These results indicate that this increasingly common disease frequently leads to a fatal outcome in patients requiring surgery and implies that earlier surgical consultation may be necessary to improve survival in patients with fulminating C. difficile colitis unresponsive to antibiotic therapy.
Relief of symptoms and alterations of superficial venous pressures as a result of' wearing elastic stockings were assessed in I 2 patients with varicose veins. The efect of wearing elastic stockings on superficial venous pressures was measured in I0 normal volunteers.In the group of patients continuous elastic stocking compression produced relief of symptoms and a lowering of the venous ambulatory pressure.ELASTIC stockings have been used in the treatment of venous insufficiency since the end of the seventeenth century (Foote, 1960). The object of the present work was t o evaluate and correlate the effect of continuous use of elastic stockings on the patients' symptoms and superficial venous pressures. The pressures exerted by the stockings on different parts of the leg were also measured.
With emerging research on the dynamics of extreme fire behavior, it is increasingly important for wind models, used in operational fire prediction, to accurately capture areas of complex flow across rugged terrain. Additionally, the emergence of ensemble and stochastic modeling frameworks has led to the discussion of uncertainty in fire prediction. To capture the uncertainty of modeled fire outputs, it is necessary to recast uncertain inputs in probabilistic terms. WindNinja is the diagnostic wind model currently being applied within a number of operational fire prediction frameworks across the world. For computational efficiency, allowing for real-time or faster than real-time prediction, the physical equations governing wind flow across a complex terrain are often simplified. The model has a number of well documented limitations, for instance, it is known to perform poorly on leeward slopes. First, this study is aimed at understanding these limitations in a probabilistic context, by comparing individual deterministic predictions to observed distributions of wind direction. Secondly, a novel application of the deterministic WindNinja model is presented in this study which is shown to enable prediction of wind direction distributions that capture some of the variability of complex wind flow. Recasting wind fields in terms of probability distributions enables a better understanding of variability across the landscape, and provides the probabilistic information required to capture uncertainty through ensemble or stochastic fire modeling. The comparisons detailed in this study indicate the potential for WindNinja to predict multi-modal wind direction distributions that represent complex wind behaviors, including re-circulation regions on leeward slopes. However, the limitations of using deterministic models within probabilistic frameworks are also highlighted. To enhance fire prediction and to better understand uncertainty, it is recommended that statistical approaches also be developed to complement existing physics-based deterministic wind models.
We report a case of necrotising fasciitis of the genitoperineum (Fournier's gangrene) in a HIV positive male following incision and drainage of bilateral ischiorectal fossa abscesses. During surgery to debride the necrotic tissue the rectum was found to be perforated necessitating laparotomy and subsequent abdomino-perineal resection. Although previous reports of Fournier's gangrene in the HIV positive population exist, rectal involvement requiring excision has not previously been reported.
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