An Unusual Complication in Johanson’s Staged Urethroplasty: Squamous Cell Carcinoma-Juniper Online Journal of Case Studies-Juniper Publishers

JUNIPER PUBLISHERS-Juniper Online Journal of Case Studies

An Unusual Complication in Johanson’s Staged Urethroplasty: Squamous Cell Carcinoma

Authored by Siddharth Pandey*

Urethral stricture is an uncommon urological condition in developing countries like India. It usually results from trauma, iatrogenic injuries and venereal infections. Penile carcinoma is a common genital cancer with usual risk factors being phimosis, human papillomavirus (HPV) infection, tobacco smoking, sexual promiscuity and poor hygiene. The occurrence of carcinoma in penile stump following Johannson’s staged urethroplasty for anterior urethral stricture is extremely rare. Herein, we report a rare delayed occurrence of squamous cell carcinoma in the penile stump following Johannson’s staged urethroplasty for anterior urethral stricture in a circumscribed man.

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Influence of Information Technologies on Competitive Strategies for SMES-International Journal of Environmental Sciences & Natural Resources-Juniper Publishers

JUNIPER PUBLISHERS-International Journal of Environmental Sciences & Natural Resources

Influence of Information Technologies on Competitive Strategies for SMES

Authored by Jose G Vargas-Hernandez*

This research proposes the use of Information Technology (IT) as a way to generate efficient strategic management in small and medium enterprises (SMEs) to achieve economic advantages. It focuses essentially on the ways in which storage is carried out, recovery, transmission and manipulation of information, since the way in which it is handled is of vital importance in the understanding of individual and organizational behavior. The main research question is: Why do people dedicate themselves to competitive strategies for SMEs? As part of the research methodology for the development of this work, the literature was thoroughly reviewed, and cases of success associated with the topic were reported and published. The work answered the questions raised and it was possible to conclude that in fact it is possible to achieve the quality strategies associated with business processes in terms of IT services, which as a final result in competitive advantages.

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Role of MiRNAs in Oral Cancer-Journal of Head Neck & Spine Surgery-Juniper Publishers

JUNIPER PUBLISHERS-JOURNAL OF HEAD NECK & SPINE SURGERY

Posterolateral Percutaneous Endoscopic Discectomy with Partial Pediculotomy for the L1-L2 High-Grade Downward Migrated Disc Herniation

Authored by Yoshihiro Kitahama*

Percutaneous endoscopic discectomy (PED) is one of the most useful minimally invasive surgical techniques for lumbar disc herniation (LDH). However, high-grade migrated disc is difficult to treat with only the standard posterolateral approach (posterolateral PED, PLPED). To overcome this difficulty, we combined the pediculotomy with PLPED for the treatment of high-grade migrated LDH. The pediculotomy is the recent technic for PED that has been explored with development of high-speed drill. A 72-year-old man had a 6-month history of left L2 radiculopathy. His general state was too poor to perform general anesthesia and invasive surgery. The left L1-L2 downward migrated fragment compressed his L2 nerve root axial portion on magnetic resonance imaging. PLPED with partial pediculotomy was used for complete total removal, which cured his symptoms without any complications. Thirty minutes after fragmentectomy, we needed to control 100-ml bleeding from the anterior epidural venous plexus (AEVP). Upper-level migrated large lumbar disc fragments often require facetectomy with some fusion in conventional microscopic surgery. This case was too complicated for indicating the conventional technique. Only the flexible bipolar device helps control hemostasis in the PED system, but some bleeding cannot be controlled easily. PLPED with partial pediculotomy was useful for a migrated fragment in patients with poor general conditions. Although the PED system requires a new device to control the bleeding from the AEVP.

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Roqia Al-Azzani (TBI) Serial CT Control Analysis of Necessity and Outcome-Open Access Journal of Neurology & Neurosurgery-Juniper Publishers

JUNIPER PUBLISHERS-Open Access Journal of Neurology & Neurosurgery

Roqia Al-Azzani (TBI) Serial CT Control Analysis of Necessity and Outcome

Authored by Roqia al-Azzani*

TBI is a leading cause of death and disability around the globe. The Glasgow Coma Scale (GCS) and the Glasgow Outcome Scale (GOS) are the most widely used methods of describing TBI and measure of outcome following head injury. Computed tomography (CT) has become the current standard for diagnosing intracranial pathology following head trauma The aims of this study were to identify radiological features of patients in who repeated CT imaging would be useful and to identify the outcome of head trauma, according to Glasgow Outcome Scale .In addition to make a development of a stratification protocol of patients into appropriate risk groups avoiding over or under investigation in such patients. A retrospective case series study analysis of head trauma patients presenting to the 48 Medical Model Compound Hospital between January and March 2017. All patients requiring a CT head on admission and then a repeat (control) CT at 6 hours or more were included. Their GCS was assessed twice before undergoing the control brain CT scans; once they arrived at the hospital, then followed by another assessment after 3 hours and assessed GOS on discharge. Of the total 27-control brain CTs, it was seen there were no different in 23 (85.2 %). In CTs of anther 1 (3.7%) there was increasing in the pathology present. And in the anther 3 (11.11%) there were a decrease in the pathology. Over all, all patients had clinical improvement and good outcome depending on of GCS and Glasgow Outcome Scale respectively. To conclude, control brain CT scans after 6 hours or more from the event are not necessary in case the initial CT was normal or when there is no clinical deterioration Background. Traumatic Brain Injury (TBI) is defined as damage to the brain resulting from external mechanical force, such as rapid acceleration or deceleration, impact, blast waves, or penetration by a projectile and presents a major worldwide social, economic, and health problem. TBI is a leading cause of death and disability around the globe. In developing countries, the incidence of traumatic brain injury is increasing as traffic increases, besides Other confounding factors such as industrialization, falls and ballistic trauma. The most widely used methods of describing TBI are the Glasgow Coma Scale (Figure 1). It is predictive of mortality in a general TBI population. The Glasgow Outcome Scale (Figure 2) is the most widely used and accepted measure of outcome following head injury. Computed Tomography (CT) is the preferred radiologic test in TBI it is quick, accurate, and widely available, it has become the current standard for diagnosing intracranial pathology following head trauma. And the role of the initial brain CT scan and of unscheduled repeat brain CTs when a neurological deterioration occurs is well established. But using of routine serial head CT in patients without neurologic deterioration is not supported by the findings of Brown et al. The aims of this study are to identify radiological features of patients in who repeated CT imaging would be useful and to Identify the outcome of head trauma, according to Glasgow Outcome Scale. In addition to make a development of a stratification protocol of patients into appropriate risk groups avoiding over or under investigation in such patients.

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Design of A Roadmap for Implementing A Quality Approach At ONS-Algeria-Biostatistics and Biometrics Open Access Journal-Juniper Publishers

JUNIPER PUBLISHERS-Biostatistics and Biometrics Open Access Journal

Design of A Roadmap for Implementing A Quality Approach At ONS-Algeria

Authored by Tarik Bourezgue*

The rapid changes in Algeria have had and continue to have a profound impact on infrastructure, economic agents and the population as a whole. These transformations have already turned the statistical landscape upside down and will continue to do so. In fact, the need for statistical data has changed and evolved in terms of the nature of the statistics, on one hand, and requirements regarding availability, quality and time, on the other hand. Starting from the context described above, the development of ONS-Algeria’s quality approach is essentially based on the capitalization of the work of cooperation with Eurostat on the principles of the European Quality Assurance Framework for Official Statistics (QAF), the option for a participatory and transparent process to enrich this approach and facilitate its appropriation and lastly, conducting the process in stages. In driving the process step by step, to optimize its management, our paper will address the issues related to the design of a roadmap for implementing the Code of Practice (CoP) for the ENP south countries.

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Pathology of Cardiovascular System in Patients with Inflammatory Bowel Diseases-Advanced Research in Gastroenterology & Hepatology-Juniper Publishers

JUNIPER PUBLISHERS-Advanced Research in Gastroenterology & Hepatology

Pathology of Cardiovascular System in Patients with Inflammatory Bowel Diseases

Authored by Khlynova OV*

The purpose the work was studying of cardiovascular system disease prevalence and structure in persons with the inflammatory bowel diseases (IBD) using Gastroenterology department of the Perm regional hospital as an example. It was the retrospective one-stage research including studying case histories of the patients with ulcerative colitis (UC) and Crohn’s disease (CD) examined and treated in gastroenterological clinic for the period of 2013-2016. There were 291 patients with IBD, chronic cardiovascular pathology was revealed only in 90 patients. Comparative analysis showed that combined diseases were mainly spread in men with UC of middle and advanced age. The most typical for them was combination of UC and ischemic heart disease (50% of cases). Cardiovascular system pathology was 1.5 times more common for women with CD pathology. Besides CD, thromboses of peripheral veins (45% of cases) and myocardial dystrophy (24.5% of cases) were the most frequent pathologies. Due to the small number of patients with IBD and cardiovascular system pathology, it is not possible to claim unambiguously the degree of cardiac disorders in patients with IBD. Thus, it is planned to increase the number of observations to reach statistically optimum conclusion. Studying of this problem is of special practical importance for the possibility to regard patients with IBD as a group of patients with high cardiovascular risk. This will necessitate a number of preventive actions to prevent cardiovascular accidents of fatal and non-fatal character.

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Research about NG-PDT Influence to Thymus-Dependent Lymphocyte Subpopulation from Peripheral Blood of Bronchogenic Carcinoma-Cancer Therapy & Oncology International Journal-Juniper Publishers

JUNIPER PUBLISHERS-Cancer Therapy & Oncology International Journal

Research about NG-PDT Influence to Thymus-Dependent Lymphocyte Subpopulation from Peripheral Blood of Bronchogenic Carcinoma

Authored by Linlin Xu*

To research about PDT influence to thymus-dependent lymphocyte subpopulation from peripheral blood of bronchogenic carcinoma. Taking forty patients as study objects who suffering the bronchogenic carcinoma, the researchers use semi-conductive laser therapy apparatus (made in China) to irradiate the diseased region, and then observe the changed information of thymus-dependent lymphocyte subpopulation from peripheral blood during pre-therapy and post-treatment by immunohistochemical techniques of streptavidin-peroxidase (abbreviation: S-P method). The level of some medical data in pre-therapy is higher than the data in post-therapy (like CD3+, CD4+, CD8+, CD4+/CD8+, CD45RA+, the absolute value of CD45RA+, the absolute value of CD45RA+ and CD45RA+/RO+); And the level of CD45RO+ (P< 0.05) is lower than the data in pre-therapy.  Photodynamic therapy provides the technical support with clinic treatment for bronchogenic carcinoma through immune adjustment to enhance the immunologic function.

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Suicidal Attempt by Hanging-Unusual Evolution-Case Report-Global Journal of Otolaryngology-Juniper Publishers

JUNIPER PUBLISHERS-Global Journal of Otolaryngology

Suicidal Attempt by Hanging-Unusual Evolution-Case Report

Authored by Cristina Otilia Laza*

Hanging is the most common suicide method that is used by men and women also. The mechanisms of death recognized are airway obstruction, carotid sinus compression with vagal inhibition (and reflex cardiac arrest), arterial blockage with brain ischemia, blockage of both IJV, with edema of the face, brain, tongue, larynx pharynx, fractures in cervical vertebral column with the cord injury. We present an extreme case of an 62 year-old man, who try to suicide by hanging, but he was discovered by the family still breathing. They call 911. SMURD resuscitate him and rush him to the hospital there was admitted in ICU-ENT unit. The patient was comatose, with giant edema of the head, and cyanosis, brain edema and ischemia with possible decerebration. We present this case because of a few unique particularities first the fact that he was a person with a permanent tracheostomy -5 years ago was diagnose with laryngeal carcinoma and treated with total laryngectomy and neck dissection followed by radiotherapy the extended period of time between hanging and salvage -was discovered hanging by the rope 2 days after the event still breathing -unique in cases reports all over the world. Also It example that mechanism of death can be other than respiratory asphyxia in hanging cases. Also is important to discuss the suicidal attempt in patients with cancer, and the quality of life after a mutilating surgery. even till now there are no signs of recurrence.

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Colorless Lucid Dreams in University Students; It’s Possible Relevance to X-Chromosome Linkage and Multi-Colored Visual Imaging-Theranostics of Brain, Spine & Neural Disorders-Juniper Publishers

JUNIPER PUBLISHERS-Theranostics of Brain, Spine & Neural Disorders

Colorless Lucid Dreams in University Students; It’s Possible Relevance to X-Chromosome Linkage and Multi-Colored Visual Imaging

Authored by Seung CK*

Some people only tend to have black and white dreams while they are dreaming. There are studies that show that experience in black and white media have influence in this dream1. Also, Middleton (1942) found that 70.7% of 277 college sophomores reported “rarely” or “never” seeing colors in their dreams. The present study replicated Middleton’s questionnaire and found that a sample of 124 students in 2001 reported a significantly greater rate of colored dreaming than the earlier sample, with only 17.7% saying that they “rarely” or “never” see colors in their dreams. In our study, 190 Yonsei University students were randomly chosen to investigate whether they experience only black and white dream. Ahead of investigation, 94 university students were asked about how frequently they dream and the validity to see color in dreams. Out of 93 respondents, a majority (34) answered that they frequently experience dreaming while they are asleep. Still, there are those who do not dream, for 20 people answered that they barely experience dreaming.

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Floristic Composition in Secondary Forests Located in a Tropical River Island - Brazil-Annals of Reviews & Research-Juniper Publishers

JUNIPER PUBLISHERS-Annals of Reviews & Research

Floristic Composition in Secondary Forests Located in a Tropical River Island - Brazil

Authored by Zviejkovski IP*

Fluvial islands are very changeable areas once they have vertical accretion by sediment from the flood as the same time as suffer erosion by channel flow. This factor acts directly over the characteristics of their vegetal cover in terms of composition and successional stages. In an island of the Upper Paraná River a floristic composition survey was performed in order to evaluate the plant succession stage of three forest fragments. The study areas were: Forest 1, an abandoned pasture under successional process over the last 10 years; Forest 2, a 55-year-old primary forest settled over a sand bar; and Forest 3, a fragment of a remaining forest. Floristic composition analysis showed that island soil has disturbed by trampling cattle reflecting on the species settlement throughout the successional process.

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Efficacy of Phytotherapy in Oral Mucosites Induced by Chemotherapy and Radiotherapy Phytotherapy in OM really work?-Global Journal of Pharmacy & Pharmaceutical Sciences-Juniper Publishers

JUNIPER PUBLISHERS-Global Journal of Pharmacy & Pharmaceutical Sciences

Efficacy of Phytotherapy in Oral Mucosites Induced by Chemotherapy and Radiotherapy Phytotherapy in OM really work?

Authored by Braz José do Nascimento Júnior*

Oral mucositis (OM) is a complication of cancer therapy. Because of the associated complications, patients with OM go through decreasing doses or until the suspension of chemotherapy treatment or radiotherapy of head and neck until the improvement of the clinical picture, with that, exposing them the progression of the tumor. Current treatments produce limited results and rely on oral cryotherapy using ice, low-power laser exposure and systemic administration of keratinocyte growth factor (Palifermin).The use of medicinal plants and herbal medicine in the treatment of OM is still little used, but with a tendency to expand and accept the pharmaceutical market. We can conclude that phytotherapy is an expanding market and that, although efficient, needs more research and better acceptance of oncologists and other health professionals. Also some mechanisms of action are still not well understood, therefore, studies are needed that evaluate the long-term effects, in addition to standardized clinical protocols that prove efficacy. An efficient natural product in the treatment of OM should have an anti-inflammatory, bactericidal, antioxidant and healing effect on oral mucosa. In this sense, the search for multi-herbs products can be promising, since the plants together can have superior synergistic effects to the isolated species. However, there are few products in the current market with this profile.

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Cannabinoid Hyperemesis Syndrome; A Growing Concern for New Mexico-Annals of Social Sciences & Management studies-Juniper Publishers

JUNIPER PUBLISHERS-Annals of Social Sciences & Management studies

Cannabinoid Hyperemesis Syndrome; A Growing Concern for New Mexico

Authored by Victoria F Dirmyer*

In 2012, New Mexico became the 12th state to allow the use of cannabis for medical use. Cannabinoid hyperemesis syndrome (CHS) is characterized by recurrent episodes of heavy nausea, vomiting, and abdominal pain. Early identification of patients with CHS will assist in decreasing orders for invasive and expensive medical procedures. A retrospective analysis was performed using emergency department (ED) data from 2010-2015 in New Mexico. CHS was defined as an ED visit with a combination of persistent vomiting and cannabis related diagnosis codes. Trends over the six years were analyzed by patient characteristics; sex, age, and geographic location, as well as overall counts of visits for this health condition. A weighted national estimate using the Nationwide Emergency Department Sample (NEDS) was used as a comparison to New Mexico state data. The overall number of ED visits increased by 24.2% from 2010 to 2015. The annual number of ED visits for CHS increased by 585.7% in New Mexico. In the U.S., a similar increase in CHS was observed at 423.3%. In New Mexico, CHS visits were more likely to be male, between the age of 18-29 years, and reside in the northeast region of the state. This analysis demonstrated that ED visits for CHS are increasing and as more states adopt recreational marijuana use legislation, larger increases will be observed.

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Dendritic Cells and Regulatory T Cells Changes During ECP for Chronic GvHD in Pediatric Patients-Open Access Blood Research & Transfusion Journal-Juniper Publishers

JUNIPER PUBLISHERS-Open Access Blood Research & Transfusion Journal

Dendritic Cells and Regulatory T Cells Changes During ECP for Chronic GvHD in Pediatric Patients

Authored by Berger Massimo*

Graft-versus-host disease (GvHD) is a leading cause of post HSCT morbidity and mortality. It is mediated by alloreactive mature donor T lymphocytes, resulting in a harmful inflammatory response and tissue injury . The pathophysiology of GvHD is constituted by precise sequences of immunological events such as the activation of antigen-presenting cells (APCs), activation, differentiation and migration of T cells, and finally the development of their full effector functions. Dendritic cells (DCs) constitute the most professional APCs, promoting alloreactivity or clonal antigen-specific T cell responses. Moreover, tolerogenic DCs may play a pivotal role in GvHD exerting an immunomodulatory or even immunosuppressive effect on T cells. DCs can be divided into two major subsets, plasmacytoid DCs (pDCs) and myeloid DCs (mDCs) which have distinct functions. pDCs play a pivotal role in peripheral tolerance through the generation of regulatory T (Treg). In addition to pDCs, mDCs also promote Th2 and Th0/Tr1 responses, depending on the activation signal types.

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PCT: Interventional Management of Cholecystitis-Current Trends in Clinical & Medical Imaging-Juniper Publishers

JUNIPER PUBLISHERS-Current Trends in Clinical & Medical Imaging

PCT: Interventional Management of Cholecystitis

Authored by Ryan Cobb*

Percutaneous cholecystostomy tube (PCT) placement has traditionally served as a temporizing measure to bridge a comorbid patient presenting with acute cholecystitis and/or acute cholangitis to the current mainstay definitive treatment of cholecystectomy. While criteria outlined by the 2013revision of the 2007 Tokyo Guidelines have subsequently resulted in a rise of PCT placements, but a definitive treatment plan is lacking in cases where surgery is forgone due to excessive perioperative risk. In our single institutional retrospective analysis of acute cholecystitis patients, a majority underwent PCT, not cholecystectomy for definitive management. Within this subset of patients a majority was lost to follow up and some patients required permanent tube placement. Our findings demonstrate a deficiency in the treatment plan for cholecystitis, one that we feel interventionalists are uniquely suited to fill.

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