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Selected AbstractsEnterobacter sakazakii infection in the newbornACTA PAEDIATRICA, Issue 3 2001B Bar-Oz Enterobacter sakazakii, a Gram-negative bacillus, previously known as "yellow pigmented Enterobacter cloacae," is a rare cause of neonatal infection. We describe the detailed clinical presentation of two cases in whom E. sakazakii was isolated in our neonatal service during the course of 1 mo. These include one case of sepsis and meningitis complicated by cerebral infarction, and one case of sepsis. In addition, three cases of intestinal colonization were identified. The source of the organism was thoroughly sought and was found to be a blender in the milk kitchen that was used for preparation of the reconstituted powdered milk formula. Conclusion: Our paper adds clinical and laboratory information about the disease spectrum caused by this relatively rare organism and emphasizes the importance of a thorough search for the source of the infection. [source] Seismotectonics of the Sinai subplate , the eastern Mediterranean regionGEOPHYSICAL JOURNAL INTERNATIONAL, Issue 1 2003Amos Salamon SUMMARY We define the Sinai subplate, from a seismotectonic perspective, as a distinct component in the plate tectonics of the eastern Mediterranean region. This is based on the tectonic characteristics of a comprehensive listing of all ML, 4 recorded seismicity in the region during the 20th century, on newly calculated and recalculated fault plane mechanisms of first P -wave arrivals and on published solutions based on waveform inversion of broad-band data. The low seismicity level and scarcity of strong events in the region required a thorough search for useful data and a careful examination of the reliability of the focal solutions. We gathered all available records of first P -wave onsets from the ISS and ISC Bulletins and the local seismic networks. Altogether, we were able to calculate 48 new focal mechanisms and 33 recalculated ones of events that occurred during the years 1940,1992. With the increasing number of teleseismic and regional broad-band stations in the later years, we added 37 solutions based on teleseismic and regional waveform inversions of events that occurred during 1977,2001. These mechanisms enabled us to examine the seismotectonic character of the Sinai subplate. The strike and rake directions of the calculated mechanisms usually reflect the geometry and the large-scale type of deformation observed along the boundaries of the Sinai subplate,the Dead Sea Transform, the Cypriot Arc convergent zone and the Suez Rift. Nevertheless, along each of these boundaries we found anomalous solutions that attest to the complexity of the deformation processes along plate margins. Earthquakes along the Dead Sea Transform exhibit mainly sinistral transtension and transpression, reflecting its leaky manner and local change in the transform geometry. The presence of other unexpected mechanisms near the transform, however, reflects the heterogeneous deformation it induces around. As expected, thrust mechanisms along the Cypriot Arc mirror its convergent nature and typical curved geometry. Transtension and transpressional solutions in the eastern segment of the arc reflect the sinistral shear motion between Anatolia and Sinai there. However, shear mechanisms found between Cyprus and the Eratosthenes Seamount pose a problem regarding its collision process. Most intriguing of all are ML, 4 thrust and shear solutions found in the Gulf of Suez. They are associated with predominantly normal mechanisms within a rift zone and therefore constitute a unique phenomenon, yet to be deciphered. [source] Sources of information on adverse effects: a systematic reviewHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 3 2010Su Golder Background:, Systematic reviews can provide accurate and timely information on adverse effects. An essential part of the systematic review process is a thorough search of the literature. This often requires searching many different sources. However, it is unclear which sources are most effective at providing information on adverse effects. Objective:, To identify and summarise studies that have evaluated sources of information on adverse effects. Methods:, Studies were located by searching in 10 databases as well as by reference checking, hand searching, citation searching and contacting experts. Results:, A total of 6218 citations were retrieved yielding 19 studies which met the inclusion criteria. The included studies tended to focus on the adverse effects of drug interventions and compare the relative value of different sources using the number of relevant references retrieved from searches of each source. However, few studies were conducted recently with a large sample of references. Conclusions:, This review suggests that embase, Derwent Drug File, medline and industry submissions may potentially provide the greatest number of relevant references for information on adverse effects of drugs. However, a systematic evaluation of the current value of different sources of information for adverse effects is urgently required. [source] Management of heart failure in elderly peopleINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2008M. Imazio Summary Aims:, To review currently available knowledge on presentation, clinical features and management of heart failure (HF) in elderly people. Methods:, To review currently available evidence, we performed a thorough search of several evidence-based sources of information, including Cochrane Database of Systematic Reviews, Clinical Evidence, Evidence-based guidelines from National Guidelines Clearinghouse and a comprehensive MEDLINE search with the MeSH terms: ,heart failure', ,elderly' and ,management'. Results:, A number of features of ageing may predispose elderly people to HF, and may impair the ability to respond to injuries. Another hallmark of elderly patients is the increasing prevalence of multiple coexisting chronic conditions and geriatric syndromes that may complicate the clinical presentation and evolution of HF. Although diagnosis may be challenging, because atypical symptoms and presentations are common, and comorbid conditions may mimic or complicate the clinical picture, diagnostic criteria do not change in elderly people. Drug treatment is not significantly different from that recommended in younger patients, and largely remains empiric, because clinical trials have generally excluded elderly people and patients with comorbid conditions. Disease management programmes may have the potential to reduce morbidity and mortality for patients with HF. Conclusions:, Heart failure is the commonest reason for hospitalisation and readmission among older adults. HF shows peculiar features in elderly people, and is usually complicated by comorbidities, presenting a significant financial burden worldwide, nevertheless elderly people have been generally excluded from clinical trials, and thus management largely remains empiric and based on evidence from younger age groups. [source] Construct Equivalence of Multiple-Choice and Constructed-Response Items: A Random Effects Synthesis of CorrelationsJOURNAL OF EDUCATIONAL MEASUREMENT, Issue 2 2003Michael C. Rodriguez A thorough search of the literature was conducted to locate empirical studies investigating the trait or construct equivalence of multiple-choice (MC) and constructed-response (CR) items. Of the 67 studies identified, 29 studies included 56 correlations between items in both formats. These 56 correlations were corrected for attenuation and synthesized to establish evidence for a common estimate of correlation (true-score correlations). The 56 disattenuated correlations were highly heterogeneous. A search for moderators to explain this variation uncovered the role of the design characteristics of test items used in the studies. When items are constructed in both formats using the same stem (stem equivalent), the mean correlation between the two formats approaches unity and is significantly higher than when using non-stem-equivalent items (particularly when using essay-type items). Construct equivalence, in part, appears to be a function of the item design method or the item writer's intent. [source] Transcranial magnetic stimulation: Potential treatment for tinnitus?PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2006SAXBY PRIDMORE md Abstract, Tinnitus is a common and often severely disabling disorder for which there is no satisfactory treatment. Transcranial magnetic stimulation (TMS) is a new, non-invasive method of modifying the excitability of the cerebral cortex, which has proven effective in auditory hallucinations and other disorders. Some early studies have been published in which TMS has been trialed in the treatment of tinnitus. The aim of the present paper was to examine the literature and consider the potential for TMS as a therapy in tinnitus. A thorough search of the tinnitus and TMS literature was conducted, and all available relevant material was examined. Discussions were held with leaders in both fields. Tinnitus is common and there are no effective treatments. It is frequently associated with deafness, and may be the result of a pathological plastic process, secondary to loss of innervation of the outer hair cells of the cochlea. Neuroimaging studies demonstrate increase blood flow to the primary and secondary auditory cortices, particularly on the left side. Transcranial magnetic stimulation is a non-invasive method of perturbing and inducing change in the cerebral cortex. It uses electromagnetic principles and has been successfully employed in the treatment of other conditions associated with increased activity of the cerebral cortex. A small number of studies have suggested that TMS may be effective in the treatment of tinnitus. There is a good theoretical basis and early research evidence suggesting that TMS may have treatment potential in tinnitus. Further, larger studies are necessary. [source] Current Loads of Coarse Woody Debris on Southeastern Australian Floodplains: Evaluation of Change and Implications for RestorationRESTORATION ECOLOGY, Issue 4 2002Ralph MacNally Abstract We evaluated the status of coarse woody debris (CWD, fallen wood) on floodplains of the southern Murray-Darling basin of southeastern Australia. The floodplains are dominated floristically by the river red gum Eucalyptus camaldulensis. Aerial survey techniques were used to estimate the amounts of woody debris within 200 m of the channels along 2,442 km of 11 rivers of the system, including the Murray and Darling Rivers and the Darling Anabranch. Aerially based indices were converted into wood volumes by using ground-truthing at a selection of sites; there was a strong correlation between index values and measured wood volume densities. For thickly forested sites such as Barmah, Gunbower Island, and the Ovens floodplains, the aerial method was not useful, so ground measurements at randomly positioned sites within the forests were used. Volumes were translated into mass by using conversion factors drawn from the literature. We estimated that total tonnage on approximately 221,000 ha of floodplain forests was 4.175 ± 0.579 × 106 tonne. In the larger forested blocks (>7,000 ha), mean wood densities ranged between approximately 12 tonne/ha on the lower Goulburn up to approximately 24 tonne/ha at Barmah State Forest. The area-weighted mean for the entire area was approximately 19 tonne/ha. A main purpose of the research was to place these figures into an historical perspective to evaluate implications for restoration. A thorough search of historical documentation revealed that there are no extant data upon which to estimate pre-European settlement levels. We used information from an apparently undisturbed "unmanaged" site in the Millewa forests of southern New South Wales as a basis. Wood density there corresponded to a mean figure of 125 tonne/ha wood-mass density. By using this figure we estimate that CWD levels on the southern Murray-Darling basin may be of the order of 15% of pre-European settlement levels. Full restoration of the 221,000 ha surveyed would require 23.5 ± 0.579 × 106 tonne, which is equivalent to about 600,000 mature (1 m diameter at breast height) river red gum trees or the amount of timber derived from clear felling about 115,000 ha of river red gum forest at current stocking levels. We discuss the implications of this massive deficit and possible short- and long-term solutions. [source] Inguinal hernia repair: Where to next?ANZ JOURNAL OF SURGERY, Issue 8 2002Martina Zib Background: Hernia repair is one of the most frequently performed operations in general surgery , a total of 39 000 elective inguinal hernia repairs were performed in public and private hospitals in Australia between July 1998 and June 1999 , and, as such, even minor alterations in outcome and resource use have appreciable impact. However, decisions regarding choice of operation for hernia repair remain controversial. The purpose of the present paper is to critically evaluate the evidence available regarding recently introduced open mesh repair techniques and to try to identify meaningful directions for future hernia research. Methods: A thorough search of all published surgical literature was undertaken. Medline, EMBASE and the Cochrane databases were searched by title, by key words and by author. References in review articles and in textbooks were pursued. The manufacturing companies were contacted for trials evaluating their product. Results: Eight original articles evaluating either the Kugel Patch, the PerFix Plug or the Prolene Hernia System were located. None of these trials directly compared two or more of these repair systems. To date, there has been no published review of the evidence regarding the newer mesh repair techniques. With one exception, all of these articles qualify as Level IV evidence. Highlighted is the lack of evidence regarding chronic significant posthernioplasty pain , this has an incidence of 6,12%. This complication is 3,5 times more common than recurrence after open repair, is clinically relevant, is poorly understood and has been poorly studied. Arguably it is a more important end point than recurrence. Conclusion: Only one study comparing the newer techniques of open hernia repair (PerFix Plug) constitutes Level II evidence. The PerFix Plug appears to be quicker to insert and uses a smaller incision. Chronic significant posthernioplasty pain is a more important endpoint in hernia research than is recurrence, and this review concludes with a proposal for a multicentre, randomized, controlled trial evaluating the incidence of chronic significant posthernioplasty pain following elective mesh repair of primary, unilateral hernias. [source] Extramammary Paget's diseases in men from the Shanghai area: its association with PSA level increase,APMIS, Issue 10 2010GUOHAI SHI Shi G, Ye D-W, Yao X, Zhang S, Dai B, Zhang H, Shen Y, Zhu Y, Zhu Y, Xiao W, Ma C. Extramammary Paget's diseases in men from the Shanghai area: its association with PSA level increase. APMIS 2010; 118: 777,81. The aim of this study was to determine the incidence of prostate cancer in patients with extramammary Paget's disease (EMPD). All cases of EMPD diagnosed between 1992 and 2007 in Shanghai Cancer Hospital were collected and analyzed for the incidence of prostate cancer. The median follow-up was 78 months. In total, 38 cases of invasive and 10 cases of in situ EMPD had been registered. A second malignancy was found in 28.9% (11/38) of patients with invasive EMPD and in 30% (3/10) of patients with in situ EMPD. Patients had an increased risk of developing a second cancer compared with the general population (standardized incidence ratio: 1.7; 95% confidence interval 1.2,2.4). Sixteen patients had serum prostate-specific antigen (PSA) level above 4 ng/mL; five developed prostate cancer, three of them with PSA levels beyond 100 ng/mL. The incidence of prostate cancer is 10.4% in this patient group. Patients with EMPD were more likely to have prostate cancer than the general population. Although the prognosis of EMPD is fairly good, a thorough search for a second tumor is recommended. [source] Aniridia among children and teenagers in Sweden and NorwayACTA OPHTHALMOLOGICA, Issue 2 2009Ulla Edén In the November 2008 issue (AOS 86:7), the article by Ulla Edén et al. was not published correctly in the printed issue. Unfortunately, part of the section ,Visual acuity' in the Results was repeated on page 732, and the start of the Discussion was omitted on page 732. The full and correct version of this article is printed hereunder. The Publisher apologises for this error. Reference EdénU, BeijarC, RiiseR & TornqvistK (2008): Aniridia among children and teenagers in Sweden and Norway. Acta Ophthalmol86: 730,734. Abstract. Purpose:, To investigate patients under the age of 20 with aniridia in Sweden and Norway in order to estimate the prevalence of aniridia, to describe clinical signs and identify complications in the young, which will help improve diagnostic tools and treatment. Methods:, A thorough search for patients with aniridia (of all ages) was performed. Sixty-two of the 181 patients were under the age of 20. Fifty-two of them were examined and they constituted the study population. Patient history was obtained and all participants underwent clinical ophthalmologic examination, including photography. Blood samples were taken for mutation analysis. Results:, Epidemiological data are only based on the results in Sweden. The age-specific prevalence in Sweden was 1:47 000, male/female ratio was 0.57, mean age 12 years and median age 14 years. The proportion of sporadic cases including WAGR (Wilms tumour, Aniridia, Genitourinary abnormalities, Mental Retardation) and Gillespie syndrome (aniridia, cerebellar ataxia and mental retardation) was 48%. In the entire study population (Sweden and Norway), the mean visual acuity (VA) was 0.2 (range 0.04,0.9). We found VA < 0.3 in 80% and <0.1 in 18% of the patients. Twenty-two patients (42%) had one or more of the sight threatening complications such as cataract/lens luxation, corneal clouding or glaucoma. Conclusion:, Descriptions of aniridia in the younger are rare. This study shows that aniridia seems to be more common than previously estimated and that some complications appear early in life. Watchfulness as regards these complications and regular examinations are essential even in the youngest. [source] Tools and strategies for searching in hypermedia environmentsJOURNAL OF COMPUTER ASSISTED LEARNING, Issue 2 2000A. Beaufils Abstract This paper presents the results of several investigations into the use made by students of a prototype system of help for the exploitation of hypermedia documents. This prototype was derived from a common type of educational CD-ROM in which the presentation of the contents was improved and certain research and note-taking tools added. The evolving, personalised note-taking system interacts constantly with the environment being explored. Beyond the storage of personal notes (clues, personal knowledge of the area), it allows the student to keep the explored sections in mind and ultimately to plan further explorations. It also enables the extraction and structuring of the data retrieved from the body of the database. The role of this system is to facilitate more thorough searches for information which might sometimes require several sessions stretched out over a long period. It could be profitably used in the context of independent student activities. [source] | |||||||||||||