scholarly journals Tuberculosis presenting as dacryoadenitis in the USA

2019 ◽  
Vol 12 (11) ◽  
pp. e231694 ◽  
Author(s):  
Harry Ross Powers ◽  
Mark Anthony Diaz ◽  
Julio C Mendez
Keyword(s):  
Correct Diagnosis ◽  
Developed Countries ◽  
Histopathological Analysis ◽  
Orbital Mass ◽  
Antituberculosis Therapy ◽  
The Usa ◽  
History Of ◽  
Patient’S History ◽  
High Degree ◽  
Filipino Woman

A 25-year-old Filipino woman living in the USA was evaluated for a 5-month history of left eye pain and a subsequent orbital mass. Histopathological analysis of the lacrimal mass showed a mixed inflammatory process with necrotising granulomas and positive cultures for Mycobacterium tuberculosis. She was treated with antituberculosis therapy, with resolution of symptoms. Tuberculosis dacryoadenitis is extremely rare in the USA and other developed countries. It requires a high degree of clinical suspicion with special attention to the patient’s history to make the correct diagnosis. It can be treated successfully with antituberculosis therapy.

scholarly journals TRANSATLANTIC INTEGRATION AND DEVELOPED COUNTRIES COMPETITIVENESS PROBLEMS

2016 ◽  
pp. 249-257
Author(s):  
A. A. Sidorov
Keyword(s):  
Mutual Recognition ◽  
Developed Countries ◽  
High Tech ◽  
Transatlantic Trade ◽  
Regulatory Cooperation ◽  
The Usa ◽  
History Of ◽  
Tariff Liberalization ◽  
General Business ◽  
The Eu

Factors and possible consequences of transatlantic integration are elaborated in the article. An overview of the history of transatlantic cooperation is provided. The author highlights the paramount goal of Transatlantic Trade and Investment Partnership (TTIP) - strengthening the positions of its parties in the world economy against the backdrop of global competition. Stalemate in Doha round of WTO trade negotiations as well as depressed state of the European economy also contributed to transatlantic integration. Validity of the EU Commission conclusion on TTIP benefits is examined. Results of TTIP econometric modelling are critically assessed. Problems of the EU-US non-tariff liberalization are analyzed. Efficiency of the EU and US labor markets is compared. Low competitiveness of the EU in comparison to the USA and underlying risks for TTIP economic growth and employment are outlined. High unemployment, difficulties of manufacturing (including high-tech industries thereof) recovery, adverse general business situation in the EU are among such risks. Various modes of regulatory cooperation and possibility of their adoption in TTIP are considered. Harmonization, erga omnes mutual recognition of regulations, bilateral mutual recognition of regulations, mutual recognition of conformity testing are distinguished. Possible implications of the modes of regulatory cooperation on TTIP members competitiveness, competition with emerging economies and global standard setting are examined. Conflict of TTIP goals and motivations is revealed. The existence of economic factors of transatlantic integration as well as overestimation of TTIP benefits (primarily for the EU economy) is concluded.

Trumping Capacity Gap with Negotiation Strategies: the Mexican USMCA Negotiation Experience

2020 ◽  
Vol 23 (1) ◽  
pp. 1-23
Author(s):  
Amrita Bahri ◽  
Monica Lugo
Keyword(s):  
Resource Constraints ◽  
Trade Agreement ◽  
Developed Countries ◽  
The United States ◽  
Negotiation Strategies ◽  
The Usa ◽  
History Of ◽  
High Level ◽  
United States Mexico ◽  
Capacity Gap

ABSTRACT In the past few months, we have witnessed the ‘worst deal’ in the history of the USA become the ‘best deal’ in the history of the USA. The negotiation leading to the United States–Mexico–Canada Agreement (USMCA) appeared as an ‘asymmetrical exchange’ scenario that could have led to an unbalanced outcome for Mexico. However, Mexico stood firm on its positions and negotiated a modernized version of North American Free Trade Agreement. Mexico faced various challenges during this renegotiation, not only because it was required to negotiate with two developed countries but also due to the high level of ambition and demands raised by the new US administration. This paper provides an account of these impediments. More importantly, it analyzes the strategies that Mexico used to overcome the resource constraints it faced amidst the unpredictable political dilemma in the US and at home. In this manner, this paper seeks to provide a blueprint of strategies that other developing countries could employ to overcome their negotiation capacity constraints, especially when they are dealing with developed countries and in uncertain political environments.

scholarly journals Congenital Pseudohypoparathyroidism – A Late Diagnosis

2019 ◽  
Vol 16 (2) ◽  
pp. 73-81
Author(s):  
Andreea Ruxandra Ilina ◽  
Andra Elena Gorun ◽  
Camelia Georgeta Badea ◽  
Cristian Răsvan Băicuș
Keyword(s):  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Laboratory Findings ◽  
Medicine Department ◽  
Immunological Tests ◽  
Fourth Finger ◽  
Dilatative Cardiomyopathy ◽  
History Of ◽  
Patient’S History ◽  
Severe Hypocalcaemia

AbstractThe purpose of this paper is to present a case of congenital pseudohypoparathyroidism, late diagnosed in a 22-year-old patient.The patient’s history revealed hypocalcaemia, diagnosed at birth and persistent despite the treatment with calcium. At 8 years old, the patient is diagnosed with epilepsy and receives treatment with Levetiracetam and Oxcarbazepine; at 12 years old she is diagnosed with dilatative cardiomyopathy and receives treatment with Spironolactone and Glycosides. At 22 years old, she visits our Internal Medicine Department with the suspicion of polymyositis and psoriasis. Clinical examination shows armonic short stature, fourth finger hypoplasia, laboratory findings show severe hypocalcaemia, the hand X-ray - third and fourth metacarpal hypoplasia, immunological tests were negative. All data leads to the diagnosis of congenital disease, and given the history of the patient and the evolution of the clinical manifestations we presume hypoparathyroidism or pseudohypoparathyroidism, therefore PTH is dosed – with normal values, and the diagnosis of congenital pseudohypoparathyroidism is established. The patient was referred to endocrinology, where genetic tests were performed to confirm the diagnosis.In conclusion, in the absence of multiple pathology integration into a single disease, the diagnosis of the genetic disease is delayed. Therefore, it is important to have a comprehensive approach and collaboration between different specialties to establish the correct diagnosis.

scholarly journals A Rare Localized Pituitary Stalk Germinoma Presenting in the Third Decade

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Alex González Bóssolo ◽  
Michelle Mangual Garcia ◽  
Kyrmarie Davila ◽  
Ricardo Brau ◽  
Javier Sanchez Ortiz ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Young Male ◽  
Pituitary Stalk ◽  
Histopathological Analysis ◽  
Male Adult ◽  
Adequate Treatment ◽  
Imaging Characteristics ◽  
Secondary Neoplasm ◽  
History Of ◽  
Localized Disease

We report the case of a 34-year-old male Hispanic patient who presented with an 8-month history of polyuria and decreased libido. An evaluation revealed hypopituitarism, central diabetes insipidus, and a pituitary stalk lesion. No evidence of a neoplasm or an inflammatory/infiltrative disease was found. We treated the patient conservatively with steroid therapy. However, as a result of disease progression, transsphenoidal surgery was performed to obtain tissue for a pathological analysis. Histopathology revealed an intrasellar germinoma, confirmed by immunochemistry. Due to localized disease, radiotherapy was initiated and clinical improvement was noted. This case emphasizes the importance of histopathological analysis; for many physicians, the presentation of a pituitary stalk lesion in a young male adult creates a clinical conundrum. Although the most common etiologies are an inflammatory or secondary neoplasm, the possible presence of an intrasellar neoplasm should not be ruled out. In many cases, imaging characteristics and tumor markers may aid in the diagnosis without the need of an aggressive diagnostic approach. However, in this case, histopathological analysis was the only way to make a correct diagnosis and provide adequate treatment for the patient.

scholarly journals Attributing the Bixby Letter using n-gram tracing

2018 ◽  
Vol 34 (3) ◽  
pp. 493-512 ◽  
Author(s):  
Jack Grieve ◽  
Isobelle Clarke ◽  
Emily Chiang ◽  
Hannah Gideon ◽  
Annina Heini ◽  
...  
Keyword(s):  
American History ◽  
Abraham Lincoln ◽  
Authorship Attribution ◽  
Standard Methods ◽  
The Usa ◽  
History Of ◽  
N Gram ◽  
A New Technique ◽  
High Degree ◽  
Very High

Abstract There is a long-standing debate about the authorship of the Bixby Letter, one of the most famous pieces of correspondence in American history. Despite being signed by President Abraham Lincoln, some historians have claimed that its true author was John Hay, Lincoln’s personal secretary. Analyses of the letter have been inconclusive in part because the text totals only 139 words and is thus far too short to be attributed using standard methods. To test whether Lincoln or Hay wrote this letter, we therefore introduce and apply a new technique for attributing short texts called ‘n-gram tracing’. After demonstrating that our method can distinguish between the known writings of Lincoln and Hay with a very high degree of accuracy, we use it to attribute the Bixby Letter. We conclude that the text was authored by John Hay—rewriting this one episode in the history of the USA, while offering a solution to one of the most persistent problems in authorship attribution.

Diversity management: a systematic review

2020 ◽  
Vol 39 (8) ◽  
pp. 901-929
Author(s):  
Shatrughan Yadav ◽  
Usha Lenka
Keyword(s):  
Systematic Review ◽  
Racial Diversity ◽  
Diversity Management ◽  
Developed Countries ◽  
High Concentration ◽  
Content Type ◽  
Depth Analysis ◽  
Management Literature ◽  
The Usa ◽  
History Of

PurposeDiversity management plays a significant role in the organization’s outcomes. This study seeks to provide a brief review of the history of diversity management and to identify the articles published on diversity management since 1991. A systematic review of the literature has been carried out to understand the literature in more detail to know the future scope of research.Design/methodology/approachThis study provides a comprehensive systematic review of quantitative, qualitative and theoretical studies published in leading peer-reviewed management journals from 1991 to 2018 and identifies 123 articles that fall within its established search inclusion criteria.FindingsThe literature review highlighted several aspects related to diversity management. The findings of the study revealed that there is a high concentration of researches in the USA and most number of articles published in the Academy of Management Journal. Although diversity management is a very emerging topic across the globe in management literature yet there is a lack of research in developed countries. Furthermore, most studies are found empirical in nature and the majority of the studies were published during the period of 1996–2000. This finding suggests that age, gender and racial diversity have been repeatedly discussed in diversity management research while other forms of diversity have given less attentionOriginality/valueThis study is one of the first systematic studies that describe the in-depth analysis of diversity management literature. The significant contribution of this study is to propose the integrated model with contemporary trends and patterns of results reported in diversity research, as well as contextual factors that have received more attention to date.

scholarly journals Clinical Implications for the Timely Diagnosis of Mycobacterium marinum in the Age of Biologic Therapy: A Case Report and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Chris J. Lata ◽  
Kelle Edgar ◽  
Stephen Vaughan
Keyword(s):  
Biologic Therapy ◽  
Correct Diagnosis ◽  
Mycobacterium Marinum ◽  
Clinical Implications ◽  
Review Of The Literature ◽  
Immunosuppressant Therapy ◽  
History Of ◽  
Nodular Lesions ◽  
Localized Disease ◽  
High Degree

Mycobacterium marinum infections typically present as cutaneous nodular lesions with a sporotrichoid lymphatic spread on extensor surfaces of extremities. The natural history of this infection can be altered if the host is immunosuppressed, leading to disseminated presentations. A detailed exposure history and high degree of suspicion for this indolent pathogen are often required for the correct diagnosis of this disease. We present a case of a 67-year-old male misdiagnosed with seronegative rheumatoid arthritis presenting with rheumatic nodules. Initiation of chronic immunosuppressant therapy including biologic monoclonal antibodies resulted in the exacerbation of initially localized disease to broadly disseminated lymphatic, joint, and myotendinous granulomatous disease and led to delay in the correct diagnosis. Cessation of immunosuppressants, with a prolonged course of antimicrobial therapy and multiple surgical debridements were required for cure.

9/11 and Armageddon: the Christian Right and George W. Bush

2003 ◽  
Vol 2 (1) ◽  
pp. 33-50
Author(s):  
Göran Gunner
Keyword(s):  
New York ◽  
Christian Right ◽  
Political Life ◽  
Religious Leader ◽  
The European Union ◽  
The World ◽  
Mega Church ◽  
The Usa ◽  
Jerry Falwell ◽  
High Degree

Authors from the Christian Right in the USA situate the September 11 attack on New York and Washington within God's intentions to bring America into the divine schedule for the end of the world. This is true of Pat Robertson and Jerry Falwell, and other leading figures in the ‘Christian Coalition’. This article analyses how Christian fundamentalists assess the roles of the USA, the State of Israel, Islam, Iraq, the European Union and Russia within what they perceive to be the divine plan for the future of the world, especially against the background of ‘9/11’. It argues that the ideas of the Christian Right and of President George W. Bush coalesce to a high degree. Whereas before 9/11 many American mega-church preachers had aspirations to direct political life, after the events of that day the President assumes some of the roles of a mega-religious leader.

Can conversation analytic findings help with differential diagnosis in routine seizure clinic interactions?

2016 ◽  
Vol 12 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Katie Ekberg ◽  
Markus Reuber
Keyword(s):  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Diagnostic Errors ◽  
Epileptic Seizures ◽  
Routine Clinical Setting ◽  
Choice Of Treatment ◽  
Transient Loss ◽  
Factual Content ◽  
Patient’S History ◽  
Linguistic Methods

There are many areas in medicine in which the diagnosis poses significant difficulties and depends essentially on the clinician’s ability to take and interpret the patient’s history. The differential diagnosis of transient loss of consciousness (TLOC) is one such example, in particular the distinction between epilepsy and ‘psychogenic’ non-epileptic seizures (NES) is often difficult. A correct diagnosis is crucial because it determines the choice of treatment. Diagnosis is typically reliant on patients’ (and witnesses’) descriptions; however, conventional methods of history-taking focusing on the factual content of these descriptions are associated with relatively high rates of diagnostic errors. The use of linguistic methods (particularly conversation analysis) in research settings has demonstrated that these approaches can provide hints likely to be useful in the differentiation of epileptic and non-epileptic seizures. This paper explores to what extent (and under which conditions) the findings of these previous studies could be transposed from a research into a routine clinical setting.

Sign in / Sign up

Export Citation Format

Share Document