Benign extracerebral fluid collections: a cause of macrocrania in infancy

In order to determine the frequency and natural history of benign extracerebral fluid collections, computed tomography reports from a period of 26 months at Oklahoma Children's Memorial Hospital were reviewed (total scans: 3,411). Bilateral frontal extracerebral fluid collections were found in 94 infants under 1 year of age. Eighty-two infants had computed tomography scans as part of the evaluation for macrocrania. Thirteen patients had the typical findings of benign extracerebral fluid collections but otherwise were completely asymptomatic. Longitudinal observation for up to 30 months failed to reveal any changes in neurologic status of these patients. Benign extracerebral fluid collections are a relatively common cause of macrocrania in infants. The presence of these fluid collections is not of immediate concern, providing that clinical evaluations fail to identify either neurologic or developmental abnormalities.     

Digital image acquisition using a consumer-type digital camera in the anatomic pathology setting

Imaging is central to anatomic pathology. The captured images are used for documentation, archiving, teaching, and publication. The advent of low-cost, consumer-type, high-end digital cameras has provided a convenient, easy-to-use alternative for routine image acquisition. The various applications for digital image acquisition in anatomic pathology include, among others, digitizing conventional photographs, digital gross photography and digital macrophotography, digitizing radiographic images, and digital photomicrography. This article reviews digital image acquisition in the anatomic pathology setting using a consumer-type digital camera. The camera type chosen as an example for the discussion was selected for its popularity and wide use among pathologists and for its potential to function as a sole image input device in all applications combined. Techniques and accessories to further increase the functionality of the camera and help overcome some of the commonly encountered problems in some applications are described.     

The management of aneurysms and arterio-venous fistulae of the popliteal artery arising from war trauma. Emphasis on sigmoid operative approach

Between 1986-1988, 600 vascular cases arising from the Iran-Iraq conflict were dealt with within an 18 month period and 60 cases of popliteal artery and/or venous disruption were encountered presenting at variable times after injury. A policy of management between the forward and base hospital surgical teams was introduced, observing the following broad categorizations: (a) assessment/referral, (b) assessment/fasciotomy/referral, (c) immediate operation/referral for further operation/review/management. Two types of incision were used to enter the popliteal fossa: (a) a medial incision and (b) a sigmoid posterior incision (which we now favor). The results of this strategy of management and operative technique (when compared with our previous experience within the same time frame) suggested an improved outcome. Fifty-four out of 60 cases had a satisfactory operative result with below-knee amputation being required in only four cases and higher amputations in two others. No operative or postoperative deaths occurred. The implementation of this "vetting policy" at the front line appeared to reduce the number of amputations and assisted the clarification of management criteria in assessing limb viability at the forward hospital when a large number of casualties were being received. Operative access using the sigmoid posterior incision was not associated with any complications, offered better exposure than the medial incision and was technically easier for the surgeon to perform.     

Ifosfamide, methotrexate, and 5-fluorouracil: effective combination in resistant breast cancer

Ifosfamide has definite efficacy in many malignant tumours, including breast cancer. In the present study we substituted cyclophosphamide with ifosfamide in the combination CMF (cyclophosphamide, methotrexate, and 5-fluorouracil) regimen in 25 patients with breast cancer whose disease was refractory to CMF or who had relapsed after previous response. Ifosfamide was given in an i.v. infusion at a dose of 1.2 g/m² daily for 5 days, together with mesna as a uroprotector (at 20% of the ifosfamide dose). Methotrexate was given at a dose of 40 mg/m² and 5-fluorouracil was given at 600 mg/m², both by i.v. push. Courses were repeated every 21 days. The 24 evaluable patients received 3–12 courses (average, 5 courses); results included a complete remission in 3 patients (12.5%) and a partial remission in 3 (12.5%). Among the remaining patients, improvement was seen in 4 (16.6%); stable disease, in 7; and progressive disease, in 7 (29.2%). The complete responses lasted for 11+, 13+, and 15+ months, and partial remissions, for 2, 6, and 9 months. The responses were detected in soft-tissue as well as visceral lesions, but not in bony lesions. The responders remain under follow-up. This study shows the efficacy of ifosfamide-containing chemotherapy in breast cancer. As toxicities were tolerable, higher doses of ifosfamide could safely be used in these patients. Use of this combination as first-line therapy in breast cancer could be considered for a future study.Presented at the Satellite Symposium Ifosfamide in Gynecological Tumors of the 5th European Conference on Clinical Oncology and Cancer Nursing, London, September 3–7, 1989     

Contributions to the sociologic analysis of the impact of sickle cell disease on families from Northern Tunisia

The improvement of the conditions of care and quality of life of people living with drepanocytosis now constitutes a major concern of health authorities and voluntary groups (associations of sick people and their parents). In order to examine the conditions and methods of care for children living with drepanocytosis in the Bizerte region of Northern Tunisia and to understand the problems and difficulties experienced by them and their families in their daily lives, an anthropological study was carried out in the region between January 16 and February 12, 1997. Thirty-three interviews were carried out with families of infected children. The interviews were semi-directive using a pre-established protocol (interview guide). Thirty interviews were then analysed. A multitude of information concerning various medical and psycho-social aspects of drepanocytosis in the region were revealed. The data were regrouped into the following categories: circumstances of discovering the illness; explicative model of the illness as perceived by the people interviewed; conditions and methods of care of the sick child; degree of satisfaction with the health care system; psychological profile of the children interviewed; educational level of the children interviewed; repercussions the illness has on the family; impact of the illness on household budget; suggestions and comments of the people interviewed. In light of the information collected, various actions have been proposed with the goal of improving the conditions of care and quality of life of people living with drepanocytosis in the region.     

Treatment with danaparoid during pregnancy for a woman with a cutenous allergy to low-molecular-weight heparin]

The authors describe a case of heparin-induced skin reaction due to two preparations of low molecular weight heparin in a pregnant woman. The main characteristics of heparin-related cutaneous allergy are reported. The use of an heparinoid, usually indicated for patients with heparin-induced thrombocytopenia, appeared to be efficient and safe for the mother and her fetus. An epidural analgesia was performed for labor analgesia, 24 hours after the last injection of danaparid of sodium.     

Prediction of Ecofriendly Concrete Compressive Strength Using Gradient Boosting Regression Tree Combined with GridSearchCV Hyperparameter-Optimization Techniques

A crucial factor in the efficient design of concrete sustainable buildings is the compressive strength (Cs) of eco-friendly concrete. In this work, a hybrid model of Gradient Boosting Regression Tree (GBRT) with grid search cross-validation (GridSearchCV) optimization technique was used to predict the compressive strength, which allowed us to increase the precision of the prediction models. In addition, to build the proposed models, 164 experiments on eco-friendly concrete compressive strength were gathered for previous researches. The dataset included the water/binder ratio (W/B), curing time (age), the recycled aggregate percentage from the total aggregate in the mixture (RA%), ground granulated blast-furnace slag (GGBFS) material percentage from the total binder used in the mixture (GGBFS%), and superplasticizer (kg). The root mean square error (RMSE) and coefficient of determination (R²) between the observed and forecast strengths were used to evaluate the accuracy of the predictive models. The obtained results indicated that—when compared to the default GBRT model—the GridSearchCV approach can capture more hyperparameters for the GBRT prediction model. Furthermore, the robustness and generalization of the GSC-GBRT model produced notable results, with RMSE and R² values (for the testing phase) of 2.3214 and 0.9612, respectively. The outcomes proved that the suggested GSC-GBRT model is advantageous. Additionally, the significance and contribution of the input factors that affect the compressive strength were explained using the Shapley additive explanation (SHAP) approach.