Ultrasound accuracy for brachial plexus pathology.

AIM: To determine (a) the accuracy of ultrasound in detecting brachial plexus pathology and (b) outline the advantages and limitations of ultrasound compared to MRI for imaging the brachial plexus. MATERIAL AND METHODS: cases with clinically suspected brachial plexus pathology were evaluated first by ultrasound, followed by MRI. Patients with prior brachial plexus imaging were excluded. The final diagnosis was based on a combination of ultrasound, MRI, clinical follow-up, and surgical findings. The accuracy of the ultrasound was assessed by comparing the ultrasound and the final diagnoses. The mean clinical follow-up time following ultrasound was 1.8 ± 1.4 years. RESULTS: Ninety-two (64%) of the 143 cases had normal brachial plexus ultrasound and MRI examinations. Fifty-one (36%) of 143 cases had brachial plexus pathology on MRI, comprising post-radiation fibrosis (n=25, 49%), nerve sheath tumor (n=11, 21%), traumatic injury (n=7, 14%), inflammatory polyneuropathy (n=4, 8%), malignant infiltration (n=2, 4%), desmoid fibromatosis (n=1,2%), and neuralgic amyotrophy (n=1, 2%). Overall diagnostic accuracy of ultrasound for brachial plexus pathology was 98% (140/143), with three discordant cases (neuralgic amyotrophy n=1, inflammatory neuropathy n=1, postradiation fibrosis n=1) regarded as normal on ultrasound assessment. Sensitivity, specificity, and positive and negative predictive value of ultrasound for identifying brachial plexus pathology were 94%, 100%, 100%, and 97%, respectively. CONCLUSION: Ultrasound identifies brachial plexus pathology with high accuracy and specificity, showing comparable diagnostic efficacy to MRI. Ultrasound can serve as an effective first-line imaging investigation for suspected brachial plexus pathology.

Caracterización de materiales (pigmentos y cerámicas) para la conservación del patrimonio cultural y social en ciudad de La Habana / Characterization of materials (pigments and ceramics) for the conservation of cultural and social heritage in the city of Havana

RESUMEN Una de las direcciones de aplicación de la Ciencia de Materiales que realiza el Centro de Aplicaciones Tecnológicas y Desarrollo Nuclear CEADEN es el apoyo mediante un grupo de técnicas físicas a la restauración y el mantenimiento de estructuras y objetos de la ciudad de La Habana, entre otras localidades de Cuba, que poseen interés artístico y social . En el presente trabajo se abordan varias aplicaciones en la caracterización de materiales para contribuir a las actividades de conservación del patrimonio cultural e histórico cubano que se encuentra en La Habana. Se presentan dos ejemplos de análisis por las técnicas de Fluorescencia de Rayos X y Difracción de rayos X de los pigmentos de obras en lienzos y de la paleta de una reconocida artista de la plástica cubana; así como el de tejas cerámicas que fueron utilizadas en la restauración de los techos de la residencia conocida como Casa Verde de 5ta Avenida en el Municipio Playa.

ABSTRACT One of the applications in Materials Science carried out at the Center for Technological Applications and Nuclear Development (CEADEN) is the technical support through several methods used, based on applied Physics for the restoration and maintenance of structures and objects holding artistic and social relevance in Havana city. The aim of this paper is to present two examples of X -ray Fluorescence and Diffraction materials characterization, intended to support conservation and restoration activities of the Cuban cultural and historic heritage: analyzed objects were pottery roof tiles for the restoration of the mansion known as The Green House at 5th Avenue, Miramar, as well as pigments from a Cuban fine artist's canvas and palette.

Contribución a la restauración y el mantenimiento de obras de importancia histórica, cultural y social de la ciudad de La Habana / Contribution to the restoration and maintenance of works of historical, cultural and social importance of the city of Havana

RESUMEN Entre las aplicaciones de la Ciencia e Ingeniería de Materiales que realiza el Centro de Aplicaciones Tecnológicas y Desarrollo Nuclear CEADEN está el apoyo mediante varias técnicas físicas a la restauración y el mantenimiento de estructuras y objetos de la ciudad de La Habana que poseen interés histórico, cultural y social . En el presente trabajo es abordado el campo de la Defectoscopía, en lo cual los Ensayos no destructivos aplicados tributaron a la restauración del patrimonio cultural, a la mejora de instalaciones deportivas de la capital y, en mayor medida, a la seguridad de instalaciones de interés social como son los parques de diversión. En ese sentido se presentan la inspección de estructuras en el marco de la restauración de la Sala Cabildo del Museo de la Ciudad de La Habana en el Palacio de los Capitanes Generales en La Habana Vieja; el diagnóstico de uniones soldadas durante la restauración de la iluminación y la instalación de la pantalla gigante del Estadio Latinoamericano del Cerro y la Inspección realizada sistemáticamente en mantenimiento a elementos críticos de equipos de los parques de diversión.

ABSTRACT Among the applications of Materials Science and Engineering carried out by the Center for Technological Applications and Nuclear Development (CEADEN) / Centro de Aplicaciones Tecnológicas y Desarrollo Nuclear CEADEN is the use of various physical techniques to support the restoration and maintenance of buildings and other work objects of historical, cultural and social interest in Havana city. The field of Defectoscopy is addressed in this paper, where the applied Nondestructive testings also contributed to restore the cultural heritage, to upgrade the structural conditions at an important sport facility in Havana, and in a greater extent, to the safety of facilities of social significance, such as amusement parks. In this regard, three examples are presented: the inspection of structures during the restoration of the City Hall in the Museum of the Havana City at the Palace of Captains General; the welded joints testing during the restoration of the lighting system and the installation of the digital screen at the Latin American Stadium in Cerro municipality; and finally, the inspection systematically performed at maintenance works to critical elements and related devices at amusement parks.

Treatment outcomes of substance abusing males who completed a 90-day residential treatment programme in Barbados

OBJECTIVE: To analyse the post-treatment outcomes of male substance abusers who completed a minimum of 90 days at a residential treatment facility in Barbados. SUBJECTS AND METHODS: A sample of 150 male clients who completed 90 days or more of the treatment programme from 2004–2014 was used for the main study. A pilot study was conducted with fifteen subjects to assess the validity and reliability of the Substance Abuse Foundation Evaluation-1 (SAFE-1) questionnaire designed for the study. Correlation coefficients were used to measure the strength of association between variables, and a p-value of0.05 was used to determine statistical significance. RESULTS: To date, data on 37 respondents were used for analysis. Positive significant relationships emerged between number of days in treatment and length of sobriety, and social support, spiritual health and length of sobriety. There was no significant relationship between drug of choice and length of sobriety, nor between trauma and relapse. Self-referred clients reported longer lengths of sobriety and clients who had more than 20 years of drug use prior to treatment were more likely to stay sober longer after treatment. Clients between three and six years post treatment were more likely to request additional support. CONCLUSIONS: There are specific factors that positively impact length of sobriety after treatment. Thus, substance abuse treatment centres should seek to incorporate these factors into their programming so as to better inform their inpatient and after care services.

The Barbados low-dose aspirin in pregnancy (BLASP): a population based trial in a developing country with excess pre eclampsia and perinatal mortality

A large randomised controlled double blind trial (RCT), BLASP was set up in Barbados' one main maternity centre (QEH). Almost all women at 12-32 weeks attending for antenatal booking were eligible in the period July 1992-1994. After consent, entry details were recorded on a computer with random allocation to either a slow-release 75 mg aspirin (A) or a placebo (P). Intention-to-treat analysis, based on the 3,643 randomized pregnant women (1,819 allocated aspirin and 1,824 a placebo), is viewed in context of all other randomised control trials (RCTs). Entry date balanced in A and P for gestational age of 20.2 weeks, average maternal age 24 years, more than half aged 20-29 years and 44 percent primigravidae. Previous obstetric complications were lower than expected at 5 percent. Family histories of diabetes mellitus and hypertension were high (> 33 percent). Compliance was moderate with 36 percent taking allocated tablets for more than 95 percent of the time, but a third for less than 80 percent. There were no serious side effects, and in particular no bleeding. PE rates were low at 2.2 percent in A and 2.5 percent in P, a 13.3 percent odds reduction with wide 95 percent CI showing no significant effect. A tendency in all predefined categories (PE + PIH, etc.) for fewer cases in A (n=203, 11.2 percent) than in P (n=231, 12.7 percent) is not confirmed in an overview of all trials. Antenatal hospital admissions occurred in 34 percent of A and 33 percent of P. There was no difference in very low-birth-weight (<1500 g) but rates were 7 percent in A and 8.3 percent in P for birthweight between 1,500 and 2,499 g. Mean pregnancy duration was virtually identical at 38.7 (SD 3.6) weeks. Stillbirths and neonatal death rates were 2.3 percent and 2 percent, and Caesarean Sections 13.6 and 13.8 percent, in A and P, respectively. It is concluded that in this large RCT conducted in the Caribbean (BLASP), there were no meaningful differences between those allocated aspirin or placebo but event rates were low, perhaps due to the "healthier recruit" effect. In the context of all other published randomised trials, these results confirm that aspirin has little effect on the prevention of PE or PIH or other specified outcomes but is entirely safe (AU)

Running large clinical trials in the Caribbean on major public health problems: examples through low-dose aspirin studies in pregnancy in Barbados and Jamaica - abstract

Advances in the management of individual patients and public health require evidence that the balance of benefit versus risk, and the cost of intervention are in favour of intervention. Since clinical 'common sense' is unreliable and unscientific, it is an inadequate guide. The only reliable way to show effectiveness is to carry out a randomised trial of adequate power and sample size to detect differences in outcome. The methodology is rigorous but simple, and is applied in the study of pregnancy-induced hypertension (PIH) and pre-eclampsia (PE) as major sources of morbidity and mortality in the Caribbean. Two double-blind randomised placebo-controlled trials are being conducted in Barbados and in Jamaica to test the hypothesis that low-dose aspirin (75/60 mg), taken once daily to term, can reduce the rates of perinatal mortality and proteinuric PE by 30 percent. Other endpoints include birth weight, pregnancy duration, number of admissions and highest blood pressures. Due to a high PIH prevalence in Barbados, all pregnant women over 12 weeks' gestation (except those with allergy or bleeding) are invited to partiacipate. Over 90 percent of the 4000 births a year in Barbados occur at the Queen Elizabeth Hospital, and the planned sample size of some 7000 births will require 3 years to collect. In Jamaica, all primiparae in high-risk antenatal clinics in Kingston and St. Andrew are eligible. Two full-time research midwives and a pharmacist run BLASP by entering data onto a dedicated clinic computer which generates randomised blinded aspirin/placebo pack numbers. One further form is completed after delivery. A monitoring group examines the data for safety independently of the steering group. By the end of November, 1993, 2358 women had consented to enter the study in Barbados, and 1691 had delivered with 112 cases of PE, 65 of PIH, 52 with growth delay and 31 perinatal deaths (19/1000). In Jamaica, 5700 women have been entered with 4414 deliveries; there are 34 cases of eclampsia (7.7/1000). If the trials show treatment to be effective, substantial reduction in the costs of antenatal and neonatal care can be expected. On the other hand compliance may be too poor in the long term to justify public health use (AU)