Search results for: rare stroke
914 A Hyperflexion Hallux Mallet Injury: A Case Report
Authors: Tan G. K. Y., Chew M. S. J., Sajeev S., Vellasamy A.
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Injuries of the extensor hallucis longus (EHL) tendon are a rare phenomenon, with most occurring due to lacerations or penetrating injuries. Closed traumatic ruptures of the EHL are described as “Mallet injuries of the toe”. These can be classified as bony or soft mallet injuries depending on the presence or absence of a fracture at the insertion site of the EHL tendon in the distal phalanx. We present a case of a 33-year-old woman who presented with a hyperflexion injury to the left big toe with an inability to extend the big toe. Ultrasound showed a complete rupture of the EHL tendon with retraction proximal to the hallucal interphalangeal joint of the big toe. The patient was treated through transarticular pinning and repair using the Arthrex Mini Bio-Suture Tak with a 2-0 fibre wire. Six months postoperatively, the patient had symmetrical EHL power and full range of motion of the toe. The lessons to be drawn from this case report are that isolated hallux mallet injuries are rare and can be easily missed in the absence of penetrating wounds. Patients who have such injuries should be investigated early with the appropriate imaging techniques, such as ultrasound or MRI, and treated surgically.Keywords: hallux mallet, extensor hallucis longus tendon, extensor hallucis longus
Procedia PDF Downloads 71913 A Rare Form of Rapidly Progressive Parkinsonism Associated with Dementia
Authors: Murat Emre, Zeynep Tufekcioglu
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Objective: We describe a patient with late onset phenylketonuria which presented with rapidly progressive dementia and parkinsonism that were reversible after management. Background: Phenylketonuria is an autosomal recessive disorder due to mutations in the phenylalanine hydroxlase gene. It normally presents in childhood, in rare cases, however, it may have its onset in adulthood and may mimic other neurological disorders. Case description: A previously normal functioning, 59 year old man was admitted for blurred vision, cognitive impairment and gait difficulty which emerged over the past eight months. In neurological examination he had brisk reflexes, slow gait and left-dominant parkinsonism. Mini-mental state examination score was 25/30, neuropsychological testing revealed a dysexecutive syndrome with constructional apraxia and simultanagnosia. In cranial MRI there were bilateral diffuse hyper-intense lesions in parietal and occipital white matter with no significant atrophy. Electroencephalography showed diffuse slowing with predominance of teta waves. In cerebrospinal fluid examination protein level was slightly elevated (61mg/dL), oligoclonal bands were negative. Electromyography was normal. Routine laboratory examinations for rapidly progressive dementia and parkinsonism were also normal. Serum amino acid levels were determined to explore metabolic leukodystrophies and phenylalanine level was found to be highly elevated (1075 µmol/L) with normal tyrosine (61,20 µmol/L). His cognitive impairment and parkinsonian symptoms improved following three months of phenylalanine restricted diet. Conclusions: Late onset phenylketonuria is a rare, potentially reversible cause of rapidly progressive parkinsonism with dementia. It should be considered in the differential diagnosis of patients with suspicious features.Keywords: dementia, neurology, Phenylketonuria, rapidly progressive parkinsonism
Procedia PDF Downloads 263912 A Modelling of Main Bearings in the Two-Stroke Diesel Engine
Authors: Marcin Szlachetka, Rafal Sochaczewski, Lukasz Grabowski
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This paper presents the results of the load simulations of main bearings in a two-stroke Diesel engine. A model of an engine lubrication system with connections of its main lubrication nodes, i.e., a connection of its main bearings in the engine block with the crankshaft, a connection of its crankpins with its connecting rod and a connection of its pin and its piston has been created for our calculations performed using the AVL EXCITE Designer. The analysis covers the loads given as a pressure distribution in a hydrodynamic oil film, a temperature distribution on the main bush surfaces for the specified radial clearance values as well as the impact of the force of gas on the minimum oil film thickness in the main bearings depending on crankshaft rotational speeds and temperatures of oil in the bearings. One of the main goals of the research has been to determine whether the minimum thickness of the oil film at which fluid friction occurs can be achieved for each value of crankshaft speed. Our model calculates different oil film parameters, i.e., its thickness, a pressure distribution there, the change in oil temperature. Additional enables an analysis of an oil temperature distribution on the surfaces of the bearing seats. It allows verifying the selected clearances in the bearings of the main engine under normal operation conditions and extremal ones that show a significant increase in temperature above the limit value. The research has been conducted for several engine crankshaft speeds ranging from 1000 rpm to 4000 rpm. The oil pressure in the bearings has ranged 2-5 bar according to engine speeds and the oil temperature has ranged 90-120 °C. The main bearing clearance has been adopted for the calculation and analysis as 0.025 mm. The oil classified as SAE 5W-30 has been used for the simulations. The paper discusses the selected research results referring to several specific operating points and different temperatures of the lubricating oil in the bearings. The received research results show that for the investigated main bearing bushes of the shaft, the results fall within the ranges of the limit values despite the increase in the oil temperature of the bearings reaching 120˚C. The fact that the bearings are loaded with the maximum pressure makes no excessive temperature rise on the bush surfaces. The oil temperature increases by 17˚C, reaching 137˚C at a speed of 4000 rpm. The minimum film thickness at which fluid friction occurs has been achieved for each of the operating points at each of the engine crankshaft speeds. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK ‘PZL-KALISZ’ S.A.’ and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.Keywords: diesel engine, main bearings, opposing pistons, two-stroke
Procedia PDF Downloads 133911 Simulation Research of Diesel Aircraft Engine
Authors: Łukasz Grabowski, Michał Gęca, Mirosław Wendeker
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This paper presents the simulation results of a new opposed piston diesel engine to power a light aircraft. Created in the AVL Boost, the model covers the entire charge passage, from the inlet up to the outlet. The model shows fuel injection into cylinders and combustion in cylinders. The calculation uses the module for two-stroke engines. The model was created using sub-models available in this software that structure the model. Each of the sub-models is complemented with parameters in line with the design premise. Since engine weight resulting from geometric dimensions is fundamental in aircraft engines, two configurations of stroke were studied. For each of the values, there were calculated selected operating conditions defined by crankshaft speed. The required power was achieved by changing air fuel ratio (AFR). There was also studied brake specific fuel consumption (BSFC). For stroke S1, the BSFC was lowest at all of the three operating points. This difference is approximately 1-2%, which means higher overall engine efficiency but the amount of fuel injected into cylinders is larger by several mg for S1. The cylinder maximum pressure is lower for S2 due to the fact that compressor gear driving remained the same and boost pressure was identical in the both cases. Calculations for various values of boost pressure were the next stage of the study. In each of the calculation case, the amount of fuel was changed to achieve the required engine power. In the former case, the intake system dimensions were modified, i.e. the duct connecting the compressor and the air cooler, so its diameter D = 40 mm was equal to the diameter of the compressor outlet duct. The impact of duct length was also examined to be able to reduce the flow pulsation during the operating cycle. For the so selected geometry of the intake system, there were calculations for various values of boost pressure. The boost pressure was changed by modifying the gear driving the compressor. To reach the required level of cruising power N = 68 kW. Due to the mechanical power consumed by the compressor, high pressure ratio results in a worsened overall engine efficiency. The figure on the change in BSFC from 210 g/kWh to nearly 270 g/kWh shows this correlation and the overall engine efficiency is reduced by about 8%. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK "PZL-KALISZ" S.A." and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.Keywords: aircraft, diesel, engine, simulation
Procedia PDF Downloads 203910 Bioinformatics Identification of Rare Codon Clusters in Proteins Structure of HBV
Authors: Abdorrasoul Malekpour, Mohammad Ghorbani Mojtaba Mortazavi, Mohammadreza Fattahi, Mohammad Hassan Meshkibaf, Ali Fakhrzad, Saeid Salehi, Saeideh Zahedi, Amir Ahmadimoghaddam, Parviz Farzadnia Dr., Mohammadreza Hajyani Asl Bs
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Hepatitis B as an infectious disease has eight main genotypes (A–H). The aim of this study is to Bioinformatically identify Rare Codon Clusters (RCC) in proteins structure of HBV. For detection of protein family accession numbers (Pfam) of HBV proteins; used of uni-prot database and Pfam search tool were used. Obtained Pfam IDs were analyzed in Sherlocc program and RCCs in HBV proteins were detected. In further, the structures of TrEMBL entries proteins studied in PDB database and 3D structures of the HBV proteins and locations of RCCs were visualized and studied using Swiss PDB Viewer software. Pfam search tool have found nine significant hits and 0 insignificant hits in 3 frames. Results of Pfams studied in the Sherlocc program show this program not identified RCCs in the external core antigen (PF08290) and truncated HBeAg protein (PF08290). By contrast the RCCs become identified in Hepatitis core antigen (PF00906) Large envelope protein S (PF00695), X protein (PF00739), DNA polymerase (viral) N-terminal domain (PF00242) and Protein P (Pf00336). In HBV genome, seven RCC identified that found in hepatitis core antigen, large envelope protein S and DNA polymerase proteins and proteins structures of TrEMBL entries sequences that reported in Sherlocc program outputs are not complete. Based on situation of RCC in structure of HBV proteins, it suggested those RCCs are important in HBV life cycle. We hoped that this study provide a new and deep perspective in protein research and drug design for treatment of HBV.Keywords: rare codon clusters, hepatitis B virus, bioinformatic study, infectious disease
Procedia PDF Downloads 482909 Left Atrial Appendage Occlusion vs Oral Anticoagulants in Atrial Fibrillation and Coronary Stenting. The DESAFIO Registry
Authors: José Ramón López-Mínguez, Estrella Suárez-Corchuelo, Sergio López-Tejero, Luis Nombela-Franco, Xavier Freixa-Rofastes, Guillermo Bastos-Fernández, Xavier Millán-Álvarez, Raúl Moreno-Gómez, José Antonio Fernández-Díaz, Ignacio Amat-Santos, Tomás Benito-González, Fernando Alfonso-Manterola, Pablo Salinas-Sanguino, Pedro Cepas-Guillén, Dabit Arzamendi, Ignacio Cruz-González, Juan Manuel Nogales-Asensio
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Background and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients’ long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.Keywords: stents, atrial fibrillation, anticoagulants, left atrial appendage occlusion
Procedia PDF Downloads 55908 The Effect of Addition of Some Rare Earth Materials to Zinc Aluminum Alloy ZA-22
Authors: Adnan I. O. Zaid
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Zinc aluminum alloys are versatile materials which are widely used in manufacturing several parts in the automobile and aircraft industries. The effect of grain refinement of these alloys by rare earth elements on their mechanical characteristics is scarce. The equal channel angular pressing is relatively recent method for producing severe plastic deformation in materials subjected to it resulting in refinement of their structure and enhancement of their mechanical characteristics. The phase diagram of these alloys indicates that large dendrites of large grain size can be formed during their solidification of the cast which tends to deteriorate their mechanical strength and surface quality. To overcome this problem they are normally grain refined by either titanium or titanium + boron to their melt prior to solidification. In this paper, comparison between the effect of adding either titanium, (Ti), titanium+boron, (Ti+B), or Molybdenum, Mo, to zinc-aluminum22, alloy, (ZA22) on its metallurgical and mechanical characteristics in the cast condition and after pressing by the ECAP process is investigated. It was found that addition of either Ti, Ti+B, or Mo to the ZA22 alloy in the cast condition resulted in refining of their structure being more refined by the addition of Mo, then .Ti+B and less refining by Ti addition. Furthermore, the ECAP process resulted in further refinement of the alloy micro structure except in case of Ti+B addition where poisoning i.e. coarsening of the grains has occurred. Regarding the addition of these element on the mechanical behavior; it was found that addition of Ti Or Ti+B resulted in little enhancement of the alloy strength factor and its flow stress at 20% true strain; whereas, the addition of resulted in deteriorating of its mechanical behavior as % decrease in the strength factor and % in its flow stress of 20%. As for the strain hardening index; addition of any of these elements resulted in decreasing the strain hardening index.Keywords: addition, grain refinement, mechanical characteristics, microstructure, rare earth elements, ZA-22, Zinc- aluminum alloy
Procedia PDF Downloads 516907 Enabling Oral Communication and Accelerating Recovery: The Creation of a Novel Low-Cost Electroencephalography-Based Brain-Computer Interface for the Differently Abled
Authors: Rishabh Ambavanekar
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Expressive Aphasia (EA) is an oral disability, common among stroke victims, in which the Broca’s area of the brain is damaged, interfering with verbal communication abilities. EA currently has no technological solutions and its only current viable solutions are inefficient or only available to the affluent. This prompts the need for an affordable, innovative solution to facilitate recovery and assist in speech generation. This project proposes a novel concept: using a wearable low-cost electroencephalography (EEG) device-based brain-computer interface (BCI) to translate a user’s inner dialogue into words. A low-cost EEG device was developed and found to be 10 to 100 times less expensive than any current EEG device on the market. As part of the BCI, a machine learning (ML) model was developed and trained using the EEG data. Two stages of testing were conducted to analyze the effectiveness of the device: a proof-of-concept and a final solution test. The proof-of-concept test demonstrated an average accuracy of above 90% and the final solution test demonstrated an average accuracy of above 75%. These two successful tests were used as a basis to demonstrate the viability of BCI research in developing lower-cost verbal communication devices. Additionally, the device proved to not only enable users to verbally communicate but has the potential to also assist in accelerated recovery from the disorder.Keywords: neurotechnology, brain-computer interface, neuroscience, human-machine interface, BCI, HMI, aphasia, verbal disability, stroke, low-cost, machine learning, ML, image recognition, EEG, signal analysis
Procedia PDF Downloads 115906 Bench Tests of Two-Stroke Opposed Piston Aircraft Diesel Engine under Propeller Characteristics Conditions
Authors: A. Majczak, G. Baranski, K. Pietrykowski
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Due to the growing popularity of light aircraft, it has become necessary to develop aircraft engines for this type of construction. One of engine system, designed to increase efficiency and reduce weight, is the engine with opposed pistons. In such an engine, the combustion chamber is formed by two pistons moving in one cylinder. Therefore, this type of engines run in a two-stroke cycle, so they have many advantages such as high power and torque, high efficiency, or a favorable power-to-weight ratio. Tests of one of the available aircraft engines with opposing piston system fueled with diesel oil were carried out on an engine dynamometer equipped with an eddy current brake and the necessary measuring and testing equipment. In order to get to know the basic parameters of the engine, the tests were carried out under partial load conditions for the following torque values: 40, 60, 80, 100 Nm. The rotational speed was changed from 1600 to 2500 rpm. Measurements were also taken for designated points of propeller characteristics. During the tests, the engine torque, engine power, fuel consumption, intake manifold pressure, and oil pressure were recorded. On the basis of the measurements carried out for particular loads, the power curve, hourly and specific fuel consumption curves were determined. Characteristics of charge pressure as a function of rotational speed as well as power, torque, hourly and specific fuel consumption curves for propeller characteristics were also prepared. The obtained characteristics make it possible to select the optimal points of engine operation.Keywords: aircraft, diesel, engine testing, opposed piston
Procedia PDF Downloads 148905 Case Report: Rare Case of Endometrial Stromal Sarcoma with Omental Metastasis in a 19-Year Old Girl
Authors: Mukurdipi Ray, Seema Singh
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Extrauterine endometrial stromal sarcoma (ESS) is a rare entity and typified by delayed recurrence of primary ESS. Here, we present an unusual case of uterine ESS in a woman with a history of hysterectomy. A 19-year-old girl, underwent a hysterectomy and bilateral salpingo-oophorectomy for uterine ESS 12 months ago and now after remaining disease free for nine months ago she presented with ascites along with pelvic and peritoneal mass. Intraoperatively, the large omental mass was found, and optimal cytoreduction with total omentomy (supracolic and infracolic ) total peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) was offered to the patient. Final histopathology report showed the involvement of only omentum by ESS cells. Immunohistochemistry (IHC) and receptor study were done and it was positive for CD-10 and desmin and negative for CK- 7. This case highlights the rarity of extrauterine ESS in the omentum with a known history of primary uterine ESS which was treated successfully with the above-mentioned procedure. Though active and long-term surveillance is recommended to monitor for late recurrences.Keywords: endrometrial stromal sarcoma, complete cytoreduction, hyperthermic intra peritoneal chemotherapy, total omentectomy
Procedia PDF Downloads 202904 Rare Earth Metal Ion-Doped SiO2 Nanocomposite Membranes for Gas Separation in Steam Atmosphere
Authors: Md. Hasan Zahir
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Y2O3-doped silica membranes were synthesized with the sol-gel method by using a tetraethyl orthosilicate-derived sol mixed with yttrium nitrate hexahydrate. These solutions were used to fabricate hydrogen separation microporous membranes with a sandwich-type structure on γ-Al2O3 supported by tubular α-Al2O3. Pore size distribution measurements were conducted directly on the membranes before and after hydrothermal treatment with a nano-permporometer. The gas permeance properties of the membranes were measured in the temperature range 100–500°C. The Y-doped SiO2 membrane (Si/Y = 3/1) was found to exhibit asymptotically stable permeances of 2.39×10-7 mol m-2 s -1 Pa-1 for He and 6.19 ×10-10 mol m-2 s -1 Pa-1 for CO2, with a high selectivity of 386 (He/CO2) at 500°C for 20 h in the presence of steam. The Y-doped silica membranes exhibit very high gas permeances for molecules with smaller kinetic diameters. The apparent activation energies of the H2 permeance at 400°C were 24.2±0.2 and 21.3±0.7 kJ mol−1 for SiO2 and Si/Y, respectively. Very high permeances were obtained for N2 and O2, 2.2 and 5 × 10-8 mol m-2 s -1 Pa-1 respectively, which demonstrates that these materials are promising air purification and/or separation systems that block larger impurity molecules by molecular sieving effects. Y-doped SiO2 exhibits greater hydrothermal stability at high temperatures and higher selectivity than SiO2 membranes.Keywords: ceramic membrane, gas separation, hydrothermal stability, rare earth doped-Silica
Procedia PDF Downloads 250903 Abnormal Features of Two Quasiparticle Rotational Bands in Rare Earths
Authors: Kawalpreet Kalra, Alpana Goel
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The behaviour of the rotational bands should be smooth but due to large amount of inertia and decreased pairing it is not so. Many experiments have been done in the last few decades, and a large amount of data is available for comprehensive study in this region. Peculiar features like signature dependence, signature inversion, and signature reversal are observed in many two quasiparticle rotational bands of doubly odd and doubly even nuclei. At high rotational frequencies, signature and parity are the only two good quantum numbers available to label a state. Signature quantum number is denoted by α. Even-angular momentum states of a rotational band have α =0, and the odd-angular momentum states have α =1. It has been observed that the odd-spin members lie lower in energy up to a certain spin Ic; the normal signature dependence is restored afterwards. This anomalous feature is termed as signature inversion. The systematic of signature inversion in high-j orbitals for doubly odd rare earth nuclei have been done. Many unusual features like signature dependence, signature inversion and signature reversal are observed in rotational bands of even-even/odd-odd nuclei. Attempts have been made to understand these phenomena using several models. These features have been analyzed within the framework of the Two Quasiparticle Plus Rotor Model (TQPRM).Keywords: rotational bands, signature dependence, signature quantum number, two quasiparticle
Procedia PDF Downloads 162902 Design Study on a Contactless Material Feeding Device for Electro Conductive Workpieces
Authors: Oliver Commichau, Richard Krimm, Bernd-Arno Behrens
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A growing demand on the production rate of modern presses leads to higher stroke rates. Commonly used material feeding devices for presses like grippers and roll-feeding systems can only achieve high stroke rates along with high gripper forces, to avoid stick-slip. These forces are limited by the sensibility of the surfaces of the workpieces. Stick-slip leads to scratches on the surface and false positioning of the workpiece. In this paper, a new contactless feeding device is presented, which develops higher feeding force without damaging the surface of the workpiece through gripping forces. It is based on the principle of the linear induction motor. A primary part creates a magnetic field and induces eddy currents in the electrically conductive material. A Lorentz-Force applies to the workpiece in feeding direction as a mutual reaction between the eddy-currents and the magnetic induction. In this study, the FEA model of this approach is shown. The calculation of this model was used to identify the influence of various design parameters on the performance of the feeder and thus showing the promising capabilities and limits of this technology. In order to validate the study, a prototype of the feeding device has been built. An experimental setup was used to measure pulling forces and placement accuracy of the experimental feeder in order to give an outlook of a potential industrial application of this approach.Keywords: conductive material, contactless feeding, linear induction, Lorentz-Force
Procedia PDF Downloads 175901 Myroides Bacteremia: A Case Report
Authors: Jamie Lynn Co, Mary Shiela Ariola-Ramos
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Myroides are aerobic, yellow-pigmented, non-motile, non-fermenting gram-negative rods. They are commonly found in the environment such as water and soil. Although found in the environment, Myroides are rare pathogens of humans. Myroides spp. primarily infect immunocompromised patients, often with diabetes mellitus, liver cirrhosis, chronic kidney disease, chronic obstructive pulmonary disease or prolonged corticosteroid therapy. We present a case of a 70-year-old immunocompromised patient with diabetes mellitus, chronic renal failure, diagnosed with sepsis caused by Myroides spp. The primary portal and source of infection were the pustules and boils found on the lower extremities of the patient. Susceptibility testing showed that our isolate was only susceptible to ciprofloxacin and meropenem; and following the treatment, the patient recovered. Myroides continues to be a rare pathogen of humans that is prevalent in our environment. It primarily affects immunocompromised patients such as those with uncontrolled diabetes mellitus, chronic kidney disease, etc. Despite their low virulence, physicians should consider this opportunistic pathogen as possible etiologic agent especially in cases wherein there is lack of response to commonly used antibiotics.Keywords: bacteremia, immunocompromised, gram negative rods, Myroides
Procedia PDF Downloads 152900 Structural Properties of Surface Modified PVA: Zn97Pr3O Polymer Nanocomposite Free Standing Films
Authors: Pandiyarajan Thangaraj, Mangalaraja Ramalinga Viswanathan, Karthikeyan Balasubramanian, Héctor D. Mansilla, José Ruiz
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Rare earth ions doped semiconductor nanostructures gained much attention due to their novel physical and chemical properties which lead to potential applications in laser technology as inexpensive luminescent materials. Doping of rare earth ions into ZnO semiconductor alter its electronic structure and emission properties. Surface modification (polymer covering) is one of the simplest techniques to modify the emission characteristics of host materials. The present work reports the synthesis and structural properties of PVA:Zn97Pr3O polymer nanocomposite free standing films. To prepare Pr3+ doped ZnO nanostructures and PVA:Zn97Pr3O polymer nanocomposite free standing films, the colloidal chemical and solution casting techniques were adopted, respectively. The formation of PVA:Zn97Pr3O films were confirmed through X-ray diffraction (XRD), absorption and Fourier transform infrared (FTIR) spectroscopy analyses. XRD measurements confirm the prepared materials are crystalline having hexagonal wurtzite structure. Polymer composite film exhibits the diffraction peaks of both PVA and ZnO structures. TEM images reveal the pure and Pr3+ doped ZnO nanostructures exhibit sheet like morphology. Optical absorption spectra show free excitonic absorption band of ZnO at 370 nm and, the PVA:Zn97Pr3O polymer film shows absorption bands at ~282 and 368 nm and these arise due to the presence of carbonyl containing structures connected to the PVA polymeric chains, mainly at the ends and free excitonic absorption of ZnO nanostructures, respectively. Transmission spectrum of as prepared film shows 57 to 69% of transparency in the visible and near IR region. FTIR spectral studies confirm the presence of A1 (TO) and E1 (TO) modes of Zn-O bond vibration and the formation of polymer composite materials.Keywords: rare earth doped ZnO, polymer composites, structural characterization, surface modification
Procedia PDF Downloads 355899 Strategic Metals and Rare Earth Elements Exploration of Lithium Cesium Tantalum Type Pegmatites: A Case Study from Northwest Himalayas
Authors: Auzair Mehmood, Mohammad Arif
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The LCT (Li, Cs and Ta rich)-type pegmatites, genetically related to peraluminous S-type granites, are being mined for strategic metals (SMs) and rare earth elements (REEs) around the world. This study investigates the SMs and REEs potentials of pegmatites that are spatially associated with an S-type granitic suite of the Himalayan sequence, specifically Mansehra Granitic Complex (MGC), northwest Pakistan. Geochemical signatures of the pegmatites and some of their mineral extracts were analyzed using Inductive Coupled Plasma Mass Spectroscopy (ICP-MS) technique to explore and generate potential prospects (if any) for SMs and REEs. In general, the REE patterns of the studied whole-rock pegmatite samples show tetrad effect and possess low total REE abundances, strong positive Europium (Eu) anomalies, weak negative Cesium (Cs) anomalies and relative enrichment in heavy REE. Similar features have been observed on the REE patterns of the feldspar extracts. However, the REE patterns of the muscovite extracts reflect preferential enrichment and possess negative Eu anomalies. The trace element evaluation further suggests that the MGC pegmatites have undergone low levels of fractionation. Various trace elements concentrations (and their ratios) including Ta versus Cs, K/Rb (Potassium/Rubidium) versus Rb and Th/U (Thorium/Uranium) versus K/Cs, were used to analyze the economically viable mineral potential of the studied rocks. On most of the plots, concentrations fall below the dividing line and confer either barren or low-level mineralization potential of the studied rocks for both SMs and REEs. The results demonstrate paucity of the MGC pegmatites with respect to Ta-Nb (Tantalum-Niobium) mineralization, which is in sharp contrast to many Pan-African S-type granites around the world. The MGC pegmatites are classified as muscovite pegmatites based on their K/Rb versus Cs relationship. This classification is consistent with the occurrence of rare accessory minerals like garnet, biotite, tourmaline, and beryl. Furthermore, the classification corroborates with an earlier sorting of the MCG pegmatites into muscovite-bearing, biotite-bearing, and subordinate muscovite-biotite types. These types of pegmatites lack any significant SMs and REEs mineralization potentials. Field relations, such as close spatial association with parent granitic rocks and absence of internal zonation structure, also reflect the barren character and hence lack of any potential prospects of the MGC pegmatites.Keywords: exploration, fractionation, Himalayas, pegmatites, rare earth elements
Procedia PDF Downloads 196898 Duplicated Common Bile Duct: A Recipe for Injury
Authors: David Armany, Matthew Allaway, Preet Gosal, Senarath Edirimanne
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A potentially devastating complication of routine laparoscopic cholecystectomy includes iatrogenic bile duct injuries, which represent a stable incidence rate of 0.3% over the past three decades. Whilst related to several relative risks such as surgeon experience and patient factors (older age, male sex), misinterpretation of biliary tree anatomy remains the most common cause, accounting for 80% of iatrogenic Common Bile Duct injuries. Whilst extremely rare, a duplicate common bile duct anomaly remains a potential variation to encounter during biliary surgery, with 30 recognised cases in the worldwide literature, of which type Vb accounts for 4. We report the case of a rare type Vb variation encountered during intra-operative laparoscopic cholecystectomy and confirmed on cholangiogram. To our knowledge, this is the first documented Type Vb case encountered in an Australian population. Given these anomalies are asymptomatic and can perpetuate iatrogenic common bile duct injuries, awareness of all subtypes is crucial. Irrevocably, preoperative Magnetic Resonance Cholangiopancreatography can help recognise these anomalies before the operating theatre; however, their widespread adoption is limited by expensive and availability.Keywords: duplicated common bile duct, type Vb, cholecystitis, MRCP, cholangiogram, iatrogenic CBD
Procedia PDF Downloads 86897 Language Development in Rare Diseases: Angelman Syndrome vs Prader-Willi Syndrome
Authors: Sara Canas Pedrosa, Esther Moraleda SepuLveda
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Angelman Syndrome (AS) and Prader-Willi Syndrome (PWS) are considered rare genetic disorders that share the same chromosomal region: 15q11.2-q13. This is why both share some common characteristics, such as, delay in language development. However, there is still little research that specifically focuses on the linguistic profile in these populations. Therefore, the objective of this study was to know the characteristics of oral and written language that Angelman Syndrome and Prader-Willi Syndrome present from the point of view of parents. The sample consisted of 36 families (with children between 6 and 17 years old), of which 23 had children with AS and 13 had children with PWS. All of them answered the Language Assessment Scale of the standardized test CELF-4, Spanish Clinical Evaluation of Language Fundamentals-4 (Wiig, Secord & Semel, 2006). The scale is made up of 40 items that assesses the perception of parents in areas such as: difficulty of listening, speaking, reading and writing. The results indicate that the majority of parents manifest problems in almost all the sub-areas related to oral language and written language, taking into account that many do not achieve a literacy level, with similar results in comparison with both syndromes. These data support the importance of working on oral language delay and its relationship with the subsequent learning of literacy throughout its development.Keywords: Angelman Syndrome , development, language, Prader-Willi Syndrome
Procedia PDF Downloads 131896 Ultrasonographic Evaluation of Tars and Metatars Region of Dromedary Camel
Authors: Aboozar Dehghan, S. Sharifi, A. Ardeshiri, F. Jafari, F. Samani
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Ultrasonography is a safe, particular, available and easy to use method to evaluate soft tissues. Tendons play the main role to body locomotors system. Ultrasonography performed in tarsus and metatarsus region of rare limb of eight adult, Dromedary camels (camelus dromedaries) in both sex. Clinical examination and gate analysis was performed before slaughtering. From the tarsus to the 1st phalanx was divided to 4 equal region include 1a, 2a, 1b and 2b. Flexor surface was clipped and covered by enough ultrasonography gel. Ultrasonography was performed by linear phased array 8-12 Mhz transducer in transverse and longitudinal section and Superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT) and suspensory ligament (SL) were imaged. Echogenicity and diameter of these structures were recorded. Size of tendons and SL measured after necropsy too. statistical analysis obtained that SDFT diameter larger than others in all described regions and mean of DDFT diameter larger than suspensory ligament. Echogenicity of SL more than SDFT and DDFT. No Significant relationship was seen between left and right rare limb structures size. Between sex and tendons and SL diameter, significant relationship not seen.Keywords: dromedary camel, tars and metatars, ultrasonography
Procedia PDF Downloads 553895 Liquid-Liquid Extraction of Rare Earths Elements by Use of Ionic Liquids
Authors: C. Lopez, S. Dourdain, G. Arrachart, S. Pellet-Rostaing
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Ionic liquids (ILs) are considered a good alternative for organic solvents in extractive processes; however, the higher or lower extraction efficiency in ILs remains difficult to predict because a lack of understanding of the extraction mechanisms in this class of diluents, making their application difficult to generalize. We have studied the extraction behavior of La(III) and Eu(III) from aqueous solution into n-dodecane and two ionic liquids (ILs), 1-ethyl-1-butylpiperidinium bis (trifluoromethylsulfonyl)imide [EBPip⁺] [NTf₂⁻] and 1-ethyl-1-octylpiperidinium bis (trifluoromethylsulfonyl)imide [EOPip⁺] [NTf₂⁻], at room temperature using N,N’- dimethyl- N,N’-dioctylhexylethoxymalonamide (DMDOHEMA) as extractant. Fe(III) was introduced to the aqueous phase in order to study the selectivity toward La(III) and Eu(III) and the effect of variation of PH was investigated by using of several HNO₃ concentrations. We found that the ionic liquid with shorter alkyl chain [EBPip⁺] [NTf₂⁻] showed a higher extraction ability than [EOPip⁺] [NTf₂⁻] and that the use of ILs as organic solvent instead n-dodecane, greatly enhanced the extraction percentage of the target metals with a good selectivity. Cation ([EBPip⁺] or [EOPip⁺]) and anion ([NTf₂⁻]) concentration in the aqueous phase, has been determined in order to elucidate the extraction mechanism.Keywords: extraction mechanism, ionic liquids, rare earths elements, solvent extraction
Procedia PDF Downloads 108894 A Rare Case of Taenia solium Induced Ileo-Cecal Intussusception in an Adult
Authors: Naraporn Taemaitree, Pruet Areesawangvong, Satchachon Changthom, Tanin Titipungul
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Adult intussusception, unlike childhood intussusception, is rare. Approximately 5-15% of cases are idiopathic without a lead point lesion. Secondary intussusception is caused by pathological conditions such as inflammatory bowel disease, postoperative adhesions, Meckel’s diverticulum, benign and malignant lesions, metastatic neoplasms, or even iatrogenically due to the presence of intestinal tubes, jejunostomy feeding tubes or after gastric surgery. Diagnosis can be delayed because of its longstanding, intermittent, and non-specific symptoms. Computed tomography is the most sensitive diagnostic modality and can help distinguish between intussusceptions with and without a lead point and lesion localization. This report presents the case of a 49-year-old man presented with increasing abdominal pain over the past three days, loss of appetite, constipation, and frequent vomiting. Computed tomography revealed distal small bowel obstruction at the right lower quadrant with thickened outer wall and internal non-dilated small bowel loop. Emergency exploratory laparotomy was performed to clear the obstruction, which upon inspection was caused by extremely long Taenia solium parasites.Keywords: intussusception, tape worm, Taenia solium, abdominal pain
Procedia PDF Downloads 121893 Seismic Behavior and Loss Assessment of High–Rise Buildings with Light Gauge Steel–Concrete Hybrid Structure
Authors: Bing Lu, Shuang Li, Hongyuan Zhou
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The steel–concrete hybrid structure has been extensively employed in high–rise buildings and super high–rise buildings. The light gauge steel–concrete hybrid structure, including light gauge steel structure and concrete hybrid structure, is a new–type steel–concrete hybrid structure, which possesses some advantages of light gauge steel structure and concrete hybrid structure. The seismic behavior and loss assessment of three high–rise buildings with three different concrete hybrid structures were investigated through finite element software, respectively. The three concrete hybrid structures are reinforced concrete column–steel beam (RC‒S) hybrid structure, concrete–filled steel tube column–steel beam (CFST‒S) hybrid structure, and tubed concrete column–steel beam (TC‒S) hybrid structure. The nonlinear time-history analysis of three high–rise buildings under 80 earthquakes was carried out. After simulation, it indicated that the seismic performances of three high–rise buildings were superior. Under extremely rare earthquakes, the maximum inter–storey drifts of three high–rise buildings are significantly lower than 1/50. The inter–storey drift and floor acceleration of high–rise building with CFST‒S hybrid structure were bigger than those of high–rise buildings with RC‒S hybrid structure, and smaller than those of high–rise building with TC‒S hybrid structure. Then, based on the time–history analysis results, the post-earthquake repair cost ratio and repair time of three high–rise buildings were predicted through an economic performance analysis method proposed in FEMA‒P58 report. Under frequent earthquakes, basic earthquakes and rare earthquakes, the repair cost ratio and repair time of three high-rise buildings were less than 5% and 15 days, respectively. Under extremely rare earthquakes, the repair cost ratio and repair time of high-rise buildings with TC‒S hybrid structure were the most among three high rise buildings. Due to the advantages of CFST-S hybrid structure, it could be extensively employed in high-rise buildings subjected to earthquake excitations.Keywords: seismic behavior, loss assessment, light gauge steel–concrete hybrid structure, high–rise building, time–history analysis
Procedia PDF Downloads 173892 Diabetic Striatopathy as an Initial Presentation of Type 2 Diabetes Mellitus in an 80 Year Old Filipina: A Case Report
Authors: Michelangelo Liban, Debbie Liquete
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A case of a 93-year-old Filipina who experienced a sudden onset of left-sided hemichorea hemiballismus after falling from a standing height due to dizziness and then sought consult at the Emergency Room. She was not known to have diabetes mellitus nor experienced any symptoms of diabetes aside from its rare neurological manifestation of hemichorea-hemiballismus prior to this consult. On further workup, her baseline laboratory tests at the Emergency Room Department showed a CBG of 340mg/dL, an HbA1c of 15%, no ketones were detected in her urine but a hyperdensity with a Hounsfeld unit of 38 on CT, and hyperintensity on T1 weighted MRI on her right striatum with an incidental finding of a subdural hematoma measured as a 0.7cm hyperdensity on her right temporoparietal area with no midline shift. She was then treated with Clonazepam 2mg ¼ tab twice a day before bedtime and insulin 70/30 16 units in the morning and eight units in the evening, which provided good glycemic control maintained at 140-180 mg/dL, complete cessation of the left-sided hemichorea hemiballismus was also observed. The subdural hematoma was deemed non-surgical, and she refused admission into our institution; hence observation on an outpatient basis was done. This is a case of a rare neurological manifestation of diabetes mellitus but with good treatment response to anti-chorea medications combined with diabetes medications.Keywords: hemichorea, hemiballismus, striatopathy, diabetes
Procedia PDF Downloads 73891 Jalovchat Gabbroic Intrusive of the Caucasus: Petrological Study, Geochemical Peculiarities and Formation Conditions
Authors: Giorgi Chichinadze, David Shengelia, Tamara Tsutsunava, Nikoloz Maisuradze, Giorgi Beridze
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The Jalovchat intrusive is built up of hornblende gabbros, gabbro-norites and norites. Within the intrusive hornblende-bearing gabbro-pegmatites are widespread. That is a coarse-grained rock with gigantic hornblende crystals. By its unusual composition, the Jalovchat intrusive has no analogue in the Caucasus. However, petrologically and geochemically, the intrusive rocks were studied insufficiently. For comprehensive investigations, the authors applied appropriate methodologies: Microscopic study of thin sections, petro- and geochemical analyses of the samples and also different petrogenic, rare and rare earth elements diagrams and spidergrams. Analytical study established that the Jalovchat intrusive by its composition corresponds mainly to the mid-ocean ridge basalts and according to geodynamic type belongs to the subduction type. In general, it is an anomalous phenomenon, as in the rocks of such composition crystallization of hornblende and especially of its gigantic crystals is atypical. The authors believe that the water-rich magma reservoir, which was necessary for the crystallization of gigantic hornblende crystals, appeared as a result of melting of water-rich mid-ocean ridge basaltic rocks during the subduction process in Bajocian time.Keywords: gabbro-pegmatite, intrusive, petrogenesis, petrogeochemistry, the Caucasus
Procedia PDF Downloads 202890 Etiologies of Megaloblastic Anemia in a Pediatric Hospital
Authors: Atitallah Sofien, Bouyahia Olfa, Mohsen S., Boussetta Khadija, Khemiri Monia, Fitouri Zohra, Boukthir Samir
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Introduction: Megaloblastic anemia (MA) is rare in children. The diversity of its etiologies can lead to misdiagnosis and may, therefore, delay the treatment. The aim of this study was to describe the epidemiological and etiological characteristics of children followed for MA at the Tunis children's hospital. Methodology: This is a retrospective study over a period of 25 years of all cases of MA in children in the Children's Hospital of Tunis. The diagnosis of MA was confirmed by myelogram in all patients. Results: We collected 29 observations, with an incidence of 1.2 cases/year and a sex ratio of 1. Sixty percent of the children were aged between 3 months and 2 years. The consultation time was between 15 and 30 days in a third of the patients. The clinical examination showed hypotrophy in 13% of cases, hepatosplenomegaly in 6% of cases, neurological or neurosensory damage in 23% of cases, and cardiac damage in 10% of children. MA was associated with thrombocytopenia in 65% of cases and leukoneutropenia in 24% of cases. One in 5 children had pancytopenia. The etiologies were mainly thiamine deficiency, Immerslund disease (20%), nutritional deficiency (13%), and Biermer anemia (13%). One of the patients presented an MA revealing visceral leishmaniasis. The outcome under vitamin B12, the dose of which was adapted to each etiology, was favorable for all patients. Conclusion: MA is rare in children with multiple etiologies that are mainly dominated by hereditary conditions and nutritional deficiencies, mainly in vitamin B12. The association with visceral leishmaniasis seems to be a particularity in our country not reported in the literature.Keywords: megaloblastic anemia, children, vitamin B12, anemia
Procedia PDF Downloads 60889 Systolic Blood Pressure and Its Determinants: Study in a Population Attending Pharmacies in a Portuguese Coastal City
Authors: M. J. Reis Lima, J. Oliveira, M. Brito, C. Lemos, A. Mascarenhas, E. Teixeira Lemos
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Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic blood pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2. and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population, we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Our study even with some limitations might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.Keywords: hypertension, age, exercise, obesity and gender
Procedia PDF Downloads 539888 Separation of Lanthanides Ions from Mineral Waste with Functionalized Pillar[5]Arenes: Synthesis, Physicochemical Characterization and Molecular Dynamics Studies
Authors: Ariesny Vera, Rodrigo Montecinos
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The rare-earth elements (REEs) or rare-earth metals (REMs), correspond to seventeen chemical elements composed by the fifteen lanthanoids, as well as scandium and yttrium. Lanthanoids corresponds to lanthanum and the f-block elements, from cerium to lutetium. Scandium and yttrium are considered rare-earth elements because they have ionic radii similar to the lighter f-block elements. These elements were called rare earths because they are simply more difficult to extract and separate individually than the most metals and, generally, they do not accumulate in minerals, they are rarely found in easily mined ores and are often unfavorably distributed in common ores/minerals. REEs show unique chemical and physical properties, in comparison to the other metals in the periodic table. Nowadays, these physicochemical properties are utilized in a wide range of synthetic, catalytic, electronic, medicinal, and military applications. Because of their applications, the global demand for rare earth metals is becoming progressively more important in the transition to a self-sustaining society and greener economy. However, due to the difficult separation between lanthanoid ions, the high cost and pollution of these processes, the scientists search the development of a method that combines selectivity and quantitative separation of lanthanoids from the leaching liquor, while being more economical and environmentally friendly processes. This motivation has favored the design and development of more efficient and environmentally friendly cation extractors with the incorporation of compounds as ionic liquids, membrane inclusion polymers (PIM) and supramolecular systems. Supramolecular chemistry focuses on the development of host-guest systems, in which a host molecule can recognize and bind a certain guest molecule or ion. Normally, the formation of a host-guest complex involves non-covalent interactions Additionally, host-guest interactions can be influenced among others effects by the structural nature of host and guests. The different macrocyclic hosts for lanthanoid species that have been studied are crown ethers, cyclodextrins, cucurbituryls, calixarenes and pillararenes.Among all the factors that can influence and affect lanthanoid (III) coordination, perhaps the most basic of them is the systematic control using macrocyclic substituents that promote a selective coordination. In this sense, macrocycles pillar[n]arenes (P[n]As) present a relatively easy functionalization and they have more π-rich cavity than other host molecules. This gives to P[n]As a negative electrostatic potential in the cavity which would be responsible for the selectivity of these compounds towards cations. Furthermore, the cavity size, the linker, and the functional groups of the polar headgroups could be modified in order to control the association of lanthanoid cations. In this sense, different P[n]As systems, specifically derivatives of the pentamer P[5]A functionalized with amide, amine, phosphate and sulfate derivatives, have been designed in terms of experimental synthesis and molecular dynamics, and the interaction between these P[5]As and some lanthanoid ions such as La³+, Eu³+ and Lu³+ has been studied by physicochemical characterization by 1H-NMR, ITC and fluorescence in the case of Eu³+ systems. The molecular dynamics study of these systems was developed in hexane as solvent, also taking into account the lanthanoid ions mentioned above, and the respective comparison studies between the different ions.Keywords: lanthanoids, macrocycles, pillar[n]arenes, rare-earth metal extraction, supramolecular chemistry, supramolecular complexes.
Procedia PDF Downloads 70887 Opposed Piston Engine Crankshaft Strength Calculation Using Finite Element Method
Authors: Konrad Pietrykowski, Michał Gęca, Michał Bialy
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The paper presents the results of the crankshaft strength simulation. The crankshaft was taken from the opposed piston engine. Calculations were made using finite element method (FEM) in Abaqus software. This program allows to perform strength tests of individual machine parts as well as their assemblies. The crankshaft that was used in the calculations will be used in the two-stroke aviation research aircraft engine. The assumptions for the calculations were obtained from the AVL Boost software, from one-dimensional engine cycle model and from the multibody model using the method developed in the MSC Adams software. The research engine will be equipped with 3 combustion chambers and two crankshafts. In order to shorten the calculation time, only one crankcase analysis was performed. The cut of the shaft has been selected with the greatest forces resulting from the engine operation. Calculations were made for two cases. For maximum piston force when maximum bending load occurs and for the maximum torque. Cast iron material was adopted. For this material, Poisson's number, density, and Young's modulus were determined. The computational grid contained of 1,977,473 Tet elements. This type of elements was chosen because of the complex design of the crankshaft. Results are presented in the form of stress distributions maps and displacements on the surface and inside the geometry of the shaft. The results show the places of tension stresses, however, no stresses are exceeded at any place. The shaft can thus be applied to the engine in its present form. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK 'PZL-KALISZ’ S.A. and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.Keywords: aircraft diesel engine, crankshaft, finite element method, two-stroke engine
Procedia PDF Downloads 178886 Novel Oral Anticoagulants (NOACS) Adherence and Bleeding Events in Atrial Fibrillation Patients: A Systematic Review and Meta-Analysis
Authors: Tadesse Melaku Abegaz, Akshaya Srikanth Bahagavathula, Abdulla Shehab Sheab, Asim Hassen
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Objectives: Non-adherence and discontinuation of anticoagulant therapy lead to increased ischemic stroke risk and contributes to suboptimal outcomes of the anticoagulant treatment. This systematic review and meta-analysis were aimed to investigate the adherence to NOACs and adverse events in patients with AF. Methods: Original research articles conducted on patients with AF and using any NOACs (dabigatran, rivoraxaban and apixaban) reporting adherence for at least 35 days were included. Scientific databases including PubMed, Web of Science, and Google Scholar were searched using MeSH keywords to obtaining literature researched between 2008 to till June, 2016. Study characteristics, patient’s sociodemographic and clinical characteristics, medication adherence levels and bleeding events reported were recorded. Results: The overall sample size of the six studies is 1,640,157, with CHADS2 scores < 2 in 551 patients, CHADS2-VASc ≥ 2 in 62,232 AF patients. Three-forth [75.6% (95%CI= 66.5-84.8), p < 0.001] are adherent to NOACs. However, a higher rate [72.7% (62.5-82.9), p < 0.001] of adherence was observed with Dabigatran than Apixaban [59.9% (3.2-123.1), p=0.063] and Rivaroxaban [59.3% (38.7-80.0), p<0.001]. Sub-group analysis revealed that nearly 57% of the AF patients on NOACs have CHADS2 scores < 2 and 20% of these patients were non-adherent to NOACs. Overall bleeding events rate associated with NOACs non-adherent AF patients was found to be 7.5% (0.2-14.8), p=0.045. However, nearly 11.2% of AF patients experienced bleeding events were non-adherent to NOAC medications. A higher proportion of bleeding events were noticed with Dabigatran (14.7%). Conclusions: Adherence rates, while uniformly suboptimal, nevertheless varied considerably, lowest at 59.3% for rivaroxaban and 59.9% for apixaban, followed by dabigatran (75.6%). Overall bleeding events associated with NOACs rates were 7.5%. However, lower adherence to NOACs was associated with worse outcomes among patients with greater stroke risk.Keywords: atrial fibrillation, bleeding events, meta-analysis, novel oral anticoagulants
Procedia PDF Downloads 331885 Solid Oral Leiomyoma: Clinical Case Report
Authors: Hurtado Zuñiga Yonel Marcos, Ferreira Joao Tiago
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Introduction: Leiomyoma is a benign smooth muscle tumor. It is predominantly found between 40-49 years with a small prevalence in men. It is commonly found in the uterus, stomach, and in areas with smooth muscle. It presents as nodular, solitary, variable size, slow growing, and asymptomatic. It is classified into solid, vascular, and epithelioid leiomyoma. Vascular leiomyoma is the most common in the oral cavity. Oral leiomyomas are very rare because a smooth muscle in the oral cavity isn’t common. The most frequent areas of this pathologyaretongue, lip, buccal mucosa, and palate. It may be derived from the vascular walls or excretory ducts of the salivary glands. The diagnosis is made by histologically analysis. The treatment of choice is complete excision. Recurrence is rare. Objective: To report the case of a solid leiomyoma on the dorsum of the tongue and review the literature. Case description: A 78-year-old female patient presented a nodular (ovoid) elevation of 8x6mm, brownish color, with irregular limits and firm consistency located in the dorsal part of the tongue with slight symptoms. An excisional biopsy was performed, photographic record, and 3 weeks post-surgical follow-up. Result: The surgical specimen was submitted to an anatomopathological analysis, resulting in a benign nodule with defined limits compatible with solid leiomyoma of the tongue. Discussion: It is a pathology that presents in a solitary, nodular, well-defined, asymptomatic form; in the oral cavity, leiomyomas are found in the tongue, lip, buccal mucosa, and palate; as in our patient, it was nodular and, in the tongue, with a difference only in the symptomatology. The most prevalent age is 40-49 years and with small predominance in men, unlike our female patient with 78 years. Conclusions: Oral leiomyoma is a rare benign lesion that presents as a solitary nodular nodule; for its diagnosis, an anatomopathological analysis should be performed, and the treatment of choice is total excision with little recurrence.Keywords: tongue, bening tumor, oral leiomyoma, leiomyoma
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