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Raises Suspicion (raise + suspicion)
Selected AbstractsThe Mercian Connection, Harold Godwineson's Ambitions, Diplomacy and Channel-crossing, 1056,1066HISTORY, Issue 313 2009AD F. J. VAN KEMPEN It is supposed that the Vita Ędwardi contains some information about Harold's dealings with William of Normandy in 1064. This article links these covert references with William of Poitiers' statements about Harold's diplomatic activities in France. The combination turns out to be fruitful. Harold's Channel-crossing was meant as a tour of diplomacy to win support for his candidacy for the throne of the English. This statement has implications for the sequence of events. Harold's expedition was a mere continuation of his diplomacy in the Midlands earlier in 1064, when he concluded a cunning deal with the rulers of Mercia. Part of the secret arrangement was the acquisition of Northumbria, so far ruled by his self-willed brother Tostig. Harold's unintended landfall in Ponthieu and captivity in Normandy set many things in motion. His explaining-away of his presence on the continent and his fabrications about a state mission revived William's latent interest in the English succession. After his return to England, Harold's extenuation of his inglorious, illegitimate promises to William did raise suspicion about the true nature of his Channel-crossing. Eventually, the full facts of his Mercian connection were revealed, resulting in Queen Edith's and Tostig's desperate moves to prevent the take-over in Northumbria. [source] Long bone fractures in children under 3 years of age: Is abuse being missed in Emergency Department presentations?JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2004J Taitz Objective: Distinguishing injuries due to accidents from those due to child abuse in young children is important to prevent further abuse. We aimed to study the presenting features, mechanism of injury, type of fracture and indicators of possible abuse in children under 3 years of age, presenting to the Emergency Department (ED) of a tertiary referral Children's Hospital, to see whether those injuries that were more likely abusive were distinguished from those that were more likely accidental. Methods: We analysed the medical records from the Emergency Department Information System of all children below 3 years of age, who were treated for a long bone fracture at the Sydney Children's Hospital, Randwick, NSW, over a 1-year period. Demographic details, presenting complaint, mechanism of injury, type of fracture, other historical and examination data and action taken were noted. Nine indicators that raise suspicion of abuse were developed from the literature. Using these indicators, patients' ED notes were reviewed to establish whether long bone fractures suspicious for abuse had been referred for further evaluation. Results: One hundred patients with a total of 103 fractures presented during the study period. No child had multiple fractures at a single visit. The fractures included 36 radius/ulna, 27 tibia/fibula, 20 humeral, 17 clavicular and three femoral. The mean age of patients was 21.6 months (range 13 days , 35 months). Fourteen patients were younger than 12 months. Review of the notes revealed 31 children with indicators suspicious for abuse, of whom 17 children had one indicator, 11 children had two indicators, and three children had three indicators. Only one child was referred for further evaluation to child protection. Conclusion: Abuse cannot usually be determined by fracture type alone. Doctors in the ED miss indicators for abuse because they do not look for these indicators in the history and examination. Knowledge of indicators that raise suspicion of abuse is needed for a further forensic assessment to occur. The development of specific referral guidelines, ongoing education and a comprehensive injury form may improve referral of children from the ED to child protection. [source] Gastroesophageal reflux disease and non-small cell lung cancer.DISEASES OF THE ESOPHAGUS, Issue 5 2008Results of a pilot study SUMMARY., The sharp rise in the frequency of adenocarcinoma and relative decrease of squamous cell carcinoma of the respiratory and digestive systems, raises suspicion of a common element in their carcinogenetic cascade, which could result in similar trends in cell,type distribution changes of esophageal and lung cancers. The possible role of chemical irritation caused by gastroesophageal reflux disease (GERD) in non-small cell lung cancer (NSCLC) patients was investigated. There was no significant difference between the adenocarcinoma and the squamous cell carcinoma groups, neither in the composite DeMeester scores nor in any of the separate parameters of the complex score investigated. However, the ratio of detected gastroesophageal reflux cases was considerably higher than in the average population. This factor may be one element of a multifactorial cancer promotion. [source] Value of quantitative MRI biomarkers (Evans' index, aqueductal flow rate, and apparent diffusion coefficient) in idiopathic normal pressure hydrocephalusJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2009FRCR, Samuel E.S. Ng MBBS Abstract Purpose To define the value of Evans' index (EI), aqueductal flow rate (FR), and apparent diffusion coefficient (ADC) in the diagnosis of normal pressure hydrocephalus (NPH) and to assess the ability of these markers preoperatively to predict shunt response. To shed some light as to the mechanisms responsible for the symptoms of NPH. Materials and Methods Preoperative EI, FR, and ADC readings in nine cases of clinically diagnosed NPH were compared with those of age- and gender-matched controls. Similar pre- and postoperative readings of responders and nonresponders were subsequently compared. Results Compared with the controls, all measurements were statistically significant except for peak systolic flow rate (pSfr), which was near statistical significance. Comparison of pre- and postoperative readings of responders and nonresponders revealed a decrease in ADC in all responders (P = 0.032). Subdural hemorrhage was found in all nonresponders (P = 0.012). Conclusion For patients presenting with signs and symptoms of NPH, readings on MRI greater than 0.3, 10 mL/min, ,9.0 mL/min, and 10.65 × 10,4 mm2/s for EI, peak diastolic flow rate (pDfr), pSfr, and ADC, respectively, add further weight to the diagnosis. The strong correlation between shunt response and ADC decline support our hypothesis that water accumulation in the cerebrum is the major cause for the symptoms of NPH. The presence of subdural hemorrhage in all nonresponders raises suspicion of decreased compliance as the other major cause. J. Magn. Reson. Imaging 2009;30:708,715. © 2009 Wiley-Liss, Inc. [source] Axillary lump: an unusual presentation of fat necrosis in the breastJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 2007A Donuru SUMMARY The clinical presentation of an axillary lump, in majority of cases, raises suspicion of an enlarged lymph node due to malignant causes. In this case report, we established a diagnosis of an axillary lump caused by fat necrosis. We present this case report with review of the literature to familiarize clinicians with this condition. [source] | ||||||||||