Although some studies have suggested a correlation between fertility treatments based mainly on the use of ovulation-inducing agents and the development of malignancy, more studies have suggested that ovulation in- duction treatment does not increase the short-term risk of ovarian cancer  . Meanwhile, other studies have suggested that infertility itself can be a risk factor for ovarian cancer. Many recent studies have also shown that an ovarian endometrial cyst is prone to develop into endometrioid adenocarcinoma and clear cell carcinoma  . This report describes a case of ovarian cancer during puerperium in a patient with endometriosis and a priorhistory of long-term fertility treatment.
Facial lesions presenting with purulent discharge following a traumatic event in a person who underwent surgery likely suggest a diagnosis such as sinusitis, soft tissue infection or surgical complications. Extranodal natural killer/T-cell lymphoma (ENK/TCL) is a rare aggressive cancer that presents with a midline facial lesion that could easily be misdiagnose (1, 2). Such malignancies affecting the head and neck area form an interesting but difficult diagnosis. The purpose of this article is to report a severe case of ENK/TCL-nasal type in a boy with a previous history of nasal trauma.
Sexual intercourse ≤ 1 time/week. Concerning Last sexual intercourse, only 20% of women had Last sexual intercourse < 48 hours. While 6.3% current used of antibiotic. More than half of women reported current IUD used. According to use of vaginal douching, 21.3% women had douching > 1 time/week, 11.3% used douching inside vagina, and 13.7% had recent use < 48 hours. The present results agreed with Wiset et al., (2004) who noticed that 0.9% reported a priorhistory of sexually transmitted diseases and 0.6% had had more than 2 sexual partners in the past 3 months. Nearly 90% had only a single sexual partner through their lifetime and about 60% reported having 1 or less sexual intercourse per week. Another study conducted by Verstraelen et al., (2010) who reported that BV may be considered a sexually enhanced disease, with frequency of intercourse being a critical factor. This goes in line with Madhivanan et al., (2008) who clarified that no significant association was demonstrated between bacterial vaginosis and days since last menstrual period, days since last sexual intercourse and priorhistory of sexual transmitted diseases. Although not statistically significant, bacterial vaginosis tended to be more prevalent among women with a lower age at first intercourse, higher numbers of lifetime partners, higher frequency of sexual intercourse, current smokers, and less prevalence among women with current antibiotic use. However, bacterial vaginosis was significantly more prevalent among women who used douching inside the vagina than those who never douched [OR = 3.98 (95% CI 1.85-8.33), p < 0.01], and significantly more prevalent among women using IUD than non-IUD users [OR = 1.84 (95%CI 1.22-2.79), p<0.01]. There was no significant association between BV and IUD use. Moreover , Joesoef et al., (2001) who emphasized that an increase risk of BV in IUD users, with the explanation that IUD might change the vaginal flora in favor of the growth of bacteria associated with BV and should be screened prior to IUD insertion. Also Gallo et al., (2011) who observed that 94% of the BV positive cases were using vaginal douches which confirms that vaginal douches represent a risk factor of BV acquisition. Previous observational studies by Mangot-Bertrand et al., (2013) suggested a strong association between vaginal douching and bacterial vaginosis. Moreover, Pourmarzi et al., (2014) demonstrated that douching at least once per month, recent douching within 7 days and douching for symptoms or hygiene was associated with BV.
Confirmatory medistinoscopy was not deemed necessary for any of the patients and close radiographic follow up was instituted. Upon follow-up for an average of 10 months (range 6–15 month), two patients developed pro- gressive cough that responded to treatment with inhaled fluticasone, while one other patient developed sympto- matic lymphocytic meningitis consistent with neurosar- coidosis and was treated with systemic steroids. All other patients remained clinically and radiographically stable except for one patient who developed an intraabdominal recurrence of endometrial cancer. Interestingly however, her mediastinal adenopathy remained unchanged. Granulomatous inflammation by EBUS-TBNA in patients without a priorhistory of cancer (n = 8)
homicide-suicide is present in upwards of 75% of cases. Between 2003 and 2011, the Domestic Violence Death Review Committee (DVDRC) classified 56% of perpetrators with depression in all the cases in Ontario. Methods: Secondary data analysis of 133 cases taken from the DVDRC database was conducted to determine whether differences exist between depressed and non- depressed perpetrators. Results: Cases with depressed perpetrators had significantly more risk factors present than in cases with non-depressed perpetrators. Depressed perpetrators and perpetrators who committed homicide-suicide were significantly older than non-depressed perpetrators and perpetrators of homicide. Key characteristics of depressed perpetrators include threats and attempts of suicide, perpetrator witnessed violence as a child, priorhistory of hostage-taking and obsessive behaviour. Conclusions: This information is essential to educate mental health professionals because they are more likely to have an opportunity to intervene in light of the presenting depression.
A total of 193 RSV positive children, from 151 families, were enrolled into the shedding study, of which 160 were birth cohort infants and 33 siblings. 192 negative results (i.e. indicating cessation of shedding) were observed. One child died in hospital before completing the study and due to lack of further information is right censored. For 120 children, the first positive sample was also the last positive sample. The children were between the ages of 2 and 164 months at recruitment into the shedding study, 10.4% were less than 1 year while 70% were 2 years of age or less. The median age of children in the study was 21 months, and 46% were male. 3% of all the children in the larger birth cohort had a birth weight of <2.5 kg. Of the 193 RSV infections 165 were classified as having an upper respiratory tract infection (URTI), 20 as mild LRTI, 8 as severe LRTI, and none with very severe LRTI. The frequency distribution of days to cessation is shown in Fig. 1. The overall rate of recovery (cessation of shedding) per day irrespective of infection history, age and severity was 0.22/person/day (95% CI 0.19-0.25) i.e. a mean duration of shedding (reciprocal of rate of recovery) of 4.5 days (95%CI 4.0- 5.3), with a median duration of shedding for all children of 4 days (IQR 2-6, range 1-14). The proportion of indi- viduals with priorhistory of infection was 0.53 in chil- dren with URTI compared with 0.5 and 0.25 in children with severe LRTI and mild LRTI, respectively. Both the URTI and mild LRTI disease categories had a higher proportion of children in the older ( ≥ 18 months) age group compared to the severe LRTI category. One hun- dred and thirty six of 193 positives were from children attending the research clinic and these records had data on the number of days with symptoms based on history. The average duration of shedding for this subset of chil- dren was 7.69 days (95% CI 6.41-8.98). A comparison of the two populations (clinic attendees and non-clinic attendees) reveals that the ages of children who attended the clinic and those seen at home were similar (t-test, P = 0.1736). All children seen at home had an URTI except for one child who had a severe LRTI and was referred to hospital for admission. By comparison 21% of children presenting to the clinic had a diagnosis of mild or severe LRTI.
Adrenal crisis should be considered in any patient who presents in a state of shock even when there is no priorhistory of adrenal disease, particularly if there is coexisting unexplained severe hypoglycemia or hyponatremia . The patient may present with abdominal pain and the crisis is usually precipitated by sepsis. Primary adrenal insufficiency is usually due to autoimmune conditions, tuberculosis, metastases or even drugs like antifungals. Secondary adrenal insufficiency is due to pituitary pathology where there is only glucocorticoid deficiency without any mineralocorticoid deficiency; hence, adrenal crisis is rare. Adrenal crisis can also occur in patients who have abruptly stopped their steroid medication . The diagnosis is ideally made by a short adrenocorticotropin hormone (ACTH) stimulation test. However, there should be no reason to delay treatment in a sick patient. It is useful to take blood for electrolytes, cortisol and ACTH before initiating steroid treatment. Emergency treatment is by the administration of intravenous fluids, 0.9% saline and dextrose saline if there is hypoglycemia as well. Steroid treatment could be in the form of hydrocortisone 100 mg three times in a day until stable, when the treatment is switched to oral hydrocortisone at the dose of 10 mg in the morning, 5 mg at 12 noon and 6 pm daily, with patient education on sick day rule .
average procedure time of 20 min (range: 2–90 min) per patient. A similar study indicated a 53% success rate of PIV placement on the first attempt with a 91% success rate within four attempts. 12,13 These studies, as well as the information from the current study, may provide concepts for future quality improvement projects in this area. Moving forward, quality improvement projects aimed to limit the number of attempts or time required to achieve peripheral venous cannulation may include better identifi- cation of the number of attempts that should be allowed prior to use of US guidance. Furthermore, we are currently conducting a prospective evaluation in a large cohort of patients to more clearly define patient and provider char- acteristics associated with DPIV.
Many Studies in humans have provided results that the response of the circadian system to light is influenced by prior exposure to light and darkness. In a study scientists had exposed subjects to a 6.5-hour 200 lux light stimulus during the biological night-time, and measured the degree of melatonin suppression. Be- fore the light stimulus, subjects were in a background light that was very dim (0.5 lux) or of room intensity (200 lux, the same intensity as the light stimulus) for 15 hours. Exposure to the dim back- ground resulted in significantly greater melatonin suppression in response to the 200-lux light stimulus than did exposure to 200-lux background light. These stu- dies have demonstrated that the response of those photoreceptors are influenced by prior light history, demonstrating larger responses to light stimuli after dim light exposure, and reduced responsive- ness to light stimuli after bright back- ground light exposure. Together, these findings suggest that the overall 24-hour pattern of light and darkness to which humans are exposed plays a role in sub- sequent sensitivity to light exposure, and thus to entrainment.
A total of 179 subjects (age range: 11–13 years) partici- pated in this prospective analysis (102 males and 77 fe- males). None of the subjects had a history of exposure to high altitude (>2500 m above sea level) in the previ- ous 6 months. All subjects were healthy, lived at alti- tudes below 500 m, and were asked not to take any medication for high-altitude illness before climbing and exposure to high altitude. None of the study participants reported prior AMS. All subjects had participated for 9 months in training regimens including swimming for 20 minutes once a week, jogging for 15 minutes once a week, and undergoing a stepping exercise for 20 minutes once a week in their physical education class at school. All written informed consent was obtained from the participants and their parents.
Among 788 asylum seekers registered in two dedicated centers during the study period, 639 were adults over 16 years old. 393 of them agreed to be screened (61.50% of the eligible population). In this group, 295 (75.06%) asylum seekers had a negative T.SPOT.TB, and 98 (24.93%) had a positive T-SPOT.TB of which 5 (5.1%) had active tuberculosis (3 culture-proven) previously not detected at the border and 2 had already been treated for active tuberculosis prior to the entry in Switzerland (Figure 1). The spot distribution is provided on Figure 2 (Figure 2). The characteristic of the 5 cases with active tuberculosis are shown on Figure 3 (Figure 3). The remaining 38, 5% did not agree respond to the proposed screening or left the country before any investigation. Detailed data on the unscreened collective is scarce but their median age is of 29.26 years, 25% were women and their origin distribution is shown on Figure 4.
Gestational trophoblastic neoplasms are a gr- oup of fetal trophoblastic tumors including cho- riocarcinomas, epithelioid trophoblastic tumors (ETTs), and placental site trophoblastic tumors (PSTTs) . ETT is considered a neoplasm com- posed of chorionic-type intermediate tropho- blasts based on histological characteristics, immunohistochemical expression, and poly- merase chain reaction analysis [2, 3]. Although cellular differentiation of ETT has clearly been elucidated, the pathogenesis remains poorly understood. ETT is usually associated with a pri- or gestational event. The antecedent gestation- al events include normal pregnancy, spontane- ous abortion, and gestational trophoblastic tu- mor. With the increased reported cases in the literature, a history of prior gestational tropho- blastic tumor seems to be present in around
a change in dropout rates. A potential reason might be that prior treatment was less successful and/or less specific for TTM symptoms, and therefore, individuals attempting our new Internet-based intervention might be more motivated and desperate to complete the whole treatment program in order to learn new skills for reducing their TTM symptoms. 3) One might assume that individuals without previous treat- ment might, due to limited skills of reducing TTM symptoms compared with individuals with prior treatment, benefit to a lesser extent. However, previous treatment(s) might not be as comprehensive or successful, which might not have pro- vided an additive improvement to our current Internet-based intervention(s). When interpreting our findings, it is impor- tant to keep in mind that the data were gathered and assessed via the Internet. Participants without previous treatment indeed sought help in our Internet-based intervention study. These individuals were actively searching for information and help related to TTM online; therefore, they might have at least some insights into their problems. Overall, the present study provided encouraging results and demonstrated that it is possible to access at least some of the “hidden” untreated individuals and that professional online information/ intervention might be important to successfully close the gap between being ill, having insight into symptoms and/or
The results of this analysis suggest that the birth history methods considered are of limited utility for estimating mortality in small samples and, in particular, for mak- ing meaningful comparisons among geographic units or strata. Given the value of these types of estimates, how- ever, investment in other data sources may be warranted. In particular, sample registration schemes may be a useful alternative to both surveys, with the problems enumerated here, and full vital registration systems, which are expen- sive and technically challenging to maintain. Alternatively, research into adapting existing small area methods fre- quently used in epidemiology and other fields [10,11] for use with birth histories could prove useful. These mod- els explicitly account for unusually high sampling error in estimates derived from small samples and attempt to overcome this challenge by exploiting spatial and tempo- ral relatedness. Several authors have already used birth history data to inform these models, though the focus of these analyses has generally been on the relationship between other factors and mortality and not on prediction of mortality levels for specific areas or subgroups [12-16]. This analysis has several limitations. The stratified anal- yses by mortality level and time prior to survey do not control for each other, making it difficult to conclusively disentangle the two effects. Further, birth histories, like all survey data, are subject to a number of data errors, including, among others, recall bias and age misreport- ing. We treat the reported population in each survey as truth and don’t consider the additional effect on error or bias that any of these errors could introduce. It is well documented that these types of errors can impact the reli- ability of mortality estimates, but future research could consider specifically how these errors interact with the problems due to sample size explicitly considered here. Microsimulation–where synthetic populations are cre- ated by simulating births and deaths given set mortality and fertility schedules–could provide useful mechanisms for more fully exploring the issues described here.
89. After Elliott v. Swartwout, 35 U.S. (10 Pet.) 137 (1836), collectors started holding back in earnest to protect themselves from suit and, for some, to enrich themselves personally. See Cary v. Curtis, 44 U.S. (3 How.) 236, 243 (1845) (“It is matter of history that the alleged right to retain . . . had led to great abuses, and to much loss to the public; and it is to these two subjects, therefore, that the  act of Congress particularly addresses itself.”). Money held back was money not getting to Treasury. Congress quickly revised tax procedure to require collectors to pay all collections to Treasury, even those made under protest and threat of suit. Act of Mar. 3, 1839, ch. 82, § 2, 5 Stat. 339, 348. At the same time, Congress authorized the Secretary to refund improperly collected money to taxpayers, but only when the taxpayers could show actual overpayment. Id., 5 Stat. at 348–49. Congress also created a statutory refund action, still nominally against the collector. Act of Feb. 26, 1845, ch. 22, 5 Stat. 727, 727. Eventually, the Supreme Court recognized that action for what is really was, an action against the United States. See United States v. Emery, Bird, Thayer Realty Co., 237 U.S. 28, 31–32 (1915) (“The objection to the jurisdiction pressed by the Government is that the only remedy is a suit against the Collector. . . . However gradually the result may have been approached in the earlier cases it now has become accepted law that claims like the present are founded upon the revenue law.” (quotation marks omitted)). For full discussion of this transformation, see generally Plumb, supra note 87.
In order to know the factors associated with maternal near-miss, two models were used in a multiple conditional logistic regression analysis. Model one contained five vari- ables which were significant in bivariate analysis (educa- tional level, place of residence, ethnicity, marital status and monthly income). However, the result of the first model showed that only place of residence was found to be associated with maternal near-miss (Table 4). The sec- ond model contained eleven variables and five variables remained significant. The factors associated with maternal near-miss in the second model were: history of chronic hypertension (AOR = 10.80,95% CI; 5.16–22.60), rural residency (AOR = 10.60,95% CI;4.59–24.46), history of stillbirth (AOR = 6.03,95% CI;2.09–17.41), no ANC attendance (AOR = 5.58,95% CI;1.94–16.07) and history of anemia (AOR = 5.26,95% CI;2.89–9.57) (Table 5). How- ever, the study did not find that female genital cutting was a determinant factor for maternal near-miss.
To our knowledge, this is the largest study to date to evaluate potential factors associated with the develop- ment of DNSE colonization and/or infection and to com- pare the characteristics of patients with prior daptomycin exposure to those without prior daptomycin exposure. We found that prior daptomycin exposure, immunosup- pression, or a concomitant gastrointestinal or intra- abdominal process, preceded the development of DNSE. During the study period, we noticed an increase in the number of cases of DNSE yearly that corresponded to in- creasing annual rates of daptomycin usage at our institu- tion. Molecular typing revealed a diverse population of isolates suggesting the development of resistance under antimicrobial pressure. Also, a high percentage of patients with DNSE colonization or infection died during their hospitalization. Limitations of this study include its retrospective nature and small number of patients. Fu- ture case – control or prospective studies comparing patients with and without DNSE and/or prior daptomy- cin exposure would be helpful in better identifying fac- tors associated with DNSE infection and/or colonization.
Results Among 103 370 eligible patients with lung cancer, 15.18% had a history of prior cancer. Lung and bronchus (25.83%), breast (14.13%), prostate (8.85%) and cervix uteri (4.74%) were the most common prior cancer types. Of prior cancers, 61.56% are localised and regional stages. More than 67.98% of prior cancers were diagnosed within 5 years of the index lung cancer diagnosis. The median times of diagnosis for prior cancers were 38 months. Patients with prior cancer had the same/non- inferior OS as that of patients without a prior cancer diagnosis (propensity score- adjusted HR=1.01, 95% CI=0.99 to 1.04, p=0.324). Subgroup analyses stratified by timing of prior cancer displayed almost the same tendency (p>0.05). Interestingly, early- stage patients with a history of prior cancer had adverse survival curves (p<0.05). Advanced- stage patients with prior cancer had non- inferior survival (p>0.05).
The prevalence of zoster infection was 17%. Although an age-matched population consisting of people with no MS and/ or a population with other neurological diseases was not stud- ied simultaneously, it appears as if the proportion of zoster infection, in this MS population that is not subject to major immunosuppressive treatments, is higher than expected in a matched general population. The prevalence of zoster is rela- tively high in the general population, to the point that almost 1 in 3 elderly people have zoster, but this prevalence increases dramatically after the age of 60, whereas the population tested here has a mean age of 53. Our results are very similar to those of Ross et al. (1999), in a Canadian MS population of similar size ( n = 633), where a history of zoster was positive in 16.8% (Ross et al. 1999). The prevalence of zoster in a practice-based survey used as comparator in that study was 5.4%, and in a group of patients with other neurological disease, it was 6.8% (Ross et al. 1999).