Extract: The current importance of public debt requires governments to increasingly shift towards Public-Private Partnerships (PPPs). They are long-term contracts of private financing method providing or contributing to public service. The payment is made by the public partner and/or users of the service. The World Health Organization (WHO) defines this type of partnership as ‘‘a means to bring together a set of actors for the common goal of improving the health of populations based on mutually agreed roles and principles.’’ Historically, the principle of PPP was established by the Private Finance Initiative (PFI), launched by the conservative government of John Major in 1992. It was from this moment that this model quickly spread to the rest of the world. In the mid-90s and from Australia, PPP agreement began to become part of the language of governments. In 1997, Labour with Tony Blair leading, strongly developed this management method, first and particularly in hospitals and then, in the entire public sector and spreading to the Royal Navy. Today, 10-15% of British public investments are made using PFI method.
Objective: The purpose of this study is to describe the clinical and radiological features of SSS, and to review therapeutic possibilities and their outcomes. Patients and Methods: Retrospective observational case series in the department of Arthur Vernes Institute between Mars 2007 and Novembre 2012. Clinical records, including ophthalmology and otolaryngology evaluations as well as computed tomography scans and operative reports, were carefully examined. A literature review for relevant studies was performed to examine similar cases. Results: Eleven cases of SSS were identified. Nine men and two women (sex ratio 4.5), aged between 23 and 54 years (mean, 30 years). there was 3 to 4 mm enophthalmos in 10 cases (90.9%), and hypoglobus in all cases, with no effect on visual function. In all 11 cases, the maxillary roof (orbital floor) was drawn downwards, and the one or more walls of the maxilla were concave. In 4 cases septal deviation was present. 8 patients (72.7%) underwent endoscopic sinus surgery, while 3 refused it. Septoplasty was performed in 4 cases (36.3%). Conclusion: The silent sinus syndrome is a rare entity. It mainly presents as unilateral enophthalmos in younger people and has very characteristic clinical and radiologic signs. This case series reports our diagnostic and therapeutic experience with this syndrome
Background: Cannabis is the illicit psychoactive substance the most consumed in the world. Little is known about the association between the use of cannabis and the risk of lung cancer. Objective:The objective of this meta-analysis is to determine whether use of cannabis is a risk factor for lung cancer. Methods: We conducted a systematic review and meta-analyses of all languages articles using relevant computerised databases. MEDLINE (online PubMed), Web of knowledge, Embase, EBSCO CINAHL, ScienceDirect, Scopus, Cochrane Library, and Directory of Open Access Journals were searched to September 2014 for cohorts and case-control studies that assessed the risk of lung cancer associated with cannabis smoking. The literature search was performed with a combination of medical subject headings terms, "cannabis" and "lung neoplasms". Data extraction: Two investigators independently analysed and extracted results from eligible studies. Our study's registration number on PROSPERO is CRD42014008872. Results: The search strategy identified 2476 citations. 13 studies were eligible for inclusion: 2 pooled analysis of 9 case-control studies, one case-control study and 3 cohorts. The cumulative analysis for all the studies under a fixed-effects model showed that cannabis smoking determined an increased risk of developing lung cancer in the future (relative risk 1.22, 95% confidence interval 0.999–1.5; p=0.051), with no evidence of heterogeneity across the studies (I2: 34%; p¼0.01). Conclusions: The use of cannabis with or without tobacco smoking is associated with an increased risk for lung cancer
Tuberculosis is a chronic granulomatous infection caused by Mycobacterium tuberculosis or bovis that can affect all organs. However being located in the salivary glands is rare, affecting mainly adults between 20 and 50 years, although a few cases were described in children. We reported a series of 4 children with parotid TB diagnosed and treated at the ENT department of the hospital of specialties of Rabat. The average age was 9.25 years and sex ratio M/F was 1. All children were admitted for parotid swelling evolving over an average period of 6 months which fistulized afterwards, a child had also facial paralysis. Histological analysis of the fine-needle aspiration or the sample taken from the fistula confirmed the diagnosis of tuberculosis with the presence of giant cell granuloma with caseous necrosis. All children received anti-bacillary treatment during 6 months, and showed good evolution. Although being rare, the parotid TB in children remains a condition to be considered at the occurrence of any chronic parotid swelling, especially in endemic countries.
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