Drug resistant epilepsy remains a major clinical challenge. Diverse criteria have been used to defi ne drug resistance by different researchers, making it diffi cult or even impossible to compare the results across different studies. To improve patient care and facilitate clinical research, the International League Against Epilepsy recently proposed a consensus defi nition to defi ne drug resistant epilepsy as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom. This article outlines the framework of the consensus defi nition, explains how to apply it in practice, and discusses the future development in its use.

No abstract available.
Esthetics*

History, 19th Century ; History, 20th Century ; Humans ; Neurosurgery ; history ; Philately ; United States

Humans ; Preventive Psychiatry ; Psychotic Disorders ; etiology ; prevention & control ; Risk Assessment

Conclusions1)The present situation of teaching English for medical purposes (EMP) in Japanese medical schools is chaotic.2)We need a standardized EMP curriculum and standardized national and international EMP goals.3) Based on Ministry of Education funding, a free Internet platform for EMP educational materials has been established and could be used to develop a national standardized EMP program.

OBJECTIVE: This study aimed to determine clinical characteristics that are associated with tuberculosis orchitis in patients who present with a testicular mass.

MATERIALS AND METHODS: This is an analytic retrospective cohort study of patients who underwent radical orchiectomy for a possible testicular malignancy based on a testicular mass from 2005 to 2009. The following data were derived from a review of the patient's charts: patient age, laterality of the disease, duration of symptoms, concomitant extra-testicular tuberculosis (TB), pre-operative anti-TB treatment received, pertinent pre-operative physical findings, pertinent diagnostics done pre-operatively, and intra-operative findings.

RESULTS: The prevalence of testicular tuberculosis in persons who underwent radical orchiectomy for a scrotal mass is 31.8%. TB orchitis occurs more often in younger patients, those who have had tuberculosis in the past, or have received treatment, those with larger testicular masses, those with scrotal skin sinus and tenderness or swelling, tunica, vaginalis invasion, scrotal skin invasion, and epididymal enlargement, and those with cheesy substance noted in intraoperative findings. There were no significant differences between testicular tuberculosis and testicular tumor in terms of ultrasound findings.

CONCLUSION: Testicular tuberculosis is prevalent among patients who underwent radical orchiectomy due to a scrotal mass. Several clinical characteristics preoperatively and intraoperatively may predict TB orchitis in these patients.

Human ; Male ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Child Preschool ; Infant ; Orchitis ; Testicular Diseases ; Male Urogenital Diseases ; Orchiectomy ; Tuberculosis-history

INTRODUCTION: Health status is one of the major determinants of national development, economic prosperity and security. Various efforts have been made by the Philippine government especially the Philippines Department of Health (DOH) to improve the performance of the health sector and to ensure that each Filipino citizen will have access to quality health services. However, in most instances, this does not always hold true. This study describes the health situation of the Aetas of Bayan-Bayanan, Orion, Bataan.
METHODS: Thirteen families participated in the survey on the community dimensions directly related and secondary to health, after informed consent. Focus group discussions and individual interviews were also conducted.
RESULTS: The respondents identified (1) poor access to medicine, (2) lack of stay-in midwife, and (3) lack of trained health personnel within the community as the primary factors that affect the health services. The foremost health status problems encountered are (1) prevalence of respiratory tract infection, (2) poor child bearing practices and (3) diarrhea.
CONCLUSION:The study showed that the indigenous Aeta people hardly receive and have access to health services provided by the main municipality of Orion, Bataan.

Human ; Male ; Female ; Child ; Diarrhea ; Focus Groups ; Health Personnel ; Health Services ; Health Status ; Informed Consent ; Midwifery ; Philippines ; Prevalence ; Respiratory Tract Infections ; Surveys And Questionnaires

A 48-year-old male with complete tetraplegia C6 presented with sweating and flushing of the right half of the face and neck that recurred when lying in supine and left lateral positions. The symptoms subsided immediately upon sitting upright or lying in a right lateral position. The symptoms were associated with occasional mild head discomfort rather than headache and were accompanied by marked elevation of blood pressure, which was 190-200/120-130 mmHg compared to his previous baseline blood pressure of 80-90/50-70 mmHg, and he had a heart rate of 60-70 beats per minute. We believe that post-traumatic syringomyelia, found upon further investigation, was the cause of the Autonomic dysreflexia (AD) in this patient. He was advised to avoid the positions causing the symptoms and the progression of symptoms was monitored regularly. AD might not have been diagnosed in this patient because of the atypical and unusual presentations. Therefore, knowledge and a heightened level of awareness of this possible complication are important when treating individuals with spinal cord injury (SCI).

Nucleopolyhedrovirus (NPV) has become an integral part of integrated pest management (IPM) in many Australian agricultural and horticultural crops. This is the culmination of years of work conducted by researchers at the Queensland Department of Primary Industries and Fisheries (QDPI&F) and Ag Biotech Australia Pty Ltd. In the early 1970's researchers at QDPI&F identified and isolated a virus in Helicoverpa armigera populations in the field. This NPV was extensively studied and shown to be highly specific to Helicoverpa and Heliothis species. Further work showed that when used appropriately the virus could be used effectively to manage these insects in crops such as sorghum, cotton, chickpea and sweet corn. A similar virus was first commercially produced in the USA in the 1970's. This product, Elcar(R), was introduced into Australia in the late 1970's by Shell Chemicals with limited success. A major factor contributing to the poor adoption of Elcar was the concurrent enormous success of the synthetic pyrethroids. The importance of integrated pest management was probably also not widely accepted at that time. Gradual development of insect resistance to synthetic pyrethroids and other synthetic insecticides in Australia and the increased awareness of the importance of IPM meant that researchers once again turned their attentions to environmentally friendly pest management tools such NPV and beneficial insects. In the 1990's a company called Rhone-Poulenc registered an NPV for use in Australian sorghum, chickpea and cotton. This product, Gemstar(R), was imported from the USA. In 2000 Ag Biotech Australia established an in-vivo production facility in Australia to produce commercial volumes of a product similar to the imported product. This product was branded, ViVUS(R), and was first registered and sold commercially in Australia in 2003. The initial production of ViVUS used a virus identical to the American product but replicating it in an Australian Helicoverpa species, H. armigera. Subsequent research collaboration between QDPI&F and Ag Biotech reinvigorated interest in the local virus strain. This was purified and the production system adapted to produce it on a commercial scale. This new version of ViVUS, which was branded ViVUS Gold(R), was first registered and sold commercially in 2004. Widespread insect resistance to insecticides and a greater understanding of integrated pest management is leading to increased adoption of technologies such NPV in Australian agriculture.