Simple Surveillance Research Articles

Congenital internal jugular phlebectasia

Congenital internal jugular phlebectasia corresponds to congenital dilatation of the vein without tortuosity. More than one hundred cases of phlebectasia involving the neck veins have been reported in the literature. The authors describe the clinical features, treatment and outcome of this anomaly. A six-year-old child with no particular past medical history presented with a two-year history of progressively enlarging mass on the right side of the neck. Physical examination revealed a non-pulsatile mass that was increased in size by all manoeuvres increasing intrathoracic pressure. Neck computed tomography confirmed the diagnosis of internal jugular vein phlebectasia. In the absence of complications, simple surveillance was advised with a follow-up of 20 months with no complications. Congenital internal jugular phlebectasia is a rare condition. Management must include imaging to confirm the diagnosis. Long-term surveillance is recommended and surgery is only required in the presence of complications.

(A327) The Importance and Benefit of Disease and Injury Surveillance within Relief Operations

Disease and injuries are expected consequences of disasters, either as direct result of the initial disaster or due to a collapse of the pre-existing public health infrastructure. While relief efforts are primarily directed at treating existing and preventing further disease and injury among victims of the disasters, it is also important to remain aware of the health impact on individuals and organizations providing assistance. The potential immune naïveness of relief workers may predispose them to contracting diseases which are normally not a concern for the local population. If significant numbers of relief workers are affected this can severely impact an organizations ability to provide assistance and may lead to a worsening of the situation. Even a simple surveillance program can provide early warning of potential problems in order to timely implement control measures which will prevent further illness and minimize mission impact.

Factors affecting the accuracy of urine-based biomarkers of BSE

BackgroundTransmissible spongiform encephalopathy diseases are untreatable, uniformly fatal degenerative syndromes of the central nervous system that can be transmitted both within as well as between species. The bovine spongiform encephalopathy (BSE) epidemic and the emergence of a new human variant of Creutzfeldt-Jakob disease (vCJD), have profoundly influenced beef production processes as well as blood donation and surgical procedures. Simple, robust and cost effective diagnostic screening and surveillance tools are needed for both the preclinical and clinical stages of TSE disease in order to minimize both the economic costs and zoonotic risk of BSE and to further reduce the risk of secondary vCJD.ObjectiveUrine is well suited as the matrix for an ante-mortem test for TSE diseases because it would permit non-invasive and repeated sampling. In this study urine samples collected from BSE infected and age matched control cattle were screened for the presence of individual proteins that exhibited disease specific changes in abundance in response to BSE infection that might form the basis of such an ante-mortem test.ResultsTwo-dimensional differential gel electrophoresis (2D-DIGE) was used to identify proteins exhibiting differential abundance in two sets of cattle. The known set consisted of BSE infected steers and age matched controls throughout the course of the disease. The blinded unknown set was composed of BSE infected and control samples of both genders, a wide range of ages and two different breeds. Multivariate analyses of individual protein abundance data generated classifiers comprised of the proteins best able to discriminate between the samples based on disease state, breed, age and gender.ConclusionDespite the presence of confounding factors, the disease specific changes in abundance exhibited by a panel of urine proteins permitted the creation of classifiers able to discriminate between control and infected cattle with a high degree of accuracy.

The Provincial Injury Mortality Surveillance System (PIMSS): a surveillance tool for the Western Cape

Mortuary-based surveillance typically collates information from three sources: postmortem reports completed by forensic pathologists, police crime incident reports and chemical pathology laboratory results. The data are an important tool to...

Surveillance for outbreaks of influenza-like illness in the institutionalized elderly

Respiratory outbreaks are common in aged-care facilities (ACFs), are both underreported and frequently identified late, and are often associated with considerable burden of illness and death. There is emerging evidence that active surveillance coupled with early and systematic intervention can reduce this burden. Active surveillance for influenza-like illness and rapid diagnosis of influenza were established in 16 ACFs in Sydney, Australia, prior to the winter of 2006. A point-of-care influenza test and laboratory direct immunofluorescence tests for common respiratory viruses were used for diagnosis. We achieved early identification of seven respiratory disease outbreaks, two of which were caused by influenza. For the influenza outbreaks, antiviral treatment and prophylaxis were initiated 4-6 days from symptom onset in the primary case. A simple active surveillance system for influenza was successfully implemented and resulted in early detection of influenza and other respiratory disease outbreaks. This enabled earlier implementation of prevention and control measures and increased the potential effectiveness of anti-influenza chemoprophylaxis.

Deployment Design of Wireless Sensor Network for Simple Multi-Point Surveillance of a Moving Target

In this paper, we focus on the problem of tracking a moving target in a wireless sensor network (WSN), in which the capability of each sensor is relatively limited, to construct large-scale WSNs at a reasonable cost. We first propose two simple multi-point surveillance schemes for a moving target in a WSN and demonstrate that one of the schemes can achieve high tracking probability with low power consumption. In addition, we examine the relationship between tracking probability and sensor density through simulations, and then derive an approximate expression representing the relationship. As the results, we present guidelines for sensor density, tracking probability, and the number of monitoring sensors that satisfy a variety of application demands.

Le sinus pericranii : une anomalie veineuse transcrânienne

Sinus pericranii is a rare midline cranial venous anomaly. It should be diagnosed radiologically. We report an asymptomatic case in a six-year-old female patient. The patient consulted for a congenital asymptomatic bluish mediofrontal swelling. The complaint was strictly esthetic. A color US and MR angiography allowed diagnosing a sinus pericranii. Simple surveillance was decided because of a limited esthetic prejudice and the absence of any functional disorder. Sinus pericranii is a communication between extra- and intracranial venous systems. Its diagnosis is suspected when a subcutaneous mass is located on the scalp close to the midline, the volume of which changes with the head's position. It is confirmed by MRI, which usually shows a drainage in the superior sagittal sinus. Surgical treatment is a complex procedure and rarely indicated. A simple follow-up is often proposed because of the usual absence of complications.

Gastric carcinoids: Between underestimation and overtreatment

Gastric carcinoids (GCs), which originate from gastric enterochromaffin-like (ECL) mucosal cells and account for 2.4% of all carcinoids, are found increasingly in the course of upper gastrointestinal tract endoscopy. Current nosography includes those occurring in chronic conditions with hypergastrinemia, as the type 1 associated with chronic atrophic gastritis, and the type 2 associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type 3, which is unrelated to hypergastrinemia and is frequently malignant, with distant metastases. The optimal clinical approach to GCs remains to be elucidated, depending upon type, size and number of carcinoids. While there is agreement concerning the treatment of type 3 carcinoids, for types 1 and 2, current possibilities include simple surveillance, endoscopic polypectomy, surgical excision, associated or not with surgical antrectomy, or total gastrectomy. Moreover, the recent introduction of somatostatin analogues represents a therapeutic option of possibly outstanding relevance.

Assessing Validity of the QuickDASH and SF-12 as Surveillance Tools among Workers with Neck or Upper Extremity Musculoskeletal Disorders

The purpose of this article was to assess validity of the regional Disabilities of Arm, Shoulder, and Hand ( QuickDASH) and Short-Form 12 (SF-12) for surveillance purpose. We compared the predictive, discriminate, and concurrent validity of the QuickDASH and SF-12 among 231 workers with specific clinical diagnoses of neck or upper extremity musculoskeletal disorders (UEMSDs) and 175 workers with symptoms only. Compared to those with symptoms only, the odds of being any neck or UEMSD case were 1.45 (95% confidence interval [95% CI]: 1.24–1.70) and 0.66 (95% CI: 0.48–0.91) with every 10-point increase in QuickDASH disability and physical component scale (PCS-12) scores, respectively. The clinical cases had significantly higher QuickDASH disability (23.0 vs. 14.3, p < 0.0001) and lower PCS-12 scores (44.8 vs. 47.3, p = 0.0133) than those with symptom only. The QuickDASH disability scores were moderately correlated with the PCS-12 scores (rho = −0.40) among the clinical cases. Either QuickDASH or PCS-12 can be used as a simple surveillance tool in an active working population.

Les microlithiases testiculaires : attitude pratique

Testicular microlithiasis detected by ultrasound either incidentally or in the context of concomitant disease remain controversial in terms of their prevalence and their link with these diseases, particularly testicular cancer. The use of high resolution ultrasound transducers, frequently used in various scrotal diseases and during assessment of infertility, partly accounts for the more frequent diagnosis of testicular microlithiasis. A standard approach cannot be proposed in these patients, but needs to be adapted to the circumstances of detection of these lesions. The circumstances in which a specific attitude appears to be justified, such as testicular biopsies or a simple rigorous surveillance of these patients, need to be defined.

The evolution of video surveillance: an overview

Over the past 10 years, computer vision research has matured significantly. Although some of the core problems, such as object recognition and shape estimation are far from solved, many applications have made considerable progress. Video Surveillance is a thriving example of such an application. On the one hand, worldwide the number of cameras is expected to continue to grow exponentially and security budgets for governments, corporations and the private sector are increasing accordingly. On the other hand, technological advances in target detection, tracking, classification, and behavior analysis improve accuracy and reliability. Simple video surveillance systems that connect cameras via wireless video servers to Home PCs offer simple motion detection capabilities and are on sale at hardware and consumer electronics stores for under $300. The impact of these advances in video surveillance is pervasive. Progress is reported in technical and security publications, abilities are hyped and exaggerated by industry and media, benefits are glamorized and dangers dramatized in movies and politics. This exposure, in turn, enables the expansion of the vocabulary of video surveillance systems paving the way for more general automated video analysis.

Prise en charge d’un séminome testiculaire avec élévation de l’alpha-fœtoprotéine. À propos d’un cas

The authors report a case of stage N3 pure testicular seminoma associated with paradoxical elevation of alphafoetoprotein (AFP). Despite the absence of histological arguments after review of the slides, this lesion was considered to be a stage pT1 N3 M0 S3 non seminomatous germ cell tumour with a poor prognosis. Simple surveillance was proposed following normalization of tumour markers, regression of retroperitoneal masses and negative PET scan. Laboratory and then clinical relapse at three months was treated by salvage chemotherapy followed by retroperitoneal lymph node dissection. The presence of embryonic carcinoma in one of the residual masses led to a revision of the initial histological diagnosis. The rare data of the literature indicate a variable approach according to alphafoetoprotein levels.

Dysplasie fibreuse costale. À propos de dix cas

Fibrous dyplasia is a rare sporadic disease accounting for 0.8% of primary bone tumors. This benign pseudotumor results from proliferation of fibrous tissue in bone and the production of immature bone tissue without an osteoblastic crown. The disease can involve one or more bones, ribs are rarely involved. We report a series of 10 cases of costal fibrous dysplasia. This series of 10 cases was collected over a period of 10 years (1996-2005). There were five men and five women, mean age 38.4 years, range 27-52 years. One rib was involved in eight patients, two ribs in two. Pain was the most frequent symptom. Plain X-rays showed signs suggestive of fibrous dysplasia. To confirm the diagnosis, rib resection was performed in all ten patients. Pathology examination provided the diagnosis. The postoperative period was uneventful in all patients and all are recurrence free at mean 50 months follow-up. Management of fibrous dysplasia can be simple surveillance in the majority of patients. Nevertheless, in the event of a single focus, particularly in a rib, fibrous dysplasia can raise a difficult problem of differential diagnosis with malignant tumors. Surgical resection is therefore required in selected cases.

A Portable Surveillance Camera Architecture using One-bit Motion Detection

We present a surveillance camera architecture using a one-bit motion detection algorithm for portable applications. The conventional surveillance system requires too many components and is too complicated for portable applications. In this paper, we propose a simple surveillance camera architecture with a motion detector that can detect changes of an object within its surroundings for low-power and low-cost applications. The proposed motion-detection algorithm uses one-bit images which are selected using a binary search algorithm that is decided by varying the reference voltage. We verify all the functions of the motion detector through the use of a user interface program on an FPGA board. Experimental results are also presented <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">1</sup> .

Étude de la croissance tumorale des tumeurs desmoïdes extra-abdominales (FDEA) primitives ou récidivées non opérées

Purpose of the study Extra-abdominal aggressive fibromatosis (EAAF) is a benign desmoid tumor with a potentially aggressive behavior. Surgical treatment is compromised by a very high rate of recurrence, sometimes with significant morbidity. We conducted a prospective surveillance of our patients (clinical and MRI) with EAAF to search for prognostic factors. Material and methods This cohort included 17 patients with EAAF. For nine patients, biopsy alone was performed. For eight, the tumor was a recurrence after surgical removal. Patients were seen for a clinical assessment and MRI every six months. Results Median follow-up was 42 months (range 6-114). Three patients worsened clinically with pain or functional impairment. One patient required neurosurgery to control pain (good stable outcome). MRI showed progression for two tumors (12%) but with a short follow-up since diagnosis (9 and 14 months), in one case despite medical treatment. Three tumors regressed and twelve remained stable on successive MRI. On average the tumor growth lasted ten months. Discussion Tumor growth was never noted beyond 36 months. This notion of an interruption in tumor growth is mentioned sporadically in reports on EAAF, which have generally included recurrent tumors. To our knowledge this is the first series reporting tumors left in place a followed with modern imaging techniques. The high rate of spontaneous interruption of tumor growth must be counterbalanced with the difficult task of local treatment: the risk of recurrence is particularly high after surgery and functional sequelae can be significant when wide resection is proposed in an anatomically difficult localization. The precise role for surgery, and combined radiotherapy, remain to be determined. There are only scarce reports on general treatments. Considering these facts, we propose that surgical resection should not be considered the only solution for the treatment of EAAF. Further work is needed to define the useful contribution of simple surveillance of these benign tumors.

Health impact of the Buncefield oil depot fire, December 2005: Study of accident and emergency case records

On Sunday 11th of December 2005, an explosion occurred at the Buncefield oil depot, Hertfordshire, resulting in a large fire that blazed for several days. Two Accident and Emergency (A&E) departments were placed on stand-by to receive casualties. A simple surveillance system was put in place during the acute phase of the incident, but this was not adequate to fully examine the health impact of the fire. Retrospective study of A&E records at Hemel Hempstead and Watford A&E departments for the period that the fire burnt. Two hundred and forty-four people attended A&E as a result of the fire: 187 were members of the emergency services; 17 were oil depot workers; and 40 were members of the public. The most common presenting complaints were respiratory symptoms (n = 66) and injuries (n = 38). Twenty-five (21%) individuals were referred for medical follow-up. There were no fatalities. There was a significant impact on local health services, with many emergency service personnel attending A&E asymptomatically. Alternative health service provision for these individuals, possibly near to the scene of the incident, should be considered. This incident has also highlighted an urgent need to develop surveillance systems that enable real-time monitoring of the acute public health impact of major incidents.

Use of nomograms as predictive tools in bladder cancer

Bladder cancer is a common genitourinary malignancy that demonstrates a great variation in risk of tumor recurrence and progression following treatment. The dramatic differences in clinical behavior dictate vastly differing treatments, which may range from simple surveillance to combination radical surgery with systemic chemotherapy. For non-muscle invasive bladder cancer prediction of the risk of recurrence and progression is necessary to assess the need for intravesical therapy and possible early cystectomy. In contrast, prediction of advanced disease response to primary treatment such as cystectomy and the response to systemic chemotherapy plays an important role in treatment assignment for patients with muscle invasive disease. To estimate these risk traditional risk grouping schemes such as the present TNM staging system has been used to guide patient treatment. More recently, improved prognostic tools such as nomograms have been developed to provide a more accurate assessment of outcomes. Clinicians are enthusiastically working to utilize these statistical methods in bladder cancer. We summarize the current status of outcome predictive models for bladder cancer; and focus particularly on the ability of nomograms to predict disease recurrence, progression, and patient survival.

Using Streamline-Derived Injection Efficiencies for Improved Waterflood Management

Summary This paper describes a novel approach to predict injection- and production-well rate targets for improved management of water-floods. The methodology centers on the unique ability of streamlines to define dynamic well allocation factors (WAFs) between injection and production wells. Streamlines allow well allocation factors to be broken down additionally into phase rates at either end of each injector/producer pair. Armed with these unique data, it is possible to define the injection efficiency (IE) for each injector and for injector/producer pairs in a simulation model. The IE quantifies how much oil can be recovered at a producing well for every unit of water injected by an offset injector connected to it. Because WAFs are derived directly from streamlines, the data reflect all the complexities impacting the dynamic behavior of the reservoir model, including the spatial permeability and porosity distributions, fault locations, the underlying computational grid, relative permeability data, pressure/volume/temperature (PVT) properties, and most importantly, historical well rates. The possibility to define IEs through streamline simulation stands in contrast to the ad hoc definition of geometric WAFs and simple surveillance methods used by many practicing reservoir engineers today. Once IEs are known, improved waterflood management can be implemented by reallocating injection water from low-efficiency to high-efficiency injectors. Even in the case in which water cannot be reallocated because of local surface-facility constraints, knowing IEs on an injector/producer pair allows the setting of target rates to maintain oil production while reducing water production. We demonstrate this methodology by first introducing the concept of IEs, then use a small reservoir as an example application.

Short communication: Strengthening sub‐national communicable disease surveillance in a remote Pacific Island country by adapting a successful African outbreak surveillance model

Successful communicable disease surveillance depends on effective bidirectional information flow between clinicians at the periphery and communicable disease control units at regional, national and global levels. Resource-poor countries often struggle to establish and maintain the crucial link with the periphery. A simple syndrome-based outbreak surveillance system initially developed and evaluated in Mpumalanga Province, South Africa was adapted for the Pacific island nation of Tuvalu. Eight syndromes were identified for surveillance: acute flaccid paralysis (poliomyelitis), profuse watery diarrhoea (cholera), diarrhoea outbreak, dysentery outbreak, febrile disease with abdominal symptoms and headache (typhoid), febrile disease with generalized non-blistering rash (measles), febrile disease with intense headache and/or neck stiffness with or without haemorrhagic rash (meningococcal meningitis), and outbreaks of other febrile diseases of unknown origin. A user-oriented manual, the Tuvalu Outbreak Manual (http://www.wepi.org/books/tom/), was developed to support introduction of the surveillance system. Nurses working in seven outer island clinics and the hospital outpatient department on the main island rapidly report suspected outbreaks and submit weekly zero-reports to the central communicable disease control unit. An evaluation of the system after 12 months indicated that the Outbreak Manual was regarded as very useful by clinic nurses, and there was early evidence of improved surveillance and response to the disease syndromes under surveillance.

Postoperative Surveillance in Patients With Colorectal Cancer Who Have Undergone Curative Resection: A Prospective, Multicenter, Randomized, Controlled Trial

Although systematic postoperative surveillance of patients with colorectal cancer has been demonstrated to improve survival, it remains unknown whether a more intensive strategy provides any significant advantage. This prospective, multicenter, randomized, controlled trial was aimed at comparing the efficacy of two different surveillance strategies in terms of both survival and recurrence resectability. Patients with stage II or III colorectal cancer were allocated randomly to either a simple surveillance strategy including clinical evaluation and serum carcinoembryonic antigen monitoring, or an intensive strategy in which abdominal computed tomography or ultrasonography, chest radiograph, and colonoscopy were added. A total of 259 patients were included: 132 were observed according to the simple strategy and 127 were observed according to the intensive strategy. Both groups were similar with respect to baseline characteristics and rate and type of tumor recurrence. After a median follow-up of 48 months, there was no difference in the probability of overall survival in the whole series (hazard ratio [HR] = 0.87; 95% CI, 0.49 to 1.54; P = .62). However, the intensive strategy was associated with higher overall survival in patients with stage II tumors (HR = 0.34; 95% CI, 0.12 to 0.98; P = .045) and in those with rectal lesions (HR = 0.09; 95% CI, 0.01 to 0.81; P = .03), mainly due to higher rate of resectability for recurrent tumors. Colonoscopy was responsible for the detection of the highest proportion (44%) of resectable tumor recurrence in the intensive arm. A more intensive surveillance strategy improves the prognosis of patients with stage II colorectal cancer or those with rectal tumors. Inclusion of regular performance of colonoscopy seems justified up to the fifth year of follow-up, at least.