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Based on previous work (Assimakopoulos et al. Proceedings of KICSS’2013 [5]) where we introduced HelpMe tool, a tool that automatically selects a group of people according to rules and metrics, we now introduce inconsistency between divergent ranking concerning answers during collaborative tasks among experts. In HelpMe tool, users collaboratively create a knowledge base about a subject and evaluate user opinions in order to achieve quality of knowledge. The basic assumption of the tool is that “Knowledge comes from experts.” This is achieved by collective evaluation, through voting and discussion in every stage (Task) of the discussion (Activity). Inconsistency appears when a set of sentences cannot be true at the same time (Adrian et al. Proceedings of KICSS’2013 [3]). During collaborative tasks in Communities of Practice, inconsistency may inspire new associations and lead to more interesting solutions. However, there are cases such as medical, legal, etc. issues in which contradicting views are not helpful since a final decision has to be made. This paper is focused on such cases and examines the possible options and the methods that have to be implemented in order for a final decision to be made. When difference in the evaluation range is observed (divergent voting), the community should be informed in order to evaluate the existing answer with an “up vote” or a “down vote.” No other option is available. In case of inconsistency, we introduce a loop procedure that informs experts in order to evaluate the task being observed as inconsistent. If inconsistency remains, or the number of evaluators is small, the process keeps going until it meets the criteria introduced in this paper. On the other hand, the system should be able to find, in its knowledge database, related conversations and examines the decisions made on related or same subject.

This report describes a patient complaining of low back pain and presenting with neurological symptoms that proved to be due to epidural metastasis from retroorbital malignant fibrous histiocytoma (MFH). Because of its origin, primary or metastatic MFH can appear virtually anywhere. Both imaging studies and intraoperative findings of this patient clearly demonstrated tumor in the epidural space but no involvement of vertebra. Resection of the tumor was followed by adjuvant radiotherapy, but the patient died 6 months postoperatively. On the basis of histologic examination, the tumor was diagnosed as a histiocytoma. Orbital and epidural MFH are very rare. This is the first reported case of epidural metastasis from retroorbital MFH. MFH is a highly malignant neoplasm with guarded prognosis despite treatment.

Age dependent decrease in androgen levels is the main and most important mechanism responsible for involutional osteoporosis in men. Decreased physical activity may contribute to the development of osteoporosis. Supplementation with DHEA and increased physical activity may counteract the development of male osteoporosis and decrease fracture risk. DHEA may increase bone formation after conversion to testosterone, and exercise — by activation of the canonical Wnt/β-catenin pathway. The aim of the present study was to examine the effect of DHEA and moderate exercise on mechanical properties of long bones in rats with androgen deficiency induced by orchidectomy. The experiments were carried out on 3-month-old Wistar rats, divided into following groups (n=8–10 rats per group): non-orchidectomized control rats, orchidectomized (ORX) control rats, ORX rats receiving DHEA, ORX rats submitted to exercise, ORX rats receiving DHEA submitted to exercise. The rats were submitted to the moderate exercise on the treadmill once daily (1 hour) for 8 weeks. DHEA was administered at a dose 7 mg/kg p.o. once daily for 8 weeks. Mechanical properties of tibial metaphysis and femoral diaphysis (in three-point bending tests) and femoral neck (in a compression test), bone turnover markers (serum osteocalcin and C-terminal telopeptide of type I collagen fragments), geometric parameters, mass, and mass of bone mineral in the tibia and femur were studied. Androgen deficiency inhibited bone formation and resorption. It weakened mechanical properties of tibial metaphysis as well as femoral neck and diaphysis, and decreased bone mass and mass of bone mineral. Exercise increased bone formation and counteracted unfavorable changes in mechanical properties of tibial metaphysis and femoral neck, induced by androgen deficiency. DHEA increased bone formation and significantly inhibited the effect of androgen deficiency on the mechanical properties of the tibial metaphysis. Administration of DHAE combined with exercise counteracted unfavorable changes in bone mechanical properties (especially in the tibial metaphysis) induced by androgen deficiency. This article is part of a Special Issue entitled ECTS 2011. Disclosure of interest: None declared. doi:10.1016/j.bone.2011.03.670 PP540-T Physiotherapy interventions for the management of whiplash injuries V. Barkatsa ⁎, C. Iliadis , V. Moraitis , N. Syrmos , M. Tzagarakis , K. Tsipras d a Physiotherapy, Greece b Neurosurgery, Venizeleion General Hospital, Heraklion, Greece c Pathology, General Hospital, Rethymno, Greece d Endocrinology, Greek Institute of Social Security, Athens, Greece Abstract: Introduction/background: Whiplash injuries are associated with motor Introduction/background: Whiplash injuries are associated with motor vehicle accidents or in sporting mishaps after an acceleration–deceleration mechanism of energy transfer to the neck. The injury results in a series of clinical manifestations (mainly cervical pain 88% and headaches) known as Whiplash Associated Disorder. The syndrome involves trauma to amultiplicity of tissues in the cervical spine and it may affect other areas of the vertebral column. Clinicians are challenged to use different treatments in order to relieve symptoms and to improve body function. Method: systematic review of the effectiveness of physiotherapy interventions in the management of whiplash injuries using MEDLINE, CINAHL, Cochrane database systematic reviews and published guidelines. Results: In the acute stage (0 to 2 weeks after injury) physiotherapy interventions recommended for pain reduction are active exercises, manual mobilisation, use of TENS, education and advice and relaxation techniques compared to electrotherapy, traction, and the use of soft collar. There is insufficient evidence to support the use of massage and acupuncture. In the sub acute stage (2–12 weeks after injury) and in the chronic stage( after 12 weeks) a multimodal programme including active exercises, postural training, manual techniques, physical agents and psychosocial support should be used to reduce pain and enable people to return to normal activities. Conclusion: Recovery is improved by early active management and early return to pre-accidental activities. This article is part of a Special Issue entitled ECTS 2011.

Reference is made to five cases appearing as expansive lesions in the head and neck. In all cases angiography allowed a precise diagnosis of the nature and extent of the lesion. Biopsy which could have been hazardous was thus unnecessary. Moreover, therapeutic embolization in a case of juvenile nasopharyngeal angiofibroma prevented massive bleeding during surgery.

We report one case of chondrosarcoma of the larynx, which is considered to be rather uncommon. Clinical signs and symptoms have been noted, as well as some suggestions on the aetiology, incidence and site of cartliaginous tumours of the larynx.