Spinaalne sarkoidoos lapseeas

Sarkoidoos on ebaselge etioloogiaga krooniline multisüsteemne granulomatoosne haigus. Enamasti haigestuvad 20–40aastased inimesed. Neurosarkoidoos lapseeas on väga haruldane haigus, mille kohta võib kirjandusest leida vähe ülevaateartikleid. Käesolevas artiklis on toodud neurosarkoidoosi, sh spinaalse sarkoidoosi esinemissagedus täiskasvanute ja laste seas ning diagnostika ja ravi põhimõtted. Närvisüsteemi biopsia teostamine ei ole neurosarkoidoosi diagnoosimiseks alati vajalik, piisab teadmisest, et närvisüsteemi kahjustusega patsient põeb teadaolevalt sarkoidoosi kui haigust üldse. Eelistatud radioloogiline uuring neurosarkoidoosi kahtluse korral on magnetresonantstomograafi a (MRT). Artiklis on kirjeldatud haigusjuhtu, kus 16aastasel poisil diagnoositi spinaalset sarkoidoosi, kasutades lisaks kliinilislaboratoorsele leiule erinevate radioloogiliste uuringute ning kopsubiopsia tulemust. Eesti Arst 2009; 88(Lisa4):81−8

Spatio-temporal coherent control of thermal excitations in solids

X-ray reflectivity (XRR) measurements of femtosecond laser-induced transient gratings are applied to demonstrate the spatio-temporal coherent control of thermally induced surface deformations on ultrafast timescales. Using gracing incidence X-ray diffraction we unambiguously measure the amplitude of transient surface deformations with sub-\AA{} resolution. Understanding the dynamics of femtosecond TG excitations in terms of superposition of acoustic and thermal gratings makes it possible to develop new ways of coherent control in X-ray diffraction experiments. Being the dominant source of TG signal, the long-living thermal grating with spatial period $\Lambda$ can be canceled by a second, time-delayed TG excitation shifted by $\Lambda/2$. The ultimate speed limits of such an ultrafast X-ray shutter are inferred from the detailed analysis of thermal and acoustic dynamics in TG experiments

Inferential statistics as descriptive statistics: there is no replication crisis if we don't expect replication

Statistical inference often fails to replicate. One reason is that many results may be selected for drawing inference because some threshold of a statistic like the P-value was crossed, leading to biased reported effect sizes. Nonetheless, considerable non-replication is to be expected even without selective reporting, and generalizations from single studies are rarely if ever warranted. Honestly reported results must vary from replication to replication because of varying assumption violations and random variation; excessive agreement itself would suggest deeper problems, such as failure to publish results in conflict with group expectations or desires. A general perception of a "replication crisis" may thus reflect failure to recognize that statistical tests not only test hypotheses, but countless assumptions and the entire environment in which research takes place. Because of all the uncertain and unknown assumptions that underpin statistical inferences, we should treat inferential statistics as highly unstable local descriptions of relations between assumptions and data, rather than as providing generalizable inferences about hypotheses or models. And that means we should treat statistical results as being much more incomplete and uncertain than is currently the norm. Acknowledging this uncertainty could help reduce the allure of selective reporting: Since a small P-value could be large in a replication study, and a large P-value could be small, there is simply no need to selectively report studies based on statistical results. Rather than focusing our study reports on uncertain conclusions, we should thus focus on describing accurately how the study was conducted, what problems occurred, what data were obtained, what analysis methods were used and why, and what output those methods produced

Digital capitalism, datafication, and media education

As digitization and datafication continue to extend into all areas of society, digital capitalism becomes equally ubiquitous and universal. Digital capitalism, and related phenomena such as data, surveillance or platform capitalism, operate on the basis of a comprehensive expropriation and exploitation of personal data profiles. It functionalizes life worlds and places of education to an unprecedented extent

Peaajutrauma lastel

Peaajutrauma on oluline sotsiaalne ja meditsiiniline probleem kogu maailmas. Artiklis on retrospektiivselt analüüsitud aastatel 1999–2003 Tallinna Lastehaigla anestesioloogia- ja intensiivravi osakonda hospitaliseeritud ajutrauma juhtude põhjuseid. Eraldi on analüüsitud raske peaajutraumaga (GSK ≤8) laste ravi ja haiguse lõpet. Suurema osa peaajutraumadest moodustasid liiklusõnnetused. Artiklis on käsitletud ajutrauma ravi aspekte nagu intrakraniaalse rõhu kontrolli, adekvaatse vererõhu ja aju perfusioonirõhu säilitamise küsimusi. Ravi kaugtulemusi hinnati Glasgow Outcome Scale’i (Glasgow neuroloogilise lõpptulemuse hindamise skaala, GOS) abil. Suremus ajutrauma tagajärjel, samas ka haigete hilisem elukvaliteet on sarnane kirjanduses tooduga. Eesti Arst 2004; 83 (7): 452–45

Topiramaat – uus krambivastane ravim Ülevaade ja esimesed kogemused Eestis

Topiramaat on uus kolmanda põlvkonna krambivastane ravim, mis on kasutusel alates 1995. aastast. Eestis on selle preparaadi kasutamise kogemus väike, kuid esialgsed kogemused kinnitavad, et see on tõhus ja hästi talutav ravim. Topiramaati kasutatakse epilepsia ravis nii kombinatsioonis teiste antiepileptiliste ravimitega kui ka monoteraapiana

The TOSCA Registry for Tuberous Sclerosis-Lessons Learnt for Future Registry Development in Rare and Complex Diseases.

Introduction: The TuberOus SClerosis registry to increase disease Awareness (TOSCA) is an international disease registry designed to provide insights into the clinical characteristics of patients with Tuberous Sclerosis Complex (TSC). The aims of this study were to identify issues that arose during the design, execution, and publication phases of TOSCA, and to reflect on lessons learnt that may guide future registries in rare and complex diseases. Methods: A questionnaire was designed to identify the strengths, weaknesses, and issues that arose at any stage of development and implementation of the TOSCA registry. The questionnaire contained 225 questions distributed in 7 sections (identification of issues during registry planning, during the operation of the registry, during data analysis, during the publication of the results, other issues, assessment of lessons learnt, and additional comments), and was sent by e-mail to 511 people involved in the registry, including 28 members of the Scientific Advisory Board (SAB), 162 principal investigators (PIs), and 321 employees of the sponsor belonging to the medical department or that were clinical research associate (CRA). Questionnaires received within the 2 months from the initial mailing were included in the analysis. Results: A total of 53 (10.4%) questionnaires were received (64.3% for SAB members, 12.3% for PIs and 4.7% for employees of the sponsor), and the overall completeness rate for closed questions was 87.6%. The most common issues identified were the limited duration of the registry (38%) and issues related to handling of missing data (32%). In addition, 25% of the respondents commented that biases might have compromised the validity of the results. More than 80% of the respondents reported that the registry improved the knowledge on the natural history and manifestations of TSC, increased disease awareness and helped to identify relevant information for clinical research in TSC. Conclusions: This analysis shows the importance of registries as a powerful tool to increase disease awareness, to produce real-world evidence, and to generate questions for future research. However, there is a need to implement strategies to ensure patient retention and long-term sustainability of patient registries, to improve data quality, and to reduce biases

Fish-borne trematodosis: Potential risk of infection by Ascocotyle (Phagicola) longa (Heterophyidae)

AbstractOwing to the veterinary and medical importance of heterophyid trematodes, a survey on Ascocotyle (Phagicola) longa in different organs of mullets Mugil liza from Rio de Janeiro was undertaken. The prevalence of metacercariae varied greatly between different organs of the mullets: spleen (100%), heart (98%), intestine wall (97%), liver (97%), muscle (87%), stomach wall (77%), brain (47%), gonads (30%) and gall bladder (30%). The high level of the intensity of the infection in relation to different fish organs was confirmed in two experimental infections performed during the spring/summer and autumn/winter seasons when 258 and 47 adult parasites were recovered from hamsters fed only with small pieces of muscle tissue. The potential risk of infection was considered to be high in view of the high prevalence and intensity of A. (P.) longa in the muscles of mullets throughout the year. Additionally new confocal imaging of metacercariae and adults experimentally obtained, enabled for the first time the description of a short genital atrium formed by the union of uterus and ejaculatory duct