bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological Profiling: Investigative Implications from Crime Scene Analysis
Authors: Schlesinger Louis B.
Published: January 2017

Psychological profiling-often referred to as behavioral, criminal or investigative profiling-began informally in the late 1940s when members of law enforcement were unable to make an arrest involving serial crime. This presentation describes the six stages of profiling, as well as other important aspects such as victim and offender characteristics, escalation, time and location factors, modus operandi and signature, and staging. The organized vs. disorganized dichotomy is discussed as well as how personality is an intervening variable and how crime scene analysis reveals aspects of personality. But for profiling to gain general scientific acceptability, a higher level of empirical validation and general scientific acceptance of this technique will be necessary.
Elucidating the Contours of Competency for Execution: The Implications of Ford and Panetti for Assessment
Authors: Zapf Patricia A.
Published: January 2017

This article reviews the various statutes, case law, and commentary regarding legal tests for competency and sets forth conclusions regarding an appropriate legal test for competence (CFE), drawing parallels to competence to stand trial where appropriate. Two imporatant Supreme Court Cases, Ford v. Wainwright (1986) and Panetti v. Quarterman (2007), are discussed in detail and relevant aspects of the Panetti case are used to underscore important facets regarding the evaluation of CFE. Implications of Ford and Panetti for the test of CFE and its evaluation are highlighted. Six practical guidelines following them from Panetti for the evaluation of CFE are disc used.
Sexual Harassment in the Military
Authors: Harris Richard J. , McDonald Daniel P. , Sparks Corey S.
Published: January 2017

Purpose:

Sexual harassment remains a persistent problem in the U.S. military despite extensive research and policy initiatives. Theoretical explanations identify individual circumstances (e.g., power differentials) and organizational factors (e.g., climate, culture). However, data constraints limit the capacity to link individual contexts with independent measures of environments.

Data/Methods:

A unique Defense Equality Opportunity Climate Survey allows assessment of organizational climates and individual experiences with multilevel analyses.

Results:

Sexist environmental context increases the likelihood of personal harassment experiences after controlling for individual-level variables. However, unit-level climate, group cohesion, and job satisfaction are not significant.

Conclusion:

Both individual and organizational factors are important. However, the organizational context has less to do with culture or unit cohesion and more to do with tolerance of sexism. Focusing on problem units may be effective for reducing the prevalence and persistence of sexual harassment.
Four and a half years of experience of a clinician born and raised in Fukushima: discrepancy found through dialogues and practices
Authors: Miyazaki M.
Published: January 2017

Many initiatives to measure the internal and external exposures of the residents of Fukushima have been undertaken since the accident at Fukushima Daiichi nuclear power plant. However, residents have had few, if any, opportunities for face-to-face explanations to understand the meaning of such measurements. Although the personal data of tens of thousands of residents were collected, these data were not analysed adequately, and were therefore not used to implement large-scale programmes to manage/reduce exposures. One of the lessons learned from the Fukushima accident is that it is imperative for the government to implement these measures for radiation protection, and to build an effective functioning service for the residents. The author, as a physician from the region, has worked as an explainer/interpreter of exposure dose measurements to individual residents. Another lesson learned from this experience is that local medical and health professionals can contribute to building a public system for radiation protection, by acting as ‘liaising officers’ to connect residents, the authorities, and experts from outside the region. This paper describes the author’s experience and lessons learned in the hope that this information will be useful in the event of a future accident.
The Impact of Medicare Part D on Self-Employment
Authors: Moulton Jeremy G. , Diebold Jeffrey C. , Scott John C.
Published: January 2017

We explore the relationship between access to affordable health insurance and self-employment using exogenous variation from the introduction of Medicare Part D that reduced the out-of-pocket cost of prescription drugs and improved health outcomes in a difference-in-differences model using the American Community Survey. We find that our treatment group of individuals aged 65–69 were 0.5 percentage points (or 5%) more likely to be self-employed in relation to a control group aged 60–64.
Adorno’s ‘addendum’
Authors: Jaffe Aaron
Published: January 2017

Adorno’s ‘addendum’ names the experience by which socially constrained agents are jolted into resistance against their suffering. The impulse to action is simultaneously intra-mental and somatic, and thus forms the locus of a jointly conscious and bodily impetus to confronting the ideological and material forces that produce contemporary unfreedom. In this way the ‘addendum’ is a historically developing, indeterminate, yet inexhaustible glimmer of hope for both agents and theorists who make social suffering central to their critical analysis. This article explores the structure of the addendum by unpacking its presentation first in Negative Dialectics and then by way of the one-sided and cautionary illustrations of Buridan’s ass and Hamlet in the History and Freedom lectures. While aesthetic, ideal, affect-centered and Freudian interpretations of the addendum have been developed, appreciating the somatic or bodily, the intra-mental or conscious, and the historicized accounts of nature and reason that Adorno weaves together to explain ever-present possibilities of resistance requires instead a non-reductive materialist and dialectical lens.
Alternative Multiorgan Initiation–Promotion Assay for Chemical Carcinogenesis in the Wistar Rat
Authors: Solano Marize de Lourdes Marzo , Rocha Noeme Souza , Barbisan Luis Fernando , Franchi Carla Adriene da Silva , Spinardi-Barbisan Ana Lúcia Tozzi , de Oliveira Maria Luiza Cotrim Sartor , Salvadori Daisy Maria Fávero , Ribeiro Lúcia Regina , de Camargo João Lauro Viana
Published: January 2017

The medium-term multiorgan initiation–promotion chemical bioassay (diethylnitrosamine, methyl-nitrosourea, butyl-hydroxybutylnitrosamine, dihydroxypropylnitrosamine, dimethylhydrazine [DMBDD]) with the Fischer 344 rat was proposed as an alternative to the conventional 2-year carcinogenesis bioassay for regulatory purposes. The acronym DMBDD stands for the names of five genotoxic agents used for initiation of multiorgan carcinogenesis. The Brazilian Agency for the Environment officially recognized a variation of this assay (DMBDDb) as a valid method to assess the carcinogenic potential of agrochemicals. Different from the original protocol, this DMBDDb is 30-week long, uses Wistar rats and two positive control groups exposed to carcinogenesis promoters sodium phenobarbital (PB) or 2-acetylaminofluorene (2-AAF). This report presents the experience of an academic laboratory with the DMBDDb assay and contributes to the establishment of this alternative DMBDD bioassay in a different rat strain. Frequent lesions observed in positive groups to evaluate the promoting potential of pesticides and the immunohistochemical expressions of liver cytochrome P450 (CYP) 2B1/2B2 and CYP1A2 enzymes were assessed. Commonly affected organs were liver, kidney, intestines, urinary bladder, and thyroid. PB promoting activity was less evident than that of 2-AAF, especially in males. This study provides a repository of characteristic lesions occurring in positive control animals submitted to a modified alternative 2-stage multiorgan protocol for carcinogenesis in Wistar rat.
Neurons of the Hypoglossal Nucleus of the Rat
Authors: Cooper Margaret H.
Published: January 2017

The neurons of the hypoglossal nucleus in the medulla of the brain stem of the laboratory rat are described from Nissl, Golgi impregnation, horseradish peroxidase, and electron microscopic preparations. The cell body of the neuron is multipolar, measures 30μm to 40μm in its largest diameter, and gives off four to five primary dendrites. As the dendrites radiate from the cell body they may remain within the ipsilateral hypoglossal nucleus, cross the midline into the contralateral hypoglossal nucleus, or extend out into the adjacent reticular formation.
Nasopharyngeal Irradiation Treatment of Hyperplastic Adenoids
Authors: Pratt Loring W.
Published: January 2017

Radiotherapy treatment in childhood is an important cause of thyroid cancer. In the 1930 to 1950 era, radium irradiation of the nasopharynx was used to control hyperplastic adenoids. Because of the technical characteristics of this applicator, sufficient radiation was not applied to the thyroid by this technique to stimulate the development of thyroid malignancies. No malignancies have been reported thus far as a result of> this treatment.
Parapharyngeal Schwannomas
Authors: Mikaelian Diran O. , Holmes William F. , Simonian Simon K.
Published: January 2017

Schwannomas of the parapharyngeal space are rare benign tumors arising from nerves located in the parapharyngeal space. Most of them occur as a mass behind the ascending ramus of the mandible, and bimanual palpation is important in ascertaining their exact location. The anatomy of the parapharyngeal space is described in detail. Treatment of these tumors is surgical through an external neck approach. A combined neurosurgical approach is indicated for tumors extending intracranially.

Four cases of parapharyngeal schwannomas are added to the world literature (114 reported), with one extending intracranially through the jugular foramen.
Microscopic Controlled Excisions for Epidermoid Carcinoma of the Head and Neck
Authors: Davidson Terence M. , Nahum Alan M. , Astarita Robert W.
Published: January 2017

A concept for microscopic frozen section control of head and neck primary cancers is described. Skilled application of these principles should significantly increase local control of epidermoid carcinoma of the upper aerodigestive tract.
Emergency Orbital Decompression: A Reprieve from Blindness
Authors: Krausen Anthony S. , Ogura Joseph H. , Burde Ronald M. , Ostrow David E.
Published: January 2017

Orbital decompression to treat progressive loss of vision owing to long‐term hormonal disease is a well‐documented curative procedure. Over the past four years, two patients suffering from acute visual problems, owing to trauma and infection, have rapidly deteriorated to a no light perception visual level. In these two instances, vision was restored by timely orbital decompression.
Hearing in Adult‐Onset Diabetes Mellitus
Authors: Harner Stephen G.
Published: January 2017

Hearing acuity and otologic symptoms were examined in 200 patients with adult‐onset diabetes mellitus. Data were analyzed according to sex and age and were compared with values of other documented studies; values were within normal limits except in two instances. Speech testing revealed that median speech reception thresholds and median discrimination scores were at the lower limits of normal. Hearing loss and otologic problems did not occur with any increased frequency in patients with adult‐onset diabetes mellitus.
Computed Tomography vs Laryngography: A Comparison of Relative Diagnostic Value
Authors: Friedman William H. , Archer Carol R. , Yeager Vernon L. , Katsantonis George P.
Published: January 2017

The computed tomography (CT) scans and laryngograms of 25 patients with laryngeal cancer were compared and evaluated in an assessment of the diagnostic accuracy of each modality in the supraglottis glottic, and subglottic regions. Fourth generation scanners were used in these patients, all of whom subsequently underwent laryngectomy or partial laryngectomy. The clinical superiority of CT scanning was evident in several areas—confirming clinical impressions that laryngography is not as accurate as CT, is frequently misleading, and offers no significant advantages over CT. In this regard, we now believe that computed tomography is the most important radiologic adjunct in the diagnosis of laryngeal cancer, and we no longer order the laryngogram on a routine basis.
Delayed Reinnervation of Unilateral Vocal Cord Paralysis in Dogs
Authors: Neal G. David , Cummings Charles W. , Sutton Dwight
Published: January 2017

The neuromuscular implantation technique for rehabilitation of unilateral vocal cord paralysis was performed in four dogs at the time of denervation and in six dogs after varying intervals of chronic denervation. As would be expected, the chronically denervated animals did not achieve the vocal cord excursion of the acute denervations, but some return of motion was noted even after six months. Histologic examination of the posterior cricoarytenoid muscle was correlated with the return of movement.
Sebaceous Cell Carcinoma of the External Auditory Canal
Authors: Doble H. Peter , Snyder G. Gordon , Carpenter Robert J.
Published: January 2017

Sebaceous cell carcinoma is an extremely uncommon tumor; fewer than 100 cases have been reported, with most of these lesions arising in the meibomian glands in the tarsal plates. Other sites in the head and neck have been noted, but this is the first reported case originating in the external auditory canal.
Hemangiopericytoma of the Sphenoid Sinus
Authors: Kimmelman Charles P.
Published: January 2017

A 51‐year‐old woman complained of intermittent nasal obstruction and rhinorrhea. Sinus roentgenograms and polytomograms revealed a small mucocele of the right sphenoid sinus. There was no encroachment of the orbital apex or intracranial contents. The mucocele was marsupialized via an external ethmoidectomy, and the scant tissue present inside the sinus was examined histologically. The pathologic diagnosis was hemangiopericytoma. The small tumor had apparently originated at the sinus ostium, thus creating the mucocele. Several months postoperatively, a small, vascular tumor nodule was noted in the incision. No recurrence was evident intranasally. A course of 5,040 rads of external beam radiation therapy was given to the right ethmoid labyrinth and right sphenoid. Since completing her radiation therapy, there has been no recurrence. This case is of interest because the tumor occurred as a mucocele of the sphenoid sinus.
Comparison of Vestibulo‐Ocular and Vestibulospinal Screening Tests
Authors: Black F. Owen , Wall Conrad
Published: January 2017

A comparison of a newly developed vestibulospinal screening test and two vestibulo‐ocular screening tests (caloric and rotation) was performed on two groups of patients, one with Meniere's disease (MD) the other with benign paroxysmal positional nystagmus (BPPN) and vertigo. Vestibulospinal screening tests were slightly more sensitive (not statistically significant) than caloric tests for detection of a peripheral vestibular disorder. Caloric, rotation, and vestibulospinal screening tests were specific neither for MD nor BPPN groups. The caloric test false‐positive rate for the involved ear was unacceptably high for the BPPN group. The rotation test false‐positive rate was the highest of the three tests for both groups. The vestibulospinal test combined with either the caloric or the rotational tests increased the sensitivity for detection of a peripheral vestibular disturbance, particularly for the MD patients.
Perilymphatic Communication Routes in the Auditory and Vestibular System
Authors: Asher David L. , Sando Isamu
Published: January 2017

Horseradish peroxidase was injected into the foramen magnum and oval window of guinea pigs to determine perilymphatic communication routes and boundaries. The primary route to the auditory system appeared to be through the cochlear aqueduct. Perineural spaces of the eighth nerve contributed to this communication and provided the principal perilymphatic communication routes to the vestibular system. Light and electron microscopic examination were used to identify membrane permeability and define boundaries in the epithelial lining of the auditory and vestibular endorgans.
Measures of Middle Ear Admittance during Experimentally Induced Changes in Middle Ear Volume in the Hamster
Authors: Zwillenberg David , Konkle Dan F. , Saunders James C.
Published: January 2017

The relation between middle ear admittance measured at the tympanic membrane and middle ear volume was studied in adult hamsters. A modified tympanometric procedure was used to measure complex admittance at eight test frequencies. Middle ear volume was varied by injecting small amounts of water into the bulla cavity. As bulla volume decreased, the value of admittance magnitude also decreased. The measured values of admittance magnitude could be accurately predicted by the equation for admittance magnitude until the bulla was about 70% filled. The results confirm that measures of middle ear admittance reflect the volume of the middle ear cavity as would be expected of a pure compliance. Where such measures are available in man, they might be used to predict the degree of fluid intrusion into the middle ear cavity.
Papillary Cystadenoma Lymphomatosum of the Larynx
Authors: Foulsham Charles K. , Snyder G. Gordon , Carpenter Robert J.
Published: January 2017

Papillary cystadenoma lymphomatosum, or Warthin's tumor, is a benign lesion of the salivary glands occurring most frequently in the parotid region. Since the initial report of this lesion in 1910, numerous reports have appeared in the literature concerning the occurrence of Warthin's tumor in many extraparotid locations, including the larynx. The vast majority of those tumors arising in the larynx have been disproved because of the absence of one or more of the histologic characteristics of this lesion within the surgical specimen.

This paper will review the histologic criteria of Warthin's tumor and the typical clinical occurrence. We will discuss a case of papillary cystadenoma lymphomatosum of the larynx that satisfies all the histologic criteria of this lesion. A review of the possible origins of this tumor will demonstrate that this case may lend support to the hypothesis that papillary cystadenoma lymphomatosum may be the end result of a delayed hypersensitivity reaction.
Facial Paralysis in the Newborn
Authors: Smith James D. , Crumley Roger L. , Harker Lee A.
Published: January 2017

A group of 95 patients with facial paralysis in the neonatal period are presented. In 74 patients it was believed to be secondary to trauma associated with pregnancy and delivery, and in 21 to be secondary to congenital lesions. The cause, extent, and clinical course of the paralyses are discussed. A classification is outlined to help in organizing a logical and systematic evaluation plan for these patients. Patients may be divided into four groups based on the time they are seen after birth, whether the nerve is stimulable, or whether the nerve loses its stimulability. On the basis of this classification, electromyogram studies, and roentgenographic findings, a presumptive diagnosis may be made and a treatment plan formulated. The treatment plan is based on the diagnosis, facial nerve excitability testing, and degree of deformity present. If there is evidence of facial nerve disruption, a facial nerve exploration is indicated. In congenital cases, reanimation procedures may be necessary.
Antimotion Sickness Drug Efficacy
Authors: Wood Charles D. , Cramer D. Bryant , Graybiel Ashton
Published: January 2017

The principal medications available for the prevention of motion sickness were tested for their relative efficacy in a Navy National Aeronautics and Space Administration program at Pensacola, Fla. The drugs were tested on the human centrifuge, at sea, in the air, and in zero gravity flights. The results of this research indicated that drugs with central anticholinergic actions such as scopolamine, promethazine, dimenhydrinate (Dramamine), cyclizine (Marezine), and meclizine (Bonine) were effective in increasing resistance to motion sickness. Drugs with central effects which enhanced the action of norepinephrine were also effective. These included dextroamphetamine sulfate (Dexedrine) and ephedrine. It is recommended that all antimotion sickness drugs be taken at least one hour before exposure to motion. For severe conditions of motion it is recommended that one of the following drug combinations be used: (1) scopolamine, 0.6 mg, plus dextroamphetamine sulfate, 5 mg, or (2) promethazine, 25 mg, plus ephedrine, 25 mg. Moderate conditions may be controlled by dimenhydrinate, 50 mg, and in mild conditions such as automobile travel, cyclizine, 50 mg, or meclizine, 50 mg, may be sufficient. The proper dose of an effective antimotion sickness drug given at the proper time will protect most susceptible patients from motion sickness. After motion sickness has developed, intramuscular injections of promethazine or scopolamine have a therapeutic effect.
Cartilage Implantation in Head and Neck Surgery: Report of a National Survey
Authors: Donald Paul J. , Col AL
Published: January 2017

As enthusiasm for alloplastic grafts wanes, the use of biologic materials for facial reconstructive and aesthetic surgery is regaining popularity. A plethora of methods exists for preservation of one of the most popular implants, human cartilage. The con‐troversy over the efficacy of autologous v preserved homologous cartilage grafts continues. A national study was developed to determine the efficacy of autologous v the various techniques of cartilage preservation based on the criteria of graft extrusion, infection, and absorption. Autologous grafts were most commonly used. The most popular preservation methods used alcohol or merthiolate. Autologous grafts had less absorption than preserved grafts, but both groups had approximately equivalent infection and extrusion rates. Irradiated cartilage showed the least absorption of all preservation methods.
Immunobiology of Langerhans' Cells Migrating into Aural Cholesteatomas
Authors: Veldman Jan E. , Visser Cees E. , Schuurman Henk‐Jan , De Groot John C. M. J. , Huizing Egbert H.
Published: January 2017

Immunohistochemical and submicroscopic analyses of human cholesteatoma matrices reveal the presence of Langerhans' cells and T lymphocytes. Through cell‐to‐cell Interaction, Langerhans' cells probably play a key role In skin‐related disorders, including cholesteatomas. They originate from a mobile cell population of monocyte origin and migrate into and out of the body's lining. Their custodial function is always carried out In close relation with T lymphocytes. Various monoclonal antibodies directed against Langerhans' cell and T lymphocyte membrane receptors reveal the presence of these cell populations in cholesteatoma matrices but not in the tympanic membrane. Langerhans' cell and T cell traffic through cholesteatomas are discussed in relation to the pathogenesis, natural course, and recurrence rate of cholesteatomas. Through Immunopathologic evaluation the clinical aggressiveness of a cholesteatoma will probably become predictable. Medical manipulation of Langerhans' cell and T cell functions‐as an adjuvant to surgery‐may have consequences for the future handling of cholesteatomas.
Complications of CO2 Laser Surgery of the Aerodigestive Tract: Experience of 4416 Cases
Authors: Healy Gerald B. , Strong M. Stuart , Shapshay Stanley , Vaughan Charles , Jako Geza
Published: January 2017

The CO2 laser was first Introduced for surgery of the aerodigestive tract in 1971. Since that time, great advances in application have been made in both the adult and pediatric population. Recent reports of isolated complications have appeared in the literature. However, a realistic complication rate in a large series of patients has yet to be reported. This report relates the combined experience of the authors in a total of 4416 cases during the 11–year period from 1971 to 1982. There were nine instances of complications, representing a complication rate of 0.2%. These complications provided a unique learning experience for the authors, and led to the establishment of certain basic principles that should be followed in all laser operations. This survey indicates that the CO2 laser is a safe, extremely useful surgical modality in the aerodigestive tract.
Cochlear Nucleus Implant
Authors: Hitselberger William E. , House William F. , Edgerton Bradly J. , Whitaker Samuel
Published: January 2017

The case of a 51‐year‐old woman with an acoustic neuroma in her only hearing ear is presented. At the time the tumor was removed, May 24, 1979, a depth electrode was implanted In the cochlear nucleus. This worked for 2 months, allowing her to perceive sound in her environment. On March 12, 1981, the depth electrode was replaced with a surface electrode. Since that time her hearing has been as good as that of a patient with a cochlear implant. It has now been over 2 years since her last surgery and she continues to do well.
Vestibular Neurophysiology
Authors: Barber Hugh O.
Published: January 2017

An important function of the vestibular system is to secure visual stabilization during head movement, and at low‐frequency movements the optokinetic and pursuit systems collaborate to this end. Oscillopsia results when eye velocity fails to match head velocity. Simple bedside tests to identify oscillopsia and impaired cancellation of the vestibulo‐ocular reflex (VOR) are described. Adaptive plasticity, directed to the goal of maintenance of foveation despite marked changes in the external (e.g., reversed visual surround) or internal (e.g., after labyrinthectomy) environment, is an important attribute of the vestibular system. The flocculus and some of its connections are essential to this function. Reduction of floccular efficiency, as in the elderly, might be an important cause of defective adaptation to a vestibular lesion, such as labyrinthectomy.
Surgical Treatment of Skull‐Base Malignancy
Authors: Kinney Sam E. , Wood Benjamin G.
Published: January 2017

Improved radiographic diagnosis and new surgical approaches make it possible to consider surgical treatment of skull‐base malignancies. For many years treatment of external auditory canal and middle ear malignancies has involved subtotal or radical temporal bone surgery; these approaches and techniques will be discussed in detail, in our experience the need for radical temporal bone resection has changed considerably. Total tumor removal followed by radiation therapy seems to yield survival rates and relief of pain equal to formal temporal bone resection with the attendant complications. The new radio‐diagnostic techniques, including high‐resolution computerized tomographic scans and digital subtraction angiography, allow better assessment of skull‐base lesions. If we can determine by computerized tomography that a skull‐base malignancy is well defined and not extending into different areas, en bloc surgical resection might be indicated. Details of this radiologic evaluation will be presented along with some surgical approaches to lesions possibly amenable to surgical resection.
Hearing preservation after acoustic neuroma surgery with intraoperative direct eighth cranial nerve monitoring: Part II. A classification of results
Authors: Silverstein Herbert , McDaniel Alan , Norrell Horace
Published: January 2017

Since the advent of brainstem auditory evoked response audiometry and computerized tomography, small acoustic neuromas are more frequently found. Often the patient has serviceable hearing, which we would like to preserve during complete tumor removal. Since 1978, sixteen patients with acoustic neuromas have been operated upon through the retrosigmoid suboccipital approach, with the goal of hearing preservation. In 1983, we began using intraoperative direct eighth nerve monitoring, which produced a rapid assessment of cochlear nerve function during the excision of small acoustic neuromas. The tumors varied in size from intracanalicular lesions to one lesion with a 3.0 cm protrusion medial to the porus acousticus. In eight of sixteen cases, intraoperative monitoring was used, and in four of the patients hearing was preserved. In eight cases, intraoperative monitoring was not used, and hearing was preserved in only two patients. The overall success rate—in total tumor removal with hearing preservation—was 37%. Hearing was preserved in six of eight patients who had tumors which measured less than 1.5 cm. In this group of cases, two of the patients had a Class I good hearing result (PTA 0 to 30 dB and 70 to 100% discrimination), one patient had Class III nonserviceable hearing, (PTA 65 to 75 dB and 25 to 45% discrimination), and three patients had Class IV poor hearing, (PTA 80 to 100 dB and 0 to 20% discrimination). We found that continuous monitoring of direct eighth‐nerve‐evoked action potentials were extremely valuable and rapidly indicated reversible cochlear nerve trauma.
Eustachian Tube and Nasal Function during Pregnancy: A Prospective Study
Authors: Derkay Craig S.
Published: January 2017

Eustachian tube dysfunction (ETD) during pregnancy and the so‐called “rhinitis of pregnancy” were investigated in a prospective manner by use of sonotubometry, the nine‐step inflation‐deflation tympanometric test, and computer‐assisted anterior rhinomanometry. Twenty pregnant volunteers with symptoms of ETD were compared to 20 asymptomatic trimester‐matched pregnant subjects and 20 nonpregnant, age‐matched controls. Among the symptomatic women, 16 of 20 (80%) demonstrated ETD, compared to 9 of 20 (45%) of the asymptomatic women and 6 of 20 (30%) of the nonpregnant controls (p < 0.01). A statistically significant difference was also demonstrated between the symptomatic pregnant group and the control women with respect to nasal conductance and inspiratory work/liter. Resolution of ETD and nasal obstruction were documented upon repeat testing of pregnant subjects 4 to 10 weeks postpartum. Otologic history and current cigarette‐smoking habit were found to predispose women toward ETD (p < 0.05). We conclude that ETD during pregnancy and rhinitis of pregnancy are genuine clinical entities that can be demonstrated in the clinical laboratory and that the natural history of these disorders predicts resolution postpartum.
The role of computed tomography in the management of peritonsillar abscess
Authors: Patel Kalpesh S. , Ahmad Shireen , O'leary Gerard , Michel Michael
Published: January 2017

Twenty‐four patients who fulfilled the clinical criteria for peritonsillar abscess (PTA) were randomized into two groups over a 6‐month period. Group A (n = 13) underwent CT with contrast, whereas group B (n = 11) was managed without radiologic Investigation. In group A, CT with contrast enabled differentiation of PTA from peritonsillar cellulitis in all 13 cases (100%) and demonstrated abscesses in 11 patients (85%), thereby allowing drainage at first attempt. Two patients with peritonsillar cellulitis were successfully managed with antibiotics only. In group B, all patients underwent needle aspiration. In seven patients (64%), pus was found after needle aspiration at first attempt and In one patient after needle aspirations at two locations. In three patients (27%), no pus was found after needle aspirations at three different locations. We conclude that CT enhances diagnostic accuracy, obviating unnecessary drainage procedures, and reduces patient morbidity.
Seropositive, adenoid hypertrophy, and secretory otitis media in adults—A recognized clinical entity
Authors: Desai Shailesh Dhirubhai
Published: January 2017

Otolaryngologic manifestations of AIDS have been described in the past. In this study, I had examined 14 adults with nasal obstruction and mouth breathing. Nine patients also reported deafness‐unilateral in three of them and bilateral in six. All of them revealed a mass in the nasopharynx, either on the posterior rhinoscopy or the x‐ray neck‐lateral view. To exclude nasopharyngeal malignancy, all of the patients underwent examination of the nasopharynx while under general anaesthesia and biopsy. The histopathologic diagnosis in every patient was nonspecific, reactive lymphoid hyperplasia, which has been described in the background of HIV Infections. Four were already confirmed HIV‐positive and 10 were found positive on the HIV antibody test. A strong association was established between seropositivlty, adenoid hypertrophy, and secretory otitis media in adults.
Mast cell stabilizers
Authors: King Hueston C.
Published: January 2017

The precise mode of action of the well‐studied cromolyn sodium and the newer nedocromil sodium has not been completely elucidated. Because the drugs do not pass the cell membrane and enter the cell, they are virtually not metabolized, do not exert a systemic action, and therefore are associated with only minimal systemic toxicity. To be effective either drug must be applied topically and directly to the nasal mucosa. Proper contact with the nasal mucosa is essential for efficacy; in patients with nasal congestion and secretions, vasoconstrictors or saline lavages are indicated before cromolyn or nedocromil use. Both products are highly effective in patients who have IgE‐mediated allergic rhinitis but must be administered prophylactically before exposure to an allergen to prevent development of the allergic event. Neither drug is effective in vasomotor rhinitis, exercise‐induced rhinitis, or in the management of nasal polyps. Correct diagnosis is essential before therapy.
Revisiting the Participatory Model of Development: Institutional Survival in Watershed Programmes in Four Indian States
Authors: Sen Sucharita
Published: January 2017

The watershed development programmes have been hailed as an important agent for overall rural development in India by enhancing livelihoods through natural resource management. The tenure for these government-funded projects end after five years but the benefits of the project are expected to be taken forward beyond the project duration through the active participation of the community-based organisations. This study aims to address the relatively untouched area of post-project management of watershed programmes, and draws experience from a primary survey covering 201 watershed projects in four major states of India, 3 to 5 years after the completion of the project period. Through the lens of institutional survival after the withdrawal of government funding, this paper follows the debate around the community-based institutions created for the purpose of project ideally meant to promote development through a ‘neat’ bureaucratic design that seeks to remove ‘political’ interference referred widely to as ‘anti-politics machines’ in the academic discourse. In reality, they leave out large sections of the community in terms of their representation. This paper questions the institution-building process and its outcome, particularly with respect to survival of the core watershed institution, that is, the Watershed Committee.
Bereavement - whose responsibility?
Authors: Oliver David , McMurray Nan
Published: January 2017

Bereavement care begins during the terminal phase of motor neurone disease as the family prepare for the death. Due to the long-term nature of the illness there is a need to allow the expression of painful feelings and to ensure that the family is adequately supported. The responsibility for care in bereavement lies not only with the family but with the health care professions, bereavement support groups and the whole community.
Congenital lung malformations: radiological findings and clues for differential diagnosis
Authors: Garcia-Peña Pilar , Coma Ana , Enríquez Goya
Published: January 2017

Congenital lung malformations encompass a wide spectrum of conditions with a broadly varying clinical presentation. They are often a source of morbidity in infants and children. Their management depends on the type of malformation and its clinical presentation. Usually, the diagnosis requires an imaging evaluation. Classifications of bronchopulmonary malformations have undergone significant revision in recent years and several theories have attempted to explain their confusing pathogenesis. There are considerable degrees of overlapping and hybrid conditions are common, with interrelated malformations showing various radiologic and pathologic features. Attending to the pathophysiological mechanisms and structures involved, lung malformations can be divided into three categories: bronchopulmonary anomalies, combined lung and vascular abnormalities, and vascular anomalies. The purpose of this article is to review the current imaging techniques for evaluating lung malformations in pediatric patients and their characteristic imaging findings. Moreover, this review discusses a useful classification and offers some clues to facilitate the differential diagnosis.
Interim Report of a Large French Multicentre Study of Efficacy and Safety of 3.75 mg Leuprorelin Depot in Metastatic Prostatic Cancer
Authors: Giraud B.
Published: January 2017

A study carried out in 470 patients with metastasized adenocarcinoma of the prostate confirmed the efficacy of 3.75 mg leuprorelin acetate depot given subcutaneously once monthly. Bone pain was rapidly decreased and the general condition of patients and urinary signs improved. Sexual activity was maintained in 50% of patients. After 3 months’ treatment, there was no progression in 95% of patients, complete regression in 39% and partial regression in 49%; 17% of cases were stabilized. Improvement in clinical signs was directly related to a decline in amounts of prostate-specific antigen and was associated with a decline in serum testosterone concentrations within 3–4 weeks of starting treatment; Leuprorelin acetate depot was well tolerated and was easy to store and use.

Une étude entreprise sur 470 malades souffrant d'adénocarcinome métastatique de la prostate a confirmé l'efficacité de Facétate de leuproréline sous forme retard%aG la dose de 3,75 mg administré par injection sous-cutanée une fois par mois. Les douleurs osseuses ont rapidement régressé et l'état générale des malades et les signes urinaires se sont améliorés. Une activité sexuelle s'est vue maintenue chez ces malades (50%). Après un traitement de 3 mois, il n'a pas été noté de progression de la tumeur chez 95 % des patients, une régression complète a été observée chez 39 % des malades, une régression partielle chez 49 % des malades, et une stabilisation de la maladie a été notée dans 17 % des cas. L'amélioration des signes cliniques a été directement mise en relation avec une diminution du nombre des antigènes spécifiquesà la prostate et des concentrations sanguines en testostérone 3 à 4 semaine après le démarrage du traitement. L'acétate de leuproréline retard a été bien toléré et il s'est avéré d'utilisation aisées.

Uno studio condotto su 470 pazienti affetti da adenocarcinoma metas-tatizzato delia prostata ha confermato l'efficacia di 3,75 mg di leuprorelin acetato, in preparazione “ritardo”, somministrato per via sottocutanea una volta al mese. E’ stata riscontrata una rapida remissione del dolore osseo ed un miglioramento delie condizioni generali del paziente e delia minzione. L'attività sessuale è stata conservata dal 50% dei pazienti. Dopo un trattamento di 3 mesi, non è stato registrate alcun peggioramento nel 95% dei pazienti, una completa remissione nel 39% ed una parziale remissione nel 49%, il 17% dei casi si è stabilizzato. II miglioramento dei parametri clinici è stato posto in diretta correlazione con il decremento delia quantità di antigene specifico prostatico ed è stato associato con un decremento delie concentrazioni seriche di testosterone entro 3–4 settimane dall'inizio del trattamento. Il leuprorelin acetato, in preparazione “ritardo”, è stato ben tollerato ed è risultato di facile impiego e conservazione.
The Children’s Aid Society
Authors: Batista Tara , Johnson Allen
Published: January 2017

The Children’s Aid Society (CAS) was founded in 1853 to help impoverished and orphaned children. In the process of fulfilling its mission, CAS may have unwittingly planted some of the first participatory seeds that grew into youth empowerment, elements of which were eventually incorporated into parts of the modern US foster care system. Specific empowering aspects of CAS’s include (1) providing asset-building opportunities, (2) adult facilitation of a prosocial environment, and (3) treating children as independent clients who helped shape the program. This article provides evidence of the participatory aspects of CAS using examples from nineteenth-century periodicals and annual reports.
Interreligious Encounter and Proselytism in Pre-Mughal Bengal
Authors: Zami Tahmidal , Lorea Carola Erika
Published: January 2017

The Jesuit father Nicolas Pimenta’s report mentions one of the first Christianmissions to Bengal (1598–1604). Based on fresh translations of the chapters in the report describing the Bengal mission, this article examines interreligious relations in contemporary Bengal characterised by the dialectic of coexistence and disjunction. Local kingship or lordship was the keystone in the structure of interreligious coexistence in Bengal. The Christian preachers carried an incompatibilist and exclusivist approach to interreligious relations that was at odds with the inclusivist and compatibilist approach prevalent among the Bengal lords. The welcome accorded to the preachers by the lords reflected the inclusive approach. The eventual persecution and expulsion of the fathers was due to political exigencies rather than interreligious antagonism.
Suicide Ideation in Different Generations of Immigrants
Authors: Kennedy M Alexis , Parhar Karen K , Samra Joti , Gorzalka Boris
Published: January 2017

Objective:

To identify whether pressures associated with acculturation are related to suicide ideation.

Method:

We assessed 1135 undergraduates, using suicide measures and the Vancouver Index of Acculturation.

Results and Conclusions:

Suicide ideation, plans, and attempts did not vary by generation level or with mainstream acculturation for any of the ethnic groups studied (European, Chinese, and Indo-Asian), nor did they vary among ethnic groups. The results indicate that individuals who identified closely with their heritage culture were at an increased risk for suicidal thoughts but not for suicide plans or attempts.
Nightmares and Serum Cholesterol Level: A Preliminary Report
Authors: Agargun Mehmet Yucel , Gulec Mustafa , Cilli Ali Savas , Kara Hayrettin , Sekeroglu Ramazan , Dulger Haluk , Besiroglu Lutfullah , Inci Rifat
Published: January 2017

Objective:

To examine whether there is a relation between nightmares and serum lipid levels.

Methods:

Fifteen subjects who met DSM-IV criteria for the diagnosis of nightmare disorder and 15 healthy control subjects participated in the study. We used an enzymatic colorimetric method for cholesterol and triglyceride determination. We measured high-density lipoprotien (HDL) cholesterol using the direct HDL-cholesterol method. Low-density lipoprotein (LDL) was calculated according to the Friedewald formula.

Results:

Patients with nightmare disorder had lower serum triglyceride, lower total cholesterol, and lower LDL levels than healthy control subjects.

Conclusion:

These findings suggest that nightmares are associated with low serum lipid levels.
Open-Label Adjunctive Topiramate in the Treatment of Unstable Bipolar Disorder
Authors: McIntyre Roger S , Riccardelli Rosanna , Binder Carin , Kusumakar Vivek
Published: January 2017

Objective:

To assess open-label adjunctive topiramate in the treatment of outpatients with unstable bipolar disorder (BD).

Method:

Outpatients with DSM-IV–defined BD (I or II) exhibiting mood instability were enrolled in this 16-week, open-label, multicentre study. Topiramate was added to existing mood stabilizers and other psychotropic treatments. The primary effectiveness measure was the Clinical Global Impression of Severity (CGI-S) scale; other scales included the Young Mania Rating Scale (YMRS) and the Montgomery–Asberg Depression Rating Scale (MADRS). Safety assessments included monitoring adverse events, measuring tremor, monitoring vital signs and weight, and laboratory indices. We also evaluated patient satisfaction with treatment.

Results:

A total of 109 patients were enrolled. Intent-to-treat analysis showed significant improvement from baseline in the CGI-S, YMRS, and MADRS, starting at Week 2 ( P < 0.001), with further accrual of benefit between Week 2 and Week 16 ( P < 0.001). The mean modal dosage of topiramate during the stable dosing period was 180 mg daily. There was a mean 1.8 kg decrease in patient weight from topiramate initiation to Week 16 ( P < 0.001). Topiramate was well tolerated by most patients; 11% withdrew from the study owing to adverse events. We noted a significant reduction in the mean severity score for preexisting tremor by Week 8 of treatment ( P < 0.005); no notable changes in vital signs were observed. At Week 16, 50% of the patients were “completely satisfied” with topiramate treatment.

Conclusions:

Adjunctive topiramate treatment can reduce the severity of manic and depressive symptoms, as well as reducing tremor and weight in outpatients with BD I or II.
Le traitement des symptômes obsessionnels-compulsifs dans la schizophrénie
Authors: Faucher Sophie , Dardennes Roland , Ghaëm Olivier , Guelfi Julien-Daniel
Published: January 2017

Les symptômes obsessionnels et compulsifs (SOC) sont fréquents, dans la schizophrénie, et semblent aggraver le pronostic. Plusieurs études de cas suggèrent l'apparition ou l'aggravation des SOC lors de traitements neuroleptiques atypiques (rispéridone, olanzapine et clozapine). Il semble donc souhaitable de rechercher des antécédents familiaux ou personnels de SOC avant d'initier un tel traitement, et de surveiller l'apparition des SOC après l'avoir instauré. Une grande partie de ces cas concerne la clozapine. En cas d'apparition de SOC sous clozapine, on peut diminuer les doses de clozapine et adjoindre un traitement par inhibiteur du recaptage de la sérotonine. Les travaux actuels suggèrent que les patients souffrant de schizophrénie avec des SOC devraient bénéficier d'un traitement neuroleptique et d'un traitement anti-obsessionnel. Il existe 2 études contrôlées portant sur le traitement des SOC dans la schizophrénie: l'une avec la clomipramine, l'autre avec la fluvoxamine. Toutes 2 ont démontré leur efficacité. Cependant, ces essais comprennent un faible nombre de patients aux caractéristiques hétérogènes.
Screening for Major Depression and Posttraumatic Stress Disorder among Asylum Seekers: Adapting a Standardized Instrument to the Social and Cultural Context
Authors: Durieux-Paillard Sophie , Whitaker-Clinch Barbara , Bovier Patrick A , Eytan Ariel
Published: January 2017

Objective:

To adapt the PTSD and MDE sections of a validated psychiatric diagnostic instrument, we used the Mini International Neuropsychiatric Interview (MINI) during an initial health assessment into a primary care facility for asylum seekers.

Method:

A 3-step process was carried out. First, items of the original version of the MINI were adapted to the specific context of life of asylum seekers in the host country (by a multidisciplinary group that included public health nurses, a primary care physician, a psychologist, a psychiatrist, and an epidemiologist). Second, we submitted the reworded and original versions of the MINI to 14 interpreters' who tested for general and cultural acceptability. Each diagnostic criterion was rated according to interpreters' comments on a 4-point Likert scale (1 = an item good for translation and 4 = an unusable or completely inadequate item). In the third step, we rephrased the most problematic items identified by the interpreters.

Results:

Some original items were considered particularly ill-adapted for this context, and 4 had to be dropped. This final rewording took into account cultural inadequacies and lack of structure (including temporal organization) of the everyday life of newly arrived asylum seekers.

Conclusion:

The reworded MINI was successfully tested, and its items are presented in the final part of the study.