Search results for: surgical site infection
3727 Prescribing Pattern of Drugs in Patients with ARDS: An Observational Study
Authors: Rahul Magazine, Shobitha Rao
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The aim of this study was to study the prescribing pattern of drugs in patients with ARDS (Acute Respiratory Distress Syndrome) managed at a tertiary care hospital. This observational study was conducted at Kasturba Hospital, Karnataka, India. Data of patients admitted from January 2010 to December 2012 was collected. A total of 150 patients of ARDS were included. Data included patients’ age, gender, clinical disorders precipitating ARDS, and prescribing pattern of drugs. The mean age of the study population was 42.92±13.91 years. 48% of patients were less than 40 years of age. Infection was the cause of ARDS in 81.3% of subjects. Antibiotics were prescribed in all the subjects and beta-lactams were prescribed in 97.3%. 41.3% were prescribed corticosteroids, 39.3% diuretics and 89.3% intravenous fluids. Infection was the commonest etiology for ARDS, and beta-lactams were the commonest antibiotics prescribed. Corticosteroids and diuretics were prescribed in a significant number of patients. Most of the patients received intravenous fluids.Keywords: acute respiratory syndrome, beta lactams, corticosteroids, Acute Respiratory Distress Syndrome (ARDS)
Procedia PDF Downloads 3693726 Association of Clostridium difficile Infection and Bone Cancer
Authors: Daniela Prado, Lexi Frankel, Amalia Ardeljan, Lokesh Manjani, Matthew Cardeiro, Omar Rashid
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Background: Clostridium difficile (C. diff) is a gram-positive bacterium that is known to cause life-threatening diarrhea and severe inflammation of the colon. It originates as an alteration of the gut microbiome and can be transmitted through spores. Recent studies have shown a high association between the development of C. diff in cancer patients due to extensive hospitalization. However, research is lacking regarding C. diff’s association in the causation or prevention of cancer. The objective of this study was to therefore assess the correlation between Clostridium difficile infection (CDI) and the incidence of bone cancer. Methods: This retrospective analysis used data provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to evaluate the patients infected versus patients not infected with C. diff using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale, for the purpose of academic research. Standard statistical methods were used. Results: Between January 2010 and December 2019, the query was analyzed and resulted in 78863 patients in both the infected and control group, respectively. The two groups were matched by age range and CCI score. The incidence of bone cancer was 659 patients (0.835%) in the C. diff group compared to 1941 patients (2.461%) in the control group. The difference was statistically significant by a P-value < 2.2x10^-16 with an odds ratio (OR)= 0.33 (0.31-0.37) with a 95% confidence interval (CI). Treatment for CDI was analyzed for both C. diff infected and noninfected populations. 91 out of 16,676 (0.55%) patients with a prior C. diff infection and treated with antibiotics were compared to the control group were 275 out of 16,676 (1.65%) patients with no history of CDI and received antibiotic treatment. Results remained statistically significant by P-value <2.2x10-16 with an OR= 0.42 (0.37, 0.48). and a 95% CI. Conclusion: The study shows a statistically significant correlation between C. diff and a reduced incidence of bone cancer. Further evaluation is recommended to assess the potential of C. difficile in reducing bone cancer incidence.Keywords: bone cancer, colitis, clostridium difficile, microbiome
Procedia PDF Downloads 2813725 The Clinical Use of Ahmed Valve Implant as an Aqueous Shunt for Control of Uveitic Glaucoma in Dogs
Authors: Khaled M. Ali, M. A. Abdel-Hamid, Ayman A. Mostafa
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Objective: Safety and efficacy of Ahmed glaucoma valve implantation for the management of uveitis induced glaucoma evaluated on the five dogs with uncontrollable glaucoma. Materials and Methods: Ahmed Glaucoma Valve (AGV®; New World Medical, Rancho Cucamonga, CA, USA) is a flow restrictive, non-obstructive self-regulating valve system. Preoperative ocular evaluation included direct ophthalmoscopy and measurement of the intraocular pressure (IOP). The implant was examined and primed prior to implantation. The selected site of the valve implantation was the superior quadrant between the superior and lateral rectus muscles. A fornix-based incision was made through the conjunectiva and Tenon’s capsule. A pocket is formed by blunt dissection of Tenon’s capsule from the episclera. The body of the implant was inserted into the pocket with the leading edge of the device around 8-10 mm from the limbus. Results: No post operative complications were detected in the operated eyes except a persistent corneal edema occupied the upper half of the cornea in one case. Hyphaema was very mild and seen only in two cases which resolved quickly two days after surgery. Endoscopical evaluation for the operated eyes revealed a normal ocular fundus with clearly visible optic papilla, tapetum and retinal blood vessels. No evidence of hemorrhage, infection, adhesions or retinal abnormalities was detected. Conclusion: Ahmed glaucoma valve is safe and effective implant for treatment of uveitic glaucoma in dogs.Keywords: Ahmed valve, endoscopy, glaucoma, ocular fundus
Procedia PDF Downloads 5883724 Seismic History and Liquefaction Resistance: A Comparative Study of Sites in California
Authors: Tarek Abdoun, Waleed Elsekelly
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Introduction: Liquefaction of soils during earthquakes can have significant consequences on the stability of structures and infrastructure. This study focuses on comparing two liquefaction case histories in California, namely the response of the Wildlife site in the Imperial Valley to the 2010 El-Mayor Cucapah earthquake (Mw = 7.2, amax = 0.15g) and the response of the Treasure Island Fire Station (F.S.) site in the San Francisco Bay area to the 1989 Loma Prieta Earthquake (Mw = 6.9, amax = 0.16g). Both case histories involve liquefiable layers of silty sand with non-plastic fines, similar shear wave velocities, low CPT cone penetration resistances, and groundwater tables at similar depths. The liquefaction charts based on shear wave velocity field predict liquefaction at both sites. However, a significant difference arises in their pore pressure responses during the earthquakes. The Wildlife site did not experience liquefaction, as evidenced by piezometer data, while the Treasure Island F.S. site did liquefy during the shaking. Objective: The primary objective of this study is to investigate and understand the reason for the contrasting pore pressure responses observed at the Wildlife site and the Treasure Island F.S. site despite their similar geological characteristics and predicted liquefaction potential. By conducting a detailed analysis of similarities and differences between the two case histories, the objective is to identify the factors that contributed to the higher liquefaction resistance exhibited by the Wildlife site. Methodology: To achieve this objective, the geological and seismic data available for both sites were gathered and analyzed. Then their soil profiles, seismic characteristics, and liquefaction potential as predicted by shear wave velocity-based liquefaction charts were analyzed. Furthermore, the seismic histories of both regions were examined. The number of previous earthquakes capable of generating significant excess pore pressures for each critical layer was assessed. This analysis involved estimating the total seismic activity that the Wildlife and Treasure Island F.S. critical layers experienced over time. In addition to historical data, centrifuge and large-scale experiments were conducted to explore the impact of prior seismic activity on liquefaction resistance. These findings served as supporting evidence for the investigation. Conclusions: The higher liquefaction resistance observed at the Wildlife site and other sites in the Imperial Valley can be attributed to preshaking by previous earthquakes. The Wildlife critical layer was subjected to a substantially greater number of seismic events capable of generating significant excess pore pressures over time compared to the Treasure Island F.S. layer. This crucial disparity arises from the difference in seismic activity between the two regions in the past century. In conclusion, this research sheds light on the complex interplay between geological characteristics, seismic history, and liquefaction behavior. It emphasizes the significant impact of past seismic activity on liquefaction resistance and can provide valuable insights for evaluating the stability of sandy sites in other seismic regions.Keywords: liquefaction, case histories, centrifuge, preshaking
Procedia PDF Downloads 763723 The Nursing Experience in a Stroke Patient after Lumbar Surgery at Surgical Intensive Care Unit
Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao
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The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery
Procedia PDF Downloads 1203722 Prevalence and Antimicrobial Susceptibility of Thermophilic Campylobacter Strains Isolated from Humans and Poultry in Batna
Authors: Baali Mohamed
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Campylobacter are among the most common human bacterial gastroenteritis cases in many countries, and poultry meat is considered as a major source of human campylobacteriosis. This study is conducted, on one hand, to determine the prevalence of infection with thermotolerant Campylobacter both in broiler flocks and men, and to study their sensitivity to antibiotics, and secondly for comparing the two methods of isolation of Campylobacter thermotolerant: technique of passive filtration and selective isolation technique using the Karmali medium. This study examined 310 samples, 260 of avian origin and 50 of human origin, during the period from June 2011 to March 2012. Detecting Campylobacter thermotolerant is conducted using the standard ISO 10272. The results show that 66% (95% CI : 60-72%) of avian samples are contaminated with C. TT (172/260). The study of antibiotic susceptibility revealed that all strains (100%) are resistant to ampicillin and amoxicillin/clavulanic acid, 90% to erythromycin, 66.3% to tetracycline, 53.3% to chloramphenicol and 46.7% to enrofloxacin. However, no resistance is noted to gentamycin. In human samples, three strains of C. thermotolerant are detected, with a contamination rate of 6%. The results of the statistical analysis using the chi-square test (χ2) showed that Campylobacter infection, on the one hand, had seasonal variation with a summer peak (p < 0.05) and, on the other hand, are not influenced by the size of the herd.Keywords: thermotolerant campylobacter, broiler, man, Karmali
Procedia PDF Downloads 3963721 Offshore Wind Assessment and Analysis for South Western Mediterranean Sea
Authors: Abdallah Touaibia, Nachida Kasbadji Merzouk, Mustapha Merzouk, Ryma Belarbi
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accuracy assessment and a better understand of the wind resource distribution are the most important tasks for decision making before installing wind energy operating systems in a given region, there where our interest come to the Algerian coastline and its Mediterranean sea area. Despite its large coastline overlooking the border of Mediterranean Sea, there is still no strategy encouraging the development of offshore wind farms in Algerian waters. The present work aims to estimate the offshore wind fields for the Algerian Mediterranean Sea based on wind data measurements ranging from 1995 to 2018 provided of 24 years of measurement by seven observation stations focusing on three coastline cities in Algeria under a different measurement time step recorded from 30 min, 60 min, and 180 min variate from one to each other, two stations in Spain, two other ones in Italy and three in the coast of Algeria from the east Annaba, at the center Algiers, and to Oran taken place at the west of it. The idea behind consists to have multiple measurement points that helping to characterize this area in terms of wind potential by the use of interpolation method of their average wind speed values between these available data to achieve the approximate values of others locations where aren’t any available measurement because of the difficulties against the implementation of masts within the deep depth water. This study is organized as follow: first, a brief description of the studied area and its climatic characteristics were done. After that, the statistical properties of the recorded data were checked by evaluating wind histograms, direction roses, and average speeds using MatLab programs. Finally, ArcGIS and MapInfo soft-wares were used to establish offshore wind maps for better understanding the wind resource distribution, as well as to identify windy sites for wind farm installation and power management. The study pointed out that Cap Carbonara is the windiest site with an average wind speed of 7.26 m/s at 10 m, inducing a power density of 902 W/m², then the site of Cap Caccia with 4.88 m/s inducing a power density of 282 W/m². The average wind speed of 4.83 m/s is occurred for the site of Oran, inducing a power density of 230 W/m². The results indicated also that the dominant wind direction where the frequencies are highest for the site of Cap Carbonara is the West with 34%, an average wind speed of 9.49 m/s, and a power density of 1722 W/m². Then comes the site of Cap Caccia, where the prevailing wind direction is the North-west, about 20% and 5.82 m/s occurring a power density of 452 W/m². The site of Oran comes in third place with the North dominant direction with 32% inducing an average wind speed of 4.59 m/s and power density of 189 W/m². It also shown that the proposed method is either crucial in understanding wind resource distribution for revealing windy sites over a large area and more effective for wind turbines micro-siting.Keywords: wind ressources, mediterranean sea, offshore, arcGIS, mapInfo, wind maps, wind farms
Procedia PDF Downloads 1473720 Pathogenic Candida Biofilms Producers Involved in Healthcare Associated Infections
Authors: Ouassila Bekkal Brikci Benhabib, Zahia Boucherit Otmani, Kebir Boucherit, A. Seghir
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The establishment of intravenous catheters in hospitalized patient is an act common in many clinical situations. These therapeutic tools, from their insertion in the body, represent gateways including fungal germs prone. The latter can generate the growth of biofilms, which can be the cause of fungal infection. Faced with this problem, we conducted a study at the University Hospital of Tlemcen in the neurosurgery unit and aims to isolate and identify Candida yeasts from intravenous catheters. Then test their ability to form biofilms. Materials and methods: 256 patient hospitalized in surgery of the hospital in west Algeria were submitted to this study. All samples were taken from peripheral venous catheters implanted for 72 hours or more days. A total of 31 isolates of Candida species were isolated. MIC and SMIC are determined at 80% inhibition by the test XTT tetrazolium measured at 490 nm. The final concentrations of antifungal agent being between 0.03 and 16 mg / ml for amphotericin B and from 0.015 to 8 mg / mL caspofungin. Results: 31 Candida species isolates from catheters including 14 Candida albicans and 17 Candida non albicans . 21 strains of all the isolates were able to form biofilms. In their form of Planktonic cells, all isolates are 100% susceptible to antifungal agents tested. However, in their state of biofilms, more isolates have become tolerant to the tested antifungals. Conclusion: Candida yeasts isolated from intravascular catheters are considered an important virulence factor in the pathogenesis of infections. Their involvement in catheter-related infections can be disastrous for their potential to generate biofilms. They survive high concentrations of antifungal where treatment failure. Pending the development of a therapeutic approach antibiofilm related to catheters, their mastery is going through: -The risk of infection prevention based on the training and awareness of medical staff, -Strict hygiene and maximum asepsis, and -The choice of material limiting microbial colonization.Keywords: candida, biofilm, hospital, infection, amphotericin B, caspofungin
Procedia PDF Downloads 3243719 Pre-Operative Tool for Facial-Post-Surgical Estimation and Detection
Authors: Ayat E. Ali, Christeen R. Aziz, Merna A. Helmy, Mohammed M. Malek, Sherif H. El-Gohary
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Goal: Purpose of the project was to make a plastic surgery prediction by using pre-operative images for the plastic surgeries’ patients and to show this prediction on a screen to compare between the current case and the appearance after the surgery. Methods: To this aim, we implemented a software which used data from the internet for facial skin diseases, skin burns, pre-and post-images for plastic surgeries then the post- surgical prediction is done by using K-nearest neighbor (KNN). So we designed and fabricated a smart mirror divided into two parts a screen and a reflective mirror so patient's pre- and post-appearance will be showed at the same time. Results: We worked on some skin diseases like vitiligo, skin burns and wrinkles. We classified the three degrees of burns using KNN classifier with accuracy 60%. We also succeeded in segmenting the area of vitiligo. Our future work will include working on more skin diseases, classify them and give a prediction for the look after the surgery. Also we will go deeper into facial deformities and plastic surgeries like nose reshaping and face slim down. Conclusion: Our project will give a prediction relates strongly to the real look after surgery and decrease different diagnoses among doctors. Significance: The mirror may have broad societal appeal as it will make the distance between patient's satisfaction and the medical standards smaller.Keywords: k-nearest neighbor (knn), face detection, vitiligo, bone deformity
Procedia PDF Downloads 1673718 Evaluation of the Synergistic Inhibition of Enterovirus 71 Infection by Interferon-α Coupled with Pleconaril in RD Cells
Authors: Wen-Yu Lin, Yi-Ching Chung, Tzyy-Rong Jinn
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It is well known that enterovirus 71 (EV71) causes recurring outbreaks of hand, foot and mouth disease (HFMD) and encephalitis leading to complications or death in young children. And, several HFMD of EV71 with high mortalities occurred in Asia countries, such as Malaysia (1997), Taiwan (1998) and China (2008). Thus, more effective antiviral drugs are needed to prevent or reduce EV71-related complications. As reported, interferon-α protects mice from lethal EV71 challenge by the modulation of innate immunity and then degrade enterovirus protease 3Cᵖʳᵒ. On the other side, pleconaril by targeting enterovirus VP1 protein and then block virus entry and attachment. Thus, the aim of this study was to evaluate the synergistic antiviral activity of interferon-α and pleconaril against enterovirus 71 infection. In a preliminary study showed that pleconaril at concentrations of 50, 100 and 300 µg/mL reduced EV71-induced CPE to 52.0 ± 2.5%, 40.2 ± 3.5% and 26.5 ± 1.5%, respectively, of that of the EV71-infected RD control cells (taken as 100%). Notably, 1000 IU/mL of interferon-α in combination with pleconaril at concentrations of 50, 100 and 300µg/mL suppressed EV71-induced CPE by 30.2 ± 3.8%, 16.5 ± 1.3% and 2.8 ± 2.0%, respectively, of that of the pleconaril alone treated with the infected RD cells. These results indicated that interferon-α 1000 IU/mL combination with pleconaril (50, 100 and 300µg/mL) inhibited EV71-induced CPE more effectively than treated with pleconaril alone in the infected RD cells.Keywords: enterovirus 71, interferon-α, pleconaril, RD cells
Procedia PDF Downloads 1413717 Numerical Modeling of Determination of in situ Rock Mass Deformation Modulus Using the Plate Load Test
Authors: A. Khodabakhshi, A. Mortazavi
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Accurate determination of rock mass deformation modulus, as an important design parameter, is one of the most controversial issues in most engineering projects. A 3D numerical model of standard plate load test (PLT) using the FLAC3D code was carried to investigate the mechanism governing the test process. Five objectives were the focus of this study. The first goal was to employ 3D modeling in the interpretation of PLT conducted at the Bazoft dam site, Iran. The second objective was to investigate the effect of displacements measuring depth from the loading plates on the calculated moduli. The magnitude of rock mass deformation modulus calculated from PLT depends on anchor depth, and in practice, this may be a cause of error in the selection of realistic deformation modulus for the rock mass. The third goal of the study was to investigate the effect of testing plate diameter on the calculated modulus. Moreover, a comparison of the calculated modulus from ISRM formula, numerical modeling and calculated modulus from the actual PLT carried out at right abutment of the Bazoft dam site was another objective of the study. Finally, the effect of plastic strains on the calculated moduli in each of the loading-unloading cycles for three loading plates was investigated. The geometry, material properties, and boundary conditions on the constructed 3D model were selected based on the in-situ conditions of PLT at Bazoft dam site. A good agreement was achieved between numerical model results and the field tests results.Keywords: deformation modulus, numerical model, plate loading test, rock mass
Procedia PDF Downloads 1713716 Some Characteristics and Identification of Fungi Contaminated by Alkomos Cement Factory
Authors: Abdulmajeed Bashir Mlitan, Ethan Hack
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Soil samples were collected from and around Alkomos cement factory, Alkomos town, Libya. Soil physiochemical properties were determined. In addition, olive leaves were scanned for their fungal content. This work can conclude that the results obtained for the examined physiochemical characteristics of soil in the area studied prove that cement dust from the Alkomos cement factory in Libya has had a significant impact on the soil. The affected soil properties are pH and total calcium content. These characteristics were found to be higher than those in similar soils from the same area. The increment of soil pH in the same area may be a result of precipitation of cement dust over the years. Different responses were found in each season and each site. For instance, the dominance of fungi of soil and leaves was lowest at 100 m from the factory and the evenness and diversity increased at this site compared to the control area and 250 m from the factory.Keywords: pollution, soil microbial, alkomos, Libya
Procedia PDF Downloads 6163715 Study of the Efficacy of Cysteine Protease Inhibitors Alone or Combined with Praziquantel as Chemotherapy for Mice Schistosomiasis mansoni
Authors: Alyaa Ahmed Farid, Aida Ismail, Ibrahim Rabia, Azza Fahmy, Azza El Amir
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This study was designed for assessment of 3 types of Cysteine protease inhibitors (CPIs) fluromethylketone (FMK), vinyl sulfone (VS) and sodium nitro prussid (SNP), to define which of them is the best? The experiments aimed to define the protective power of each inhibitor alone or combined with PZQ for curing S. mansoni infection in mice. In vitro, treated S. mansoni adult worms recorded a mortality rate after 1 hr of exposure to 500 ppm of FMK, VS and SNP as 75, 70 and 60%, while, treated cercaria recorded 75, 60 and 50%, respectively. FMK+PZQ treatment recorded the maximum reduction in worm burden (97.2% at 5 wk PI). VS treatment alone or combined with PZQ increases IgM, total IgG, IgG2 and IgG4 levels. In EM study of worm tegument, while only detachment of spines was observed in PZQ treated group, the completely implanted spines were reported in the degenerated tegument of adult worms in all groups treated with CPIs. Treatment with VS+PZQ increased Igs levels but, its effect was different on worm reduction. So, it is not enough to eliminate the infection and FMK+PZQ considered the antischistosomicidal drug of choice.Keywords: praziquantel, fluromethylketone, vinyl sulfone, worm burden, immunoglobulin pattern
Procedia PDF Downloads 3733714 The Influence of Destination Image on Tourists' Experience at Osun Osogbo World Heritage Site
Authors: Bola Adeleke, Kayode Ogunsusi
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Heritage sites have evolved to preserve culture and heritage and also to educate and entertain tourists. Tourist travel decisions and behavior are influenced by destination image and value of the experience of tourists. Perceived value is one of the important tools for securing a competitive edge in tourism destinations. The model of Ritchie and Crouch distinguished 36 attributes of competitiveness which are classified into five factors which are quality of experience, touristic attractiveness, environment and infrastructure, entertainment/outdoor activities and cultural traditions. The study extended this model with a different grouping of the determinants of destination competitiveness. The theoretical framework used for this study assumes that apart from attractions already situated in the grove, satisfaction with destination common service, and entertainment and events, can all be used in creating a positive image for/and in attracting customers (destination selection) to visit Osun Sacred Osogbo Grove during and after annual celebrations. All these will impact positively on travel experience of customers as well as their spiritual fulfillment. Destination image has a direct impact on tourists’ satisfaction which consequently impacts on tourists’ likely future behavior on whether to revisit a cultural destination or not. The study investigated the variables responsible for destination image competitiveness of the Heritage Site; assessed the factors enhancing the destination image; and evaluated the perceived value realized by tourists from their cultural experience at the grove. A complete enumeration of tourists above 18 years of age who visited the Heritage Site within the month of March and April 2017 was taken. 240 respondents, therefore, were used for the study. The structured questionnaire with 5 Likert scales was administered. Five factors comprising 63 variables were used to determine the destination image competitiveness through principal component analysis, while multiple regressions were used to evaluate perceived value of tourists at the grove. Results revealed that 11 out of the 12 variables determining the destination image competitiveness were significant in attracting tourists to the grove. From the R-value, all factors predicted tourists’ value of experience strongly (R= 0.936). The percentage variance of customer value was explained by 87.70% of the variance of destination common service, entertainment and event satisfaction, travel environment satisfaction and spiritual satisfaction, with F-value being significant at 0.00. Factors with high alpha value contributed greatly to adding value to enhancing destination and tourists’ experience. 11 variables positively predicted tourist value with significance. Managers of Osun World Heritage Site should improve on variables critical to adding values to tourists’ experience.Keywords: competitiveness, destination image, Osun Osogbo world heritage site, tourists
Procedia PDF Downloads 1873713 Atmospheric Dispersion Modeling for a Hypothetical Accidental Release from the 3 MW TRIGA Research Reactor of Bangladesh
Authors: G. R. Khan, Sadia Mahjabin, A. S. Mollah, M. R. Mawla
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Atmospheric dispersion modeling is significant for any nuclear facilities in the country to predict the impact of radiological doses on environment as well as human health. That is why to ensure safety of workers and population at plant site; Atmospheric dispersion modeling and radiation dose calculations were carried out for a hypothetical accidental release of airborne radionuclide from the 3 MW TRIGA research reactor of Savar, Bangladesh. It is designed with reactor core which consists of 100 fuel elements(1.82245 cm in diameter and 38.1 cm in length), arranged in an annular corefor steady-state and square wave power level of 3 MW (thermal) and for pulsing with maximum power level of 860MWth.The fuel is in the form of a uniform mixture of 20% uranium and 80% zirconium hydride. Total effective doses (TEDs) to the public at various downwind distances were evaluated with a health physics computer code “HotSpot” developed by Lawrence Livermore National Laboratory, USA. The doses were estimated at different Pasquill stability classes (categories A-F) with site-specific averaged meteorological conditions. The meteorological data, such as, average wind speed, frequency distribution of wind direction, etc. have also been analyzed based on the data collected near the reactor site. The results of effective doses obtained remain within the recommended maximum effective dose.Keywords: accidental release, dispersion modeling, total effective dose, TRIGA
Procedia PDF Downloads 1383712 Enhancing the Sensitivity of Antigen Based Sandwich ELISA for COVID-19 Diagnosis in Saliva Using Gold Conjugated Nanobodies
Authors: Manal Kamel, Sara Maher
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Development of sensitive non-invasive tests for detection of SARS-CoV-2 antigens is imperative to manage the extent of infection throughout the population, yet, it is still challenging. Here, we designed and optimized a sandwich enzyme-linked immunosorbent assay (ELISA) for SARS-CoV-2 S1 antigen detection in saliva. Both saliva samples and nasopharyngeal swapswere collected from 170 PCR-confirmed positive and negative cases. Gold nanoparticles (AuNPs) were conjugated with S1protein receptor binding domain (RBD) nanobodies. Recombinant S1 monoclonal antibodies (S1mAb) as primery antibody and gold conjugated nanobodies as secondary antibody were employed in sandwich ELISA. Our developed system were optimized to achieve 87.5 % sensitivity and 100% specificity for saliva samples compared to 89 % and 100% for nasopharyngeal swaps, respectively. This means that saliva could be a suitable replacement for nasopharyngeal swaps No cross reaction was detected with other corona virus antigens. These results revealed that our developed ELISAcould be establishedas a new, reliable, sensitive, and non-invasive test for diagnosis of SARS-CoV-2 infection, using the easily collected saliva samples.Keywords: COVID 19, diagnosis, ELISA, nanobodies
Procedia PDF Downloads 1353711 Role of Imaging in Alzheimer's Disease Trials: Impact on Trial Planning, Patient Recruitment and Retention
Authors: Kohkan Shamsi
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Background: MRI and PET are now extensively utilized in Alzheimer's disease (AD) trials for patient eligibility, efficacy assessment, and safety evaluations but including imaging in AD trials impacts site selection process, patient recruitment, and patient retention. Methods: PET/MRI are performed at baseline and at multiple follow-up timepoints. This requires prospective site imaging qualification, evaluation of phantom data, training and continuous monitoring of machines for acquisition of standardized and consistent data. This also requires prospective patient/caregiver training as patients must go to multiple facilities for imaging examinations. We will share our experience form one of the largest AD programs. Lesson learned: Many neurological diseases have a similar presentation as AD or could confound the assessment of drug therapy. The inclusion of wrong patients has ethical and legal issues, and data could be excluded from the analysis. Centralized eligibility evaluation read process will be discussed. Amyloid related imaging abnormalities (ARIA) were observed in amyloid-β trials. FDA recommended regular monitoring of ARIA. Our experience in ARIA evaluations in large phase III study at > 350 sites will be presented. Efficacy evaluation: MRI is utilized to evaluate various volumes of the brain. FDG PET or amyloid PET agents has been used in AD trials. We will share our experience about site and central independent reads. Imaging logistic issues that need to be handled in the planning phase will also be discussed as it can impact patient compliance thereby increasing missing data and affecting study results. Conclusion: imaging must be prospectively planned to include standardizing imaging methodologies, site selection process and selecting assessment criteria. Training should be transparently conducted and documented. Prospective patient/caregiver awareness of imaging requirement is essential for patient compliance and reduction in missing imaging data.Keywords: Alzheimer's disease, ARIA, MRI, PET, patient recruitment, retention
Procedia PDF Downloads 1173710 Valorization of Local Materials in the Waterproofing Technique of Landfills Site "TLS"
Authors: M. Debieche, F. Kaoua
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This paper deals with the use two locals materials abundant in our country, with the view to use a mixture in the waterproofing the landfills. Our interest comes from the necessity to the environment protection, which has recently considerably grown. The site's waterproofing technique, in the landfills sites, is nowadays a very necessary condition to protect the environment, which requires the use of appropriate materials. To this end, an optimal mixture ensuring good performance in terms of hydraulic conductivity, durability and shear strength, mixtures based of sand at different concentrations of sodium bentonite, at compact state are prepared and studied. This study showed that a low permeability of mixture (sand / bentonite) can be achieved 6% of sodium bentonite. This mixture confers also good mechanical behavior, expressed by the recorded, reduction of friction (φ) and the increase of the cohesion (C). Thus, the selected formulation represents an optimal mixture for waterproofing systems. It guarantees an economical and ecological advantages.Keywords: hydraulic conductivity, sand, sodium bentonite, sustainability
Procedia PDF Downloads 2763709 Urban Dust Influence on the Foliar Surface and Biochemical Constituents of Selected Plants in the National Capital Region of Delhi, India
Authors: G. P. Gupta, B. Kumar, S. Singh, U. C. Kulshrestha
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Very high loadings of atmospheric dust in the Indian region contribute to remarkably higher levels of particulate matter. During dry weather conditions which prevail most of the year, dustfall is deposited onto the foliar surfaces affecting their morphology, stomata and biochemical constituents. This study reports chemical characteristics of dustfall, its effect on foliar morphology and biochemical constituents of two medicinal plants i.e. Morus (Morus alba) and Arjun (Terminalia arjuna) in the urban environment of National Capital Region (NCR) of Delhi at two sites i.e. Jawaharlal Nehru University (residential) and Sahibabad (industrial). Atmospheric dust was characterized for major anions (F-, Cl-, NO3-, SO4--) and cations (Na+, NH4+, K+, Mg++, Ca++) along with the biochemical parameters Chl a, Chl b, total chlorophyll, carotenoid, total soluble sugar, relative water content (RWC), pH, and ascorbic acid. The results showed that the concentrations of major ions in dustfall were higher at the industrial site as compared to the residential site due to the higher level of anthropogenic activities. Both the plant species grown at industrial site had significantly lower values of chlorophyll ‘a’, chlorophyll ‘b’, total chlorophyll, carotenoid but relatively higher values of total soluble sugar and ascorbic acid indicating stressful conditions due to industrial and vehicular emissions.Keywords: dustfall, urban environment, biochemical constituents, atmospheric dust
Procedia PDF Downloads 3053708 Ecological Studies on Bulinus truncatus Snail the Intermediate Host of Schistosoma haematobium, in White Nile State, Sudan
Authors: Mohammed Hussein Eltoum Salih
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This study was conducted in four villages, namely: Jadeed, Alandraba, Um Gaar, and EL Shetabe in the White Nile State Sudan, to determine the ecological factors; water vegetations, physical and chemical properties of the water in Snails habitat. Bulinus truncatus, which act as an intermediate host for S. haematobium, were collected from water bodies adjacent to study villages where the residents were suspected to swim, and humans get in contact with water for various purposes. Water samples from the stretches were collected and then measured for parameters that are indicative of the quality of water and sustaining the survival of snails and would confirm even further if the contact between humans and water had taken place. The parameters measured included water conductivity, pH, dissolved oxygen, calcium, and magnesium content. Also, a single water sample from each contact site was collected for microbiological tests. The result revealed that the B. truncatus showed that these animals were fewer and free of infection and their sites of the collection were dense with different plant species making them suitable to harbor snails. Moreover, the results of microbial tests showed that there was higher bacterial contamination. Also, physical and chemical analysis of water sample of contact sites revealed that there were significant differences (p < 0.05) in water pH, calcium, and magnesium content between sites of study villages, and these were discussed in relation to factors suitable for the intermediate hosts and thus for the transmission of the S. haematobium disease.Keywords: health, parasitology, Schistosoma, snails
Procedia PDF Downloads 1483707 Eliciting and Confirming Data, Information, Knowledge and Wisdom in a Specialist Health Care Setting - The Wicked Method
Authors: Sinead Impey, Damon Berry, Selma Furtado, Miriam Galvin, Loretto Grogan, Orla Hardiman, Lucy Hederman, Mark Heverin, Vincent Wade, Linda Douris, Declan O'Sullivan, Gaye Stephens
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Healthcare is a knowledge-rich environment. This knowledge, while valuable, is not always accessible outside the borders of individual clinics. This research aims to address part of this problem (at a study site) by constructing a maximal data set (knowledge artefact) for motor neurone disease (MND). This data set is proposed as an initial knowledge base for a concurrent project to develop an MND patient data platform. It represents the domain knowledge at the study site for the duration of the research (12 months). A knowledge elicitation method was also developed from the lessons learned during this process - the WICKED method. WICKED is an anagram of the words: eliciting and confirming data, information, knowledge, wisdom. But it is also a reference to the concept of wicked problems, which are complex and challenging, as is eliciting expert knowledge. The method was evaluated at a second site, and benefits and limitations were noted. Benefits include that the method provided a systematic way to manage data, information, knowledge and wisdom (DIKW) from various sources, including healthcare specialists and existing data sets. Limitations surrounded the time required and how the data set produced only represents DIKW known during the research period. Future work is underway to address these limitations.Keywords: healthcare, knowledge acquisition, maximal data sets, action design science
Procedia PDF Downloads 3673706 Identification of Outliers in Flood Frequency Analysis: Comparison of Original and Multiple Grubbs-Beck Test
Authors: Ayesha S. Rahman, Khaled Haddad, Ataur Rahman
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At-site flood frequency analysis is used to estimate flood quantiles when at-site record length is reasonably long. In Australia, FLIKE software has been introduced for at-site flood frequency analysis. The advantage of FLIKE is that, for a given application, the user can compare a number of most commonly adopted probability distributions and parameter estimation methods relatively quickly using a windows interface. The new version of FLIKE has been incorporated with the multiple Grubbs and Beck test which can identify multiple numbers of potentially influential low flows. This paper presents a case study considering six catchments in eastern Australia which compares two outlier identification tests (original Grubbs and Beck test and multiple Grubbs and Beck test) and two commonly applied probability distributions (Generalized Extreme Value (GEV) and Log Pearson type 3 (LP3)) using FLIKE software. It has been found that the multiple Grubbs and Beck test when used with LP3 distribution provides more accurate flood quantile estimates than when LP3 distribution is used with the original Grubbs and Beck test. Between these two methods, the differences in flood quantile estimates have been found to be up to 61% for the six study catchments. It has also been found that GEV distribution (with L moments) and LP3 distribution with the multiple Grubbs and Beck test provide quite similar results in most of the cases; however, a difference up to 38% has been noted for flood quantiles for annual exceedance probability (AEP) of 1 in 100 for one catchment. These findings need to be confirmed with a greater number of stations across other Australian states.Keywords: floods, FLIKE, probability distributions, flood frequency, outlier
Procedia PDF Downloads 4523705 Salter Pelvic Osteotomy for the Treatment of Developmental Dysplasia of the Hip: Assessment of Postoperative Results and Risk Factors
Authors: Suvorov Vasyl, Filipchuk Viktor
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Background: If non-surgical treatment of developmental dysplasia of the hip (DDH) fails or if DDH is late-detected, surgery is necessary. Salter pelvic osteotomy (SPO) is an effective surgical option for such cases. The objectives of this study were to assess the results after SPO, evaluate risk factors, and reveal those radiological parameters that may correlate with the results. Mid- and long-term postoperative results after SPO in 17 patients (22 hip joints) were analyzed. Risk factors included those that do not depend on the surgeon (patient's age, value of the acetabular index (AI) preoperatively, DDH Tonnis grade) and those that depend on the surgeon (amount of AI correction). To radiological parameters which may correlate with the amount of AI correction, we referred distance "d" and the lateral rotation angle. Results: SPO allows performing AI correction in ranges 24.1 ± 6.5°. Excellent and good clinical results were obtained in 95.5% of patients; excellent and good radiological results in 86.4% of patients. Risk factors that do not depend on the surgeon were older patient’s age and higher preoperative AI values (p < 0.05). The risk factor that depends on the surgeon was the amount of AI correction (p < 0.05). The distance "d" was recognized as a radiological parameter that may indicate sufficient AI correction (p < 0.05). Conclusion: In older patients with a higher preoperative AI value, the results will be predictably worse. The surgeon may influence the result with a greater amount of AI correction (which may also be indicated radiologically by the distance "d" values).Keywords: developmental dysplasia of the hip, results, risk factor, pelvic osteotomy, salter osteotomy
Procedia PDF Downloads 1313704 Identification of Viruses Infecting Garlic Plants in Colombia
Authors: Diana M. Torres, Anngie K. Hernandez, Andrea Villareal, Magda R. Gomez, Sadao Kobayashi
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Colombian Garlic crops exhibited mild mosaic, yellow stripes, and deformation. This group of symptoms suggested a viral infection. Several viruses belonging to the genera Potyvirus, Carlavirus and Allexivirus are known to infect garlic and lower their yield worldwide, but in Colombia, there are no studies of viral infections in this crop, only leek yellow stripe virus (LYSV) has been reported to our best knowledge. In Colombia, there are no management strategies for viral diseases in garlic because of the lack of information about viral infections on this crop, which is reflected in (i) high prevalence of viral related symptoms in garlic fields and (ii) high dispersal rate. For these reasons, the purpose of the present study was to evaluate the viral status of garlic in Colombia, which can represent a major threat on garlic yield and quality for this country 55 symptomatic leaf samples were collected for virus detection by RT-PCR and mechanical inoculation. Total RNA isolated from infected samples were subjected to RT-PCR with primers 1-OYDV-G/2-OYDV-G for Onion yellow dwarf virus (OYDV) (expected size 774pb), 1LYSV/2LYSV for LYSV (expected size 1000pb), SLV 7044/SLV 8004 for Shallot latent virus (SLV) (expected size 960pb), GCL-N30/GCL-C40 for Garlic common latent virus (GCLV) (expected size 481pb) and EF1F/EF1R for internal control (expected size 358pb). GCLV, SLV, and LYSV were detected in infected samples; in 95.6% of the analyzed samples was detected at least one of the viruses. GCLV and SLV were detected in single infection with low prevalence (9.3% and 7.4%, respectively). Garlic generally becomes coinfected with several types of viruses. Four viral complexes were identified: three double infection (64% of analyzed samples) and one triple infection (15%). The most frequent viral complex was SLV + GCLV infecting 48.1% of the samples. The other double complexes identified had a prevalence of 7% (GCLV + LYSV and SLV + LYSV) and 5.6% of the samples were free from these viruses. Mechanical transmission experiments were set up using leaf tissues of collected samples from infected fields, different test plants were assessed to know the host range, but it was restricted to C. quinoa, confirming the presence of detected viruses which have limited host range and were detected in C. quinoa by RT-PCR. The results of molecular and biological tests confirm the presence of SLV, LYSV, and GCLV; this is the first report of SLV and LYSV in garlic plants in Colombia, which can represent a serious threat for this crop in this country.Keywords: SLV, GCLV, LYSV, leek yellow stripe virus, Allium sativum
Procedia PDF Downloads 1483703 Evaluating Energy Transition of a complex of buildings in a historic site of Rome toward Zero-Emissions for a Sustainable Future
Authors: Silvia Di Turi, Nicolandrea Calabrese, Francesca Caffari, Giulia Centi, Francesca Margiotta, Giovanni Murano, Laura Ronchetti, Paolo Signoretti, Lisa Volpe, Domenico Palladino
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Recent European policies have been set ambitious targets aimed at significantly reducing CO2 emissions by 2030, with a long-term vision of transforming existing buildings into Zero-Emissions Buildings (ZEmB) by 2050. This vision represents a key point for the energy transition as the whole building stock currently accounts for 36% of total energy consumption across the Europe, mainly due to their poor energy performance. The challenge towards Zero-Emissions Buildings is particularly felt in Italy, where a significant number of buildings with historical significance or situated within protected/constrained areas can be found. Furthermore, an estimated 70% of the national building stock are built before 1976, indicating a widespread issue of poor energy performance. Addressing the energy ineƯiciency of these buildings is crucial to refining a comprehensive energy renovation approach aimed at facilitating their energy transition. In this framework the current study focuses on analysing a challenging complex of buildings to be totally restored through significant energy renovation interventions. The goal is to recover these disused buildings situated in a significant archaeological zone of Rome, contributing to the restoration and reintegration of this historically valuable site, while also oƯering insights useful for achieving zeroemission requirements for buildings within such contexts. In pursuit of meeting the stringent zero-emission requirements, a comprehensive study was carried out to assess the complex of buildings, envisioning substantial renovation measures on building envelope and plant systems and incorporating renewable energy system solutions, always respecting and preserving the historic site. An energy audit of the complex of buildings was performed to define the actual energy consumption for each energy service by adopting the hourly calculation methods. Subsequently, significant energy renovation interventions on both building envelope and mechanical systems have been examined respecting the historical value and preservation of site. These retrofit strategies have been investigated with threefold aims: 1) to recover the existing buildings ensuring the energy eƯiciency of the whole complex of buildings, 2) to explore which solutions have allowed achieving and facilitating the ZEmB status, 3) to balance the energy transition requirements with the sustainable aspect in order to preserve the historic value of the buildings and site. This study has pointed out the potentiality and the technical challenges associated with implementing renovation solutions for such buildings, representing one of the first attempt towards realizing this ambitious target for this type of building.Keywords: energy conservation and transition, complex of buildings in historic site, zero-emission buildings, energy efficiency recovery
Procedia PDF Downloads 773702 Analysis of the Degradation of the I-V Curve of the PV Module in a Harsh Environment: Estimation of the Site-Specific Factor (Installation Area)
Authors: Maibigue Nanglet, Arafat Ousman Béchir, Mahamat Hassan Béchir
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The economy of Central African countries is growing very fast, and the demand for energy is increasing every day. As a result, insufficient power generation is one of the major problems slowing down development. This paper explores the factors of degradation of the I-V curve of the PV Generator (GPV) in harsh environments, taking the case of two locals: Mongo and Abeche. Its objective is to quantify the voltage leaks due to the different GPV installation areas; after using the Newton-Raphson numerical method of the solar cell, a survey of several experimental measurement points was made. The results of the simulation in MATLAB/Simulink show a relative power loss factor of 11.8765% on the GPVs installed in Mongo and 8.5463% on those installed in Abeche; these results allow us to say that the supports on which the modules are installed have an average impact of 10.2114% on their efficiency.Keywords: calculation, degradation, site, GPV, severe environment
Procedia PDF Downloads 403701 Juvenile Fish Associated with Pondweed and Charophyte Habitat: A Case Study Using Upgraded Pop-up Net in the Estuarine Part of the Curonian Lagoon
Authors: M. Bučas, A. Skersonas, E. Ivanauskas, J. Lesutienė, N. Nika, G. Srėbalienė, E. Tiškus, J. Gintauskas, A.Šaškov, G. Martin
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Submerged vegetation enhances heterogeneity of sublittoral habitats; therefore, macrophyte stands are essential elements of aquatic ecosystems to maintain a diverse fish fauna. Fish-habitat relations have been extensively studied in streams and coastal waters, but in lakes and estuaries are still underestimated. The aim of this study is to assess temporal (diurnal and seasonal) patterns of fish juvenile assemblages associated with common submerged macrophyte habitats, which have significantly spread during the recent decade in the upper littoral part of the Curonian Lagoon. The assessment was performed by means of an upgraded pop-up net approach resulting in much precise sampling versus other techniques. The optimal number of samples (i.e., pop-up nets) required to cover>80% of the total number of fish species depended on the time of the day in both study sites: at least 7and 9 nets in the evening (18-24 pm) in the Southern and Northern study sites, respectively. In total, 14 fish species were recorded, where perch and roach dominated (respectively 48% and 24%). From multivariate analysis, water salinity and seasonality (temperature or sampling month) were primary factors determining fish assemblage composition. The southern littoral area, less affected by brackish water conditions, hosted a higher number of species (13) than in the Northern site (8). In the latter site, brackish water tolerant species (three-spined and nine-spined sticklebacks, spiny loach, roach, and round goby) were more abundant than in the Southern site. Perch and ruffe dominated in the Southern site. Spiny loach and nine-spined stickleback were more frequent in September, while ruffe, perch, and roach occurred more in July. The diel dynamics of the common species such as perch, roach, and ruffe followed the general pattern, but it was species specific and depended on the study site, habitat, and month. The species composition between macrophyte habitats did not significantly differ; however, it differed from the results obtained in 2005 at both study sites indicating the importance of expanded charophyte stands during the last decade in the littoral zone.Keywords: diel dynamics, charophytes, pondweeds, herbivorous and benthivorous fishes, littoral, nursery habitat, shelter
Procedia PDF Downloads 1893700 Prevalence of Trichomonas Tenax in Patients with Pulmonary Disease and Watersheds and Its Potential Implications for Pulmonary Virus Infection
Authors: Pei Chi Fang, Wei Chen Lin
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Trichomonas tenax is a microaerophilic oral protozoan found in patients with poor oral hygiene. It participates in the inflammatory process of periodontal disease and can potentially be aspirated into the lungs, giving rise to pulmonary trichomoniasis. However, the precise roles of T. tenax in the pulmonary system remain largely unexplored and warrant comprehensive epidemiological investigation. To assess the prevalence of T. tenax infection, we collected bronchoalveolar lavage fluid (BALF) samples from hospitalized patients with lung diseases. A specific nested PCR approach was employed to determine prevalence rates, yielding 21 positive cases out of 61 samples from Ditmanson Medical Foundation Chia-Yi Christian Hospital, and 11 positive cases out of 55 samples from National Cheng Kung University Hospital. Furthermore, there is a critical need for comprehensive data regarding the presence of T. tenax in environmental surface watersheds. In this context, we present findings from investigations in the Yanshuei and Donggang river basins in southern Taiwan, which are crucial sources for public drinking water in the region. In order to elucidate potential implications on pulmonary virus infections, we conducted an analysis of gene expression level changes in H292 cell line after exposure to T. tenax. Our findings revealed significant regulation of multiple virus-related genes, including IFI44L and IFITM3. Ongoing research endeavors are focused on identifying the key components within T. tenax responsible for these observed effects. Crucially, this study lays the groundwork for a preliminary understanding of T. tenax prevalence in patients with pulmonary diseases. It also seeks to establish a meaningful correlation between lung infections and oral hygiene practices, with the ultimate aim of informing distinct treatment and prevention strategies.Keywords: parasitology, genes, virus, human health, infection, lung
Procedia PDF Downloads 753699 Bionaut™: A Minimally Invasive Microsurgical Platform to Treat Non-Communicating Hydrocephalus in Dandy-Walker Malformation
Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher
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The Dandy-Walker malformation (DWM) represents a clinical syndrome manifesting as a combination of posterior fossa cyst, hypoplasia of the cerebellar vermis, and obstructive hydrocephalus. Anatomic hallmarks include hypoplasia of the cerebellar vermis, enlargement of the posterior fossa, and cystic dilatation of the fourth ventricle. Current treatments of DWM, including shunting of the cerebral spinal fluid ventricular system and endoscopic third ventriculostomy (ETV), are frequently clinically insufficient, require additional surgical interventions, and carry risks of infections and neurological deficits. Bionaut Labs develops an alternative way to treat Dandy-Walker Malformation (DWM) associated with non-communicating hydrocephalus. We utilize our discreet microsurgical Bionaut™ particles that are controlled externally and remotely to perform safe, accurate, effective fenestration of the Dandy-Walker cyst, specifically in the posterior fossa of the brain, to directly normalize intracranial pressure. Bionaut™ allows for complex non-linear trajectories not feasible by any conventional surgical techniques. The microsurgical particle safely reaches targets in the lower occipital section of the brain. Bionaut™ offers a minimally invasive surgical alternative to highly involved posterior craniotomy or shunts via direct fenestration of the fourth ventricular cyst at the locus defined by the individual anatomy. Our approach offers significant advantages over the current standards of care in patients exhibiting anatomical challenge(s) as a manifestation of DWM, and therefore, is intended to replace conventional therapeutic strategies. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.Keywords: Bionaut™, cerebral spinal fluid, CSF, cyst, Dandy-Walker, fenestration, hydrocephalus, micro-robot
Procedia PDF Downloads 2223698 Combine Resection of Talocalcaneal Tarsal Coalition and Calcaneal Lengthening Osteotomy. Short-to-Intermediate Term Results
Authors: Naum Simanovsky, Vladimir Goldman, Michael Zaidman
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Background: The optimal algorithm for the management of symptomatic tarsal coalition is still under discussion in pediatric literature. It's debatable what surgical steps are essential to achieve the best outcome. Method: The investigators retrospectively reviewed the records of twelve patients with symptomatic tarsal coalition that were treated operatively between 2017 and 2019. Only painful flat feet were operated. Two patients were excluded from the study due to lack of sufficient follow-up. Ten of eleven feet were treated with the combination of calcaneal lengthening osteotomy (CLO) and resection of coalition (RC). Only one foot was operated with CLO alone. In half of our patients, Achilles lengthening was performed. For two children, medial plication was added. Short leg cast was applied to all children for 6-8 weeks, and soft shoe insoles for medial arch support were prescribed after. Demographic, clinical, and radiographic records were reviewed. The outcome was evaluated using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results: There were seven boys and three girls. The mean age at the time of surgery was 13.9 (range 12 to 17) years, and the mean follow-up was 18 (range 8 to 34) months. The early complications included one superficial wound infection and dehiscence. Late complication includes two children with residual forefoot supination. None of our patients required additional operations during the follow-up period. All feet achieved complete deformity correction or dramatic improvement. In the last follow-up, seven feet were painless, and four children had some mild pain after intensive activities. All feet achieved excellent and good scoring on AOFAS. Conclusions: Many patients with talocalcaneal coalition also have rigid or stiff, painful, flat feet. For these patients, the resection of coalition with concomitant CLO can be safely recommended.Keywords: Tarsal coalition, calcaneal lengthening osteotomy., flat foot, coalition resection
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