Case Histories (case + history)

Distribution by Scientific Domains
Distribution within Medical Sciences


Selected Abstracts


"Whippets"-Induced Cobalamin Deficiency Manifesting as Cervical Myelopathy

JOURNAL OF NEUROIMAGING, Issue 3 2004
Alan L. Diamond
ABSTRACT Background. Nitrous oxide (N O) is inhaled in anesthesia and as a recreational drug from whipped cream dispensers. Its abuse reaches ,10% in some age groups. By inactivating cobalamin (Cbl) (vitamin B12), N O can cause neurologic and hematologic manifestations. We present a case of N O-induced Cbl deficiency presenting as cervical myelopathy. Case History. After regularly inhaling N O for many months, a 31-year-old man developed limb paresthesiae and ataxia over 3 months. Examination revealed finger pseudoathetosis, hyporeflexia, decreased sensation, and gait ataxia. Brain magnetic resonance imaging (MRI) was normal, but the posterior columns of the cervical and upper thoracic cord revealed patchy nonenhancing hyperintense lesions. Serum Cbl was 98 pg/mL (normal = 170,900 pg/mL). Cbl replacement led to recovery within 3 months.Discussion. This patient presented with the symptoms and signs of Cbl deficiency. The MRI lesions in the posterior columns aided the diagnosis. Physicians need to have a high level of suspicion in cases of unexplained Cbl deficiency and myelopathy. [source]


Rethinking the OSCE as a Tool for National Competency Evaluation

EUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2004
M. A. Boyd
The relatively recent curriculum change to Problem-Based Learning/Case-Based Education has stimulated the development of new evaluation tools for student assessment. The Objective Structured Clinical Examination (OSCE) has become a popular method for such assessment. The National Dental Examining Board of Canada (NDEB) began using an OSCE format as part of the national certification testing process for licensure of beginning dentists in Canada in 1996. The OSCE has been well received by provincial licensing authorities, dental schools and students. ,Hands on' clinical competency is trusted to the dental programs and verified through NDEB participation in the Accreditation process. The desire to refine the OCSE has resulted in the development of a new format. Previously OSCE stations consisted of case-based materials and related multiple-choice questions. The new format has case-based material with an extended match presentation. Candidates ,select one or more correct answers' from a group of up to15 options. The blueprint is referenced to the national competencies for beginning practitioners in Canada. This new format will be available to students on the NDEB website for information and study purposes. Question stems and options will remain constant. Case histories and case materials will change each year. This new OSCE will be easier to administer and be less expensive in terms of test development. Reliability and validity is enhanced by involving content experts from all faculties in test development, by having the OSCE verified by general practitioners and by making the format available to candidates. The new OSCE will be pilot tested in September 2004. Examples will be provided for information and discussion. [source]


Dementia in Parkinson's disease: a post-mortem study in a population of brain donors

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2005
S. Papapetropoulos
Abstract Objective To identify factors associated with dementia in a cohort of Parkinson's disease (PD) brain donors and determine whether its presence may influence the clinical phenotype of the disease. Methods We included 67 consecutive patients with a clinical and pathological diagnosis of PD, who while alive, consented to donate their brains to the University of Miami Brain Endowment BankTM. Dementia and psychiatric complications of PD were diagnosed according to established criteria. Case histories were abstracted and reviewed and comparisons between PD patients with (PD-D, n,=,34) and without (PD, n,=,33) dementia were made. Results Age at death, age at disease onset and disease duration did not differ significantly between PD-D and PD patients. Other symptoms were similar in both groups. Visual hallucinations and bilateral symptoms at diagnosis were significantly higher in PD-D patients. No association between dementia and overall survival duration was found. Although the frequency of depression and psychosis was higher in the PD patients with dementia no statistical significance was reached. The overall lifetime prevalence of dementia in our group was 50.7%. Conclusions Visual hallucinations and bilateral symptoms were associated with dementia in our cohort of PD brain donors. No association between dementia and survival duration was found. Understanding the influence of dementia on the clinical phenotype of the disease and predicting its development is essential for the successful management of PD. Copyright © 2005 John Wiley & Sons, Ltd. [source]


What Went Wrong?-Case histories of process plant disasters and how they could have been avoided, 5th edition (2009)

PROCESS SAFETY PROGRESS, Issue 4 2009
Stanley S. Grossel
No abstract is available for this article. [source]


Selective Neck Dissection in the Management of the Clinically Node-Negative Neck ,

THE LARYNGOSCOPE, Issue 12 2000
A. Sefik Hosal MD
Abstract Objective To evaluate the efficacy of the selective neck dissection (SND) in the management of the clinically node-negative neck. Study Design Case histories were evaluated retrospectively. Methods The results of 300 neck dissections performed on 210 patients were studied. Results The primary sites were oral cavity (91), oropharyn- (30), hypopharyn- (16), and laryn- (73). Seventy-one necks (23%) were node positive on pathological e-amination. The number of positive nodes varied from 1 to 9 per side. Of necks with positive nodes, 17 (24%) had e-tracapsular spread. The median follow-up was 41 months. Recurrent disease developed in the dissected neck of 11 patients (4%). Two recurrences developed outside the dissected field. The incidence of regional recurrences was similar in patients in whom nodes were negative on histological e-amination (3%) when compared with patients with positive nodes without e-tracapsular spread (4%). In contrast, regional recurrence developed in 18% of necks with e-tracapsular spread. This observation was statistically significant. Patients having more than two metastatic lymph nodes had a higher incidence of recurrent disease than the patients with carcinoma limited to one or two nodes. Recurrence rate in the pathologically node positive (pN+) necks was comparable to recurrence in those pathologically node negative (pN0) necks in the patients who did not have irradiation. Conclusion SND is effective for controlling neck disease and serves to detect patients who require adjuvant therapy. [source]


Actinomycotic canaliculitis: resolution following surgery and short topical antibiotic treatment

ACTA OPHTHALMOLOGICA, Issue 3 2010
Eyrún Baldursdóttir
Abstract. Purpose:, This study aimed to study the incidence and clinical characteristics of patients diagnosed with actinomycotic canaliculitis in Iceland. Methods:, We present a nationwide, retrospective case series for which cases were identified by searches of hospital diagnostic registries and pathology databases. Case histories were reviewed and histopathological analysis repeated to confirm the diagnosis. Results:, Nine cases of actinomycotic canaliculitis were diagnosed in Iceland during 1988,2007. Subjects included six women and three men and represented 16% of all patients diagnosed with actinomycosis in the country. The incidence was 0.16 cases/100 000 inhabitants/year. Age-specific incidence rates were 0.59 cases/100 000 inhabitants/year for the 40,59-year-old age group and 1.37 cases/100 000 inhabitants/year for individuals aged 60,79 years. All patients underwent a three-way snip procedure and 1 week of topical antibacterial therapy. Conclusions:, Actinomycotic canaliculitis is an uncommon condition which frequently eludes diagnosis. Topical antibiotics for 1 week may be sufficient following surgery, a finding which contrasts with previous reports. [source]


Skin burn, bilateral iridocyclitis and amnesia following a lightning injury

ACTA OPHTHALMOLOGICA, Issue 5 2004
Lone K. Sommer
Abstract. Purpose:,To describe a case of lightning injury restricted to the eyes and facial skin. Methods:,Case history describing the clinical examination of a 54-year-old woman. Results:,Following a lightning stroke the patient suffered from a sharply demarcated facial skin burn and bilateral iridocyclitis with raised intraocular pressure. Initially she had amnesia regarding the incident. She recovered on symptomatic treatment, with dry eyes as the only sequela. Conclusion:,We suggest that a lightning current travelled over the outside of the patient's body facilitated by her wet raincoat, a so-called flash-over. Thereby, she was spared from more severe injury, and only the exposed areas of the face and eyes were affected. [source]


Conservation Status as a Biodiversity Trend Indicator: Recommendations from a Decade of Listing Species at Risk in British Columbia

CONSERVATION BIOLOGY, Issue 4 2005
JAMES F. QUAYLE
especies amenazadas; especies en peligro; estado del ambiente Abstract:,Species conservation status is commonly used as a broad-scale indicator of the state of biological diversity. To learn about its value for tracking trends, we examined provincial lists of terrestrial vertebrate species and subspecies at risk in British Columbia, Canada, for 1992 and 2002 to see whether changes in these lists reflected changes in the status of the taxa they represent. Examination of the case histories of individual species and subspecies showed that 65% of additions and deletions to the British Columbia Red List were the result of improvement in knowledge of species status, changes in assessment procedures, and refinements in taxonomy rather than actual changes in a species' status. Comparison to an alternate set of rank scores provided by NatureServe for taxa that appeared on both 1992 and 2002 British Columbia Red Lists revealed changes in status that were not reflected by movement from the list. Estimates of historical conservation status for species on the 1992 British Columbia Red List demonstrated ambiguity around the natural baseline with regard to tracking changes in list composition over time. We discourage the continued use of indicators based solely on conservation status as a means of tracking biodiversity. Instead we recommend advancing strategic indicators around species at risk based on long-term monitoring data, deliberate and explicitly stated baselines, and consistent methods of conservation ranking. Resumen:,El estatus de conservación de las especies comúnmente es utilizado como un indicador de escala amplia del estado de la diversidad biológica. En un esfuerzo por aprender sobre su valor para el seguimiento de tendencias, examinamos listas provinciales, para 1992 y 2002, de especies y subespecies de vertebrados terrestres en riesgo en Columbia Británica, Canadá, para ver si los cambios en estas listas reflejaban cambios en el estatus de los taxa que representan. El examen de la historia del caso de especies y subespecies individuales mostró que 65% de las adiciones y supresiones en la Lista Roja de Columbia Británica fueron el resultado de avances en el conocimiento del estatus de la especie, de cambios en los procedimientos de evaluación y de refinamientos en la taxonomía y no de cambios en el estatus de una especie. La comparación con un conjunto alternativo de valores de clasificación proporcionado por NatureServe para taxa que aparecieron tanto en la Lista Roja de Columbia Británica de 1992 como de 2002 reveló cambios en el estatus que no se reflejaron en movimientos en la lista. Estimaciones del estatus de conservación histórico de especies en la Lista Roja de Columbia Británica de 1992 demostraron ambigüedad alrededor de la línea de base natural en relación con el seguimiento de cambios en el tiempo en la composición de la lista. Desalentamos el uso continuo de indicadores basados solamente en el estatus de conservación como un medio para el seguimiento de biodiversidad. En cambio, recomendamos avanzar con indicadores estratégicos en torno a especies en riesgo con base en datos de monitoreo de largo plazo, en líneas básicas puestas de manifiesto deliberada y explícitamente y en métodos consistentes para la clasificación de la conservación. [source]


Multiple Primary Acral Melanomas in African-Americans: A Case Series and Review of the Literature

DERMATOLOGIC SURGERY, Issue 1 2007
ANGELA C. S. HUTCHESON MD
BACKGROUND Although melanoma accounts for only 4% to 5% of all skin cancers in the United States, it causes most skin cancer,related deaths. We describe a unique group of African-American patients with multiple primary acral lentiginous melanomas (ALMs). OBJECTIVE The purpose of this study was to review the case histories and management of a cohort of patients in the Mohs practice of our dermatologic surgeon with multiple primary ALM. METHODS This is a case series of patients with multiple ALM identified by chart review from 2000 to 2005. A thorough review of the literature was performed. RESULTS Four patients, all African-American, were identified with multiple ALM. All patients were managed with excision or Mohs micrographic surgery utilizing permanent sections. None of the patients with ALM had melanomas at nonacral sites or other types of skin cancer. Several had acral melanosis. Information in the literature on patients with multiple primary acral melanomas was insufficient. CONCLUSION Patients with multiple acral melanomas have not, to our knowledge, been reported thus far. It can be extrapolated from current literature, however, that appropriate management of these patients, including staging work and surgical intervention, is to be determined by the individual characteristics of the melanoma and the patient's concomitant risk factors, if any. [source]


Epileptic Seizures after Treatment with Thiocolchicoside

EPILEPSIA, Issue 8 2001
Pier Luigi De Riu
Summary: ,Purpose: To report the occurrence of epileptic seizures in humans, closely related to the use of the centrally acting muscle relaxant thiocolchicoside. Methods: Description of three case histories. Results: Two patients, affected with complex-partial seizures, sometimes secondarily generalized, receiving antiepileptic therapy, were seizure free for 7 and 9 years, respectively. They had the reappearance of tonic,clonic seizures few days after the continued use of thiocolchicoside, at a cumulative dose of the drug of 52 mg and 76 mg, respectively. The third patient was brain damaged and without a history of seizures. He had a sudden, convulsive seizure a few minutes after 4 mg intramuscular thiocolchicoside. Conclusions: Our case histories indicate that thiocolchicoside has a powerful epileptogenic activity. This drug should be avoided in patients with epilepsy or acute brain injury and possible disruption of the blood,brain barrier. [source]


The history of eating disorders in Norway

EUROPEAN EATING DISORDERS REVIEW, Issue 4 2001
Finn Skårderud
Abstract The history of eating disorders in Norway is described in four phases: (1) early case histories of eating disorder symptoms in the late 19th century Norwegian medical literature, (2) the pioneers of the post-World War 2 decades, (3) the 1980s when eating disorders became visible to the public and a focus of interest among professionals, and (4) the consolidation of professional networks and the emergence of a national policy for treatment. In contrast to many other countries, the official Norwegian policy is to improve clinical competence and knowledge about eating disorders at all levels of health care rather than establishing special clinics. Beside arguing for such a policy, we suggest that discussing the balance between general and specialist services is an important future issue. Copyright © 2001 John Wiley & Sons, Ltd and Eating Disorders Association. [source]


The Poetics of Pathology: Freud's Studien über Hysterie and the Tropes of the ,Novelle'

GERMAN LIFE AND LETTERS, Issue 1 2006
Petra Rau
Freud's self-conscious reflections on the ,Novelle' in his first major work, Studien über Hysterie, have sometimes been interpreted as rhetorical remarks in which his writerly ambitions came to the surface. This article argues that the case histories of hysteria and the genre of the ,Novelle' (particularly the psychopathic or psychographic nineteenth-century ,Novelle') share a poetics of pathology. Indeed their common features (dependence on symbolic condensation, central traumatic events and narrative gaps, exegetical challenges and hermeneutic paradoxes, the self-reflexive narrator, framing devices) suggest that the psychopathic ,Novelle' provided Freud with the means to legitimise his representation of psychoanalysis and hysteria. Like the case history, the psychopathic ,Novelle' is concerned with validating and interpreting idiosyncratic pathological semiotics. Yet like the ,Novelle', Freud's case histories suffer from a contagion in which representation is infected with, and by necessity performs, the pathologies it claims to map and cure. This article suggests that at the heart of the poetics of pathology is a hermeneutic aporia that allows for intertextual transfer but that also deconstructs the novellesque as well as the psychoanalytic project and renders it impossible. [source]


Necrotizing fasciitis of the head and neck: A report of two patients and review

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2002
Deowall Chattar-Cora MD
Abstract Background Necrotizing fasciitis is a disfiguring condition that can be fatal. The head and neck region is rarely affected. However, when involved, the functional and cosmetic sequelae can be considerable. Materials and Methods We present two case histories, discuss salient diagnostic points, treatment, and review published data on this topic. Results With a timely diagnosis we were able to diagnose and appropriately treat these patients. Conclusions Necrotizing fasciitis is a disfiguring condition that can be fatal if not diagnosed in a timely fashion. Diagnosis and treatment require a high index of suspicion, immediate operative intervention, broad-spectrum antibiotics, and appropriate supportive care. © 2002 Wiley Periodicals, Inc. [source]


PDE5 inhibitors in diabetic peripheral neuropathy

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 9 2006
G. HACKETT
Summary Peripheral neuropathy is the most common complication of diabetes. This paper reviews the case histories of five patients with diabetic peripheral neuropathy or severe peripheral vascular disease who reported improvement in their symptoms when treated with regular or daily dosing with phosphodiesterase type 5 inhibitors (PDE5Is). These patients had been previously treated with PDE5Is for erectile dysfunction (ED) and not responded to on-demand therapy with a PDE5I at maximal recommended dose. This improvement is likely to be due to the known benefit of these drugs on endothelial dysfunction via an improvement of blood supply to the vasa nervorum. These cases suggest that further research is indicated to evaluate the potential use of PDE5Is in the treatment and prevention of diabetic peripheral neuropathy, particularly as these drugs are already licensed to treat ED, which occurs in around 50% of male diabetics. [source]


Suspected allergy to local anaesthetics: follow-up in 135 cases

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2010
T. HARBOE
Background: Local anaesthetics (LA) are generally considered safe with respect to allergy. However, various clinical reactions steadily occur. Even though most reactions are manifestations of reflexes to perceptive stimuli, uncertainty often remains regarding a possible allergic mechanism. This uncertainty later leads to an avoidance of local anaesthesia and unnecessarily painful interventions, resource-consuming general anaesthesia or even the risk of re-exposure to other yet unidentified allergens. In the present study, follow-up procedures at an allergy clinic were analysed to examine the frequency of identified causative agents and pathogenetic mechanisms and evaluate the strength of the diagnostic conclusions. Method: The medical records of 135 cases with alleged allergic reactions to LA were reviewed. Diagnoses were based on case histories, skin tests, subcutaneous challenge tests and in vitro IgE analyses. Results: Two events (1.5%) were diagnosed as hypersensitivity to LA, articaine,adrenaline and tetracaine,adrenaline, respectively. Ten reactions (7%) were diagnosed as IgE-mediated allergy to other substances including chlorhexidine, latex, triamcinolone and possibly hexaminolevulinate. As challenge testing was not consistently performed with the culprit LA compound, follow-ups were short of definitely refuting hypersensitivity in 61% of the cases. The reported clinical manifestations were in general diagnostically unspecific, but itch and generalised urticaria were most frequent in test-positive cases. Conclusion: Reactions during local anaesthesia are rarely found to be an IgE-mediated LA allergy. Whenever the clinical picture is compatible with allergy, other allergens should also be tested. [source]


FINANCIAL STRATEGY FOR MIDDLE MARKET COMPANIES: a ROUNDTABLE DISCUSSION

JOURNAL OF APPLIED CORPORATE FINANCE, Issue 4 2000
Article first published online: 5 APR 200
Dennis Soter begins with the provocative observation that "U.S. companies, private as well as public, are systematically underleveraged," and goes on to suggest that debt-financed stock repurchases may help address the current valuation problems faced by many middle market companies (and by many larger firms in basic industries as well). Soter makes his case by presenting two case histories. In the first, Equifax, the Atlanta-based provider of credit information services, combined a leveraged Dutch auction stock repurchase with a multi-year series of open market repurchase programs and an EVA incentive plan to produce large increases in operating efficiency and shareholder value. In the second, FPL Group (the parent of Florida Power and Light) became the first profitable utility to cut its dividend, substituting a policy of ongoing stock repurchase for its 33% reduction in dividend payments. Following Soter, John Brehm, the CFO of IPALCO Enterprises (the parent of Indianapolis Power and Light), explains the rationale for his company's decision to become the first utility to do a leveraged recap (while also cutting its dividend by a third). As in the case of Equifax, IPALCO's dramatic change in capital structure (also combined with an EVA incentive plan) was associated with major operating improvements and a positive stock market response. But, of course, high leverage is not right for all companies. And, to reinforce that point, James Perry, CEO of Argosy Gaming, recounts his harrowing experience of having to raise new equity shortly after taking charge of his overleveraged company. By arranging an infusion of convertible preferred, Argosy was able not only to stave off bankruptcy, but to fund major new investment and engineer a remarkable turnaround of its operations. Finally, William Dutmers, Chairman of Knape & Vogt, a small midwestern manufacturing company, discusses the role of debt-financed stock repurchases and an EVA management approach in his company's recent operating improvements. [source]


Applied Ethics: Naturalism, Normativity and Public Policy

JOURNAL OF APPLIED PHILOSOPHY, Issue 3 2009
ONORA O'NEILL
abstract,Normative argument is supposed to guide ways in which we might change the world, rather than to fit the world as it is. This poses certain difficulties for the notion of applied ethics. Taken literally the phrase ,applied ethics' suggests that principles or standards with substantial philosophical justification, in particular ethical and political principles with such justification, are applied to particular cases and guide action. However, the ,cases' which applied ethics discusses are themselves indeterminate, and the relation of principles to these ,cases' differs from the relation of principles to cases in naturalistic, truth-oriented inquiry. Writing in ,applied ethics', I shall argue, does not need elaborate case histories or scenarios, since the testing points for normative principles are other normative principles rather than particular cases. Normative principles and contexts to which they are applicable are indeed needed for any reasoning that is practical, but they are not sufficient. Practical ethics needs principles that can not merely be applied in certain cases or situations, but also enacted in certain ways, and requires an account of practical judgement and of the public policies that support that judgement. [source]


Delusional disorder,jealous type: how inclusive are the DSM,IV diagnostic criteria?

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 3 2008
Judith A. Easton
Abstract Delusional disorder,jealous type is a new diagnostic category in the Diagnostic and Statistical Manual for Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) in which delusions concerning a partner's infidelity must be present. Therefore, patients who experience a jealousy disorder, but do not experience delusions will not fit the diagnostic criteria. Using a database of 398 case histories of jealousy disorders reported in the literature from 1940,2002, we examined the percentage of these cases that met the diagnostic criteria for delusional disorder,jealous type. Only 4% of the cases met all diagnostic criteria. This is the first systematic comparison of the prevalence of these disorders. The results provide evidence that the diagnostic criteria are not inclusive, as most individuals suffering with a jealousy disorder were excluded from the diagnosis. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64: 1,12, 2008. [source]


Cosmetic use of polylactic acid: report of 568 patients

JOURNAL OF COSMETIC DERMATOLOGY, Issue 4 2009
Alessio Redaelli MD
Summary Background, There are few methods for the correction of the reduction of subcutaneous volumes. Polylactic acid is a new material with which we can achieve interesting results. Objective, To review our case histories in the assessment of this material's safety and effectiveness, its best indications, and to outline our technique. Materials and Method, Polylactic acid was prepared and diluted with 5,8 mL depending on injection sites, which included patients' face, neck and hands volume restoration, as well as arm and thigh revitalization. A total of 568 patients were treated from January 1999 to December 2007. Results, The Definitive Graduated Score varied from 6.3 to 8.4 with an average score of 7.8. The principal side effect, collagen late nodules, appeared with a very low frequency (1%) and were the result of incorrect technique. Conclusions, The fibro-connective restoration of face contours and volumes is the winning strategy for a holistic, three-dimensional approach to the aged face, neck, and hands. Since the introduction of certified courses, side effects have become less common than in other methods, and can probably be further reduced to a minimum. [source]


How should the risk associated with the introduction of biological control agents be estimated?

AGRICULTURAL AND FOREST ENTOMOLOGY, Issue 1 2010
Earl D. McCoy
1Florida has an exceptional burden of invasive species. The history of the classical biological control of invasive arthropod pest species in the region largely is one of inadequate pre-release testing for nontarget effects. 2A recent analysis indicated that a substantial risk of nontarget effects may exist in Florida, although the risk appears to be confined to a relatively small group of species within approximately ten families and documented cases of nontarget effects are rare, despite previous risky practices. 3Great progress has been made recently in creating an organized framework for dealing with the uncertainty accompanying biological control importations in Florida and elsewhere. We suggest some ways in which balancing the risks and associated costs of releasing a biological control agent against the risks and associated costs of not releasing the agent may be improved. 4Ultimately, experts will need to set some level of acceptable risk, and the ,precautionary principle' has been advanced to guide this process. As it stands, however, the precautionary principle applied to biological control falls short as a guide because it does not provide a prescription for action. 5Florida case histories clearly illustrate both the complexity and urgency related to developing a prescription for action. [source]


Paediatric bronchiectasis in the twenty-first century: Experience of a tertiary children's hospital in New Zealand

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 2 2003
EA Edwards
Objective: Despite its decline in developed countries, bronchiectasis appeared to be a common diagnosis in Auckland, New Zealand children. The aims of this study were: to document the number of children in Auckland with bronchiectasis, their severity, clinical characteristics and possible aetiologies; to assess whether there was a relationship between ethnicity and poverty; and to estimate a crude bronchiectasis prevalence rate for New Zealand. Methods: A retrospective review of the case histories of all children attending a tertiary children's hospital in Auckland with bronchiectasis diagnosed by high-resolution chest computed tomography (CT) scan, during the period 1998,2000 was undertaken. Data collected included patient demographics, number of hospitalizations pre- and post-diagnosis, lung function tests, radiology and investigations. The New Zealand deprivation 1996 index was applied to the data to obtain a measure of socio-economic status. Results: Bronchiectasis was found to be common, with an estimated prevalence of approximately one in 6000 in the Auckland paediatric population. It was disproportionately more common in the Pacific Island and Maori children. In Pacific Island children, bronchiectasis not caused by cystic fibrosis was nearly twice as common in the general population than cystic fibrosis. Socio-economic deprivation and low immunization rates may be significant contributing factors. The bronchiectasis seen was extensive. Ninety-three percent had bilateral disease and 64% had involvement of four or more lobes on chest CT scan. A wide range of comorbidities and underlying aetiologies were evident. Conclusions: Paediatric bronchiectasis in Auckland, New Zealand, is common but underresourced. Only the most severe cases are being recognized, providing a significant challenge for paediatric health professionals. [source]


Skill Is Not Enough: Seeking Connectedness and Authority in Mediation

NEGOTIATION JOURNAL, Issue 4 2004
Christopher Honeyman
Coauthor Christopher Honeyman was struck by the flagging "marketability" of mainstream professionally trained mediators in the U.S. More and more parties were choosing retired judges and other practitioners who were not classically trained mediators to help them resolve their disputes. Searching for an explanation of this phenomenon, Honeyman found a possible answer in Melbourne, Australia, where he listened with a Western ear to the presentations of coauthors Loretta Kelly and Bee Chen Goh about the importance of connectedness and individual perceptions of authority to the parties in the mediation of indigenous disputes. In this article, the authors present case histories from Australia and Malaysia to illustrate these concepts. They contend the same concepts are behind the shifting of the market for mediation in the United States. [source]


Intensification of workplace regimes in British horticulture: the role of migrant workers

POPULATION, SPACE AND PLACE (PREVIOUSLY:-INT JOURNAL OF POPULATION GEOGRAPHY), Issue 6 2008
Ben Rogaly
Abstract In Britain, international migrants have very recently become the major workforce in labour-intensive horticulture. This paper explores the causes of the dramatic increase since the 1990s in the employment of migrant workers in this subsector. It locates this major change in a general pattern of intensification of horticultural production driven by an ongoing process of concentration in retailer power, and in the greater availability of migrant workers, shaped in part by state initiatives to manage immigration. The paper draws on concepts developed in the US literature on agrarian capitalism. It then uses case histories from British horticulture to illustrate how growers have directly linked innovations involving intensification through labour control to their relationships with retailers. Under pressure on ,quality', volume and price, growers are found to have ratcheted up the effort required from workers to achieve the minimum wage through reducing the rates paid for piecework, and in some cases to have changed the type of labour contractor they use to larger, more anonymous businesses. The paper calls for further, commodity-specific and spatially-aware research with a strong ethnographic component. Copyright © 2008 John Wiley & Sons, Ltd. [source]


Treating fungal skin infections

PRESCRIBER, Issue 19 2006
Article first published online: 28 JAN 200
Specialists Dr Rosemary Barnes and Dr Brendan Healy answer questions posed by GP Dr Tom Poyner on fungal skin infections and comment on two case histories. Copyright © 2006 Wiley Interface Ltd [source]


Examining the Sexual Offenses of Female Juveniles: The Relevance of Childhood Maltreatment

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 4 2008
Dominique Roe-Sepowitz MSW
Research on female juvenile sex offenders is limited by small clinical samples. Little is known about the characteristics of female sexual offending and how it is related to child maltreatment. This study examines data from the case histories of 118 female juvenile sex offenders. In contrast to portrayals in previous research, this study shows that female sex offenders are not a homogeneous group. Findings also included differentiation between female juvenile sexual offenders with a history of child maltreatment and those without a history of child maltreatment. Female juvenile sex offenders who had a history of child maltreatment were more likely to have a current mental health diagnosis and experience clinical levels of anger-irritability and depression-anxiety than those without a history of child maltreatment. The impact of a history of sexual abuse for female juvenile sex offenders was found to be important with regard to higher levels of coercion of their sexual abuse victims. Important distinctions are highlighted that have implications for female-specific assessment, treatment, and prevention. [source]


No place called home: the causes and social consequences of the UK housing ,bubble'

THE BRITISH JOURNAL OF SOCIOLOGY, Issue 2 2010
John Bone
Abstract This paper examines the key causes and social consequences of the much debated UK ,housing bubble' and its aftermath from a multidimensional sociological approach, as opposed to the economic perspective of many popular discussions. This is a phenomenon that has affected numerous economies in the first decade of the new millennium. The discussion is based on a comprehensive study that includes exhaustive analysis of secondary data, content and debate in the mass media and academia, primary data gathered from the monitoring of weblogs and forums debating housing issues, and case histories of individuals experiencing housing difficulties during this period. This paper is intended to provide a broad overview of the key findings and preliminary analysis of this ongoing study, and is informed by a perspective which considers secure and affordable housing to be an essential foundation of stable and cohesive societies, with its absence contributing to a range of social ills that negatively impact on both individual and collective well being. Overall, it is argued that we must return to viewing decent, affordable housing as an essential social resource, that provides the bedrock of stable individual, family and community life, while recognizing that its increasing treatment as a purely economic asset is a key contributor to our so-called ,broken society'. [source]


Practitioner Review: Clinical applications of pediatric hypnosis

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 8 2007
Jeffrey I. Gold
Background:, Over the past quarter century, hypnosis has been employed in a broad range of pediatric clinical settings; however, its efficacy and feasibility as a treatment approach for children and adolescents remain in question. Method:, Published studies on the role of clinical hypnosis in the management of specific pediatric medical and psychological conditions were identified and reviewed. Results:, Pediatric clinical hypnosis has been employed in diverse medical settings to treat primary conditions (e.g., enuresis), as well as to address factors related to management of the condition (e.g., skills training for asthma) or its treatment (e.g., burn dressing changes). Despite great breadth to the possible applications of pediatric hypnosis and many reported successes, much of the present research comprises case histories and small, uncontrolled group studies. Conclusion:, To date, research in pediatrics views clinical hypnosis as a promising tool with the potential to help manage a variety of conditions. However, additional research, particularly utilizing randomized, controlled methodologies and adequate sample sizes, is required. [source]


The difficulty with experience: Does practice increase susceptibility to premature closure?

THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 3 2006
Kevin W. Eva PhD
Abstract Introduction: A recent review of the physician performance literature concluded that the risk of prematurely closing one's diagnostic search increases with years of experience. To minimize confounding variables and gain insight into cognitive issues relevant to continuing education, the current study was performed to test this conclusion. Methods: Physician participants were shown a series of case histories and asked to judge the probability of a pair of diagnoses. The order in which features were presented was manipulated across participants and the probabilities compared to determine the impact of information order. Two groups of participants were recruited, 1 older than and 1 younger than 60 years. Results: The probability assigned to a diagnosis tended to be greater when features consistent with that diagnosis preceded those consistent with an alternative than when the same features followed those consistent with the alternative. Older participants revealed a greater primacy effect than less experienced participants across 4 experimental conditions. Discussion: Physicians with greater experience appear to weigh their first impressions more heavily than those with less experience. Educators should design instructional activities that account for experience-specific cognitive tendencies. [source]


From experience: Capturing hard-won NPD lessons in checklists

THE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 5 2001
Raymond F. Riek
The application of a good New Product Development (NPD) process is frequently limited by the experience of the user. Avoiding relatively minor errors and omissions that can lead to seriously flawed project results is still an art. Checklists for each stage of a development project can capture this art and their disciplined use can avoid many potentially critical omissions and errors. Development of checklists frequently comes from the hard experiences many of us have had in bringing new products to market. Consequently, benchmarking "trials and tribulations" rather than success stories can be more appropriate to developing a thoughtful checklist. This article is a partial accumulation of one practitioner's experiences of over three decades of executing, managing, directing and observing these projects. Fifteen NPD case histories are examined to develop learnings from these experiences. These cases are organized around three basic product development issues: managing technical risks, managing commercial risks, and managing NPD personnel. In these examples, NPD project problems have a common theme of poor technical or commercial risk management, as opposed to technical failure. Improved planning and a more disciplined management interface would have avoided many of the problems discussed in these case histories. Analysis of each of the case histories and learnings is provided from which suggested checklist items are derived. These checklist additions are presented by development stage to allow use by other NPD teams, with the intention of avoiding the repetition of similar problems. [source]


The Value of Enhanced Magnetic Resonance Imaging in the Evaluation of Endocochlear Disease,

THE LARYNGOSCOPE, Issue 1 2002
Joseph L. Hegarty MD
Abstract Background Gadolinium-enhanced magnetic resonance imaging (GdMRI) is routinely used in the evaluation and management of suspected retrocochlear pathology such as vestibular schwannoma. However, its value in the evaluation and diagnosis of cochlear pathology associated with sensorineural hearing loss (SNHL) has been less clear. Study Design Retrospective review of case histories and imaging studies of patients with SNHL and cochlear enhancement on GdMRI diagnosed between 1998 and 2000. Results Five patients with SNHL who required gadolinium administration to establish the diagnosis of endocochlear disease were identified. Diagnosed lesions included an intralabyrinthine schwannoma, intracochlear hemorrhage, radiation-induced ischemic change, autoimmune labyrinthitis, and meningogenic labyrinthitis. In these illustrative cases, the GdMRI demonstrated intrinsic high signal or contrast enhancement within the cochlea and labyrinth in the absence of a retrocochlear mass. In one patient with meningogenic labyrinthitis, cochlear enhancement on MRI led to prompt cochlear implantation before the potential development of cochlear ossification. Conclusion Our experience suggests that GdMRI plays a crucial role in the diagnosis of cochlear pathology associated with sensorineural hearing loss and may directly impact patient management. [source]