Cases Of Today Research Articles

Shock One Week after Abdominal Surgery

Dr. Patricia Henwood: Today's case is that of a 68-year-old woman with recent abdominal surgery who presented to the Emergency Department (ED) in transfer from an outside hospital with the chief complaint of altered mental status and acute renal failure. The patient reported decreased intake by mouth and no urination over the last 2 days and no bowel movements since the day prior to her abdominal surgery, which had been 1 week ago.

The tribunal of modern life: the case of UZ Brussels in the light of Odo Marquard's discussion on autonomy and theodicy

Recently, a court in Belgium awarded a sum of 400 000 euros to the parents of a child with disability who at that point had already died of Sanfilippo syndrome. Their charge was not that the baby was born with disability, but that the child was born. The charge was brought in the child's name, and so effectively, the child had sued against its own birth. This so-called 'unique case' is analyzed with the work of the German philosopher Odo Marquard. Marquard's work on theodicy, and the question of suffering and evil, is very useful to explain why this case is the current apotheosis of a logic present in modernity: existence as a tribunal. This paper explains why Marquard's work sheds an interesting light on this case for today's medicine.

장소의 문화화를 타겟으로 한 농촌마을 권역종합정비사업 모델 - 영천시 가상권역 사업을 중심으로 -

This study deals with rural village development project of Gasangri, Yeongcheon city area, based on the use of the cultural factors and strengthening them in study area. Unlike other cases of today`s Korean rural village development projects, this plan keenly concerns not only for tourists but also for the village people. Since culture means the quality of life also, this project especially deals with `community`, `well-being`, and `convenience` for the inhabitants. On the other hand, it attempts to connect with Cyan Museum, which is the first grade art gallery remodelled from closed school, to make village of culturally abundant atmosphere. In result, seven sub-projects of the expansion of basic living foundation, and two improvement of landscape in area have planned. Among stereotype of rural development projects and similar programs of tourism, the project makes difference on targeting for the meaning and resource of place culture.

Intramuscular Epinephrine and Acute Myocardial Infarction

Dr. Katherine Kroll: Today's case is that of a 38-year-old man with a history of hypertension and post-traumatic stress disorder (PTSD) who presented to the Emergency Department (ED) with a chief complaint of chest pain and electrocardiogram (ECG) changes. Earlier in the day the patient developed blurry vision, dizziness, shortness of breath, three episodes of vomiting, and throat swelling while mowing the lawn. He was taken to an outside hospital ED where he was diagnosed with anaphylaxis and given Solu-Medrol (Pfizer Inc., New York, NY) 125mg intravenously (i.v.), Zofran (GlaxoSmithKline, Brentford, Middlesex, UK) 4mg i.v., Benadryl (McNeil Consumer Healthcare, Fort Washington, PA) 50mg i.v., Ativan (Pfizer) 1mg i.v., Zantac (Boehringer-Ingelheim Pharmaceuticals, Inc., Ridgefield, CT) 50mg i.v., and two COMBIVENT® (Boehringer-Ingelheim) nebulizer treatments.

개별 사용자 환경을 위한 스마트TV 리모트컨트롤 인터랙션 방식 제안

Today cases of using individual service on community TV are increasing with the advent of smart TV. The traditional way for using individual service like e-mail or SNS on TV is not simple and puts in too much time because it has to type so many text using remote control that is unsuitable for typing. In this paper, interaction using cube remote control is proposed in order to facilitate individual service on TV. It is simple interaction like shaking and tapping instead of a complex interaction method. In addition, it is believed that the proposed simple interaction using cube interaction might be one of great alternatives for using individual service on smart TV.

GENETİK, ÇEVRESEL VE KÜLTÜREL ETMENLERİN IŞIĞINDA ANEMİ: BAZI ESKİ ANADOLU TOPLULUKLARINDAN ÖRNEKLER

GENETİK, ÇEVRESEL VE KÜLTÜREL ETMENLERİN IŞIĞINDA ANEMİ: BAZI ESKİ ANADOLU TOPLULUKLARINDAN ÖRNEKLER

Today's Case Manager and the State of the Licensing Dilemma

Today's Case Manager and the State of the Licensing Dilemma

Multi-agent-based transport planning in the newspaper industry

In many cases of today's planning tasks, the synchronization of production and distribution is becoming increasingly important in order to minimize costs and to maximize customer satisfaction. This is especially the case if transport schedules are closely connected to production schedules, as it is in the newspaper industry—where perishable goods are distributed immediately after production. In order to achieve the above mentioned competing objectives, a special kind of vehicle routing problem, the vehicle routing problem with time windows and cluster-dependent tour starts (VRPTWCD), has to be solved. Moreover, the varying print and post-processing schedules due to unknown editorial deadlines lead to the need for a dynamic online control of the newspaper production and distribution process. In this contribution, the outlined dynamic transport problem is solved online under consideration of unforeseen changes in production schedules. The solution concept is based on a multi-agent system consisting of, amongst others, several Edition and Vehicle Agents. This system is exemplarily applied to a real life application case of one of the largest German newspaper companies. It is shown that a static (centralized) optimization of the underlying problem would even lead to worse results in comparison to the current situation and that the appliance of the multi-agent system is suitable in the newspaper industry.

Dyspnea and Multiple Pulmonary Nodules

Dr. Adam Levine: Today's case is that of a 67-year-old man, a retired physician of Indian origin, who was referred to the emergency department (ED) by his primary care physician for a 2-day history of increasing shortness of breath and an outpatient computed tomography (CT) scan that showed multiple pulmonary nodules. The patient stated that he was well until 2 months previously, when he acutely developed lower back pain. His primary care physician ordered magnetic resonance imaging (MRI) of the lumbar spine, which showed L2/3 spinal stenosis. The patient subsequently received steroid injections on two occasions. Of note, he reported receiving significant dental work during the same time period. A week after the spinal injections, the patient developed a low grade fever and night sweats. He began to suffer from continuous back pain and stiffness as well as pain in the pelvic girdle. The primary care physician noted an erythrocyte sedimentation rate (ESR) of 70 mm/hour and diagnosed him with polymyalgia rheumatica. She started him on 20 mg prednisolone QD (daily), but the patient noticed no substantial improvement after 1 week's use. He subsequently developed jaw pain and was referred to a rheumatologist, who diagnosed him with temporal arteritis and increased the dose of prednisolone to 60 mg QD. The fever subsided and the lethargy seemed to improve. However, 1 month preceding presentation to the ED, the patient became increasingly lethargic and lost 10–12 pounds. He developed dyspnea on exertion as well as a non-productive cough. The lethargy and dyspnea were evaluated by a hematologist, who ordered an outpatient chest CT scan and blood cultures. Several days later, the patient's dyspnea worsened acutely. The chest CT scan revealed multiple pulmonary nodules, and blood cultures grew “Gram-positive cocci in chains and pairs.” The patient was advised to proceed directly to the ED.

A 46-Year-Old Woman with Altered Mental Status and Garbled Speech

Dr. Edward Kimlin: Today's case is that of a 46-year-old woman who was brought to the Emergency Department (ED) by ambulance for evaluation of garbled speech and bizarre behavior for over 4 h. On initial ED evaluation, the patient was confused and agitated, but able to answer questions appropriately. Other than nausea, she denied any other complaints. She also denied taking any medications, drinking alcohol, or ingesting illicit drugs. The history was limited by a waxing and waning mental status.

An Unusual Cause of Spontaneous Paralysis

Dr. Ryan Friedberg: Today's case is that of a 49-year-old man who presented to the Emergency Department (ED) complaining of bilateral weakness and numbness of his lower extremities for about 12 h. The symptoms began suddenly while he was seated eating breakfast, and he was unable to rise from the chair. He denied any pain in his back or lower extremities or any traumatic event. He described a recent history of a “flu-like” illness 2 days prior that included headache, nasal congestion, nausea, and vomiting.

Pneumothorax in a Blunt Trauma Patient

Dr. Maame Yaa Yiadom: Today's case is that of a 53-year-old man brought in by Emergency Medical Services after being thrown off his horse while riding at low speed. He was thrown backwards and to the left, landing initially on the left side of his upper back and then on his lower back and buttocks. He was wearing a helmet, denied head trauma or loss of consciousness, and did not stand or sit up after landing on the ground. Paramedics were on scene within 15 min. At that time he complained of left-sided flank and chest pain that was worse with moving, and feeling “as if someone was holding his breath.” Paramedics reported that his oxygen saturation decreased from 99% to 96% on room air en route, but increased to 100% with application of 2 L oxygen delivered via nasal cannula.

RL-huffman encoding for test compression and power reduction in scan applications

This article mixes two encoding techniques to reduce test data volume, test pattern delivery time, and power dissipation in scan test applications. This is achieved by using run-length encoding followed by Huffman encoding. This combination is especially effective when the percentage of don't cares in a test set is high, which is a common case in today's large systems-on-chips (SoCs). Our analysis and experimental results confirm that achieving up to an 89% compression ratio and a 93% scan-in power reduction is possible for scan-testable circuits such as ISCAS89 benchmarks.

Understanding and using the IEC 61850: a case for meta-modelling

This paper argues for means to rigorously specify data models and communications services of industrial data communications standards. It uses the example of the recently published IEC 61850 standard “Communications networks and systems in substations”. The latter applies mainly to electrical supply systems such as substations and decentralised power resources (based on wind, photovoltaic, fuel cells, hydropower). However, the concepts of the IEC 61850 could be used in other industrial areas, as well. The paper shows how the complex standard can be modelled elegantly and precisely with a meta-modelling approach, in which we utilise the UML for the model representation. The conceptual approach presented makes the inherent complexity of the standard's data model manageable for both humans and machines. That is, it facilitates human comprehension and machine processability and thereby contributes to a better understanding of the standard as well as to a better utilisation of the standard through functionality provided in today's CASE tools. One important aspect is that it allows one to establish and maintain consistency across the standard's data and communications models.

Chest pain

Dr. David W. Osborne: Today's case is that of a 57-year-old man who presented to the Emergency Department (ED) with a complaint of chest pain. He was brought to the ED by Emergency Medical Services (EMS) from a local shopping mall. Upon arrival the patient appeared in moderate discomfort, describing “10 out of 10” substernal chest pressure. He reported the pain started approximately 12 hour before arrival in the ED. The patient described constant pain, which increased with exertion, and was associated with radiation to his left arm, dyspnea, mild lightheadedness, nausea, and diaphoresis. The patient had been discharged the prior day from a community hospital, also for evaluation of chest pain, with a “negative” workup.

Blunt renal trauma

Dr. Todd Thomsen: Today's case is that of a 17-year-old youth who was involved in a single-car motor vehicle collision. He was the unrestrained driver of the automobile, which was traveling at approximately 80 miles-per-hour. He lost control while negotiating a sharp curve in the road, and the car rolled over several times. The patient was ejected from the vehicle, which sustained extensive internal and external damage. Upon arrival of the paramedic crew, the patient was unresponsive to all stimuli. The pre-hospital vital signs were: heart rate 110 beats per minute (bpm), systolic blood pressure 93 mm Hg by palpation, and respiratory rate of 22 breaths per minute. The paramedics noted a strong odor of alcohol on his breath. He was immobilized with a cervical collar and long spine board and transported to our Level I trauma center. En route to the hospital, he became arousable and periodically combative.

Disaster medicine and the emergency medicine resident

Disaster medicine and the emergency medicine resident

The Original Meaning of the Necessary and Proper Clause

This article presents evidence of the original public meaning of the Necessary and Proper Clause. I show that the meanings of necessary we have inherited from John Marshall's discussion in McCulloch v. Maryland - a choice between indispensably requisite on the one hand and mere convenience on the other - is undercut by the available evidence. truth lies somewhere in between. While these findings will, of course, be of interest to originalists, they should also interest the many constitutional scholars who consider original meaning to be one among several legitimate modes of constitutional analysis, as well as those scholars for whom original meaning is the starting point of a process in which it is translated into modern terms. By either account, it is important to get the original meaning right, even if it is not alone dispositive of today's cases and controversies. This is the companion to two previous articles - The Original Meaning of the Commerce 68 U. Chi. L. Rev. 101(2002) and New Evidence on the Original Meaning of the Commerce 55 U. Ark. L. Rev. 847 (2003) - in which I presented evidence of the public meaning of Congress's power regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes. To determine the constitutionality of any particular legislation and evaluate judicial applications of the Commerce Clause, however, we must also consider the meaning of the Necessary and Proper Clause. For the expansive post-New Deal reading of congressional power owes as much to the Supreme Court's interpretation of the Necessary and Proper Clause as it does to its expansive reading of the Commerce Clause.

Lupus nephritis and the anti-phospholipid antibody syndrome in pregnancy

Lupus nephritis and the anti-phospholipid antibody syndrome in pregnancy

When a strategic plan includes bankruptcy

B usiness failures have begun to play a more important role in the American economy. In an average week, more than 300 companies fail-a rate higher than at any time since the 1930s. More than 75 percent of these financially desperate firms file for a “liquidation bankruptcy”; they agree to a complete distribution of their assets to creditors, most of whom receive a small fraction of the amount they are owed. Liquidation is what the layman views as bankruptcy. The business cannot pay its debts, so it must close its doors. Investors lose their money, employees lose their jobs, and managers lose their credibility. In owner-managed firms, company and personal bankruptcy commonly go hand-in-hand. The other 25 percent of these firms refuse to surrender until one final option is exhausted. Choosing a strategy to recapture its viability, such a company asks the courts for a “reorganization bankruptcy.” It attempts to persuade its creditors to freeze their claims temporarily while it undertakes to reorganize and rebuild the company’s operations more profitably. The appeal of a reorganization bankruptcy is based on the company’s ability to convince creditors it can succeed in the marketplace by implementing a new strategic plan, and that when the plan produces profits, the company will be able to repay its creditors-perhaps in full. In other words, the business offers its creditors a carefully designed alternative to forcing an immediate but fractional repayment of its financial obligations. The option of reorganization bankruptcy offers maximum repayment of debt at some specified future time if a new strategic plan is successful at turning the company around. Consider the case of Today’s Man retail clothing stores. Led by David Feld, a dynamic entrepreneur who owned 52 percent of the corporation (about 5.5 million shares), Today’s Man was enjoying explosive success in 1993, trading at $15