scholarly journals Autopsy and premortem diagnostic discrepancy review in an Irish tertiary PICU.

2021 ◽  
Author(s):  
Mark O'Rahelly ◽  
Michael McDermott ◽  
Martina Healy
Keyword(s):  
Diagnostic Errors ◽  
Class I ◽  
Post Mortem ◽  
Class Iii ◽  
Class V ◽  
Autopsy Data ◽  
Discrepancy Rate ◽  
Error Classification ◽  
Post Cardiac Surgery

Abstract Objective: 1) Review ante- and post-mortem diagnoses and assign a Goldman error classification. 2) Establish autopsy rates. Design: A retrospective analysis of autopsies performed on patients who died in Paediatric intensive care unit (PICU) between November 13th 2012 and October 31st 2018. We reviewed medical and autopsy data of all patients and Goldman classification of discrepancy between ante- and post-mortem diagnoses was assigned. Setting: Tertiary PICU. Patients: All patients that died in PICU within the designated timeframe. Interventions: Goldman error classification assignment. Measurements and main results: 396 deaths occurred in PICU from 8,329 (4.75%) admissions. 99 (25%) had an autopsy, 75 required by the coroner. All were included in the study. Fifty-three were male and 46 females. Fifty-three patients were transfers from external hospitals, 46 from our centre. Forty-one were neonates, 32 were <1 year of age, and 26 were >1 year of age. Median length of stay was 3 days. Eighteen were post cardiac surgery, and three post cardiac catheter procedure. Major diagnostic errors (Class I/II) were identified in 14 (14.1%), 2 (2%) Class I, and 12 (12.1%) were Class II errors. Class III and IV errors occurred in 28 (28.2%) patients. Complete concordance (Class V) occurred in 57 (57.5%) cases. Conclusion: The autopsy rate and the diagnostic discrepancy rate within our PICU is comparable to those previously reported. Our findings show the continuing value of autopsy in determining cause of death and providing greater diagnostic clarity. Given their value, post-mortem examinations, where indicated, should be considered part of a physician’s duty of care to families and future patients.

Morphology classification of circulating tumor cells could be a predictor of recurrent disease in patients with non-small cell lung cancer after surgery.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e15530-e15530
Author(s):  
Yun Wu ◽  
Yuxu Niu ◽  
Fanzhen Lv ◽  
Wen Gao ◽  
Xiaoyong Shen
Keyword(s):  
Lung Cancer ◽  
Recurrent Disease ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Class V ◽  
Lung Cancer Patients ◽  
Increased Risk ◽  
Class Iv

e15530 Background: CTCs have been widely used in monitoring the efficacy and prognosis of lung cancer. However, CTCs number count alone cannot accurately predict the recurrent disease in patients. In this study, we investigate whether the morphology classification of CTCs could be as a prognostic marker for increased risk of recurrence after surgery. Methods: In this study, 105 lung cancer patients (median age 68y) who underwent surgery were prospectively enrolled in this study. Samples were obtained before, after, and serially up to 24 months after surgery. CTCs were collected and morphology classified by utilizing a CTC test workflow which uses negative enrichment and immunofluorescence methods to capture and identify CTCs from blood sample. Captured CTCs (epithelial type) were screened with a customized imaging analysis pipeline, a cytological profile of each CTC was created, including cell size, shape, fluorescent intensity and texture etc. Results: The CTC detection rate was 78.1% (78 of 105) prior to surgery, and a total of 726 CTCs were enumerated. Median CTC count number was 3. 5 classes of CTCs with distinct morphological features were observed in lung cancer patients’ CTC tests, briefly, CTC class I and class II possessed large nuclei but relatively lower epithelial expression level, CTC class III, IV, V possessed small nuclei but relatively higher epithelial expression level, CTC class III possessed irregular shaped nuclei, CTC class V possessed relatively lower nuclei/cytoplasm ratio. Class III accounted for the highest proportion of captured CTCs III, about 35.5% with Class I 14.8%, Class II 15.3%,Class IV 17.8% and Class 5 16.6%. Postoperative recurrence and metastasis were observed in 16 patients. CTCs positive were found in 14 patients (87.5%). 145 CTCs were collected, Median CTC count number was 3,Cluster III accounted for 47.3%, with Class I 11.8%,Class II 13.3%,Class IV 14.5% and Class V 11.8%; Patients with Cluster 3 dominant were associated with increased risk of local recurrence ( p < 0.05) and distant metastasis ( p < 0.05). Conclusions: Small and irregular nuclei CTC is significant associated with increased risk of recurrence disease. Morphology Classification of circulating tumor cells is feasible in monitoring the recurrence of disease and may potentially identify the patients who may benefit from further therapy.

scholarly journals ANALYSIS ON THE PATTERN OF USING THE SERVICE OF REMOVABLE PARTIAL DENTURE MAKING IN A DENTAL LABORATORY IN SURABAYA

2017 ◽  
Vol 52 (4) ◽  
pp. 270
Author(s):  
Okti Setyowati ◽  
Endang Kusdarjanti
Keyword(s):  
Dental Health ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Removable Partial Denture ◽  
Partial Denture ◽  
Metal Framework ◽  
Removable Denture ◽  
Class Iv

The making of removable denture is performed by a dental laboratory. To facilitate the identification, according to Kennedy classification, classes are divided onto groups, the Kennedy class I, II, III and IV. To suit with the needs of the dental laboratory tasks commonly done, priority are necessary for common cases and should to be taught to students of Dental Health Technology Diploma. In Surabaya, research of various cases of removable partial denture with the various Kennedy classifications has never been done before. This study was to analyze the pattern of service for the removable partial denture manufacture in dental laboratory at Surabaya (2011 – 2013). The research is an observatory analytic. The population is all dental laboratories located around the campus of the Faculty of Dentistry Airlangga University Surabaya. The sample was the whole population is willing to become respondents. Sampling by total sampling. The method of collecting data using secondary data from a dental laboratory in Surabaya from 2011 until 2013. The note is cases removable denture according to the classification of Kennedy that Kennedy Class I, II, III and IV. Also of note kinds of materials used to make the denture base that is heat cured acrylic resins, thermoplastic resins and metals coherent. The data is a compilation table charting the frequency until needed, then analyzed using cross tabulation. Mostly denture type is flexible type and the least is metal framework. Most cases by classification Kennedy is followed by class II class III and class II and more recently is the fourth. In conclusion, in 2011 and 2013 the manufacture of removable partial dentures according to the classification of Kennedy Class III is the most common in both the upper arch and lower jaw, followed by Class II, Class I and Class IV. In 2012 which is the highest grade III followed by class II, class IV and class I. The denture type most used is a flexible denture, followed acrylic denture and the last is the metal framework.

scholarly journals Novel Class of Mutations of pilS Mutants, Encoding Plasmid R64 Type IV Prepilin: Interface of PilS-PilV Interactions

2007 ◽  
Vol 190 (4) ◽  
pp. 1202-1208 ◽  
Author(s):  
Eriko Shimoda ◽  
Tatsuya Muto ◽  
Takayuki Horiuchi ◽  
Nobuhisa Furuya ◽  
Teruya Komano
Keyword(s):  
Genetic Analysis ◽  
Type Iv Pili ◽  
Class I ◽  
Minor Components ◽  
Class Iii ◽  
Class V ◽  
Type Iv ◽  
Prepilin Peptidase ◽  
Class Iv ◽  
Plasmid R64

ABSTRACT The type IV pili of plasmid R64 belonging to the type IVB group are required only for liquid mating. They consist of the major and minor components PilS pilin and PilV adhesin, respectively. PilS pilin is first synthesized as a 22-kDa prepilin from the pilS gene and is then processed to a 19-kDa mature pilin by PilU prepilin peptidase. In a previous genetic analysis, we identified four classes of the pilS mutants (T. Horiuchi and T. Komano, J. Bacteriol. 180:4613-4620, 1998). The products of the class I pilS mutants were not processed by prepilin peptidase; the products of the class II mutants were not secreted; in the class III mutants type IV pili with reduced activities in liquid mating were produced; and in the class IV mutants type IV pili with normal activities were produced. Here, we describe a novel class, class V, of pilS mutants. Mutations in the pilS gene at Gly-56 or Tyr-57 produced type IV pili lacking PilV adhesin, which were inactive in liquid mating. Residues 56 and 57 of PilS pilin are suggested to function as an interface of PilS-PilV interactions.

scholarly journals Validity of Index of Orthodontic Treatment Complexity in Assessing Complexity of Treatment among the Malocclusion Groups

2021 ◽  
Vol 10 (14) ◽  
pp. 1003-1007
Author(s):  
Sriman Vishnu ◽  
Saravanakumar Subranmanian ◽  
Prema Anbarasu ◽  
Nagappan Nagappan ◽  
Annamalai P.R. ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Predictor Variable ◽  
Correlation Coefficients ◽  
Class Ii ◽  
Class I ◽  
Class Ii Malocclusion ◽  
Class Iii ◽  
Division 1 ◽  
Treatment Complexity

BACKGROUND To provide efficient and well-planned orthodontic treatment orthodontists must be able to assess the type of malocclusion and the complexity involved in its treatment. Hence, the purpose of this study was to validate index of orthodontic treatment complexity (IOTC) as a reliable index to assess the treatment complexity in treating different malocclusion groups. METHODS A retrospective study with sample of 120 pairs of orthodontic study model consisting of treated and untreated cases, were collected and equally divided into class I, class II including both division 1 and division 2 and class III malocclusions based on Angles system of classification of malocclusion. Study casts were scored according to criteria given by the index of orthodontic treatment complexity and the degree of complexity is established for each of the malocclusion groups and the occlusal traits. RESULTS The Spearman correlation coefficients test shows that occlusal traits like overjet, centreline discrepancy, molar correction, overbite, crowding, posterior cross bite, alone significantly correlated with degree of complexity. Multiple regression analysis and one way ANOVA tests were performed for the three types of malocclusion and the test showed that in individual classes of malocclusion, the predictor variable (occlusal traits) significantly predicts the degree of complexity in class I and class II malocclusion cases, but not in class III. CONCLUSIONS Overjet, centreline discrepancy, molar correction, overbite, crowding, posterior cross bite correlated with degree of complexity. IOTC forecasts the degree of complexity in class I and class II malocclusion cases, but not in class III. KEY WORDS IOTC, Malocclusion, Occlusal Traits

BIOMECHANICAL RISK FACTORS FOR VASCULAR DISEASE IN HYPERTENSIVE PATIENTS ACCORDING TO ULTRASOUND MORPHOLOGY OF PERIPHERAL ARTERY ATHEROSCLEROSIS

2019 ◽  
pp. 46-52
Author(s):  
В.В. Генкель ◽  
А.О. Салашенко ◽  
О.А. Алексеева ◽  
И.И. Шапошник
Keyword(s):  
Shear Rate ◽  
Class I ◽  
Wall Tension ◽  
Class Iii ◽  
Peripheral Artery ◽  
Morphological Classification ◽  
Atherosclerotic Lesions ◽  
The Common ◽  
Peak Blood

Цель. Оценка показателей эндотелиальной скорости сдвига и циркулярного напряжения сосудистой стенки у пациентов с гипертонической болезнью в зависимости от тяжести атеросклеротического поражения периферических артерий. Методика. В исследование были включены 85 пациентов с гипертонической болезнью, 46 мужчин и 39 женщин, средний возраст которых составлял 57,1±11,7 лет. Проводили дуплексное сканирование сонных артерий и артерий нижних конечностей. Определение эндотелиальной скорости сдвига и циркулярного напряжения сосудистой стенки проводили на участке общей сонной артерии. При разделении исследуемой когорты пациентов на группы использовали ультразвуковую морфологическую классификацию атеросклеротического поражения сосудистой стенки по G. Belcaro и соавт. Результаты. У пациентов III класса скорость сдвига составляла 402±107 с-1, что было статистически значимо ниже значений пациентов I класса - 538±123 с-1 (p=0,001). Увеличение количества баллов по классификации G. Belcaro и соавт., отражающее прогрессирование атеросклероза, ассоциировалось со снижением скорости сдвига (r= -0,281; p=0,01). У пациентов III (5,68±1,12 дин/см*104) и IV (6,19±1,31 дин/см*104) классов циркулярное напряжение стенки было статистически значимо выше в сравнении с пациентами I класса - 4,90±1,00 дин/см*104. Выявлены обратные корреляционные связи между эндотелиальной скоростью сдвига и циркулярным напряжением сосудистой стенки (r=-0,289; p=0,007). Заключение. У пациентов с гипертонической болезнью по мере увеличения тяжести поражения периферических артерий выявлено увеличение циркулярного напряжения сосудистой стенки и снижение эндотелиальной скорости сдвига с последующим повышением при стенозирующем атеросклерозе. Aim. To evaluate endothelial shear rate and circumferential wall tension in patients with hypertension based on severity of atherosclerotic lesions in peripheral arteries. Methods. The study included 85 patients with hypertension (46 men and 39 women) aged 57.1±11.7. All patients underwent a duplex scanning of carotid arteries and lower limb arteries. Measurements of endothelial shear rate and circumferential wall tension were performed at the site of the common carotid artery (CCA). The peak blood flow velocity and the diastolic diameter of the blood vessel were measured in the M-mode. The shear rate was calculated using the Hagen-Poiseuille equation. Circumferential wall tension was determined in accordance with the Laplace’s law. Patients were divided into four groups using the ultrasonic morphological classification of the arterial wall by G. Belcaro et al. Results. In class III patients, the shear rate was significantly lower than in class I patients (402±107 s-1 vs. 538±123 s-1, respectively, p = 0.001). An increased number of points (by G. Belcaro et al. classification) was associated with a decreased shear rate in CCA (r = -0.281; p = 0.01). Class III (5.68±1.12 dyne/cm*104) and class IV (6.19±1.31 dyne/cm*104) patients had significantly higher values of the circumferential wall tension than class I patients (4.90±1.00 dyne/cm*104). The endothelial shear rate inversely correlated with the circumferential wall tension (r = -0.289; p = 0.007). Conclusion. In patients with hypertension and peripheral artery atherosclerosis, nonlinear changes in the endothelial shear rate and the increased circumferential wall tension paralleled the increasing severity of peripheral atherosclerosis.

Research on Evaluation of the Landscape and its Functions in Houtan Park of the World Exposition 2010 Shanghai, China

2014 ◽  
Vol 955-959 ◽  
pp. 4061-4073
Author(s):  
Yin Jiang Zhang ◽  
Yue Dong ◽  
Pei Min He ◽  
Kong Jian Yu ◽  
Jing Jin
Keyword(s):  
Evaluation System ◽  
Comprehensive Evaluation ◽  
Class I ◽  
Class Iii ◽  
Index Method ◽  
Class V ◽  
Landscape Characteristics ◽  
The World ◽  
World Exposition ◽  
Inferior Class

Construction of urban waterscape parks based on ecological concepts and functions is becoming the tendency of modern urban parks. Unfortunately, there are no suitable evaluation systems for these parks. This study establishes a comprehensive evaluation system for a landscape and its functions via the analytic hierarchy process and the comprehensive index method. The evaluation model consisted of 3 evaluation indexes and 23 evaluation indicators relevant to the landscape characteristics of Houtan Park of the World Exposition 2010 Shanghai, China. The evaluation indicators were monitored from 2006 to 2010, and the results of the investigation led to the following conclusions: the park fulfills a range of desirable functions, and ranks high in aesthetic, economic and societal values; ecological functions were applied well within the landscape, and following ecological restoration and the construction of a functional aquatic ecosystem, the water quality of Houtan River has been continuously purified from inferior class V~ class V to class III~ class I range, while the heavy metals in the sediment were improved from inferior class V~ class V to class I; the biodiversity was improved from 0.72 into 1.49; and the results for other indicators were improved overall. In general, the comprehensive score of the evaluation increased from 1.227 to 4.341. Although minor problems remain to be solved, the results indicate that the design concept and construction methods applied in Houtan Park are well applicable to sustainable landscapes, and the evaluation system as a whole can be extended and applied in similar cases.

scholarly journals Pattern of Malocclusion among Patients Seeking Orthodontic Treatment at Hospitals and Private Clinics of Province 2, Nepal

2020 ◽  
Vol 10 (3) ◽  
pp. 35-39
Author(s):  
Kaushal K Singh ◽  
Binita Singh ◽  
Rajiv Yadav
Keyword(s):  
Orthodontic Treatment ◽  
Public Awareness ◽  
Class Ii ◽  
Class I ◽  
Teaching Hospitals ◽  
P Value ◽  
Fisher Exact Test ◽  
Class Iii ◽  
Orthodontic Patients

Introduction: Malocclusion affect the esthetic, function of the patients, so they seek orthodontic treatment for normal function and healthy and beautiful smile. Increase in public awareness and availability of orthodontic specialty services have led to increasing number of orthodontic patients in specialty clinics and hospitals. The objective of this study is to examine the pattern of malocclusion in the patients visiting medical and dental teaching hospitals and dental clinics and to measure the different Angle’s classification of malocclusion with discrepancies in all three planes. Materials and Method: Three hundred seventeen acceptable study casts were selected from 403 case records of orthodontic patients who visited the different hospitals and private clinics of Province 2, Nepal. A standard guidance of Angle’s classification was used to classify the cases and casts were measured to record the data. Different Angle’s classification of malocclusion with discrepancies in all three planes was studied. Descriptive statistics (frequency, percentage, mean and SD) and inferential statistics (chi square and fisher exact test) was used to find out the association between occlusal traits and demographic variables. Result: According to the Angle’s classification of malocclusion, most of the patient’s cast 65.9% were of class I, followed by class II 31.8%, class III 5.3% occlusion pattern. Among the class II malocclusion, class II division 1 malocclusion was more prevalent (86.13%). Under space discrepancies, crowding of teeth was present in 42.58% of patient. Of the total teeth crowding patient, 70.3% had crowding of teeth in both the arches followed by only mandibular arch (25.18%). There is statistically significant association between the age and the occlusal traits like crowding (p value 0.008), spacing (p value 0.000) and overjet (p value 0.000) at 0.01 level of significance. Conclusion: Angle’s class I was the most prevalent malocclusion followed by class II and class III. Increased overjet was the commonest occlusal trait. There was statistically significant association between the age and occlusal traits like crowding, spacing and overjet.

Direct Restorative Material Use of Selected Practitioners in the United Kingdom

2002 ◽  
Vol os9 (4) ◽  
pp. 133-137 ◽  
Author(s):  
Paul A Brunton ◽  
Reinhard Hickel ◽  
Nairn HF Wilson
Keyword(s):  
Resin Composite ◽  
Postal Questionnaire ◽  
Class I ◽  
Glass Ionomer ◽  
Class Iii ◽  
Cervical Lesions ◽  
Class V ◽  
The United Kingdom ◽  
Restorative Materials ◽  
Materials Used

Purpose of the Investigation To investigate, by questionnaire, the direct restorative materials used by a sample of practitioners from the Unite d Kingdom. Basic Procedures A postal questionnaire was distributed to a group of self-selected practitioners, who volunteered to participate in the study. In all 110 practitioners participated in the study. Main Findings The most used material for the restoration of occlusal (Class I) and approximal (Class II) lesions was amalgam with 61% and 73% of practitioners indicating that they used amalgam in this situation. Adhesive tooth-coloured materials, specifically composites and compomers, were preferred by the majority of practitioners for anterior approximal (Class III) and incisal (Class IV) restorations with compomer preferred for Class V restorations including non-carious cervical lesions and for the restoration of primary teeth. Principal Conclusions It is concluded that the general practitioners surveyed in this study tend to use amalgam for the restoration of Class I and II lesions as opposed to resin composite. The majority of practitioners in this study used compomers, a relatively new group of restorative materials, with little evidence of traditional glass-ionomer cements being used routinely.

scholarly journals MP32: The Pulmonary Embolism Severity Index (PESI) score and disposition decisions in Calgary emergency departments

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S76
Author(s):  
S. Brunet ◽  
D. Wang ◽  
E. Lang
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Mortality Rate ◽  
Class Ii ◽  
Low Risk ◽  
Class I ◽  
Class Iii ◽  
Class V ◽  
Risk Class ◽  
Class Iv

Introduction: The Pulmonary Embolism Severity Index (PESI) score predicts short-term mortality from pulmonary embolism and low-risk patients suitable for home therapy. However, it is unknown if it is a driver for disposition decisions for emergency department (ED) patients. The primary objective of this study was to define the relationship between disposition decisions and the PESI score in Calgary zone hospitals. Methods: The PESI score was calculated retrospectively for 576 patients presenting to one of four Calgary zone hospitals for pulmonary embolism over the last 2 years. The calculated PESI score allowed the mortality risk of each patient to be estimated for very low risk (Class I, 0-1.6% 30-day mortality rate), low risk (Class II, 1.7-3.5% 30-day mortality rate), intermediate risk (Class III, 3.2-7.1% 30-day mortality rate), high risk (Class IV, 4.0-11.4% 30-day mortality rate), and very high risk (Class V, 10.0- 24.5% 30- day mortality rate). The patients were grouped based on being admitted to the hospital for inpatient care, or discharged for outpatient care. Descriptive statistics were used to describe the data. Results: Of the 576 patients, 317 (55%) were discharged and 259 (45%) were admitted to the hospital for inpatient care. Among admitted patients, 20.5% were considered Class I, 29.3% were Class II, 24.3% were Class III, 17.6% were Class IV, and 8.1% were Class V. Among discharged patients, 53.9 % were Class I, 25.6% were Class II, 15.5% were Class III, 4.4% were Class IV, and 0.6% were Class V. Of the 25 very high-risk (Class V) patients, 2 (8.0%) were discharged from the ED and treated as outpatients. Of the 223 very low risk (Class I) patients, 171 (76.7%) were discharged and 52 (23.3%) were admitted to hospital. Conclusion: A significant percentage of pulmonary embolism patients admitted to Calgary Zone hospital wards are PESI low risk (29.3%) or very low risk (20.5%). Implementation of a PESI score-based disposition pathway could improve the safety, cost-effectiveness and quality of ED disposition decisions for PE.

scholarly journals Facial height proportion based on Angle’s malocclusion in Deutero-Malayids

2021 ◽  
Vol 54 (2) ◽  
pp. 96
Author(s):  
Aulia Rohadatul Aisy ◽  
Avi Laviana ◽  
Gita Gayatri
Keyword(s):  
Class Ii ◽  
Class I ◽  
Class Ii Malocclusion ◽  
Racial Groups ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Facial Aesthetics ◽  
Cross Sectional ◽  
Facial Height

Background: Facial aesthetics are closely related to the harmonious proportions of the facial components. One of the components is facial height. The reference of facial height proportion of certain racial groups needs to be known by orthodontists and surgeons to create treatment outcomes that can be specifically designed for these particular demographics. One of the factors that can affect facial height proportion is malocclusion. Purpose: This study aimed to determine facial height proportion based on Angle’s classification of malocclusion in Deutero-Malayids. Methods: This study used a descriptive cross-sectional method, which was conducted on 116 Deutero-Malayid subjects. The subjects’ malocclusion was first examined using Angle’s classification of malocclusion. Upper and lower facial height were then measured to determine the proportion of these dimensions. The results were then grouped based on each malocclusion class. Results: It was found that the upper and lower facial height proportions in the class I malocclusion group were 46.74% and 53.26% in males and 47.52% and 52.48% in females, respectively. The upper and lower facial height proportions in the class II malocclusion group were 48.46% and 51.54% in females. Upper and lower facial height proportions in the class III malocclusion group were 45.31% and 54.69% in males and 46.29% and 53.71% in females, respectively. Conclusion: The largest proportion of upper facial height in Deutero-Malayids was seen in the class II malocclusion group, followed by class I and class III. The largest proportion of lower facial height in Deutero-Malayids was seen in the class III malocclusion group, followed by class I and class II.

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