We present the case of a 30 years old patient (male) victim of a high speed car crush assisted by ED Craiova. Coma, severe head trauma, serious chest trauma with multiple rib fractures, bilateral lung contusions, pericardial fluid, multiple spine and pelvic unstable fracture, medullar injury, progressive shock, paroxysmal cardiac dysrhythmias. Increased levels of CKMB with atipical evolution for a myocardial contusion. Two cardiopulmonary arrest (asystole), both resuscitated.\nTaking into account the kinematics and severity of thoracic trauma, myocardial contusion was the first diagnostic hypotheses, but it was also considered the possibility of an acute coronary syndrome, toxicologic ethyology and the spinal cord damage as causes of cardiogenic shock and cardiac rhythm disturbance. \nThe association of neurotrauma, haemorrhage and pulmonary contusion limited treatment of an potential acute coronary syndrome, fast volume replacement and the possibilitys to assist ventilation, in context of shock and risk of secondary brain and spinal injury.\nSpecifying these contingencies determined the management orientation for both possible primary reperfusion and advanced management for neurotrauma.
ABSTRACT\nThe present work is included within a large and complex research project regarding Romanian Grey Steppe breed, unique as biologic and cultural–historic importance, in verge of extinction and involved into a preservation programme of Romanian’s genetic fund. The study of proteic fractions genetic polymorphism, especially of kappa-casein and genotype relations of these lactoproteins with some qualitative and quantitative features of milk production, it is an actual theme and for these breed it is a novelty. Research were carried out on a number of 30 Romanian Grey Steppe cows and focused on: milk production indicators by successive lactations, genetic structure, genetic parameters for some features and serum proteins of milk production. In the first lactation 62.69 % of the maximum lactation was attained, a value which highlights the tardiness of Romanian Grey Steppe breeds in terms of milk production. The milk quantity ranged between 1589.64 kg (1st lactation) and 2535.43 kg in the 5th lactation which was the maximum one. Starting with the 6th lactation, the milk quantity decreased reaching in the 8th lactation the value of 1078.5 kg. Milk fat percentage reached the maximal value in the 5th lactation, namely 4.73 %. The same evolution could be noticed for the percentage of protein which registered the value of 3.71 % in the 5th lactation. The main lactoprotein from milk, kappa-casein (K-cz), characterized in literature as a feature with a high degree of hereditary transmission, in the nucleus under study it acted as such, and its value was confirmed by the heritability index (h2=0.57 %). We must mention the medium values for milk and fat quantities (h2=0.27, 0.30 %) and the fat percentage from milk which had a greater hereditary influence h2 = 0.71 %. Correlations between kappa-casein and milk quantity are negative and powerful. Between kappa-casein and other qualitative features of milk (with fat content 0.58-0.67 % and protein content 0.77-0.87%), there are positive and very powerful correlations.
This paper presents an efficient multi-objective evolutionary algorithm for circuit bi-partitioning applications. Multi-objective optimization algorithms such as Weighted Sum Genetic Algorithm (WSGA), Elitist Non-dominated sorting Genetic Algorithm (ENGA) and Multi-Objective Particle Swarm Optimization using Crowding Distance (MOPSO-CD) are applied to circuit bi-partitioning problems. To valídate the performance of these evolutionary algorithms, MCNC benchmark circuits are used. Two objectives such as cut-cost and area- imbalance of the bi-partition are simultaneously optimized. The experimental results showed that ENGA performs better than WSGA and MOPSO-CD for circuit bi-partitioning applications.
The identification of radars with the use of classic techniques (methods of classic identification) which base on the statistic analysis of basic measurable parameters of a signal such as Radio Frequency (RF), Amplitude (A), Pulse Width (PW) or Pulse Repetition Interval (PRI) is for SEI problems not sufficient. \nThus, what is more often seen, for the identification process are adopted methods which for instance, use unintentional emissions or extraction of additional distinctive features which increase explicitness of the results received in the process of emission sources. One of such methods is hierarchical clustering in the form of a dendrogram. This article presents the method of hierarchical data clustering which is used in the process of radar identification. The results of clustering are presented in dendrograms of Pulse Repetition Interval. The algorithm implemented and used in the research method was parameterized therefore, it is possible to compare the results. This method makes it possible to differentiate particular radar copies of the same type on the basis of the dendrograms received.
Great challenges in modern medical image acquisition (CT and MRI) systems have been created with respect to storing and transmitting medical images in a health care system. The proposed method is a novel hybrid medical compression scheme in a lossless manner for different medical modality. First partitioning the medical image in to region of importance (ROI) and region of non importance (RNOI) depending upon the selection using an improved K-Means algorithm. The region of importance (ROI) is compressed losslessly using the curvelet transform and differential pulse code modulation (DPCM) and the region of non-importance (RNOI) is compressed by using integer wavelet transform technique and set portioning in hierarchical tree SPIHT followed by adaptive arithmetic encoder. Finally, both the compressed outputs are fused together to give the final output compressed image. The storage and transmission of important medical data and imagery is made lucid using this model. The quality measures of proposed model are compared with different techniques.
The genetic epidemiological studies revealed that schizophrenia is highly heritable. The aim of this study is to determine whether the common tagging single nucleotide polymorphism (tSNP) rs166531 in activating transcription factor 2 (ATF2) gene contributes to risk of paranoid schizophrenia. We conducted a two-stage candidate gene association, involving 722 patients with paranoid schizophrenia and 757 normal controls of Chinese Han descent recruited. TaqMan probe method was carried out to genotype all DNA from peripheral leukocytes. In the discovery stage, we found that the number of genotype TT in cases was more than that from controls (adjusted OR 1.54, 95% CI 1.07-2.19, P = 0.019). This risk quality increased in a dose-dependent manner as genotype AA decreased (Ptrend = 0.041). Interestingly, this SNP showed consistent association in replication cohort (adjusted OR 1.49, 95% CI 1.13-1.98, P = 0.005, Ptrend = 0.003) and combined cohort (adjusted OR 1.41, 95% CI 1.10-1.79, P = 2.839×10-4, Ptrend = 8.264×10-5). This study replicated a predisposition locus to paranoid schizophrenia, and strongly suggested that ATF2 may be involved in the development of this serious disease.
Introduction.\nAccidental Hypothermia produces a multitude of complex issues in the evaluation plan, investigative strategy, tactics and choice of therapeutic modalities and the development and prognosis of the patient, especially in the plurilessional context.\nCase study\nWe examined the case of a 79 years old patient, assisted at ED Craiova in November 2012 with severe hypothermia, found down the street. On admission to the ED, he appeared confused, disoriented in space and time, GCS = 10, no focal signs with generalized rigidity, tremor. Cardiogenic shock Kkillip III peripheral pulses hardly perceptible. Cold extremities, mottled.\nThe patient with severe hypothermia (Tc - 29.1 ° C) had multiple confounding aspects of cerebral ischaemia, peripherical of the limb and myocardial, possible attributable to both hypothermia, cardiogenic shock (acute coronary syndrome in the comment), an evolving ischemic stroke, an acute peripheral left limb ischaemia with severe rhabdomyolysis, acute bilateral pneumonia, or association in different degrees and their sequences,with the prognosis of extreme gravity.\nThe determinism, primary or secondary of the cardiac rhythm disorders in relation to hypothermia, give also rise to discussions and the possibility of little peripheral embolism can be neglected.\nConclusions\n• Cardiogenic shock was the turning point in determining the evolution of this case and its double determinism conditioned most likely the poor prognosis of the patient.\n• Pneumonia was the second severe impairment that influenced survival, limiting refilling and affecting oxygenation optimization\n• The question of etiology of heart disrhythmia, its seniority and role in the induction of cerebral and peripheral ischemia\n• The vulnerability of the miocard- maintained both during hypothermia and after reheating.\n• A number of clinical syndromes may have particular aggravating evolution in the context of hypothermia.\n• Therapeutic response was affected by hypothermia.\n• A series of subclinical suffering became manifests in these circumstances, such as renal suffering and peripheral arterial disease.\n• It is always difficult to distinguish the primary event in - a clinical context complicated by the presence of hypothermia.
Background: The school screening for spine deformities is an important health activity where a large numbers of health workers, it burden with the cost of the activity itself, and the education of the staff. Bad posturesare frequent last decades, because are increasing long bad positions and physical non activity by adolescents. The aim of our investigation was to determinate the bad posture level among school children by clinical examination tests and spine mouse software. Material and method: Examination included 840 children age 6-15 years in nine classes of basic school, with examination of 4 clinical tests by standard way, and spine mouse device software.Results: Test was the most positive in class 2, and test 1 was positive by 75% of population. The frequency of positive tests by classes was not significant p>0.05, but percentage of total children by positive tests was significant. Conclusion: Tests for School screening are only qualitative measurement and are not used for condition evaluation, spine mouse devise is significant for early detection of bad posture by school children.
We are proposing a mathematical model for the blood flow in large vessels, based on the non-Newtonian Cross rheological approach of the blood and taking into account the viscoelastic behavior of the vessel wall. In the case of this work only axisymmetric geometries are considered. Some numerical experiments in arteries with stenosis and aneurysm, using COMSOL Multiphysics 3.3 are made. The results of the numerical simulations are compared to some obtained by real medical measurements. Beside other physical quantities the variation of the wall shear stress, which is believed to have a special importance in the rupture of aneurysms, is calculated.