investigate whether patients with psoriasis have more difficult-to-manage hypertension compared to non-psoriatic hypertensive patients. APPROACH: We performed a case-control study using the University of California Davis electronic medical records. The cases were defined as patients diagnosed with both psoriasis and hypertension, and controls were defined as patients with hypertension and without psoriasis. In this identified population, 835 cases were matched on age, sex, and body mass index (BMI) to 2418 control patients. KEY RESULTS: Treatment with multiple anti-hypertensives was significantly associated with the presence of psoriasis using univariate (p < 0.0001) and multivariable analysis, after adjusting for diabetes, hyperlipidemia, and race (p < 0.0001). Compared to hypertensive patients without psoriasis, psoriasis patients with hypertension were 5 times more likely to be on a monotherapy antihypertensive regimen (95% CI 3.607.05), 9.5 times more likely to be on dual antihypertensive therapy (95% CI 6.68-13.65), 16.5 times more likely to be on triple antihypertensive regimen (95% CI 11.01-24.84), and 19.9 times more likely to be on quadruple therapy or centrally-acting agent (95% CI 10.58-37.33) in multivariable analysis after adjusting for traditional cardiac risk factors. CONCLUSIONS: Psoriasis patients appear to have more difficult-to-control hypertension compared to non-psoriatic, hypertensive patients

Magnetic resonance imaging in patients with meningitis induced hearing loss

The aim of this multicentre study was to compare T1 with T2 weighted MRI scans of the labyrinth after meningitis and to investigate whether waiting with scanning improved the reliability of diagnosing an ongoing process such as cochlear osteogenesis. Forty-five patients were included who suffered from meningitis induced hearing loss (radiological imaging <1 year after meningitis). Twenty-one gadolinium enhanced T1 and 45 T2 weighted MRI scans were scored by two radiologists regarding the condition of the labyrinth. These radiological observations were compared with the condition of the cochlea as described during cochlear implantation. A higher percentage of agreement with surgery was found for T2 (both radiologists 73%) than for T1 weighted MRI scans (radiologist 1: 62%, radiologist 2: 67%), but this difference is not significant. There was no significant difference between early (0–3 months) and late (>3 months) scanning, showing that radiological imaging soon after meningitis allows early diagnosis without suffering from a lower agreement with surgical findings

Effective risk relievers for dimensional perceived risks on mail-order purchase: a case study on speciality foods in the UK

This article examines the effective risk relievers for different dimensions of perceived risk on mail-order purchase of food products. The sample comprised 1,600 active and inactive mail-order specialty food shoppers in the UK. The analysis focused on the correlation coefficients between consumers' levels of perceived risk and their weight on the importance of the risk relievers. Amongst 15 risk relievers, the results implied that there are certain risk relievers attached to higher levels of importance by consumers, who perceive higher levels of risks in certain aspects of mail-order purchase. Therefore, mail-order companies should promote the effective risk relievers to reduce specific dimensions of perceived risks

Influence of country and city images on students’ perception of host universities and their satisfaction with the assigned destination for their exchange programmes

ABSTRACT: This research focuses on the effect that country image, city image and university image has on students’ a priori satisfaction with the assigned destination for their international exchange programme (Bachelor and Master). In particular, this study establishes six hypotheses related to the causal relationships among the different typologies of image and their effects on students’ satisfaction with the assigned destination to study at least one semester in a host university. In order to contrast these hypotheses, a quantitative research was carried out in the Spanish city of Santander (Spain), by obtaining a sample of 245 international students who participated in an exchange programme at the University of Cantabria. The research findings are: (1) students’ satisfaction with the assigned destination is positively influenced by the university image; (2) the university image is positively influenced by the city image; and (3) the city image is positively influenced by the country image