A condition mimicking lung mass appearance in childhood: Round pneumonia [Çocukta akcigerde kitle görünümünü taklit eden bir durum: Yuvarlak pnömoni]

In childhood, pneumonia is one of the major infectious diseases responsible for significant morbidity and mortality. Clinical and radiographic features of round pneumonia simulate pulmonary masses. Streptococcus pneumoniae, Mycobacterium tuberculosis, and Klebsiella pneumoniae are the most frequent etiologic agents of Round pneumonia in children. A two-year-old boy presented with fever, cough, respiratory distress, tachypnea, suprasternal-intercostal retractions, rales and expiratory wheezes. In the laboratory findings white blood cell count was 17300/mm 3, neutrophils 56%, erythrocyte sedimentation rate 54 mm/hour, C-reactive protein 68.84 mg/L, and chest radiogram showed right perihilar 2.5 cm density. In the chest computed tomography scan a 24 mm size irregular contoured consolidation-atelectasis complex in the superior segment of the lower lobe of right lung, demineralization at the right side of T5 vertebra and enlargement at the neural foramina was present. Thorax-abdomen magnetic resonance imaging was performed to exclude neuroblastoma. The spinal cord and neural foramina were normal. The case was discussed at the Aegean University Medicine Faculty Pediatric Respiratory-Allergy Council and the round consolidation with air bronchogram was consistent with round pneumonia. Clinical and radiographic recovery was performed after third generation cephalosporin treatment. In this case we aim to mention the round pneumonia which mimics lung masses

Metacognitive Beliefs and Their Relation with Symptoms in Obsessive-Compulsive Disorder.

INTRODUCTION: Metacognitive constructs have shown promise in explaining the symptoms of Obsessive-Compulsive Disorder (OCD). Few studies have examined the role of metacognitions in symptom dimensions of OCD, despite mounting clinical, neuropsychological and imaging evidence for the distinctiveness of these dimensions. METHODS: Metacognitions were assessed using the Metacognitions Questionnaire (MCQ-30) in 51 participants with DSM IV OCD and 46 healthy controls. The Maudsley Obsessional Compulsive Inventory (MOCI) was used to quantify symptom dimensions, along with the Hamilton Anxiety Rating Scale (HAM-A) for anxiety, and Hamilton Depression Rating Scale (HAM-D) for depression. RESULTS: Individuals with OCD differed from healthy controls on beliefs of uncontrollability and danger when depression and anxiety were controlled for. Correlations between metacognitive beliefs and obsessive-compulsive symptom dimensions were largely similar across the OCD and healthy control groups. Hierarchical regression showed that need to control thoughts contributed to checking, cleaning and rumination symptoms; cognitive self-consciousness to symptoms of slowness; uncontrollability and danger to doubt symptoms; positive beliefs to checking symptoms. CONCLUSIONS: Specific associations between metacognitive variables and the different symptom dimensions of OCD are evident, however, severity of anxiety and depression also contribute to these associations

Key stone plasty and asymmetric hump resection in crooked nose deformity

© 2022 Elsevier Inc.Objective: The aim of this study is to propose a new approach in crooked nose deformity with key-stone plasty and asymmetric hump resection. Method: Twelve patients with crooked nose deformities were operated using the open rhinoplasty technique. Our method, unlike other methods, has two different steps. Following asymmetric hump resection, cartilaginous and osseous septum were cut separated at the key stone area or more caudally and fix the septum with sutures again by allowing them to slide over each other in a way that directs the septum to the midline. If there is an inability to reveal the septum, we apply a longer spreader graft to the cartilage septum side. Results: The mean ages were 27.4 years. The mean follow-up time of the patients was 19.1 months. No complications were observed due to this technique. This technique was effective in the treatment of all our patients with crooked nose deformities. Conclusion: A novel surgical approach with key-stone plasty and asymmetric hump resection method was proposed in crooked nose deformity with a video animation

Decreasing the complexity of deriving test suites against nondeterministic finite state machines

The paper presents a Finite State Machine (FSM) based approach for deriving tests with reduced complexity, under the White Box testing assumption where all the faulty implementations are explicitly enumerated. The specification and implementation FSMs are assumed to be initialized, i.e., each possibly partial and (non-observable) nondeterministic FSM has a reliable reset. The proposed technique is illustrated by the application to a communication protocol

Successful desensitization of a case with desferrioxamine hypersensitivity

PubMed ID: 17093379Thalassaemia major is a severe chronic hemolytic disease, resulted with iron overload mainly due to regular blood transfusions. Iron overload may lead to serious organ toxicity and even fatal complications, if no iron excretion is achieved by a chelating agent. First introduced in 1976 as s.c. treatment for thalassaemia major, desferrioxamine (DFO) has substantially improved the life expectancy in the disease. While DFO can cause local allergic reactions including redness, itching, pain and lumps, on rare occasion anaphylactic reactions can occur. The mechanism of anaphylaxis like reactions is not well understood. In this case report, we presented a 10 years-old girl with thalassaemia major who had to stop DFO therapy after appearing of systemic allergic reactions with hypotension, tachycardia, pruritus and urticaria against this drug. Serum IgE level was normal, specific IgE and skin prick tests were negative. Intradermal test was resulted with positive reaction to DFO. The patient was hospitalized and desensitization protocol was initiated with rapid s.c. infusions per 15 min. The protocol was stopped at the 17th cycle because of local reaction reappeared. After that, DFO was further diluted and was restarted with lower dosage and longer infusion period. Then, DFO dosage was increased and the dilutions and infusion times were decreased gradually. By this desensitization programme, the patient would continue to use DFO chelation safely for 10 months

Column generation approaches to a robust airline crew pairing model for managing extra flights

The airline crew pairing problem (CPP) is one of the classical problems in airline operations research due to its crucial impact on the cost structure of an airline. Moreover, the complex crew regulations and the large scale of the resulting mathematical programming models have rendered it an academically interesting problem over decades. The CPP is a tactical problem, typically solved over a monthly planning horizon, with the objective of creating a set of crew pairings so that every ight in the schedule is covered, where a crew pairing refers to a sequence of ights operated by a single crew starting and ending at the same crew base. This paper discusses how an airline may hedge against a certain type of operational disruption by incorporating robustness into the pairings generated at the planning level. In particular, we address how a set of extra fights may be added into the fight schedule at the time of operation by modifying the pairings at hand and without delaying or canceling the existing fights in the schedule. We assume that the set of potential extra fights and their associated departure time windows areknown at the planning stage. We note that this study was partially motivated during our interactions with the smaller local airlines in Turkey which sometimes have to add extra fights to their schedule at short notice, e.g., charter fights. These airlines can typically estimate the potential time windows of the extra fights based on their past experiences, but prefer to ignore this information during planning since these flights may not need to be actually operated. Typically, these extra flights are then handled by recovery procedures at the time of operation which may lead to substantial deviations from the planned crew pairings and costs. The reader is referred to [3] for an in-depth discussion of the conceptual framework of this problem which we refer to as the Robust Crew Pairing for Managing Extra Flights (RCPEF). In [3], the authors introduce how an extra flight may be accommodated by modifying the existing pairings and introduce a set of integer programming models that provide natural recovery options without disrupting the existing flights. These recovery options are available at the planning stage and render operational recovery procedures that pertain to crew pairing unnecessar

Column generation approaches to a robust airline crew pairing model for managing extra flights

The airline crew pairing problem (CPP) is one of the classical problems in airline operations research due to its crucial impact on the cost structure of an airline. Moreover, the complex crew regulations and the large scale of the resulting mathematical programming models have rendered it an academically interesting problem over decades. The CPP is a tactical problem, typically solved over a monthly planning horizon, with the objective of creating a set of crew pairings so that every ight in the schedule is covered, where a crew pairing refers to a sequence of ights operated by a single crew starting and ending at the same crew base. This paper discusses how an airline may hedge against a certain type of operational disruption by incorporating robustness into the pairings generated at the planning level. In particular, we address how a set of extra fights may be added into the fight schedule at the time of operation by modifying the pairings at hand and without delaying or canceling the existing fights in the schedule. We assume that the set of potential extra fights and their associated departure time windows areknown at the planning stage. We note that this study was partially motivated during our interactions with the smaller local airlines in Turkey which sometimes have to add extra fights to their schedule at short notice, e.g., charter fights. These airlines can typically estimate the potential time windows of the extra fights based on their past experiences, but prefer to ignore this information during planning since these flights may not need to be actually operated. Typically, these extra flights are then handled by recovery procedures at the time of operation which may lead to substantial deviations from the planned crew pairings and costs. The reader is referred to [3] for an in-depth discussion of the conceptual framework of this problem which we refer to as the Robust Crew Pairing for Managing Extra Flights (RCPEF). In [3], the authors introduce how an extra flight may be accommodated by modifying the existing pairings and introduce a set of integer programming models that provide natural recovery options without disrupting the existing flights. These recovery options are available at the planning stage and render operational recovery procedures that pertain to crew pairing unnecessar