[Diagnosis of neurocysticercosis in patients with epilepsy living in the south-western Dominican Republic]. / Diagnóstico de neurocisticercosis en pacientes con epilepsia residentes en el suroeste de la República Dominicana.

INTRODUCTION: Neurocysticercosis (NCC), a possible cause of epilepsy with limited epidemiological data in the Dominican Republic, is endemic in four provinces in the country's south-western region. This study aimed to determine the association between NCC and epilepsy among people living in these endemic regions, and to obtain preliminary data on the prevalence of NCC in these provinces. PATIENTS AND METHODS: A case-control design was used, consisting of 111 patients with epilepsy with unknown causes, and 60 controls without epilepsy or NCC. The diagnosis of NCC was based on computed tomography and magnetic resonance imaging of the skull, as well as Western immunoblotting for serum antibodies using Taenia solium, following the criteria of Del Brutto et al. RESULTS. NCC was found in 27% of the epileptic patients (n = 30/111) and in 5% of the controls (n = 3/60); the probability of the epileptic patients having NCC was seven times higher than the controls (odds ratio = 7.04, 95% confidence interval: 2.04-24.18; p < 0.001). The participants' sociodemographic characteristics, including their age, sex, level of education, occupation, and province of residence presented no statistical significance in terms of their association with NCC. CONCLUSIONS: This study suggests that NCC is strongly associated with epilepsy in the south-western region of the Dominican Republic, and highlights the need for public health measures to improve the prevention, diagnosis and treatment of both diseases.

TITLE: Diagnóstico de neurocisticercosis en pacientes con epilepsia residentes en el suroeste de la República Dominicana.Introducción. La neurocisticercosis (NCC), una posible causa de epilepsia con datos epidemiológicos limitados en la República Dominicana, es endémica en cuatro provincias de la región suroeste. El objetivo de este estudio fue determinar la asociación entre la NCC y la epilepsia en personas que viven en estas regiones endémicas, así como obtener datos preliminares sobre la prevalencia de NCC en estas provincias. Sujetos y métodos. Se utilizó un diseño de casos y controles compuesto por 111 pacientes con epilepsia de causa desconocida y 60 controles sin epilepsia ni NCC. El diagnóstico de NCC se basó en la tomografía computarizada y la resonancia magnética del cráneo, así como en el inmunotransferencia de Western para anticuerpos séricos contra Taenia solium, siguiendo los criterios de Del Brutto et al. Resultados. Se encontró NCC en el 27% de los pacientes con epilepsia (n = 30/111) y en el 5% de los controles (n = 3/60); los casos de epilepsia tenían siete veces más probabilidades de tener NCC que los controles (odds ratio = 7,04, intervalo de confianza al 95%: 2,04-24,18; p < 0,001). Las características sociodemográficas de los participantes, como la edad, el sexo, el nivel de escolaridad, la ocupación y la provincia de residencia no mostraron significación estadística en cuanto a la asociación con NCC. Conclusiones. Este estudio sugiere que la NCC está fuertemente asociada con la epilepsia en la región suroeste de la República Dominicana, y destaca la necesidad de medidas de salud pública para mejorar la prevención, el diagnóstico y el tratamiento de ambas enfermedades.

Children's pain perspectives.

BACKGROUND: Previous studies on children's pain perspectives remain limited to English-speaking populations. METHODS: An exploratory cross-sectional descriptive design was used to investigate the developmental progression of children's pain perspectives, including their pain experience, its definition and attributes, causality and coping. The Children's Pain Perspectives Inventory was applied to 180 healthy Spanish children. A coding system was developed following the content analysis method. Three age groups were compared: 4-6 years, corresponding to the Piagetian pre-operational stage of cognitive development; 7-11 years, corresponding to stage of concrete operations; and 12-14 years, corresponding to the period of early formal operations. RESULTS: In children between 4 and 6, the predominant narratives related to physical injuries, the notion of causality and the definition of pain. In children between 7 and 11, the predominant narratives were those in which pain was described as a sensation in one part of the body. The view of pain as having an emotional basis significantly increased with age and was more frequent in adolescents. In contrast, children between 4-6 and 7-11 indicated that pain occurs spontaneously. The denial of any positive aspects of pain significantly decreased with age; some children between 7 and 11 referred to the 'possibility of relief', while the view that pain is a 'learning experience' was significantly more frequent among adolescents aged between 12 and 14 years. The use of cognitive strategies to control pain significantly increased with age. Between 12 and 14 years of age, adolescents communicate pain by non-verbal behaviour and reported that they do not express demands for relief. CONCLUSIONS: There was a progression from concrete to more complex notions of pain as age increased. These results may be of use to health professionals and parents to understand how children at various developmental stages express and cope with pain and to develop tools that effectively assess and manage pain in children.

Considerations for non-invasive in-flight monitoring of astronaut immune status with potential use of MEMS and NEMS devices.

The dynamics of how astronauts' immune systems respond to space flight have been studied extensively, but the complex process has not to date been thoroughly characterized, nor have the underlying principles of what causes the immune system to change in microgravity been fully determined. Statistically significant results regarding overall immunological effects in space have not yet been established due to the relatively limited amount of experimental data available, and are further complicated by the findings not showing systematically reproducible trends. Collecting in vivo data during flight without affecting the system being measured would increase understanding of the immune response process. The aims of this paper are to briefly review the current knowledge regarding how the immune system is altered in space flight; to present a group of candidate biomarkers that could be useful for in-flight monitoring and give an overview of the current methods used to measure these markers; and finally, to further establish the need and usefulness of incorporating real-time analytical techniques for in-flight assessment of astronaut health, emphasizing the potential application of MEMS/NEMS devices.

Analysis of a spacecraft life support system for a Mars mission.

This report summarizes a trade study conducted as part of the Fall 2002 semester Spacecraft Life Support System Design course (ASEN 5116) in the Aerospace Engineering Sciences Department at the University of Colorado. It presents an analysis of current life support system technologies and a preliminary design of an integrated system for supporting humans during transit to and on the surface of the planet Mars. This effort was based on the NASA Design Reference Mission (DRM) for the human exploration of Mars [NASA Design Reference Mission (DRM) for Mars, Addendum 3.0, from the world wide web: http://exploration.jsc.nasa.gov/marsref/contents.html.]. The integrated design was broken into four subsystems: Water Management, Atmosphere Management, Waste Processing, and Food Supply. The process started with the derivation of top-level requirements from the DRM. Additional system and subsystem level assumptions were added where clarification was needed. Candidate technologies were identified and characterized based on performance factors. Trade studies were then conducted for each subsystem. The resulting technologies were integrated into an overall design solution using mass flow relationships. The system level trade study yielded two different configurations--one for the transit to Mars and another for the surface habitat, which included in situ resource utilization. Equivalent System Mass analyses were used to compare each design against an open-loop (non-regenerable) baseline system.

Myocardial abscess resulting in a pseudoaneurysm: case report.

This report describes the diagnostic workup of a case of a pseudoaneurysm of the heart resulting from Staphylococcal pericarditis and/or abscesses of the myocardium. The pericardial effusion and myocardial abscesses were detected on 2D echocardiography and computed tomography. The resulting pseudoaneurysm could be demonstrated on magnetic resonance imaging and color Doppler ultrasound, and confirmed by left ventriculography. Color-encoded Doppler ultrasound alone would have provided the definitive diagnosis of the aneurysm.

Cystic fibrosis: scoring system with thin-section CT.

The progression of lung disease in patients with cystic fibrosis (CF) was evaluated with chest radiography. The severity and extent of the various radiographic changes were scored with the Chrispin or the Birmingham method, which involves the use of imprecise and subjective terms, such as line shadows, large pulmonary shadows, and nodular cystic lesions. Although computed tomography (CT) has been shown to be helpful in the evaluation of lung disease in CF, no scoring system or other objective criteria have been developed for the evaluation of the wide range of pulmonary changes in these patients. A CT scoring system was devised that incorporates all of the changes seen in the lungs of patients with CF. Such a scoring system may facilitate objective evaluation of existing and newly developed therapeutic regimens and may be a valuable tool in the preoperative evaluation of patients being considered for lobectomy or bullectomy and in the selection of patients for lung transplantation.