A palaeoenvironmental context for terminal upper Palaeolithic and Mesolithic activity in the Colne Valley: offsite records contemporary with occupation at three ways Wharf, Uxbridge

Multi-proxy analyses from floodplain deposits in the Colne Valley, southern England, have provided a palaeoenvironmental context for the immediately adjacent Terminal Upper Palaeolithic and Early Mesolithic site of Three Ways Wharf. These deposits show the transition from an open cool environment to fully developed heterogeneous floodplain vegetation during the Early Mesolithic. Several distinct phases of burning are shown to have occurred that are chronologically contemporary with the local archaeological record. The floodplain itself is shown to have supported a number of rare Urwaldrelikt insect species implying human manipulation of the floodplain at this time must have been limited or episodic. By the Late Mesolithic a reed-sedge swamp had developed across much of the floodplain, within which repeated burning of the in situ vegetation took place. This indicates deliberate land management practices utilising fire, comparable with findings from other floodplain sequences in southern Britain. With similar sedimentary sequences known to exist across the Colne Valley, often closely associated with contemporary archaeology, the potential for placing the archaeological record within a spatially explicit palaeoenvironmental context is great.

Management of tracheobronchial foreign body in children

To study cases of foreign bodies (FB) in the tracheobronchial tree investigating the clinical and radiological FB characteristics, complications and endoscopic and surgical intervention. Medical and radiological records review of all FB aspiration cases treated at S (a) over tilde uo Paulo State University Hospital over the last 30 years. One hundred and sixty-four FB cases were analyzed; 57% were male, 84% of these were under 16 years old. The most common clinical manifestations were coughing (68.3%) and choking (54.9%). The most common FBs were seeds (peanut, bean, maize) and also small metal or plastic objects. Radiography was normal in 21.3%, atelectasis was present in 40.9%, hyperinsufflation in 17.1% and the FB was radio-opaque in 20.7%. FB time in the bronchial tree varied from hours to years. The most serious complications, as fibroatelectasis and difficult resolution pneumonia, were caused by the long time that the FB remained in the bronchial tree. FB extraction was by endoscopy in 89% of cases, while 6% required surgical extraction or resection of destroyed part of lung, and 5% spontaneously eliminated the FB. There was no mortality in this series. Coughing and choking were the commonest clinical findings. Most FBs were dried seeds. Complications were due to delays in diagnosis, and most would not have existed if the doctor had given credence to the history. Radiography can be normal as most FBs are radiotransparent. FB extraction was by endoscopy, but a few cases required surgery and others were spontaneously eliminated.

Health management contracts in Costa Rica from a comparative perspective

Includes bibliography

Come-See-Me Festival Records - Accession 815

The Come-See-Me Festival Records consist of records and memorabilia from the Come-See-Me Festivals since its founding in 1962. The collection contains correspondence, newspaper clippings, photographs, financial reports and papers, promotional materials, and other records and material chronicling the development of the Come-See-Me Festival in Rock Hill, SC.

Come-See-Me Festival Records - Accession 1408

The Come-See-Me Festival Records consist of papers, photographs, meeting minutes, scrapbooks, media kits, publicity kits, awards, applications, invitations, bylaws, guidelines, histories, correspondence, promotions and advertisements, posters, and memorabilia from the Come-See-Me Festivals from the 1980s to 2013.

South Carolina Federal Feminist Credit Union Records - Accession 106 - M45 (60)

The South Carolina Federal Feminist Credit Union Records consists of a charter, newspaper clippings, photographs, statements, minutes, correspondence, memoranda and brochures relating to the creation and early history of the Credit Union, the first of its kind in the Southeast and the tenth one established in the nation. The Credit Union dissolved on September 1, 1977.

Distribution of North Pacific right whales (Eubalaena japonica) as shown by 19th and 20th century whaling catch and sighting records

North Pacific right whales (Eubalaena japonica) were extensively exploited in the 19th century, and their recovery was further retarded (severely so in the eastern population) by illegal Soviet catches in the 20th century, primarily in the 1960s. Monthly plots of right whale sightings and catches from both the 19th and 20th centuries are provided, using data summarized by Scarff (1991, from the whale charts of Matthew Fontaine Maury) and Brownell et al. (2001), respectively. Right whales had an extensive offshore distribution in the 19th century, and were common in areas (such as the Gulf of Alaska and Sea of Japan) where few or no right whales occur today. Seasonal movements of right whales are apparent in the data, although to some extent these reflect survey and whaling effort. That said, these seasonal movements indicate a general northward migration in spring from lower latitudes, and major concentrations above 40°N in summer. Sightings diminished and occurred further south in autumn, and few animals were recorded anywhere in winter. These north-south migratory movements support the hypothesis of two largely discrete populations of right whales in the eastern and western North Pacific. Overall, these analyses confirm that the size and range of the right whale population is now considerably diminished in the North Pacific relative to the situation during the peak period of whaling for this species in the 19th century. For management purposes, new surveys are urgently required to establish the present distribution of this species; existing data suggest that the Bering Sea, the Gulf of Alaska, the Okhotsk Sea, the Kuril Islands and the coast of Kamchatka are the areas with the greatest likelihood of finding right whales today.

THE ROLE OF BIRD MANAGEMENT IN FIRE PROTECTION

Two years ago, Mike Fall and I showed you some ideas we had regarding mod¬ern architecture and bird problems. This year we've switched to considering bird hazards in older frame dwellings and on buildings where a fire hazard may be ap¬parent. During a class project some time ago, I was examining a nest of house sparrows and discovered that these birds incorporated cellulose cigarette filters into their nests. Filters were stripped of their paper wrapping and were apparently used by the sparrows as a substitute for or a supplement to fluffy air-born seeds and seed mat¬erials. The incidence of the cigarette filters varied. In the nests that I sampled the numbers varied anywhere from six up to two dozen filter remnants. We feel that the incidence will probably vary with the relative availability of discarded cigarette filter butts. We are concerned with the incidence of filters as an index to the possibility that the birds are picking up live cigarette butts, and this leads us to investigate some records of fires over the past three quarters of a century that were claimed to have been caused by birds.

Management of gallstone disease in children: a new protocol based on the experience of a single center

Background/purpose: Gallstones and cholelithiasis are being increasingly diagnosed in children owing to the widespread use of ultrasonography. The treatment of choice is cholecystectomy, and routine intraoperative cholangiography is recommended to explore the common bile duct. The objectives of this study were to describe our experience with the management of gallstone disease in childhood over the last 18 years and to propose an algorithm to guide the approach to cholelithiasis in children based on clinical and ultrasonographic findings. Methods: The data for this study were obtained by reviewing the records of all patients with gallstone disease treated between January 1994 and October 2011. The patients were divided into the following 5 groups based on their symptoms: group 1, asymptomatic; group 2, nonbiliary obstructive symptoms; group 3, acute cholecystitis symptoms; group 4, a history of biliary obstructive symptoms that were completely resolved by the time of surgery; and group 5, ongoing biliary obstructive symptoms. Patients were treated according to an algorithm based on their clinical, ultrasonographic, and endoscopic retrograde cholangiopancreatography (ERCP) findings. Results: A total of 223 patients were diagnosed with cholelithiasis, and comorbidities were present in 177 patients (79.3%). The most common comorbidities were hemolytic disorders in 139 patients (62.3%) and previous bariatric surgery in 16 (7.1%). Although symptoms were present in 134 patients (60.0%), cholecystectomy was performed for all patients with cholelithiasis, even if they were asymptomatic; the surgery was laparoscopic in 204 patients and open in 19. Fifty-six patients (25.1%) presented with complications as the first sign of cholelithiasis (eg, pancreatitis, choledocolithiasis, or acute calculous cholecystitis). Intraoperative cholangiography was indicated in 15 children, and it was positive in only 1 (0.4%) for whom ERCP was necessary to extract the stone after a laparoscopic cholecystectomy (LC). Preoperative ERCP was performed in 11 patients to extract the stones, and a hepaticojejunostomy was indicated in 2 patients. There were no injuries to the hepatic artery or common bile duct in our series. Conclusions: Based on our experience, we can propose an algorithm to guide the approach to cholelithiasis in the pediatric population. The final conclusion is that LC results in limited postoperative complications in children with gallstones. When a diagnosis of choledocolithiasis or dilation of the choledocus is made, ERCP is necessary if obstructive symptoms persist either before or after an LC. Intraoperative cholangiography and laparoscopic common bile duct exploration are not mandatory. Published by Elsevier Inc.

Lithiasis in 1,313 Kidney Transplants: Incidence, Diagnosis, and Management

Background. Renal transplantation remains the optimal treatment of patients with end-stage renal disease. Urinary lithiasis represents an unusual urologic complication in renal transplantation, with an incidence of <1%. Today, recipients of kidneys from deceased donors are more likely to receive grafts with undiagnosed lithiasis, which does not occur in patients from living donors, owing to screening with computerized tomography. Objective. The aim of this study was to evaluate the incidence, diagnosis, and therapeutic management of renal lithiasis in transplanted kidneys at a single institution. Methods. We reviewed the medical records for 1,313 patients who underwent kidney transplantation from February 1968 to February 2011. Results. Among the grafts, 17 patients (1.29%) had nephrolithiasis: 9 women and 8 men. Ages ranged from 32 to 63 years (mean = 45.6 years). Fifteen patients received kidneys from cadaveric and only 2 from living related donors. Two stones, both located inside the ureter, were identified during transplant surgery (11.7%). Three instances of lithiasis were incidentally diagnosed by ultrasound during graft evaluation, within 7 days after surgery (17.6%); all 3 were in the calyces. The 12 remaining patients had the stones diagnosed later (70.58%): 6 in the calyces, 3 in the renal pelvis, and 3 inside the ureter. Conclusions. Urinary lithiasis is a rare complication in renal transplantation. In most patients the condition occurs without pain. The diagnosis and treatment options for graft urolithiasis are similar to those patients with nephrofithiasis in the general population. Extracorporeal shock wave lithotripsy (ESWL) was the most common treatment method.

TRAUMATIC SPONDYLOLISTHESIS OF THE AXIS: EPIDEMIOLOGY, MANAGEMENT AND OUTCOME

Objective: To evaluate cases of traumatic spondylolisthesis of the axis and describe them in relation to epidemiology, classification, neurological deficit, healing time and treatment method. Method: A retrospective analysis of the medical records of patients treated between 2002 and 2010 at IOT-FMUSP. Inclusion criteria: pars interarticularis fracture of C2. Results: 68% were male patients, with a mean age of 39.1 years. We used the classification by Effendi, modified by Levine-Edwards. Type I fractures were observed in five patients (31.2%) and type II in eight patients (50%). Only three patients (18%) had type IIa fracture. There were no cases of type III. Mechanism: Eight car accidents and four falls. Other mechanisms: being run over, and diving accidents. Treatment with halo traction was used in eleven patients, using minerva cast and halo-cast. Healing time: 3.6 months. Follow-up time: 9.6 months. Discussion: In general, hangman fracture has a good prognosis, which is confirmed by our results. There was no need for surgery in any of the cases. The incidence of neurological deficit is low. No patient had unstable fracture (type III). Conclusion: This paper suggests that traumatic spondylolisthesis of the axis continues to be an injury that is successfully treated by conservative treatment in most cases. Level of Evidence IV, Case series.

The application of medical informatics to the veterinary management programs at companion animal practices in Alberta, Canada: a case study.

Companion animals closely share their domestic environment with people and have the potential to, act as sources of zoonotic diseases. They also have the potential to be sentinels of infectious and noninfectious, diseases. With the exception of rabies, there has been minimal ongoing surveillance of, companion animals in Canada. We developed customized data extraction software, the University of, Calgary Data Extraction Program (UCDEP), to automatically extract and warehouse the electronic, medical records (EMR) from participating private veterinary practices to make them available for, disease surveillance and knowledge creation for evidence-based practice. It was not possible to build, generic data extraction software; the UCDEP required customization to meet the specific software, capabilities of the veterinary practices. The UCDEP, tailored to the participating veterinary practices', management software, was capable of extracting data from the EMR with greater than 99%, completeness and accuracy. The experiences of the people developing and using the UCDEP and the, quality of the extracted data were evaluated. The electronic medical record data stored in the data, warehouse may be a valuable resource for surveillance and evidence-based medical research.

Mining free-text medical records for companion animal enteric syndrome surveillance.

Large amounts of animal health care data are present in veterinary electronic medical records (EMR) and they present an opportunity for companion animal disease surveillance. Veterinary patient records are largely in free-text without clinical coding or fixed vocabulary. Text-mining, a computer and information technology application, is needed to identify cases of interest and to add structure to the otherwise unstructured data. In this study EMR's were extracted from veterinary management programs of 12 participating veterinary practices and stored in a data warehouse. Using commercially available text-mining software (WordStat™), we developed a categorization dictionary that could be used to automatically classify and extract enteric syndrome cases from the warehoused electronic medical records. The diagnostic accuracy of the text-miner for retrieving cases of enteric syndrome was measured against human reviewers who independently categorized a random sample of 2500 cases as enteric syndrome positive or negative. Compared to the reviewers, the text-miner retrieved cases with enteric signs with a sensitivity of 87.6% (95%CI, 80.4-92.9%) and a specificity of 99.3% (95%CI, 98.9-99.6%). Automatic and accurate detection of enteric syndrome cases provides an opportunity for community surveillance of enteric pathogens in companion animals.

Using Informatics and the Electronic Medical Record to Describe Antimicrobial Use in the Clinical Management of Diarrhea Cases at 12 Companion Animal Practices

Antimicrobial drugs may be used to treat diarrheal illness in companion animals. It is important to monitor antimicrobial use to better understand trends and patterns in antimicrobial resistance. There is no monitoring of antimicrobial use in companion animals in Canada. To explore how the use of electronic medical records could contribute to the ongoing, systematic collection of antimicrobial use data in companion animals, anonymized electronic medical records were extracted from 12 participating companion animal practices and warehoused at the University of Calgary. We used the pre-diagnostic, clinical features of diarrhea as the case definition in this study. Using text-mining technologies, cases of diarrhea were described by each of the following variables: diagnostic laboratory tests performed, the etiological diagnosis and antimicrobial therapies. The ability of the text miner to accurately describe the cases for each of the variables was evaluated. It could not reliably classify cases in terms of diagnostic tests or etiological diagnosis; a manual review of a random sample of 500 diarrhea cases determined that 88/500 (17.6%) of the target cases underwent diagnostic testing of which 36/88 (40.9%) had an etiological diagnosis. Text mining, compared to a human reviewer, could accurately identify cases that had been treated with antimicrobials with high sensitivity (92%, 95% confidence interval, 88.1%-95.4%) and specificity (85%, 95% confidence interval, 80.2%-89.1%). Overall, 7400/15,928 (46.5%) of pets presenting with diarrhea were treated with antimicrobials. Some temporal trends and patterns of the antimicrobial use are described. The results from this study suggest that informatics and the electronic medical records could be useful for monitoring trends in antimicrobial use.