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Open access

Neha Gupta and Chrystal Rutledge

Abstract

Pyruvate dehydrogenase complex deficiency (PDCD) is a rare neurodegenerative disorder associated with abnormal mitochondrial metabolism. Structural brain abnormalities are common in PDCD. A case of a patient with PDCD with an unusual presentation is described. A 20-month-old boy with hypotonia and developmental delay, presented with hypoxia and respiratory distress due to bronchiolitis. During hospitalisation, he was prescribed PediaSure® feeds. Two days after starting these feeds, he developed respiratory arrest requiring intubation. His blood gas before arrest revealed lactate of 8.9 mmol/L despite normal haemodynamics. After stabilisation and a period of compulsory fasting, subsequent feeding with PediaSure® resulted in the recurrence of lactic acidosis. A metabolic workup revealed an elevated serum pyruvate level. Brain MRI was normal. Skeletal muscle biopsy confirmed PDCD. The most common cause of PDCD is a mutation in the X-linked PDHA1 gene. The severity of PDCD can range from neonatal death to more delayed onset of symptoms as in our index case. Normal brain MRI is reported in only 2% of patients with PDCD. There is no effective treatment for PDCD. In patients with proximal muscle weakness and feeding intolerance with glucose-containing feeds, the presence of lactic acidosis should raise the suspicion of PDCD irrespective of the patient's age and normal MRI.

Open access

Shane Belvedere

Abstract

Introduction

Phlegmasia cerulea dolens (PCD) is a severe, rare complication of deep vein thrombosis, which is characterised by compartment syndrome, arterial compromise, venous gangrene, and shock. Prothrombotic states are the primary risk factor for PCD, which, in most cases, is associated with pulmonary embolism and carries a high mortality.

Case report

A 46-year-old male presented following a pulseless electrical activity (PEA) arrest due to saddle pulmonary embolism (PE). He subsequently developed PCD and venous gangrene secondary to inferior vena cava obstruction, in the setting of a new diagnosis of testicular germ cell tumour.

Discussion

PEA arrest, as the initial presenting problem in malignancy, is rare. It is extreme for the first indication of cancer to be a PEA arrest from massive PE. While hypoxic brain injury from the cardiac arrest precluded intervention in this case, a surgical approach entailing en bloc resection of aortocaval metastasis, with subsequent IVC reconstruction, followed by lower limb venous thrombectomy would have been favoured as it was considered that an endovascular approach would not have been successful.

Conclusion

A case of a patient with phlegmasia cerulea dolens secondary to testicular cancer, who presented following PEA arrest is described.

Open access

S. Abrakasa and H.O. Nwankwoala

Abstract

Some oil samples from various Nigerian oil fields were examined for the presence of Thermochemical Sulphate Reduction (TSR) derived organo sulphur compounds. Oil samples were diluted with DCM and injected into the GC–MS for full scan analysis. The GC–MS results show the presence 2–thiaadamantane, 1–methyl-2-thiaadamanatane and 5–methyl-2-thiaadamanatane, the compounds were identified by comparison of extracted spectras with literature. The presence of these compounds in oils has been accepted on a wider horizon as indicators of reservoir souring. The plot of 5–Methyl-2-thiaadamantane/Adamantane and Dibenzothiophene/Adamanatane showed a fair correlation, corroborating the presence of 5–Methyl-2-thiaadamantane and fairly high abundance of Dibenzothiophene, the plot of 2-thiaadamantane/Adamantane and 5–Methyl -2-Thiaadamantane/Adamantane corroborating the presence of 2-thiaadamantane and 5–Methyl -2-Thiaadamantane inferring that the presence of 2-thiaadamantane and 5–Methyl -2-Thiaadamantane indicate that reservoir souring is active.

Open access

Buti Y. Christy, Dewi I. Roesma and Dahelmi

Abstract

Tetragonula a genus in the Meliponini tribe (Apidae), is difficult to identify due to the many cryptic species. As technology develops, molecular taxonomic studies are used to help identify species with limited morphological characteristics. This study presents an analysis of the phylogenetic relationship between several species in the Tetragonula genus based on the sequences of the cytochrome b gene. Maximum parsimony, neighbor joining, maximum likelihood and minimum evolution methods were used to construct phylogenetic trees. The sequence divergence between T. minangkabau collected from Limau Manis and Ulu Gadut is 0.8%, while between T. minangkabau with T. minangkabau forma darek 5.5%. The low sequence divergence indicated that T. minangkabau and T. minangkabau forma darek have a close phylogenetic relationship. The analysis showed that Tetragonula (T. minangkabau, T. minangkabau forma darek, T. laeviceps, T. drescheri and T. fuscobalteata) is monophyletic. A sequence divergence of 5.5% supports the separation of Tetragonula minangkabau and T. minangkabau forma darek.

Open access

Barbara Zupanc Terglav, Špela Selak, Mitja Vrdelja, Boris Miha Kaučič and Branko Gabrovec

Abstract

Introduction. Patients’ satisfaction has a very important role regarding reforms of the healthcare system, which aim at improvement of health and optimisation of costs. Informed patient is one of the factors which notably influences patients’ satisfaction.

Aim. To determine the level of satisfaction of Slovenian residents with the current healthcare system and how well informed they are about the draft law changes to the Healthcare and Health Insurance Act, debated in public in 2017.

Methods. A descriptive, non-experimental sampling method was used (snowball method). A structured questionnaire was used as a measurement tool. The number of 488 persons finished the entire online questionnaire. The data were analysed using the SPSS programme, version 21 (significance level p<0.05), and using descriptive statistics, correlation analysis, t-test and linear regression analysis.

Results. Slovenian residents are fairly (un)satisfied with the current healthcare system. Waiting lines affect satisfaction with the current health care system the most, followed by the level of trust in a doctor’s decision concerning treatment and the level of respectfulness in the communication of healthcare workers with patients. Although respondents are less informed about the proposed changes, they support the draft law changes to a high degree. They perceive the information provided on the proposed changes in healthcare as relatively understandable and evaluate them positively. Television is the most important source of information on law changes in healthcare.

Discussion and conclusions. Slovenian residents support the public healthcare system to a very high degree and are less in favour of private healthcare. In the future, more attention needs to be directed towards the related strategic communication and the choice of communication channels with the planned changes in healthcare.

Open access

Paweł Węgrzynowicz, Dariusz Gerula, Adam Tofilski, Beata Panasiuk and Małgorzata Bieńkowska

Abstract

The identification of honey bee (Apis mellifera) subspecies is often based on the measurements of workers’ fore-wings. The interpretation of the measurements can be difficult because the phenotype of workers is affected by both genetic and environmental factors. Moreover, it is not clear how the phenotype is affected by maternal inheritance. We have used the methodology of geometric morphometrics to verify if hybrids of honey bee subspecies and their backcrosses are more similar to either the father or mother colony. The comparison was based on fore-wing venation of three honey bee subspecies: A. m. carnica, A. m. caucasica, A. m. mellifera. First generation hybrids and backcrosses of those subspecies were obtained through instrumental insemination. Workers of the hybrids were compared with their parental colonies. The shape of wing venation was more similar to the maternal than to parental colony. This phenomenon was particularly visible in first generation of hybrids but it was also present in backcrosses. There were also symptoms of genetic dominance of some subspecies but this effect interacted with maternal inheritance and was difficult to interpret.

Open access

Paulo Araldi, Carlos Eduardo Tino Balestra and Gustavo Savaris

Abstract

The present study aimed to analyze the interference of different curing conditions on the development of the concrete compressive strength under the perspective of construction management. It is known that the conditions of humidity and temperature are the main factors related to the behavior of the concrete strength, so that modifying these parameters directly affects the material’s behavior and, consequently, construction management. Forty-two specimens of concrete were molded and each 6 specimens were submitted to different temperature and humidity conditions. The first group was oven-cured at a temperature of 100°C. The second and third groups were kept at ambient temperature of 23 + 2°C being that the latter was submerged in water and the former was exposed to the air humidity. The specimens of groups 4 and 5 were placed in a freezer at 5°C. Group 4 was submerged in water and group 5 was not. The curing of group 6 occurred under submerged condition with water at about 100°C. Group 7, on the other hand, was cured in water vapor. The group submitted to curing at room temperature and submerged condition was the one with the highest compressive strength value, while the ones with the lowest compressive strength were the groups of samples cured in the oven and those submerged at 100°C. The results were compared and tested using statistic methods, which proved that the curing conditions directly affected concrete properties.

Open access

Cristina Petrișor, Sebastian Trancă, Andreea Cordoș and Vasile Bințințan

Abstract

Introduction

Patient-controlled analgesia with morphine is routinely used for postoperative pain management. Due to the safety profiles of the technique, which are patient/disease related or technique/equipment related, severe respiratory depression requiring opioid antagonists or airway management are uncommon.

Case presentation

The case of a patient with right colon carcinoma who was operated on for hemicolectomy under general anaesthesia and who presented with apnoea, after postoperatively receiving an initial bolus of 1mg of morphine. A large post-traumatic porencephalic cyst of the left brain hemisphere, previously undiagnosed, was found on the computed tomography scan. We excluded human errors, technique and equipment factors, and the patient did not have any other predisposing conditions like sleep apnoea, obesity, recent head injury or concurrent use of other sedatives. Previously the patient had been entirely asymptomatic, and her increased susceptibility to respiratory depression was the only clinical manifestation of porencephaly.

Conclusion

Adult acquired porencephaly is seldom reported in the literature, clinical manifestations depending on the location and size of the cyst. In the present reported case, increased susceptibility to low-dose opioids might be associated with the structural and functional reorganisation of the brain after head trauma with the occurrence of the porencephalic cyst of the brain.

Open access

Lara N. Schulze, Sandra Van der Auwera, Deborah Janowitz, Johannes Hertel, Katharina Wittfeld, René Walk, Nele Friedrich, Henry Völzke and Hans J. Grabe

Abstract

Objectives

Obesity is associated with several somatic diseases and increased psychological burden. This study focused on two potential psychological predictors of the body mass index (BMI), childhood trauma and depressive symptoms.

Methods

We used three independent populations: two general population samples (Study of Health in Pomerania, SHIP-2, N = 1,657; SHIP-TREND-0, N = 3,278) and one patient sample (GANI_MED, N = 1,742). Childhood trauma was measured with the childhood trauma questionnaire (CTQ) and depression with the Beck Depression Inventory (BDI-II) in SHIP-2 and the Patient Health Questionnaire (PHQ-9) in SHIP-TREND-0 and GANI_MED. We investigated the impact of childhood trauma and depression on BMI. Furthermore, we used mediation analysis to assess whether depression was a significant mediator on the path from childhood trauma to adult BMI in each of the three samples.

Results

In all the three populations, depressive symptoms exhibited a significant association towards higher BMI (p < 0.05). Childhood trauma was positively associated with BMI with significant associations in SHIP-TREND-0 (p < 0.001) and GANI_MED (p = 0.005). The relationship between CTQ and BMI was significantly partially mediated (p < 0.05) by depressive symptoms in SHIP-TREND-0 (38.0%) and GANI_MED (16.4%), in SHIP-2 results pointed in the same direction. All the trauma sub-dimensions, except sexual abuse, exhibited at least one significant association towards increased BMI in one of the samples.

Conclusions

Childhood trauma and depressive symptoms may be considered as causes of obesity. These results suggest that psychological treatments against obesity should address childhood maltreatment as well as depressive symptoms in their diagnostic assessment and could facilitate psychotherapeutic treatment when necessary.