bluuebunny/crossref_metadata_2025 huggingface dataset:
Cibersociedad, net art, ciberfeminismo y cibercultura: el cuerpo en internet
Authors: García Manso Almudena
Published: May 2021

La expresión artística en el ciberespacio da a conocer una nueva imagen del cuerpo, icono por ende del arte a lo largo de la historia de la humanidad, dicho icono ve cómo su dimensión se modifica merced el uso de las Tecnologías de la Información y las Comunicaciones. Las posibilidades que estas tecnologías proporcionan han posibilitado un cuerpo obra de arte en el ciberespacio, merced a las performances propias del Net Art. El cuerpo y la obra de arte en esta dimensión virtual adquiere una dimensión de deslocalización que antes no poseían.Así como el Net Art ciberfeminista permite una visión de la identidad de género virtual que viene dado por la performatividad de la representación corporal de los sujetos mediante el Net art.
Elementos para una prospectiva de la universidad colombiana en la sociedad del conocimiento
Authors: Vera Silva Alhim Adonaí
Published: May 2021

En el presente artículo se analizan las relaciones entre las normas concebidas desde la burocracia que amarran el futuro de las universidades públicas a sus intereses particulares representados en los Consejos Superiores, a través, de por lo menos dos figuras: la discrecionalidad y la delegabilidad en la Sociedad del Conocimiento que nos invita a construir, desde la prospectiva, los escenarios de las universidades del futuro, dónde, las normas arropan el ejercicio de la democracia en la transformación positiva del bienestar social.
Patrocinio o mecenazgo: una estrategia de la empresa en el desarrollo cultural
Authors: Aráez Fernández Juan Francisco
Published: May 2021

La cultura como principio digno de tutela, protección y fomento por parte de los Poderes Públicos es el signo determinante de la mayoría de los países desarrollados hasta el punto de ser recogida en los textos constitucionales -sobre todo tras la II Guerra Mundial- para garantizar dicho estatus. Puesto que de dicho elemento integrador e identificador deben disfrutar todos los ciudadanos, se hace necesaria en esta labor de promoción de la misma la intervención de todos los miembros de la sociedad en la que se proyecta, superando esquemas y posiciones ideológicas. Así la empresa a través de fórmulas como el mecenazgo y patrocinio cultural, ha conseguido superar como exclusivos los objetivos del puro beneficio mercantil y revirtiendo estos en la misma sociedad de la que forma parte, mejorando su imagen.

A través de la experiencia se ha puesto de manifiesto que la fórmula de sistemas mixtos -Estado y particulares, en este caso empresas- en la participación del fomento de la cultura a través de mecanismos como el patrocinio y el mecenazgo, que a su vez se convierten en elementos de comunicación de empresa, favorecen el desarrollo de la cultura implicando a todos los miembros del grupo humano, permitiendo la identificación de éstos en el resultado.
La entrevista de prensa. Consideración práctica y conceptual de un género informativo esencial.
Authors: Torregrosa Carmona Juan Francisco
Published: May 2021

El presente trabajo se acerca al mundo del periodismo impreso a partir de un género informativo esencial como es la entrevista, modalidad propia de presentación textual, además de base de otros géneros como el reportaje y, en su caso, la crónica, entre algunos posibles más.

Se hace un repaso sobre su papel en el trabajo diario del periodista, además de una aproximación conceptual al género. En este sentido, se abordan los principales tipos de entrevista que suelen ofrecer tanto los periódicos diarios como la prensa semanal, para lo cual se tiene en cuenta la bibiografía más destacada sobre la materia.

Tanto la entrevista en su fórmula más convencional como otras variantes son tenidas en cuenta para valorar el papel que desempeñan esta clase de textos informativos e informativo-interpretativos en la narración de la actualidad informativa. Una narración que debería apoyarse en la separación clara entre información y opinión, ámbito este último para el que están precisamente reservados unos géneros específicos. De hecho, la mejor tradición periodística anglosajona, la de mayor calidad, siempre ha reivindicado la observación de esa separación, y la fidelidad a la información factual, como un elemento necesario incluso en el aspecto deontológico, a partir de la siguiente sentencia clásica: “Los hechos son sagrados, las opiniones son libres”.
Cuestiones didácticas en el uso de las tic en la educación
Authors: Durán Medina José Francisco
Published: May 2021

Los cambios en las formas de interrelacionarse profesores y alumnos otorgan cada vez más importancia a las Nuevas Tecnologías de la Información y de la Comunicación, mediante las cuales se abre notablemente el campo de posibilidades en este aspecto. La reunión en el despacho para hablar personalmente y cara a cara de cualquier problema o duda surgida deja de ser la única posibilidad de contacto con el profesor, dejando paso a otras muchas como pueden ser el correo electrónico, el Chat, Libros de Visitas, Listas de Distribución, el Blog, Foros, etc., cada uno con sus particulares características, ventajas e inconvenientes.
La televisión, mano amiga y enemiga
Authors: Raya González Pura
Published: May 2021

La televisión, según algunos comunicólogos, no es buena maestra. Sin embargo, en general, los medios de comunicación, también contribuyen a afianzar en nosotros valores que, inculcados desde la escuela y la familia, nos hacen ser mejores personas. Lo que nadie duda es que estos, los mass media, considerados el cuarto poder, condicionan el comportamiento social y contribuyen a la creación de la realidad colectiva, especialmente en lo que respecta a las situaciones que no vivimos y que nos llegan a través de ellos.

Para comprender esta breve reflexión, cómo la televisión puede ser al mismo tiempo nuestra amiga y enemiga, analizaremos en el presente capítulo los principales elementos que posibilitan todo proceso de comunicación y, por tanto, alimentan esa «relación amor-odio», objeto de gran debate en los últimos años.
Historia de los blogs
Authors: Durán Medina José Francisco
Published: May 2021

El mundo de los blogs está entrando con fuerza en todos los ámbitos de la sociedad, incluso en los educativos, que están iniciando algunas investigaciones respecto a la utilización de esta novedosa herramienta, tan atractiva y motivadora para sus usuarios, cobrando especial interés pedagógico como herramienta de intercomunicación entre profesor y alumnos.
La narrativa breve del exilio de María Teresa León
Authors: González de Garay Mª Teresa
Published: May 2021

Durante el exilio de María Teresa León vieron la luz los cuentos de Morirás lejos, en Buenos Aires (editorial Americalee) el año de 1942. Allí recuperaba diez relatos publicados en 1936 en México bajo el título de Cuentos de la España actual. Incluía ocho nuevos, y la mezcla de éstos con los anteriores no resultó incoherente porque las preocupaciones sociales y la ideología política eran ya las mismas.
“Discurso de paz desde la radio comunitaria en tiempos del posconflicto en el Caribe Colombiano”
Authors: Ramos Maldonado Carlos
Published: May 2021

En el desarrollo de este trabajo se puede afirmar que el medio más eficaz para implementar masivamente cultura de paz en regiones de provincia donde no tienen presencia los medios tradicionales del orden nacional y regional es la radio comunitaria, por su proximidad y sus efectos (Rodrigo, 2001), lo que permite con mucha facilidad participación de la audiencia y la construcción de un lenguaje de paz (Peresson, Mariño y Cendales,1983).En este sentido, el parlamento radial, bien construido dentro de la lógica sociopolítica y cultural, es un instrumento adecuado para la relación dialógica y la convivencia pacífica en poblaciones donde ha imperado la violencia entre grupos irregulares armados de derecha e izquierda y el ejército colombiano, principalmente en la región Caribe colombiano, donde más ha azotado y en donde se comienzan a implementar los procesos de posconflicto motivados por el mismo gobierno nacional.La palabra, como ente simbólico de paz, conductora hacia ella, utilizada estratégicamente de manera franca y conciliadora, asertiva (Pottier, 1992), refuerza los lazos de entendimiento y conciliación, construyendo con ella significaciones semióticas nucleares e ideas afines (Charaudeau, 2003; van Dijk, 1990, y Apel, 1987) que signifiquen, por ejemplo, identidad, comprensión, tolerancia, inclusión, respeto, participación, en fin, afecto en situaciones de interlocución para promover cultura de paz (Barreto, Broja y Serrano, 2009, y Centeno, 2008).
El mobiliario como modelo de comunicación social: algunos comentarios sobre un conjunto de muebles art decó provincial y los valores que transmiten.
Authors: Fernández Paradas Antonio Rafael
Published: May 2021

En una sociedad en la que todo está mediatizado, y donde todo pasa por el tamiz de la virtualidad, nos olvidamos que hasta no hace tanto, las personas requerían otra serie de medios para comunicar valores sociales, económicos culturales, etc., que los situaran en una posición social diferenciadora con respecto a sus congéneres. Una de las vías con las que históricamente han contado las personas para transmitir estos valores, ha sido el mobiliario, testigo mudo de las sociedades y de evolución de estas. Los muebles son un elemento de comunicación de primer orden, que debidamente interrogados, podrán de manifiesto una serie de “sutilezas” que nos hablan de determinados códigos y modelos de comunicación social. Partiendo de un conjunto de muebles Art Decó provincial español, pretendemos extraer una serie convencionalismos que fueron utilizados en el periodo como instrumentos de comunicación social.
Infonomía y comunicación interna
Authors: Peña Acuña Beatriz , Del Henar Sánchez Cobarro Paloma
Published: May 2021

Este texto pretende reflexionar sobre un artículo clásico de gestión de la información de Alfons Cornellá “Hacia la infonomía” debido a la importancia que está cobrando en la Sociedad de la Información y, de modo especial en el tejido empresarial, la gestión de la Información, ahora más llamada Gestión del Conocimiento sobre todo en el ámbito de la Comunicación Internas.
El desarrollo humano y el conocimiento o la metáfora de las manzanas: la manzana de eva a la "apple" de bill gates
Authors: Proença Garcia Rui
Published: May 2021

Esta disertación es de tipo antropológica y a la vez filosófica donde se reflexiona sobre el desarrollo humano en cuanto a la concepción del conocimiento (gnoseología) y la visión del alcance de lo real haciendo un recorrido retrospectivo-histórico a través de la sugerente metáfora de la manzana por protagonistas de la Historia en momentos memorables (la manzana de Eva, de Newton, de Bill Gates, etc). Más que contestar preguntas este escrito realiza sugerentes preguntas a partir de planteamientos filosóficos o reflexiones sobre los sucesos históricos. Este escrito hace reflexionar desde un punto de vista ético sobre la actual epistemología vista por la autoridad que otorgamos a lo científico y a lo tecnológico mientras lo real se sigue mostrando hasta un punto misterioso y donde el hombre todavía se está descubriendo a sí mismo. No cabe duda que este debe respetarse y ser fiel a sí mismo, a su dignidad.
Motivos de consumo de programas taurinos en televisión
Authors: Marta-Lazo Carmen , Pérez-González Javier
Published: May 2021

Este artículo de investigación pretende analizar los principales argumentos por los que un sector de la audiencia televisiva en España se interesa por el visionado de la programación de contenido taurino. También intenta examinar las motivaciones de aquellos televidentes que no siguen esta temática, así como profundizar en los argumentos de su rechazo o falta de interés. Con objeto de examinar estas razones, hemos utilizado como técnica de análisis cualitativo los grupos de discusión. De esta forma, conoceremos los motivos por los cuales un segmento de público selecciona para su consumo este tipo de contenidos. Además, la técnica cualitativa de los grupos de discusión nos permitirá profundizar en unos cuantos casos específicos y particulares para llegar a conocer el porqué de estas acciones. Por tanto, mediante el análisis del discurso de varios casos investigaremos los motivos principales por los que una parte de la sociedad española decide ver o no este tipo de programas.
PENGARUH PERUBAHAN TUTUPAN LAHAN TERHADAP KARAKTERISTIK HIDROLOGI DI DAS SAMPEAN KABUPATEN BONDOWOSO
Authors: Pribadi Arif Darmawan , Kusumawati Rita Dwi , Firdausi Atika Audia
Published: May 2021

DAS Sampean di Kabupaten Bondowoso memiliki luas 1.248 km2. Selama 20 tahun terakhir, perkembangan ekonomi yang pesat telah menyebabkan konversi lahan dari area hijau ke lahan pengembangan yang menyebabkan kemampuan infiltrasi tanah menurun. Data yang tercatat periode waktu tahun 2002-2017 terjadi kenaikan debit harian sebesar 4 m3/s dan debit maksimum tahunan harian sebesar 42 m3/s, sedangkan kondisi curah hujan yang tercatat pada wilayah DAS Sampean mengalami tren penurunan. Penelitian ini bertujuan untuk mengetahui dampak yang ditimbulkan dari perubahan tutupan lahan terhadap debit aliran sungai, disimulasikan menggunakan model SWAT (Soil and Water Assesment Tools). Perubahan tutupan lahan juga mengakibatkan penurunan aliran dasar sebesar 104,99 mm. Data debit pengamatan, curah hujan, dan tutupan lahan dari Tahun 2003 hingga 2016 digunakan untuk kalibrasi model dan verifikasi. Hasilnya menunjukkan perubahan tutupan lahan yang terjadi selama tiga belas tahun terakhir di DAS Sampean mengakibatkan peningkatan aliran permukaan (SUR_Q) 35.81 mm, total air sungai (WYLD) meningkat 114 mm, debit maksimum per bulan meningkat 15,93 m3/s. Studi ini menggarisbawahi pentingnya faktor tutupan lahan sebagai Daerah Resapan Air (DRA) dalam perencanaan dan pengelolaan infrastruktur kawasan di masa depan pada DAS Sampean, Kabupaten Bondowoso.
AN ANALYSIS OF HUMOR SPEECH ACT OF THE BIG BANG THEORY AT CBS TELEVISION SERIES
Authors: Suardi
Published: May 2021

Some of the problems faced by students in learning English are speech acts. This research focused on finding the speech acts. This study aims to get an overview of humor speech acts of the big bang theory. The qualitative descriptive approach will be used along with the content analysis technique. The result shows that: (1) there are three parts of speech acts used, including locutionary, illocutionary, and perlocutionary acts, (2) there is a violation of quantity, quality, relevance, and manner maxim. However, the most violation maxim was at the quantity maxim, (3) the screenwriters intentionally create a dialogue with several principles’ violations of speech acts, team-works, and humor categories. It can be concluded that the speech acts humor of the big bang theory screenwriters intentionally made some mistakes to create humor to raise up the jocularity atmosphere that can be enjoyed by the viewers. It is expected that this research can enrich the knowledge as regard the linguistic phenomena especially those which are related to speech acts.
THE ILLOCUTIONARY ACTS AND THE TRANSLATION TECHNIQUES IN SHERLOCK HOLMES MOVIE SERIES
Authors: Tambunan Sunarti Desrieny
Published: May 2021

Understanding the context of the speech act is very important before translating it into its target language. Therefore, this research aims at: (1) finding out the types of illocutionary acts produced by Sherlock Holmes and (2) discovering the translation techniques used in translating Sherlock Homes’ illocutionary acts. This research is a descriptive qualitative. The results show that there are 132 illocutionary acts found in the movie. From 18 translation techniques proposed by Molina and Albir, there are only eight translation techniques used by the subtitler to translate the illocutionary acts. Those translation techniques are amplification, adaptation, discursive creation, modulation, literal, particularization, reduction, and transposition.
Employees’ Work-Life Balance Reviewed From Work From Home Aspect During COVID-19 Pandemic
Authors: Putri Amanda , Amran Ali
Published: May 2021

The COVID-19 pandemic suddenly made the company inevitably has to run its operational activities in a way of work from home. The sudden change in the operational activity system can have an impact on the work-life balance of employees. In this study, the researchers wanted to know the work-life balance of the employees during the COVID-19 pandemic in terms of work from home. The research method used is a survey method with descriptive verification research type. The data used are primary data obtained from distributing the questionnaire. The results showed that work from home respectively has a positive and significant effect on the work-life balance on the employees. There are dimensions and indicators that are the highest and lowest in constructing each variable and the results of this study are expected to be used by the company to minimize and anticipate the occurrence of negative effects on work-life balance in terms of the aspects of work from home.
Pelatihan Internet dan Power Point untuk Guru-Guru di Sekolah Dasar 23 Kota Sabang
Authors: Munawir  , Rizal Syamsul , Salam Abdus , Ismail Ismail
Published: May 2021

Kebutuhan orang untuk memanfaatkan fasilitas email internet semakin meningkat, seiring dengan pertumbuhan internet yang ada di instansi-instansi baik pemerintah maupun non pemerintah. Di SD ada beberapa yang telah memiliki jaringan internet sebagai sarana koneksitas dengan dunia luar. Namun beberapa kendala masih ada mengingat persentase guru yang mampu memanfaat internet dan power point masih kecil. Seperti dicontohkan di SD N 23 Kota Sabang, hanya sekitar 2 orang guru yang biasa memakai internet dan power point, sedang guru lainnya belum bisa mengoperasikan internet. Sasaran dalam program pengabdian ini adalah meningkatkan kemampuan dan kompetensi guru-guru di SD N 23 Kota Sabang dalam menerapkan teknologi informasi yaitu dengan pelatihan internet sehingga mampu memanfaatkan sarana yang ada di internet untuk kepentingan komunikasi (E-mail), serta meningkatkan kemampuan dan kompetensi guru dalam media pembelajaran melalui pelatihan power point untuk sarana presentasi. Berdasarkan hasil pengamatan dan evaluasi terlihat guru-guru mengikuti pelatihan dengan sangat antusias. Pelatihan internet dan power point ini telah dilaksanakan selama 2 hari yaitu pada tanggal 29 Agustus 2014 dengan jumlah peserta 10 guru, dan tanggal 31 Agustus 2014 dengan jumlah peserta 10 guru. Guru yang mengikuti program pelatihan ini memiliki disiplin ilmu yang berbeda-beda sesuai dengan bidang keahlian dan mata pelajaran yang diampunya. Selama 2 hari tersebut, pada hari pertama peserta yaitu para guru SD N 23 Kota Sabang telah berhasil mempraktikkan materi internet yaitu Browsing, Searching, Downloading, dan Email. Pada hari kedua, peserta juga telah berhasil mempraktikkan materi power point dengan membuat tulisan, membuat rancangan tampilan, mengatur animasi tampilan untuk presentasi.
Penguatan Karakteristik SDM dalam Implementasi Manajemen Berbasis Risiko di Lazis Muhammadiyah (LazisMu) Kabupaten Malang
Authors: Mudrifah Mudrifah , Wisyastuti Aviani
Published: May 2021

dihadapi Lazis Muhammadiyah (LazisMu) kabupaten Malang. Pertama, risiko reputasi dan kehilangan muzakki. Kedua, risiko penyaluran, ketiga risiko operasional, dan yang ke empat adalah risiko transfer zakat antar negara. Solusi yang diberikan dengan cara melakukan pelatihan dan pendampingan penguatan karakter SDM (kemampuan, nilai, sikap, minat, dan religiusitas) dalam penerapan manajemen berbasis risiko, karena tidak dapat dipungkiri bahwa SDM memegang peranan penting dalam suatu organisasi. Metode pelaksanaan pengabdian masyarakat berbasis IPTEKS ini dilakukan melalui penyelenggaraan pelatihan praktis dan aplikatif manajemen profesional untuk diterapkan pada LazisMu Kabupaten Malang meliputi pengelolaan SDM yang disajikan dalam bentuk pelatihan, ceramah, praktek lapangan/ teknis dan diskusi. Target luaran yang dihasilkan dari kegiatan pengabdian masyarakat ini adalah meningkatnya pengetahuan dasar tentang pentingnya penerapan manajemen berbasis risiko, meningkatnya keterampilan (skills) yang meliputi nilai, kemampuan, sikap,  minat dan religiusitas SDM dalam menerapkan manajemen berbasis risiko di LazisMu Kabupaten Malang. Mitigasi risiko juga dilakukan berupa evaluasi penerapan manajemen berbasis risiko serta model manajemen berbasis risiko yang sesuai dengan kebutuhan LazisMu Kabupaten Malang.
Pengaruh partisipasi anggaran, kompensasi finansial dan kompensasi nonfinansial terhadap kinerja karyawan PT. Budi Berlian Motors di Lampung
Authors:   Fakultas Ekonomi dan Bisnis, Universitas Lampung, Bandar Lampung, Gybona Manik Adelin , Andi Kiagus ,   Fakultas Ekonomi dan Bisnis, Universitas Lampung, Bandar Lampung, Kusumawardani Niken ,   Fakultas Ekonomi dan Bisnis, Universitas Lampung, Bandar Lampung
Published: May 2021

Abstract Purpose: This study aimed to provide empirical evidence regarding the effect of budget participation, financial compensation and non-financial compensation on the performance of employees of PT. Budi Berlian Motors in Lampung. Research methodology: The population in this study were all employees of PT. Budi Berlian Motors in Lampung, with a sample of 100 respondents. The methods of data analysis were multiple regression with the F test and T-test as a hypothesis test. Results: This study shows empirical evidence that budget participation does not have a positive and significant effect on employee performance, while financial compensation and non-financial compensation have a positive and significant effect on employee performance. Limitations: The results of the questionnaire are based on the respondents' responses to the questions in the questionnaire presented so that the answers generated may not necessarily correspond to actual conditions that occur in the company. Contribution: This study can provide information about the effect of budgetary participation, financial compensation and non-financial compensation on the performance of employees of PT. Budi Berlian in Lampung.
Intrathecal Bleed Following Percutaneous Spinal Cord Stimulator
Trial Lead Placement
Authors: Nobles Ryan
Published: May 2021

An intrathecal bleed is an exceedingly rare, yet
potentially devastating consequence of accessing
the epidural space for lead placement during a
spinal cord stimulator trial. We present a case of
radiologic evidence of intrathecal blood products
and the neurologic consequences thereof following
a percutaneous spinal cord stimulator trial.
A 34-year-old man with a primary diagnosis
of failed back surgery syndrome underwent
percutaneous spinal cord stimulator lead placement.
During the trial, the patient experienced
paresthesia with initial right-side lead placement
at T12-L1. The lead and needle were removed
and placed at L1-2 where the patient did not
report any problems. The patient reported right
calf pain in the postanesthesia care unit following
the trial that improved with intravenous
hydromorphone. However, following discharge
the patient experienced worsening dysesthesia
with edema of the right lower extremity to the calf.
Magnetic resonance imaging of the lumbar spine
confirmed the presence of blood products within
the intrathecal space.
Spinal cord stimulator placement may be viewed
as a safe and effective treatment modality despite
the incidence of several neurologic, mechanical,
and biologic complications. A few case reports
discuss the occurrence of spinal epidural hematoma
formation but none present a case of an
intrathecal bleed following percutaneous spinal
cord stimulator lead placement. This case report
highlights the need to further elucidate the incidence
of neurologic sequelae after spinal cord
stimulator placement.
Key words: Spinal cord stimulation, antiplatelets,
anticoagulation, intrathecal bleed, complications,
failed back surgery syndrome
Skin Burn after Sacroiliac Denervation: An Unusual but Significant
Complication
Authors: Trescot Andrea
Published: May 2021

Radiofrequency (RF) lesioning, developed in
1965, has been very useful in pain medicine,
providing long-term relief for many chronic pain
problems by denervating the regions involved in
the generation of pain. The technique involves
the use of a probe placed into the targeted tissue
to be ablated. An electrical current is then
passed from the machine to the tip of the probe,
ionically heating up the tissues, which destroys
the nerve tissue. The circuit is completed when
the electrons are collected by a distal dispersing
electrode that carries the current back to the
generator. The potential sites for RF lesioning
are expanding, and this has led to an expansion
of the use of RF in a variety of medical fields,
including cardiology, gastroenterology, otolaryngology,
neurosurgery, and pain medicine. The
size of the probes is increasing as well, as is the
length of time used in lesioning, which increases
the power and therefore the electrical field generated
by the ablating system. By the nature of the
electrical field created, the RF technique creates
a risk of superficial (and potentially deep) burns
at the dispersive electrode. This small but significant
risk of burns has been reported after cardiac
and gastrointestinal ablation, but has not been
emphasized to practicing pain physicians. We
present here the case report of a significant burn
at the dispersive electrode site after a denervation
procedure of the sacroiliac joint. We describe
the mechanism of injury and propose potential
methods of prevention.
Key words: Radiofrequency lesioning, sacroiliac
denervation, complications, sacroiliac joint treatment
Pharmacologic Pain Treatment for Adiposis Dolorosa: A Case Report
Authors: Patel Ankur
Published: May 2021

Dercum’s disease, also known as adiposis
dolorosa, is a rare pain syndrome caused by
one or more painful lipomas. We present an
educational case of Dercum’s disease resulting
in debilitating pain. An 80-year-old male developed
multiple painful lipomas within a span of 24
months. The patient underwent surgical excision
of the larger lipomas on the anterior thorax and
thoracolumbar region, but continued to complain
of diffuse pain. The pain at the post-resection
sites was consistent with nociceptive-related
pain from acute surgical intervention, but he also
continued to complain of burning, neuropathiclike
pain in the surrounding areas of the lipomas.
The patient received minimal benefits from
nonsteroidal anti-inflammatory drugs (NSAIDs)
and adjuvant therapy, including neuromodulating
agents. The patient was started on progressively
larger doses of oral opioids which resulted in
no relief. The medical regimen was changed to
transdermal fentanyl and monitored closely by the
pain management physician. Fentanyl was used
to capitalize on the highly lipophilic nature of this
medication, which was hypothesized to address
the fatty tumor-related pain. The patient reported
pain reduction of more than 50% and thus was
able to continue activities of daily living with an
improved quality of life.
Key words: Adiposis dolorosa, Dercum’s disease,
lipoma, lipophilic, opioid, pain management
Subcutaneous Botulinum Toxin Injections for the Treatment of
Chronically Painful Post-Craniotomy Scars: A Case Report of Two
Patients Treated Successfully for More Than Eight Years
Authors: Dykstra Dennis
Published: May 2021

Recently, the use of botulinum toxin type A
(BoNT-A) has been reported to help with neuropathic
pain reduction in numerous conditions,
including painful chronic scar formation. The
mechanism by which BoNT-A inhibits pain is
unclear, but it appears to involve a reduction of
peripheral pain sensitization, which indirectly
reduces central pain sensitization. Two patients
who underwent surgery for brain tumor resection
developed chronic painful neuropathic postcraniotomy
scars. Their scar pain was not relieved
with oral pain medications or trigger point injections
with steroids but was helped significantly
with BoNT-A injections. In the first patient, over
the past 8 years, we have gradually increased
her scar BoNT-A dose to 150 units diluted 2:1
with normal saline (NS) and injected the dose at
20 sites around her scar. She now reports her
scar pain is 80%-90% resolved with the effect
lasting 10 to 11 weeks. She denies side effects
at this dose. In the second patient, over 9 years,
we gradually increased the BoNT-A dose to 175
units diluted 2:1 with NS at 30 sites around her
scar and in the left occipital area. She now notes
her scar pain is 70%-75% improved from baseline
with the effect lasting 8 to 10 weeks followed by a
gradual reduction in benefit. She reports no side
effects with this dose. The results of this 2-patient
case study suggests BoNT-A (specifically onabotulinumtoxinA)
may be helpful for patients with
chronic postcraniotomy scar pain. Further studies
on the dose, injection sites and timing follow-up
injections are needed to determine treatment effectiveness
for this patient population.
Key words: Scar pain, Botulinum toxin, chronic
pain, subcutaneous, injections, post-craniotomy
The Role of Platelet Rich Plasma in the Treatment Algorithm of
Knee Osteoarthritis
Authors: Chang Chien George
Published: May 2021

Osteoarthritis (OA) is a progressive joint disease
associated with both mechanical and biologic
abnormalities of the articular cartilage and subchondral
bone. In normal cartilage, a delicate
balance exists between matrix synthesis and
degradation; in OA, however, cartilage degradation
exceeds synthesis. Treatment modalities
include nonpharmacological, pharmacological,
and surgical approaches. Intrarticular platelet
rich plasma (PRP) has emerged as promising
treatment for early stages of knee OA.
PRP is an autologous blood product defined as
a volume of plasma that has a supraphysiologic
platelet count. PRP can accelerate the physiological
recovery process, relieve pain, and contains
anti-inflammatory and anti-bacterial activity.
Although the mechanisms for these complex
interactions are not completely understood, they
are attributed to the more than 30 bioactive proteins
contained in the alpha granules of platelets
including growth factors and proteins, such as
fibrin, fibronectin, vitronectin and thrombospondin.
Several studies now have demonstrated that
intraarticular PRP injections are safe and effective
treatment to reduce pain and improve quality of
life through increased function in knee OA.
The available literature suggests that PRP is a
better option than hyaluronic acid for many knee
OA patients. We identified 12 comparative studies
that demonstrated superiority of PRP as compared
to hyaluronic acid for knee OA. Considering what
is known about the deleterious effects of local anesthetic
and corticosteroids on soft tissue health,
it may be time for a shift in the knee OA treatment
algorithm to favor early intervention for regenerative
therapies including platelet rich plasma.
Key words: Platelet rich plasma, hyaluronic acid,
knee pain, knee osteoarthritis, arthritis, chondrotoxicity
A Challenging Case of Ganglion Impar Block in a Patient with
Coccygeal Deformity and Rectal Resection from Metastatic Rectal
Cancer
Authors: Wong Kevin
Published: May 2021

The ganglion impar is a solitary retroperitoneal
structure that marks the termination of paravertebral
sympathetic chains in the presacral space
and receives nociceptive inputs from pelvic
organs. Chronic perineal pain (CPP) in patients
with advanced cancer can be very debilitating.
Ganglion impar block can ameliorate CPP and
hence, improve quality of life.
Here, we describe the case of a 65-year-old
woman with a deformed coccyx caused by childhood
trauma and rectal resection from rectal
cancer who presented with CPP that substantially
affected her quality of life. She was unable to
tolerate the side effects of World Health Organization
Step 3 analgesics. The patient underwent
ganglion impar block that was challenging due to
anatomical abnormalities. There was significant
immediate and long-term improvement in quality
of life and disease coping in our patient after the
ganglion impar block. She was able to restore
physical activity, decrease the need for potent
opioids, and improve sleep quality.
We conclude that a ganglion impar block can
effectively treat CPP, and in palliative settings,
neurolytic ablation can be considered. It is often
challenging in patients with cancer due to anatomical
abnormalities. Further studies are needed
in patients with cancer who have CPP given the
suggestion of a better quality of life after ganglion
impar block.
Key words: Ganglion impar, chronic perineal
pain, quality of life, cancer pain, coccyx
Endoscopic Pulsed Radiofrequency Ablation of Genicular Nerves
for the Treatment of Chronic Knee Pain
Authors: Patel Dipan
Published: May 2021

Chronic knee pain is the second most common
cause of chronic pain in the United States.
Occasionally, patients become refractory to
conventional treatments such as intraarticular
cortisone injections and viscosupplementation.
Patients who have exhausted these therapies or
have a contraindication to the therapies may be
candidates for diagnostic genicular nerve block
and if successful, subsequent radiofrequency
ablation (RFA).
For patients who have undergone image-guided
genicular nerve radiofrequency ablation with fluoroscopic
or ultrasound guidance without success,
an endoscopic approach can be used as an alternative
modality with success. With direct visualization
of the genicular nerves, the likelihood of
success with an endoscopic approach increases
as some patients can have varying anatomy of
the genicular nerves for which cannot always be
detected with fluoroscopy or ultrasound.
The purpose of this study is to demonstrate the
utilization of a direct endoscopic approach for
genicular nerve RFA for patients with chronic
knee pain that have failed to improve after
image-guided genicular RFA with fluoroscopic
or ultrasound guidance.
Two patients who had underwent successful diagnostic
genicular nerve blocks were assessed for
pre-procedure and post-procedure visual analog
scale (VAS) scores following endoscopic genicular
nerve RFA after failure of the conventional image
guided approach at 6 and 12 months.
Both patients reported greater than 80% reduction
in VAS score and improvement in function at
6 and 12 months
Limitations of the current study is a limited number
of patients, and lack of the use of a formal
functional scale to demonstrate improvement.
Ultimately, the conclusion was drawn that an
endoscopically-guided genicular nerve RFA can
be utilized successfully due to direct visualization
of the genicular nerves when conventional approaches
with Fluoroscopic/ultrasound guidance
has failed to achieve analgesia and functional
improvement.
Key words: Genicular nerve block, endoscopic,
radiofrequency ablation. knee pain, chronic osteoarthritis,
genicular neuritis, genicular neuralgia,
total knee arthroplasty, arthritis
Epidural Anesthesia to Effectively Manage Pain and Facilitate
Rehabilitation in a Pediatric Case of Complex Regional Pain Syndrome
Authors: Tubic Goran
Published: May 2021

There is a paucity of information related to treatment
of pediatric CRPS. Treatment of CRPS
in pediatric patients has been guided by adult
recommendations, which consist of a multidisciplinary
approach involving pharmacotherapy,
physical therapy, and psychotherapy, as appropriate.
Patients unable to tolerate physical therapy
with traditional oral pharmacotherapy may require
more invasive pain management techniques
such as sympathetic blocks, epidural infusion of
analgesics, or spinal cord stimulation to facilitate
restoration of function.
This case report describes the successful use
of epidural infusion of fentanyl, clonidine, and
bupivacaine through a tunneled epidural lumbar
catheter for pain management in an 11-year-old
girl who developed complex regional pain syndrome
I (CRPS I) approximately 2 months after
sustaining an injury to her right knee. Following
short-lasting pain relief from 3 repeated blocks,
she underwent an implant of a tunneled epidural
catheter (TEC) and a 4-week infusion of fentanyl
(2 mcg/mL), clonidine (1 mcg/mL), and bupivacaine
(0.04%). At last follow-up, approximately
3.5 months after implant of the TEC, the patient’s
pain and symptoms were completely resolved,
her range of motion and function were completely
restored, and her physical activity had returned to
pre-injury levels.
Key words: Complex regional pain syndrome
(CRPS), tunneled epidural catheter, pediatric,
continuous regional anesthesia, epidural analgesia,
continuous epidural anesthesia, interventional
pain management
Intra-Operative Complic atio n of Lumbar Kyphoplasty Instrumentatio n
in Non-Osteoporotic Patients with Compression Fractures
Authors: Chen Calvin R.
Published: May 2021

Background: Vertebral augmentation is a
surgical procedure used to stabilize fractured
vertebrae and reduce pain in patients with compression
fractures. When intra-operative and
post-operative complications do occur, they can
have dire consequences. Some of the common
risks associated with kyphoplasty are worsening
of the fracture, infections, spinal cord compression,
etc. Typically, we do not consider the risk
of instrumentation failure.
Objectives: In 2 cases, we describe patients
who has undergone kyphoplasties with live
fluoroscopic guidance. Both procedures used
a unipedicular approach and the CareFusion
system (Becton Dickinson, Franklin Lakes, NJ).
The CareFusion AVAFlex curved augmentation
needle was used, and intra-operatively the
handle broke off at the neck making it difficult
to remove the cannula and curved needle. To
remove the system, an Arthrex Reamer (Arthrex
Inc., Naples, NY).was used with Chuck Key (Arthrex
Inc., Naples, NY).
Study Design: Case report.
Setting: Outpatient Interventional Pain Clinic.
Methods: The vertebral body was accessed with
an AVAFlex curved needle, a CareFusion AVAMax
vertebral balloon, and Cement injection with
polymethylmethacrylate, were used. The removal
of the AVAFlex cannula was attempted with a gripping
and pulling motion of the blue handle on the
cannula, which resulted in the handle breaking at
the most distal portion of the cannula. The cannula
was then removed using the Arthrex Reamer with
Chuck Key. The entire cannula was successfully
removed from the vertebral body after cement had
been delivered.
Results: The density of bone tissue in a traumatic
compression fracture of a nonosteoporotic individual
will be higher and less porous when placing
the needle and cannulas. Also, it is important to
have an understanding of the different instruments
that are available in the operative setting.
Limitations: Small sample size.
Conclusion: Instrumentation experience, understanding
how to handle instrument failures, bone
health of the patient, and the history of mechanism
for compression fracture should all be considered
when performing kyphoplasty.
Key words: Kyphoplasty, vertebroplasty, compression
fracture, instrumentation failure
Inadvertent Spinal Shock during an Intrathecal Drug Delivery System
Refill – A Case Report and Troubleshooting Algorithm
Authors: Chauhan Gaurav
Published: May 2021

Intrathecal drug delivery systems (IDDS) are
used to treat patients with chronic refractory
pain syndromes and spasticity. IDDS offer an
effective therapy to control pain while offering
the advantage of a decrease in the incidence
of side effects from high-dose systemic opioid
therapy. Serious outcomes including death
or permanent brain damage may occur from
medication administration errors, primarily during
maintenance of IDDS. The pump refill and reprogramming
procedures, although elemental in
theory, are not bereft of serious and fatal side effects
.The importance of understanding the IDDS
and competency in performing pump refills and
programming is of critical importance. To reduce
the risk of drug-related errors, particular attention
should be paid to the proper functioning of pump
hardware, drug reservoir volume discrepancies
and overdose symptoms reported by patients.
Furthermore, the clinician should be prepared for
drug errors and follow the risk mitigation flowchart
mentioned in the clinician refill reference card
provided by the IDDS manufacturer. We present
a case report of a 62-year old male with a history
of post-laminectomy syndrome, associated with
chronic back pain for the last 4 years. The patient
developed inadvertent total spinal shock during a
refill procedure of the IDDS reservoir. The educational
objective of this case report is to highlight
troubleshooting options, plus some of the risks
and complications that can occur when managing
an intrathecal pump delivery system. Clinicians
involved in the ongoing care of patients with IDDS
should undergo periodic competency validations.
Imaging modalities are useful adjuncts for intrathecal
pump refills when a patient has a more difficult
entry or previous complications at the time of refill.
A rapid recognition of evolving complications and
implementation of appropriate treatment are the
cornerstones of successfully managing complications
associated with refilling of IDDS.
Key words: Intrathecal drug delivery system,
drug refill, total spinal shock, seroma, catheter
port study, rotor study
Acute Epidural Hematoma Occurring After Removal of Percutaneous
Spinal Cord Stimulator Trial Leads in a Cancer Patient with Chronic
Thrombocytopenia: A Case Report
Authors: Gulati Amitabh
Published: May 2021

Background: While the possibility of spinal
epidural hematoma (SEH) has been considered
a complication of removal of spinal cord stimulator
(SCS) leads, acute hematoma has not been
described in the oncologic population.
Objectives: We describe concerns of neuraxial
procedures in cancer patients. This population
represents a unique subset of patients as thrombocytopenia,
as well as platelet dysfunction, are
common complications of cancer and chemotherapy.
The literature regarding the assessment
and management of thrombocytopenia in patients
undergoing neuraxial techniques is reviewed.
Study Design: Case report.
Setting: A major academic cancer hospital, Memorial
Sloan Kettering Cancer Center.
Methods: We report a case of acute SEH occurring
in a patient 5 minutes after removal of SCS
trial leads. The patient has a history of chronic
thrombocytopenia and lymphoma.
Results: Although the patient’s trial leads were
placed without incident and platelets were “corrected”
with transfusions, she presented with
acute back pain and headache. Computed tomography
(CT) imaging confirmed an epidural
hematoma, which clinically resolved and led to
no long-term sequelae.
Limitations: Retrospective design, no possibility
to establish a cause-effect relationship, and
subject to risk of over-interpretation.
Conclusions: We present a patient experiencing
symptoms of acute neuraxial bleeding immediately
following removal of SCS trial leads. The patient’s
chronic thrombocytopenia was attributed to
splenic sequestration, and therefore, was treated
with platelet transfusions. The patient, however,
had several risk factors for platelet dysfunction,
as well. The use of point-of-care platelet function
assays, such as platelet function analyzer and
viscoelastic methodologies, would have perhaps
helped to better elucidate the bleeding risk in this
patient and help guide management. The discovery
of platelet dysfunction would have precluded
our patient from neuromodulation.
Key words: Spinal cord stimulation, epidural
hematoma, removal of spinal cord stimulator
leads, dorsal column stimulation, acute epidural
hematoma
Declining Utilization of Percutaneous Epidural Adhesiolysis in
Medicare Population: Evidence-Based or Over-Regulated?
Authors: Manchikanti Laxmaiah
Published: May 2021

Background: Recent reviews have shown
a reversal of growth of utilization of a majority
of interventional techniques in the Medicare
population post passage of the Affordable Care
Act (ACA). Despite the presence of supportive
evidence, there has been a significant decline in
the utilization of percutaneous adhesiolysis. We
hypothesize that this is most likely attributable to
regulations governing interventional procedures
and coverage policies.
Study Design: Assessment of utilization characteristics
of percutaneous adhesiolysis procedures
in managing chronic low back and lower
extremity pain in fee-for-service (FFS) Medicare
population.
Objective: To assess the utilization patterns
of percutaneous adhesiolysis and correlation
between regulations and declining utilization
patterns.
Methods: FFS Medicare data from Centers for
Medicare and Medicaid Services (CMS) Physician/
Supplier Procedure Summary Master File
from 2000 to 2016 was utilized.
Results: From 2009 to 2016, there was a decline
of 53.2% with an annual decline of 10.3%,
whereas from 2000 to 2009, overall increase
was 62.6% with an annual increase of 6.5% per
100,000 Medicare population. The states controlled
by Noridian Medicare carrier have shown
a steep decline of 100% from 2009 to 2016 due to
a noncoverage policy issued by Noridian.
Limitations: This analysis has not included Medicare
Advantage Plans. However, an overwhelming
majority of Medicare Advantage Plans do not
cover adhesiolysis procedures.
Conclusion: Percutaneous adhesiolysis procedures
faced a steep decline in utilization from 2009
to 2016 of 53.2% and an annual decline of 10.3%
per 100,000 Medicare population. This is occurring
simultaneous to an increase in the evidence base.
Key words: Interventional techniques, chronic
low back pain, lower extremity pain, epidural injections,
percutaneous adhesiolysis, post-surgery
syndrome, spinal stenosis, neuroplasty
Obturator Nerve Block for Management of Chronic Pelvic Pain
Authors: Udoji Mercy A.
Published: May 2021

Every year, thousands of women undergo
surgeries to treat severe female pelvic organ
prolapse or stress urinary incontinence. Unfortunately,
chronic pelvic pain may result from these
surgical interventions, especially if mesh was
used. This case report describes the management
of 2 patients that presented at an outpatient
pain center with chronic pelvic pain secondary to
obturator neuralgia.
The first patient was a 45-year-old with history
of vaginal reconstruction surgery, who presented
to the pain clinic with severe pain in the medial
thigh radiating to the perineal area. This pain had
been present for months and persisted despite
use of oral opioids, neuropathic pain medications,
and topical agents. The patient had been seen
and evaluated by neurology and urogynecology
post operatively, but they could not ascertain the
cause of her chronic complaints. The second
patient was a 47-year-old with pain in the medial
thigh and left side of her groin after transobturator
sling procedure. Her pain was resistant to oral
neuropathic pain medications (gabapentin and
pregabalin) primarily due to the patient’s inability
to tolerate therapeutic doses of these medications.
She was referred to neurology and nerve conduction
studies was notable for decreased conduction
in the left obturator nerve.
Both patients chose to try ultrasound guided obturator
nerve blocks as a diagnostic and treatment
modality. After the injection, the patients endorsed
significant relief of their pain that persisted through
their 3 month follow-up appointments leading to
improved functionality in many aspects of their
daily lives.
In a clinical situation like the one described
above, the pain practitioner should more readily
consider use of these blocks in the outpatient
setting for pelvic pain patients whose symptoms
are suggestive of obturator neuralgia.
Key words: Chronic pelvic pain, obturator nerve
block, mesh pain, obturator neuralgia