106,460 research outputs found
Excavations and survey at Coats Hill, near Moffat, 1990-1
No full textThis report describes the results of the survey and sample excavations of small cairns,
annular structures and other remains on Coats Hill, near Moffat. The difficulties of assessing
the dates and functions of certain of the structures are discussed. The project formed
part of the archaeological studies for the North Western Ethylene Pipeline (NWEP) Project
for Shell Chemicals UK Ltd, which wholly funded the archaeological work and the publication
of this report
Fovea-sparing coats disease: A rare clinical entity
No full textPurpose: To evaluate the rarity, clinical features and management of Coats disease characterized by fovea-sparing enhancing the importance of pediatric retinal screening and early management to maintain a good visual acuity. Methods: Retrospective analysis of approximately 40 patients affected by Coats disease between 2000 and 2020 at the Retinoblastoma Referral Center and Ophthalmology unit of the University of Siena in Italy. Results: Two patients with fovea sparing Coats disease were included. Both presented an extrafoveal Coats disease (stage 2A by Shields classification) when they were 5 and 6 years old respectively. They had no anterior findings and a presenting visual acuity of 20/20 reflecting the early stage and a milder phenotype of the disease which are indeed more likely to be found in patients older than 3 years at presentation. Both presented telangiectasia and retinal exudation in the affected eye. Standard Argon laser photocoagulation and subsequently Cryotherapy were performed in the telangiectatic retinal periphery of both patients obtaining an excellent control and regression of the disease. Conclusions: Careful pediatric retinal screening and early management are crucial to ensure a good visual prognosis in such an early feature of Coats disease as fovea sparing since this condition unfortunately tends to recall the physician’s attention in more advanced stages. Due to the extremely poor number of articles regarding such a rare feature of Coats disease like fovea sparing, we report our experience. © The Author(s) 2020
Letter, [Author unclear] to Paulina T. Merritt
No full textHandwritten letter to Paulina Merritt from an unknown author, October 1, 1876.
turn-coats
No full textturn vall turn-coats from the Church of England to the Salvation ArmyDNE-citUsed I and SupUsed I and Sup4Used Imake, spread v, turning, turn around, turncoat, turner, turn-out, turn-out ha
Reemergence of dormant Coats disease after 30 years
No full textLa maladie de Coats est une vasculopathie non héréditaire. Elle est caractérisée par la présence de télangiectasies rétiniennes idiopathiques, d'exsudats lipidiques intrarétiniens et sousrétiniens, une rétinopathie ischémique et un décollement de rétine exsudative. Cette maladie se présente typiquement dans l'enfance, elle est unilatérale et atteint les hommes dans la majorité des cas. Nous décrivons un cas atypique d'un patient avec une maladie de Coats qui a récidivé 30 ans plus tard malgré un traitement initial efficace. Ce cas illustre l'évolution de la maladie de Coats à long terme.
L'enjeu de ce cas est de faire une étude exhaustive des différents traitements possibles de cette maladie.
Nous avons réalisé une révision de la littérature des cas de la maladie de Coats qui ont récidivé à long terme. Il y a peu de cas décrits dans la littérature avec un long suivi.
En conclusion, la maladie de Coats doit être considérée comme une maladie chronique qui nécessite un suivi à long terme. Cette maladie peut se réveiller et récidiver dans des zones de la rétine, qui n'ont pas été atteintes auparavant, et plusieures décennies plus tard.
Le traitement standard de cette maladie est la réalisation d'une cryothérapie et du laser argon dans les zones atteintes de la rétine. Dans les cas où l'exsudation rétinienne est très importante il peut s'avérer de faire un traitement chirurgical avec drainage du liquide sousrétinien, ce qui a été réalisé sur ce patient
Unusual anterior and posterior segment features of coats disease
No full textPurpose To report the clinical course and management of unusual anterior and posterior segment features of Coats disease and their relation to the age of the patients to increase the awareness towards these rare clinical features rarely described in the current literature. Methods A retrospective descriptive review of 45 eyes of 45 patients affected by Coats disease was conducted at the Retinoblastoma Referral Center and Ophthalmology Unit of the University of Siena in Italy analyzing data from 2000 to 2022. Medical records and images were revised to find some cases presenting unusual anterior and posterior segment features in patients affected by Coats disease. We identified therefore 4 unusual clinical conditions: retinal macrocysts, anterior chamber cholesterolosis, fovea-sparing Coats disease and secondary vasoproliferative tumor. Results Two patients presented with retinal macrocyst (2/45 = 4.4%), one with anterior chamber cholesterolosis (1/45 = 2.2%), two with fovea sparing Coats disease (2/45 = 4.4%) and one with vasoproliferative tumor associated (1/45 = 2.2%) for a total of six (6/45 = 13.3%) patients manifesting unusual anterior or posterior segment features in Coats disease. Conclusion Unusual anterior and posterior segment features of Coats disease such as retinal macrocyst and anterior chamber cholesterolosis have been more frequently reported in younger children while fovea-sparing and vasoproliferative tumors have been more commonly described in older patients. Age is then a strong prognostic marker which allows to distinguish two different phenotypes of Coats disease: patients younger and older than 3 years old with more aggressive and milder phenotype respectively
The Effect of a High Thermal Gradient on Sintering and Stiffening in the Top Coat of a Thermal Barrier Coating (TBC) System
No full textSuperalloy substrates coated with plasma sprayed CoNiCrAlY bond coats and yttria-stabilized zirconia top coats have been subjected to a high heat flux in a controlled atmosphere chamber. The sintering exhibited by the top coat under these conditions has been studied and compared with the behavior observed during isothermal heating, both when attached to the substrate and when detached. Sintering has been characterized by (a) microstructural examinations, (b) dilatometry, in both in-plane and through-thickness directions, and (c) stiffness measurements, using both cantilever bending and nanoindentation. A numerical heat flow model has been used to explore the stress state under isothermal and thermal gradient conditions. Sintering proceeds faster at higher temperature, but is retarded by the presence of tensile stresses (from differential thermal expansion between coating and substrate) within the top coat. Sintering occurs preferentially near the free surface of the top coat under gradient conditions, not only because of the higher temperature, but also because the in-plane stress is more compressive in that region
The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients.
No full textBACKGROUND Among trauma patients who survive to reach hospital, exsanguination is a common cause of death. A widely practicable treatment that reduces blood loss after trauma could prevent thousands of premature deaths each year. The CRASH-2 trial aimed to determine the effect of the early administration of tranexamic acid on death and transfusion requirement in bleeding trauma patients. In addition, the effort of tranexamic acid on the risk of vascular occlusive events was assessed.
OBJECTIVE Tranexamic acid (TXA) reduces bleeding in patients undergoing elective surgery. We assessed the effects and cost-effectiveness of the early administration of a short course of TXA on death, vascular occlusive events and the receipt of blood transfusion in trauma patients.
DESIGN Randomised placebo-controlled trial and economic evaluation. Randomisation was balanced by centre, with an allocation sequence based on a block size of eight, generated with a computer random number generator. Both participants and study staff (site investigators and trial co-ordinating centre staff) were masked to treatment allocation. All analyses were by intention to treat. A Markov model was used to assess cost-effectiveness. The health outcome was the number of life-years (LYs) gained. Cost data were obtained from hospitals, the World Health Organization database and UK reference costs. Cost-effectiveness was measured in international dollars (30,830. The incremental cost of giving TXA compared with not giving TXA was 64.
CONCLUSIONS Early administration of TXA safely reduced the risk of death in bleeding trauma patients and is highly cost-effective. Treatment beyond 3 hours of injury is unlikely to be effective. Future work [the Clinical Randomisation of an Antifibrinolytic in Significant Head injury-3 (CRASH-3) trial] will evaluate the effectiveness and safety of TXA in the treatments of isolated traumatic brain injury (http://crash3.lshtm.ac.uk/).
TRIAL REGISTRATION Current Controlled Trials ISRCTN86750102, ClinicalTrials.gov NCT00375258 and South African Clinical Trial Register DOH-27-0607-1919.
FUNDING The project was funded by the Bupa Foundation, the J P Moulton Charitable Foundation and the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 17, No. 10. See HTA programme website for further project information
Doença de Coats: diferentes apresentações
No full textIntrodução: A Doença de Coats caracteriza-se pelo desenvolvimento anormal dos vasos retinianos (telangiectasia), com deposição progressiva de exsudados intra e subretinianos e consequente descolamento de retina exsudativo. É uma patologia rara, esporádica, idiopática e unilateral (95%), que afecta maioritariamente indivíduos do sexo masculino (75%). A idade média de diagnóstico é aos 10 anos de idade.
Na maioria dos doentes manifesta-se por diminuição da acuidade visual, estrabismo e/ou leucocória. O diagnóstico é clínico baseando-se nos achados fundoscópicos característicos. Vários exames complementares como a angiografia fluoresceínica, podem auxiliar a caracterizar a patologia.
A classificação da Doença de Coats é útil para a escolha da opção terapêutica e prognóstico.
Material e métodos: Os autores descrevem 4 casos clínicos de Doença de Coats, quanto à sua clínica, abordagem diagnóstica, opções terapêuticas e seguimento em consulta.
Resultados: Os doentes foram submetidos a fotocoagulação laser indirecta e a crioterapia quando indicada. Após tratamento demonstraram melhoria clínica e funcional.
Conclusão: A laserterapia e a crioterapia são opções terapêuticas nos estádios iniciais da patologia, permitindo a estabilização da doença. O diagnóstico precoce e a abordagem terapêutica atempada são essenciais para prevenir a diminuição progressiva da função visual. O tempo médio de recorrência da doença é de dez anos, sendo um seguimento regular e a longo prazo essenciais.
Bibliografia:
1. Shields J, Shields C. Coats disease: The 2001 LuEsther T. Mertz Lecture. Retina. 2002; 22(1): 80-91.
2. Shields J, Shields C, Honavar S, Demirci H. Clinical variations and complications of Coats disease in 150 cases: The 2000 Sanford Gifford Memorial Lecture. Am J Ophthalmol. 2001 May; 131(5): 561-71.
3. Shields J, Shields C, Honavar S, Demirci H, Cater J. Classification and management of Coats disease: The 2000 Proctor Lecture. Am J Ophthalmol. 2001 May; 131(5): 572-83.
4. Hu Z, Gao R, Jin C, Liang X, Zhang S. Photocoagulation and scleral cryotherapy for Coats disease. Yan Ke Xue Bao. 1996 Dec; 12(4): 199-201.
5. Mosin I, Moshetova L. Tactics of treating children with Coats disease. Vestn Oftalmol. 2002 Mar-Apr; 118(2): 11-5
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