Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Τετάρτη 2 Μαρτίου 2016
Dermatophytosis: fluorostaining enhances speed and sensitivity in direct microscopy of skin, nail and hair specimens from dermatology outpatients
Summary
Direct microscopy of keratinised specimens is a standard screening procedure that assists clinicians to differentiate true superficial mycoses from non-fungal disorders of the skin, nail and hair. Most clinical dermatologists use bright-field microscopy when searching for dermatophyte fungi in clinical samples while laboratory-based mycologists increasingly favour fluorescence microscopy in order to optimise visualisation of fungal elements. This study compared the validity and speediness of fluorescence microscopy vs. conventional light microscopy when screening for fungi in 206 dermatological samples from dermatology outpatients. Both senior dermatologist and a less experienced investigator (medical student) attained high and comparable levels of specificity (91.7–93.8%), positive predictive value (77.1–81.4%) and negative predictive value (83.7–89.9%) using either method. Fluorostaining with Blankophor prior to fluorescence microscopy increased the sensitivity by 22 ± 1% as compared to light microscopy of unstained samples. For both investigators, the time required to identify fungal elements by the fluorescence-based technique was reduced by at least 50%, thus improving the performance of direct microscopy in the clinical setting.
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Cryptococcus neoformans infection in malignancy
Summary
Cryptococcosis is an opportunistic invasive fungal infection that is well described and easily recognised when it occurs as meningitis in HIV-infected persons. Malignancy and its treatment may also confer a higher risk of infection with Cryptococcus neoformans, but this association has not been as well described. A case of cryptococcosis in a cancer patient is presented, and all cases of coincident C. neoformans infection and malignancy in adults published in the literature in English between 1970 and 2014 are reviewed. Data from these cases were aggregated in order to describe the demographics, type of malignancy, site of infection, clinical manifestations, treatment and outcomes of cryptococcosis in patients with cancer. Haematologic malignancies accounted for 82% of cases, with lymphomas over-represented compared to US population data (66% vs. 53% respectively). Cryptococcosis was reported rarely in patients with solid tumours. Haematologic malignancy patients were more likely to have central nervous system (P < 0.001) or disseminated disease (P < 0.001), receive Amphotericin B as part of initial therapy (P = 0.023), and had higher reported mortality rates than those with solid tumours (P = 0.222). Providers should have heightened awareness of the possibility of cryptococcosis in patients with haematologic malignancy presenting with infection.
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Diversity and origins of Indian multi-triazole resistant strains of Aspergillus fumigatus
Summary
Aspergillus fumigatus is a widespread opportunistic fungal pathogen causing an alarmingly high mortality rate in immunocompromised patients. Nosocomial infections by drug-resistant A. fumigatus strains are of particular concern, and there is a pressing need to understand the origin, dispersal and long-term evolution of drug resistance in this organism. The objective of this study was to investigate the diversity and putative origins of triazole resistance of A. fumigatus from India. Eighty-nine isolates, including 51 multiple triazole resistant (MTR) isolates and 38 azole-susceptible isolates, were genotyped using multilocus sequence typing (MLST), mating typing and PCR fingerprinting. MLST resolved the 51 MTR isolates into three genotypes, two of which have susceptible counterparts, suggesting that MTR isolates originated multiple times in India. The multiple-origin hypothesis was further supported by the diversity of sequences at the triazole target gene CYP51A among the MTR isolates, and by PCR fingerprints. Interestingly, there is abundant evidence for mating and recombination in natural population of A. fumigatus in India, suggesting that sexual spread of TR34/L98H, the dominant MTR allele, is possible. Our results call for greater attention to MTR in A. fumigatus and for better management of antifungal drug use.
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A prospective observational study of vulvovagintis in pregnant women in Argentina, with special reference to candidiasis
Summary
To evaluate the frequency of yeast, bacteria or protozoa in pregnant women and to correlate the possible associations of these microorganisms and their relationships with vulvovaginitis (VV) and cervicitis. Vaginal specimens were collected and prepared for smears in microscope slides for the evaluation of yeast, Trichomonas vaginalis and bacteria. Samples were cultured in specific culture medium. Cervical specimens were used to investigate the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma hominis. We enrolled 210 pregnant women, aged 10–42 years old. Of them, 38.1% were symptomatic. Symptoms were most prevalent in the second and third trimesters of pregnancy coincident with a major prevalence of microorganisms. In this study, 39.5% of pregnant women had normal microbial biota and symptoms of VV due to non-infectious causes were observed (6.2%). The occurrence of vulvovaginal candidiasis was 25% and Candida albicans with a prevalence of 80.7% was the dominant species (P = 0.005) while non-albicans Candida species and other yeast were more common in asymptomatic ones (P = 0.0038). The frequency of bacterial vaginosis, T. vaginalis, C. trachomatis and N. gonorrhoeae were 18.1%, 1.4, 1.4% and 0.5% respectively.
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Candidemia in major burns patients
Summary
Major burn patients have characteristics that make them especially susceptible to candidemia, but few studies focused on this have been published. The objectives were to evaluate the epidemiological, microbiological and clinical aspects of candidemia in major burn patients, determining factors associated with a poorer prognosis and mortality. We conducted a retrospective observational study of candidemia between 1996 and 2012 in major burn patients admitted to the La Fe University Hospital, Valencia, Spain. The study included 36 episodes of candidemia in the same number of patients, 55.6% men, mean age 37.33 years and low associated comorbidity. The incidence of candidemia varied between 0.26 and 6.09 episodes/1000 days stay in the different years studied. Candida albicans was the most common species (61.1%) followed by Candida parapsilosis (27.8%). Candidemia by C. krusei, C. glabrata or C. tropicalis were all identified after 2004. Central vascular catheter (CVC) was established as a potential source of candidemia in 36.1%, followed by skin and soft tissues of thermal injury (22.2%) and urinary tract (8.3%). Fluconazole was used in 19 patients (52.7%) and its in vitro resistance rate was 13.9%. The overall mortality was 47.2%, and mortality related to candidemia was 30.6%. Factors associated with increased mortality were those related to severe infection and shock. CVC was the most usual focus of candidemia. Fluconazole was the most common antifungal drug administered. The management of candidemia in major burn patients is still a challenge.
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Dynamic Foldamer Chemistry
Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC00788K, Feature Article
DOI: 10.1039/C6CC00788K, Feature Article
Bryden Le Bailly, Jonathan Clayden
Foldamers can be made more than pieces of static, conformationally uniform molecular architecture by designing into their structure the conformational dynamism characteristic of functional molecular machines. We show that these...
The content of this RSS Feed (c) The Royal Society of Chemistry
Foldamers can be made more than pieces of static, conformationally uniform molecular architecture by designing into their structure the conformational dynamism characteristic of functional molecular machines. We show that these...
The content of this RSS Feed (c) The Royal Society of Chemistry
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Toxins, Vol. 8, Pages 62: Occurrence of Staphylococcus aureus on Farms with Small Scale Production of Raw Milk Cheeses in Poland
This paper describes the results of a 3-year study on the prevalence, enterotoxinogenicity and resistance to antimicrobials of S. aureus isolated on dairy farms with small scale production of raw cow milk cheeses. The samples of raw milk, semi-finished products and the final products as well as swabs were collected between 2011 and 2013 from nine dairy farms in Poland. A total of 244 samples were examined, of which 122 (50.0%) were contaminated with S. aureus including 18 of 26 (69.2%) mature cheese samples with log10 CFU g−1 between <1- and 7.41. In swabs collected from the staff and production environment the highest contamination rate with coagulase positive staphylococci (CPS) was detected on hands of cheese makers (4.34 log10 CFU/swab). None of the cheese samples contaminated with CPS contained staphylococcal enterotoxins (SEs). However, 55 of 122 (45.1%) S. aureus isolates possessed SEs genes, mainly (26 of 55; 47.3%) a combination of the sed, sej and ser genes. Furthermore, the sep (15 of 55; 27.3%) as well as seg and sei (9 of 55; 16.4%) genes were also identified. The remaining S. aureus isolates possessed the sea gene (one isolate), the combination of sec, seg and sei (three isolates) as well as the sed, sej, sep and ser markers together (one CPS). Resistance to penicillin (62 of 122 isolates; 50.8%) was the most common among the tested isolates. Some CPS were also resistant to chloramphenicol (7; 5.7%) and tetracycline (5; 4.1%). The obtained results indicated that the analyzed cheeses were safe for consumers. To improve the microbiological quality of traditional cheese products more attention should be paid to animal welfare and hygiene practices during the process of cheese manufacturing in some dairy farms.
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Estimation of postmortem interval using the data of insulin level in the cadaver׳s blood
Publication date: Available online 2 March 2016
Source:Data in Brief
Author(s): Sachil Kumar, Anoop K. Verma
An assessment of levels of Insulin in cadaveric fluids, to estimate the postmortem interval (PMI) was carried out.To profile postmortem changes of Insulin, it was extracted at different intervals i.e. (0, 3, 6, 12, 24h), from the heart of 22 human cadavers. The cases included were the subjects of accidental deaths without any prior history of disease and their exact time of death was known. Immunoanalyzer Cobas e-411 instrument was used to detect the relationship between the amount of Insulin and PMI.Level of Insulin was measured in cardiac blood. Statically, significant correlations between levels of Insulin and PMI were studied and correlation coefficients were calculated. SPSS (version 12.0) was used for statistical analysis.Insulin levels in cadaver blood are correlated significantly with PMI with a p value of <0.001. When insulin level increases by 1 unit the duration decreases by 0.93 units. The least square regression line is: [Duration(Y)=22.71−0.93 Insulin level (X)]
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Comparison of proteomic datasets from hypertrophic chondrocytes in response to ER stress
Publication date: Available online 2 March 2016
Source:Data in Brief
Author(s): Mateusz Kudelko, Rakesh Sharma, Kathryn S.E. Cheah, Danny Chan
Cartilage proteomics is challenging due to the dominance of poorly soluble matrix components and limited available tissue. Using a "spatial" strategy coupled to MS/MS analysis we have specifically labeled and extracted hypertrophic chondrocytes within the growth plate providing thus a comprehensive proteomic map of normal hypertrophic chondrocytes. Furthermore our established 13del mouse model in which the activation of ER stress did not lead to apoptosis of the hypertrophic cells allowed us to address the natural consequences of ER stress in vivo. Thus our data provide also an overview of proteomic changes occurring in cells under ER stress. Associated with the published study (1) this dataset article provided the detailed information of experimental designing, methods, features as well as the raw data of mass spectrometry (MS) identification. Furthermore the data presented here allow the reader to assert the extent of proteomic changes occurring under ER stress in hypertrophic chondrocytes as well as address the data technical reproducibility in both wild type and stress condition. The mass spectrometry proteomics data can be fully accessed from the ProteomeXchange Consortium via the PRIDE partner repository with the dataset identifier PXD002125.
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SILAC based protein profiling data of MKK3 knockout mouse embryonic fibroblasts
Publication date: Available online 2 March 2016
Source:Data in Brief
Author(s): Anup Srivastava, Amanda S. Shinn, TuKiet T. Lam, Patty J. Lee, Praveen Mannam
This data article reports changes in the phospho and total proteome of MKK3 knock out (MKK3−/−) mouse embryonic fibroblasts (MEFs). The dataset generated highlights the changes at protein level which can be helpful for understanding targets of the MAP kinase signaling pathway. Data was collected after TiO2-based phosphopeptide enrichment of whole cell lysate at baseline condition with bottom-up SILAC-based LC MS/MS quantitative mass spectrometry. We report all the proteins and peptides identified and quantified in MKK3−/− and WT MEFs. The altered pathways in MKK3−/− MEFs were analyzed by Database for Annotation, Visualization and Integrated Discovery (DAVID, v6.7) and Ingenuity Pathway Analysis (IPA) and are presented as a table and graph, respectively. The data reported here is related to the published work [1]. All the associated mass spectrometry data has been deposited in the Yale Protein Expression Database (YPED) with the web-link to the data: http://ift.tt/1LwqZyb.
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Data on phylogenetic analyses of gazelles (genus Gazella) based on mitochondrial and nuclear intron markers
Publication date: Available online 2 March 2016
Source:Data in Brief
Author(s): Hannes Lerp, Sebastian Klaus, Stefanie Allgöwer, Torsten Wronski, Markus Pfenninger, Martin Plath
The data provided is related to the article "Phylogenetic analyses of gazelles reveal repeated transitions of key ecological traits and provide novel insights into the origin of the genus Gazella" [1]. The data is based on 48 tissue samples of all nine extant species of the genus Gazella, namely G. gazella, G. arabica, G. bennettii, G. cuvieri, G. dorcas, G. leptoceros, G. marica, G. spekei, and G. subgutturosa and four related taxa (Saiga tatarica, Antidorcas marsupialis, Antilope cervicapra and Eudorcas rufifrons). It comprises alignments of sequences of a cytochrome b data set and of six nuclear intron markers. For the latter new primers were designed based on cattle and sheep genomes. Based on these alignments phylogenetic trees were inferred using Bayesian Inference and Maximum Likelihood methods. Furthermore, ancestral character states (inferred with BayesTraits 1.0) and ancestral ranges based on a Dispersal-Extinction-Cladogenesis model were estimated and results' files were stored within this article.
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A virtual species set for robust and reproducible species distribution modelling tests
Publication date: Available online 2 March 2016
Source:Data in Brief
Author(s): Carol X. Garzon-Lopez, Lucy Bastin, Giles M. Foody, Duccio Rocchini
Predicting species potential and future distribution has become a relevant tool in biodiversity monitoring and conservation. In this data article we present the suitability map of a virtual species generated based on two bioclimatic variables, and a dataset containing more than 700,000 random observations at the extent of Europe. The dataset includes spatial attributes such as: distance to roads, protected areas, country codes, and the habitat suitability of two spatially clustered species (grassland and forest species) and a wide-spread species.
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Data showing the circumvention of oxaliplatin resistance by vatalanib in colon cancer
Publication date: Available online 2 March 2016
Source:Data in Brief
Author(s): Kenneth K.W. To, Daniel C. Poon, Yuming Wei, Fang Wang, Ge Lin, Li-wu Fu
We have recently reported that vatalanib, an orally active small molecule multi-tyrosine kinase inhibitor [1], can sensitize multidrug resistant (MDR) colon cancer cells to chemotherapy under hypoxia by inhibiting two MDR transporters ABCB1 and ABCG2 [2]. This data article describes the possible circumvention of resistance to specifically platinum (Pt)-based anticancer drugs by vatalanib via inhibition of two other efflux transporters ABCC2 and ATP7A. Data from the flow cytometric transporter efflux assay showed specific inhibition of ABCC2 activity by vatalanib in stable transfected cells and ABCC2-overexpressing oxaliplatin-resistant colon cancer cells HCT116/Oxa. We also performed the transporter ABCC2 ATPase assay and showed an increase in ATP hydrolysis by ABCC2 in the presence of vatalanib. ATP7A mRNA expression was also shown to be upregulated in HCT116/Oxa cells. Vatalanib was shown to suppress this upregulated ATP7A expression. Data from the cellular Pt accumulation assay showed a lower Pt accumulation in HCT116/Oxa cells than the parental sensitive HCT116 cells. Vatalanib was shown to increase cellular Pt accumulation in a concentration-dependent manner. Combination of oxaliplatin and vatalanib was shown to restore the suppressed apoptosis in HCT116/Oxa cells.
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Building nanostructures with drugs
Publication date: Available online 2 March 2016
Source:Nano Today
Author(s): Wang Ma, Andrew G. Cheetham, Honggang Cui
The convergence of nanoscience and drug delivery has prompted the formation of the field of nanomedicine, one that exploits the novel physicochemical and biological properties of nanostructures for improved medical treatments and reduced side effects. Until recently, this nanostructure-mediated strategy considered the drug to be solely a biologically active compound to be delivered, and its potential as a molecular building unit remained largely unexplored. A growing trend within nanomedicine has been the use of drug molecules to build well-defined nanostructures of various sizes and shapes. This strategy allows for the creation of self-delivering supramolecular nanomedicines containing a high and fixed drug content. Through rational design of the number and type of the drug incorporated, the resulting nanostructures can be tailored to assume various morphologies (e.g. nanospheres, rods, nanofibers, or nanotubes) for a particular mode of administration such as systemic, topical, or local delivery. This review covers the recent advances in this rapidly developing field, with the aim of providing an in-depth evaluation of the exciting opportunities that this new field could create to improve the current clinical practice of nanomedicine.
Graphical abstract
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The nanotechnology race between China and the United States
Publication date: Available online 2 March 2016
Source:Nano Today
Author(s): Haiyan Dong, Yu Gao, Patrick J. Sinko, Zaisheng Wu, Jianguo Xu, Lee Jia
It is generally agreed that the United States National Nanotechnology Initiative (NNI) has significantly influenced global nanotechnology development since its inception in 2000. The far-reaching impact of NNI and nanotechnology development, as evidenced by publications in high impact journals, has been rising rapidly over the last 10 years. Recently, the global nanotechnology community witnessed China's ascent in nanotechnology. With increased governmental funding and improved research infrastructure, China has made significant advances and currently has the fastest growing nanotechnology publications and related industrialization. On the one hand, the Chinese government, like the American government, continues to build and support a fertile nanotechnology community. On the other hand, efforts appear less organized in the European Union. Although the gap in nanotechnology impact between the USA and China has narrowed significantly over recent years, the two countries have evolved with their own research focuses. Yet, China is still left behind American nanotechnology in terms of average citations per papers and publications in high-impact journals. It is hopeful that competition and collaboration between the two countries in this field will positively advance the global nanotechnology development.
Graphical abstract
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Renal aquaporins and water balance disorders
Publication date: Available online 2 March 2016
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): Hanne B. Møller, Cecilia H. Fuglsang, Robert A. Fenton
Aquaporins (AQPs) are a 13 member family (AQP0-12) of proteins that act as channels, through which water and, for some family members, glycerol, urea and other small solutes can be transported. Aquaporins are highly abundant in kidney epithelial cells where they play a critical role with respect to water balance. In this review we summarize the current knowledge with respect to the localization and function of AQPs within the kidney tubule, and their role in mammalian water homeostasis and the water balance disorders. Overviews of practical aspects with regard to differential diagnosis for some of these disorders, alongside treatment strategies are also discussed.
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A copeptin-based classification of the osmoregulatory defects in the Syndrome of Inappropriate Antidiuresis
Publication date: Available online 2 March 2016
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): W. Fenske, B. Sandner, M. Christ-Crain
The syndrome of inappropriate antidiuretic hormone secretion (SIADH), also referred to as syndrome of inappropriate antidiuresis (SIAD), is the most common cause of hyponatremia characterized by extracellular hypotonicity and impaired urine dilution in the absence of any recognizable nonosmotic stimuli for the antidiuretic hormone arginine vasopressin (AVP). Hyponatremia in SIADH is primarily the result of excessive water retention caused by a combination of inappropriate antidiuresis and persistent fluid intake in the presence of impaired osmoregulated inhibition of thirst. It is sometimes aggravated by a sodium deficiency caused by a decreased intake or a secondary natriuresis in response to elevated extracellular volume. Inappropriate antidiuresis usually results from endogenous production of AVP that can be either ectopic (from a malignancy) or eutopic (from the hypothalamus/neurohypophysis). Regardless of its origin, different types of osmotic dysregulation of AVP have been reported with possibly fundamental deviations in treatment need and efficacy. A recent quantitative analysis of 50 patients with SIADH, which underwent serial measurements of copeptin during hypertonic saline infusion, revealed five distinct types of osmoregulatory defect ("type A to E") without affiliation to specific underlying diseases. In addition to apparently impaired osmoregulated inhibition of AVP release in the majority of patients, 12% of patients showed an AVP-independent mechanism of inappropriate antidiuresis, whilst 20% of them presented a reverse relation between hormone release and serum osmolality, presumably related to interrupted nonosmotic inhibitory pathways. The interference of these different types of SIAD with clinical presentation and therapy response will be a relevant subject for future research.
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Genetic Forms of Nephrogenic Diabetes Insipidus: Vasopressin Receptor Defect (X-linked) and Aquaporin Defect (Autosomal Recessive and Dominant)
Publication date: Available online 2 March 2016
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): Daniel G. Bichet, Detlef Bockenhauer
Nephrogenic diabetes insipidus (NDI), which can be inherited or acquired, is characterized by an inability to concentrate urine despite normal or elevated plasma concentrations of the antidiuretic hormone, arginine vasopressin (AVP). Polyuria with hyposthenuria and polydipsia are the cardinal clinical manifestations of the disease. About 90 percent of patients with congenital NDI are males with X-linked NDI who have mutations in the vasopressin V2 receptor (AVPR2) gene encoding the vasopressin V2 receptor. In less than 10 percent of the families studied, congenital NDI has an autosomal recessive or autosomal dominant mode of inheritance with mutations in the aquaporin-2 (AQP2) gene. When studied in vitro, most AVPR2 and AQP2 mutations lead to proteins trapped in the endoplasmic reticulum and are unable to reach the plasma membrane. Prior knowledge of AVPR2 or AQP2 mutations in NDI families and perinatal mutation testing is of direct clinical value and can avert the physical and mental retardation associated with repeated episodes of dehydration.
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Photographing Injuries in the Acute Care Setting: Development and Evaluation of a Standardized Protocol for Research, Forensics, and Clinical Practice
Abstract
Background
Photographing injuries in the acute setting allows for improved documentation as well as assessment by clinicians and others who have not personally examined a patient. This tool is important, particularly for telemedicine, tracking of wound healing, the evaluation of potential abuse, and injury research. Despite this, protocols to ensure standardization of photography in clinical practice, forensics, or research have not been published. In preparation for a study of injury patterns in elder abuse and geriatric falls, our goal was to develop and evaluate a protocol for standardized photography of injuries that may be broadly applied.
Methods
We conducted a literature review for techniques and standards in medical, forensic, and legal photography. We developed a novel protocol describing types of photographs and body positioning for 8 body regions, including instructional diagrams. We revised it iteratively in consultation with experts in medical photography, forensics, elder, child, and domestic abuse. The resulting protocol requires a minimum of four photos of each injury at multiple distances with and without a ruler/color guide. To evaluate the protocol's efficacy, multiple research assistants without previous photography experience photographed injuries from a convenience sample of elderly patients presenting to a single large, urban, academic emergency department. A selection of these patients' images were then evaluated in a blinded fashion by four non-treating emergency medicine physicians and the inter-rater reliability between these physicians was calculated.
Results
Among the 131 injuries, from 53 patients, photographed by 18 photographers using this protocol, photographs of 25 injuries (10 bruises, 7 lacerations, and 8 abrasions) were used to assess characterization of the injury. Physicians' characterizations of the injuries were reliable for the size of the injury (κ=0.91; 95% CI 0.77, 1.00), side of the body (κ=0.97; 95% CI 0.88, 1.00), precise location of the injury (κ=0.74; 95% CI 0.63, 0.81), and type of abrasion (κ=0.76; 95% CI 0.45, 1.00). The exact shape of the injury (κ=0.44; 95% CI 0.17, 0.51) and the primary color of bruises (κ=0.37; 95% CI 0.25, 0.48) were not as reliably characterized.
Conclusions
Standardizing the documentation of injuries with photographs for clinical and research assessment can be conducted by non-professional photographers. A photography protocol will ensure that this important mechanism for documentation is optimized.
This article is protected by copyright. All rights reserved.
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Επιστολή προς ΕΣΑμεΑ από την Ελληνική Εταιρεία Αναπηρίας – Κοινωνικής Ασφάλισης & Πρόνοιας (ΕΛΙΕΑΚΑΠ)
Αθήνα, 1 Μαρτίου 2016
Αξιότιμοι κύριοι
Με μεγάλο ενδιαφέρον διαβάσαμε την Πέμπτη 25 Φεβρουαρίου 2015 την ανάρτηση της ΕΣΑμεΑ στο διαδίκτυο, η οποίο αφορά τη λειτουργία των ΚΕ.Π.Α. και την επάρκεια των ιατρών, που εργάζονται σε αυτά.
Είμαστε βέβαιοι πως δεν θα βρεθεί κανείς, ο οποίος να εγκρίνει την έκδοση πλαστών πιστοποιητικών, και να μην επικροτεί την τιμωρία των υπευθύνων.
Εμείς οι ιατροί μέλη της ΕΛΙΕΑΚΑΠ, αλλά και όλοι οι άλλοι συνάδελφοι, οι οποίοι εργαζόμαστε από ετών σε επιτροπές αναπηρίας ΚΕ.Π.Α., είμαστε μεταξύ των «θυμάτων» αυτών των κυκλωμάτων, επειδή ζούμε και εργαζόμαστε υπό τη σκιά του κινδύνου, να παραπλανηθούμε και επομένως να εκτιμήσουμε λάθος την κατάσταση υγείας και το βαθμό αναπηρίας των εξεταζομένων συμπολιτών μας στα ΚΕ.Π.Α.
Η τυχόν χορήγηση συντάξεων αναπηρίας, επιδομάτων ή άλλων παροχών της Πολιτείας σε άτομα, τα οποία δεν τα δικαιούνται, αυξάνει τη ζήτηση για την ύπαρξη κυκλωμάτων και τη διαφθορά, αποδυναμώνει τα αιτήματα των ατόμων με υπαρκτά προβλήματα και μειώνει τις δυνατότητες του Κράτους, να φροντίσει τους ανάπηρους πολίτες, έτσι όπως θα όφειλε.
Ήδη από τις πρώτες εβδομάδες ύπαρξης της Εταιρείας μας και ως ένας από τους κύριους σκοπούς της ίδρυσης της, τονίζουμε και αγωνιζόμαστε προς την κατεύθυνση της αναδιαμόρφωσης του κανονισμού που διέπει την αξιολόγηση των προσερχόντων στα ΚΕ.Π.Α. Η Εταιρεία μας έχει καταθέσει πληθώρα προτάσεων και προβληματισμών γύρω από αυτό το θέμα. Συνέδρια, διημερίδες, στρογγυλές τράπεζες, διαλέξεις, μαθήματα σε συναδέλφους μας σε όλη την Ελλάδα πιστοποιούν τη σοβαρότητα με την οποία αντιμετωπίζουμε το μεγάλο και ευαίσθητο θέμα της αξιολόγησης των αναπήρων σε αυτή τη χώρα.
Δεν είναι τυχαίο πως η Πολιτεία μας έδωσε τη δυνατότητα να συμμετάσχουμε στην ΕΕΕ, που συστάθηκε στο Υπ. Κοιν Ασφ. τόσο ως φορέας (ΕΛΙΕΑΚΑΠ), όσο και ως μεμονωμένα μέλη, οι οποίοι μαζί με όλα τα άλλα τακτικά και αναπληρωματικά μέλη της επιτροπής εργαζόμαστε σκληρά για την επίτευξη των στόχων της ΕΕΕ.
Δεν δεχόμαστε πως ιατροί, οι οποίοι κατέχουν τους τίτλους των Ιατρικών Ειδικοτήτων τους κατά μέσον όρο 20 έως 30 έτη, δεν έχουν τις γνώσεις, την εμπειρία και την ευαισθησία να κρίνουν έναν εξεταζόμενο, λαμβάνοντας υπόψιν τόσο τα ιατρικά στοιχεία, όσο τα δεδομένα από την κλινική εκτίμηση εκάστου αιτούντος. Οι ορολογίες που χρησιμοποιούνται στις αποφάσεις είναι Ιατρικές Ορολογίες, οι οποίες εκφράζουν την πραγματική κατάσταση των εξεταζομένων, όπως κρίνει η επιτροπή ιατρικά, και όχι γραφειοκρατικά. Όποτε η επιτροπή ΚΕ.Π.Α, διαφωνεί με τη γνωμάτευση του θεράποντος, καταγράφεται αναλυτικά το σκεπτικό της διαφωνίας, αιτιολογείται η διαφοροποίηση μεταξύ υποβληθέντων στοιχείων και απόφασης της επιτροπής.
ΠΟΤΕ δεν έχει πιεστεί οποιοσδήποτε ιατρός ΚΕ.Π.Α. από οποιονδήποτε θεσμικό παράγοντα, ώστε να μειώσει το πραγματικό ποσοστό αναπηρίας έτσι ώστε να αποφευχθεί από την Πολιτεία η καταβολή σύνταξης ή επιδομάτων.
Επειδή η γενικόλογη και συλλήβδην καταγγελία των ιατρών ΚΕ.Π.Α. πρέπει επιτέλους να σταματήσει, σας καλούμε να είστε εγκρατείς με παρόμοιες δηλώσεις. Γενικεύσεις λοιδορούν ολόκληρους κλάδους και σαφώς δεν βοηθούν στην κατανόηση πιθανών λαθών και στην κοινή προσπάθεια για βελτίωση του θέματος απονομής των ευεργετημάτων της Κοινωνικής Πολιτικής.
ΙΩΑΝΝΗΣ ΓΚΙΟΥΖΕΛΗΣ ΓΡΗΓΟΡΙΟΣ ΜΟΥΤΖΟΥΡΙΔΗΣ
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Host–virus interactions in hepatitis B and hepatitis C infection
Journal of Gastroenterology
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[18]Annulene put into a new perspective
Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC01309K, Communication
DOI: 10.1039/C6CC01309K, Communication
Dominik Lungerich, Alexey V Nizovtsev, Frank Heinemann, Frank Hampel, Karsten Meyer, George F. Majetich, Paul von Rague Schleyer, Norbert Jux
New insights to [18]annulene were gained by looking closer at its X-ray structure, revealing a close face-to-face stacking of 3.16 A in a herringbone-like crystal packing. Hexadehydro[18]annulene was co-crystalized in...
The content of this RSS Feed (c) The Royal Society of Chemistry
New insights to [18]annulene were gained by looking closer at its X-ray structure, revealing a close face-to-face stacking of 3.16 A in a herringbone-like crystal packing. Hexadehydro[18]annulene was co-crystalized in...
The content of this RSS Feed (c) The Royal Society of Chemistry
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Adults with myelomeningocele and other forms of spinal dysraphism: hospital care in the United States since the turn of the millennium
Journal of Neurosurgery: Spine, Ahead of Print.
OBJECTIVE The natural history and management of myelomeningocele (MM) in children is fairly well understood. There is a deficiency of knowledge regarding the care of adults, however, even though there are now more adults than children living with MM. The purpose of this study was to characterize the hospital care of adults with MM and hydrocephalus on a nationwide population base. Adults with other forms of spina bifida (SB) were studied for contrast. METHODS The Nationwide Inpatient Sample for the years 2001, 2004, 2007, and 2010 was queried for admissions with diagnostic ICD-9-CM codes for MM with hydrocephalus and for other forms of SB. RESULTS There were 4657 admissions of patients with MM and 12,369 admissions of patients with SB in the sample. Nationwide rates of admission increased steadily for both MM and SB patients throughout the study period. Hospital charges increased faster than the health care component of the Consumer Price Index. Patients with MM were younger than patients with SB, but annual admissions of MM patients older than 40 years increased significantly during the study period. With respect to hospital death and discharge home, outcomes of surgery for hydrocephalus were superior at high-volume hospitals. Patients with MM and SB were admitted to the hospital more frequently than the general population for surgery to treat degenerative spine disease. CONCLUSIONS Patients with MM and SB continue to require neurosurgical attention in adulthood, and the demand for services for older patients with MM is increasing. Management of hydrocephalus at high-volume centers is advantageous for this population. Patients with MM or SB may experience high rates of degenerative spine disease.
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Practice variations in the management of inflammatory bowel disease between pediatric and adult gastroenterologists
Journal of Pediatric Gastroenterology and Nutrition
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Gastric emptying of liquids in children
Journal of Pediatric Gastroenterology and Nutrition
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Long-course oxaliplatin based preoperative chemoradiation vs. 5 x 5 Gy and consolidation chemotherapy for cT4 or fixed cT3 rectal cancer: results of a randomised phase III study
Annals of Oncology
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Toll-like Receptor 4 Signaling on Dendritic Cells Suppresses Polymorphonuclear Leukocyte CXCR2 Expression and Trafficking via Interleukin 10 During Intra-abdominal Sepsis
The Journal of Infectious Diseases
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A comparison of the gut microbiome between long-term users and non-users of proton pump inhibitors
Alimentary Pharmacology and Therapeutics
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Prevalence of anterior cutaneous nerve entrapment syndrome in a pediatric population with chronic abdominal pain
Journal of Pediatric Gastroenterology and Nutrition
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Etiopathogenesis, prevention, and treatment of thromboembolism in inflammatory bowel disease
Clinical and Applied Thrombosis/Hemostasis
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Candidate predictors of health-related quality of life of colorectal cancer survivors: a systematic review
The Oncologist
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Regional differences in sorafenib-treated patients with hepatocellular carcinoma: GIDEON observational study
Liver International
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Polidocanol injection therapy for small-bowel hemangioma using double-balloon endoscopy
Gastrointestinal Endoscopy
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Magnetic resonance enterography healing and magnetic resonance enterography remission predicts improved outcome in pediatric Crohn's disease
Journal of Pediatric Gastroenterology and Nutrition
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Time trends, clinical characteristics, and risk factors of chronic anal fissure among a national cohort of patients with inflammatory bowel disease
Digestive Diseases and Sciences
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Effect of prior hepatitis B virus exposure on long-term risk of liver-related events after liver transplantation
Clinical Transplantation
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Active Staphylococcus aureus infection: Is it a contra-indication to the repair of complex hernias with synthetic mesh? A prospective observational study on the outcomes of synthetic mesh replacement, in patients with chronic mesh infection caused by Staphylococcus aureus
International Journal of Surgery
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Influence of light alcohol consumption on lifestyle-related diseases: a predictor of fatty liver with liver enzyme elevation in Japanese females with metabolic syndrome
BMC Gastroenterology
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Exploring association between gastrointestinal heat retention syndrome and recurrent respiratory tract infections in children: a prospective cohort study
BMC Complementary and Alternative Medicine
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Does catastrophic thinking enhance oesophageal pain sensitivity? An experimental investigation
European Journal of Pain
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