499 research outputs found
Seizures and intracranial dynamics in Kenyan children with acute non-traumatic encephalopathies
No full textSamson Gwer onderzocht veranderingen van de hersenen en van de druk in de schedel bij kinderen in Afrika die in coma raken. Uit zijn resultaten blijkt dat bij kinderen die in de kuststreek van Kenia wonen, malaria steeds minder vaak de oorzaak is van coma. Wel constateert hij dat deze kinderen steeds vaker plotseling een epileptische aanval krijgen. Het medicijn dat wordt gegeven om dit soort aanvallen te voorkomen (fosphenytoin), werkt bij hen niet goed. Gwer keek ook naar een hulpmiddel om de hersendruk bij kinderen in coma te meten en ging na of bepaalde middelen gebruikt kunnen worden om deze kinderen te behandelen
Seizures and intracranial dynamics in Kenyan children with acute non-traumatic encephalopathies
No full textSamson Gwer onderzocht veranderingen van de hersenen en van de druk in de schedel bij kinderen in Afrika die in coma raken. Uit zijn resultaten blijkt dat bij kinderen die in de kuststreek van Kenia wonen, malaria steeds minder vaak de oorzaak is van coma. Wel constateert hij dat deze kinderen steeds vaker plotseling een epileptische aanval krijgen. Het medicijn dat wordt gegeven om dit soort aanvallen te voorkomen (fosphenytoin), werkt bij hen niet goed. Gwer keek ook naar een hulpmiddel om de hersendruk bij kinderen in coma te meten en ging na of bepaalde middelen gebruikt kunnen worden om deze kinderen te behandelen
Unexpected relationship between tympanometry and mortality in children with nontraumatic coma
No full textOBJECTIVE:
We sought to further examine the relationship between tympanometry and mortality after noting an unexpected association on assessment of baseline data of a study whose primary aim was to investigate the utility of noninvasive tympanic membrane displacement measurement for monitoring intracranial pressure in childhood coma.
METHODS:
We recruited children who presented with acute nontraumatic coma to the high-dependency unit of Kilifi District Hospital on the rural coast of Kenya. We excluded children with sickle cell disease, epilepsy, and neurodevelopmental delay. We performed tympanometry on the right ear before tympanic membrane displacement analyzer measurements. All children were managed according to standard World Health Organization guidelines.
RESULTS:
We recruited 72 children with a median age of 3.2 years (interquartile range [IQR]: 2.0–4.3 years); 31 (43%) were female. Thirty-eight (53%) had cerebral malaria, 8 (11%) acute bacterial meningitis, 4 (6%) sepsis, and 22 (30%) encephalopathy of unknown etiology. Twenty (28%) children died. Tympanometry was normal in 25 (35%) children. Adjusting for diagnosis and clinical features of increased intracranial pressure, both associated with death on univariable analysis, children with abnormal tympanometry had greater odds of dying than did those with normal tympanometry (adjusted odds ratio: 17.0; 95% confidence interval: 1.9–152.4; P = .01). Children who died had a lower compliance (0.29 mL; IQR: 0.09–0.33 mL) compared with those who survived (0.48 mL; IQR: 0.29–0.70 mL) (P < .01).
CONCLUSIONS:
Abnormal tympanometry appears to be significantly associated with death in children with acute nontraumatic coma. This finding needs to be explored further through a prospective study that incorporates imaging and intensive physiologic monitoring
Victoria Samson
No full textVictoria Samson is the Washington Office Director for Secure World Foundation and has nearly twenty years of experience in military space and security issues.
Before joining SWF, Ms. Samson served as a Senior Analyst for the Center for Defense Information (CDI), where she leveraged her expertise in missile defense, nuclear reductions, and space security issues to conduct in-depth analysis and media commentary. Prior to her time at CDI, Ms. Samson was the Senior Policy Associate at the Coalition to Reduce Nuclear Dangers, a consortium of arms control groups in the Washington, D.C. area, where she worked with Congressional staffers, members of the media, embassy officials, citizens, and think-tanks on issues surrounding dealing with national missile defense and nuclear weapons reductions. Before that, she was a researcher at Riverside Research Institute, where she worked on war-gaming scenarios for the Missile Defense Agency\u27s Directorate of Intelligence.
Known throughout the space and security arena as a thought leader on policy and budgetary issues, Ms. Samson is often interviewed by multinational media outlets, including the New York Times, Space News, and NPR. She is also a prolific author of numerous op-eds, analytical pieces, journal articles, and updates on missile defense and space security matters. Read Ms. Samson\u27s publications.https://commons.erau.edu/stm-images/1096/thumbnail.jp
Changing trends in incidence and aetiology of childhood acute non-traumatic coma over a period of changing malaria transmission in rural coastal Kenya: A retrospective analysis
No full textObjectives: Recent changes in malaria transmission have likely altered the aetiology and outcome of childhood coma in sub-Saharan Africa. The authors conducted this study to examine change in incidence, aetiology, clinical presentation, mortality and risk factors for death in childhood non-traumatic coma over a 6-year period. Design: Retrospective analysis of prospectively collected data. Setting: Secondary level health facility: Kilifi, Coast, Kenya. Participants: Children aged 9 months to 13 years admitted with acute non-traumatic coma (Blantyre Coma Score =2) between January 2004 and December 2009 to Kilifi District Hospital, Kenya. Exclusion criteria: delayed development, epilepsy and sickle cell disease. Results: During the study period, 665 children (median age 32 (IQR 20-46) months; 46% were girls) were admitted in coma. The incidence of childhood coma declined from 93/100 000 children in 2004 to 44/ 100 000 children in 2009. There was a 64% overall drop in annual malaria-positive coma admissions and a 272% overall increase in annual admissions with encephalopathies of undetermined cause over the study period. There was no change in case death of coma. Vomiting, breathing difficulties, bradycardia, profound coma (Blantyre Coma Score=0), bacteraemia and clinical signs of meningitis were associated with increased risk of death. Seizures within 24 h prior to admission, and malaria parasitaemia, were independently associated with survival, unchanging during the study period. Conclusion: The decline in the incidence and number of admissions of childhood acute non-traumatic coma is due to decreased malaria transmission. The relative and absolute increase in admissions of encephalopathy of undetermined aetiology could represent aetiologies previously masked by malaria or new aetiologies.</p
Austin also must be remembered. The Augustinian legacy in Milton's work
No full textWhen I started working on this project, with a limited knowledge of Augustine, but determined to spot his presence in Miltonâs poetry, I was little aware of the intricacy of the relationship between the two authors. At this stage of my research, I do subscribe to Savoyeâs opinion, that this relationship is pervasive. However, one could safely add, it is as pervasive as it is hidden, primarily because of changed cultural paradigms, so that Miltonâs references are no longer familiar to the reader.
As I have pointed out in my presentation of the state of the art, these articulations are hardly made explicit in Miltonâs Oeuvre and also in critical literature they are hardly brought to the surface. My objective has been to make them a little more visible.
I have started my own process of discovery from the works where Milton more openly (but not completely) acknowledges his Augustinian sources, although arguably mediated. As concerns Samson Agonistes, I have presented a reading through Augustinian lenses. I am by no means claiming that mine is the best of all possible readings, but through those lenses I have been able to see a coherence, in Miltonâs dramatic poem, that is not generally recognized.
On the other hand, I thoroughly agree that âone cannot simply take any English poet and turn the post-structuralist critical machine loose on him or her in good faithâ. In particular, I am aware that I have read Miltonâs works against the current critical grain which, with a powerful turn impressed by Empsonâs Miltonâs God, is continually surfacing Miltonâs idiosyncrasies in order to cancel the received picture of a Christian author. Rather, I agree with Cirillo that Miltonâs perspective is that of âa professed Christian poet whose Christian consciousness, no matter how heterodox, colored virtually everything he wrote.â.We may ask, echoing Febvre on Rabelais, âMais de quel christianisme? In accordance with very traditional, even traditionalist Milton Criticism, I think it can safely be stated that Milton is a post-Reformation religious author, and one whose endeavour to âjustify the ways of God to menâ had to come to terms with the difficult task to find signs of providential history in the aftermath of a civil war and in the adverse context of the Restoration. His last published poems deal with this problem in different terms. As readers, we can come to different conclusions as to the texts. Behind them there is the man, âest abyssus humanae conscientiae,â in front of which, after Augustine, I can only say: "nescio"
Continuous EEG monitoring in Kenyan children with non-traumatic coma
No full textBackground The aim of this study was to describe the EEG and clinical profile of seizures in children with non-traumatic coma, compare seizure detection by clinical observations with that by continuous EEG, and relate EEG features to outcome.
Methods This prospective observational study was conducted at the paediatric high dependency unit of Kilifi District Hospital, Kenya. Children aged 9 months to 13 years presenting with acute coma were monitored by EEG for 72 h or until they regained consciousness or died. Poor outcome was defined as death or gross motor deficits at discharge.
Results 82 children (median age 2.8 (IQR 2.0–3.9) years) were recruited. An initial medium EEG amplitude (100–300 mV) was associated with less risk of poor outcome compared to low amplitude (≤100 mV) (OR 0.2, 95% CI 0.1 to 0.7; p<0.01). 363 seizures in 28 (34%) children were observed: 240 (66%) were electrographic and 112 (31%) electroclinical. In 16 (20%) children, electrographic seizures were the only seizure types detected. The majority (63%) of electroclinical seizures had focal clinical features but appeared as generalised (79%) or focal with secondary generalisation (14%) on EEG. Occurrence of any seizure or status epilepticus during monitoring was associated with poor outcome (OR 3.2, 95% CI 1.2 to 8.7; p=0.02 and OR 4.5, 95% CI 1.3 to 15.3; p<0.01, respectively).
Conclusion Initial EEG background amplitude is prognostic in paediatric non-traumatic coma. Clinical observations do not detect two out of three seizures. Seizures and status epilepticus after admission are associated with poor outcome
Evaluation of SAMSON for use in a South Platte decision support system
No full textDecember 1996.The South Platte River basin is a tributary of the Missouri River. Three states share the basin (Colorado, Nebraska, and Wyoming), with most of the basin in Colorado (79 percent). Colorado's population has been growing rapidly, especially in Front-Range cities, increasing the demand on water resources in the basin. Highly productive plains agriculture is also a substantial user of water resources and new uses also can be expected for wildlife and recreation. A decision support system (DSS) is being planned by the State of Colorado for water management in South Platte River Basin. Anticipated needs of the system include data development and some model development specific to the South Platte. Due to the unique characteristics of the South Platte River Basin, the implementation of this framework is expected to be slightly different from other basins in Colorado. The SAMSON (Stream-Aquifer Model for Management by SimulatiON) Model, developed in the 1980s specifically for the South Platte River Basin, has been recommended by past studies for use in a South Platte DSS. This report provides and analysis of the current SAMSON model. The conclusions of this report recommend that SAMSON in its present form not be used as part of a DSS, largely due to recent developments in modeling philosophy, application, and use. SAMSON proved the entire South Platte River Basin system could be effectively modeled, and pointed to the priorities for data collection and development. Components of SAMSON could be part of future DSS systems, but they should be separated into individual modules and evaluated individually against existing models. In summary, the analysis of SAMSON clearly show the need for a modular and data-centered approach for a South Platte DSS.Grant no. 14-08-0001-G2008/5 Project no. 09; financed in part by the Department of the Interior, U.S. Geological Survey, through the Colorado Water Resources Research Institute
The tympanic membrane displacement analyser for monitoring intracranial pressure in children
No full textPurpose: Raised intracranial pressure (ICP) is a potentially treatable cause of morbidity and mortality but tools for monitoring are invasive. We sought to investigate the utility of the tympanic membrane displacement (TMD) analyser for non-invasive measurement of ICP in children.
Methods: We made TMD observations on normal and acutely comatose children presenting to Kilifi District Hospital (KDH) at the rural coast of Kenya and on children on follow-up for idiopathic intracranial hypertension at Evelina Children’s Hospital (ECH), in London, UK.
Results: We recruited 63 patients (median age 3.3 (inter-quartile range (IQR) 2.0–4.3) years) at KDH and 14 children (median age 10 (IQR 5–11) years) at ECH. We observed significantly higher (more negative) TMD measurements in KDH children presenting with coma compared to normal children seen at the hospital’s outpatient department, in both semi-recumbent [mean −61.3 (95 % confidence interval (95 % CI) −93.5 to 29.1) nl versus mean −7.1 (95 % CI −54.0 to 68.3) nl, respectively; P = 0.03] and recumbent postures [mean −61.4 (95 % CI −93.4 to −29.3) nl, n = 59) versus mean −25.9 (95 % CI −71.4 to 123.2) nl, respectively; P = 0.03]. We also observed higher TMD measurements in ECH children with raised ICP measurements, as indicated by lumbar puncture manometry, compared to those with normal ICP, in both semi-recumbent [mean −259.3 (95 % CI −363.8 to −154.8) nl versus mean 26.7 (95 % CI −52.3 to 105.7) nl, respectively; P < 0.01] and recumbent postures [mean −137.5 (95 % CI −260.6 to −14.4) nl versus mean 96.6 (95 % CI 6.5 to 186.6) nl, respectively; P < 0.01].
Conclusion: The TMD analyser has a potential utility in monitoring ICP in a variety of clinical circumstances
Project: Children and youth center "SAMSON"
No full textMaģistra darba mērķis ir SIA „SAMSON” - bērnu un jauniešu centra - dibināšana. Bērnu centrs sniegs tādus sporta pakalpojumus kā karatē un vispārattīstoša vingrošana. Latvijā ir daudz sporta uzņēmumu, kas darbojas šajā jomā, tomēr autore nolēma dibināt sporta klubu Imantas rajonā, kur šobrīd jau eksistē vairāki sporta klubi, bet tie piedāvā tikai vienu sporta pakalpojuma veidu. Līdz ar to jaunam, topošam uzņēmumam SIA „SAMSON” - bērnu un jauniešu centram- būs mazāka konkurence un vairāk iespēju popularizēt un attīstīt sporta jomu noteiktā rajonā. Mūsdienās sabiedrība sāk vairāk pievērst uzmanību savam fiziskajam stāvoklim, rūpējas par veselības uzlabošanu. Vecāki arī domā par bērnu veselību un ved bērnus uz sporta nodarbībām. Līdz ar to autorei radās ideja izveidot bērnu un jauniešu sporta centru.The aim goal of the project is Ltd. Children and Youth Centre „SAMSON” foundation. The children center will give such sport services, as karate and gymnastics. Latvia has many sports companies operating in this field, however, the author has decided to establish a sports club in Imanta district, where there are sports clubs, but they offer only one type of sports service. Consequently, Ltd. Children and Youth Centre „SAMSON” will have less competition and more opportunities to promote and develop the sport in a given area. Today, people pay more attention to their physical condition, taking care of health. Parents also think about children's health and brought children to sports activities. Thus, the author have children and youth sports center creation idea
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