We report a case of hyperpyrexia presumed due to topical salicylate toxicity occurring immediately following general anaesthesia for appendicectomy in an eleven year old boy. Some of the features strongly suggested the diagnosis of malignant hyperpyrexia.
A distinctive adenomatous and cribriform hyperplasia of gland and reserve cells of the uterine cervix is attributed to progestogens. The lesions were polypoid or verrucose and located near the squamocolumnar junction. Carcinoma was usually suspected on clinical examination, and on biopsy the diagnosis of adenocarcinoma was either made or seriously entertained for seven of 12 patients. The natural history of the lesion does not indicate any likelihood of progression to carcinoma.Several groups of workers have referred briefly to the effects of progestogens on the human uterine cervix.13 The observed changes were hypersecretion, hyperplasia of glandular epithelium, and stromal edema. They were considered to be similar to but not as intense as those observed during preg¬ nancy. None of the investigators reported severe or atypical hyperplasia of endocervical epithelium.During the past four years we have encountered several examples of a distinctive hyperplasia of glandular epithelium in the cervices of women re¬ ceiving progestogens. In several instances, errone¬ ous diagnoses of adenocarcinoma were made ini¬ tially from biopsy specimens. Although our series of cases is small and the periods of observation short, there is no evidence to suggest that the lesion is anything but benign. The main purpose of this re¬ port is to acquaint those concerned with the inter¬ pretation of biopsy specimens with this particular cervical lesion, as the consequences of overdiagnosis in young women, in whom it predominates, are serious. Materials and MethodsAll biopsy specimens of uterine cervix examined which exhibited adenomatous or atypical gland cell hyperplasia were as¬ sessed. Specimens from 12 patients showed a dis¬ tinctive and florid adenomatous hyperplasia. In material from several additional patients, minor de¬ grees of a similar change were noted, but only those specimens in which the hyperplasia was marked and unquestionable were accepted for study. Clini¬ cal records of the patients were reviewed and particular attention directed to the assessment of presenting symptoms, gross appearance of cervix, hormonal medication, subsequent treatment, and survival.Tissue specimens were stained routinely with hematoxylin and eosin. In most instances addi¬ tional material was on hand so that a variety of special histologie stains were employed, including alcian green and mucicarmine stains for mucus,
Munculnya risiko dalam kegiatan bisnis perusahaan berpotensi menghambat kinerja perusahaan dalam memaksimalkan nilai perusahaan sehingga dapat mempengaruhi kekayaan yang dimiliki oleh pemegang saham. Tujuan dalam penelitian adalah mengetahui pengaruh Enterprise Risk Management (ERM) terhadap corporate value. Terdapat 87 perusahaan manufaktur yang memenuhi kriteria digunakan sebagai sampel dalam penelitian ini setelah dilakukan purposive sampling. Sumber data pada penelitian ini merupakan data sekunder yaitu laporan keuangan dan laporan tahunan tahun 2016-2020 dari setiap sampel perusahaan dan akan dibantu oleh program software Stata 13 dalam pengujian data. Dalam penelitian ini juga menggunakan 3 variabel kontrol yaitu firm size, leverage, dan age. Diperoleh hasil penelitian yaitu pengaruh signifikan positif ERM terhadap corporate value. Robustness test menunjukkan bahwa hasil penelitian yang ditemukan valid serta tidak bias karena adanya persamaan hasil yang diperoleh saat uji regresi dan robustness test. Hasil penelitian ini berimplikasi pada regulator, praktisi, dan akademisi. Lewat adanya penemuan ini memberikan dukungan pada perusahaan untuk mengadopsi sistem manajemen risiko yang lebih terintegrasi dan komprehensif yaitu ERM.
Penelitian bertujuan untuk menginvestigasi seberapa besar loyalitas dari sebuah merek yang dipengaruhi oleh brand image, perceived quality dan brand awareness. Objek penelitian yang diambil adalah salah satu merek internasional yang cukup terkenal di Indonesia yaitu Starbucks. Penelitian kali ini akan membahas mengenai seberapa besar kesetiaan konsumen terhadap Starbucks yang sudah terdengar tidak asing lagi dan banyak sudah mengenali merek tersebut dimana menjual minuman kopi dengan harga yang lumayan tinggi dibandingkan kopi lain dikarenakan kekuatan dari brand. Banyak sekali peminat dari Starbucks bahkan para wisatawan asing cenderung membeli merek tersebut di negara mana pun dikarenakan Starbucks sudah terkenal mendunia. Brand loyalty adalah salah satu preferensi yang mempengaruhi konsumen untuk membeli suatu produk secara berulang terus menerus. Lokasi penelitian dilaksanakan di Starbucks yang berada di Kota Batam. Metode pengambilan sampel diambil tidak secara acak sebanyak 191 responden. Hasil yang ditemukan bahwa adanya hubungan signifikan antara brand image, perceived quality dan brand awareness terhadap brand loyalty. Sedangkan perceived quality dan brand awareness berhasil dimediasikan oleh customer satisfaction.
Trauma is the leading cause of death among people under 50 years old worldwide. Severe trauma will trigger systemic inflammatory response syndrome (SIRS) which can worsen into multiple organ failure MOF). This study was aimed to evaluate whether there was a correlation between neutrophil count and C reactive protein concentration in multi-traumatic patients and whether both variables could become predictors of the occurence of MOF. This was a correlation study with a cross sectional design. There were 71 multitraumatic patients enrolled in this study, obtained from Surgery Emergency Unit of Prof. Dr. R. D. Kandou Hospital Manado; 31 of them were associated with SIRS, MODS, and MOF. The regression analysis showed that the higher the neutrophil count was, the greater the chance of the patient to suffer from MOF (P < 0.001), as well as the higher the CRP concentration, the greater the chance of the patient to suffer from MOF (P < 0.001). The cut-off point of neutrophil to MOF was 17121.7 and the specifity was higher than the sensitivity. Morover, the cut-off point of CRP to MOF was 169.7 and the specifity was higher than the sensitivity. Conclusion: There were significant correlations between the neutrophil count and MOF as well as between CRP concentration and MOF. Neutrophil count and CRP concentration could become predictors of the occurence of MOF and were significant in sensitivity and specifity in acute multi-traumatic patients.Keywords: multiple trauma, MOF, neutrophil, CRPAbstrak: Trauma merupakan penyebab kematian nomor satu pada orang berusia kurang dari 50 tahun. Trauma berat akan memicu timbulnya respons inflamasi sistemik berat (Systemic Inflammatory Response Syndrome, SIRS) yang dapat memburuk menjadi kegagalan multi-organ. Penelitian ini bertujuan untuk mengetahui ada tidaknya korelasi antara besaran neutrofil dan kadar CRP pada pasien multi-trauma, dan apakah keduanya dapat digunakan sebagai faktor prediktor dalam mendeteksi terjadinya multi-organ failure (MOF). Jenis penelitian ialah korelasi dengan desain potong lintang. Hasil penelitian mendapatkan 71 pasien multi-trauma yang dirawat di Instalasi Gawat Darurat Bedah RSUP Prof. Dr. R. D. Kandou Manado; 31 di antaranya disertai SIRS, MODS dan MOF. Hasil analisis regresi menyatakan bahwa makin tinggi besaran neutrofil maka makin besar peluang pasien untuk terjadi MOF (P < 0,001), dan makin tinggi CRP maka makin besar peluang pasien untuk terjadi MOF (P < 0,001). Cut-off point neutrofil terhadap MOF ialah 17121,7 dengan nilai spesifisitas lebih besar dari sensitivitas sedangkan cut-off point CRP terhadap MOF ialah 169,7 dengan nilai spesifisitas lebih besar dari sensitivitas. Simpulan: Terdapat hubungan bermakna antara besaran neutrofil dan MOF serta antara CRP dan MOF. Besaran neutrofil dan CRP merupakan prediktor terjadinya MOF yang mempunyai signifikansi dalam sensitivitas dan spesifisitas pada pasien dengan multi- trauma akut.Kata kunci: multi-trauma, MOF, neutrofil, CRP
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