Congenital Lymphoedema, Bronchiectasis And Seizure: Case Report

A l0-year-old girl with facial anomalies, mental retardation, peripheral lymphoedema, convulsions, cerebral cortical dysgenetic changes, bronchiectasis and chronic sinusitis is presented. She had features of both yellow nail syndrome and Hennekam syndrome. We think that our case might be a new congenital lymphoedema syndrome or an intermediate form between these syndromes. East African Medical Journal Vol. 85 (3) 2008: pp. 145-14

Body fat distribution in childhood obesity: Association with metabolic risk factors

Objectives: To evaluate the clinical significance of body fat distribution in childhood obesity, we investigated the associations of subcutaneous and intraabdominal (preperitoneal and visceral) fat, estimated by ultrasonography, with metabolic risk factors. Subjects: Fifty-one obese (age 11.5±2.6 years) and 33 nonobese (age 12.2±2.7 years) children. Study Design: Case control study. Methods: Ultrasonographic measurements of fat thickness [maximum and minimum preperitoneal fat thicknesses (Pmax, Pmin), maximum and minimum subcutaneous fat thicknesses (Smax, Smin), visceral fat thickness (V), triceps (Tr) and subscapular (Ss) skin fold thicknesses] were documented. Blood pressures, lipid profiles, fasting insulin levels, glucose/insulin ratio and HOMAIR (homeostasis model assessment for insulin resistance) were evaluated in both groups and these parameters were correlated with body fat distribution. Results: In the obese group, fasting insulin level was correlated to Smin, Smax, and Pmin. HOMA, accordingly, was also correlated to Smin, Smax, and Pmin. Fasting insulin level and HOMA showed no correlation with either Pmax or visceral fat thickness. Analysis: Abdominal subcutaneous fat thickness measurements were the best predictors of hyperinsulinemia (R2: 0.32). Conclusion: We did not observe a significant correlation between blood pressure, lipid parameters and body fat distribution in obese group. Abdominal subcutaneous fat thickness might be a better predictor of the risk for hyperinsulinemia in childhood obesity

The Dirac Equation Is Separable On The Dyon Black Hole Metric

Using the tetrad formalism, we carry out the separation of variables for the massive complex Dirac equation in the gravitational and electromagnetic field of a four-parameter (mass, angular momentum, electric and magnetic charges) black hole.Comment: 13 page

Concordancia entre la técnica de hemaglutinación indirecta e inmunoabsorción ligado a enzimas en el diagnóstico de toxoplasmosis porcina

El documento digital no refiere un asesorDetermina la concordancia entre las pruebas de HAI y ELISA, para detectar IgG anti-Toxoplasma gondii en el diagnóstico de toxoplasmosis porcina. El trabajo se desarrolla en 407 animales provenientes de crianzas porcinas ubicadas en la franja costera del departamento de Lima. Se colectan las muestras de sangre de cerdos en la fase de acabado, posteriormente las muestras de suero son conservadas en congelación (-70ºC) hasta su procesamiento en el Laboratorio de Parasitología de la Facultad de Medicina Veterinaria de la UNMSM. La concordancia de las técnicas diagnósticas y la seroprevalencia correspondiente se evalúan mediante dos diferentes modelos estadísticos: Indice de Kappa y la prueba de McNemar. En los resultados se halla que la concordancia entre las pruebas de HAI-ELISA a través del índice de Kapa es igual a 26% considerándose de tipo regular, con valores de 18.7 ± 3.8% por el método de HAI, y 14.7 ± 3.4%, por el método de ELISA; sin embargo, mediante la prueba de McNemar no se encuentra diferencias significativas y sugerirían que ambas técnicas son mutuamente reemplazables. Concluyendo que, como la correlación es regular, no se recomienda.Tesi

Overcharging a Black Hole and Cosmic Censorship

We show that, contrary to a widespread belief, one can overcharge a near extremal Reissner-Nordstrom black hole by throwing in a charged particle, as long as the backreaction effects may be considered negligible. Furthermore, we find that we can make the particle's classical radius, mass, and charge, as well as the relative size of the backreaction terms arbitrarily small, by adjusting the parameters corresponding to the particle appropriately. This suggests that the question of cosmic censorship is still not wholly resolved even in this simple scenario. We contrast this with attempting to overcharge a black hole with a charged imploding shell, where we find that cosmic censorship is upheld. We also briefly comment on a number of possible extensions.Comment: 26 pages, 3 figures, LaTe

Test of the weak cosmic censorship conjecture with a charged scalar field and dyonic Kerr-Newman black holes

A thought experiment considered recently in the literature, in which it is investigated whether a dyonic Kerr-Newman black hole can be destroyed by overcharging or overspinning it past extremality by a massive complex scalar test field, is revisited. Another derivation of the result that this is not possible, i.e. the weak cosmic censorship is not violated in this thought experiment, is given. The derivation is based on conservation laws, on a null energy condition, and on specific properties of the metric and the electromagnetic field of dyonic Kerr-Newman black holes. The metric is kept fixed, whereas the dynamics of the electromagnetic field is taken into account. A detailed knowledge of the solutions of the equations of motion is not needed. The approximation in which the electromagnetic field is fixed is also considered, and a derivation for this case is also given. In addition, an older version of the thought experiment, in which a pointlike test particle is used, is revisited. The same result, namely the non-violation of the cosmic censorship, is rederived in a way which is simpler than in earlier works.Comment: 18 pages, LaTe

Holographic Derivation of Kerr-Newman Scattering Amplitudes for General Charge and Spin

Near-superradiant scattering of charged scalars and fermions by a near-extreme Kerr-Newman black hole and photons and gravitons by a near-extreme Kerr black hole are computed as certain Fourier transforms of correlators in a two-dimensional conformal field theory. The results agree with the classic spacetime calculations from the 1970s, thereby providing good evidence for a conjectured Kerr-Newman/CFT correspondence.Comment: 22 page

Emotion dysregulation mediates the relationship between nightmares and psychotic experiences: Results from a student population

Sleep-disruption is commonly associated with psychotic experiences. Whilst sparse, the literature to date highlights nightmares and related distress as prominent risk factors for psychosis in students. We aimed to further explore the relationship between specific nightmare symptoms and psychotic experiences in university students whilst examining the mediating role of emotion dysregulation. A sample (N=1273) of student respondents from UK universities completed measures of psychotic experiences, nightmare disorder symptomology, and emotion dysregulation. Psychotic experiences were significantly more prevalent in students reporting nightmares (n=757) relative to those who did not (n=516). Hierarchical linear regression analysis showed that psychotic experiences were significantly associated (Adjusted R2 = 32.4%) with perceived nightmare intensity, consequences and resulting awakenings, and with emotion regulation difficulties. Furthermore, multiple mediation analysis showed that the association between psychotic experiences and nightmare factors was mediated by emotion regulation difficulties. Adaptive regulation of dream content during rapid eye-movement sleep has previously been demonstrated to attenuate surges in affective arousal by controlling the intensity and variability of emotional content. Difficulties in emotion regulation may partially explain the experience of more intense and disruptive nightmares amongst individuals with psychotic experiences. Emotion regulation may represent an important control mechanism that safeguards dream content and sleep quality

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Sonographic assessment of abdominal fat distribution in infancy

There is growing evidence that not only the total amount of fat, but also the distribution of body fat determines risks for metabolic and cardiovascular disease. Developmental studies on factors influencing body fat distribution have been hampered by a lack of appropriate techniques for measuring intraabdominal fat in early life. Sonography, which is an established method for assessing abdominal fat distribution in adults, has not yet been evaluated in infants. To adapt the sonographic measurement of abdominal fat distribution to infants and study its reliability. The Generation R study, a population-based prospective cohort study. We included 212 one- and 227 two-year old Dutch infants in the present analysis. Sixty-two infants underwent replicate measurements to assess reproducibility. We developed a standardized protocol to measure the thickness of (1) subcutaneous and (2) preperitoneal fat in the upper abdomen of infants. To this end we defined infancy specific measurement areas to quantify fat thickness. Reproducibility of fat measurements was good to excellent with intraclass correlation coefficients of 0.93–0.97 for intra-observer agreement and of 0.89–0.95 for inter-observer agreement. We observed a pronounced increase in preperitoneal fat thickness in the second year of life while subcutaneous fat thickness increased only slightly, resulting in an altered body fat distribution. Gender did not significantly influence fat distribution in the first two years of life. Our age specific protocol for the sonographic measurement of central subcutaneous and preperitoneal fat is a reproducible method that can be instrumental for investigating fat distribution in early life