Going Beyond The Final Impression With Radiologic Data In The Era Of Clerical Medicine: A Case Report Of Coronary Artery Disease Found Incidentally On Computed Tomography

Introduction: Given the challenges in modern healthcare, physicians find themselves devoting a great deal of mental and emotional energy into executing the appropriate care for patients as well as performing their daily clerical duties. Many clinicians have resorted to innovative ways to minimize their tasks which often leads to narrowing the focus of a patient’s overall care and the birth of medical errors described in the Swiss cheese effect model. Case Description: A 66 year old male established care with a new primary care physician. Previous radiologic data revealed a pulmonary nodule that did not have appropriate follow up imaging. Repeat imaging showed a stable nodule in the final impression of the report. In the details of the report, coronary artery disease was noted, but it was not mentioned in the conclusion of the report. Patient was referred to cardiology for risk stratification and assessment, and he was found to have multi-vessel coronary artery disease requiring immediate coronary artery bypass grafting. Conclusion: There is a demand for physicians to be efficient and productive in the face of an ever growing difficult healthcare culture. This creates a medium in which approach to patient care could be dangerously narrowed. This case illustrates that a final impression of a radiologic report should not be the only item read. A physician’s standard approach should be to look at the report as a whole to appropriately treat diagnosed and previously undiagnosed pathologies in order to decrease patient morbidity and mortality

The effect of temperature and relative humidity during drying on the covering power of processed x-ray films

With the constantly decreasing silver reserves and correspondingly higher costs, film manufacturers are continually searching for methods to reduce the amount of silver that is used. By using closely controlled conditions of temperature and saturated salt solutions to provide control of relative humidity during drying of processed x-ray film, it was found that the covering power may be as low as 70$ of its maximum value depending on the conditions used for drying the film. The highest values for covering power existed when the film was dried at low temperatures and high relative humidities or high temperatures and low relative humidities. The lowest values existed when both the temperature and relative humidity conditions together were either high or low. These results are promising in that high temperatures and low relative humidities can yield maximum covering power values while also providing the fastest possible rate of drying

An unusual case of Escherichia coli meningitis and bacteremia in an elderly woman presenting with intractable low back pain

Abstract Introduction: We report an unusual case of E. coli meningitis in an elderly woman who presented to the emergency room with a chief complaint of intractable low back pain. Case Description: A 67 year old woman presented to the emergency room for a chief complaint of intractable low back pain. After admission, the patient developed delirium. Blood cultures were drawn. Patient underwent a lumbar puncture which revealed purulent cerebrospinal fluid. Results of the cerebrospinal fluid and blood cultures revealed pan-sensitive E. coli. Conclusion: In the geriatric population, delayed presentation of meningitis can occur for various reasons. With the older adult population, existing co-morbidities and decline in immunologic function can mask symptoms. Clinicians caring for the elderly population need to have a high index of suspicion in the setting of subtle symptoms when it comes to diagnosing acute bacterial meningitis. Key Words: bacteremia, meningitis, geriatric, E. Coli, clinical, cerebrospinal, cultures, deliriu

Suelos volcanicos endurecidos

In Mexico, there is very few informations about the soil surface crusting in relation to the rain. When creating a new soil from a indurated volcanic tuff, it is important to study the behaviour and dynamics of the new structure under the action of rain and cultivation practices. We followed 6 terraces during 3 years on different kinds of soil and tepetate, as well as different kinds of soil tillage and crops. We used the rugosimeter and a crop covermeter of 2 m2 with a precision of 10 cm2 for each mesure. We measured the humidity and thecrusting of the soil after every runoff-producing event and the vegetation covering once a week. At the same time, we followed the state of the row and their ruptures along every terrace. This study confirms and details the 4 different kinds of crusting of this new soil. They are following this dynamic: 1) a structure crust with predominance of plasma is formed; 2) then come the erosion crust; 3) then the runoff crust and nearly in the same time; 4) the deposit crust. To pass from the phase 1 to 2, the cumulated energy of the rain must be higher than 560 MJ/h. In the case of the beginning of destruction of the row, this energy is nearly the same: 530 for the tepetate and 580 MJ/ha for the soil (phoeozem). Laboratory tests and the following of agregates bigger than 5 cm show that in the case of terraces with manure, the strucutre of the soil is more stable. But in the fields, there is not such a clear difference with the other treatments. The protection of the soil by vegetation is clearly better with the other treatments. It does not only protect the aggregates but also the row. In effect, corn produces a stem flow which destrys the row at the foot of the plant, while the association of corn and string bean limitsthis influence by the captation of the rain by the string bean. In the case of barley, the erosion is laminar and diffuse but, at the base of the terrace, it is possible to notice a clear runoff concentration. In the case of corn, water is concentrated inside the row and under certain conditions occurs a movement from one row to the other one due to their rupture. Erosion is more visible but really less intense than with barley because there is runoff only during strong and exceptional rains, while with barley runoff occurs during quite all rains over 3 mm. Cleaning of the fields during the rainy season could have catastrophic results. Under this climate, we recommend rows with little rain catchment and with an association of corn and string bean to limit destruction of the furrows and soil erosion. (Résumé d'auteur)

Going Beyond The Final Impression With Radiologic Data In The Era Of Clerical Medicine: A Case Report Of Coronary Artery Disease Found Incidentally On Computed Tomography

Introduction: Given the challenges in modern healthcare, physicians find themselves devoting a great deal of mental and emotional energy into executing the appropriate care for patients as well as performing their daily clerical duties. Many clinicians have resorted to innovative ways to minimize their tasks which often leads to narrowing the focus of a patient’s overall care and the birth of medical errors described in the Swiss cheese effect model. Case Description: A 66 year old male established care with a new primary care physician. Previous radiologic data revealed a pulmonary nodule that did not have appropriate follow up imaging. Repeat imaging showed a stable nodule in the final impression of the report. In the details of the report, coronary artery disease was noted, but it was not mentioned in the conclusion of the report. Patient was referred to cardiology for risk stratification and assessment, and he was found to have multi-vessel coronary artery disease requiring immediate coronary artery bypass grafting. Conclusion: There is a demand for physicians to be efficient and productive in the face of an ever growing difficult healthcare culture. This creates a medium in which approach to patient care could be dangerously narrowed. This case illustrates that a final impression of a radiologic report should not be the only item read. A physician’s standard approach should be to look at the report as a whole to appropriately treat diagnosed and previously undiagnosed pathologies in order to decrease patient morbidity and mortality

Baylisascaris Procyonis Exposure Case Study

We report a case of exposure to raccoon feces found to be contaminated with baylisascaris procyonis. The exposure was recognized early enough by the family to allow prophylaxis with albendazole. Because of the potential fatal or neurologically catastrophic effects of this disease immediate treatment is indicated. This is started in advance of environmental studies that are done to determine if the feces is indeed contaminated

La Guinée maritime aujourd’hui

Les travaux menés à l’occasion du programme « Observatoire des mangroves de Guinée » , soit la cartographie de l’ensemble des informations thématiques disponibles sur la Guinée Maritime, une cartographie plus fine pour des sous-préfectures témoins, des enquêtes directes sur un échantillon de villages sur les thèmes des modes de mise en valeur, de leurs contextes ethno-historiques, sociaux et économiques, permettent de faire apparaître les principales dynamiques qui affectent la Guinée Maritime depuis la libéralisation économique de 1984. Deux tendances lourdes se dégagent : la monétarisation croissante des activités dans les campagnes et la polarisation de l’espace régional. Ces dynamiques conjuguées sont porteuses de progrès social mais constituent aussi un nouveau risque pour les ressources.Coastal Guinea Today. The research and study undertaken during the “Observatory of the Guinean Mangroves” program, whether the mapping of the total information available regarding Coastal Guinea, or a more detailed mapping for the sub-prefecture areas concerned, plus direct investigations based on a selection of villages as regards development, their ethno-historical, social and economic contexts, make it possible to reveal the main dynamic forces that affect Coastal Guinea since the economic liberalization inaugurated in 1984. Two tendancies, pregnant with significance, stand out : the growing money-making activities in the countrysides, and the polarization of the regional space. These combined dynamics are encouraging for social progress, but they also constitute a new risk for the natural resources in the entire area

An unusual case of Escherichia coli meningitis and bacteremia in an elderly woman presenting with intractable low back pain

Introduction: We report an unusual case of E. coli meningitis in an elderly woman who presented to the emergency room with a chief complaint of intractable low back pain. Case Description: A 67 year old woman presented to the emergency room for a chief complaint of intractable low back pain. After admission, the patient developed delirium. Blood cultures were drawn. Patient underwent a lumbar puncture which revealed purulent cerebrospinal fluid. Results of the cerebrospinal fluid and blood cultures revealed pan-sensitive E. coli. Conclusion: In the geriatric population, delayed presentation of meningitis can occur for various reasons. With the older adult population, existing co-morbidities and decline in immunologic function can mask symptoms. Clinicians caring for the elderly population need to have a high index of suspicion in the setting of subtle symptoms when it comes to diagnosing acute bacterial meningitis