Utility of ambulatory blood pressure monitoring in children and adolescents

Diagnosis of hypertension is critically dependent on accurate blood pressure measurement. “Accurate” refers to carefully following the guidelines for blood pressure measurement laid out for children and adults to minimize observer and subject errors that commonly occur in clinical blood pressure measurement. Accurate blood pressure measurement is more important in children and adolescents as the misdiagnosis of hypertension may have a life-long adverse impact on insurability and employment. Automated blood pressure measurement offers multiple advantages in achieving high-quality blood pressure determinations by reducing observer errors. The most commonly used form of automated blood pressure measurement is 24-h ambulatory blood pressure measurement (ABPM). Information on ABPM in children has grown exponentially over the last decade. Normative data exists for diagnosis of hypertension in children using ABPM including a novel method for determining normal values with the LMS method. There is further information about the utility of different determinants of 24-h blood pressure such as dipping status, morning surge and blood pressure load. ABPM has been able to detect significant differences in blood pressure in many disease states in children including chronic renal failure, polycystic kidney disease, solitary functioning kidney, and after renal transplantation. Increasingly nonambulatory automated blood pressure determinations have been used in management of hypertension in children. Although nonambulatory automated readings lack information about nocturnal blood pressure or blood pressure during daily activity, studies have suggested that home automated blood pressure measurements are a helpful adjunct to the usual office blood pressure reading.     

Measurement of the mechanical properties of soccer balls using digital image correlation method

There are some features for an approved soccer ball by Fédération Internationale de Football Association (FIFA), such as properties of the material, mass, pressure, stitches, etc. Many of these features up to now have been studied; nevertheless, the mechanical properties of the soccer balls to date have not been well reported. The chief purposes of the current research, hence, were to calculate the mechanical properties of the soccer balls, i.e., linear elastic, nonlinear hyperelastic, and viscoelastic, at two different sizes, including 4 and 5 which are using for football and futsal, respectively. To do this, compressive and stress-relaxation loading were applied to 38 approved soccer balls to quantify the stress–strain as well as reduced relaxation function of the balls. The strain/displacement of the balls was also measured via a high-speed camera using Digital Image Correlation (DIC) technique. The results revealed the mean elastic modulus of 66 and 67 kPa for the football and futsal balls, respectively. In addition, the maximum stresses of the football and futsal balls were 16 and 13 kPa, respectively. The nonlinear mechanical response of the soccer balls were analyzed using hyperelastic material models, i.e., Mooney-Rivlin and Ogden. A Finite Element (FE) model was also developed to verify the hyperelastic data compared to the experimental ones and, remarkably, the numerical data were in consistence with the experimental data. Finally, Prony- series was employed to quantify the viscoelastic properties of the balls. During the game, a soccer ball can reach to a speed of 210 km/h that can damage the human eye; however, the injury detail still has not been studied.     

Prognostic value of chromosome 1 and 8 copy number in invasive ductal breast carcinoma among iranian women: An interphase FISH analysis

Breast cancer is amongst the leading causes of death in women worldwide and the most common cancer amongst Iranian women. Unfortunately, the current clinical and histological criteria can only help 60 percent of women with breast cancer in diagnosis and long-term treatment. Therefore, genetic markers both at single gene and chromosomal level can play an important role in improving the diagnosis and prognosis of breast cancer patients. The aim of this retrospective study was to investigate the role of chromosome 1 and 8 copy number assessed by interphase fluorescence in situ hybridization (FISH), as prognostic parameters in 50 Iranian women, aged 35 to 64 years, with sporadic invasive ductal breast carcinoma. Chromosome 1 and 8 copy numbers were evaluated in relation to established clinicopathological parameters, the immunohistochemical markers ER, PR, P53 and cathepsin D, DNA index by flow cytometry, age and survival status of the patients. FISH using centromeric probes for chromosomes 1 and 8 was applied to interphase cell suspensions prepared from archived, Carnoyfixed tumor cells and selected paraffin-embedded tumor sections. Aneusomy for chromosomes 1 and 8 was present in all 50 patients to different levels. The total abnormality rate for chromosome 1 was 33.92 percent (4.24 percent monosomy and 29.68 percent polysomy), whereas for chromosome 8 this rate was 28.30 percent (6.48 percent monosomy and 21.82 percent polysomy). Statistically significant association (p<0.05) was demonstrated between monosomy 1 and patients’ age below 50 years, and between monosomy 1 and poor survival, respectively. Disomy 8 was significantly associated with P53 expression. A borderline significant correlation was demonstrated between polysomy 8 and diploid DNA content, as well as between disomy 1 and disease-free status of the patients. Chromosome 1 and 8 copy numbers may be considered as useful prognostic markers in invasive ductal carcinoma of the breast.     

Modelling and multivariable control in anaesthesia using neural-fuzzy paradigms. Part I. Classification of depth of anaesthesia and development of a patient model

OBJECTIVE: The first part of this research relates to two strands: classification of depth of anaesthesia (DOA) and the modelling of patient's vital signs. METHODS AND MATERIAL: First, a fuzzy relational classifier was developed to classify a set of wavelet-extracted features from the auditory evoked potential (AEP) into different levels of DOA. Second, a hybrid patient model using Takagi-Sugeno Kang fuzzy models was developed. This model relates the heart rate, the systolic arterial pressure and the AEP features with the effect concentrations of the anaesthetic drug propofol and the analgesic drug remifentanil. The surgical stimulus effect was incorporated into the patient model using Mamdani fuzzy models. RESULTS: The result of this study is a comprehensive patient model which predicts the effects of the above two drugs on DOA while monitoring several vital patient's signs. CONCLUSION: This model will form the basis for the development of a multivariable closed-loop control algorithm which administers "optimally" the above two drugs simultaneously in the operating theatre during surgery.     

Low Level Laser Therapy--a conservative approach to the burn scar?

Burn scars are known to be difficult to treat because of their tendency to worsen with hypertrophy and contracture. Various experimental and clinical efforts have been made to alleviate their effects but the problem has not been solved. Since patients keep asking for Low Level Laser Therapy (LLLT) and believe in its effectiveness on burn scars, and since former studies show contradictory results of the influence of LLLT on wound healing, this prospective study was designed to objectify the effects of LLLT on burn scars. Nineteen patients with 19 burn scars were treated with a 400 mW 670 nm Softlaser twice a week over 8 weeks. In each patient a control area was defined, that was not irradiated. Parameters assessed were the Vancouver Scar Scale (VSS) for macroscopic evaluation and the Visual Analogue Scale (VAS) for pruritus and pain. Photographical and clinical assessments were recorded in all the patients. Seventeen out of 19 scars exhibited an improvement after treatment. The average rating on the VSS decreased from 7.10+/-2.13 to 4.68+/-2.05 points in the treated areas, whereas the VSS in the control areas decreased from 6.10+/-2.86 to 5.88+/-2.72. A correlation between scar duration and improvement through LLLT could be found. No negative effects of LLLT were reported. The present study shows that the 400 mW 670 nm softlaser has a positive, yet sometimes limited effect on burn scars concerning macroscopic appearance, pruritus, and pain.     

Successful percutaneous coil occlusion of a large pulmonary arteriovenous malformation

Pulmonary arteriovenous malformation is one of the rarest congenital anomalies of cardiovascular system. We present a case of 30-year-old female with a large pulmonary arteriovenous malformation (PAVM) arising from the right lower pulmonary artery and draining to the left atrium. She underwent successful embolization using three detachable Cook coils.     

Simulation of a Hirschman-Herfindahl index without complete market share information

This paper utilizes maximum likelihood methods to simulate a Hirschman-Herfindahl index (HHI) for markets in which complete market share information is unavailable or delayed. Many jurisdictions either may be unable to administratively collect data or experience delays in collection that make data regarding turbulent markets of limited use. With the development of this method, regulatory authorities monitoring health-care competition or health-care firms can now use market surveys--in which reliable recall is often limited to the largest three or four firms--to produce an on-the-spot measure of market concentration.