Cardiac injury secondary to non-penetrating trauma is more common than thought, albeit, the injury is usually minor and goes undiagnosed without significant sequelae in most cases. Blunt cardiac ...rupture is much rarer accounting for <0.05% of all trauma cases but lethal in most circumstances. We present a case report of a young trauma victim who presented with both right atrial rupture and traumatic atrial septal disruption (ASD) requiring extra-corporeal life support (ECLS) and surgical repair.
Blunt cardiac trauma with chamber rupture and septal disruption is a devastating injury. Stopping the hemorrhage and using ECLS gave our patient time to stabilize before definitive management of her traumatic ASD.
In view of solving in a closed form initial and/or boundary value problems of interest in nonlinear hyperbolic and dissipative wave processes it is considered a reduction approach based upon ...appending differential constraints to quasilinear nonhomogeneous hyperbolic systems of first order PDEs. In this context a governing model of traffic flow is analyzed thoroughly and a classification of possible constraints along with sets of consistent response functions involved therein is worked out whereupon the classes of corresponding exact solutions are determined. To some extent these solutions generalize the classical simple wave solutions and may also incorporate dissipative effects. Furthermore, in order to solve a Riemann Problem, an exact rarefaction wave-like solution is built. Finally an application of the results to the so-called “green traffic light problem” is also illustrated.
Mass drug administration (MDA) of praziquantel is one of the main control measures against human schistosomiasis. Although there are claims for including pregnant women, infants and children under ...the age of 5 years in high-endemic regions in MDA campaigns, they are usually not treated without a diagnosis. Diagnostic tools identifying infections at the primary health care centre (PHCC) level could therefore help to integrate these vulnerable groups into control programmes. freeBILy (fast and reliable easy-to-use-diagnostics for eliminating bilharzia in young children and mothers) is an international consortium focused on implementing and evaluating new schistosomiasis diagnostic strategies. In Madagascar, the study aims to determine the effectiveness of a test-based schistosomiasis treatment (TBST) strategy for pregnant women and their infants and children up until the age of 2 years.
A two-armed, cluster-randomized, controlled phase III trial including 5200 women and their offspring assesses the impact of TBST on child growth and maternal haemoglobin in areas of medium to high endemicity of Schistosoma mansoni. The participants are being tested with the point of care-circulating cathodic antigen (POC-CCA) test, a commercially available urine-based non-invasive rapid diagnostic test for schistosomiasis. In the intervention arm, a POC-CCA-TBST strategy is offered to women during pregnancy and 9 months after delivery, for their infants at 9 months of age. In the control arm, study visit procedures are the same, but without the POC-CCA-TBST procedure. All participants are being offered the POC-CCA-TBST 24 months after delivery. This trial is being integrated into the routine maternal and child primary health care programmes at 40 different PHCC in Madagascar's highlands. The purpose of the trial is to assess the effectiveness of the POC-CCA-TBST for controlling schistosomiasis in young children and mothers.
This trial assesses a strategy to integrate pregnant women and their children under the age of 2 years into schistosomiasis control programmes using rapid diagnostic tests. It includes local capacity building for clinical trials and large-scale intervention research.
Pan-African Clinical Trial Register PACTR201905784271304. Retrospectively registered on 15 May 2019.
Decompression of Chiari malformation is a common procedure in both pediatric and adult neurosurgery. Although the necessity for some bony removal is universally accepted, other aspects of Chiari ...surgery are the subject of debate. The most controversial points include the optimal amount of bony removal, the use of duraplasty (and the type of material), the need for subarachnoid dissection, and the need for tonsillar shrinkage.
We critically reviewed the literature to elucidate the risks and benefits of different graft types and to clarify optimal treatment options therein. Based on our search results, 108 relevant articles were identified. With specific inclusion and exclusion criteria, we noted three studies that directly compared two tlpes of dural substitutes in Chiari malformation surgery.
Our review did not support the superiority of either autologous or nonautologous grafts when duraplasty is employed. Our institutional experience, however, dictates that when the pericranium is available and of good quality, it should be utilized for duraplasty. It is non-immunogenic, inexpensive, and capable of creating a watertight closure with the dura.
Discrepancies between the three comparative studies analyzed are likely attributable to increases in pericranial quality and thickness with maturity. Future randomized studies with large numbers and the power to resolve differences in the relatively low rates of complications in Chiari surgery are warranted.
By means of a reduction approach to 2 × 2 quasilinear hyperbolic homogeneous systems of first-order PDEs, a full and exhaustive analysis of nonlinear wave interactions is achieved. The alteration in ...the profile as well as in the wave time distortion of the emerging pulses caused by the interaction process is illustrated in detail through exact solutions of initial value problems. Canonical forms of 2 × 2 systems which allow for special (soliton-like) hyperbolic wave interactions and of interest in applications are also determined.
Multiple-reflection time-of-flight mass spectrometers (MR-TOF-MS) have been demonstrated to have a mass resolving power in the range of few hundreds of thousand. The TITAN MR-TOF-MS has been used to ...separate isobaric impurities and measure masses of many rare isotopes. Recently we have measured the mass and half-lives of neutron-rich Rubidium isotopes with the MR-TOF-MS. This technique is capable of measuring the half-life of rare isotopes in the range of few tens of millisecond. In this proceeding, we present the measurement of half-life of 100Rb that was found to be 50±5 ms, in good agreement with literature value of 48±3 ms.
Objectives. Interventions that address inequalities in health care are a priority for public health research. We evaluated the impact of the Regional Health Care Evaluation Program in the Lazio ...region, which systematically calculates and publicly releases hospital performance data, on socioeconomic differences in the quality of healthcare for hip fracture. Design. Retrospective cohort study. Settings and participants. We identified, in the hospital information system, elderly patients hospitalized for hip fracture between 01 January 2006 and 31 December 2007 (period 1) and between 01 January 2009 and 30 November 2010 (period 2). Main outcome measures. We used multivariate regression models to test the association between socioeconomic position index (SEP, level I well-off to level III disadvantaged) and outcomes: mortality within 30 days of hospital arrival, median waiting time for surgery and proportion of interventions within 48 h. Results. We studied 11 581 admissions. Lower SEP was associated with a higher risk of 30-day mortality in period 1 (relative risk (RR) = 1.42, P = 0.027), but not in period 2. Disadvantaged people were less likely to undergo intervention within 48 h than well-off persons in period 1 (level II: RR = 0.72, P < 0.001; level III: RR = 0.46, P<0.001) and period 2 (level II: RR = 0.88, P = 0.037; level III: RR = 0.63, P< 0.001). We observed a higher probability of undergoing intervention within 48 h in period 2 compared with the period 1 for each socioeconomic level. Conclusion. This study suggests that a systematic evaluation of health outcome approach, including public disclosure of results, could reduce socioeconomic differences in healthcare through a general improvement in the quality of care.
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