scholarly journals Rare congenital hearth disease as a cause of tuberculosis activation

2010 ◽  
Vol 63 (7-8) ◽  
pp. 565-569
Author(s):  
Milan Radovic ◽  
Lidija Ristic ◽  
Ivana Stankovic ◽  
Dejan Petrovic
Keyword(s):  
Respiratory Insufficiency ◽  
Heart Defects ◽  
X Rays ◽  
Pulmonary Lesions ◽  
Echocardiographic Examination ◽  
Chronic Respiratory Insufficiency ◽  
The Right ◽  
High Level ◽  
Very High ◽  
Culture Conversion

Introduction. Patients with congenital cyanotic heart defects and the left-to-right shunt are at a three times higher risk of getting tuberculosis than acyanotic ones. No TB cases have been recorded in adult patients with the right-to-left shunt having cyanosis since their birth. Case report. A 34-year-old man was referred to our Clinic with the discomforts such as chronic cough, hemoptysis and insomnia. At the admission he was pale, cyanotic, with a partial manifest respiratory insufficiency and characteristic TB pulmonary lesions detected by x-rays and tomography. After the sputum positive TB recidivism had been diagnosed, the antituberculotics treatment was introduced resulting in the successful smear and culture conversion and radiological regression of pulmonary lesions, but associated with non-explicable deterioration of cyanosis and chronic respiratory insufficiency until Doppler-echocardiographic examination verified the presence of tetralogy of Fallot. Conclusion. Congenital cyanotic heart defects are extremely rare in adults. Nevertheless, it is necessary to maintain a very high level of clinical suspicion regarding TB activation even in the cases of defects with the right-to-left shunt.

Echocardiographic Diagnosis of Congenital Membranous Ventricular Septal Aneurysm in the Dog and Cat

2005 ◽  
Vol 41 (4) ◽  
pp. 215-220 ◽  
Author(s):  
William P. Thomas
Keyword(s):  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Cardiac Dysfunction ◽  
Congenital Heart ◽  
Septal Defect ◽  
Incidental Finding ◽  
Heart Defects ◽  
Thin Membrane ◽  
Echocardiographic Examination ◽  
The Right

Membranous ventricular septal aneurysm was diagnosed by echocardiography in 17 dogs and three cats. The aneurysm appeared as a thin membrane protruding into the right ventricle from the margins of a congenital ventricular septal defect (VSD). The aneurysm was intact in nine dogs and two cats and perforated by a small VSD in eight dogs and one cat. Other congenital heart defects were present in seven dogs. In all animals, the aneurysm was an incidental finding observed during echocardiographic examination, and it did not appear to directly cause any cardiac dysfunction.

scholarly journals Metode Simple Multi Attribute Rating Technique Dalam Keputusan Pemilihan Dosen Berprestasi yang Tepat

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Rezi Elsya Putra ◽  
Selvia Djasmayena
Keyword(s):  
Higher Education ◽  
Tertiary Institutions ◽  
The Right ◽  
High Level ◽  
Very High

Each lecturer is required to carry out the tridarma of higher education, a career to become a lecturer must be professional in accordance with his knowledge and expertise. Almost every year state or private tertiary institutions, give an award to lecturers who excel one of the benchmarks is from the tri darma performance of higher education. At present in determining the right lecturer with good achievements there are still many weaknesses of one of the criteria used. Then the research has the aim to determine the outstanding lecturers by using the right criteria effectively. The method used is the Simple Multi Attribute Rating Technique (SMART) method using Sekolah Tinggi Ilmu Komputer (STIKOM) Muhammadiyah Batam’s lecturer data. The results of this study set the right criteria, so get a very high level of accuracy which is 79%. So this research becomes the right indicator in determining the outstanding lecturers.

scholarly journals Dyslexia Among University Students: Reading Base

Twejer ◽  
2021 ◽  
Vol 4 (1) ◽  
pp. 103-142
Author(s):  
Dler Sadiq Kanabi ◽  
◽  
Karwan kakabra Kakamad ◽  
Keyword(s):  
University Students ◽  
Quantitative Research ◽  
Right Hemisphere ◽  
Left Handed ◽  
Undergraduate University Students ◽  
The Right ◽  
High Level ◽  
One Way Anova ◽  
Very High ◽  
Test Result

Reading difficulties is one of the most problems that face students when they enter universities. The main purpose of this study was to measure the reading basis of Dyslexia among undergraduate university students. The researchers performed a quantitative research method, also the non-random purposive sampling was used to collect data. The study was conducted with the participation of 414 undergraduate university students which comprising 310 males (74.88 %) and 104 (25.12%) females. After following all psychometric steps (24) (Five- Likert- Scale) for reading basis of Dyslexia was developed. The T. Test result showed a very high level of dyslexia among the participants. Moreover, males show a higher level of dyslexia than females. By using regression, this research found male participants are more dyslexics than female participants. However, this research showed that left handed and right handed has no effect on dyslexia. Also, by using one-way ANOVA, the results indicated that participants who have brain injury show a higher risk of dyslexia. Participants with left hemisphere injury showed a higher level of dyslexia compares to the participants with having an injury in the right hemisphere. In conclusion, some recommendations are presented educational sectors.

scholarly journals Spontaneous regression of maligan breast neoplasia in a female patient with high level of immunoglobulin ig e

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Jackson Roberto de Moura
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Hormone Receptors ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Minas Gerais ◽  
X Rays ◽  
Breast Neoplasia ◽  
The Right ◽  
High Level

M.C.V., aged 54, born in Presidente Bernardes, Minas Gerais, was admitted on 09/10/2018 with a palpable alteration in the right breast, having a 15mm heterogeneous lobed nodule at the junction of the upper quadrant of the right breast (BI-RADS 5) with mammography having focal asymmetry in the same position (BI-RADS 0), being submitted to core-biopsy by ultrasound with resulting Infiltrating Ductal Carcinoma – Grade 3. Immunohistochemical pattern reveals positivity of the estrogen and progesterone hormone receptors, C-ERB B2 with a score of +2 and Ki67‒positive by 20%. Negative Fish test. She refused treatment, returning to the service on 14/08/2019 with normal physical examination, an 8 mm ultrasound lesion at the junction of the upper quadrants of the right breast (BI-RADS 6) and regression in mammography of focal asymmetry. Staging study performed with chest X-rays, total abdomen ultrasound and normal bone scintigraphy. Laboratory study was normal, except for the high level of total IgE in 4,290. She underwent segmental and sentinel lymph node resection in the right breast on 17/08/2019 at Hospital São Vicente de Paula, Ubá, Minas Gerais, with histological result, infiltrating lobular carcinoma, 9 mm in size, free margins and study of the negative sentinel lymph node. Radiotherapy and use of Tamoxifen 20mg for 5 years were indicated. It was possible to conclude that there is something different, possibly associated with the high level of IgE, which we continue to study to further understand.

Sustainability of Cardiac Imaging

2011 ◽  
Vol 7 (3) ◽  
pp. 167 ◽  
Author(s):  
Eugenio Picano ◽  
Keyword(s):  
Medical Imaging ◽  
Radiation Exposure ◽  
Interventional Cardiology ◽  
X Rays ◽  
Energy Agency ◽  
Radiation Induced Cancer ◽  
Cardiovascular Testing ◽  
Radiological Dose ◽  
The Right ◽  
High Level

Medical imaging is the largest controllable source of radiation exposure in the population of industrialised countries – totalling around 150 chest X-rays per head per year. Of these exposures, one half comes from cardiovascular testing (cardio-computed tomography [CT], nuclear cardiology and interventional cardiology). The high level of radiation exposure provides immense benefits when appropriate, but may result in an increased incidence of radiation-induced cancer in the not-too-distant future. Current estimates suggest that about five to 10 % of all cancers may be due to medical radiation exposure. Of every three examinations, one is inappropriately prescribed (lack of justification) and another is performed with inappropriately high radiation doses (lack of optimisation). Cardiologists are often unaware of the radiological dose of the examination they prescribe or practice, but they should make every effort so that “each patient should get the right imaging exam, at the right time, with the right radiation dose”, as suggested by US Food and Drug Administration (FDA) in the 2010 initiative to reduce unnecessary radiation exposure from medical imaging. This is best obtained through a systematic implementation of the ‘3A’s strategy’ proposed by the International Atomic Energy Agency in 2011: audit (of true delivered dose); appropriateness (since at least one-third of examinations are inappropriate); awareness (since the knowledge of doses and risks is largely suboptimal in doctors and patients). A good cardiologist cannot be scared of radiation, but must always remain aware of the risks.

التغير المناخي واثره في المقنن المائي لمحصول العنب في محافظة ديالى

2019 ◽  
Vol 1 (34) ◽  
pp. 391-422
Author(s):  
اشواق حسن حميد صالح
Keyword(s):  
Climate Change ◽  
Statistical Analysis ◽  
Wind Speed ◽  
Extreme Temperature ◽  
Solar Brightness ◽  
The Subject ◽  
Climate Station ◽  
The Times ◽  
High Level ◽  
Very High

Climate change and its impact on water resources is the problem of the times. Therefore, this study is concerned with the subject of climate change and its impact on the water ration of the grape harvest in Diyala Governorate. The study was based on the data of the Khanaqin climate station for the period 1973-2017, (1986-2017) due to lack of data at governorate level. The general trend of the elements of the climate and its effect on the water formula was extracted. The equation of change was extracted for the duration of the study. The statistical analysis was also used between the elements of the climate (actual brightness, normal temperature, micro and maximum degrees Celsius, wind speed m / s, relative humidity% The results of the statistical analysis confirm that the water ration for the study area is based mainly on the X7 evaporation / netting variable, which is affected by a set of independent variables X1 Solar Brightness X4 X5 Extreme Temperature Wind Speed ​​3X Minimal Temperature and Very High Level .

IMMUNOTHERAPY FOR NSCLC: THE RIGHT TREATMENT FOR THE RIGHT PERSON

2019 ◽  
Vol 65 (1) ◽  
pp. 27-41
Author(s):  
Yelena Artamonova
Keyword(s):  
Life Expectancy ◽  
Tumor Cells ◽  
Advanced Nsclc ◽  
Objective Response ◽  
Combination Group ◽  
Line Treatment ◽  
Phase 3 ◽  
Median Response ◽  
The Right ◽  
High Level

Lung cancer is the leading cause of mortality from malignant tumors all over the world. Since most patients at the time of diagnosis already have stage III-IV of the disease, the search for new effective treatment strategies for advanced NSCLC is the most important problem of modern oncology. The results of the study of the anti-PD1 monoclonal antibody pembrolizumab were a real breakthrough in the treatment of NSCLC. In the KEYN0TE-001 study, the expression of PD-L1 on tumor cells was validated as a predictive biomarker of the drug's efficiency. Pembrolizumab demonstrated the possibility of achieving long-term objective responses, and a 4-year 0S with all histological types in the subgroup of pre-treated patients with PD-L1 expression> 50% was 24.8% and 15.6% in the PD-L1> 1% group. In a phase 2/3 randomized study KEYN0TE-10 in the 2nd line treatment of NSCLC with PD-L1 expression > 1% pembrolizumab significantly increased life expectancy compared to docetaxel and confirmed the possibility of longterm duration of objective responses, even after cessation of treatment. Then the focus of research shifted to the 1st line of treatment. About 30% of patients with NSCLC have a high level of PD-L1 expression on tumor cells and demonstrate the most impressive response to pembrolizumab therapy. A randomized phase 3 study KEYN0TE-024 compared the effectiveness of pembrolizumab monotherapy with a standard platinum combination in patients with advanced NSCLC with a high level of PD-L1 expression without EGFR mutations or ALK translocation. Compared with the platinum doublet the administration of pembrolizumab significantly increased all estimated parameters, including the median of progression-free survival (mPFS was 10.3 months versus 6 months; HR = 0.50; 95% CI 0.37-0.68, p < 0.001), the objective response rate (ORR 44.8% versus 27.8%), duration of response (in the pembrolizumab arm the median was not reached, in the chemotherapy (CT) group - 6.3 months). Despite the approved crossover, the use of pembrolizumab in the 1st line of treatment more than doubled the life expectancy of NSCLC patients with high PD-L1 expression as compared to CT: the median overall survival (OS) was 30.0 months versus 14.2 months (HR = 0.63, p = 0.002), 1-year OS 70.3% versus 54.8%; 2-year OS - 51.5% versus 34.5%. The remaining population to study were untreated patients with any level of PD-L1 expression. A randomized phase 3 study KEYNOTE-189 evaluated the effectiveness of adding pembrolizumab to the platinum combination in the 1st line treatment of non-squamous NSCLC without EGFR and ALK mutations with any PD-L1 expression. The addition of pembrolizumab to the standard 1st line CT significantly increased all estimated efficacy indicators including OS, PFS and ORR. After a median follow-up of 10.5 months the median OS in the pembrolizumab combination group was not reached and in CT group was 11.3 months. The estimated 12-months survival was 69.2% and 49.4% respectively (HR = 0.49; 95% CI 0.38-0,64; p <0.001). The median PFS was 8.8 months versus 4.9 months, alive 1 year without progression 34.1% and 17.3% of patients respectively (HR = 0.52; p <0.001). The ORR in the group with pembrolizumab reached 47.6% versus 18.9% in CT group, moreover the tumor regressions were much longer. Finally a randomized 3-phase study KEYN0TE-407 evaluated the effectiveness of adding pembrolizumab to 1st-line CT of NSCLC with squamous histology with any PD-L1 expression. As the first analysis showed, the addition of permboli-zumab significantly increased OS of patients with squamous NSCLC, median OS 15.9 months versus 11.3 months in the groups of pembrolizumab + CT and placebo + CT respectively (HR = 0.64; 95% CI 0,49-0.95; p = 0.0006), median PFS 6.4 months and 4.8 months respectively (HR = 0.56; 95% CI 0.450.70; p <0, 0001) and OrR 57.9% versus 38.4%, the median response duration 7.7 months versus 4.8 months. Thus, the convincing advantages of using pembrolizumab in 1st line therapy were demonstrated in 3 randomized phase 3 studies: in monotherapy of NSCLC of any histological subtype with high PD-L1 expression, and in combination with CT in squamous and non-squamous hystologies regardless of the level of PD-L1 expression.

Relations between carbon removal rates, biofilm size and density of a novel anaerobic reactor: the inverse turbulent bed

2000 ◽  
Vol 41 (4-5) ◽  
pp. 253-260 ◽  
Author(s):  
P. Buffière ◽  
R. Moletta
Keyword(s):  
Removal Rate ◽  
Removal Rates ◽  
Carbon Removal ◽  
Biofilm Growth ◽  
Loading Rates ◽  
Biomass Activity ◽  
High Turbulence ◽  
The One ◽  
High Level ◽  
Very High

An anaerobic inverse turbulent bed, in which the biogas only ensures fluidisation of floating carrier particles, was investigated for carbon removal kinetics and for biofilm growth and detachment. The range of operation of the reactor was kept within 5 and 30 kgCOD· m−3· d−1, with Hydraulic Retention Times between 0.28 and 1 day. The carbon removal efficiency remained between 70 and 85%. Biofilm size were rather low (between 5 and 30 μm) while biofilm density reached very high values (over 80 kgVS· m−3). The biofilm size and density varied with increasing carbon removal rates with opposite trends; as biofilm size increases, its density decreases. On the one hand, biomass activity within the reactor was kept at a high level, (between 0.23 and 0.75 kgTOC· kgVS· d−1, i.e. between 0.6 and 1.85 kgCOD·kgVS · d−1).This result indicates that high turbulence and shear may favour growth of thin, dense and active biofilms. It is thus an interesting tool for biomass control. On the other hand, volatile solid detachment increases quasi linearly with carbon removal rate and the total amount of solid in the reactor levels off at high OLR. This means that detachment could be a limit of the process at higher organic loading rates.

A Tight Connection Among Wealth, Income, Sustainability, and Accounting in an Ultra-Simplified Setting

2017 ◽  
Author(s):  
Martin L. Weitzman
Keyword(s):  
Economic Theory ◽  
Quantitative Relationship ◽  
Theoretical Relationship ◽  
Level Of Abstraction ◽  
Tight Connection ◽  
Basic Concepts ◽  
High Level ◽  
Very High

In theory, and under some very strong assumptions, there exists a tight quantitative relationship among the following four fundamental economic concepts: (1) ‘wealth’; (2) ‘income’; (3) ‘sustainability’; (4) ‘accounting’. These four basic concepts are placed in quotation marks here because a necessary first step will be to carefully and rigorously define what exactly is meant by each. This chapter reviews what is known about this important fourfold quantitative relationship in an ultra-simplified setting. It identifies some basic applications of this simplified economic theory of wealth and income (and sustainability and accounting). While the contents of this chapter are expressed at a very high level of abstraction and require many restrictive assumptions, the fundamental fourfold relationship it sharply highlights should be useful for conceptualizing, at least in principle, what is ‘wealth’ and what is its theoretical relationship to ‘income’, ‘sustainability’, and ‘accounting’.

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