Accessory spleen as lead point in intussusception

A 15-year-old boy, who had an episode of abdominal colic 4 years earlier, presented now with a week-long episode of abdominal pain. A computed tomographic scan confirmed the presence of an intussusception. Surprisingly, the surgery identified an accessory spleen as the lead point. At 9 months follow-up, the young boy has had no further abdominal discomfort. This report adds accessory spleen to the list of very rare pathological lead points in intussusception

A study to compare the effects of three different methods of reading copy when proofreading straight paragraph copy materials by first-year typewriting students

An experimental study was conducted with beginning typewriting students to investigate the effects of two variables in proofreading straight copy paragraph materials in the independent method of proofreading. One was the influence of repetition which was examined through the use of three different methods of reading. The second was the effect of the use of paper of different colours as background context defined as illuminating, neutral, or unilluminating in terms of whether colour was an aid or hindrance to readability. A comparison of the level of inaccuracy in proofreading was made between seven types of errors. These include: 1. Doubling of small words or of syllables within a word 2. Omission of a letter within a word 3. Omission of one of a pair of doubled letters 4. Transposition of letters within a word 5. Spacing errors 6. Substitution of words 7. Transpositions of words The influence of error location was investigated through an analysis of the mean percentage inaccuracy score by vertical and horizontal quartiles. Method Two independent groups composed of 172 and 171 subjects were randomly selected from beginning typewriting classes in two urban school districts. Each group wrote three criterion tests in which 14 errors (2 each of 7 error types selected) were loaded. One group wrote tests printed on white paper, defined as neutral, while the other completed tests printed on paper of colours defined as illuminating, unilluminating, and neutral respectively. These tests were equivalent in readability level and error load to each other, and to the materials used in beginning typewriting classes. The effect of repetition was investigated by asking subjects to proofread with 0, 1, and 2 repetitions on three tests that were administered on three successive days. Performance was measured in terms of time, total errors, number of errors by type, and the mean percentage of errors by location. The significance of the differences between means was determined through an analysis of variance and F tests at the one and five percent levels. Findings 1. Colour does not affect the proofreading time rate. The use of white or neutral paper produces a higher accuracy level in proofreading over coloured paper in terms of total errors, mean errors by type, and mean percentage of errors by vertical and horizontal location. 2. The proofreading rate recorded in relation to the frequency of repetition in reading was 1.03 minutes per 100 words for 0 repetition, 1.05 minutes for 1 repetition, and 1.33 minutes for 2 repetitions. One repetition yielded the highest level of accuracy in terms of total errors, error type, and vertical and horizontal location of errors. 3. The inaccuracy level recorded in terms of mean total errors was 39%, 30%, and 31% for 0, 1, and 2 repetitions respectively, indicating that a single reading is insufficient and a third reading does not assist a reader in finding errors that were undetected with 1 repetition. 4. The rank order of inaccuracy of the seven types of errors are: 1. transposition of words within a sentence 2. spacing errors - omission and extra spaces 3. substitution of one small word for another 4. omission of one of a pair of doubled letters 5. omission of a letter within a word 6. doubling of small words or of syllables within a word 7. transpositions of letters within a word 5. Errors located on the left half of the page and on the bottom half of the page are more difficult to detect

Costs associated with febrile neutropenia in solid tumor and lymphoma patients - an observational study in Singapore.

BackgroundThe primary objective was to describe the total direct inpatient costs among solid tumor and lymphoma patients with chemotherapy-induced febrile neutropenia (FN) and the factors that were associated with higher direct cost. The secondary objective was to describe the out-of-pocket patient payments and the factors that were associated with higher out-of-pocket patient payments.MethodsThis was a single-center observational study conducted at the largest cancer center in Singapore. All of the adult cancer patients hospitalized due to FN from 2009 to 2012 were studied. The primary outcomes were the total hospital cost and the out-of-pocket patient payments (adjusted by government subsidy) per FN episode. Univariate analysis and multiple linear regression were conducted to identify the factors associated with higher FN costs.ResultsThree hundred and sixty seven adult cancer patients were documented with FN-related hospitalizations. The mean total hospital cost was US$4,193 (95$3,779-4,607) and the mean out-of-pocket patient payment was US$2,230 (95$1,976-2,484), per FN episode. The factors associated with a higher total hospital cost were longer length of stay, severe sepsis, and lymphoma as underlying cancer. The out-of-pocket patient payment was positively associated with longer length of stay, severe sepsis, lymphoma diagnosed as underlying cancer, the therapeutic use of granulocyte colony-stimulating factor (GCSF), the private ward class, and younger patients.ConclusionsThe total hospital cost and out-of-pocket patient payments of FN management in lymphoma cases were substantial compared with other solid tumors. Factors associated with a higher FN management cost may be useful for developing appropriate strategies to reduce the cost of FN for cancer patients

Tuberculosis extrapulmonar. Presentación de un caso

Se presenta el caso de una paciente de 49 años de edad, que presentó manifestaciones generales de cinco meses de evolución, dadas por pérdida de peso y astenia, acompañados de aumento de volumen en ganglios del cuello. Al examen físico presentó aumento de volumen en ganglios de cadena cervical lateral derecha, que formaban una masa de aproximadamente dos centímetros, sin signos de inflamación. Los exámenes complementarios tuvieron como hallazgo principal varias adenopatías, la mayor de ellas de 16 × 14 mm, hipoecogénica, por detrás del lóbulo derecho del tiroides. Se realizó extracción de ganglio para estudio anatomopatológico, el cual informó una adenitis granulomatosa tuberculoide, altamente sugestiva de tuberculosis, cultivo en Lowenstein- Jensen positivo de mycobacterium tuberculosis. Aunque la tuberculosis es en la actualidad una enfermedad curable, aún no es un problema resuelto. Es importante mantener la vigilancia, y un determinado índice de sospecha no solo ante enfermedades pulmonares, sino aquellas que comprometen a otros órganos sistemas

International Classification of Functioning, Disability, and Health-based rehabilitation program promotes activity and participation of post-stroke patients

BackgroundThe International Classification of Functioning, Disability, and Health (ICF) model has been applied in post-stroke rehabilitation, yet limited studies explored its clinical application on enhancing patients’ Activity and Participation (ICF-A&P) level.PurposeThis study gathered evidence of the effects of an ICF-based post-stroke rehabilitation program (ICF-PSRP) in enhancing community reintegration in terms of ICF-A&P of post-stroke patients.MethodsFifty-two post-stroke patients completed an 8 to 12 weeks multidisciplinary ICF-PSRP after setting personal treatment goals in an outpatient community rehabilitation center. Intake and pre-discharge assessments were administered for primary outcomes of Body function (ICF-BF; e.g., muscle strength) and ICF-A&P (e.g., mobility), and secondary outcomes of perceived improvements in ability (e.g., goal attainment and quality of life).ResultsThere were significantly higher levels in the ICF-BF and ICF-A&P domains, except cognitive function under the ICF-BF. Improvements in the primary outcomes predicted corresponding secondary outcomes. Firstly, expressive and receptive functions (ICP-BF) were mediated by the everyday language (ICF-A&P) which predicted patients’ satisfaction with the language-related quality of life. Secondly, upper extremity function (ICP-BF) was mediated by the lower extremity mobility (ICF-A&P) predicting work and productivity-related quality of life. Content analyses showed that combined ICF-BF and ICF-A&P contents throughout the ICF-PSRP contributed to the positive treatment effects.ConclusionThe ICF-PSRP was effective in promoting body function, and activity and participation levels of post-stroke patients. Positive treatment effects are characterized by goal-setting process, cross-domain content design, and community-setting delivery.Clinical trial registration: https://clinicaltrials.gov/study/NCT05941078?id=NCT05941078&rank=1, identifier NCT05941078

Replication and Meta-analysis of the Association between BDNF Val66Met Polymorphism and Cognitive Impairment in Patients Receiving Chemotherapy.

Cancer-related cognitive impairment (CRCI) adversely affects cancer patients. We had previously demonstrated that the BDNF Val66Met genetic polymorphism is associated with lower odds of subjective CRCI in the multitasking and verbal ability domains among breast cancer patients receiving chemotherapy. To further assess our previous findings, we evaluated the association of BDNF Val66Met polymorphism with subjective and objective CRCI in a temporally separate cohort of patients and pooled findings from both the original (n = 145) and current (n = 193) cohorts in a meta-analysis. Subjective CRCI was assessed using FACT-Cog. Objective CRCI was evaluated using computerized neuropsychological tests. Genotyping was carried out using Sanger sequencing. The association of BDNF Val66Met genotypes and CRCI was examined with logistic regression. A fixed-effect meta-analysis was conducted using the inverse variance method. In the meta-analysis (n = 338), significantly lower odds of CRCI were associated with Met allele carriers based on the global FACT-Cog score (OR = 0.52, 95% CI 0.29-0.94). Furthermore, Met allele carriers were at lower odds of developing impairment in the domains of memory (OR = 0.34, 95% CI: 0.17-0.70), multitasking (OR = 0.33, 95% CI: 0.18-0.59), and verbal ability (OR = 0.46, 95% CI: 0.24-0.88). Consistent with the previous study, lower odds of subjective CRCI among patients with the BDNF Met allele was observed after adjusting for potential confounders in the multitasking (OR = 0.30, 95% CI: 0.14-0.67) domain. In conclusion, carriers of the BDNF Met allele were protected against global subjective CRCI, particularly in the domains of memory, multitasking, and verbal ability. Our findings further contribute to the understanding of CRCI pathophysiology

Retrovirus-mediated gene transfer to cystic fibrosis airway epithelial cells: effect of selectable marker sequences on long-term expression

Retrovirus-mediated gene transfer offers the potential for stable long-term expression of transduced genes in host cells subsequent to integration of vector DNA into the host genome. Using a murine amphotropic retrovirus vector containing an interleukin-2 receptor (IL-2R) gene as a reporter and a neomycin phosphotransferase

Antioxidant Profile of Different Types of Herbal Infusions and Teas Commercially Available in Mexico

Different types of teas and herbal infusions were studied. Antioxidant properties and phenolics compounds were estimated. Camellia sinensis based teas presented the highest values for inhibition of free radicals such as DPPH· and ABTS·+. The results showed different values between teas (Camellia sinensis) and herbal infusions (as Hibiscus sabdariffa). Green tea presented the highest values for inhibition of lipid oxidation (95.03 ± 3.34 to 31.68 ± 14.50 %) and polyphenolics content (0.112 ± 0.018 to 1.343 ± 0.068 GAE mg mL-1). In HPLC test, suggested the presence of antioxidant compounds such as epsyringic acid, procyanidin among others phenolic compounds. This study concluded that mexican teas and herbal infusions have potential to provide several benefits for human health, due to phenolic compounds present in them

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