Sinonasal cysts causing dyspnoea in two cattle – case report

Two cattle were referred to the University Clinic for Ruminants of the University of Veterinary Medicine in Vienna. The main clinical sign in both cattle was dyspnoea with nasal stridor. Clinical examination of the upper respiratory tract was conducted, supplemented by ultrasonography, endoscopy and radiography. In addition, histological, bacteriological, and cytological examinations of different specimen materials were performed. The cow of Case 1 suffered from cystic nasal conchae, which was treated successfully by a laser technique. The cow of Case 2 also suffered from cystic nasal conchae. No surgery was performed in this case because the cyst opened spontaneously the day after diagnostic endoscopic procedures had been performed and the animal did not show any respiratory signs anymore. Pathological changes in the upper respiratory tract, such as nasal obstructions, should be included in the list of differential diagnoses in cattle showing respiratory distress

Integrating chromosomal aberrations and gene expression profiles to dissect rectal tumorigenesis

<p>Abstract</p> <p>Background</p> <p>Accurate staging of rectal tumors is essential for making the correct treatment choice. In a previous study, we found that loss of 17p, 18q and gain of 8q, 13q and 20q could distinguish adenoma from carcinoma tissue and that gain of 1q was related to lymph node metastasis. In order to find markers for tumor staging, we searched for candidate genes on these specific chromosomes.</p> <p>Methods</p> <p>We performed gene expression microarray analysis on 79 rectal tumors and integrated these data with genomic data from the same sample series. We performed supervised analysis to find candidate genes on affected chromosomes and validated the results with qRT-PCR and immunohistochemistry.</p> <p>Results</p> <p>Integration of gene expression and chromosomal instability data revealed similarity between these two data types. Supervised analysis identified up-regulation of <it>EFNA1 </it>in cases with 1q gain, and <it>EFNA1 </it>expression was correlated with the expression of a target gene (<it>VEGF</it>). The <it>BOP1 </it>gene, involved in ribosome biogenesis and related to chromosomal instability, was over-expressed in cases with 8q gain. <it>SMAD2 </it>was the most down-regulated gene on 18q, and on 20q, <it>STMN3 </it>and <it>TGIF2 </it>were highly up-regulated. Immunohistochemistry for SMAD4 correlated with <it>SMAD2 </it>gene expression and 18q loss.</p> <p>Conclusion</p> <p>On basis of integrative analysis this study identified one well known CRC gene (<it>SMAD2</it>) and several other genes (<it>EFNA1, BOP1, TGIF2 </it>and <it>STMN3</it>) that possibly could be used for rectal cancer characterization.</p

Design and Investigation of a Contra-Rotating Centrifugal Fan

Centrifugal fans are common in many fields of application. A centrifugal fan consists of a drive, an impeller, and a volute. The volute casing is designed to turn the dynamic pressure at the outlet of the fan impeller into static pressure and to guide the flow towards a connected geometry, e.g. a flange. However, centrifugal fans without a volute are being used more and more often. A common application is the installation in an air conditioning unit, where typically the dynamic pressure at the outlet is dissipated. In this way, both manufacturing costs and installation space can be saved. On the other hand it must be noted that the air at the outlet of the fan is strongly swirled, which may lead to inadequate acoustic and aerodynamic behaviour of the flow in subsequent devices. These two disadvantages of a fan without casing led to the consideration of a contra-rotating fan. The opportunities of a contra-rotating fans are well known and examined for axial fans, but rarely investigated for centrifugal fans. In this approach we present the design and the measurement of a contra-rotating radial fan comprising two concentrically rotating impellers and two drives. The fan is designed for a volume flow of 150 m³ h-1 and 125 Pa (static pressure). The diameter is 150 mm and the rotational speed of the inner impeller (impeller A) and the outer impeller (impeller B) is 3000 min-1 and 1500 min-1, respectively. The impeller were designed by means of CFturbo latest approach for the calculation of contra-rotating fans. This design's prototype was created by means of 3d printing and measured on a test-rig as well as examined by means of CFD. The results indicate that the simulations are in good agreement with the experiment and provide more detailed insights into the internal flow structure of the impellers. Based on these findings, investigations were made at the leakage point between the two impellers. The results of the test rig measurements and the laser optical measurements demonstrate the influence of different sealing geometries on the leakage. It has been shown that, compared to a centrifugal fan without volute, a contra-rotating fan can significantly reduce the power loss due to swirl at the outlet and increases the power transfer to the fluid compared to a diffuser with guide vanes at the same time

Role-management in patients undergoing Renal Replacement Therapy. Development of an intervention programme.

INTRODUCTION The prevalence of chronic kidney disease is increasing worldwide, particularly affecting older adults. It is a complex progressive disease that in its end-stage necessitates renal replacement therapy (RRT) through kidney transplantation or dialysis. It carries a high disease and treatment burden, impacting patients’ ‘life participation’ substantially. Self-management, or the process through which patients are able to cope with the disease in the context of their daily lives, is essential in patients undergoing RRT. Though self-management includes medical-, emotional-, and role-management, current intervention programmes mainly focus on medical-management and to a lesser degree emotional-management. Role-management (i.e. how to fulfil life roles, engage in meaningful activity and social relations) is pivotal in supporting ‘life participation’, yet evidence in RRT-care is lacking. METHOD This protocol, based on Medical Research Council guidelines, guides the development of a role-management programme that can be deployed in a nephrology department. First, a systematic review will examine current evidence. Second, an ethnographic study will explore practical theory. Third, an initial role-management programme will be developed based on the previous phases, aided by expert/stakeholder perspectives. A usability study will assess feasibility. Finally, a definite version of the programme will be evaluated through a randomized controlled trial. CONCLUSION In recent years, ‘life participation’ has become an increasingly important outcome in RRT. It carries the highest priority for patients and caregivers, contrasting the current focus on medical priorities in standard care. Patients want to stay as meaningfully active as possible, as long as possible. A role-management programme could prove beneficial

The impact of in-centre haemodialysis treatment on the everyday life of older adults with end-stage kidney disease : a qualitative study

Background Older adults with end-stage kidney disease experience a diminished ability to perform the activities of their daily life. For those living at home, the initiation of in-centre haemodialysis treatment (ICHD) carries a risk of cascading functional decline leading to early nursing home placement and mortality. Research on how older adults adapt to their newly impacted daily life is scarce. Methods Individual semi-structured interviews were conducted using a purposeful maximum variation sample of older adult (≥65 years) ICHD patients living at home. Interviews were conducted between October and December 2018. Interview coding followed an inductive and broad-based approach. Thematic analysis was used to group meaning units into common themes and subthemes. Results Twenty patients (12 females) were interviewed. Analysis resulted in two main themes and seven subthemes. The first main theme showed the impact of ICHD on everyday roles and functioning through four subthemes: a stepwise decline in daily activities, managing time, role changes and an incomplete retirement. The second main theme showed potential areas of remediation through three subthemes: the social environment, developing new daily activity patterns and meaningful activities and goals. Conclusions The older adults experienced a process of adaptation that generally progressed from a phase of initial disruption towards a period of mere survival. Being able to accept a life on dialysis was intricately connected with the ability to perform activities that were personally meaningful. Early and continued support of meaningful activities may prove valuable in breaking or delaying the cycle of functional decline

Variation in case-mix between hospitals treating colorectal cancer patients in the Netherlands

Contains fulltext : 98509.pdf (publisher's version ) (Closed access)AIMS: The purpose of this study was to determine how expected mortality based on case-mix varies between colorectal cancer patients treated in non-teaching, teaching and university hospitals, or high, intermediate and low-volume hospitals in the Netherlands. MATERIAL AND METHODS: We used the database of the Dutch Surgical Colorectal Audit 2010. Factors predicting mortality after colon and rectum carcinoma resections were identified using logistic regression models. Using these models, expected mortality was calculated for each patient. RESULTS: 8580 patients treated in 90 hospitals were included in the analysis. For colon carcinoma, hospitals' expected mortality ranged from 1.5 to 14%. Average expected mortality was lower in patients treated in high-volume hospitals than in low-volume hospitals (5.0 vs. 4.3%, p < 0.05). For rectum carcinoma, hospitals expected mortality varied from 0.5 to 7.5%. Average expected mortality was higher in patients treated in non-teaching and teaching hospitals than in university hospitals (2.7 and 2.3 vs. 1.3%, p < 0.01). Furthermore, rectum carcinoma patients treated in high-volume hospitals had a higher expected mortality than patients treated in low-volume hospitals (2.6 vs. 2.2% p < 0.05). We found no differences in risk-adjusted mortality. CONCLUSIONS: High-risk patients are not evenly distributed between hospitals. Using the expected mortality as an integrated measure for case-mix can help to gain insight in where high-risk patients go. The large variation in expected mortality between individual hospitals, hospital types and volume groups underlines the need for risk-adjustment when comparing hospital performances