Mixed medullary-papillary carcinoma of the thyroid: report of a case and review of the literature.

BACKGROUND: Mixed medullary-follicular thyroid carcinoma denotes a rare and heterogeneous group of tumors displaying morphological and immunophenotypical features of both origins within the same lesion. METHOD: We report a case of a 41-year-old woman with a lump in the right side of the neck, increasing in pain and size over several weeks. Serum levels of calcitonine (1140 ng/L) and carcinoembryonic antigen (288 microg/L) were very high. Fine-needle aspiration cytology suggested a diagnosis of medullary thyroid carcinoma. Total thyroidectomy, along with bilateral functional neck and mediastinal lymph-node dissection, were performed. RESULTS: The histopathological examination yielded a diagnosis of medullary carcinoma in the right thyroid lobe, closely intermingled with a nonencapsulated classical papillary carcinoma. One ipsilateral lymph node showed micrometastasis of the medullary counterpart. CONCLUSION: When compared with other cases reported in literature, this particular presentation should be recognized, if required, morphologic and functional criteria are used. The treatment is mostly surgical, driven by the medullary component. The presence of micrometastasis in 1 ipsilateral cervical lymph-node underlines the importance of cervicomediastinal lymph-node dissection and careful searching for metastatic disease.

Infection prothétique de hanche à Listeria monocytogenes [Prosthetic hip infection due to Listeria monocytogenes: review of the literature and case report].

With the ageing of the population, articular prosthetic replacements are becoming more and more frequent. One of the most feared complications is prosthetic infection, mostly due to bacteria of the cutaneous flora. Listeria monocytogenes is rarely the cause. This paper describes the management of a hip prosthetic infection due to Listeria monocytogenes. The patient was cured with antimicrobial therapy and a two-stage exchange. This case report creates an opportunity to review the literature in the aim of determining the risk factors and the optimal care.

Clinical results of enzyme replacement therapy in Fabry disease: a comprehensive review of literature.

Enzyme replacement therapy (ERT) has been used to treat Fabry disease - a progressive lysosomal storage disorder - since 2001. Two preparations of the enzyme alpha-galactosidase A are available in Europe: agalsidase alpha, produced in a human cell line, and agalsidase beta, produced in Chinese hamster ovary cells. To review critically the published evidence for the clinical efficacy of these two enzyme preparations. A systematic literature search was undertaken to identify open or randomised controlled trials published on Fabry disease since 2001. Eleven trials fulfilled the criteria for inclusion in this review, of a total of 586 references on Fabry disease. To date, no direct comparisons exists between the two available enzyme preparations. Significant clinical benefits compared with placebo, however, have been demonstrated with ERT, with positive effects on the heart, kidneys, nervous system and quality of life. The quality of most of these publications was less than optimal. Further prospective studies are required to confirm the long-term clinical benefits of ERT. More studies are also needed on the effects of ERT in women and on the use of ERT early in the course of Fabry disease, to prevent organ damage. Large national and international outcomes databases will also be invaluable in evaluating treatment effects and safety.

Supervised injection services : what has been demonstrated? : a systematic literature review

BACKGROUND: Supervised injection services (SISs) have been developed to promote safer drug injection practices, enhance health-related behaviors among people who inject drugs (PWID), and connect PWID with external health and social services. Nevertheless, SISs have also been accused of fostering drug use and drug trafficking. AIMS: To systematically collect and synthesize the currently available evidence regarding SIS-induced benefits and harm. METHODS: A systematic review was performed via the PubMed, Web of Science, and ScienceDirect databases using the keyword algorithm [("SUPERVISED" OR "SAFER") AND ("INJECTION" OR "INJECTING" OR "SHOOTING" OR "CONSUMPTION") AND ("FACILITY" OR "FACILITIES" OR "ROOM" OR "GALLERY" OR "CENTRE" OR "SITE")]. RESULTS: Seventy-five relevant articles were found. All studies converged to find that SISs were efficacious in attracting the most marginalized PWID, promoting safer injection conditions, enhancing access to primary health care, and reducing the overdose frequency. SISs were not found to increase drug injecting, drug trafficking or crime in the surrounding environments. SISs were found to be associated with reduced levels of public drug injections and dropped syringes. Of the articles, 85% originated from Vancouver or Sydney. CONCLUSION: SISs have largely fulfilled their initial objectives without enhancing drug use or drug trafficking. Almost all of the studies found in this review were performed in Canada or Australia, whereas the majority of SISs are located in Europe. The implementation of new SISs in places with high rates of injection drug use and associated harms appears to be supported by evidence.

Viral Retinitis following Intraocular or Periocular Corticosteroid Administration: A Case Series and Comprehensive Review of the Literature.

Abstract Purpose: To describe viral retinitis following intravitreal and periocular corticosteroid administration. Methods: Retrospective case series and comprehensive literature review. Results: We analyzed 5 unreported and 25 previously published cases of viral retinitis following local corticosteroid administration. Causes of retinitis included 23 CMV (76.7%), 5 HSV (16.7%), and 1 each VZV and unspecified (3.3%). Two of 22 tested patients (9.1%) were HIV positive. Twenty-one of 30 (70.0%) cases followed one or more intravitreal injections of triamcinolone acetonide (TA), 4 (13.3%) after one or more posterior sub-Tenon injections of TA, 3 (10.0%) after placement of a 0.59-mg fluocinolone acetonide implant (Retisert), and 1 (3.3%) each after an anterior subconjunctival injection of TA (together with IVTA), an anterior chamber injection, and an anterior sub-Tenon injection. Mean time from most recent corticosteroid administration to development of retinitis was 4.2 months (median 3.8; range 0.25-13.0). Twelve patients (40.0%) had type II diabetes mellitus. Treatments used included systemic antiviral agents (26/30, 86.7%), intravitreal antiviral injections (20/30, 66.7%), and ganciclovir intravitreal implants (4/30, 13.3%). Conclusions: Viral retinitis may develop or reactivate following intraocular or periocular corticosteroid administration. Average time to development of retinitis was 4 months, and CMV was the most frequently observed agent. Diabetes was a frequent co-morbidity and several patients with uveitis who developed retinitis were also receiving systemic immunosuppressive therapy.

OSIRISv1.2: a named entity recognition system for sequence variants of genes in biomedical literature

Background: Single Nucleotide Polymorphisms, among other type of sequence variants, constitute key elements in genetic epidemiology and pharmacogenomics. While sequence data about genetic variation is found at databases such as dbSNP, clues about the functional and phenotypic consequences of the variations are generally found in biomedical literature. The identification of the relevant documents and the extraction of the information from them are hampered by the large size of literature databases and the lack of widely accepted standard notation for biomedical entities. Thus, automatic systems for the identification of citations of allelic variants of genes in biomedical texts are required. Results: Our group has previously reported the development of OSIRIS, a system aimed at the retrieval of literature about allelic variants of genes http://ibi.imim.es/osirisform.html. Here we describe the development of a new version of OSIRIS (OSIRISv1.2, http://ibi.imim.es/OSIRISv1.2.html webcite) which incorporates a new entity recognition module and is built on top of a local mirror of the MEDLINE collection and HgenetInfoDB: a database that collects data on human gene sequence variations. The new entity recognition module is based on a pattern-based search algorithm for the identification of variation terms in the texts and their mapping to dbSNP identifiers. The performance of OSIRISv1.2 was evaluated on a manually annotated corpus, resulting in 99% precision, 82% recall, and an F-score of 0.89. As an example, the application of the system for collecting literature citations for the allelic variants of genes related to the diseases intracranial aneurysm and breast cancer is presented. Conclusion: OSIRISv1.2 can be used to link literature references to dbSNP database entries with high accuracy, and therefore is suitable for collecting current knowledge on gene sequence variations and supporting the functional annotation of variation databases. The application of OSIRISv1.2 in combination with controlled vocabularies like MeSH provides a way to identify associations of biomedical interest, such as those that relate SNPs with diseases.

Neuroretinitis: review of the literature and new observations.

Neuroretinitis (NR) is an inflammatory disorder characterized by optic disc edema and subsequent formation of a macular star figure. The underlying pathophysiology involves increased permeability of disc vasculature, but the etiology is not fully defined. In some cases, NR is probably due to an infectious process involving the disc; in others, a postviral or autoimmune mechanism is more likely. Cases can be divided into those in which a specific infectious agent has been identified, those considered idiopathic, and those with recurrent attacks. Some reports have not distinguished among these subgroups, and it is unclear if their clinical features vary. We reviewed the literature and our own patients looking particularly at features that might better distinguish these subtypes. Features common to all 3 groups included age, absence of pain, and fundus appearance. Preceding systemic symptoms were more common in patients with cat scratch disease (CSD) and uncommon in those with recurrence. The pattern and magnitude of visual field loss differed, more commonly confined to the central field in CSD cases and more severe in recurrent cases. Recovery of visual acuity and field was less substantial in recurrent cases even after the initial episode. MRI was usually normal in all 3 groups. Enhancement confined to the optic disc was found in all 3 groups, but enhancement of the retrobulbar optic nerve was seen only in recurrent cases. Findings that are strongly suggestive of CSD include very young age, preceding systemic symptoms, and poor visual acuity but with a small or absent relative afferent pupil defect (RAPD). In contrast, the following are suggestive of idiopathic NR with a high risk of recurrence: absence of systemic symptoms, visual field defect outside the central field, preserved visual acuity with a large RAPD, and poor recovery of vision. Decisions regarding evaluation and treatment should be made with these features in mind.

Localized fibrous tumours of the pleura: 15 new cases and review of the literature.

OBJECTIVE: To present a series of localized fibrous tumours of the pleura (LFTP), to define the clinical and histopathological diagnostic criteria of this tumour, and to determine the optimal treatment and follow-up. METHODS: Review of the charts of the patients with the diagnosis of LFTP (formerly called benign fibrous mesothelioma), as well as of all the histological sections, including immunohistochemical stains. Review of the literature with special emphasis on the clinical and histological criteria of malignancy. RESULTS: During the last 30 years, we found 15 patients with a complete clinical chart and histological material, particularly paraffin blocks of the tumour. The mean age was 57 years (range 27-79). Eight patients were asymptomatic, and the remaining seven presented with non-specific symptoms. All but one had complete resection of the tumour, including partial lung resection in two and partial chest wall resection in three. The diagnosis was confirmed by histological review in 15 cases. Immunohistochemical stainings showed positivity for vimentin in all cases, for CD 34 in 80%, but were consistently negative for cytokeratins. Nine tumours were histologically classified as malignant. Among them, five recurred, two of which were responsible for death. One benign tumour recurred after 1 year, and was treated successfully by repeat resection and radiotherapy. Overall, 13 patients (86%) were alive with no evidence of disease between 10 months and 27 years after the first resection. CONCLUSIONS: LFTP is a rare tumour which has a benign clinical course in over 80% of the cases, and is asymptomatic in half the patients. The diagnosis is difficult to establish before operation. Treatment consists of complete resection including adjacent structures if necessary. The clinical behaviour of LFTP cannot be predicted on the basis of histological aspects only. If histologically malignant tumours are more prone to recurrence and poor outcome, broad-based and locally invasive tumours bear a higher risk of recurrence. Long term follow-up is therefore mandatory in all cases in order to perform early re-resection when recurrence occurs.

Teaching Literature in EFL through the Story Grammar and Reader Response Approach

La Literatura ha de ser implementada a les aules com a eina per a l’ensenyament i aprenentatge de la llengua anglesa, i hauria de complementar els llibres de text d’ensenyament d’aquesta llengua. D’aquesta manera els alumnes seran exposats encara més a una varietat de registres, expressions i vocabulari d’aquesta llengua. La metodologia d’ensenyar la gramàtica dels contes o històries coneguda en anglès com “Story Grammar Approach” (SGA) i la metodologia sobre la comprensió i reacció lectora o “Reader Response Approach” (RRA) són excel•lent vehicles per a implementar la Literatura com a eina a les aules per a ensenyar anglès.La metodologia sobre la gramàtica de contes o “SGA” només es pot posar en pràctica quan els textos són narratius perquè aquests posseeixen tots els següents elements:• Personatges• Ambient• Trama• Conflicte• Resolució• Tema La metodologia de la reacció lectiva o “RRA” es centra principalment en la comprensió subjectiva i reacció del lector sobre un text, en la qual el lector formula una hipòtesis i aporta les seves idees sobre el text a una conversa grupal. Els estudiants han de poder aportar les seves reaccions, idees i respostes sobre els textos. La metodologia “RRA” també enfoca les habilitats cognitives superiors i empenya a l’alumne a millorar la seva expressió oral.Aquestes dues metodologies aporten incomptable avantatges. Treballen totes les intel•ligències múltiples i totes les competències acadèmiques (menys la matemàtica), els alumnes aprenen a treballar i a escolar als altres (i valorar altres opinions), poden aprendre sobre diferents cultures, la història, geografia, són exposats a diferents gèneres, i fomenten i estimulen la lectura i escriptura, com també treballen les habilitats productives i receptives en l’aprenentatge del anglès.

Bayesian networks for evaluating forensic DNA profiling evidence: a review and guide to literature

Almost 30 years ago, Bayesian networks (BNs) were developed in the field of artificial intelligence as a framework that should assist researchers and practitioners in applying the theory of probability to inference problems of more substantive size and, thus, to more realistic and practical problems. Since the late 1980s, Bayesian networks have also attracted researchers in forensic science and this tendency has considerably intensified throughout the last decade. This review article provides an overview of the scientific literature that describes research on Bayesian networks as a tool that can be used to study, develop and implement probabilistic procedures for evaluating the probative value of particular items of scientific evidence in forensic science. Primary attention is drawn here to evaluative issues that pertain to forensic DNA profiling evidence because this is one of the main categories of evidence whose assessment has been studied through Bayesian networks. The scope of topics is large and includes almost any aspect that relates to forensic DNA profiling. Typical examples are inference of source (or, 'criminal identification'), relatedness testing, database searching and special trace evidence evaluation (such as mixed DNA stains or stains with low quantities of DNA). The perspective of the review presented here is not exclusively restricted to DNA evidence, but also includes relevant references and discussion on both, the concept of Bayesian networks as well as its general usage in legal sciences as one among several different graphical approaches to evidence evaluation.

Confronting a victim of intimate partner violence in nursing care : a literature review

Intimate partner violence is a growing problem in health care. The purpose of this thesis was to find ways of confronting a victim of intimate partner violence in nursing care and methods how nurses can encourage the victim to disclose the abuse. The aim of this thesis was to help the health care professionals to understand the issue and the need of the victims better, and that way provide a better care. This thesis is a literature review of previously made research articles about intimate partner violence. The research material consisted of 10 published articles, which were collected from different databases. The articles were published within 10 years. A content analysis method was used to examine the articles by making descriptive summary tables according to each questions. The results of this study showed multiple factors which the health care providers should take into consideration when caring the patients. Asking with a non-judgemental attitude, in a safe, confidential setting without the partner present and prioritizing the abuse was mentioned to be important for the victims. Routinely screening and different kind of brochures was considered as good methods to encourage the victims to disclose the abuse. The need for better training and counselling of the health care providers was also discovered. The results of this thesis, did answer to the chosen study questions and that way the purpose of the thesis was filled. Hopefully, in the future this problem can be minimized and prevented in advanced. Further studies are needed to examine whether these caring methods are actually being used in clinical settings and do they have any effect.

Pyoderma gangrenosum after minor trauma in a pregnant woman, mistaken for necrotizing fasciitis: report of a case and literature review.

Abstract Background: Pyoderma gangrenosum is an ulcerative, non-infectious skin disorder. However, it can be mistaken as necrotizing fasciitis, a life-threatening infective condition. We describe here a case of pyoderma gangrenosum after minor trauma treated as necrotizing fasciitis. METHODS: Case report and literature review. CASE REPORT: A 27-year-old pregnant nurse had a pretibial wound after a fall on a rough surface. When erythema developed and no response to empirical antibiotic therapy was observed, multiple debridements were performed. Paradoxically, her condition became worse. The diagnosis of pyoderma gangrenosum was suspected. Treatment with corticosteroids was started and this was successful. CONCLUSION: Pyoderma gangrenosum can mimic infectious necrotizing fasciitis. Differentiating these two conditions is important because mistreatment of pyoderma can lead to disfigurement.

The periodicity of crises: a survey of the literature

This paper examines the literature on the periodical recurrence of economic crises up to the 1840s, illustrating how the awareness of this phenomenon was far more widespread than the few existing histories of business cycle theories indicate, and also that early writers were more interested in emphasizing the intermittent return of crises rather than their precise timing

Evaluation of Virtual Reality Snowplow Simulator Training: A Literature Review, September 2006

Each winter, the Iowa Department of Transportation (Iowa DOT) maintenance operators are primarily responsible for plowing snow off federal and state roads. Drivers typically work long shifts under treacherous conditions. In addition to properly navigating the vehicle, drivers are required to operate several plowing mechanisms simultaneously, such as plow controls and salt sprayers. However, operators have few opportunities during the year to practice and refine their skills. An ideal training program would provide operators with the opportunity to practice these skills under realistic yet safe conditions, as well as provide basic training to novice or less-experienced operators. Recent technological advancements have made driving simulators a desirable training and research tool. This literature review discusses much of the recent research establishing simulator fidelity and espousing its applicability. Additionally, this report provides a summary of behavioral and eye tracking research involving driving simulators. Other research topics include comparisons between novice and expert drivers’ behavioral patterns, methods for avoiding cybersickness in virtual environments, and a synopsis of current personality measures with respect to job performance and driving performance. This literature review coincides with a study designed to examine the effectiveness of virtual reality snowplow simulator training for current maintenance operators, using the TranSim VS III truck and snowplow simulator recently purchased by the Iowa DOT.