Limits Of Normal Variation Research Articles

Geospatial analysis of stream sediment samples for gold and base metal concentration in Daya Dawa, West Guji, Oromia Region, Southern Ethiopia

The present study is to evaluate gold and base metallic minerals in the stream sediments of Daya Dawa area, West Guji, southern Ethiopia. In this research work, spatial association analyses of geochemical and geological indicative features were carried for gold, silver, and base metals. Totally, 39 stream sediment samples were collected from active and non-active stream drainage. The extraction methods of Pearson correlation, principal component analysis (PCA), cluster analysis, and histograms were applied in order to determine the threshold value for each element using IBM SPSS Statistics v21 software. The geochemical data were over laid in Arc GIS 10.1 to get information about the anomalous concentration of gold, silver, and base metals in different sampling media. The geochemical result shows that the strong correlation between some of the base metals due to the lithological alteration of biotite-potassium feldspar-quartz gneiss and biotite-plagioclase-quartz gneiss. Three factors are derived from the PCA, in that Au was dominant in one of the factor because of bedrock mineralization. The anomalies are identified by setting threshold values, which mark the upper and lower limits of normal variation for stream sediment samples data. Gold concentrations in the samples are fitful, most below the detection limit and attain a high threshold values in sample numbers S31 and S39 due to hydrothermal alteration. These results demonstrate the usefulness of geochemical analysis and data interpretation using GIS tools reveal that the area S31 and S39 is having high economic potential for gold and silver.

Reduced 30-day gastrostomy placement mortality following the introduction of a multidisciplinary nutrition support team: a cohort study.

Percutaneous endoscopic gastrostomy feeding allows patients with dysphagia to receive adequate nutritional support, although gastrostomy insertion is associated with mortality. A nutrition support team (NST) may improve a gastrostomy service. The present study aimed to evaluate the introduction of a NST for assessment and follow-up of patients referred for gastrostomy. We included adult inpatients referred for gastrostomy insertion consecutively between 1 October 2010 and 31 March 2013. During the first 6months, a multidisciplinary NST assessment service was implemented. Patient characteristics, clinical condition, referral appropriateness and follow-up were documented prospectively. We compared the frequencies of appropriate referrals, 30-day mortality and mental capacity/consent assessment time spent between the 6months implementation phase and 2years following establishment of the assessment service ('established phase'). In total, 309 patients were referred for gastrostomy insertion and 199 (64%) gastrostomies placed. The percentage of appropriate referrals rose from 72% (61/85) during the implementation phase to 87% (194/224) during the established phase (P=0.002). Thirty-day mortality reduced from 10% (5/52) to 2% (3/147) (P=0.01), whereas time allocated to assessment of mental capacity and attainment of informed consent rose from mean 3days (limits of normal variation 0-7) to mean 6 (0-13) days. The introduction of a NST to assess and select patients referred for gastrostomy placement was associated with a rise in the frequency of appropriate referrals and a decrease in 30-day mortality following gastrostomy insertion. Concomitantly, time spent on patient assessment and attainment of informed consent increased.

Quality and safety impact on the provision of parenteral nutrition through introduction of a nutrition support team.

Parenteral nutrition (PN) should be provided to the malnourished patient if enteral feeding is insufficient or unsafe. A nutrition support team (NST) may improve PN services. We compared the use and complications of hospital PN before and after the implementation of an NST. All inpatients referred for PN outside of the intensive care unit and the intestinal failure unit were prospectively included from 2009 to 2012. The NST was introduced in 2010. Quality improvement methodology was applied. In 2009, a mean of 16 (limits of normal variation 4-28) patients were referred for PN each month. After introduction of the NST, this rose to 26 (10-42) referrals per month. The percentage of referrals where PN was not initiated increased from 5.3% in 2009 to 10.1% in 2012 (P=0.03). This increase was restricted to teams that infrequently referred for PN, and enteral nutrition could replace PN in 31 of 51 patients (61%) as compared with 8 of 32 (25%) patients referred from teams that frequently referred for PN (P=0.001). The frequency of PN started owing to an insufficient oral or enteral intake decreased from 11% to 3% (P=0.01). The catheter-related bloodstream infection rate dropped from 6.7 to 0.7 episodes per 1000 catheter days (P<0.001). Introduction of an NST increased both the total PN use and the percentage of referrals where enteral nutrition could replace PN. Medical specialty influenced the referral pattern and the likelihood that a referral resulted in PN being initiated. Safety of PN catheters improved significantly following NST introduction.

Behavioral response of Zebrafish Danio rerio Hamilton 1822 to sublethal stress by sodium hypochlorite: ecotoxicological assay using an image analysis biomonitoring system

We evaluated behavioral responses of zebrafish Danio rerio exposed to sublethal concentrations of sodium hypochlorite using an image analysis biomonitoring system (IABS). First, the limits of normal variation in swimming activity of zebrafish were determined by monitoring traveled distance of 40 control fishes using the IABS. An acute toxicity test was performed to determine the LC(50(24 h)) for D. rerio to NaOCl. To evaluate the toxic effects in swimming activity, 32 fishes were exposed to 40%, 30%, 20%, 10% of the LC(50 )and 32 were used as control using the IABS. We considered toxic concentrations where more than 10% intervals of the treated group were below the limits of normal variation and were significantly different from the control group. Two main responses were observed: an escape response (increased swimming activity) at 10% treated group, a gradual decrease in swimming activity from the 20% of the LC(50) on, and an avoidance response at higher concentrations. The response of the 20% treated group were considered as a NOAEL and responses of the 30% and 40% treated groups indicated significant hypoactivity (adverse effect). This behavioral biomonitoring system has proven to be a useful tool to detect sublethal toxicity that could be incorporated in biomonitoring protocols in Brazil.

Hemihypertrophy. Concepts and controversies.

Hemihypertrophy is best defined as asymmetry between the right and left sides of the body to a greater degree than can be attributed to normal variation. This asymmetry often appears as a difference in the size or length of the extremities, but it may also involve the head, trunk, and internal organs. It is often extremely difficult to distinguish hemihypertrophy from normal variation. However, this distinction is very important because young children who have hemihypertrophy are at increased risk of malignant intra-abdominal tumors, such as Wilms tumor or hepatoblastoma9,21,22,24,27,29,31,47,60. The increased risk of neoplasia has led to the controversial recommendation of frequent abdominal ultrasound screening designed to detect the tumor at the earliest possible stage2,12,16,25. The orthopaedic literature regarding hemihypertrophy has focused primarily on the treatment of discrepancy between the lengths of the lower limbs and has only superficially acknowledged link between hemihypertrophy and cancer in children4,37,38,45. Even the most recent pediatric and pediatric orthopaedic textbooks mention this association only briefly if at all8,42,59. The objectives of the present review were to describe the clinical features of hemihypertrophy and its related syndromes, to focus on the relationship between hemihypertrophy and malignant tumors in children, and to discuss the controversy surrounding the frequent abdominal ultrasound screening that is recommended for this group of patients. Hemihypertrophy occurs when a limb or one side of the body enlarges asymmetrically compared with the contralateral limb or side beyond the limits of normal variation. This enlargement may affect only the soft tissues, but it ordinarily involves both the soft tissues and the underlying skeleton. Although …

Nutrition monitoring of Russian schoolchildren in a period of economic change: a World Health Organization multicenter survey, 1992–1995

Annual surveys of the food intakes and nutritional status of schoolchildren (aged 10 and 15 y) in a Moscow district were conducted in 1992-1995, a period of rapid economic transformation in Russia. Food intake was assessed through use of two 24-h recalls. A few socioeconomic variables-parental educational level, family size, participation in organized sports, and use of school breakfast and lunch options-were included in the dietary interview. Nutritional status was assessed by measurement of height and weight and comparison with international standards. There was a slight difference in the food pattern in the two age groups and some differences between boys and girls. Milk and other dairy products, fruit, juices, and vegetables were consumed in small quantities and relatively infrequently. Bread and bread products, porridge, confectionery, and meat and meat products were consumed more frequently and in larger quantities. Protein contributed approximately 12% and fat 29-32% of dietary energy. About 70% of the subjects had low intakes of riboflavin and calcium compared with reference values. Mean nutrient intakes did not change significantly during the study period. During the first 3 y of the study period, there was a nonsignificant overall decrease in height and weight but this was within the limits of normal variation.

Brief communication: the skull attributed to Mozart--craniosynostosis or not?

The results of a detailed morphological analysis of the skull attributed to Mozart are presented which refute a recent claim that the skull as well as several of Mozart's portraits show indications of uncomplicated trigonocephaly. These indications according to the present analysis are within the limits of normal variation and derive from retention of part of the long arm of the anterior fontanelle.

Design elements of monitoring programs: The necessary ingredients for success

Natural resource managers must know the condition of resources entrusted to their steward-ship so that they can maintain unimpaired resources and know when to restore impaired ecosystems. Resource monitoring programs should be designed to provide indications of ecosystem health, define limits of normal variation, identify abnormal conditions, and suggest potential agents of abnormal changes. Development of a conceptual model that identifies all ecosystem components and their relationships is the first step in the design of such a diagnostic monitoring program. Design studies, with field testing on each selected system component, are required to determine the parameters to be measured and to establish monitoring protocols. The best approach to diagnostic monitoring appears to be based on the population dynamics of selected species relative to physical and chemical environmental factors. Both management and monitoring of natural ecosystems need to be recognized as experimental endeavors, and thus approached in an iterative fashion with the scientific method to reduce uncertainty and cost.

The effect of radiation on normal human CNS as detected by NMR spectroscopy

In a prospective study, proton ( 1H) and phosphorus ( 31P) nuclear magnetic resonance spectroscopy were used to search for effects of brain tumor radiotherapy on normal human central nervous system. Phosphorus spectroscopy data at 1.5 T seems to suggest that any radiation induced damage that may occur as a result of therapeutic brain irradiation, does not alter the relative concentrations of phosphorus metabolites or the intracellular pH beyond the limits of normal variation (approximately ±20%). Proton spectroscopy, on the other hand, detects post radiation changes in the ratios of certain nuclear magnetic resonance visible metabolites following radiotherapy, particularly choline/N-acetylaspartate, and especially in regions of brain receiving high doses of radiation. Such changes may be indicative of the release of membrane bound choline during radiation induced demyelination of brain. Of interest, we have found elevated metabolite ratios of 31P in normal central nervous system prior to radiotherapy, which persisted throughout the time span of the study in both the ipsilateral and contralateral cerebral hemispheres.

Pancreatic islet abnormalities in sudden infant death syndrome. Qualitative and quantitative analyses of 15 cases.

The pancreata of 15 autopsy cases of sudden infant death syndrome (SIDS) and those of 14 age-matched controls were examined qualitatively and quantitatively to re-evaluate the relationship between pancreatic islet abnormalities and sudden death in infancy. Histopathologically, a diffuse or focal form of nesidioblastosis and septal islets were frequently observed in the pancreata of both groups. Endocrine cell dysplasia was found only in 2 infants who had died of SIDS. Quantitatively, there was little difference of islet cell composition between the SIDS cases and the controls. A relatively high proportion of islet cell area to total pancreatic tissue area was demonstrated in the SIDS group (8.46 +/- 4.90% in the pancreatic head; 8.66 +/- 4.23% in the pancreatic body to tail) in comparison with the controls (5.32 +/- 1.77%; 5.63 +/- 1.60%). Although nesidioblastosis and septal islets were considered to be within the limits of normal variation during pancreatic development, endocrine cell dysplasia and quantitatively unusual proliferation of the pancreatic endocrine tissue suggest the possibility that abnormalities in the endocrine pancreas may be causally related to sudden death in infancy.

Scanning electron microscopic observations on photodynamic effects in cells in vitro

This paper reports an ultrastructural study of cell surfaces in normal (PTK2) and malignant (Hela) cells in vitro using the scanning electron microscope. The study describes cells treated by haematoporphyrin derivatives (HPDs) from different sources as well as the destruction of cells which have taken up HPD in combination with laser microirradiation of single cells. The results indicate that an HPD effect on cell surface structure occurred: in general the microvilli were markedly reduced and some of the filopodia broken, shortened and thickened. The effects of different HPD drugs on cell surface structure differed to a certain extent within the limits of normal variation. In addition ultrastructural observations following HPD treatment plus laser microirradiation showed remarkable photodynamic cell damage identifiable within seconds after treatment.

Effect of reserpine on regional cerebral glucose metabolism in control and migraine subjects.

The regional cerebral metabolic rate of glucose metabolism (RCMRGlu) in five headache and six control subjects was measured with positron emission tomography (PET) using the tracer 2-deoxy-D-[1-11C] glucose before and after the administration of reserpine. The short half-life of the carbon 11 tracer made possible a test-retest paradigm wherein each subject served as his own control in assessing the effect of reserpine on RCMRGlu. Thus, measurements were first performed with subjects at rest and subsequently at 1 1/2 hours after the parenteral administration of reserpine (rest-reserpine). In control subjects without history of migraine, reserpine did not induce headache, and, furthermore, PET measurements 1 1/2 hours after drug administration consistently showed a global increase in RCMRGlu over resting values similar to that observed in a normal control (rest-rest) group not receiving reserpine. By contrast, four of the five subjects with migraine began to experience a mild unilateral headache or visual disturbances 1 1/2 hours after reserpine, at which time PET scanning showed a 5% to 30% decline in RCMRGlu below the values that had been measured before reserpine injection, all well outside of the 99% confidence limits of normal variation separately determined on 25 control subjects (rest-rest). There was no apparent laterality, and subjects with a history of either common or classic migraine responded in a similar manner. The difference in percent change in RCMRGlu following administration of reserpine observed in these four subjects with migraine headaches was significantly different over all regions of interest as compared with all six control subjects receiving the drug.(ABSTRACT TRUNCATED AT 250 WORDS)

Book reviewRadiology of the Normal Skull. By ShapiroR., pp. xi + 386, 1980 (Year Book Medical Publishers, Europublication, Chicago/London), £70.00. ISBN 0–8151–7631–7

At a time when the standard radiographic skull series has a diminishing place in the evaluation of many neurological problems the need for a publication devoted to the radiology of the normal skull may well be questioned. However, the confident distinction on a skull X ray between the limits of normal variation and significant pathology can still be an important factor in clinical management in which the radiologist should play a decisive part.

Quantitative indexes of computed tomography in dementia and normal aging.

Quantitative indexes of compute tomography were compared in 28 patients with Alzheimer dementia and in 30 elderly persons with no history of neurologic disease. Age-corrected ventricle-brain ratios were abnormal for half of the dementia patients, whereas only a single subject in the control group had ventricles outside the limits of normal variation. Measurement of the distance between the third ventricle and Sylvian fissure indicated that the dementia patients had significantly more atrophy in this area. Employment of quantitative indexes standardized for age may aid in differentiating cerebral atrophy associated with dementia from that associated with normal aging.

An Aberrant Pattern Morph in a Western Diamondback Rattlesnake, Crotalus atrox, from Southern Texas

Aberrant patterns have been reported for several North American crotaline species (Gloyd, 1935 and 1958; Klauber, 1972; Livezey, 1949; and Nickerson and Mays, 1968). Herein, I report another pattern aberration in an adult male Crotalus atrc)x (Texas A & I Collections, TAIC-1423) from Texas. The snake was collected by a Mr. Ammons, on the Laureles Division of the King Ranch, Nueces Co., in September 1968. This specimen is unusual in that the typical rhombic or diamond-shaped blotches are absent? as are the black and white alternating tail bands (Fig. 1). The pattern instead consists of a pair of dark brown paravertebral stripes beginning immediately posterior to the head. The stripes are two to three dorsal scale rows wide and are separated by a mid-dorsal light stripe two to three scale rows wide. The paravertebral stripes remain separate to the level of the 79th ventral. At this area the dark stripes merge, terminating the light mid-dorsal stripe. The dark color is slightly diffuse at the merger, but nevertheless discernible? and occupies five mid-dorsal scale rows at the 89th ventral. It continues to approximately the 129th ventral, where it fades into the light brown color of the lateral and posterior dorsal surfaces. The ventral pattern is not atypical. The tail is mostly black-brown on the dorsal and lateral surfaces with occasional single scales having diffuse white areas sprinkled with black. The subcaudal scales are mottied with black and white. The light-bordered ocular stripe is absent. Gloyd (1958) described three Crotulus cltrox from southern Texas with similar color aberrations. Mensural and meristic data of these three specimens and TAIC-1423 are compared (Table 1) with the mean values for C. atrox presented by Klauber (1972). The meristics of scutellation for all aberrant specimens are within the limits of normal variation for the species (Klauber, 1972: Table 2:7). The four anomalous specimens are from localities within 250 km of each other in south Texas. Anomalous paravertebral striping is evidently not deleterious to survival! as many of the reported specimens are adults, including TAIC-1423, with a total length of 1169 mm and fully ossified hemipenal spines. The ground

Occurrence of oral sebaceous glands in 43,654 industrial workers of Gujarat, India

Abstract In the course of an extensive study on oral cancer and precancerous lesions in a selected sample of Indian industrial workers, 43,654 individuals over the age of 35 years were clinically examined for the presence and location of oral sebaceous glands. The prevalence of oral sebaceous glands was found to be 25 % in the study sample. This comparatively low prevalence rate is attributed to the high frequency of oral habits which may cause an atrophy of these glandular structures. Bilateral buccal mucosal involvement was the most common finding. The upper lip was much more frequently involved than the lower lip. Because these glands do not have any pathologic significance, they should be considered developmental disorders or structures within the limits of normal variation. Occasionally, when widespread, they may be mistaken for oral white lesions such as leukoplakia, lichen planus, etc.

SERUM OESTRIOL IN NORMAL PREGNANCY

Serial measurements of serum oestriol (E3) were made in 56 normal pregnancies from 10 to 40 weeks gestation using a radioreceptor assay. Several parameters of the assay and its intrapatient variability were examined. The mean curve for pregnancy E3 levels and limits of normal variation have been identified and compared with those of other series. A positive correlation was found to exist between infant birth weight and the last E3 value in normal pregnancies prior to the onset of labour. Advantages of serum E3 assays over urinary E3 determinations are discussed.

Plasma unconjugated 15alpha-hydroxyoestriol (oestetrol) levels in normal human pregnancy.

Serial measurements were made of the concentration of plasma unconjugated oestetrol in normal human pregnancy. The mean curve and limits of normal variation have been established. Plasma levels rose from just below 2 ng/ml at 20 weeks to approximately 5 ng/ml at term.

Psychiatric morbidity in Berlevåg.

For the population of Berlevåg the psychiatric morbidity is 37.3% registered with the Harvard health and family life survey and 20.5% with clinical estimates (life prevalence). The actual psychiatric morbidity (point prevalence) is assumed to be markably less than 20%. By checking psychiatric cases seen by the public health officer in the first half of 1973 and by 2 psychiatrists during field work the summer of 1974, the morbidity not registered yet, predominantly consists of borderline neurotic states, who by many psychiatrists will be considered as being within the limits of normal variation.

Pyrimidinyl Nicotinic Acid and Cerebrocortical Necrosis

Pyrimidinyl nicotinic acid (PNA) exhibits great structural similarities to amprolium, which is a known thiamine antagonist. Experimental cerebrocortical necrosis (CCN) has been induced by oral administration of amprolium. PNA has been demonstrated in ruminai fluid from animals suffering from CCN. The aim of this investigation was to study whether PNA can act as thiamine antagonist and whether it can give rise to CCN. For this purpose PNA was synthesized and was daily given intravenously to a calf. The dose corresponded to roughly 10 times the content of thiamine in the blood. After three weeks the dose was doubled. During the entire experimental period comprising nine weeks no clinical sign of thiamine deficiency or CCN was noticeable. The values for all recorded blood chemical parameters, with the exception of occasional GOT and PK values, were within the normal limits of variation. Rats were used in a similar experiment with the same aim. PNA was homogeneously added to their feed in quantities equivalent to five and 10 times the thiamine content. The rats were clinically healthy throughout the experimental period comprising eight weeks. No significant difference in TK activity and TPP effect was observed between the experimental groups and the control group.