RESUMO
This paper proposes the use of a pseudo-3D ball-lattice artifact to characterize a handheld laser scanner from a metrological standpoint. The artifact allows the computation of local and global errors in measurement by using the reference-frame-independent parameters of size, form, and distance within the measuring volume of the scanner, and in a single point cloud, without the need for registration. A set of tests was performed using the whole measuring volume, and three acquisition parameters, namely the orientation of the sweeps during the scans, the exposure time, and the distance to the scanner were analyzed for their effects on the accuracy of the scan data. A composite error including the errors in measuring size, form, and distance was used as a single figure of merit to characterize the performance of the scanner in relation to the data-acquisition parameters. The orientation of sweeps did not have a considerable effect on the errors. The accuracy of the scan data was strongly affected by exposure time and its interaction with the distance at which the artifact was scanned. The errors followed a quadratic trend with respect to the distance of the artifact to the scanner. The tested scanner performed best at its manufacturer's recommended stand-off distance.
RESUMO
REASONS FOR PERFORMING STUDY: Medical management of sand enteropathy is common in equine practice, but the clinical features and outcomes associated with medically managed sand enteropathy are not well described. OBJECTIVES: To review clinical features, therapeutic approaches and outcomes associated with primary medical management of sand enteropathy in the mature horse. METHODS: Medical record databases at 3 equine referral hospitals from January 2000 to April 2010 were reviewed for cases of sand enteropathy diagnosed via abdominal radiographs in mature horses that were initially managed medically. Data were collected and descriptive analyses compiled. Uni- and multivariate logistic regression was used to evaluate factors potentially associated with treatment failure. RESULTS: The medical records of 62 horses were analysed; 90% of horses survived to discharge and 50% of horses that had repeat abdominal radiographs taken demonstrated improvement in the degree of sand accumulation after treatment. Nine horses underwent exploratory laparotomy during hospitalisation, and colonic sand impaction was found in all 9, with a concurrent gastrointestinal lesion identified in 7. Four horses were subjected to euthanasia during or after surgery because of disease severity or complications. Need for exploratory laparotomy was the factor most strongly associated with nonsurvival. CONCLUSIONS: These data suggest that medical management can result in clinical and radiographic resolution of uncomplicated sand enteropathy in mature horses, and is associated with a good prognosis. Horses with sand enteropathy that exhibit persistent colic signs despite medical management are likely to have a concurrent gastrointestinal lesion, so prompt exploratory laparotomy should be considered in such cases. POTENTIAL RELEVANCE: Uncomplicated sand enteropathy can be managed medically in mature horses, and serial abdominal radiography can be used to monitor sand clearance. Surgery to evaluate for and correct concurrent gastrointestinal lesions should be recommended without delay in horses showing persistent colic signs.
Assuntos
Hidratação/veterinária , Doenças dos Cavalos/terapia , Enteropatias/veterinária , Laxantes/uso terapêutico , Dióxido de Silício , Analgésicos , Animais , Feminino , Doenças dos Cavalos/patologia , Cavalos , Enteropatias/patologia , Enteropatias/terapia , Masculino , Estudos RetrospectivosAssuntos
Acne Vulgar/tratamento farmacológico , Minociclina/efeitos adversos , Pseudotumor Cerebral/induzido quimicamente , Acetazolamida/uso terapêutico , Criança , Serviços de Informação sobre Medicamentos/normas , Serviços de Informação sobre Medicamentos/estatística & dados numéricos , Rotulagem de Medicamentos/normas , Rotulagem de Medicamentos/estatística & dados numéricos , Humanos , Internato e Residência/normas , Internato e Residência/estatística & dados numéricos , Masculino , Minociclina/uso terapêutico , Pediatria/educação , Pediatria/estatística & dados numéricos , Publicações Periódicas como Assunto/normas , Publicações Periódicas como Assunto/estatística & dados numéricos , Pseudotumor Cerebral/tratamento farmacológicoRESUMO
Fungal urinary tract infections are an increasing problem in hospitalized patients. Funguria may be a result of contamination of the urine specimen, colonization of hte urinary tract, or may be indicative of true invasive infection. In this study, we report the risk factors, clinical features, treatments and outcome in a group of 68 hospitalized patients (adults and children) with fungal isolates recovered from 103 urinary samples. Underlying medical conditions were present in most patients. In the pediatric group, urinary tract abnormalities (86%) and prematurity (19%)accounted for the majority of the cases. Diabetes mellitus (28%), nephrolithiasis, and benign prostatic hyperplasia were the most common diseases in adults. Indwelling urethral catheters were noted in 38% of the pediatric patients and in 43% of adults during hospitalization. Candida albicans strains were responsible for 97% and 75% of positive cultures in children and adults, respectively. Symptoms such as fever, dysuria, frequency and flank pain were generally absent in both groups. Fluconazole was the most frequent antifungal utilized (61%) in children and ketoconazole in the adult group (42%). Removing the urinary catheter was attempted in 6 pediatric patients (29%) and in only 8 adults (17%). One patient (4%) in the pediatric group died compared to 10 in the adult group (21%, p=0.04). Successful diagnosis and treatment of funguria depends on a clear understanding of the risk factors and awareness of fungal epidemiology.
Assuntos
Antifúngicos/uso terapêutico , Fungos , Fungos/isolamento & purificação , Hospitalização , Micoses , Infecções Urinárias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Candida albicans/isolamento & purificação , Candidíase/tratamento farmacológico , Candidíase/epidemiologia , Candidíase/microbiologia , Candidíase/fisiopatologia , Criança , Pré-Escolar , Meios de Cultura , Feminino , Fungos/classificação , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Micoses/tratamento farmacológico , Micoses/epidemiologia , Micoses/microbiologia , Micoses/fisiopatologia , Fatores de Risco , Resultado do Tratamento , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Infecções Urinárias/fisiopatologia , Urina/microbiologiaRESUMO
Status epilepticus causes significant morbidity and mortality. A case of generalized status epilepticus followed by massive pulmonary aspiration, acute respiratory failure and transient central diabetes insipidus is presented. Seizures were promptly controlled, but the patient required mechanical ventilation and correction of polyuria with desmopressin acetate. During hospitalization mental status improved, diabetes insipidus spontaneously remitted and he was discharged without neurologic sequelae. The clinical and pathophysiological features of this case are discussed.
Assuntos
Diabetes Insípido/complicações , Pneumonia Aspirativa/complicações , Estado Epiléptico/etiologia , Doença Aguda , Adulto , Humanos , Masculino , Insuficiência Respiratória/complicações , Vasopressinas/metabolismoRESUMO
5,10-dideaza-5,6,7,8-terrahydrofolic acid (DDATHF) is a potent antiproliferative agent in cell culture systems and in vivo in a number of murine and human xenograft tumors. In contrast to classical antifolates, which are dihydrofolate reductase inhibitors, DDATHF primarily inhibits GAR transformylase, the first folate-dependent enzyme along the pathway of de novo purine biosynthesis. The (6R) diastereomer of DDATHF (Lometrexol), currently undergoing clinical investigation, was used to develop CCRF-CEM human leukemia sublines resistant to increasing concentrations of the drug. Three cell lines were selected for ability to grow in medium containing 0.1 microM, 1.0 microM, and 10 microM of (6R)DDATHF, respectively. Impaired polyglutamylation was identified as a common mechanism of resistance in all three cell lines. A progressive decrease in the level of polyglutamylation was associated with diminished folylpolyglutamate synthetase activity and paralleled increasing levels of resistance to the drug. However, the expression of folylpolyglutamate synthetase RNA was not altered in the resistant cell lines compared to the parent cells. The most resistant cell subline also displayed an increased activity of gamma-glutamyl hydrolase. The sublines were scrutinized for other possible mechanisms of resistance. No alterations in drug transport or in purine economy were found. Modest increases were found in the activity of methylene tetrahydrofolate dehydrogenase but no alterations of other folate-dependent enzymes were observed. Increases in accumulation and conversion of folic acid to reduced forms, particularly 10-formyltetrahydrofolate, was also seen. The resistant cell lines were sensitive to dihydrofolate reductase inhibitors, methotrexate and trimetrexate, for a 72-h exposure period but showed cross-resistance to methotrexate for 4 and 24 h exposures. Cross-resistance was also shown toward other deazafolate analogues for both short- and long-term exposures.
Assuntos
Aciltransferases/metabolismo , Antineoplásicos/farmacologia , Resistência a Medicamentos , Hidroximetil e Formil Transferases , Tetra-Hidrofolatos/farmacologia , 5,10-Metilenotetra-Hidrofolato Redutase (FADH2) , Aciltransferases/antagonistas & inibidores , Aciltransferases/isolamento & purificação , Células Clonais , Antagonistas do Ácido Fólico/farmacologia , Formiato-Tetra-Hidrofolato Ligase/metabolismo , Glicina Hidroximetiltransferase/metabolismo , Humanos , Leucemia Linfoide , Metilenotetra-Hidrofolato Desidrogenase (NADP)/metabolismo , Metilenotetra-Hidrofolato Redutase (NADPH2) , Oxirredutases/metabolismo , Peptídeo Sintases/metabolismo , Fosforribosilaminoimidazolcarboxamida Formiltransferase , Fosforribosilglicinamido Formiltransferase , Estereoisomerismo , Tetra-Hidrofolato Desidrogenase/metabolismo , Timidilato Sintase/metabolismo , Células Tumorais Cultivadas , gama-Glutamil Hidrolase/metabolismoRESUMO
Nine fairways of a golf course located in Bellingham, Washington were treated with diazinon AG500 at a target application rate of 2.2 kg active ingredient (AI) per ha. The chemical application with a "boomless" sprayer resulted in a variable distribution of diazinon residues on the turf (associated with a deep thatch layer) that ranged from 1.0 to 6.2 kg AI/ha. The diazinon-treated turf was irrigated with 1.3 cm of water immediately following application. The post-irrigation diazinon residue levels ranged from 100 to 333 ppm (mean = 209; SD = 88; n = 8). These residue levels were higher than expected based on results of turf studies in other regions of the United States. Eighty-five American wigeon (Anas americana) died after grazing on one treated fairway on the day of application following irrigation. The brains of all 85 wigeon were analyzed for acetylcholinesterase (AChE) activity. Wigeon that died on the study area (n = 85) showed 44% to 87% depression of AChE (mean = 76%; SD = 7.1%) when compared to control wigeon (n = 3; AChE Activity = 1.86) AChE levels. Upper GI tract contents of 15 of the 85 dead wigeon contained 0.96 to 18.1 ppm diazinon. Extensive carcass searches revealed no other avian mortality attributable to diazinon toxicity on the treated study area. Although initial post-irrigation diazinon residues in grass samples were higher than expected, diazinon levels in grass samples on day seven post-application had declined to an average of 29 ppm. American wigeon appear to be vulnerable to exposure to diazinon.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Doenças das Aves/induzido quimicamente , Diazinon/intoxicação , Patos , Acetilcolinesterase/análise , Animais , Animais Selvagens , Doenças das Aves/mortalidade , Encéfalo/enzimologia , Diazinon/análise , Resíduos de Praguicidas/análise , Poaceae/química , Intoxicação/mortalidade , Intoxicação/veterinária , WashingtonRESUMO
Transvaginal ultrasonography is routinely performed in the course of egg retrieval in patients presenting for in vitro fertilization (IVF) and results in the discovery of occult, subclinical ovarian cysts that would otherwise have gone undetected. This study (1) evaluated the cellular composition of the cyst fluids based on a comparison with cells obtained from cysts of known and documented histologic type, and (2) attempted to determine if the cytologic evaluation of cyst fluid was necessary to exclude occult ovarian cancer. During the 1.8 years of our study, 931 patients underwent 1,544 ultrasound-guided ovum retrievals; during this same period, 90 specimens of ovarian cyst fluid were examined. Of them, none contained cancer cells. A single case of cystic ovarian cancer was detected by ultrasound but was not aspirated. The cytologic diagnosis of endometriosis was established in 12 specimens from 10 patients, 5 of whom did not have a previously documented clinical diagnosis of endometriosis. The role of routine ovarian cyst fluid cytology as part of an IVF protocol may be of limited value in cancer diagnosis. However, until the incidence of ovarian cancer in the subset of women with both infertility and ovarian cysts is known, it would seem prudent to continue to examine any voluminous or discolored ovarian cyst fluid obtained from IVF patients. The presence of ovarian cysts did not affect the clinical pregnancy rate per retrieval.
Assuntos
Fertilização in vitro , Cistos Ovarianos/patologia , Neoplasias Ovarianas/patologia , Adulto , Biópsia por Agulha , Feminino , Cisto Folicular/patologia , HumanosRESUMO
This is a report of an unusual case in which cytologic monitoring played a key role in the six-and-one-half-year survival of a 21-year-old woman with disseminated histiocytic lymphoma involving the central nervous system. At this writing the patient showed no further evidence of malignant disease. After primary diagnosis, remissions and exacerbations of the tumor were accurately detected by periodic cytologic examinations of 78 spinal fluid specimens. Therapeutic measures included total brain irradiation, implantation of an Ommaya reservoir and combination chemotherapy. This case study demonstrates that cytologic examination of cerebrospinal fluid is an important method of monitoring the responses of tumors to therapeutic measures.
Assuntos
Líquido Cefalorraquidiano/citologia , Linfoma Difuso de Grandes Células B/líquido cefalorraquidiano , Adulto , Citarabina/uso terapêutico , Feminino , Humanos , Linfoma Difuso de Grandes Células B/radioterapia , Linfoma Difuso de Grandes Células B/terapia , Remissão EspontâneaRESUMO
Many types of trauma may lead to vascular compromise unless treated effectively and promptly. In addition to direct trauma to a major vessel are the crushing injuries, fractures, and burn injuries which give rise to an ischemia-edema cycle and subsequent muscle necrosis and tissue loss. Objective adjuncts to clinical impressions, such as isotope clearance muscle blood flow or the ultrasound Doppler flowmeter are generally not suitable for continuous, uninterrupted monitoring of the degree of vascular compromise. A technique that appears promising in this respect is that of photoplethysmography. This technique uses a small LED infrared emitter/detector array. Blood volume changes in an illuminated vascular bed produce variations in the amount of reflected light sensed by the detector, which after appropriate electronic amplification results in pulsatile blood flow (if present) and its change with time being displayed on the monitor. This technique was used with 25 trauma patients with good results, avoiding unnecessary compartmental decompression in some cases. It has proved to be a simple technique that requires little or no training for interpretation, provides continuous monitoring, is noninvasive and atraumatic in nature, is portable for easy set-up, and is relatively inexpensive.
Assuntos
Circulação Sanguínea , Ferimentos e Lesões/fisiopatologia , Volume Sanguíneo , Humanos , Monitorização Fisiológica/métodos , Pletismografia/métodos , Fluxo Sanguíneo RegionalRESUMO
We have developed a photoplethysmographic technique for monitoring early signs of vascular compromise in extremities affected by direct vessel trauma, crushing trauma, or circumferential burns. The technique consists of positioning a small infrared emitter-detector array shielded from room light over a nailbed of the affected extremity and connecting the array to standard electronic monitoring equipment, thus producing a pulse tracing very similar in contour to an arterial pressure wave. In normal volunteers, simultaneous observations of the tracing and studies of muscle blood flow using Xe133 clearance showed correspondence of disappearance of the plethysmographic signal with limb-threatening levels of ischemia produced by inflation of a blood-pressure cuff. Studies comparing this technique to compartment pressures and arterial flow determined by ultrasound Doppler measurement are continuing. Clinically, we have used this monitoring technique on 29 trauma patients thus far, including 18 with circumferential full-thickness burns of at least one extremity. We believe that these preliminary studies suggest that photoplethysmography is a valuable continuous monitor of vascular status following trauma and a reliable indicator of nutritional blood flow.
Assuntos
Vasos Sanguíneos/lesões , Queimaduras/fisiopatologia , Pletismografia , Vasos Sanguíneos/fisiopatologia , Humanos , Pletismografia/métodosRESUMO
The Snell dwarf mouse (dw/dw) has no detectable PRL-binding sites in the microsomal fractions of its liver. Both bGH and bPRL, purified by preparative gel electrophoresis, induce PRL-binding sites when injected into dw/dw. Intraperitoneal injection of 100 micrograms bGH every 8 h results in the appearance of a high affinity PRL receptor 8--16 h after initiation of treatment. This induced binding capacity plateaus after 32 h of treatment and subsequently decreases to nondetectable levels 48 h after the last injection. [125I]Iodo-ovine PRL is displaced from the induced receptor equally well by similar concentrations of ovine PRL, human GH, and bovine PRL, but is displaced by bovine GH (bGH) only at approximately 100-fold higher concentrations. While untreated dw/dw livers do possess high affinity bGH-binding sites, treatment with bGH did not alter the bGH-binding activity. Treatment of dw/dw with cycloheximide does not prevent induction of PRL receptors by bGH injections. These observations indicate that bGH induces the PRL receptor by interacting with the cell at some point distal to the induced receptor site and does not require the synthesis of new proteins.
Assuntos
Nanismo/genética , Hormônio do Crescimento/farmacologia , Fígado/metabolismo , Prolactina/metabolismo , Receptores de Superfície Celular/biossíntese , Animais , Membrana Celular/metabolismo , Eletroforese em Gel de Poliacrilamida , Feminino , Fígado/efeitos dos fármacos , Masculino , CamundongosRESUMO
The lateral antebrachial cutaneous nerve was used as a nerve graft to bridge a defect in a digital nerve, when with the digit in full extension the nerve ends could not be approximated without tension. Thirteen grafts have been followed from 7 to 23 months. Two patients did not regain two point discrimination and therefore had a poor result. The remaining 11 patients recovered two point discrimination between 7 and 20 mm.
Assuntos
Dedos/inervação , Nervo Musculocutâneo/transplante , Nervo Radial/cirurgia , Nervo Ulnar/cirurgia , Adulto , Dedos/fisiologia , Humanos , Pessoa de Meia-Idade , Sensação , Transplante AutólogoRESUMO
A review of the anatomy of the course of the ulnar nerve at the wrist, in the pisohamate tunnel. The exit from this tunnel is the most likely place for compression of the ulnar nerve at the wrist.