Characteristics of Clostridium difficile infection in patients with discordant diagnostic test results

Background: Clinical features of Clostridium difficile infection (CDI) cases diagnosed by detection of polymerase chain reaction (PCR), with negative toxin enzyme immunoassay results (EIA) have not been fully elucidated. The purpose of this study was to determine the magnitude of CDI patients who had negative EIA toxin determinations but positive PCR tests, and their differences in clinical presentation. Methods: We performed a retrospective study comparing the clinical features of CDI cases detected by EIA (toxins A + B) with cases detected by PCR (toxin negative, PCR positive) over a 16-month period. Only patients with an initial Clostridium difficile infection episode that fulfilled a standardized definition were included. Results: During the study period, 107 episodes of CDI were detected. Seventy-four patients (69%) had positive glutamate dehydrogenase (GDH) antigen and EIA determinations (EIA positive patients). Thirty-three patients (31%) had GDH positive, negative toxin EIA and positive PCR determination (PCR positive patients). PCR positive patients were younger, 57 (27) years (mean [SD]), than EIA positive patients, 71 (16) years, (p < 0.001). Fewer PCR positive patients were receiving proton pump inhibitors (21 patients, 64%) than EIA positive patients (61 patients, 82%, p = 0.034). The clinical presentation was similar in both groups. In the multivariate analysis, lower age was identified as the only independent variable associated with PCR positive patients. Conclusions: One third of Clostridium difficile infection patients present negative toxin EIA and PCR positive tests. Performing PCR determination after the negative EIA test is more relevant in younger patients.

Travel report fiscal year 2003-2004

The South Carolina Office of the Comptroller General publishes an annual travel report with provides information on state travel expenditures by all agencies during the fiscal year. The reports also contain a summary of total travel expenditures by agency and a breakdown of the top travelers in each agency.

Travel report fiscal year 2004-2005

The South Carolina Office of the Comptroller General publishes an annual travel report with provides information on state travel expenditures by all agencies during the fiscal year. The reports also contain a summary of total travel expenditures by agency and a breakdown of the top travelers in each agency.

Travel report fiscal year 2005-2006

The South Carolina Office of the Comptroller General publishes an annual travel report with provides information on state travel expenditures by all agencies during the fiscal year. The reports also contain a summary of total travel expenditures by agency and a breakdown of the top travelers in each agency.

Travel report fiscal year 2006-2007

The South Carolina Office of the Comptroller General publishes an annual travel report with provides information on state travel expenditures by all agencies during the fiscal year. The reports also contain a summary of total travel expenditures by agency and a breakdown of the top travelers in each agency.

Endoscopy as a diagnostic and therapeutic alternative technique of taeniasis

Despite a low incidence in developed countries, gastrointestinal taeniasis should be suspected in patients with abdominal pain, diarrhea, anemia, and/or malabsorption of unknown origin, even more so if they come from endemic regions or areas with poor hygienic and alimentary habits. Diagnosis is traditionally reached by identifying the parasite in stools, but more recently both serological and immunological approaches are also available. Based on a patient diagnosed by gastroscopy, a literature review was undertaken of patients diagnosed by endoscopy. We discuss endoscopy as diagnostic modality, and the effectiveness and safety that endoscopic treatment may provide in view of the potential risk for neurocysticercosis.

Travel report fiscal year 2007-2008

The South Carolina Office of the Comptroller General publishes an annual travel report with provides information on state travel expenditures by all agencies during the fiscal year. The reports also contain a summary of total travel expenditures by agency and a breakdown of the top travelers in each agency.

Travel report fiscal year 2008-2009

The South Carolina Office of the Comptroller General publishes an annual travel report with provides information on state travel expenditures by all agencies during the fiscal year. The reports also contain a summary of total travel expenditures by agency and a breakdown of the top travelers in each agency.

Travel report fiscal year 2009-2010

The South Carolina Office of the Comptroller General publishes an annual travel report with provides information on state travel expenditures by all agencies during the fiscal year. The reports also contain a summary of total travel expenditures by agency and a breakdown of the top travelers in each agency.

Travel report fiscal year 2010-2011

The South Carolina Office of the Comptroller General publishes an annual travel report with provides information on state travel expenditures by all agencies during the fiscal year. The reports also contain a summary of total travel expenditures by agency and a breakdown of the top travelers in each agency.

Travel report fiscal year 2011-2012

The South Carolina Office of the Comptroller General publishes an annual travel report with provides information on state travel expenditures by all agencies during the fiscal year. The reports also contain a summary of total travel expenditures by agency and a breakdown of the top travelers in each agency.

Travel report fiscal year 2012-2013

The South Carolina Office of the Comptroller General publishes an annual travel report with provides information on state travel expenditures by all agencies during the fiscal year. The reports also contain a summary of total travel expenditures by agency and a breakdown of the top travelers in each agency.

Travel report fiscal year 2014-2015

The South Carolina Office of the Comptroller General publishes an annual travel report with provides information on state travel expenditures by all agencies during the fiscal year. The reports also contain a summary of total travel expenditures by agency and a breakdown of the top travelers in each agency.

Del videojuego a la realidad : sistema interactivo para la seguridad vial

El vertiginoso crecimiento de los centros urbanos, las tecnologías emergentes y la demanda de nuevos servicios por parte de la población plantea encaminar esfuerzos hacia el desarrollo de las ciudades inteligentes. Éste concepto ha tomado fuerza entre los sectores político, económico, social, académico, ambiental y civil; de forma paralela, se han generado iniciativas que conducen hacia la integración de la infraestructura, la tecnología y los servicios para los ciudadanos. En éste contexto, una de las problemáticas con mayor impacto en la sociedad es la seguridad vial. Es necesario contar con mecanismos que disminuyan la accidentalidad, mejoren la atención a incidentes, optimicen la movilidad urbana y planeación municipal, ayuden a reducir el consumo de combustible y la emisión de gases de efecto de invernadero, así como ofrecer información dinámica y efectiva a los viajeros. En este artículo se describen dos (2) enfoques que contribuyen de manera eficiente dicho problema: los videojuegos como juegos serios y los sistemas de transporte inteligente. Ambos enfoques están encaminados a evitar colisiones y su diseño e implementación requieren componentes altamente tecnológicos (e.g. sistemas telemáticos e informáticos, inteligencia artificial, procesamiento de imágenes y modelado 3D).

Different Kinds of Paraneoplastic Syndromes in Childhood Neuroblastoma

Background: Clinical presentations of paraneoplastic syndromes in neuroblastoma may multiply. Review of the clinical data and the literature on this syndrome may help in the diagnosis of neuroblastoma. Objectives: In order to make more accurate diagnosis, we reviewed the clinical data and the literature on this syndrome. Patients and Methods: Between April 2007 and April 2012, 68 children were diagnosed with neuroblastoma or ganglioneuroblastoma in our institution, 9 of which presented exclusively with paraneoplastic syndromes and were not treated with chemotherapy prior to diagnosis. After the diagnosis, all patients received chemotherapy and operation on NB97 protocol. Results: Among 68 pediatric patients with neuroblastoma or ganglioneuroblastoma, 4 (5.9%) patients suffered from neurological complications at diagnosis, 2 (2.9%) patients had digestive tract disorders, 2 (2.9%) patients had immune diseases, and 1 (1.5%) suffered from hematological disorder (without bone marrow involvement). All paraneoplastic syndrome patients achieved complete remission on paraneoplastic syndrome before completion of chemotherapy. Conclusions: Neuroblastoma may present with a range of non-specific neurologic symptoms in addition to the well-known opsoclonus-myoclonus syndrome and cerebellar ataxia. In any case, the presence of unexplained neurologic manifestations and other common clinical presentations such as rash, constipation, diarrhea, and especially immune disorders in an otherwise healthy child had raised the possibility of paraneoplastic syndrome due to the presence of an undiagnosed tumor.