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Latter Instance (latter + instance)

Distribution by Scientific Domains

Medical Sciences	50%
Life Sciences	50%

Selected Abstracts

Clinical approach to the patient with unexpected bleeding

INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 2000
J. M. Teitel
Bleeding can be considered unexpected if it is disproportionate to the intensity of the haemostatic stress in a patient with no known haemorrhagic disorder or if it occurs in a patient in whom a bleeding disorder has been characterized but is adequately treated. A thorough history usually allows the clinician to predict reasonably accurately whether the patient is likely to have a systemic haemostatic defect (and if so whether it is congenital or acquired), or whether the bleeding likely has a purely anatomical basis. The nature of bleeding is instructive with respect to preliminary categorization. Thus, mucocutaneous bleeding suggests defects of primary haemostasis (disordered platelet,vascular interactions). Bleeding into deeper structures is more suggestive of coagulation defects leading to impaired fibrin clot formation, and delayed bleeding after primary haemostasis is characteristic of hyperfibrinolysis. Localized bleeding suggests an anatomical cause, although an underlying haemostatic defect may coexist. Where bleeding is so acutely threatening as to require urgent intervention, diagnosis and treatment must proceed simultaneously. In the case of minor haemorrhage (not threatening to life or limb) it may be preferable to defer therapy while the nature of the bleeding disorder is methodically investigated. Initial laboratory evaluation is guided by the preliminary clinical impression. The amount of blood loss can be inferred from the haematocrit or haemoglobin concentration, and the platelet count will quickly identify cases in which thrombocytopenia is the likely cause of bleeding. In the latter instance, examination of the red cell morphology, leucocyte differential, and mean platelet volume may allow the aetiological mechanism to be presumptively identified as hypoproliferative or consumptive. With regard to coagulation testing, the activated PTT, prothrombin time, and thrombin time usually constitute an adequate battery of screening tests, unless the clinical picture is sufficiently distinctive to indicate the immediate need for more focused testing. In any event, sufficient blood should be taken to allow more detailed studies to be done based on the results of these screening tests. These results will direct the need for further assays, such as specific clotting factor activity levels, von Willebrand factor assays, tests for coagulation inhibitors, platelet function assays, and markers of primary or secondary fibrinolytic activity. [source]

Green woodhoopoe Phoeniculus purpureus territories remain stable despite group-size fluctuations

JOURNAL OF AVIAN BIOLOGY, Issue 3 2004
Andrew N. Radford
Cooperatively breeding groups may be constrained in size by the territory available to them, or territories may be expanded to accommodate extra group members. Here, we show that there was no relationship between the number of adult green woodhoopoes Phoeniculus purpureus in a group and the size of its territory. Furthermore, territories were remarkably stable between seasons, with no significant changes in area, despite fluctuating group sizes. These results suggest that food was not limiting at the group sizes found in this study: sufficient resources were available within existing territories for groups that were expanding in size. Following an increase in group membership, a larger proportion of the available area was utilised. Groups also used a larger area in the non-breeding season compared to when breeding: in the latter instance, foraging was concentrated in the vicinity of the nest. [source]

The mean measure of divergence: Its utility in model-free and model-bound analyses relative to the Mahalanobis D2 distance for nonmetric traits

AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2010
Joel D. Irish
The mean measure of divergence (MMD) distance statistic has been used by researchers for nearly 50 years to assess inter-sample phenetic affinity. Its widespread and often successful use is well documented, especially in the study of cranial and dental nonmetric traits. However, the statistic has accumulated some undesired mathematical baggage through the years from various workers in their attempts to improve or alter its performance. Others may not fully understand how to apply the MMD or interpret its output, whereas some described a number of perceived shortcomings. As a result, the statistic and its sometimes flawed application(s) have taken several well-aimed hits; a few researchers even argued that it should no longer be utilized or, at least, that its use be reevaluated. The objective of this report is to support the MMD, and in the process: (1) provide a brief history of the statistic, (2) review its attributes and applicability relative to the often-used Mahalanobis D2 statistic for nonmetric traits, (3) compare results from MMD and D2 model-free analyses of previously-recorded sub-Saharan African dental samples, and (4) investigate its utility for model-bound analyses. In the latter instance, the ability of the D2 and other squared Euclidean-based statistics to approximate a genetic relationship matrix and Sewall Wright's fixation index using phenotypic data, and the inability of the MMD to do so, is addressed. Three methods for obtaining such results with nonlinear MMD distances, as well as an assessment of the fit of the isolation-by-distance model, are presented. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source]

Effect of treatment delay upon pulp and periodontal healing of traumatic dental injuries , a review article

DENTAL TRAUMATOLOGY, Issue 3 2002
J.O. Andreasen
Abstract,,,Based on an analysis of the literature concerning parameters influencing the prognosis of traumatic dental injuries, few studies were found to have examined possible relationships between treatment delay and pulpal and periodontal ligament healing complications. It has been commonly accepted that all injuries should be treated on an emergency basis, for the comfort of the patient and also to reduce wound healing complications. For practical and especially economic reasons, various approaches can be selected to fulfill such a demand, such as acute treatment (i.e. within a few hours), subacute (i.e. within the first 24 h), and delayed (i.e. after the first 24 h). In this survey the consequences of treatment delay on pulpal and periodontal healing have been analyzed for the various dental trauma groups. Applying such a treatment approach to the various types of injuries, the following treatment guidelines can be recommended, based on our present rather limited knowledge of the effect of treatment delay upon wound healing. Crown and crown/root fractures: Subacute or delayed approach. Root fractures: Acute or subacute approach. Alveolar fractures: Acute approach (evidence however questionable). Concussion and subluxation: Subacute approach. Extrusion and lateral luxation: Acute or subacute approach (evidence however questionable). Intrusion: Subacute approach (evidence however questionable). Avulsion: If the tooth is not replanted at the time of injury, acute approach; otherwise subacute. Primary tooth injury: Subacute approach, unless the primary tooth is displaced into the follicle of the permanent tooth or occlusal problems are present; in the latter instances, an acute approach should be chosen. These treatment guidelines are based on very limited evidence from the literature and should be revised as soon as more evidence about the effect of treatment delay becomes available. [source]