Selectively arranged single-wire based nanosensor array systems for gas monitoring.

Gas nanosensors, comprised of arrays of nanoelectrodes with finger-widths of ∼100 nm developed by electron beam lithography and aerosol assisted chemical vapor deposited non-functionalized and Pt-functionalized tungsten oxide nanowires (<100 nm) subsequently integrated across the pairs of electrodes via the dielectrophoresis method, are developed in this work. The functionality of these devices is validated towards various concentrations of NO2 and C2H5OH. The results demonstrate reproducible and consistent responses with better sensitivity and partial selectivity for the non-functionalized systems to NO2, as opposed to the Pt-functionalized systems, which display better sensing properties towards C2H5OH with a loss of response to NO2. These results are explained on the basis of the additional chemical and electronic interactions at the Pt/tungsten oxide interface, which increase the pre-adsorption of oxygen species and make the functionalized surface rather more sensitive to C2H5OH than to NO2, in contrast to the non-functionalized surface.

High proportion of extrapulmonary tuberculosis in a low prevalence setting: a retrospective cohort study.

OBJECTIVES: The proportion of extrapulmonary tuberculosis (EPTB) cases in the United States (US) has been rising due to a slower rate of decline in EPTB compared to pulmonary tuberculosis (PTB). The purpose of this study was to characterise the clinical and treatment differences between EPTB and PTB patients, and identify patient factors associated with EPTB. STUDY DESIGN: We performed a retrospective cohort study of active tuberculosis (TB) cases treated at the Baltimore City Health Department between 2008 and 2013. METHODS: We categorised patients as having 'only PTB' (infection in the lung parenchyma), 'EPTB/PTB' (infection in the lung and an additional site), and 'only EPTB' (infection not involving the lung). Pearson's chi-squared tests were used to evaluate categorical variables and compare clinical and demographic differences between only PTB, only EPTB, and EPTB/PTB patients. Student t-tests and one-way analysis of variance tests were utilised to assess continuous variables and to compare treatment differences. RESULTS: One hundred and sixty-three patients were treated for TB; 39.3% had some form of EPTB (either EPTB/PTB or only EPTB). There was no difference found between EPTB, PTB, and EPTB/PTB patients with respect to HIV status, gender, race, foreign-born status, or mean age. Patients with only EPTB were less likely than patients with some form of PTB (only PTB or EPTB/PTB) to present with cough (30.4% vs 61.5%; P < 0.001), night sweats (10.9% vs 39.3%; P < 0.001), and weight loss (28.3% vs 47.9%; P = 0.023). Patients with some form of EPTB were also more likely to be hospitalised postdiagnosis compared to patients with only PTB (39.1% vs 20.2%; P = 0.009), and to have longer mean durations of treatment (37.9 weeks [SD = 11.1] vs 31.8 weeks [SD = 8.1]; P < 0.001). CONCLUSIONS: EPTB patients present with atypical symptoms, undergo prolonged treatment, and experience increased hospitalisations. In order to improve diagnostic algorithms and treatment modalities, EPTB must be further characterised.

[How do Cameroonian women experience their first gynecological examination? How can the procedure be modified to improve this experience?]. / Le vécu du premier examen gynécologique en milieu africain : cas du Cameroun Quels ajustements apporter à son déroulement pour un meilleur vécu ?

UNLABELLED: The gynecological examination is a key element in the diagnosis of the most genitourinary disorders. Improving how women experience the first gynecological examination (FGE) should have a significant impact on their perception of this examination and on their general feeling about it afterwards. OBJECTIVE: The aim of our study was to describe the general feeling of Cameroonian women towards the FGE and to identify the factors associated with negative feelings. METHODOLOGY: In this one-month survey study, we asked patients to complete a questionnaire about how they had experienced the FGE. The answers have been analyzed and the factors influencing the way they experience this examination determined. RESULTS: At the end of the FGE, 41.5% of the women had negative feelings, and 38.6% reported that the examination had been painful. The average age of women who experienced pain was younger than that of those who did not [19.4 vs 20.39 years, P = 0.029], as was that of women with negative feelings lower [19.41 vs 20.43 years, P = 0.024]. A negative experience was significantly associated with a painful examination [P≤0.001], an examiner not specialized in gynecology [P = 0.04], lack of information [P = 0.001], and lack of a separate room to undress [P = 0.038]. The rate of subsequent refusals of a gynecological examination was higher among women with a negative first experience [56.2% vs. 35.9%, P = 0.008]. CONCLUSION: The FGE is experienced by Cameroonian women as very difficult. Their feelings at the end of this examination significantly influences their behavior towards gynecological examinations in general.

Studies of Filipino patients with systemic lupus erythematosus: autoantibody profile of first-degree relatives.

This study surveyed the frequency of autoantibodies among un-affected first-degree relatives (FDRs) of Filipino systemic lupus erythematosus (SLE) patients compared with healthy un-related Filipino controls. The sensitivity, specificity and predictive value of the autoantibodies for SLE diagnosis were also assessed in this Filipino cohort. Filipino patients included in the University of Santo Tomas (UST) Lupus Database and un-affected FDRs were recruited. Healthy controls included those with no known personal or family history of autoimmune disease. The following autoantibodies were tested in all subjects: anti-nuclear antibody (ANA), anti-dsDNA, anti-Ro/SSA, anti-chromatin, anti-thyroid microsome, and anti-cardiolipin antibodies. Participants included 232 SLE patients, 546 FDRs, and 221 healthy controls. Median age of patients was 27 (range 8-66) years with median disease duration of 27.5 (range 1-292) months. Median age of FDRs was 42.0 (range 5-87) years. Compared with healthy controls, there were significantly more FDRs with positive ANA at titers 1 : 40 to 1 : 160 (p < 0.001) and 1 : 320 (p = 0.003), anti-Ro/SSA (4.94% versus 0.45%, p = 0.003), and anti-dsDNA ≥ 5.0 IU/ml (4.58% versus 1.36%, p = 0.031). ANA titer ≥1 : 160, anti-dsDNA, anti-Ro/SSA and anti-chromatin had the highest predictive value for SLE diagnosis. These findings reinforce the role of genetic influence in SLE risk among Filipinos, with a significant proportion of un-affected FDRs of SLE patients testing positive for autoantibodies compared with healthy Filipino controls. A longitudinal observational study in this same cohort will determine which proportion of these un-affected FDRs will evolve into clinical SLE disease in the future.

Modelling trends in woody vegetation structure in semi-arid Australia as determined from aerial photography.

Accounting of carbon stocks in woody vegetation for greenhouse purposes requires definition of medium term trends with accurate error assessment. Tree and shrub cover was sampled through time at randomly located sites over a large area of central Queensland, Australia using aerial photography from 1945 to 1999. Calibration models developed from field data for the same land types as those represented within the study area allowed for the extrapolation of overstorey and understorey cover, basal area and biomass values and these were modelled as trends over the latter half of the 20th century. These structural attributes have declined over the region because of land clearing with values for biomass changing from a mean of 58.0(+/-1.2)t/ha in 1953 to 41.1(+/-1.0)t/ha in 1991. The biomass of Acacia on clay and Eucalypt on texture contrast soils land types has declined most dramatically. Within uncleared vegetation there was an overall trend of increase from 56.1(+/-1.2)t/ha in 1951 to 67.6(+/-1.3)t/ha in 1995. The increase in structural attributes within uncleared vegetation was most pronounced for the Eucalypt on texture contrast soils and Eucalypt on clay land types. It was demonstrated that the sites sampled were representative of their land types and that spatial bias of the photography, undetected tree-killing, sampling error, inherent variability of structural attributes and measurement error should not have impacted greatly on bias or precision of trend estimates for well-sampled land types. Certainly the errors are not likely to be substantial for trends averaged over all land types and they provide an accurate assessment of the magnitude and direction of change. The technique presented here would appear to be a robust means of accounting for the above-ground woody component of woodlands and open forests and will also contribute to a broader understanding of savanna dynamics.

Incidental finding of malignant mixed mesodermal tumor at hysterectomy for uterine prolapse. A case report.

BACKGROUND: The finding of unanticipated pathology in a uterus after vaginal hysterectomy for prolapse is uncommon. CASE: An incidental small malignant mixed mesodermal tumor was found at vaginal hysterectomy in a 68-year-old woman. CONCLUSION: A MED-LINE search found no other reported cases of malignant mixed mesodermal tumor in a patient undergoing vaginal hysterectomy for uterine prolapse. Unexpected endometrial and cervical lesions will be discovered occasionally after hysterectomy for benign disease.

Basaloid squamous cell carcinoma of the vagina metastasizing to the lung. A case report.

BACKGROUND: While observed on the vulva, basaloid squamous cell carcinoma (BC) of the vagina is extremely rare, with no reported cases. CASE: A 54-year-old, African American woman presented with carcinoma metastatic to both lungs, morphologically similar to her BC of the vagina four years previously. She was treated initially in 1995 with local excision. Reexcision and radiation therapy were given for a recurrence in 1996. CONCLUSION: BC of the vagina is an extremely rare and aggressive tumor, which can recur and metastasize.

Endometriosis presenting as bloody pleural effusion and ascites-report of a case and review of the literature.

A 34 year-old female presented with blood-stained pleural effusion and ascites. Investigation revealed a pelvic mass. She underwent exploratory laparotomy, and was found to have endometriosis. Total abdominal hysterectomy and right salpingo-oophorectomy was performed.

Periurethral vaginal adenocarcinoma of the intestinal type: report of two cases and review of the literature.

INTRODUCTION: Vaginal adenocarcinomas in the absence of diethylstilbestrol (DES) exposure are rare neoplasms. Only a few cases with enteric type histology have been reported. Also rare are urethral adenocarcinomas in women. CASE REPORTS: Two cases of vaginal adenocarcinoma of the intestinal type in the absence of DES exposure are presented. Both cases arose in the periurethral area, raising the issue of urethral as well as vaginal origin. DISCUSSION: The possible histogenesis of these neoplasms is considered.

Unilateral chronic tuboovarian abscess secondary to ruptured colonic diverticulum presenting as a brain abscess. A case report.

BACKGROUND: Tuboovarian abscesses (TOAs) are a somewhat unusual finding in postmenopausal patients without risk factors. We present a rare case of unilateral TOA initially presenting as a brain abscess in a postmenopausal woman. CASE: A 61-year-old woman presented with a complaint of forgetfulness, nausea and vomiting, with lower abdominal pain and diarrhea. She was found to have a brain abscess, which was treated by craniotomy, with drainage of the abscess, and intravenous antibiotics. The patient was subsequently found to have a pelvic mass, which, on laparotomy, was a unilateral TOA. Pathology demonstrated that the abscess contained vegetable matter consistent with origin in a ruptured diverticulum. CONCLUSION: Diagnosis of a brain abscess should prompt a thorough investigation for a primary infectious source, including the gastrointestinal and genitourinary tracts.

Maternal weight and fetal injury at birth: data deriving from medico-legal research.

The relationships among maternal weight, gestational weight gain, fetal birth weight and birth injuries have been investigated in connection with 62 cases of shoulder dystocia that involved permanent impairment of the newborn or neonatal demise. A high prevalence of > 13.5 kgs. gestational weight increase between the first and last office visits (62%) obesity expressed as > or = 87 kg. body weight at term (64.1%) and > or = 4000 gm. birth weight (80%) was found in this group of patients. The results indicate that the relationship between excessive maternal and fetal body weights and shoulder dystocia related fetal or neonatal impairment is closer than previous studies have suggested. These results underline the importance of appropriate and intensive nutritional counselling of the mother throughout pregnancy, noting that arrest of the shoulders is only one of those obstetric complications that are closely related to maternal obesity. The findings underline the usefulness of medico-legal reviews in clinical research.

Adenosquamous-cell carcinoma of the ovary: report of a case with positive peritoneal fluid cytology.

Cytologic examination of peritoneal fluid showed only malignant squamous cells, without revealing adenocarcinomatous cell components, in a patient who had an endometrioid adenosquamous-cell carcinoma of the ovary. Histologic examination of the ovary demonstrated diffuse squamous-cell carcinoma with rare foci of endometrioid and abortive malignant glands, as well as isolated mucin-positive cells. The cytologic differential diagnosis of malignant squamous cells in peritoneal fluid and the pathogenesis of squamous-cell carcinoma of the ovary are discussed.

Artificial double vagina in association with Rokitansky syndrome.

A case of Rokitansky syndrome is described where the typical anomalies of the entity were associated with cribriform hymen. The appearance of the external genitalia led to an erroneous diagnosis of complete vaginal agenesis and to surgical creation of an artificial vagina by the McIndoe technique at the patient's age of 19. She had a satisfactory sexual life subsequently. Ten years following the surgery, routine examination revealed that the patient had an essentially normal vagina with a blind upper ending. Prior to this, she and her husband had been unaware of the fact that their marital relations were conducted through her natural vagina during the years of their sexual activities.

Expectant management of presumed ectopic pregnancies.

Thirteen patients with presumed diagnosis of unruptured ectopic pregnancy underwent expectant management. The diagnosis was based on the criteria of clinical stability, no intrauterine gestation sac by sonogram, and falling beta subunit human chorionic gonadotropin titer. The diagnosis also was based on no gross evidence of trophoblastic tissue on sharp curettage and alteration in uterotubal anatomy at laparoscopy. In these 13 patients, titers continued to drop and were below assay detectability (1.5 miu/ml) by 1 to 5 weeks. Only one patient required a laparotomy. Hysterosalpingograms in ten of the patients showed normal, patent tubes in seven. One patient had cornual occlusion and two showed a hydrosalpinx with spillage. A second laparoscopy in seven patients demonstrated normal tubes in all but one. At present, three patients have delivered term infants and two have had first trimester spontaneous abortions. These observations suggest that expectant management of tubal pregnancies is appropriate under rigidly controlled conditions.