bluuebunny/crossref_metadata_2025 huggingface dataset:
Aproximaciones al concepto de conocimiento en los discursos históricos a partir de los aportes de Teun Van Dijk
Authors: Del Valle Mejías María Elena
Published: May 2021

¿Qué son los discursos sino versiones de la verdad? ¿Qué es la Historia, sino una construcción en la que queremos vernos con orgullo? ¿Hasta qué punto es válida esta construcción? ¿Dónde comienza la Historia y termina la memoria selectiva? ¿Será la Historia que aprendemos, mentiras que nos hacen felices? ¿Dónde está la verdad de la Historia? ¿Podré yo o podrá alguien responder estas preguntas?
Masculinidades en Indiana Jones and the temple of doom (Spielberg 1984)
Authors: Díaz-Cuesta José
Published: May 2021

En el año 2006 se pone en valor la obra de Steven Spielberg en el ámbito académico anglosajón con la publicación de dos obras de muy diferente calado. Se empieza a rellenar el importante hueco que suponía que no hubiera monografías académicas en inglés sobre su obra.
Publicidad in game: el movimiento coca-cola
Authors: Martínez-Rodrigo Estrella , Sánchez Martín Lourdes
Published: May 2021

En la actualidad, el auge de los videojuegos entre el público adolescente y joven es notorio. Como señala Lamb et al, esta industria supone “el segundo segmento de más rápido crecimiento en el entretenimiento, después de Internet”1 y “un 68% de niños entre 7 y 13 juega habitualmente”2. Es sobre todo a partir de los 12 años cuando estos juegos se van consolidando según los intereses del adolescente.
Masculinidades en Raiders of the Lost Ark (Spielberg 1981)
Authors: Díaz-Cuesta José
Published: May 2021

La obra de Steven Spielberg está comenzando a gozar de reconocimiento académico en España. David Caldevilla Domínguez publica en este año 2005, fruto de su tesis doctoral, El sello Spielberg, localizando los estilemas del director apoyándose en la de momento trilogía de Indiana Jones. Precede a esta obra la versión divulgativa de otra tesis doctoral, realizada por Antonio Sánchez-Escalonilla (1994), publicada en 1995 y extendida en 2004.Fuera de España cabe también destacar la compilación de Yosefa Loshitzky (1997) centrada en Schindler’s List (Spielberg 1993), y la de Charles Silet (2002), que abarca diversas obras del director.Pero ninguno de los autores mencionados cifra en la representación de masculinidades la cuestión de sus investigaciones, hueco que nos proponemos rellenar, en lo que atañe a Raiders of the Lost Ark (Spielberg 1981a), en este artículo.
Comunicación y negociación en babel, de Alejandro González Iñárritu
Authors: Padilla Castillo Graciela
Published: May 2021

La presente investigación analiza la película Babel (2006), dirigida por el mexicano Alejandro González Iñárritu. Su tercera obra indaga en la comunicación intrapersonal e interpersonal del ser humano, a través de todo lo que se dice y lo que no se dice. Más allá de la perfección estética o cinematográfica, se analizan diversas teorías de la comunicación y la negociación, que aparecen y destacan sobremanera en el metraje. La hipótesis de la que se parte es que la grandeza y calidad de Babel no está sólo en su montaje, paisajes, música original o interpretaciones de los actores, sino en la profundidad del mensaje que quiere transmitir. Los personajes apenas hablan y la película tiene muchos momentos de silencio. Sin embargo, sus breves líneas de diálogo, unidas a sus gestos y movimientos, están plagadas de ejemplos comunicativos dignos de ser examinados.
Diez años de excelencia publicitaria. la radio en el festival de san sebastián-el sol (1996-2006)
Authors: Piñeiro Maria Teresa
Published: May 2021

Los festivales constituyen un escaparate de la producción de una agencia publicitaria. El análisis del palmarés de los certámenes más prestigiosos del sector es suficiente para comprobar la relevancia de agencias, medios y marcas. En efecto, aunque la radio forma parte de los medios publicitarios clásicos, su presencia y participación en los festivales supone un reflejo de su escasa relevancia en el contexto actual.El objeto de este trabajo ha sido el de conocer la presencia y evolución de la publicidad radiofónica en El Sol. Un análisis que se ha efectuado teniendo en cuenta tanto el número de categorías presentes en su palmarés, como el volumen de piezas presentadas.
La sociedad de la información: la educación y nuevas alfabetizaciones para la igualdad de oportunidades
Authors: Rayón Rumayor Laura , Rodríguez Javier
Published: May 2021

El presente artículo plantea unas reflexiones que permiten identificar un discurso clarificador en torno al papel de las tecnologías de la información y la comunicación (TIC) en la educación obligatoria, y sus implicaciones en la igualdad de oportunidades en el acceso a la educación. Pero en cualquier caso, nos exige detenernos, como condición irrenunciable, a reflexionar y construir un marco de análisis más amplio en el que poder clarificar en qué afectan las tecnologías de la información y la comunicación a la educación como un proyecto basado en la equidad y la justicia social.
Características de la publicidad en las redes sociales: coca-cola en tuenti
Authors: Sánchez Martín Lourdes
Published: May 2021

El término Web 2.0 fue acuñado por Tim O`Reilly para referirse a la “red como plataforma, que se extiende a todos los equipos que están conectadas a la misma; las aplicaciones Web 2.0 son aquellas que consiguen las ventajas más intrínsecas de la plataforma: presentando el software como un servicio de actualidad de forma continua y que mejora a medida que más personas lo utilizan, consumiendo y remezclando datos de múltiples fuentes, incluyendo también a usuarios individuales que al realizar su aportación y sus datos permiten que otros a su vez los utilicen, creando así efectos de red a través de una arquitectura de la participación”
La audiencia televisiva. una aproximación teórica a la eficiencia y legitimidad de las audiencias
Authors: Martínez-Rolán Xabier
Published: May 2021

En el momento televisivo actual, superada la liberalización del mercado en España en los años 90 y en plena expansión de licencias televisivas al albor de la digitalización del servicio, se ha multiplicado la oferta televisiva en beneficio del telespectador. Sin embargo, la multiplicación de canales no ha implicado la calidad ni la diversidad de los contenidos televisivos emitidos.Grupos mediáticos y cadenas de televisión justifican su oferta de programación basándose en los criterios de audiencia y, en relación a éstos, a la demanda real de la audiencia. No obstante, ¿es realmente así? ¿Es la audiencia quien decide qué contenidos se programan, o se adapta a la oferta emitida?.El objetivo de este trabajo es realizar una aproximación al concepto de la elección de la audiencia y su relación con la programación televisiva, desde una perspectiva teórica.
El caso de la red social pinterest: representación propia y coleccionismo virtual a través de imágenes
Authors: Visa Barbosa Mariona
Published: May 2021

Los usos de la fotografía nos hablan de la sociedad de cada momento y en los últimos años vemos como la representación personal, la comunicación y el coleccionismo forman parte de estos usos. Muchos usuarios de las redes sociales no producen contenido, sino que lo utilizan como herramienta para comunicarse entre ellos. La plataforma emergente Pinterest es un lugar dónde organizar aquello que nos interesa en distintas carpetas y a la vez exhibirlo al resto del mundo, posibilitando así la transmisión de información y la comunicación horizontal entre los usuarios, característica clave de los medios sociales que pueblan Internet desde principios del siglo XXI.
El liderazgo directivo en la empresa: ¿una mera habilidad o una auténtica herramienta de desarrollo personal?
Authors: Conde Colmenero Pilar
Published: May 2021

El liderazgo ha sido entendido tradicionalmente como una habilidad esencial en el ámbito de la gestión empresarial, en especial en lo concerniente a la dirección de los recursos humanos y al fomento de la iniciativa emprendedora. El presente trabajo pretende reflexionar sobre aquellos modelos de liderazgo que pueden constituir, no solo una clave en la gestión del capital humano, sino también una herramienta potenciadora del desarrollo personal de los miembros de la estructura organizativa y del mismo líder emprendedor, siguiendo los postulados de la responsabilidad social corporativa o las últimas iniciativas legales a favor del emprendimiento. Desde esta perspectiva, el liderazgo directivo cobra una nueva dimensión al ser estudiada como fórmula favorecedora del progreso del individuo (conectada a parámetros éticos y de transmisión de valores), que va más allá de las exigencias legales propias de cada ordenamiento jurídico e incluso de la superación de los diversos retos a los que se encuentran expuestos actualmente las organizaciones empresariales. En definitiva, se trata de asumir unas prerrogativas éticas a la hora de liderar a las personas; cuestión esta que parece indispensable en las modernas sociedades azotadas por crisis financieras que han evidenciado los puntos débiles de un sistema de mercado marcado por conductas corporativas poco honestas.
Aproximación a los conceptos de conocimiento, creencia e ideología en la enseñanza de la historia de Venezuela a partir de los aportes de Teun Van Dijk
Authors: Del Valle Mejías María Elena
Published: May 2021

El presente artículo analiza los conceptos de conocimiento, creencia e ideología en la enseñanza de la Historia de Venezuela desarrollados en los textos escolares. El análisis se hace a partir de los aportes teóricos de Teun van Dijk que en su prolífica obra aborda los mencionados constructos y como estos pueden ser analizados en diferentes discursos, en este caso, en un discurso concreto que es el académico. Se compilan ejemplos concretos en los cuales pueden observarse el específico tratamiento de las categorías de análisis mencionadas.
El Expresionismo alemán: una aproximación histórica
Authors: Ziegler Delgado María Magdalena
Published: May 2021

Este artículo resume una exhaustiva revisión bibliográfica de las referencias teóricas e históricas usadas para la definición del expresionismo alemán. En él están las compiladas las principales contribuciones de los más reconocidos historiadores en el área de la Historia del arte.
La Importancia de las artes en el desarrollo intelectual y creativo: hacia un sistema cultural
Authors: Gacto Sánchez Marina
Published: May 2021

En el presente estudio se aportan algunas reflexiones sobre la importancia de la formación artística en la sociedad actual. Para ello trazamos un análisis de su valoración en épocas anteriores, abordando paralelamente la consideración social de los artistas plásticos y los factores que han influido en la revalorización de su figura a través de la literatura biográfica. En esta época de confusión sobre qué es el arte y cuál debe ser su función, es importante volver la vista atrás hacia nuestro pasado cultural y realizar una breve historia del arte. De este modo, podremos comprender mejor su situación actual.
AN ANALYSIS OF DEIXIS EXISTED ON ARTICLES AT JAKARTA POST
Authors: Ramasari Maria
Published: May 2021

The use of deixis on every language has different forms including English because of the various different context, such as grammatical rules and also background of culture or custom in society. This research is conducted to identify and analyze the forms of Deixis existed on Articles at Jakarta Post as contextual information. Research method of analyzing data used was descriptive qualitative research. Human instrument and text analysis are used as instruments of collecting data. Based on the data analyzed, it was found that pronoun of person deixis was most frequently used (existed) as second person deixis, third person deixis, possessive personal plural person deixis, and reflective personal person deixis that was used as reference to participant role of a referent for describing the speaker, the addressee and referent which are neither speaker nor addressee in written forms. In addition, the deixis with focus on time was also existed on Jakarta Post’s articles as the moment of utterance which is the coding time (the time of utterance conveyed by informants) and receiving time (the time of recovery of information by the hearer who got the information). The deixis of place that was existed on articles of Jakarta Post, was deictic reference to describe the current locations of informants indicated.
The Design Of The Spk In Fulfilling The Production Target Of Vegetable Availability In Lut Tawar Sub-District Uses The SAW Method
Authors: Rayuwati Rayuwati , Putri Yelli Novelia
Published: May 2021

Efforts to meet the availability of vegetables in fulfilling vegetable intake, especially for people in Lutawar sub-district, Central Aceh district, community agriculture requires a technology development that supports the calculation of production at each harvest and can also determine the fulfillment of community food availability. In this case, the fulfillment of production targets for the availability of vegetables will be very effective if it is calculated using a decision support system application, using the Simple Additive weighting (SAW) method.The process of collecting and analyzing data is carried out systematically and logically using a survey, which is to collect as much data as possible about the vegetables found in Lut Tawar Subdistrict, which is a decision support for the quality of the research. Then analyze vegetables in meeting production targets and food availability. Application of the Simple Additive Weighting (SAW) method into a decision support system to create a decision support system for food availability that is assessed from its production, including 4 criteria used to make an assessment, C1: Productivity, C2: Harvest Area, C3: Area Planting, C4: Population, then decision making assigns weight to each criterion. The types of vegetables as an alternative in this study are as follows
PENDAMPINGAN REMAJA PUTRI TENTANG KESEHATAN REPRODUKSI DALAM MENGURANGI TINGKAT STRES PADA SAAT KEPUTIHAN DI PESANTREN ALMUQRI PARENDUAN
Authors: Permatasari Dian , Suprayitno Emdat
Published: May 2021

Leucorrhoea (fluorine Albus / vaginal discharge) is an excessive discharge of non-blood from the female genitals (vagina). Leucorrhoea is often considered normal by the community so that it is not handled properly, but this vaginal discharge could indicate disease. Physiological leucorrhoea is found in the condition before and after menstruation, sexual stimulation, pregnancy, ovulation, and emotional stress. The mentoring method used is to provide health education on reproductive health. The results of the implementation of health education were Al Muqri Parenduan Islamic boarding school students were active, enthusiastic in participating in activities, and active in discussing reproductive health. Activity participants can understand the level of stress on vaginal discharge and can explain again what has been conveyed.
Application of hierarchical method and fuzzy AHP-TOPSIS method for multi-criteria decision making in financing
Authors:   PhD student, Systems Optimization Engineering, Department of Industrial Engineering, Kish International University, Iran, Soleimani Elham , Dehyadegari Mohaddeseh ,   Master, Industrial Management, Faculty of Management, Hormozgan University, Bandar Abbas, Iran, Zarei Gerami Hassan ,   Professor, Department of Industrial Engineering, Faculty of Engineering, Payame Noor Central University, Assaluyeh Special Zone, Iran
Published: May 2021

Purpose: One way to make more profit in different companies is to choose the right method of financing. While the impact of financial structure on the economic structure is so important that today they believe that economic growth cannot be achieved without an efficient financial sector. The method of financing is financial. At first, in this study, the fuzzy Delphi method (Delphi) has been used in order to identify the factors and criteria of supply. Research methodology: The absorption of foreign capital has been identified as a method of financing. For this purpose, in this research, AHP hierarchical analysis method is used. Results: In this article, the application of fuzzy AHP - TOPSIS method for the problem of financing is investigated. The process of managing financial resources is one of the reasons for allocating its technical equipment to various applications in this company. Limitations: However, the results of our studies show that although a set of known values in this company, the financing process may not adhere strongly to these values. Emphasis on evaluation aspects - changes in various areas that indicate local values may also affect the supply trend. Contribution: Multi-criteria decision methods are useful in that they provide a basis for analyzing and transforming complex and complex problems into simpler ones; In that framework, the planner can easily evaluate the options with the help of criteria and sub-criteria. Using these methods can help a lot in choosing the best available solution. Other advantages of these methods include flexibility, simplicity of calculations and the possibility of the final ranking of options.
Akuntabilitas pengelolaan dana desa dalam upaya meningkatkan kesejahteraan masyarakat desa di kecamatan Jangka
Authors:   Magister Akuntansi, Universitas Pancasila, Jakarta Selatan, Gibran Khalil , Jaddang Syahril ,   Magister Akuntansi, Universitas Pancasila, Jakarta Selatan, Ardiansyah Muh. ,   Magister Akuntansi, Universitas Pancasila, Jakarta Selatan
Published: May 2021

Abstract Purpose: This study aimed to investigate the accountability of village fund management and to evaluate the efforts made by the village government in order to improve the welfare of society in Jangka district. Research methodology: This study was qualitative research with a phenomenological approach. The results show that the management of village funds ranging from planning, implementation, administration, reporting to accountability activities has not fully fulfilled the principle of accountability and the welfare indicators show that the villagers are not yet fully prosperous. Results: There are still villages that have not prioritized the management of village funds for villager empowerment programs so that the efforts of the village government to improve welfare are not optimal. Limitations: The management of village funds studied is only in the planning, implementation, administration, reporting and accountability activities within the village government scope, and does not discuss the management of village funds in the city/regency level or the process of allocation, distribution and accountability of village funds in the scope of the Ministry of Finance. Contribution: The research was carried out by conducting interviews with informants, observing the implementation of development, and tracing into supporting documents in efforts to improve community welfare in Alue Bie and Meulinteung Village.
A Case of Intrathecal Pump Therapy for Intractable Head and Neck
Cancer Pain
Authors: Kandil Enas
Published: May 2021

We present a case of a 34-year-old man who had
refractory oral pain secondary to squamous cell
carcinoma of the tongue and describe his status
post multiple surgical procedures. After failing
a variety of treatment modalities, an intrathecal
pump (ITP) was placed in the lower cervical
spine region. He was assessed at several points,
initially every 2 weeks, then every 6 months and
reported significant and continued pain relief with
the ITP past the first 6-month follow-up and no
neurological or respiratory side effects were noted.
In addition to substantial pain relief, this invasive
modality allowed the patient to be a candidate
for further chemotherapeutic medications, which
induced temporary remission and extended the
patient’s life expectancy by over 4 months.
Key words: Intrathecal pump, intractable pain,
head and neck cancer
FISH OIL AS A POTENTIAL CONTRIBUTOR TO EPIDURAL HEMATOMA
FOLLOWING CERVICAL EPIDURAL STEROID INJECTION: A CASE REPORT
AND FOCUSED LITERATURE REVIEW
Authors: Benyamin Ramsin
Published: May 2021

Fish oil has been anecdotally linked to bleeding
complications during interventional spinal
procedures. We present a case report involving
a cervical epidural hematoma following cervical
epidural injection in a patient who has been taking
fi sh oil, with detailed literature review.
A 49-year-old woman with a previous history of
anterior cervical disc fusion at C5-C6 underwent
routine cervical epidural injection for neck pain
due to a disc herniation below her fusion. Thirty
minutes after the procedure, she experienced
numbness and tingling in both arms and developed
severe pain between her shoulder blades.
She was sent to the emergency room and soon
developed a left-sided wrist drop. An emergent
cervical magnetic resonance image (MRI) revealed
an epidural hematoma at C6-C7. She
underwent emergent surgical decompression of
the hematoma through multiple laminectomies at
C6, C7, and T1. The surgeon noticed excessive
blood oozing through the incision site and left
two drains in the wound. She recovered without
neurological defi cit. Upon further investigation,
it was discovered that she had been taking high
doses of over-the-counter fi sh oil.
Ingredients in over-the-counter preparations
are not regulated or standardized. Fish oil use
may predispose a patient to bleeding complications
when used in higher doses alone or when
used at any dose in conjunction with antiplatelet
therapy. The benefi ts of fi sh oil use should be
weighed against the potential risk of bleeding with
cessation of fi sh oil in patients undergoing spinal
interventions. As described by others, signifi cant
pain at the site of injection which is unusual and
different from the pain experienced in the past as
well as complicating factor of loss of resistance
technique in closed space must be considered.
Finally, rapid diagnosis and intervention avoids
neurological defi cit.
Key words: Fish oil, omega-3, aspirin, cervical
epidural steroid injection, complication, epidural
hematoma, literature review
Implanted Spinal Cord Stimulator Dysfunction After Electrical
Shock
Authors: Quick Johnny L.
Published: May 2021

Spinal cord stimulation (SCS) has played a
significant role in chronic pain since its inception
during the late 1960s. There are several proposed
mechanisms for SCS, one of which works
via electrical pulses that target the dorsal horn of
the spinal cord to inhibit afferent pain signals to
achieve analgesia (Gate Control Theory). This
can lead to an overall improvement in pain control
when pharmacologic therapy is inadequate
or ineffective. SCS also reduces pharmacologic
needs, and hence alleviates side effects associated
with opioids and other medications.
We present the case of a 44-year-old male with
chronic pain and an implanted SCS in place who
presented to our university institution pain clinic
for lumbar back pain with bilateral radiculopathy.
He had suffered from back pain since 1996 and
an implanted SCS was placed in June 2013.
Three years after the SCS placement, the patient
suffered an alternating (60 Hz) current 120-volt
electrical shock while working on kitchen appliances
resulting in SCS dysfunction. Prior to the
electrocution event, the SCS was operating normally
with a battery life registering three-fourths
full. The stimulator was turned on one day prior to
the incident. At the time of the electrical shock, the
SCS was not actively stimulating. Following the
incident, the patient tried to turn on the stimulator
without success.
Implantable devices, including pacemakers and
neuromodulators, have a circuit protective mode
which should prevent this type of occurrence.
Using the physician programmer, we were unable
to detect, connect, or interrogate his stimulator.
With the help of a device representative, we attempted
a physician mode recharge (PMR) for
10 minutes while in office. We were then able to
pair the patient’s charger with the stimulator, and
enter into the normal feedback-enabled charge
mode. His charger display screen indicated a
drained battery. After approximately 25 minutes
of recharging, a second attempt to interrogate the
device was successful.
We hope this encourages all current and future
SCS manufacturers to perform further device
testing, quality control development, and research
and development to make subsequent SCS even
more reliable and resistant to damage or premature
failure.
Key words: Spinal cord stimulator (SCS), spinal
cord generator, power-on reset (POR), SCS malfunction,
electrical shock, dysfunction
TWO CASES OF ACUTE EPIDURAL HEMATOMA FORMATION AFTER CERVICAL
INTERLAMINAR EPIDURAL STEROID INJECTIONS
Authors: Manchikanti Laxmaiah
Published: May 2021

Cervical interlaminar epidural injections are
rarely associated with epidural hematoma resulting
in surgical decompression. Multiple strategies
in the prevention of epidural hematoma after cervical
epidural injections are based on cessation
of therapy in patients with bleeding disorders on
antiplatelet therapy, fi sh oil, and multiple other
drugs. Multiple guidelines from organizations
across the globe have recommended continuation
of nonsteroidal anti-infl ammatory drugs
(NSAIDs) and low dose aspirin. Guidelines also
have recommended to continue or cessation
of antithrombotic agent therapy based on risk
benefi t ratio, due to associated risks of thrombotic
events with interventional techniques or
other surgeries with discontinuation of antiplatelet
therapy.
We report 2 cases of cervical epidural hematoma
requiring surgical decompression, without
residual dysfunction.
The fi rst case was in a 41-year-old Caucasian
woman with controlled hypertension; however,
with no drug therapy contributing to bleeding and
2 uneventful cervical interlaminar epidural injections,
the patient developed a cervical epidural
hematoma after the third procedure which was
performed uneventfully. She developed rapid
paralysis and underwent surgical decompression
without residual dysfunction.
The second case involved a cervical epidural
injection resulting in a cervical epidural hematoma.
This patient was on 81 mg of aspirin and was
continued with therapy. Surgical decompression
was carried out with no residual dysfunction. This
patient also received Toradol for pain control in the
recovery room which may have exacerbated the
epidural hematoma.
These 2 case reports illustrate that cervical epidural
hematoma is a rare, but fatal occurrence
associated with cervical epidural injections. Appropriate
patient selection with constant vigilance on
post operative course and follow-up treatment with
surgical intervention or conservative management
is crucial. It is also crucial to understand the role
of loss of resistance technique with air only which
may complicate the closed space phenomenon
of cord compression and post procedure pain at
the injection site which is different from the pain
ever experienced by the patient with the previous
injections.
Key words: Interventional techniques, cervical
epidural injections, cervical epidural hematoma,
bleeding disorders, aspirin, antithrombotic agents,
Ketoralac
Spinal Cord Stimulator Placement in a Patient with Type 2
von Willebrand’s Disease
Authors: Masson Scott
Published: May 2021

We present a case of a 76-year-old female with
a history of lumbar post-laminectomy pain syndrome
and Type II von Willebrand’s disease who
underwent successful implantation of a spinal
cord stimulator. A consultation with the patient’s
hematologist was obtained, and antihemophilic
factor/von Willebrand factor complex was administered
immediately prior to insertion and removal
of trial leads. After reporting greater than 90%
pain relief, the patient then underwent permanent
implantation with administration of antihemophilic
factor/von Willebrand factor complex prior
to placement. The epidural space was entered
atraumatically, and lead placement was uneventful
with minimal resistance met. Leads were tunneled
to her right gluteal region, where a pocket was
created for her generator. She continues to report
good relief without neurological signs of epidural
hematoma nearly 6 months post-procedure.
Key words: von Willebrand disease, high-frequency
spinal cord stimulator, post-laminectomy
pain syndrome
PLATELET-RICH PLASMA INJECTION THERAPY FOR REFRACTORY COCCYDYNIA: A CASE SERIES
Authors: Montero-Cruz Fergie-Ross
Published: May 2021

Background: Coccydynia is pain in the coccyx
region. The most common cause of coccydynia
is trauma, either from a direct axial force such
as during a fall onto the coccyx or from cumulative
trauma as a result of poor sitting mechanics.
Risk factors include obesity, female gender and
rapid weight loss. The anatomy of the region is
not well vascularized, and consists of the coccyx
bones, and supporting ligaments and tendons.
For a majority of patients, conservative management
may be successful but for the remainder
of patients, pain relief may only be transient and
pain can become debilitating. What has yet to be
fully explored is the possible beneficial effect of
local injection of platelet-rich plasma (PRP) for
the treatment of refractory coccydynia. PRP injections
have been successful in treating a variety
of chronic tendon, ligament and bone injuries by
inducing an inflammatory response to promote or
re-initiate healing. In addition, local injections of
PRP to the coccyx would be a less invasive option
than surgery for patients who have exhausted all
other treatment options and continue to struggle
with the debilitating effects of coccydynia.
Objectives: To demonstrate the important role
of PRP therapy in treating coccydynia refractory
to traditional conservative management.
Study Design: Retrospective case series.
Methods: Three patients with coccygeal pain
for greater than 6 months who presented to an
outpatient pain management office in New York
from 2014 until 2016, and failed conventional
treatments. When the pain was deemed refractory
for the patient, offering for PRP was done.
This was presented with the option to repeat once
again at the 6-8 week mark if needed. All patients
underwent PRP with fluoroscopic injection, and
the use of the same PRP commercially available
system; Magellan-Arteriocyte. The patients were
evaluated with a numerical rating scale, and percentage
of pain relief at 6-8 week post-injection, 6
months post-injection, 12 months post-injection,
and 24 months post-injection was recorded.
Percentage of pain relief was then calculated.
Results: Overall the patient series demonstrated
significant improvement in numeric pain scale, as
well as percentage of pain reduction. At the 6-8
week follow-up for all the post-PRP injections,
there was an average of 75% improvement in
overall pain. At 6 months, 1 patient had no change,
while 2 patients maintained the same reduction
in pain at the 12- and 24-month follow-ups.
Limitations: This retrospective case
series is only a small sample size of pat
i e n t s w i t h r e f r a c t o r y c o c c y d y n i a .
Conclusions: Here we discuss the first case
series of PRP for coccydynia. The results of the
3 patients in this case series are encouraging.
Quadratus Lumborum Block for Back Pain Related to Pancreatic
Cancer – A Report of Two Cases
Authors: Hochberg Uri
Published: May 2021

Pancreatic cancer is often accompanied by
severe pain. Patients typically experience upper
abdominal and/or thoracolumbar back pain.
For those cases failing to respond to standard
medical management, as suggested by the World
Health Organization, interventions designated at
interruption of the sympathetic axis (such as neurolysis
of the celiac plexus or splanchnic nerves)
have been shown to be efficacious. Other than
axial drug delivery, there are few interventional
alternatives in patients with pancreatic cancerrelated
pain.
There is little knowledge regarding the therapeutic
effects of treating peripheral somatic soft tissue
among oncological patients. Here we report
on 2 such patients, whose back pain improved
following a quadratus lumborum block.
Two patients diagnosed with pancreatic cancer
presented with severe back pain. The pain pattern
and patients’ physical exams were compatible
with myofascial pain arising from the quadratus
lumborum muscle, possibly irritated by the
abdominal tumor. Advanced pain management,
including long- and short-acting opioids and adjuvants,
as well as celiac plexus neurolytic block,
failed to provide satisfactory pain relief. Given the
apparent muscular origin of the pain, a bilateral
ultrasound-guided quadratus lumborum block
was performed. Four weeks post procedure, the 2
patients reported substantial pain relief supported
by reduced consumption of pain medication and
improved functional status. No adverse events or
complications were observed in either case.
In the patients described here, quadratus lumborum
block proved to be safe and efficacious in
alleviating back pain related to pancreatic cancer.
In our opinion, clinicians should be aware of the
possible contribution of a myofascial component
to pain in pancreatic cancer and in cancer-related
pain in general.
Key words: Quadratus lumborum block, cancer
pain, pancreatic cancer, pain control, myofascial
pain syndrome, interventional pain management
Cervicothoracic Epidural Blood Patch Provides Pain Relief after
Failed Lumbar Epidural Blood Patch: A Case Report
Authors: Dua Antepreet
Published: May 2021

Background: Spontaneous intracranial hypotension
is an increasingly relevant cause of headaches
as the breadth and depth of its diagnosis
and management improves.
Objectives: The objective of this case report is to
describe a novel treatment for headaches caused
by spontaneous intracranial hypotension without
locating the cerebrospinal fluid (CSF) leak and to
review the diagnostic and therapeutic options for
spontaneous intracranial hypotension.
Study Design: This is a report of a single case.
Setting: The setting for this case report is a major
academic center.
Methods: After a review of the treatments and
interventions that our patient had previously
undergone, we decided to trial epidural blood
patches for her chronic headaches.
Results: Although the exact site of a CSF leak
could not be identified despite exhaustive diagnostic
interventions, cervicothoracic epidural
blood patches provided excellent pain control for
our patient’s severe headaches. The patient was
completely free of headaches for 15 hours and
reported well-controlled pain for approximately
a month after her procedure as well as after 5
subsequent monthly procedures.
Limitations: As this is a report of a single case,
more rigorous study in a larger patient population
is needed to provide guidance.
Conclusions: This case demonstrates that a
nontargeted cervicothoracic epidural blood patch
can be a treatment option for patients with spontaneous
intracranial hypotension in which clinical
suspicion is high despite nondiagnostic imaging.
Key words: Spontaneous intracranial hypotension,
cervicothoracic epidural blood patch,
headache
Percutaneous, Thermal, and Pulsed Radiofrequency for
Nonmalignant Hip Pain
Authors: Woodbury Anna
Published: May 2021

Background: Although radiofrequency (RF) has
been used to treat several types of chronic osteoarthritic
pain, the role of percutaneous thermal RF
ablation and pulsed RF in treating nonmalignant
hip pain has not been well established.
Objective: To estimate the effectiveness of thermal
and pulsed RF therapy in treating nonmalignant
hip pain and encourage further research.
Study Design: A systematic review of English
and non-English articles was performed
on 1/20/2017 using the following databases:
PubMed (1960-2017), Cochrane Controlled
Trials Register (1960-2017), and EMBASE
(1966-2017). Studies for which complete articles
were not accessible were excluded if primary
authors could not be successfully contacted
after attempts via at least 2 different mediums.
Search terms included RF, hip, and human
(“radiofrequency”[All Fields] AND (“hip”[MeSH
Terms] AND “humans”[MeSH Terms]).
Results: Two clinical trials for hip RF (n = 32)
and a collection of 7 case series or studies (n
= 25) met our inclusion criteria. Both trials used
percutaneous RF of the periarticular sensory
branches of the obturator and femoral nerves
near the hip joint. Ten studies were found to be
eligible after screening title, abstract, and full text
for inclusion and exclusion criteria. Both clinical
trials saw improved post procedure pain scores
when compared with standard conservative treatment
for inoperable chronic hip pain. The overall
complication rate of pooled cohort of all cases
reviewed was 9.5% (6/57), but did not result in
any self-reported injury.
Conclusions: There is low quality evidence to
suggest that thermal or pulsed RF therapy is a
suitable option for chronic inoperable hip pain.
Higher quality trials are needed for stronger recommendations.
Key words: Radiofrequency, ablation, hip, pain,
coxalgia, review, chronic, inoperable, nonsurgical,
femoral, obturator
Use of Color Flow Doppler Ultrasonography to Increase the Safety
of Intrathecal Drug Delivery System Refills
Authors: Mehta Ankur D.
Published: May 2021

Intrathecal drug delivery systems are effective
tools in the treatment of chronic pain or spasticity.
Using intrathecal drug delivery systems, drugs
are directly infused into the cerebrospinal fluid
and gain access to critical receptors in the central
nervous system. This delivery method allows for
the use of markedly reduced doses of medications
to produce the same effects as seen with
higher orally administered doses. Reduced dosing
produces fewer side effects, creating a more
favorable treatment course for patients already
suffering from chronic pain or spasticity. Complications
with intrathecal drug delivery systems
can occur during both the implantation process
and the postoperative maintenance of the device.
The most common procedure carried out during
postoperative maintenance of these devices is the
intrathecal pump refill. This procedure must be
performed by experienced practitioners in a systematic
way in order to prevent complications. The
most dreaded of these complications is inadvertent
injection of medication into the subcutaneous
space as opposed to into the device, commonly
referred to as a “pocket fill.” This paper describes
and recommends the routine use of color flow doppler
ultrasonography as an easy, safe, and effective
tool to reduce the chance of a catastrophic “pocket
fill.” Routine utilization of live color flow ultrasound
guidance during pump refills allows the practitioner
to carefully document flow of medication into the
pump under the silicone septum. It also allows for
demonstration of no leakage from, or fluid increase
superficial to, the septum. Additionally, 2 ultrasound
images are obtained to document color flow deep
to the septum and no color flow/leak/fluid superficial
to the septum. Although this complication is
rare, it can lead to severe complications including
oversedation, respiratory depression, and death. As
such, we believe that the utilization of color phase
doppler ultrasonography could further reduce this
incidence.
Key words: Analgesics, opioids, chronic pain, drug
overdose, infusion pumps, implantable, injections,
spinal, medication errors, spasticity, ultrasonics,
methods, ultrasonography, interventional
Retinal Hemorrhage after Epiduroscopy in a Patient using Dexamethasone:
A Case Report
Authors: Kallewaard JanWillem
Published: May 2021

Epiduroscopy is a minimally invasive procedure
used to diagnose epidural fibrosis and to
release this fibrosis; epiduroscopy is also used
to precisely deposit medication into the epidural
space. It is commonly used in patients who are
diagnosed with failed back surgery syndrome
(FBSS) after more conservative treatment has
failed to provide sufficient relief of symptoms.
A rare complication of epiduroscopy is retinal
hemorrhaging, which is likely caused by overpressurization
of the epidural space during the
procedure. Patient-related risk factors for developing
retinal hemorrhage after epiduroscopy
remain largely unknown. This is the first case
report of retinal hemorrhage in a patient using
chronic dexamethasone.
We describe a 73-year-old man diagnosed with
FBSS who underwent epiduroscopy to diagnose
and relieve epidural fibrosis. The procedure was
uneventful and he was discharged from our clinic
the same day, but upon routine check-up he mentioned
blurry vision. Immediately he was referred
to an ophthalmologist who diagnosed retinal
hemorrhages in both eyes upon fundoscopic examination.
Our patient was using dexamethasone
for the treatment of allergies. Three months after
the procedure, his vision was restored fully in the
right eye and 95% in the left eye.
Chronic corticosteroid use may weaken retinal
veins, making them prone to rupture when there
is increased pressure, even for a short period
of time. Chronic use of corticosteroids must be
considered a risk factor for developing retinal hemorrhages
in patients undergoing epiduroscopy.
Long-term use of corticosteroid can be considered
as a relative contraindication for epiduroscopy.
Key words: Epiduroscopy, complications, interventional
pain, corticosteroids, retinal hemmorhage,
failed back surgery syndrome
Effectiveness of Genicular Nerve Cooled Radiofrequency Ablation
on Chronic Knee Osteoarthritis Pain
Authors: Carrier Jonathan
Published: May 2021

Background: Outside of an invasive total knee
arthroplasty, the available therapies for the treatment
of pain secondary to knee osteoarthritis
(OA) provide marginal and short-lived symptomatic
relief. Genicular nerve radiofrequency
ablation (RFA) serves as an alternative treatment
modality for OA-associated knee pain and
disability.
Objectives: To quantify the effectiveness of
cooled radiofrequency ablation (C-RFA) of the
genicular nerves for chronic knee pain secondary
to OA.
Study Design: Retrospective chart review
performed using Redcap, implementing current
procedural terminology codes.
Setting: An academic pain management center.
Methods: Study population included patients
treated with C-RFA from April 2015 through June
2017. Numeric Rating Scale (NRS) data were
analyzed at 3 time points: 2 weeks, 4-6 weeks,
and 7-33 weeks post-RFA (extended follow-up).
Primary outcome for statistical analysis was NRS
and the change in NRS from baseline at each
of the 3 predetermined time points. Differences
between the change in NRS and the number of
diagnostic blocks performed (1 vs. 2) was evaluated.
Correlation between the change in NRS and
patient body mass index (BMI) was calculated.
Results: Pre-RFA average NRS scores were
available for 47 knees from 31 individuals, which
were included in the analysis. The mean NRS
score decreased by 50% at 2 weeks (n = 33; P
< 0.001), 55% at 4-6 weeks (n = 18; P < 0.001),
and 26% at 7-33 weeks (n = 18; P = 0.009).
Eight patients (12 knees) provided specific data
on the total duration of relief following RFA. The
mean duration was 39 weeks or approximately
9 months. There were no statistically significant
differences between groups receiving 1 versus 2
diagnostic blocks at 2 weeks or 4-6 weeks post-
RFA. At 7-33 weeks, those who received 1 block
had a decrease in NRS of –3.1, whereas those
who received 2 blocks had an increase in NRS
of +0.1 (P = 0.008). There was no correlation
identified between BMI and change in NRS at
any time point.
Limitations: This study’s retrospective design
inherently leads to a higher risk of selection bias.
The sample size was relatively small as a high
percentage of patients were lost to follow-up. The
primary outcome measure for this study was the
change in mean NRS pain score, and the mean
of ordinal data with a nonnormal distribution lacks
validity in statistical analysis.
Conclusions: In this study population, C-RFA of
the genicular nerves lead to 50% or greater pain
relief at 2 weeks and 4-6 weeks postintervention.
A 26% pain relief was achieved at 7-33 weeks,
but this did not meet the established minimal clinically
important difference cutoff. Two diagnostic
genicular nerve blocks did not improve the rate
of treatment success when compared to a single
diagnostic block. BMI does not appear to correlate
with outcomes.
Key words: Genicular radiofrequency ablation,
genicular RFA, cooled radiofrequency ablation,
chronic knee pain, knee osteoarthritis
Pain Outcomes after Platelet-Rich Plasma Application in
Chronic Tibialis Anterior Pain: A Retrospective Case Series
Analysis
Authors: Rong Chen Calvin
Published: May 2021

Background: Platelet-rich plasma (PRP) has
become a main component of regenerative
medicine. It is used in various musculoskeletal
tendinous and skeletal injuries, however, literature
regarding PRP’s use in chronic anterior ankle
pain is limited.
Objectives: To determine the effectiveness of
PRP in treating tibialis anterior (TA) tendon pain in
patients who have failed traditional conventional
therapeutic treatments.
Study Design: Retrospective chart review.
Setting: Outpatient interventional pain clinic at
an academic center.
Methods: Adults (n = 10), aged 18 and older,
with greater than 6 months of TA tendon pain
who failed conservative therapies. Patients who
had undergone previous regenerative injections
were excluded. PRP injection was administered
with ultrasound guidance. Change in pain score
was assessed using the Numeric Rating Scale
(NRS-11: 0 = no pain, 10 = excruciating pain),
and patient’s self-reported reduction in pain
(percentage), pre- and postprocedure. There
was a reduction in opioid dosage postprocedure.
Adverse effects were recorded.
Results: Average pain score at baseline was 8
± 1.5 on the NRS-11 scale. The average percent
change in pain between baseline and 8 weeks
posttreatment was a 36% ± 23.2% reduction in
pain. This was a significant reduction in pain score
at 8 weeks post-PRP treatment when compared
with baseline, P = 0.008. Average reduction
in opioid dose between baseline and 8 weeks
posttreatment was 17% ± 21.2%, P = 0.063. No
patients experienced adverse effects.
Limitations: Small sample size, and no doubleblind
randomization with control group.
Conclusions: PRP use in chronic TA pain 8 weeks
post-PRP treatment significantly improved chronic
TA pain. There is also a tendency toward lower
opioid pain medication dosages after 8 weeks
post-PRP treatment, although this was not statistically
significant.
Key words: Platelet-rich plasma, regenerative
medicine, pain, ultrasound
KNOWLEDGE OF MOTHERS REGARDING IMMUNIZATION
Authors: R C Nandini , R A Prakruthi , Narayana D H Ashwath
Published: May 2021

Introduction: According to WHO, immunization interventions have proven to be a success across the globe and today
reach out to over 100 million children and prevent 2.5 million deaths per year. As new global health paradigms emerge,
fresh perspectives and priorities are emerging in immunization as well. There are at least ten new antigens now available that can be added to the
traditional EPI interventions including vaccines against Hepatitis B, Rotavirus, Japanese Encephalitis, and Human Papilloma Virus
Methodology: All the mothers coming for BCG immunization of their infants were interviewed for assessing their baseline knowledge and
attitude towards immunization and AEFI. Knowledge of the mothers was assessed with 0 and 1 scale, with 0 as not correct knowledge and 1 for
correct knowledge. It was observed from this study that the Mean ± SD of pre-test Results: knowledge score on immunization was 2.86 ± 2.12 and
post-test knowledge score on immunization was for 6.53 ± 2.17. There was a statistically highly signicant difference (t = 13.675, P < 0.001)
between pre-test and post-test knowledge score on immunization. Conclusion: This implies that there was improvement of knowledge on
immunization following health education in study subjects.