bluuebunny/crossref_metadata_2025 huggingface dataset:
Diversité et complexité des pratiques cliniques
Authors: Roussillon René
Published: May 2013

L’évolution des pratiques cliniques s’est effectuée d’une part en direction de plus de diversité quant aux cadres et aux techniques de soin, et d’autre part dans un accroissement de son aptitude à cerner la complexité du fonctionnement psychique. La diversification des formes de la pratique clinique dépend autant de l’évolution de la demande que de la possibilité de penser des réponses cliniques à des formes de pathologie et de souffrance psychique sur lesquelles elle ne s’était que peu aventurée antérieurement. La complexité résulte des nécessités inhérentes à l’extension de la compétence de la métapsychologie dans l’exploration des états psychiques liés aux nouvelles formes de pathologies qu’elle a pu commencer à prendre comme objet d’analyse. Mais les acquis issus de la diversification des formes de pratique et de la complexification des modèles d’intelligibilité du fonctionnement psychique ne doivent pas être cantonnés à aux pratiques qui ont pu ainsi émerger, elles ont des effets rétroactifs sur l’ensemble des pratiques cliniques.
In-Home Fall Risk Assessment and Detection Sensor System
Authors: Rantz Marilyn J. , Skubic Marjorie , Abbott Carmen , Galambos Colleen , Pak Youngju , Ho Dominic K.C. , Stone Erik E. , Rui Liyang , Back Jessica , Miller Steven J.
Published: May 2013

Falls are a major problem in older adults. A continuous, unobtrusive, environmentally mounted (i.e., embedded into the environment and not worn by the individual), in-home monitoring system that automatically detects when falls have occurred or when the risk of falling is increasing could alert health care providers and family members to intervene to improve physical function or manage illnesses that may precipitate falls. Researchers at the University of Missouri Center for Eldercare and Rehabilitation Technology are testing such sensor systems for fall risk assessment (FRA) and detection in older adults’ apartments in a senior living community. Initial results comparing ground truth (validated measures) of FRA data and GAITRite System parameters with data captured from Microsoft
®
Kinect and pulse-Doppler radar are reported. [
Journal of Gerontological Nursing, 39
(7), 18–22.]
Surgery for Retinal Detachment in Patients With Giant Retinal Tear: Etiologies, Management Strategies, and Outcomes
Authors: Gonzalez Marco A. , Flynn Harry W. , Smiddy William E. , Albini Thomas A. , Tenzel Paul
Published: May 2013

BACKGROUND AND OBJECTIVE:

To evaluate etiologies, management, and outcomes for patients with giant retinal tears undergoing initial surgery at a single institution.

PATIENTS AND METHODS:

Noncomparative, retrospective, consecutive case series at a university referral center including 79 eyes of 77 patients.

RESULTS:

Blunt trauma constituted 22% of cases. All patients underwent pars plana vitrectomy with gas or silicone oil tamponade. Eighty-five percent (67 eyes) underwent an encircling scleral buckle. Perfluorocarbon liquids were used in 71% (61 eyes). Eighteen percent (14 eyes) underwent re-operation for recurrent retinal detachment. Ninety-two percent (73 eyes) achieved anatomic success with one or more surgical procedures. Visual acuity at last follow-up was at least 20/400 in 84.9% of patients (28 of 33) with 3 clock hours compared to 65.2% (30 of 46) with tears greater than 3 clock hours.

CONCLUSION:

Patients with giant retinal tear undergoing surgery achieved high rates of anatomic success, but re-operations were frequent. Better visual outcomes were associated with smaller circumferential dimensions in the giant retinal tears.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:232–237.]
The Role of ILM Peeling in Vitreous Surgery for Proliferative Diabetic Retinopathy Complications
Authors: Michalewska Zofia , Bednarski Maciej , Michalewski Janusz , Jerzy Nawrocki
Published: May 2013

BACKGROUND AND OBJECTIVE:

To evaluate the influence of pars plana vitrectomy (PPV) with or without internal limiting membrane (ILM) peeling on spectral-domain optical coherence tomography (SD-OCT) in vitreous hemorrhage and tractional retinal detachment as a complication of diabetic retinopathy.

PATIENTS AND METHODS:

Retrospective study of PPV in patients with diabetic retinopathy complications. Group A (53 patients) had PPV with ILM peeling, and group B (59 patients) had PPV without ILM peeling. SD-OCT imaging and fluorescein angiography were performed postoperatively.

RESULTS:

Preoperative visual acuity was 0.04 and final postoperative visual acuity was 0.27 in both groups (23.4 months in group A, 60 months in group B). Postoperative central retinal thickness was 193 μm (group A) and 258.6 μm (group B). Epiretinal membranes were observed less frequently in group A than in group B (24% vs 49%). Repeated surgeries were performed in 38 cases in group A and in 51 cases in group B.

CONCLUSION:

Fewer cases of epiretinal membranes and macular edema are observed postoperatively with ILM peeling. Visual acuity is similar in both groups, but additional surgeries are fewer with ILM peeling.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:238–242.]
Transvitreal Endoresection of Refractory Retinal Capillary Hemangioblastoma After Feeder Vessel Ligation
Authors: Khurshid Gibran S.
Published: May 2013

BACKGROUND AND OBJECTIVE:

Retinal capillary hemangioma (RCH) is a developmental vascular tumor occurring sporadically or associated with Von Hippel-Lindau syndrome. Treatment for large solitary RCH is challenging. Laser, cryotherapy, radiotherapy, photodynamic therapy, and en bloc resection for advanced cases have been described in the literature without consensus on standard management.

MATERIALS AND METHODS:

A novel technique of 20-gauge transvitreal endoresection of solitary peripheral RCH after ligating the feeder vessels is described.

RESULTS:

Tumors were successfully resected after ligating the feeder vessels bimanually in a closed and more controlled ocular environment. Feeder vessel ligation is intended to compensate for the involution time of the caliber of feeder vessels, when postoperative hemorrhage is more likely to occur. Another advantage of ligating the blood vessels is to secure hemostasis without using heavy endocautery. Postoperatively, proliferative vitreoretinopathy remains a concern.

CONCLUSION:

Pending a larger randomized trial, performing endoresection in RCH that is large and unresponsive to conventional treatment is an acceptable option.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:278–280.]
Hypopyon and Pseudoendophthalmitis 1 Month After Vitrectomy for Retinal Detachment With Subretinal Hemorrhage
Authors: Nahas Zayna , Shienbaum Gary , Smiddy William E. , Flynn Harry W.
Published: May 2013

The presence of postoperative hypopyon warrants consideration of the diagnosis of infectious endophthalmitis, but other etiologies may mimic a hypopyon. The differential diagnosis of a postoperative hypopyon must include causes of pseudoendophthalmitis to avoid unnecessary and invasive interventions. The context and clinical presentation are the most important factors allowing such a distinction. A patient with a hypopyon and elevated intraocular pressure presented 1 month after pars plana vitrectomy for a hemorrhagic retinal detachment. Slit lamp examination disclosed khaki-colored cells layered in the anterior chamber, and a diagnosis of pseudoendophthalmitis was made. The hypopyon resolved without intervention.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:281–283.]
Resolution of Serous Retinal Detachment Following Partial Sclerectomy With Mitomycin C in Nanophthalmos
Authors: Venkatesh Pradeep , Majumdar Saptorshi S. , Kakkar Ashish , Singh Subodh , Gogia Varun , Garg Satpal
Published: May 2013

The authors report the results of partial-thickness sclerectomy combined with mitomycin C in a nanophthalmic eye with serous retinal detachment. Partial sclerectomy in two quadrants with adjuvant use of mitomycin C without drainage of subretinal fluid was performed. The patient was monitored with serial fundus photographs and spectral-domain optical coherence tomography (SD-OCT) for up to 16 weeks postoperatively. Best corrected visual acuity improved from counting fingers at 1 meter preoperatively to 6/60 at final follow-up. There was gradual but complete resolution of serous retinal detachment both clinically and on SD-OCT. Partial-thickness sclerectomy with mitomycin C is an effective and safe procedure in the management of nanophthalmic eyes with uveal effusion.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:287–289.]
Risk factors for pre-eclampsia among women at antenatal booking in Kano, Northern Nigeria
Authors: Yakasai Ibrahim A. , Morhason-Bello Imran O.
Published: May 2013

Pre-eclampsia (PE) is an important cause of maternal mortality. There have been several studies on risk factors assessment with conflicting reports across the globe on this disease; however, rigorous recent evaluation of these factors is uncommon in this region. The aim of the present study was to determine the risks factors in the early-onset PE in Aminu Kano Teaching Hospital (AKTH), Kano (Northern Nigeria). We conducted a case-control study in Nigeria between April 2009 and January 2010 to identify the risk factors associated with the early-onset PE in women attending antenatal clinic in AKTH. Information on socio-cultural characteristics, medical history, previous obstetrics history, level of stress at home, and type of family were obtained and recorded in a proforma designed for the study. Multiple logistic regression analysis was used to determine the risk factors for PE at 95% confidence level. Pregnant women with early-onset PE (150 in each case and control group). Risk factors associated with increased risk of early-onset PE were: history of pre-eclampsia/eclampsia (PE/E) in a previous pregnancy [adjusted odds ratio (AOR) 2.09]; exposure to passive smoking (AOR 1.34); inadequate antenatal supervision (AOR 15.21); family history of hypertension in one or more 1st-degree relative (AOR 8.92); living in a joint family (AOR 6.93); overweight (120% to 150% of pre-pregnancy ideal body weight, AOR 4.65). Risk factors among women in Northern Nigeria are similar to those reported from other studies. Good antenatal cares, early detection, reduction of stressful conditions at home are the most important preventive measures of early-onset severe PE among these women.
Exergaming and Static Postural Control in Individuals With a History of Lower Limb Injury
Authors: Sims Jennifer , Cosby Nicole , Saliba Ethan N. , Hertel Jay , Saliba Susan A.
Published: May 2013

Context:

Therapeutic exercise programs that incorporate real-time feedback have been reported to enhance outcomes in patients with lower extremity joint injuries. The Wii Fit has been purported to improve balance, strength, flexibility, and fitness.

Objective:

To determine the effects of Wii Fit rehabilitation on postural control and self-reported function in patients with a history of lower limb injury.

Design:

Single-blinded, randomized controlled trial.

Setting:

Laboratory.

Patients or Other Participants:

Twenty-eight physically active participants with a history of lower limb injuries were randomly assigned to 1 of 3 groups (9 Wii Fit, 10 traditional, 9 control).

Intervention(s):

Intervention groups performed supervised rehabilitation 3 d/wk for a total of 12 sessions.

Main Outcome Measure(s):

Time to boundary (TTB) and the Star Excursion Balance Test (SEBT) were conducted at baseline, 2 weeks, and 4 weeks. Self-reported function was measured at baseline and 4-week follow-up. Between-groups differences were compared using repeated-measures multivariate analysis of variance.

Results:

With the eyes open, both intervention groups improved (P < .05) in the mean and the SD of the TTB anterior-posterior minima. In the eyes-closed condition, a time main effect (P < .05) for absolute TTB medial-lateral minima was observed. A time main effect was also noted in the posteromedial and posterolateral reach directions of the SEBT. When the scores for each group were pooled, improvement (P < .05) in self-reported function was demonstrated at 4-week follow-up.

Conclusions:

Rehabilitation using the Wii Fit and traditional exercises improved static postural control in patients with a history of lower extremity injury.
Perceptions of Wellness and Burnout Among Certified Athletic Trainers: Sex Differences
Authors: Naugle Keith E. , Behar-Horenstein Linda S. , Dodd Virginia J. , Tillman Mark D. , Borsa Paul A.
Published: May 2013

Context:

Athletic trainers are exposed to various stressors, increasing the potential for burnout and decreasing perceived wellness. Burnout and decreased perceived wellness can result from many factors: years of experience, hours per week worked, or decreased levels of physical activity. Another factor that accounts for a portion of the variance is sex differences.

Objective:

To determine the differences in burnout, physical activity, and perceived wellness scores relating to sex in District 9 of the National Athletic Trainers' Association (NATA).

Design:

Cross-sectional study.

Setting:

Web-based questionnaire.

Patients or Other Participants:

Athletic trainers who were included in the e-mail directory of NATA District 9 (men = 232, women = 158).

Intervention(s):

A 19-item questionnaire for burnout, a 36-item questionnaire for perceived wellness, and a 16-item activity questionnaire for physical activity and demographics.

Main Outcome Measure(s):

The variables included demographics (hours per week worked, years of experience, sex), Copenhagen Burnout Inventory (CBI; scores range from 0–100, and higher scores represent a higher level of burnout), Perceived Wellness Survey (PWS; scores range from 1–36, and scores close to 29 are considered healthy), and Baecke Physical Activity Questionnaire (BPAQ; scores range from 1–15, and higher scores represent more physical activity).

Results:

Of the 1560 members contacted, 390 responded (response rate = 25%), and 59.5% (n = 232) were male. The mean scores were 38.73 ± 16.9 for men and 46.2 ± 17.1 for women for the CBI, 16.68 ± 2.76 for men and 16.41 ± 2.81 for women for the PWS, and 8.42 ± 1.32 for men and 8.77 ± 1.36 for women for the BPAQ. Men and women worked an average of 55.60 ± 26.03 and 47.86 ± 20.57 hours per week, respectively, and had a mean experience of 14.79 ± 9.86 and 8.92 ± 6.51 years, respectively. Women reported a higher level of burnout (t388 = −4.255, P = .001) and greater levels of physical activity (t388 = −2.52, P = .01) than men. Men reported working more hours (t388 = 3.131, P = .002) and having more years of experience (t388 = 6.568, P = .001) than women. Perceived wellness was not different between sexes (t388 = 0.958, P = .34).

Conclusions:

Our results suggest that women experienced moderate to high burnout and men experienced moderate burnout. Interestingly, men reported lower levels of burnout but worked more hours than women. Future researchers should focus on why women experience higher levels of burnout but work fewer hours. These findings may lead to educational interventions that might reduce burnout and increase professional longevity and quality of work.
Foot Structure and Muscle Reaction Time to a Simulated Ankle Sprain
Authors: Denyer Joanna R. , Hewitt Naomi L. A. , Mitchell Andrew C. S.
Published: May 2013

Context:

Foot structure has been shown to affect aspects of neuromuscular control, including postural stability and proprioception. However, despite an association between pronated and supinated foot structures and the incidence of lateral ankle sprains, no one to our knowledge has measured muscle reaction time to a simulated ankle-sprain mechanism in participants with different foot structures.

Objective:

To determine whether pronated or supinated foot structures contribute to neuromuscular deficits as measured by muscle reaction time to a simulated ankle-sprain mechanism.

Design:

Cross-sectional study.

Setting:

University biomechanics laboratory.

Patients or Other Participants:

Thirty volunteers were categorized into 3 groups according to navicular-drop–height measures. Ten participants (4 men, 6 women) had neutral feet (navicular-drop height = 5–9 mm), 10 participants (4 men, 6 women) had pronated feet (navicular-drop height ≥ 10 mm), and 10 participants (4 men, 6 women) had supinated feet (navicular-drop height ≤ 4 mm).

Intervention(s):

Three perturbations on a standing tilt platform simulating the mechanics of an inversion and plantar-flexion ankle sprain.

Main Outcome Measure(s):

Muscle reaction time in milliseconds of the peroneus longus, tibialis anterior, and gluteus medius to the tilt-platform perturbation.

Results:

Participants with pronated or supinated foot structures had slower peroneus longus reaction times than participants with neutral feet (P = .01 and P = .04, respectively). We found no differences for the tibialis anterior or gluteus medius.

Conclusions:

Foot structure influenced peroneus longus reaction time. Further research is required to establish the consequences of slower peroneal reaction times in pronated and supinated foot structures. Researchers investigating lower limb muscle reaction time should control for foot structure because it may influence results.
Use of Evidence-Based Practice Among Athletic Training Educators, Clinicians, and Students, Part 1: Perceived Importance, Knowledge, and Confidence
Authors: Hankemeier Dorice A. , Walter Jessica M. , McCarty Cailee W. , Newton Eric J. , Walker Stacy E. , Pribesh Shana L. , Jamali Beth E. , Manspeaker Sarah A. , Van Lunen Bonnie L.
Published: May 2013

Context:

Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown.

Objective:

To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels.

Design:

Cross-sectional study.

Setting:

Online survey instrument.

Patients or Other Participants:

The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%.

Main Outcome Measure(s):

Demographic information and perceived importance and knowledge of and confidence in the steps of EBP were obtained. One-way analysis of variance, a Kruskal-Wallis test, and an independent-samples t test were used to determine differences in scores among the demographic variables.

Results:

Athletic trainers demonstrated low knowledge scores (64.2% ± 1.29%) and mild to moderate confidence (2.71 ± 0.55 out of 4.0). They valued EBP as moderately to extremely important (3.49 ± 0.41 out of 4.0). Perceived importance scores differed among roles (clinicians unaffiliated with an education program scored lower than postprofessional educators, P = .001) and highest educational degree attained (athletic trainers with terminal degrees scored higher than those with bachelor's or master's degrees, P < .001). Postprofessional athletic training students demonstrated the highest total EBP knowledge scores (4.65 ± 0.91), whereas clinicians demonstrated the lowest scores (3.62 ± 1.35). Individuals with terminal degrees had higher (P < .001) total knowledge scores (4.31 ± 1.24) than those with bachelor's (3.78 ± 1.2) or master's degrees (3.76 ± 1.35). Postprofessional educators demonstrated greater confidence in knowledge scores (3.36 ± 0.40 out of 4.0) than did those in all other athletic training roles (P < .001).

Conclusions:

Overall knowledge of the basic EBP steps remained low across the various athletic trainers' roles. The higher level of importance indicated that athletic trainers valued EBP, but this value was not reflected in the knowledge of EBP concepts. Individuals with a terminal degree possessed higher knowledge scores than those with other educational preparations; however, EBP knowledge needs to increase across all demographics of the profession.
A Learner-Centered Technique and Clinical Reasoning, Reflection, and Case Presentation Attributes in Athletic Training Students
Authors: Heinerichs Scott , Vela Luzita I. , Drouin Joshua M.
Published: May 2013

Context:

Providing opportunities to develop clinical decision-making skills, including clinical reasoning, is an important aspect of clinical education. The learner-centered technique of summarizing the history and findings, narrowing the differential, analyzing the differential, probing the instructor about uncertainties, plan management, and selecting an issue for self-directed study (SNAPPS) is used in medicine to express clinical reasoning.

Objective:

To investigate the effects of SNAPPS on the clinical reasoning, reflection, and 4 case presentation attributes (length, conciseness, case summary, and expression of clinical reasoning) in athletic training students.

Design:

Randomized controlled clinical trial.

Setting:

Three undergraduate programs accredited by the Commission on Accreditation of Athletic Training Education.

Patients or Other Participants:

We randomly assigned 38 athletic training students (17 men, 21 women; age = 21.53 ± 1.18 years, grade point average = 3.25 ± 0.31) who had completed at least 1 year of clinical education and all orthopaedic evaluation coursework to the SNAPPS group or the usual and customary group using a stratification scheme.

Intervention(s):

The SNAPPS group completed four 45-minute clinical reasoning and case presentation learning modules led by an investigator to learn the SNAPPS technique, whereas the usual and customary group received no formal instruction. Both groups audio recorded all injury evaluations performed over a 2-week period.

Main Outcome Measures:

Participants completed the Diagnostic Thinking Inventory and Reflection in Learning Scale twice. Case presentations were analyzed for 4 attributes: length, conciseness, case summary, and expression of clinical reasoning.

Results:

Case presentations were longer (t18.806 = −5.862, P < .001) but were more concise (t32 = 11.297, P < .001) for the SNAPPS group than for the usual and customary group. The SNAPPS group performed better on both the case summary subscale (t32 = 2.857, P = .007) and the clinical reasoning subscale (t25.773 = −14.162, P < .001) than the other group. We found a time effect for Diagnostic Thinking Inventory scores (F1,34 = 6.230, P = .02) but observed no group effects (F1,34 = 0.698, P = .41) or time-by-group interaction (F1,34 = 1.050, P = .31). The Reflection in Learning Scale scores analysis revealed no group-by-time interaction (F1,34 = 1.470, P = .23) and no group (F1,34 = 3.751, P = .06) or time (F1,34 = 0.835, P = .37) effects.

Conclusions:

The SNAPPS is an effective and feasible clinical education technique for case presentations. This learner-centered technique provides the opportunity for the expression of clinical reasoning skills.
Use of Evidence-Based Practice Among Athletic Training Educators, Clinicians, and Students, Part 2: Attitudes, Beliefs, Accessibility, and Barriers
Authors: W. McCarty Cailee , Hankemeier Dorice A. , Walter Jessica M. , Newton Eric J. , Van Lunen Bonnie L.
Published: May 2013

Context:

Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students.

Objective:

To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students.

Design:

Cross-sectional study.

Setting:

Online survey instrument.

Patients or Other Participants:

A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training educators (n = 24) and postprofessional students (n = 71).

Main Outcome Measure(s):

Likert-scale items (1 = strongly disagree, 4 = strongly agree) assessed attitudes and beliefs and perceived barriers, whereas multipart questions assessed accessibility to resources. Kruskal-Wallis H tests (P ≤ .05) and Mann-Whitney U tests with a Bonferroni adjustment (P ≤ .01) were used to determine differences among groups.

Results:

Athletic trainers agreed (3.27 ± 0.39 out of 4.0) that EBP has various benefits to clinical practice and disagreed (2.23 ± 0.42 out of 4.0) that negative perceptions are associated with EBP. Benefits to practice scores (P = .002) and negative perception scores (P < .001) differed among groups. With respect to perceived barriers, athletic trainers disagreed that personal skills and attributes (2.29 ± 0.52 out of 4.0) as well as support and accessibility to resources (2.40 ± 0.40 out of 4.0) were barriers to EBP implementation. Differences were found among groups for personal skills and attributes scores (P < .001) and support and accessibility to resources scores (P < .001). Time (76.6%) and availability of EBP mentors (69.6%) were the 2 most prevalent barriers reported. Of the resources assessed, participants were most unfamiliar with clinical prediction rules (37.6%) and Cochrane databases (52.5%); direct access to these 2 resources varied among participants.

Conclusions:

Athletic trainers had positive attitudes toward the implementation of EBP within didactic education and clinical practice. However, accessibility and resource use remained low for some EBP-related resources. Although the perceived barriers to implementation are minimal, effective integration of EBP within athletic training will present challenges until these barriers dissolve.
Intramuscular Heating Through Fluidotherapy and Heat Shock Protein Response
Authors: Vardiman John P. , Jefferies Laura , Touchberry Chad , Gallagher Phillip
Published: May 2013

Context:

Therapeutic modalities that can increase intramuscular temperature commonly are used to treat injuries in the clinical setting. Researchers recently have suggested that the physiologic changes occurring during an increase in temperature also could provide a cytoprotective effect for exercise-induced muscle damage.

Objective(s):

To determine if the Fluidotherapy treatment increases the inducible expression of heat shock protein (HSP), to identify the rate of heating that occurs in the lower extremity with Fluidotherapy treatment, and to evaluate the relationship between the inducible expression of HSP and temperature.

Design:

Controlled laboratory study.

Setting:

Laboratory.

Patients or Other Participants:

Six male (age = 21.67 ± 1.63 years, height = 180.09 ± 4.83 cm, mass = 87.60 ± 10.51 kg) and 6 female (age = 24.60 ± 4.59 years, height = 151.05 ± 35.76 cm, mass = 55.59 ± 14.58 kg) college-aged students.

Intervention(s):

One lower extremity was randomly selected to receive the heat treatment, and the other extremity received no treatment.

Main Outcome Measure(s):

We measured intramuscular temperature every 10 minutes, determining peak intramuscular temperature by 2 identical sequential measurements, and we analyzed the time to peak temperature. We analyzed the amount of HSP70 expression and HSP27P:T (ratio of HSP27 to the total HSP27 expression) in the gastrocnemius and soleus muscles and measured baseline skinfold thickness and estradiol levels.

Results:

Fluidotherapy increased intramuscular temperature by 5.66 ± 0.78°C (t11 = 25.67, P < .001) compared with baseline temperature, with a peak temperature of 39.08°C ± 0.39°C occurring at 84.17 ± 6.69 minutes. We did not find a heat treatment effect for HSP70 or HSP27P:T in the gastrocnemius or soleus muscles (P > .05). Peak temperature and the percentage change of HSP70 were positively correlated for the gastrocnemius and soleus muscles (P < .05). We found no other correlations for skinfold thickness, sex, or estradiol levels (P > .05). No effect of sex for skinfold thickness or estradiol levels at baseline was discovered (P > .05).

Conclusions:

This Fluidotherapy protocol increased the intramuscular temperature to a therapeutic level; however, it did not stimulate inducible HSP70 or HSP27P:T in the soleus and gastrocnemius muscles regardless of sex or skinfold thickness. These data confirmed that Fluidotherapy is an effective heating modality but suggested it is not an effective method for stimulating an HSP response in the lower limb.
A three-dimensional approach to the gender/sex of nouns in Biblical Hebrew
Authors: Kroeze J. H.
Published: May 2013

The phenomenon of the gender/sex of nouns is normally handled two-dimensionally. Two levels are distinguished: (grammatical) gender and sex. Gender refers to the morphological and syntactic features of the noun, sex to the extralingual reality. This use of the term gender rests on the assumption that the morphological and syntactic features o f a noun are normally consistent. This assumption is tested and the results show that a three-dimensional approach would he better. In the relevant literature, there are indications of such a three-dimensional differentiation, where gender is used to indicate only the syntactic features of a noun. In this article it is proposed that morphological gender, syntactic gender and semantic gender (sex) should be distinguished consistently. A list of 23 different combinations were found among nouns occurring most frequently. These combinations are illustrated with examples. Morphological, syntactic and semantic statistics are also given which illustrate the unique characteristics of the three levels.
Nou, toe en dan as temporele leksikale elemente in Afrikaans
Authors: Van der Merwe T.
Published: May 2013

Nou, toe and dan as temporal linguistic items in Afrikaans The temporal Afrikaans words nou, toe and dan are very frequently used in reference to the three contrasts of the temporal deixis: the present, past and future tenses. They also have the temporal function in common to mark the time-relations between different parts of utterances which refer to a sequence of actions, events or slate of affairs. Each has, however, its own unique features. Toe for example could be described as "marked", since it can be used only to be indicative of the past, while nou and dan, on the other hand, are applicable in the broader spectrum of deictic reference, but not exactly parallel to each other in the different tenses.
Perspektief in Raka
Authors: Viljoen H. M.
Published: May 2013

Die verteller in Raka dring op nog ’n manier in die innerlike van sy karakters in, naamlik deur hulle hul ruim te te laat belewe. Die ruim te word beskryf soos die karakter dit ervaar, en daarom kan ’n mens hierdie ruimtebelewing ook beskou as beperking, van die alwetendheid van die verteller. Veral twee stukke ruimtebeskrywing is belangrik in Raka. Dit is die beskrywing van Koki en Raka se swemplekke (p. 13 en p. 21 onderskeidelik).
Literatuur en rewolusie met besondere verwysing na Anna M. Louw: Twenty days that autumn en Jeanette Ferreira: Sitate om ’n rewolusie
Authors: Steenberg D. H.
Published: May 2013

With the publication of Jeanette Ferreira’s brief novel Sitate om ’n rewolusie in 1985 a phenomenon was given shape in the authorial text of which traces had for some considerable time been present in the work of more than one Afrikaans prosewriter. The theme of revolution is clearly discernible at the surface level, and the reader of Afrikaans prose can then begin to ask questions about the relationship, occurrence and nature of representation of the theme of revolution in the work of some important Afrikaans prose-writers, and tie in Ferreira’s work with the works of these authors. In the sixties Anna M. Louw’s novel Twenty days that autumn was published in English. Coming from the pen of an Afrikaans novelist, it can be seen as one of the first prose works from the Afrikaner community in which revolution is a precipitate, and in this article it is investigated together with Sitale om 'n rewolusie.
Investigation of dmyc Promoter and Regulatory Regions
Authors: Kharazmi Jasmine , Moshfegh Cameron
Published: May 2013

Products of the myc gene family integrate extracellular signals by modulating a wide range of their targets involved in cellular biogenesis and metabolism; the purpose of this integration is to regulate cell death, proliferation, and differentiation. However, understanding the regulation of myc at the transcription level remains a challenge. We performed rapid amplification of dmyc cDNA ends (5′ RACE) and mapped the transcription start site at P1 promoter, 18 base pairs upstream of the start of the known EST GM01143 and within the 5′ UTR. Our data show that the first TATA box, previously computationally predicted, is utilized to generate dmyc full length mRNA. The largest transcript contains all three exons, generated after the removal of the introns by constitutively regulated splicing events. Further investigation of Downstream Promoter Element (DPE) was achieved by studying lacZ reporter activity; investigation revealed that this element and its upstream cluster of binding sites are required for the dmyc intron 2 activity. These findings may provide valuable tools for further analysis of dmyc cis-elements.
The Eradication of Helicobacter pylori does not Affect Glycemic Control in Japanese Subjects with Type 2 Diabetes
Authors: Wada Yoshiharu , Hamamoto Yoshiyuki , Kawasaki Yukiko , Honjo Sachiko , Fujimoto Kanta , Tatsuoka Hisato , Matsuoka Atsuko , Ikeda Hiroki , Fujikawa Jun , Koshiyama Hiroyuki
Published: May 2013

Since infection with Helicobacter pylori has been suggested to play a pathogenic role in diabetes mellitus, we investigated whether eradication therapy for H. pylori might affect glycemic control in Japanese subjects with type 2 diabetes. A total of 72 subjects (55 males, 17 females; aged 63.7 years) with type 2 diabetes who received eradication therapy for H. pylori were included. The change of their blood glycosylated hemoglobin (A1C) levels 3 months before (-3 m) the H. pylori eradication, as well as 3 months (3 m) and 6 months (6 m) after were evaluated. Their A1C levels did not show any significant change after therapy {6.9 [0.1]% (-3 m) to 7.0 [0.1]% (3 m); P = 0.3, 7.0 [0.1] (6 m); P = 0.3}. Our findings suggest that the eradication therapy for H. pylori does not, at least profoundly, affect glycemic control in Japanese subjects with type 2 diabetes.
Mr Spectroscopic Imaging of Peripheral Zone in Prostate Cancer Using a 3t Mri Scanner: Endorectal versus External Phased Array Coils
Authors: Nagarajan Rajakumar , Margolis Daniel JA , Raman Steven S. , Ouellette David , Sarma Manoj K. , Reiter Robert E. , Thomas M. Albert
Published: May 2013

Magnetic resonance spectroscopic imaging (MRSI) detects alterations in major prostate metabolites, such as citrate (Cit), creatine (Cr), and choline (Ch). We evaluated the sensitivity and accuracy of three-dimensional MRSI of prostate using an endorectal compared to an external phased array “receive” coil on a 3T MRI scanner. Eighteen patients with prostate cancer (PCa) who underwent endorectal MR imaging and proton (1H) MRSI were included in this study. Immediately after the endorectal MRSI scan, the PCa patients were scanned with the external phased array coil. The endorectal coil-detected metabolite ratio [(Ch+Cr)/Cit] was significantly higher in cancer locations (1.667 ± 0.663) compared to non-cancer locations (0.978 ± 0.420) ( P < 0.001). Similarly, for the external phased array, the ratio was significantly higher in cancer locations (1.070 ± 0.525) compared to non-cancer locations (0.521 ± 0.310) ( P < 0.001). The sensitivity and accuracy of cancer detection were 81% and 78% using the endorectal ‘receive’ coil, and 69% and 75%, respectively using the external phased array ‘receive’ coil.
Open Label Trial of Naltrexone Implants: Measuring Blood Serum Levels of Naltrexone
Authors: Colquhoun Ross M.
Published: May 2013

The usefulness of oral naltrexone has been limited by compliance. Sub-cutaneous implants would seem to offer a solution to this problem and improve long-term outcomes. The aim of the present study was to compare levels of blood serum naltrexone of patients who had received a naltrexone implant after detoxification to a number of dependent variables of interest. These dependent variables included drug use including urine screens of each patient, any adverse response to the implant, subjective evaluation of self-esteem, quality of relationships, and changes in social functioning. Sixty six patients received an implant and were surveyed; urine and blood samples were taken at about 1, 3, and 6 months after implantation. Naltrexone levels were on average above 1 ng/mL at 6 months after insertion and patients showed significant improvements on all dependent variables. The preliminary evidence indicates that implants can improve compliance rates and outcomes.
Serum PCT and CRP Levels in Upper Respiratory Tract Infections as a Marker of Infection
Authors: Sood Archana , Chauhan Preeti , Jain Manisha , Dabla Pradeep , Sood Sanjay
Published: May 2013

Most of the upper respiratory tract infections are viral in origin and accounts for the most frequent cause of antibiotic misuse world over. Conventional test like microbiological culture for confirming bacterial etiology is not very sensitive. We evaluated the utility of biomarkers like procalcitonin (PCT), C-reactive protein (CRP) and total leukocyte count (TLC) to guide antibiotic treatment in such cases. Fifty patients were divided into two groups, those having acute suppurative tonsillitis (n = 40) and those having acute rhinosinusitis (n = 10) were included. Appropriate samples were processed for microbiological culture. Blood samples were taken for PCT, CRP and TLC estimation. Almost 34% of the patients were taking antibiotics at least 1 day prior to their consultation. Microbiological culture was positive only in 38% of cases. The levels of PCT were significantly higher in cases of acute suppurative tonsillitis as compared to rhinosinusitis. The PCT levels correlated well with CRP, TLC and degree of fever in tonsillitis cases. The levels of CRP correlated well with the TLC levels in rhinosinusitis cases. PCT and CRP levels were higher than the normal healthy population in our patients. They can be used as a marker for guiding antibiotic treatment in cases of upper respiratory tract infection of bacterial origin.

How to cite this article

Chauhan P, Sood A, Jain M, Dabla P, Sood S. Serum PCT and CRP Levels in Upper Respiratory Tract Infections as a Marker of Infection. Clin Rhinol An Int J 2013;6(1):1-4.
Reconstruction of Depressed Dorsum including Tip of Nose by Autogenous Materials: Our Experience
Authors: Majumder Aniruddha , Das Chiranjib , Hazra Tapan Kanti , Karmakar Minakshi , Paul Dipten
Published: May 2013

Reconstruction of nose is a very challenging task. It has been practiced since ancient ages. Since, then various techniques have evolved. We have used forehead and nasolabial advancement flap for reconstruction of skin defect over iliac crest bone or conchal cartilage grafts. In small gap we used composite graft from pinna. In this article we share our experience with various grafts and flaps, their success and failures and methods to avoid or treat them.

How to cite this article

Hazra TK, Majumder A, Das C, Karmakar M, Paul D. Reconstruction of Depressed Dorsum including Tip of Nose by Autogenous Materials: Our Experience. Clin Rhinol An Int J 2013;6(1):22-27.
Fungal Rhinosinusitis in Delhi-National Capital Region
Authors: Agarwal Shilpi , Garg Sunil , Songara Prafulla , Sherwal BL , Rakshit Partha
Published: May 2013

Background and objective

During past decades, fungal rhinosinusitis (FRS) has been diagnosed more frequently. Knowing the fungal flora and its prevalence in chronic rhinosinusitis (CRS) patients will allow a better understanding of this disease, diagnosis and treatment. We studied the prevalence of fungus in CRS patients in Delhi-NCR (National Capital Region) in a tertiary care hospital.

Materials and methods

In this prospective study, a total of 180 patients having CRS were enrolled in which functional endoscopic sinus surgery was done. In 173 (96.1%) patients, polyps/tissue/mass were collected during surgery. In seven (3.9%) cases, sinus secretions were obtained. All the collected samples were sent for microbiology and pathology examination. Diagnosis of FRS was confirmed by direct mycological (10% KOH) and/or culture and/or pathology analysis.

Results

Forty-eight cases were positive for fungus, out of these 180 patients of CRS. In patients of FRS, the most common presentation was nasal blockage followed by facial pain and facial fullness. The prevalence of FRS was found to be 26.6% in CRS and most common fungal pathogen isolated was Aspergillus flavus.

Conclusion

Delhi-NCR region falls under a moderate prevalence area for fungal infection in CRS patients as compared to other regions in India. Majority of cases were isolated in summer months, the dry and hot climate of the Delhi- NCR may be responsible for such prevalence.

How to cite this article

Garg S, Songara P, Sherwal BL, Agarwal S, Rakshit P, Kumar S. Fungal Rhinosinusitis in Delhi- National Capital Region. Clin Rhinol An Int J 2013;6(1): 28-31.
A Rare Association of Inflammatory Myofibroblastic Tumor of Maxilla and Idiopathic Orbital Inflammatory Disease
Authors: Sikka Kapil , Preetam C , Kumar Rakesh , Durgapal Prashant
Published: May 2013

Inflammatory myofibroblastic tumor (pseudotumor) is a rare tumor belonging to the family of fibrous mesenchymal tumors. Though it usually involves lungs, but extrapulmonary site involvement, especially head and neck region is rare. In this paper, we are presenting a 26-year-old male patient, with inflammatory myofibroblastic tumor of maxilla, with a rare association with a prior history of idiopathic orbital inflammatory disease, treated medically. The patient was treated surgically with complete excision of the pathology from maxilla. This case report intents to review the controversies in management of this tumor and also to enlighten the possible association between the orbital and maxillary pseudotumor.

How to cite this article

Preetam C, Kumar R, Sikka K, Kumar R, Durgapal P. A Rare Association of Inflammatory Myofibroblastic Tumor of Maxilla and Idiopathic Orbital Inflammatory Disease. Clin Rhinol An Int J 2013;6(1):41-43.
Transnasal Endoscopic Removal of Malformation of the Odontoid Process in a Patient with Craniovertebral Anomaly
Authors: Nagpal Tapan
Published: May 2013

The endoscopic endonasal approach is emerging as a feasible alternative to the transoral route for the resection of the odontoid process, when the latter produces a compression of the brainstem and cervicomedullary junction. This type of approach has some advantages, such as excellent prevertebral exposure of the craniovertebral junction in patients with small oral cavities and the possibility to avoid the use of mouth retractors. A report of two patients with a diagnosis of craniovertebral anomaly— basilar invagination into foramen magnum, suffering from an extreme posterior tilt of the odontoid process causing severe anterior compression of the cervicomedullary junction, is presented to stress the potential of this technique to the endoscopic rhinologist. Transnasal endoscopic removal of the odontoid process was performed and resolution of the ventral compression was achieved. This report demonstrates that, in selected cases, a multidisciplinary team approach can help our patients.

How to cite this article

Nagpal T. Transnasal Endoscopic Removal of Malformation of the Odontoid Process in a Patient with Craniovertebral Anomaly. Clin Rhinol An Int J 2013;6(1): 47-50.
Rhinophyma: A Simple and Cost-effective Management
Authors: Smitha SG , Gangaraj Smitha Soubhagya
Published: May 2013

Rhinophyma is a slowly progressive condition due to hypertrophy of the sebaceous glands of the tip of the nose, often seen in cases of long standing acne rosacea. There are many surgical methods which are followed. We present a case of rhinophyma which was treated by shaving with diathermy knife followed by regular postoperative dressings. No skin graft was used during the procedure and a complete healing with near normal cosmetic appearance was achieved.

How to cite this article

Gangaraj SS, Thimaiah AH. Rhinophyma: A Simple and Cost-effective Management. Clin Rhinol An Int J 2013;6(1):56-57.
Outside influences: Extramedia forces and the newsworthiness conceptions of online newspaper journalists
Authors: Cassidy William P.
Published: May 2013

This article examines the influence of extramedia (outside) forces on the newsworthiness conceptions of U.S. online and print daily newspaper journalists. A national survey (N=655) found that while extramedia forces exerted only a moderate influence overall, they were more influential on the online group. Online daily newspaper journalists rated Audience Research, Advertisers, Public Opinion Polls, Wire Service Budgets and Prestige Publications are significantly more influential than did print daily newspaper journalists. The findings suggest that journalists in the online environment are reconceptualizing their gate-keeping roles.
Free and open source licenses in community life: Two empirical cases
Authors: De Paoli Stefano , Teli Maurizio , D'Andrea Vincenzo
Published: May 2013

How do licenses participate in Free and Open Source Software (FLOSS) community life? This paper aims at answering this question.

Despite the dynamic character of FLOSS development, the sociological debate has taken for granted a static perspective of communities organized around a restricted range of social values and rules. Criticizing the main sociological approaches to FLOSS community, we assert, on the contrary, that the FLOSS free/open character shall not be assumed a priori to explain the coordination efforts in communities.

Focusing on the role of software licenses in everyday FLOSS communities activities, considered as boundary objects, we observe that controversies and conflicts around licenses are fundamental parts of communities life. Basing our researches on two different projects, the Geographical Information System GRASS and the OpenSolaris™ Operating System, we show how the construction of the FLOSS free/open character takes place inside the debates about licenses.
The Internet as social ally
Authors: Wells Amy Tracy , Rainie Lee
Published: May 2013

How do people use the internet to solve problems? Employing quantitative and qualitative data from two surveys, one in which a random selection of the U.S population responded and one in which a self-selected group of people responded, we argue that individuals use different sources and channels to seek information and assistance, depending on the problem they face. We find that a significant portion of online Americans turn to the internet at times because it seems to fulfill their needs more readily and thoroughly than the people in their community network do. We present evidence of when people use the internet versus seeking the assistance of friends and family and possible reasons for this behavior. This research demonstrates how, to what extent, when and why the internet supplements people’s lives.
A Romania of the imagination: Formula As, virtual community, and normative behavior
Authors: Burnett Gary , Nocasian Mihaela
Published: May 2013

Using concepts from the Theory of Normative Behavior (Burnett, et al., 2001), this article examines a print-based virtual community that interacts in the pages of a Romanian magazine named Formula As that focuses on publishing letters from its readers. This community constitutes a textually-mediated Small World, comprised of members who share a specific set of common interests and accepted modes of interaction. Its publicly visible activities—embodied as texts in the magazine’s pages—reveal a specific Worldview, as well as specific sets of Social Norms, Social Types, and Information Behaviors. Together, these features comprise the normative shape of the Formula As Small World.