An evaluation of the Swiss staging model for hypothermia using case reports from the literature.

BACKGROUND: Core body temperature is used to stage and guide the management of hypothermic patients, however obtaining accurate measurements of core temperature is challenging, especially in the pre-hospital context. The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia. The proposed temperature range for clinical stage 1 is <35-32 °C (95-90 °F), for stage 2, <32-28 °C (<90-82 °F) for stage 3, <28-24 °C (<82-75 °F), and for stage 4 below 24 °C (75 °F). However, the evidence relating these temperature ranges to the clinical stages needs to be strengthened. METHODS: Medline was used to retrieve data on as many cases of accidental hypothermia (core body temperature <35 °C (95 °F)) as possible. Cases of therapeutic or neonatal hypothermia and those with confounders or insufficient data were excluded. To evaluate the Swiss staging model for hypothermia, we estimated the percentage of those patients who were correctly classified and compared the theoretical with the observed ranges of temperatures for each clinical stage. The number of rescue collapses was also recorded. RESULTS: We analysed 183 cases; the median temperature for the sample was 25.2 °C (IQR 22-28). 95 of the 183 patients (51.9 %; 95 % CI = 44.7 %-59.2 %) were correctly classified, while the temperature was overestimated in 36 patients (19.7 %; 95 % CI = 13.9 %-25.4 %). We observed important overlaps among the four stage groups with respect to core temperature, the lowest observed temperature being 28.1 °C for Stage 1, 22 °C for Stage 2, 19.3 °C for Stage 3, and 13.7 °C for stage 4. CONCLUSION: Predicting core body temperature using clinical indicators is a difficult task. Despite the inherent limitations of our study, it increases the strength of the evidence linking the clinical hypothermia stage to core temperature. Decreasing the thresholds of temperatures distinguishing the different stages would allow a reduction in the number of cases where body temperature is overestimated, avoiding some potentially negative consequences for the management of hypothermic patients.

Primary neuroendocrine breast carcinoma: a case report and literature review

The authors present a case of a neuroendocrine carcinoma in an asymptomatic 75-year-old woman, detected in routine breast screening. The lesion was visible at mammography as a well circumscribed, medium density nodule, with no associated microcalcifications, and at ultrasonography as a hypoechoic nodule, with irregular shape and ill-defined margins. Magnetic resonance imaging revealed findings consistent with malignancy.

Miquel Martí i Pol, traducció i censura

Poeta, autor de narracions i memòries, Miquel Martí i Pol també fou un prolífic traductor del francès, amb petites incursions en les literatures anglesa, italiana i llatinoamericana. S’estrenà a la segona meitat dels anys seixanta, quan la tènue obertura del Ministeri d’Informació i Turisme aportà aires de modernitat a la indústria editorial catalana, que volgué introduir i difondre nous corrents. En vuit anys, entre 1965 i 1973, traduí al català, majoritàriament del francès, vuit obres de la literatura i del pensament contemporanis. Contextualitzades les traduccions de Miquel Martí i Pol, l’article se centra en l’estudi dels expedients de censura dels vuit títols que traduí al català entre 1965 i 1973, dipositats a l’Archivo General de la Administración d’Alcalá de Henares.

Ortner’s syndrome: a case report and literature review

AbstractThe authors report the case of a 55-year-old female, hypertensive, smoker patient presenting with dysphonia, dysphagia and persistent dry cough. Laryngoscopy diagnosed left vocal cord paralysis. Computed tomography demonstrated saccular aneurysm of the inferior wall of the aortic arch, stretching the left recurrent laryngeal nerve, a finding compatible with Ortner’s syndrome.

Solutions in radiology services management: a literature review

AbstractObjective:The present study was aimed at reviewing the literature to identify solutions for problems observed in radiology services.Materials and Methods:Basic, qualitative, exploratory literature review at Scopus and SciELO databases, utilizing the Mendeley and Illustrator CC Adobe softwares.Results:In the databases, 565 papers – 120 out of them, pdf free – were identified. Problems observed in the radiology sector are related to procedures scheduling, humanization, lack of training, poor knowledge and use of management techniques, and interaction with users. The design management provides the services with interesting solutions such as Benchmarking, CRM, Lean Approach, ServiceBlueprinting, continued education, among others.Conclusion:Literature review is an important tool to identify problems and respective solutions. However, considering the small number of studies approaching management of radiology services, this is a great field of research for the development of deeper studies.

Ultrasound scan as a potential source of nosocomial and cross-infection: a literature review

AbstractThe authors review the main concepts regarding the importance of cleaning/disinfection of ultrasonography probes, aiming a better comprehension by practitioners and thus enabling strategies to establish a safe practice without compromising the quality of the examination and the operator productivity. In the context of biosafety, it is imperative to assume that contact with blood or body fluids represents a potential source of infection. Thus, in order to implement cleaning/disinfection practice, it is necessary to understand the principles of infection control, to consider the cost/benefit ratio of the measures to be implemented, and most importantly, to comprehend that such measures will not only benefit the health professional and the patient, but the society as a whole.

Courts and Courtly Cultures in Early Modern Italy and Europe: Models and Languages

This volume deals with the forms of propaganda and self-representation, through words and images, during the rise of the 'civiltà delle corti' and through processes typical of the time, such as confrontation, adaptation, competition and rivalry. This period, which marked the passage of Italian and European culture from the Middle Ages to the Renaissance, is fundamental in the development of Modern Europe, and it lasted up to the XVIII century and beyond. At the heart of many matters debated here lies the relationship between culture and politics. The formation of a 'Lombard identity', central to the Sinergia project which was the frame of the whole research and its conferences, is closely linked to this broad general context. It places the so called 'questione milanese' - above the traditional hierarchies 'Toscana oriented' - at the centre of many questions regarding Northern Italy as a whole, starting from the dissolution of the Medieval communes, through to the rise of the signorie, from the end of the XIII century and the beginning of the XIV century up to the early XVI century.

Fingermark age determinations: legal considerations, review of the literature and practical propositions

The question of the age of fingermarks is often raised in investigations and trials when suspects admit that they have left their fingermarks at a crime scene but allege that the contact occurred at a different time than the crime and for legal reasons. In the first part of this review article, examples from American appellate court cases will be used to demonstrate that there is a lack of consensus among American courts regarding the admissibility and weight of testimony from expert witnesses who provide opinions about the age of fingermarks. Of course, these issues are not only encountered in America but have also been reported elsewhere, for example in Europe. The disparity in the way fingermark dating cases were managed in these examples is probably due to the fact that no methodology has been validated and accepted by the forensic science community so far. The second part of this review article summarizes the studies reported on fingermark dating in the literature and highlights the fact that most proposed methodologies still suffer from limitations preventing their use in practice. Nevertheless, several approaches based on the evolution of aging parameters detected in fingermark residue over time appear to show promise for the fingermark dating field. Based on these approaches, the definition of a formal methodological framework for fingermark dating cases is proposed in order to produce relevant temporal information. This framework identifies which type of information could and should be obtained about fingermark aging and what developments are still required to scientifically address dating issues.

Mixed subtype of congenital mesoblastic nephroma with poor evolution: a case report and literature review

Abstract A male child born at 27 weeks, weighting 1305 g and presenting with a right-sided abdominal tumor. Computed tomography scan demonstrated the presence of a solid mass compressing the right kidney. Puncture biopsy revealed congenital mesoblastic nephroma. The patient underwent total right nephroureterectomy, and died on the second day after surgery.

Tropheryma whipplei tricuspid endocarditis: a case report and review of the literature.

INTRODUCTION: The main clinical manifestations of Whipple's disease are weight loss, arthropathy, diarrhea and abdominal pain. Cardiac involvement is frequently described. However, endocarditis is rare and is not usually the initial presentation of the disease. To the best of our knowledge, this is the first reported case of a patient with Tropheryma whipplei tricuspid endocarditis without any other valve involved and not presenting signs of arthralgia and abdominal involvement. CASE PRESENTATION: We report a case of a 50-year-old Caucasian man with tricuspid endocarditis caused by Tropheryma whipplei, showing signs of severe shock and an absence of other more classic clinical signs of Whipple's disease, such as arthralgia, abdominal pain and diarrhea. Tropheryma whipplei was documented by polymerase chain reaction of the blood and pleural fluid. The infection was treated with a combined treatment of doxycycline, hydroxychloroquine and sulfamethoxazole-trimethoprim for one year. CONCLUSION: Tropheryma whipplei infectious endocarditis should always be considered when facing a blood-culture negative endocarditis particularly in right-sided valves. Although not standardized yet, treatment of Tropheryma whipplei endocarditis should probably include a bactericidal antibiotic (such as doxycycline) and should be given over a prolonged period of time (a minimum of one year).

Naturally occurring pentaoxygenated, hexaoxygenated and dimeric xanthones: a literature survey

This review gives information on the chemical study of 71 pentaoxygenated, 11 hexaoxygenated and 9 dimeric and more complex xanthones naturally occurring in 7 families, 29 genus and 62 species of higher plants, and 11 described as fern and fungal metabolites. The value of these groups of substances in the connection with the pharmacological activity and the therapeutic use of some species is shown. The structural formulas of 23 isolated compounds and their distribution in the species studied are given.

Les Sentències catòliques del diví poeta Dant (1545) d’en Jaume Ferrer de Blanes: edició crítica del text

Procurador reial i nobiliari, cosmògraf, joier, lapidari, mercader i escriptor, i al capdavall, un ciutadà català honrat, en Ferrer (Vidreres, ~1445 – Blanes, 1529) va marxar de ben jove, primer, a la cort de Nàpols, al servei del rei en Ferran I, i després a la cort de Sicília, al servei de la reina na Joana de Sicília. Acabada aquesta peripècia italiana va tornar a Blanes al servei del vescomte de Cabrera i de Bas fins que va morir a la mateixa vila al 1529. Un seu criat, disset anys més tard, va editar uns papers esparsos que havia trobat a can Ferrer, les (sic) Sentèncias cathòlicas del diví poeta Dant florentí, compilades per lo prudentíssim mossèn Jaume Ferrer de Blanes, incloent-hi tres parts. La primera, Conclusions, és un sumari destinat a mostrar (sic) «Entre totas las cosas necessàries a l’home per aconseguir lo seu fi y beatitut eterna principalment són tres»; la segona, Meditació, és una reflexió a fi d’il•luminar els misteris sobre la passió i mort de Jesucrist a (sic) «lo santíssim loch de Calvari»; la tercera, Letras, és un conjunt de dotze documents, entre cartes i d’altres textos, «fetas a mossèn Jaume Ferrer, respostes e regles per ell ordenades en cosmographia y en art de navegar». En Ferrer, home de grans recursos, fa un recorregut per tots els coneixements que havia acumulat al llarg de la seva vida, de Dant Alighieri a Ptolemeu i del marquès de Santillana a Albert Gran o a Aristòtil, fent servir fragments de la Commedia, dels Proverbios, de la Bíblia i de moltes altres autoritats científiques i filosòfiques, en català, italià, espanyol, llatí i, també, set mots en arameu

Fama y verdad en la épica quinientista española. El virgilianismo político y la tradición castellana del siglo xv

Fame and truth in Spanish XVth century epic. !e political vergilianism and the castilian tradition of the XVth century. The starting premise of this essay is that the Spanish Golden Age epic must be read from a historical perspective that takes into account the Hispanic literary tradition ofthe XVth century. In particular, it argues that epic should be approached from a theoretical perspective that explores its relationship with history in order to illuminate the diferences between Italian and Spanish epic theory and practice in the XVth century. The relationship between the discourses of epic and history can be explained through the imitation of the Vergilian model, specifically the Aeneid´s ideological representation of empire. However, it is also necessary to consider theoretical aspects in the light of the diferent uses of classical literature by Italian humanists and Castilian writers of the XV th century. Thus, its primary thesis is that although XVI th century Spanish epic shares the general principles of the Western Epic tradition, it should be approached from a specifically perspective Hispanic, in the light of the «political vergilianism» already enshrined in authors like Enrique de Villena and Juan de Mena, which is essential to appreciate how epic genre serves as memory for the present

Literature review on permanent magnet generators design and dynamic behavior

This paper is a literature review which describes the construction of state of the art of permanent magnet generators and motors constructing and discusses the current and possible application of these machines in industry. Permanent magnet machines are a well-know class of rotating and linear electric machines used for many years in industrial applications. A particular interest for permanent magnet generators is connected with wind mills, which seem to be becoming increasingly popular nowadays. Geared and direct-driven permanent magnet generators are described. A classification of direct-driven permanent magnet generators is given. Design aspects of permanent magnet generators are presented. Permanent magnet generators for wind turbines designs are highlighted. Dynamics and vibration problems of permanent magnet generators covered in literature are presented. The application of the Finite Element Method for mechanical problems solution in the field of permanent magnet generators is discussed.

Tuberous sclerosis complex with oral manifestations: A case report and literature review

Introduction: Tuberous sclerosis complex (TSC) is a neurocutaneous syndrome produced by a number of genetic mutations. The disease is characterized by the development of benign tumors affecting different body systems. The most common oral manifestations of TSC are fibromas, gingival hyperplasia and enamel hypoplasia. Clinical Case: A 35-year-old woman diagnosed with TSC presented with a reactive fibroma of considerable size and rapid growth in the region of the right lower third molar. Discussion: In the present case the association of TSC with dental malpositioning gave rise to a rapidly evolving reactive fibroma of considerable diameter. Few similar cases can be found in the literature. Patients with TSC present mutations of the TSC1 and TSC2 genes, which intervene in cell cycle regulation and are important for avoiding neoplastic processes. No studies have been found associating TSC with an increased risk of oral cancer, though it has been shown that the over-expression of TSC2 could exert an antitumor effect. Careful oral and dental hygiene, together with regular visits to the dentist, are needed for the prevention and early detection of any type of oral lesion. The renal, pulmonary and cardiac alterations often seen in TSC must be taken into account for the correct management of these patients.