Next generation transport network is characterized by the use of in-band signaling, where Internet Protocol (IP) packets carrying signaling or media information are mixed in transmission. Since transport resources are limited, when any segment of access or core network is congested, IP packets carrying signaling information may be discarded. As a consequence, it may be impossible to implement reachability and quality of service (QoS). Since present approaches are insufficient to completely address this problem, a novel approach is proposed, which is based on prioritizing signaling information transmission. To proof the concept, a simulation study was performed using Network Simulator version 2 (ns-2) and independently developed Session Initiation Protocol (SIP) module. The obtained results were statistically processed using Statistical Package for the Social Sciences (SPSS) version 15.0. Summarizing our research results, several issues are identified for future work.

Introduction: The aim of the research was to determine the effect of breakthrough pain (BTP) on heart and lung function in patients whose cancer pain had been treated with strong opiates.Methods: A prospective study was conducted on 80 patients who were treated in recumbent patients’ hospice of Palliative Care Centre (hospice) University Clinical Centre Tuzla. The effect of pain breakthrough onheart function was monitored by blood pressure and pulse measuring outside. The effect on respiratory function was monitored by measuring the respiration number with SpO2 and pCO2 and pO2 capillary blood valuesoutside, during and after relieving pain breakthrough.Results: Mean value for Karnofsky score for patients upon admission was 47.13 ± 11.05 and on discharge 51.25 ± 11.73. The total number of pain breakthroughs for patients within the 10 days of the treatment was1396. During the pain breakthrough the mean of systolic pressure was 133.1 mmHg and it was statistically significantly higher than the mean of systolic pressure measured after BTP relief with oral morphine. Themean of diastolic pressure measured outside of pain breakthrough was 75.9 mmHg and after the BTP relief it was 72.9 mmHg. The mean pulse outside of pain breakthrough was 92.7 heartbeats per minute and afterthe BTP relief 8 9.1 heartbeats per minute.Conclusion: Pain breakthrough leads to pulse acceleration, increased systolic and diastolic blood pressure and it also affects respiratory function by accelerating the respiration

Anemia refers to a hemoglobin or hematocrit level lower than the age-adjusted reference range in healthy children and adults. Anemia is not a specifi c disease entity but is a condition caused by various underlying pathologic processes. The clinical effects of anemia depend on its duration and severity. When a precipitous drop in the hemoglobin or hematocrit level occurs (eg, due to massive bleeding), the clinical presentation is typically dramatic and can be fatal if the patient is not immediately treated. Even then, mortality risk is very high. We report the case of a 76-year-old woman with clinical symptoms and laboratory confirmation of severe anemia with level of hemoglobin 24 g/l, and hematocrit 0.08. Anemia was a sign of malignoma of the stomach, later patohistologicaly verifi ed gastric adenocarcinoma. Aim of management is to prevent tissue hypoxia by maintaining an adequate circulating volume and oxiform capacity. However, as shown in this case, the very rapid correction of anemia and the circulatory volume does not decrease the risk of fatal outcome

Background QI are retrospectively measurable elements of practice performance for which there is evidence or consensus that can be used to assess the quality of care provided. Aim To develop a set of consensus-derived QI for pSLE to serve as international benchmarks for the quality of patient care. Methods Based on the medical literature a Delphi survey was created and distributed to the physician membership of PRES, PANLAR, CARRA and the ACR via e-mail. Consensus was considered 80% or higher. Results There was consensus (97%) among the 297 respondents that simply applying QI developed by the ACR and EULAR for adults with SLE (adult QI) was insufficient and that distinct QI for pSLE were needed. Respondents concurred that 5 of the 20 ACR and 6 of the 24 EULAR adult QI are also suitable for pSLE. An additional 14 ACR and 13 EULAR adult QI might be useful for pSLE after modifications. There was no consensus whether to consider “Pregnancy” (45%) and “Reproductive Health” (65%) as domains in the set of pSLE QI. Conclusion There is great demand among pediatric rheumatologists to develop QI for pSLE. Initial agreement has been reached about the types and domains of QI for pSLE, but additional discussion and consensus formation under consideration of the medical evidence is needed to finalize a set of QI for pSLE that can be used to define standard of care treatment for children and adolescents with pSLE.

Background Familial Mediterranean Fever (FMF) is an autosomalrecessive disorder characterized by recurrent attacks of fever and serositis. It is common in eastern Mediterranean population. There are only few FMF patients in Slovenia and Macedonia and the mutation carrier rate is not known. So far, over 80 disease associated mutations have been identified in MEFV gene; the most common are M694V, V726A, M680I, E148Q and M694I.The distribution pattern of MEFV mutation along the Mediterranean Sea is not uniform; eastern populations have the highest number of carriers (20-39%), whereas the number of carriers in western Mediterranean populations is considerably lower.

Abstract An enhanced risk of undesirable events has been described in individuals who take part in mainly high intensity physical activities. Underlying cardiac disorders are the most common cause of sudden death during sports activities. Left ventricular remodeling is associated with a long-term athletic training. Echocardiography is an easy, non-invasive and efficient way to the precise distinction between these exercise-induced changes, called “physiological” hypertrophy, that revert after detraining, and those of cardiac disorders or “pathological” hypertrophy. The identification of a cardiac disease in an athlete usually leads to his disqualification in an attempt to reduce the risk. On the other hand, a false diagnosis of a cardiac disease in an athlete may also lead to disqualification, thus depriving him of the various benefits from sports participation. Pronounced left ventricular dilatation and hypertrophy should always be suspected for underlying cardiac disease. Physiological left ventricular ...

Hantavirus infections are reported from many countries in Europe and with highly variable annual case numbers. In 2010, more than 2,000 human cases were reported in Germany, and numbers above the baseline have also been registered in other European countries. Depending on the virus type human infections are characterised by mild to severe forms of haemorrhagic fever with renal syndrome. The member laboratories of the European Network for diagnostics of Imported Viral Diseases present here an overview of the progression of human cases in the period from 2005 to 2010. Further we provide an update on the available diagnostic methods and endemic regions in their countries, with an emphasis on occurring virus types and reservoirs.

In this study, we investigate the feasibility of a BCI based on transcranial Doppler ultrasound (TCD), a medical imaging technique used to monitor cerebral blood flow velocity. We classified the cerebral blood flow velocity changes associated with two mental tasks - a word generation task, and a mental rotation task. Cerebral blood flow velocity was measured simultaneously within the left and right middle cerebral arteries while nine able-bodied adults alternated between mental activity (i.e. word generation or mental rotation) and relaxation. Using linear discriminant analysis and a set of time-domain features, word generation and mental rotation were classified with respective average accuracies of 82.9%10.5 and 85.7%10.0 across all participants. Accuracies for all participants significantly exceeded chance. These results indicate that TCD is a promising measurement modality for BCI research.