Search

AimsTo assess vision-related (VR-QOL) and health-related quality of life (HR-QOL) in a large series of patients with de novo uveitis at baseline and 6-month follow-up.MethodsNon-inferiority, prospective, multicentre, cluster randomised controlled trial registered under the Unique Identifier: NCT01162070. VR-QOL and HR-QOL were assessed by the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) and the Medical Outcomes Study 36-item Short Form Survey (SF-36).ResultsAt inclusion, 466 patients completed the VFQ-25. The mean composite score was 80.0 (±16.7). In multivariate analysis, higher age, female sex and insidious onset were significantly associated with lower QOL. At 6 months, 138 patients completed the VFQ-25, with a significantly higher mean composite score of 82.6 (±16.7). SF-36 mental component was 42.9 (±11.3) and physical component was 47.2 (±8.5) at inclusion (n=425). HR-QOL improvement at 6 months was not clinically significant.ConclusionQOL seems relatively well preserved in this cohort; only VR-QOL improved significantly at 6 months, especially in patients with low initial visual acuity.

The clinical diagnosis of a torsion of an ectopic testicle is difficult. Lack of knowledge on this pathology is often a cause of late diagnosis and can have serious consequences. This diagnosis should be made in front of any acute pelvic or inguinal pain in children with an ectopic testicle, regardless of age. We report a case of late presentation of a 6 month-old infant with torsion of an ectopic testicle leading to testicular necrosis.

Solitary bone plasmacytoma is a rare plasmocytic neoplasm accounting for about 5% of all plasmocytic neoplasms. It is usually presented as a lytic lesion mainly localized in the axial skeleton. Its presence in adolescents is extremely rare. It is unheard of in children. We report a case of solitary plasmacytoma of the iliac bone in a 7-year-old girl with a history of trauma to the iliac bone.

Background: Heavy schoolbag is known to cause health problems for school children. The aim of this study was to determine the effects of carrying heavy schoolbags on the musculoskeletal pain among primary school children of the two subsystems in Yaounde, Cameroon. Methods: A cross-sectional study was carried out in primary schools in Yaounde. A total of 457 school-children (8.2 ± 2.2 years) were included, 202 from the French-speaking subsystem, and 255 from the English-speaking subsystem. Parameters studied included weight, height, and schoolbag weight. A questionnaire was used to collect socio-demographic information and potential musculoskeletal pain in three regions: back, shoulders, and neck. Results: The mean weight of children and their bags was 28.4 ± 8.2 kg and 5.2 ± 2.3 kg respectively. More than 50% of schoolchildren in the two subsystems carried a schoolbag weighing more than 15% of body weight. The back (38%) was the least affected area in comparison to the shoulders (58.6%) and neck (42.4%) (p < 0.001). Carrying heavy bags and walking to school was associated with pain in the back, shoulders, and neck. School-children in the French-speaking subsystem had lower risk (adjusted Odds Ratio 0.438, 95% CI = 0.295-0.651; p < 0.001) to develop a sore neck compared to peers from the English-speaking subsystem. Conclusion: Carrying heavy schoolbags is associated to musculoskeletal pain in schoolchildren. The means moving to and from school is a main risk factor of developing musculoskeletal pain. French-speaking schoolchildren develop less neck pain than English-speaking schoolchildren.

This paper summarizes certain of the provisions of the FFCA and CARES Act that are most relevant to nonprofit organizations.

The primary abscess of the psoas of the child is a rare affection, the pathogenesis of which is still unexplained. The positive diagnosis of this condition is difficult and relies mainly on medical imaging. We report a case of primary psoas abscess in an immunocompetent child, whose diagnosis was facilitated by the provision of abdominal radiography without preparation and abdominal ultrasound. The evolution was favorable thanks to the combination of antibiotic therapy and surgery.

Objective: To analyze our experience in the management of ovarian hernia in children. Methods: It was a retrospective study about 11 cases treated in pediatric surgery unit of the Teaching Hospital of Bouake, in 2 years period. Results: Ovarian hernia represented 7.69% of the hernias and 73.33% of the hernia cases in girls. The mean age was 4 years and the median 36 months. The main reason for consultation was inguinal swelling (45.45%) following by swelling of the labia majora (36.36%), and a round mass of labia majora palpated by parents while bathing the child (18.18%). Nine (9) patients had been operated on; we realize the closure of peritoneo-vaginal canal, associated in 66.66% cases with a routine surgical exploration of the contralateral side. Average age of these children with contralateral hernia was 20 months. The mean follow up was 6 months (15 days - 15 months). We noticed an appearance of contralateral ovarian hernia in a girl operated on at 3 years old without routine surgical exploration. Conclusion: We recommend early management with a systematic surgical exploration of the contralateral side in young female child. A preoperative ultrasonography could be a routine in case of strangulated hernia, if available.

Osteomyelitis is a frequent pathology in the pediatric population. It is usually located on the fertile metaphyses of the long bones. However, there are rare locations such as short and flat bones. We report a case of chronic suppurative osteomyelitis in a scapular location in a 2-month-old infant with a late diagnosis. The identified germ was Staphylococcus aureus. The X-ray showed images of osteolysis of the scapula. Treatment consisted of double antibiotic therapy and drainage of the abscess with bone sequestrectomy, supplemented by immobilisation. The evolution was favorable after 2 years.

Objective Uveitis is the most common ophthalmological finding in the practice of rheumatology and clinical immunology. The condition is frequently idiopathic but about 60 causes of uveitis have been described. Our aim was to analyze the clinical patterns and etiologies of uveitis in a tertiary referral center. Methods The records of 912 consecutive patients referred to the department of internal medicine (Lyon University Hospital, Lyon, France) for the diagnostic work-up of uveitis were examined. Demographic, clinical, anatomical, and etiological features of uveitis were analyzed. Results The mean age at onset was 48.8 years; 59.8% of the patients were women and 78.2% were Caucasians. Anterior uveitis was the most common type of uveitis (40.6%), followed by panuveitis (31.7%), posterior (18.75%) and intermediate uveitis (9%). 46.9% of the patients had idiopathic uveitis. The most common etiologies were systemic diseases (37.3%), such as sarcoidosis (17.1%), HLA-B27-related uveitis and/or spondyloarthritis (12.5%), and tuberculosis (7.5%). Conclusion We describe one of the largest cohorts of consecutive uveitis patients referred to a department of internal medicine. The high percentage of uveitis associated with underlying (systemic) diseases highlights the need for a multidisciplinary approach, in order to reduce the diagnostic delay.

On October 19, 2018, the Internal Revenue Service and the U.S. Department of the Treasury issued proposed regulations under section 1400Z-2 of the Internal Revenue Code regarding the qualified opportunity zone program. This paper summarizes some of the most important aspects of the proposed regulations.

Approximately 48% of all fatal collisions in Europe are classified as single-vehicle run-off-road or head-on collisions. These crashes relate to trajectory control (road departure) and represent a safety challenge. In France, single-vehicle run-off-road crashes represent 21% of all crashes and head-on collisions represent 11%. This study evaluated the effectiveness of four perceptual treatments (i.e., a painted center line, post-delineators, rumble strips on both sides of the center line and sealed shoulders) in supporting the driver to maintain lateral control; that is, to support the driver to keep in the center of his/her lane. Forty-three participants drove a fixed-base driving simulator, on a simulated straight 3 km rural road with two crest vertical curves (CVC). Four sections were chosen for analysis: a reference section (i.e., the first CVC), a test section (i.e., the second CVC), a pre-test section (i.e., immediately before the second CVC) and a post-test section (i.e., immediately after the second CVC). The results showed that drivers drive more at the center of their lane with the rumble strips on both sides of the center line and with the sealed shoulders than with the actual marking (here center line) or other treatments.

The sole aim of media is to make as much money as they can. Or again, the media are to serve only the people in power, political or economic. If you agree to that, you might as well stop reading this. This issue of Pacific Journalism Review is predicated on the principle that media should serve the public. Journalists can only achieve that if they enjoy independence from financial and political pressures. It is not often enough underlined that they cannot enjoy that independence without the support of the public, the masses of voters and consumers. There is no way the profession can obtain public support unless it listens to readers/listeners/viewers— unless it is accountable to them.

To investigate the origin of the susceptibility to noise in subjects with histories of otitis media (OM), we assessed early sub-clinical impairments in normally hearing subjects with a history of OM using distortion product otoacoustic emissions (DPOAEs). DPOAEs of 213 normal-hearing subjects aged 18–24 years were obtained and comparisons of DPOAE levels in several groups as a function of OM past infections were tested by ANOVA. A main finding was that young normal-hearing subjects with a history of OM had significantly lower DPOAEs over all octaves tested compared to normal-hearing subjects without antecedent of OM. The mean difference was 3.5±1.1 dB in the 2–4 kHz zone, which was especially marked in subjects ( n =21) that had undergone a myringotomy (6.6±1.5 dB) in the 4 kHz zone. The level of impairment seemed to depend on the severity of the past infection as characterised by the importance and the duration of the infectious effusions.

Summary Increasing survival of very preterm and sick neonates has lead to more concern about development outcome. Risk factors include antenatal, perinatal and socioeconomic factors. Developmental assessment has to be repeated during infancy till late school age (at term 3, 6, 12, 18, 42 months corrected age…). Neurological examination, sensorial assesment and cognitive evaluation with special attention to visuo-spatial factors are mandatory.

Premature birth is a factor of impaired infant-parent attachment. In addition it is frequently associated with other factors of impaired attachment related either to the infant (mainly the various pathologies of the premature infants and the hospitalization) and/or to the parents, specially the mother. The main characteristics of the normal process of infant-parent interaction are described as a basis for the early recognition and assessment of impaired interaction and preventive intervention.

Objective. To compare the hospital course and clinical outcome of preterm infants with respiratory distress syndrome treated with surfactant and managed with high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CV) as their primary mode of ventilator support. Design. A prospective randomized clinical trial. Setting. Three community-based level III neonatal intensive care units. Subjects. A total of 125 neonates who were 35 weeks or less estimated gestation requiring intubation and assisted ventilation for respiratory distress syndrome with arterial to alveolar oxygen ratio less than .50. Interventions. Patients were randomized to continue CV (61 patients) or be changed to HFOV (64 patients) after exogenous surfactant administration (100 mg/kg). HFOV was used in a strategy to promote lung recruitment and maintain lung volume. Protocol respiratory care guidelines were followed; otherwise routine care was provided by each neonatal intensive care unit. Measurements and Main Results. No differences were noted in demographic features between the two study groups. The study population birth weight was 1.51 ± .47 kg (mean ± SD), gestational age was 30.9 ± 2.5 weeks, and study entry age was 2 to 3 hours. Patients randomized to HFOV demonstrated the following significant findings compared with CV-treated patients: vasopressor support was less intensive; surfactant redosing was not as frequent; oxygenation improved more rapidly and remained higher during the first 7 days; fewer infants required prolonged supplemental oxygen or ventilator support; treatment failure was reduced; more patients survived without chronic lung disease at 30 days; need for continuous supplemental oxygen at discharge was less; frequency of necrotizing enterocolitis illness was lower; there were fewer abnormal hearing tests; and hospital costs were decreased. No differences were seen between the two study groups in the frequency or severity of patent ductus arteriosus, air leak, retinopathy of prematurity, or intraventricular hemorrhage. Length of hospital stay and survival to discharge were similar for HFOV- and CV-treated infants. Conclusions. When used early with a lung recruitment strategy, HFOV after surfactant replacement resulted in clinical outcomes consistent with a reduction in both acute and chronic lung injury. Benefit was evident for preterm infants both less than or equal to 1 kg and more than 1 kg. In addition, early HFOV treatment may have had a more global effect on patient health throughout the hospitalization, resulting in reduced morbidity and decreased health care cost.

The mass media continue to be among the most crucial instruments for the practitioner of public relations, and, to be sure, among the most frustrating. How are the media changing? How will those changes affect public relations? And should there be new public policies about mass media in a twenty-first century where technical, political, social, and economic realities will be radically different from previous centuries, including the twentieth? Although most public relations professionals have shied away from public criticism of the media, and have not been vocal advocates for changing public policies about media, nevertheless they need answers to the questions raised above. In this thoughtful essay, Claude-Jean Bertrand looks at a possible mass media half a century from now and provides a dream scenario. Unfortunately, Professor Bertrand describes some “twentieth-century” public relations practices as part of the “old” problems and “dreams up” some changes in those practices, as well. It may be that a public relations professional or professor should write an essay devoted to a dream scenario for public relations in 2045. The Public Relations Review invites such commentary.

This paper describes various hedge fund structures, and discusses the federal income tax treatment of hedge funds, their investors and their managers.

ISBN 978-1-4244-5839-4; International audience; The SoCKET project (SoC1 toolKit for critical Embedded sysTems)2 gathers industrial and academic partners to address the issue of design methodologies for critical embedded systems. They work towards the definition of a “seamless” design flow which integrates qualification and certification, from the system level to integrated circuits and to software. This paper sketches such a design flow and the associated methodologies, and briefly describes its application to industrial case studies.

Total cortisol as well as percentage and absolute free cortisol values were determined in 75 full-term, 88 premature and 38 small-for-age (born at term) infants in the first 3 months of life. Equilibrium dialysis and radioimmunoassay were used to estimate the percentage value of the unbound fraction and the value of total cortisol from which absolute free cortisol level was calculated, respectively. A systematic decrease in the free cortisol value was observed in all the three groups of infants during the study period (in full-term infants from 32.3 to 19%, in prematures from 36.6 to 20.8%, and in small-for-age infants from 32.3 to 19.2%). A comparison between the percentage values of free cortisol in the groups studied revealed only slight differences which were not significant. The absolute free cortisol values in full-term infants were highest immediately after birth (4.05 micrograms/dl), then they fell to the lowest level of 0.67 micrograms/dl observed between the third and fifth days of life, and increased afterwards reaching the level of 1.89 micrograms/dl in the third month. The absolute free cortisol values in premature newborns at 3-5 days of life exceeded the values observed in full-term subjects. The pattern of free cortisol in the prematures seems to be 'delayed' as compared with that in full-term newborns. The absolute free cortisol values in small-for-age infants were much more similar to those found in the full-term subjects, than to those in premature babies.

Objectives: To follow up the auditory status of military personnel after an acute acoustic trauma and to identify the possible predictive value of hearing thresholds and otoacoustic emissions during the first 24 hours after the acoustic trauma. Study Design: A group of 24 young military subjects, aged 22 ± 2.3 years, without any otologic problem before the acoustic trauma, were examined at three time intervals after an accidental acoustic trauma caused by the discharge of a firearm: 24 hours, 72 hours, and 15 days. Methods: Each subject was submitted to medical examination and to a questionnaire detailing the circumstances of the acoustic trauma. Pure tone audiometry was performed from 1 to 8 kHz per half octave. Transiently evoked otoacoustic emissions were recorded in the nonlinear mode at 80 dB pSPL, and distortion product otoacoustic emissions were recorded from 1 to 6 kHz, using a distortion product-gram type procedure, at 65/55 dB SPL, with f2/f1 = 1.22. Two groups of subjects were defined: group 1 (n = 8) represented subjects with short-lasting tinnitus ( 72 h). Results: Hearing thresholds did not differ significantly between these two groups 24 hours after the acoustic trauma. However, otoacoustic emissions showed significantly lower amplitudes 24 hours after the acoustic trauma in subjects showing a longer lasting tinnitus. Conclusion: Otoacoustic emissions appear to be a better predictor of the persistence of tinnitus than hearing thresholds alone 24 hours after an acute acoustic trauma.

A peripheral left‐right assymetry has been shown at the cochlear level: Transiently evoked otoacoustic emissions (TEOAEs) amplitudes are greater in the right ear than in the left ear of right‐handed subjects, whereas no difference is obtained in left‐handed subjects (Khalfa et al., 1998). This study sought to investigate a possible link between peripheral auditory assymetry and hemispheric laterality assessed by a dichotic listening task. Peripheral auditory laterality was investigated by comparing TEOAEs from both ears of each subject in 289 normally hearing subjects, with 94 left‐handed subjects (52 women), and 194 right‐handed subjects (129 women). Results show significantly greater OAE amplitude in right ear than in left ears for both right‐handers (12.93 dB, SD=4.46 versus 11.89, SD=4.6) and left‐handers (11.62 SD=3.8 versus 10.44, SD=3.8, whereas average hearing loss across frequencies did not show any significant difference. However, in the left‐handers, only the subgroups of subjects presenting a ...

American media, in the face of the Grenada invasion “lockout”; and the Westmoreland/Sharon libel actions, seem to be running scared. No longer are there accusations of “imperial media,”; as newspapers, radio, and television news consumption decline. Media response is to look to ethics. Media should learn that corporate consciousness is less important in guiding the medium than is service to public or audience.

A randomized study of two protocols of human chorionic gonadotropin (hCG) treatment was performed in 183 prepubertal boys between 7 months and 12 years of age: protocol I, in which the boys were given 7 injections of 1,500 IU every other day, and protocol II consisting of 4 injections of 100 IU/kg at 4- to 5-day intervals. In both protocols, by the end of the test, testosterone had risen significantly to values within the normal adult male range. However, the amplitude of the rise was slightly but significantly lower using protocol II (4.08 ± 2.07 ng/ml) than protocol I (5.16 ± 2.73 ng/ml). It would thus appear that repetition of the hCG injection at intervals of less than 4 days is unnecessary, and that a total stimulation period of 2–3 weeks is sufficient. Although not correlated with testosterone levels, the success rates for treatment were similar in both protocols and comparable to rates reported in the literature.

Gonadotropins, prolactin (PRL), testosterone (T), Δ4-androstenedione, dehydroepiandrosterone sulfate and cortisol (F) levels were determined from 14 days before birth to term in 3 female an

SUMMARY The concentration of oestrone (E1) and oestradiol (E2) in plasma was measured by a radioimmunological method. In five premenopausal women, ovariectomy provoked a significant fall in the concentrations of E1 and E2. In 11 subjects of both sexes with cancer, dexamethasone (20 μg/kg/day) caused a significant fall in the levels of cortisol (84 ± 9·5%) and E1 (55 ± 16%), but not in E2 (2 ± 18%). Ninety minutes after administration of tetracosactrin, the increase in concentration of cortisol (80 ± 30%) and of E1 (70 ± 49%) was highly significant: that of E2 (5 ± 12%) was not. Similar results were observed in four subjects during infusion of corticotrophin. In six subjects, plasma concentration of E1, androstenedione and dehydroepiandrosterone was higher in the adrenal vein than in a peripheral vein, but the concentration of E2 and of testosterone was similar in the two samples. In two men, the concentration of androgens and oestrogens was measured in plasma from a peripheral vein and in plasma of mixed origin from the renal and the spermatic vein. The level of E2 was higher in plasma from the renal—spermatic mixture than in that from the peripheral vein, but the concentration of E1 was similar. All these results suggest that: (1) the adrenal secretes only 17-oxo androgens and oestrogens whereas in the testicular secretion, 17β-hydroxylated compounds predominate; (2) in men, nearly all of the E2 is secreted directly or indirectly by the testes, but the main source of E1 is the adrenal; (3) in postmenopausal women, most of the E1 also derives from the adrenal gland.

Plasma free dehydroepiandrosterone (DHA), androstenedione (delta), testosterone (T), dihydrotestosterone (DHT), estrone (E1), and estradiol (E2) were measured by radioimmunoassay in 55 boys and 54 girls 3.5 to 16.3 years of age. Plasma DHA increased significantly between 6 and 8 years of age in girls and between 8 and 10 years of age in boys. A further significant increase was noted between 10 and 12 years of age in both sexes. Delta rose significantly between 8 and 10 years of age in girls and between 10 and 12 years in boys. In contrast, no significant increase in T, DHT, or E1, was noted prior to 12 years of age in both sexes. However, E2 showed a significant increase between 10 and 12 years of age in girls. This early rise in the course of pubertal development of the two sex steroids predominantly of adrenal origin, DHA and delta, and its occurence 1 to 2 years earlier in girls than in boys, as does puberty itself, suggest a possible role for these steroids in the mechanisms involved in triggering the hypothalamic-pituitary-gonadal axis at puberty.

The religious right, Claude-Jean Bertrand In the United States believers can be categorized as pre- and post- millenarists. Among the former — conservative, even reactionary — the evangelicals are the most numerous. A minority, fervent and nostalgie for the original theocracy, followers of the biblical rules, regained popularity in the 1950s and again in the 1970s, thanks to the use of mass media. After the surge of the Reagan'era and the fleeting rise of the Moral Majority — a movement more symbolic than representative of the new Christian right — this minority now seems in a downward phase., Bertrand Claude-Jean. La droite religieuse. In: Vingtième Siècle, revue d'histoire, n°19, juillet-septembre 1988. Religion et politique aux États-Unis. pp. 17-30.

The report is of an anatomico-pathological and electron probe microanalyzer study of a patella with osteoarthritic remodelling, that had been in contact with a cast cobalt-chromium-molybdenum prosthesis for two years and seven months. Abrasion of the metal resulted in preferential phagocytosis of chromium, principally in the wall of an osteoarthritis cyst. This observation indicates that a substance administered by intra-articular pathway for the treatment of osteoarthritis can become phagocytosed, and quite deeply, in the remodelled bone.

Plasma concentrations of testosterone, D and DS, have been determined in 16 normal children before and after HCG stimulation. Mean testosterone levels were 31, 8 ± 10 mμg/100 ml. before HCG and 554 ± 121 mμg/100 ml. after HCG. D was studied in 6 children only. The mean values were 138 ± 40 mμg/100 ml. and 394 ± 204 mμg/100 ml. before and after HCG respectively. DS concentration was very low before the age of 7 years, increasing thereafter to reach levels very close to those found in adults before there was clinical evidence of the onset of puberty. In the group as a whole, the mean DS concentration before HCG was 27, 1 ± 16, 6 μg/100 ml. and after HCG 36, 4 ± 16, 9 μg/ 100 ml. the difference not being significant (p > 0, 05). However if subjects less than 8 years old were considered separately, the mean values were 5, 4 ± 2, 5 μg/100 ml. and 13, 9 ± 5, 5 μg/100 ml. before and after HCG and this difference is significant (p