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Search Results: 1 - 10 of 12040 matches for " Neal Joseph "
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Malignant peripheral nerve cell sheath tumour of the upper lip: a rare case
Joseph Ward,Vyomesh Bhatt,Neal Barnard
Journal of Surgical Case Reports , 2010,
Abstract: We present the case of a malignant peripheral nerve sheath tumour (MPNST) that developed on the upper lip of an 86 year old woman. MPNSTs are highly aggressive sarcomas that very rarely occur in the face. We know of no other reported cases of a malignant peripheral nerve sheath tumour arising from the upper lip.
Pro/con clinical debate: do colloids have advantages over crystalloids in paediatric sepsis?
Puran Khandelwal, Desmond Bohn, Joseph A Carcillo, Neal J Thomas
Critical Care , 2002, DOI: 10.1186/cc1510
Abstract: A 5-year-old girl is admitted to the paediatric intensive care unit with meningococcal sepsis. She is hypotensive and requires fluid resuscitation. You are trying to decide which type of fluid to choose (crystalloids or natural colloids [albumin]).Puran Khandelwal and Desmond BohnMeningococcal sepsis is a fulminant form of Gram-negative sepsis associated with profound shock. The release of endotoxins (lipopolysaccharides) from the bacterial cell wall initiates a cascade of events resulting in the release of cytokines (IL-1, IL-6, tumour necrosis factor alpha), which in turn causes endothelial cell injury with capillary leak and loss of vasomotor tone [1].Plasma proteins, including albumin, and water from the intravascular compartment leak into the interstitium, resulting in hypovolaemia and hypotension [2]. Fleck and colleagues [3] showed that there is an increase of 300% in the albumin escape rate from the vascular to the interstitial space, associated with hypoalbuminaemia, in septic patients. Hypoalbuminaemia is also associated with increased mortality in critically ill patients [4].Holland and colleagues [5]found albumin fragments of approximately 45 kDa, 25 kDa, and <20 kDa in the urine of children with meningococcal sepsis and associated purpura. They suggested that exogenous or endogenous proteases, or both, may be released in severe meningococcal sepsis and, in association with an inadequate antiprotease response, result in albumin degradation. This may be a contributory factor to the rapid shock, hypocalcaemia, and rash seen in meningococcal sepsis.Early fluid resuscitation in paediatric septic shock improves outcome [6], but there is ongoing controversy over the type of fluid to be used [7,8,9,10]. Two published meta-analyses, by the Cochrane group, of randomised trials that compared crystalloids with colloids or crystalloids with albumin attracted considerable attention [8,10]. They concluded that the use of both colloids was associated with increased mor
Environmental Exposure to Emissions from Petrochemical Sites and Lung Cancer: The Lower Mississippi Interagency Cancer Study
Neal Simonsen,Richard Scribner,L. Joseph Su,Donna Williams,Brian Luckett,Tong Yang,Elizabeth T. H. Fontham
Journal of Environmental and Public Health , 2010, DOI: 10.1155/2010/759645
Abstract: To investigate potential links between environmental exposure to petrochemical plant emissions and lung cancer, a population-based case-control study (LMRICS) was conducted in eleven Louisiana parishes bordering the Mississippi River. Cases and age, gender, and race-matched controls were interviewed regarding potential risk factors. Residential history was geocoded to provide indices of long-term proximity to industrial sites. Cases were more likely to have lived near a petrochemical site. Models adjusted for other risk factors, however, showed small or no association with lung cancer (odds ratio for residence within a half-mile of a site =1.10, 95% confidence interval 0.58–2.08). While associations were strongest for exposures exceeding 15 years, none approached statistical significance and there was no clear dose-response across exposure duration, distance categories, or when sites were grouped according to carcinogenicity rating of chemical releases. Residential proximity to petrochemical plants along the lower Mississippi thus showed no significant association with lung cancer.
Hepatobiliary Cystadenocarcinoma
Neal Wilkinson
Case Reports in Hepatology , 2012, DOI: 10.1155/2012/298957
Abstract: Biliary cystadenocarcinomas are rare tumors that are poorly understood. Preoperative imaging is imprecise and treatment is not standardized. We describe the presentation and treatment of one of these rare tumors and review the limited published literature.
Quantifying the Importance of Interleukin-6 for Coronary Heart Disease
Bruce Neal
PLOS Medicine , 2008, DOI: 10.1371/journal.pmed.0050084
What not to do in medical statistics
Alexander, Neal;
Revista Brasileira de Saúde Materno Infantil , 2007, DOI: 10.1590/S1519-38292007000300012
Abstract: there have been major efforts to improve the application of statistical methods in medical research, although some errors and misconceptions persist. in this paper i will review some of the topics which most often cause problems: a) comparison of two methods of clinical measurement; b) comparison of baseline values between arms of a randomized trial; c) absence of evidence as opposed to evidence of absence; and d) regression to the mean. i will also revisit a statistical error in one of my own publications. i review some causes of the continuing misuse of statistics, and make some suggestions for modifying the education of statistical and non-statistical medical researchers in order to alleviate this.
Rare earth element concentrations in dissolved and acid available particulate forms for eastern UK rivers
C. Neal
Hydrology and Earth System Sciences (HESS) & Discussions (HESSD) , 2007,
Abstract: Variations in concentration of yttrium (Y), lanthanum (La), cerium (Ce), neodymium (Nd), samarium (Sm) and gadolinium (Gd) among rivers of eastern England and the border with Scotland are described in relation to the dissolved (<0.45 μM) fraction and acid-available particulate (AAP) fractions. The rivers cover a range of rural, agricultural and urban/industrial environments. Yttrium and the lanthanides show significant levels of both dissolved and acid-available particulate forms (typically about 40% in the dissolved form). For the dissolved phase, Y and the lanthanides are linearly correlated with each other and with iron: most of this dissolved component may be in a micro-particulate/colloidal form. The Y and lanthanide relationships show marked scatter and there are anomalously high La concentrations at times for the rivers Great Ouse, Thames and Wear that are probably linked to pollutant sources. For the Ouse, and especially for one of its tributaries, the Swale, relatively high Sm concentrations are probably associated with mineralisation within the catchment and contamination of the associated flood plain. For the AAP components, there are strong linear relationships with Y and the lanthanides across all the rivers. There is also a strong link between these AAP associated REE and AAP iron, although the scatter is greater and the industrial rivers have a lower lanthanide to iron ratio, probably due to iron-rich contaminants.
Dry Valley Research: a Case Study from the Yorkshire Wolds
Cath Neal
Papers from the Institute of Archaeology , 2006, DOI: 10.5334/pia.272
The Hubble Constant
Jackson Neal
Living Reviews in Relativity , 2007,
Abstract: I review the current state of determinations of the Hubble constant, which gives the length scale of the Universe by relating the expansion velocity of objects to their distance. In the last 20 years, much progress has been made and estimates now range between 60 and 75 km s^-1 Mpc^-1, with most now between 70 and 75 km s^-1 Mpc^-1, a huge improvement over the factor-of-2 uncertainty which used to prevail. Further improvements which gave a generally agreed margin of error of a few percent rather than the current 10% would be vital input to much other interesting cosmology. There are several programmes which are likely to lead us to this point in the next 10 years.
The potential for phosphorus pollution remediation by calcite precipitation in UK freshwaters
C. Neal
Hydrology and Earth System Sciences (HESS) & Discussions (HESSD) , 2001,
Abstract: This paper examines the potential for calcium carbonate to reduce phosphate pollution in freshwaters by co-precipitation, a process known as a "self cleansing mechanism". Calcium carbonate saturation levels and phosphate concentrations (SRP - soluble reactive phosphate) across the major eastern UK river basins are examined to test for solubility controls. The study shows that calcite saturation varies for each catchment as a function of flow and biological activity rather than by direct regulation by SRP. Indeed, there is no evidence, for any of the rivers studied, that calcite solubility controls hold. However, for groundwater and groundwater-fed springs in the Chalk of the Thames basin, calcite saturation is observed with associated low SRP levels. A self-cleansing mechanism may well be operative within the Chalk due to two factors. Firstly, there is a high potential for nucleation on the calcite micro-crystals in the aquifer. Secondly, there are within aquifer reactions that remove the calcite nucleating inhibitors (SRP and dissolved organic carbon, DOC) to levels lower than those occurring within the rivers do. These inhibitors enter the catchment at very high concentrations in association with agricultural pollution (fertilizer application and animal slurry) and household contamination (e.g. sewage sources from septic tanks). Under low flow conditions, when the saturation index for calcite is at its highest, so too is the concentration of the nucleation inhibitor SRP. Companion work shows that calcite precipitation can occur at the water-sediment interface of the river and this may involve SRP removal. The data, as a whole, define an apparent bound for calcite solubility control where in the presence of nucleating centres, SRP must be less than 4 mM-P l-1 and DOC must be less than 150 mM-C l-1: a condition that does not seem to pertain within most UK rivers. Keywords: calcite, calcium carbonate, phosphate, soluble reactive phosphate, dissolved organic carbon, LOIS, UK, rivers, self-cleansing mechanisms.
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