bluuebunny/crossref_metadata_2025 huggingface dataset:
Fournier's Gangrene of Genitalia: Case Report
Authors: Salciccia P. , Poveromo G. , Salciccia S.
Published: June 2018

Fournier's gsngrene is a rare disease involving the scrotum and the penis with occasional extension up to the abdominal wall. The etiology of the disease, commonly without prodromal symptoms and with sudden onset, is still not fully understood. The organisms are usually streptococcus haemoliticus and/or anerobic bacteria.

We report a case of Fournier's gangrene, presenting septic shock. The patient was treated with reanimatory care, antibiotics, local excision and debridment. Speaking about anatomical and etiopathogenetic hypotheses, we discuss the diagnostic problems and the treatment of the disease. We emphasize the role of the early diagnosis.
Needle Colposuspension: Survey of Techniques and New Procedure Report
Authors: Mantovani F. , Castelnuovo C. , Paparella S. , Bozzini G.
Published: June 2018

To treat stress urinary incontinence plenty of techniques are today available. We present the results of a new, simple and cost free technique.

The finger of the surgeon in the vagina checks Cooper ligament and guides the needle to pass behind it. Then it reaches the vagina where it takes a double suture. The needle rises up with the suture just above the ligament and crossing it, returns with the double suture in the vagina. With a large triple knot a tension free suspension is obtained. The success rate of 75 % was reported. The procedure basis its effectiveness on the ability of the new structure made up around the sutures by a fibrosis, to create a tension free suspension of vagina to Cooper ligament.

This technique for the treatment of incontinence is reliable, simple and cheap and without controindications.
Leucocytospermia: Which Relationship with Male Infertility?
Authors: Polito M. , d'Anzeo G. , Giannubilo W. , Leone M. , Muzzonigro G.
Published: June 2018

Leucocytospermia is usually associated with genito-urinary tract infections and its role on male infertility is currently under debate. The aim of this study was to investigate the relationship between leucocytospermia and seminal fluid alterations in men with fertility problems. We evaluated 40 consecutive spemiograms of leucocystospermic men, and another 40 from individuals without leucocytospermia, with regard to age, number, motility and sperm morphology, and presence of genito-urinary tract infections. There was a significant difference in terms of motility (23.27% in non-leucocytospermic pts vs. 15.57% in leucocytospermic pts., p=0.0034). Furthermore, asthenozoospermia was more frequent in leucocytospermic pts (45% vs. 72.,%, p=0.0231), as also teratozoospermia (32.5% vs. 62.5%, p=0.0138). The probability to have at least one of the major seminal alterations was greater in leucocytospermic pts (75.3% vs. 52.5%, p=0.0048). The incidence of infections in leucocytospermic group was 13%. Our study underlines the relationship between leucocytospermia, motility, and normal morphology reduction in human semen. These data might suggest the presence of a damage due to the ROS produced by seminal leucocytes on spermatozoa. Our analysis wants to emphasize the need to treat this condition, with special regard to the frequent use of PMA procedures.
Retroperitoneal Leiomyoma. Transperitoneal Laparoscopic Surgery
Authors: Aresu L. , Amenta M. , Maritati F. , Occhipinti M. , Grosso G.
Published: June 2018

70-year-old woman with retroperitoneal mass lesion undergoing laparoscopic resection of the tumor.

The histological analysis revealed a leiomyoma, with positive immunostaging for estrogenic receptors.

The differential diagnosis is a key element: the pathologist should be able to recognize this type of lesion and to differentiate it from a retroperitoneal leiomyosarcoma.
Radicai Prostatectomy: Local Recurrence and Persistence of Disease. Is it Possible to Hypothesize any Responsibility of the Surgeon?
Authors: Zattoni Filiberto , Gigli Francesca
Published: June 2018

Radical prostatectomy (RP) represents the most frequently chosen therapeutic option for treating newly diagnosed localized prostate cancer. Cancer recurrence after surgery is linked to biologic variables. But are these the only ones that must be considered to give an explanation of a possible local or distal recurrence, or can it also admit the possibility that an incorrectly conducted surgery has a negative role in the unfavorable evolution after PR? Prostate cancer recurrence, as a matter of fact, is related also to surgical technique. The PR, by definition is a surgical, potentially complicated act. Surgery outcomes depend on a whole serires of factors: the surgeon's ability, and the way the surgical procedure is conducted, play an essential role. Here we evaluate the role of biological and surgical factors on biochemical recurrence.
Safety and Tolerability of Local Treatment with Iloprost in Patients with Peyronie's Disease. A Phase 1 Pilot Study and Proposal of a new Symptom Questionnaire
Authors: Pavone Carlo , Melloni Carlo , Oxenius Irina , Napoli Giancarlo , Usala Manuela , Abbadessa Daniela
Published: June 2018

Purpose

Intralesional therapy is a less invasive method for the treatment of Peyronie's disease. The objective of this study was to evaluate safety and tolerability of intralesional injections of lloprost (I2 Prostacyclin analogue) for its property to suppress in fibroblasts CTFG (Connective tissue growth factor) production, which acts in concert with TGF-β to stimulate the fibrotic process.

Methods

Nineteen patients with Peyronie's disease were preliminarily evaluated by considering the degree of penile curvature, plaque size and local and systemic symptoms. Each patient then received weekly intralesional injections of 200ng of lloprost in 1 ml of normal saline for 4–5 weeks. If tolerated, the single dose increased weekly to the maximum of 400 ng (2 mL).

Results

The treatment has shown that all patients seem to well tolerate a 200 ng lloprost dose; 7 of them reached a 300 ng dose and 6 tolerate a 400 ng dose without showing side effects. There was no placebo control group in this study. To evaluate the efficacy of the treatment, the absence of objective parameters (except for the auto-photograph of penis in erection) led us to develop a subjective questionnaire that was given to all patients to assess sexual function, pain reduction, ecc.

Conclusions

Due to the relatively small size of the sample, the efficacy evaluation has been restricted to check the questionnaire reliability. Iloprost is well tolerated to a dose of 400ng in the local treatment of Peyronie's disease.
Calcifilassi e Necrosi Peniena: Case Report e Revisione Della Letteratura
Authors: Grande M. , Facchini F. , Larosa M. , Leone M. , Pozzoli G. , Valli R. , Monica B.
Published: June 2018

Introduction

Calciphylaxis is a rare clinic condition characterised by skin necrosis due to medial and intimal calcification of small and medium arteries. It's observed in patients affected by end stage renal disease associated to secondary hyperparathiroidism. Penile involvement has been documented in very few cases. We present both a case of penile calciphylaxis and a review of literature, in order to increase comprehension of patophysiology diagnosis and therapy of this rare disease.

Materials and Methods

A retrospective review of literature was performed after treating a case of penile calciphylaxis. We describe patient characteristics, clinical presentation, laboratory and histopathologic findings, therapeutic strategy and outcomes of the case.

Results

A 65 year-old man, affected by diabetes, chronic ischemic cardiopathy and chronic renal failure in emodialithic treatment, was referred to our unit for the presence of increased consistency and significative pain of the distal portion of penis evolving in a complete glans necrosis. Blood levels of parathormone (PTH), calcium (Ca) and phosphorous (P) resulted pathologically elevated, promoting tissutal calcium deposition. The patient was treated with partial penectomy and the histologic findings confirm diagnosis of calciphylaxis, showing an ulcerative necrosis of glans with extensive calcium deposition and luminal narrowing of penile small arteries.

Conclusions

The increase of number of patients with chronic renal failure in emodialithic treatment could make penile calciphylaxis more p\revalent in the future. Early diagnosis, lowering of pathologic blood levels of Ca and P associated to surgical treatment of necrotic lesions of the patient could be fundamental for a better prognosis of this aggressive disease.
Diagnosis and Treatment of Octogenarian Neoplastic Patients: Bladder Cancers
Authors: Destefanis Paolo , Bisconti Alessandro , Lasaponara Fedele , Fontana Dario
Published: June 2018

Age is a risk factor for the occurrence of bladder cancer and bladder cancer is a disease of the elderly. The choice of treatment relays on the staging into non-invasive and muscle-invasive bladder cancer. Non-invasive bladder cancer is usually treated with transurethral resection of the bladder (TURB) followed by intravesical therapy with BCG or chemotherapeutic agents. The gold standard in the treatment of muscle-invasive bladder cancer is radical cystectomy.

The elderly and, in particular, the octogenarian have a worse tolerance for aggressive therapies, due to the higher incidence of side effects and complications. This problem could significantly occur for intravesical BCG therapy and for radical cystectomy.

When the urologist faces the treatment of an octogenarian affected by bladder cancer, he should answer many questions: 1. In case of a non-invasive bladder cancer, is it possible to use the same drugs that we use for younger patients (BCG vs chemotherapeutic agents)? Should the timing and the kind of follow-up be the same? 2. Should the octogenarian affected by muscle-invasive bladder cancer undergo radical cystectomy or a less invasive treatment? What kind of diversion should be preferred? Is it possible to propose an orthotopic neobladder to an octogenarian patient?

The choice of the treatment should be made on the basis of a careful evaluation of the patient, considering not only the patient's age but also comorbidities and life expectancy.
Healing of spongiosus-cutaneous fistula with Hyperbaric Oxygen Therapy (HBOT): a case report
Authors: Della Camera Pier A. , Cito Gianmartin , Morselli Simone , Sessa Francesco , Facchiano Davide , Cocci Andrea , Gacci Mauro , Serni Sergio , Carini Marco , Natali Alessandro
Published: June 2018

Introduction:

We present a case of a spongiosus-cutaneous fistula in a 39-year-old man with recurrent episodes of cutaneous abscess in dorsal middle third penis (5 × 3 cm) treated with Hyperbaric Oxygen Therapy (HBOT).

Case report:

After emptying nodular abscess, the patient was noncompliant for further surgery. Therefore, it was suggested the association between HBOT and antibiotic therapy. HBOT is carried out in a hyperbaric room, where the internal pressure is increased (compression phase) by entering compressed air up to 283.71 kPa in about 10 minutes. Every HBOT cycle lasted 24 days in which the patient had been taking Amoxicillin/Clavulanic Acid 875 mg/125 mg 3 tabs/day and Sulfamethoxazole/Trimethoprim 160 mg/800 mg 2 tabs/day for 2 weeks. At the end of the treatment, a penile magnetic resonance imaging and an ultrasonography were executed and they evidenced a complete remission of the lesion. In the subsequent 22 months, there was no recurrence.

Conclusions:

Our results suggest that HBOT is an effective treatment for chronic wounds, including a spongiosus-cutaneous fistula of unknown cause, when used in combination with conventional standard therapy or further interventions. At present time, the gold standard remains surgery; nevertheless, our experience with HBOT may stimulate its use in clinical trials.
Career Development of Lower Social Class Adolescents in South Korea
Authors: Hwang Mae Hyang , Lee Jihye , Jung Ae-Kyung
Published: June 2018

Despite increased efforts and a broadened understanding of social class and its impact on career development, the career development of lower social class adolescents and its interaction with sociocontextual factors remain understudied. The current study explored the educational and career experiences of South Korean high school seniors using a qualitative approach and the gender and social class career development model. Our sample included 14 lower class high school seniors who were preparing for different career paths after graduation. The data were collected at three time points, through two semistructured interviews, documents, and brief phone-call surveys. An inductive thematic analysis of 28 semistructured interviews and documentations revealed three domains with seven themes. The results demonstrated an influence of lower social class on adolescents’ socialization, access to resources, affectional and academic barriers, and academic and career attainment. The implications of the results for career counseling, interventions, policies, and future research are discussed.
Paying for Free Delivery: Dependent Self-Employment as a Measure of Precarity in Parcel Delivery
Authors: Moore Sian , Newsome Kirsty
Published: June 2018

This article explores supply chain pressures in parcel delivery and how the drive to contain costs to ‘preserve value in motion’, including the costs of failed delivery, underpins contractual differentiation. It focuses on owner-drivers and home couriers paid by delivery. It considers precarity through the lens of the labour process, while locating it within the supply chain, political economy and ‘instituted economic process’ that define it. Focus on the labour process shows how ‘self-employment’ is used to remove so-called ‘unproductive’ time from the remit of paid labour. Using Smith’s concept of double indeterminacy the article captures the dynamic relationship between those on standard and non-standard contracts and interdependency of effort power and mobility power. It exposes the apparent mobility and autonomy of dependent self-employed drivers while suggesting that their presence, alongside the increased use of technology, reconfigures the work-effort bargain across contractual status.
Secular risk governance and the Turkish military’s battle with political Islam, 1980s–2000s
Authors: Arik Hülya
Published: June 2018

Prior to its currently subservient position to civilian politics, the Turkish military had always had an autonomous position with a strong ideological commitment to safeguard secularism. From the 1980s to the end of the 2000s, the Turkish military played a key role in the construction of political Islam as a form of risk and in the securitization of religion both in the public sphere and within its own structure. This article examines the Turkish military’s security discourse around religion and the Islamic headscarf through the experiences of women in military families, and is based on ethnographic fieldwork conducted in 2011. Looking at headscarf regulations and the everyday life on military bases, it explores how the military governed Islamism as a form of risk in culturally and sexually specific ways. Drawing on critical security studies that approach risk as a form of social governance, the article examines secular risk governance through the lived experiences of women in military families, the regulation of their daily conduct, and the representation of their bodies and sexual identities through dress. Concluding remarks examine the significance of secular risk governance in the post-2010 era.
Prevalence of Asymptomatic Achilles Tendinosis
Authors: Noback Peter C. , Freibott Christina E. , Tantigate Direk , Jang Eugene , Greisberg Justin K. , Wong Tony , Vosseller J. Turner
Published: June 2018

Background:

Most patients who sustain Achilles tendon ruptures (ATRs) have no clinical symptoms prior to ATR. The objective of this study was to define the prevalence of ultrasound-detectable Achilles tendinopathy in asymptomatic patients in an at-risk group.

Methods:

This was a cross-sectional study that collected data from a group of volunteers. All participants were given IPAQ questionnaires to gauge daily activity level, in addition to a demographic form. Participants underwent a physical examination, Silfverskiold test, and an ultrasonographic examination to evaluate for presence of Achilles tendinopathy. Fifty-one volunteers (30 female, 21 male) and 102 Achilles tendons were assessed in this study. The mean age was 27.4±6.3, with an average BMI of 23.5±3.9. Ninety-two percent of participants were categorized as having moderate or high activity levels per the iPAQ questionnaire.

Results:

Sixteen tendons had at least 1 abnormality: 10 (9.8%) had hypoechoic foci, 9 (8.8%) had calcifications, 1 (0.9%) had increased vascularity, and 1 (0.9%) had a low-grade interstitial tear. Approximately 40% of patients were noted to have a gastroc equinus contracture on Silfverskiold testing. In addition, 14.7% of patients with a gastroc equinus had a hypoechoic focus compared to 8.6% of patients without gastroc equinus ( P = .5003). Logistic regression analysis demonstrated that an increased BMI was a significant risk factor for having an Achilles tendon abnormality on ultrasonography ( P < .01, odds ratio = 1.41).

Conclusion:

In this study, 16% of the Achilles tendons were abnormal and had at least 1 abnormality on ultrasonography. This group of patients was generally young, healthy, and active, thus a group at risk for ATRs. Only 40% of patients had gastrocnemius equinus, although a slightly higher non-significant percentage of those with hypoechoic foci had gastrocnemius equinus. It may be advantageous to prophylactically treat these patients with rehabilitation exercises to minimize the risk of ATR.

Level of Evidence:

Level II, comparative prognostic study.
Effectiveness of interventions involving nurses in secondary stroke prevention: A systematic review and meta-analysis
Authors: Parappilly Beena P , Field Thalia S , Mortenson William B , Sakakibara Brodie M , Eng Janice J
Published: June 2018

Background and purpose:

Among members of the health care team, nurses play a large role in actively engaging stroke survivors in secondary stroke prevention programs. This systematic review and meta-analysis examines the effectiveness of interventions in which nurses have a primary role on modification of risk factors among stroke survivors.

Methods:

We systematically searched for randomized controlled trials in relevant databases investigating the role of nurses in secondary stroke prevention. Meta-analyses were conducted using Cochrane Review Manager Software. The mean pooled effect size, a 95% confidence interval (CI), and I-squared ( I2) for heterogeneity were calculated.

Results:

Sixteen randomized controlled trials were included with a total of 3568 stroke and transient ischemic attack patients. After removing one outlier, the models demonstrated a statistically significant effect on reducing systolic blood pressure (SMD = −0.14 (95% CI = −0.23, –0.05), I2 = 0%; p = 0.002, six studies, n =1885) and diastolic blood pressure (SMD = −0.16 (95% CI = −0.27, –0.05), I2 = 0%; p = 0.003, four studies, n =1316). The interventions also significantly improved physical activity (five studies, n=1234), diet (three studies, n=425), medication adherence (two studies, n=270), and knowledge of risk factors (three studies, n=516). However, there was no effect on smoking cessation or reduction in use of alcohol.

Conclusion:

We found that interventions in which nurses had a primary role were effective on improving medical and behavioral risk factors, as well as knowledge of risk factors as part of secondary prevention of stroke.
Feasibility of Endovascular Catheter Biopsy as a Diagnostic Modality for Patients With Pulmonary Artery Sarcoma: Case Series of a Single-Center Experience
Authors: Kwon Byoung Soo , Park Ji Hyun , Gwon Dong Il , Lee Jae Seung
Published: June 2018

Pulmonary artery sarcoma (PAS) is a rare but lethal malignant neoplasm that often mimics pulmonary artery embolism. However, owing to its rarity as well as fatality, there has been no firm consensus with regard to the standard diagnostic tool. We evaluate the feasibility of endovascular catheter biopsy as a diagnostic modality for PAS. We retrospectively reviewed the medical records of patients with histologically confirmed PAS between 2000 and 2016 at Asan Medical Center. Among a total of 25 patients with PAS, 5 patients underwent endovascular catheter biopsy and 3 of them were successfully diagnosed with PAS, while 2 patients underwent either endobronchial ultrasonography–transbronchial needle aspiration or surgical biopsy after failure of endovascular biopsy. There were no acute or fatal complications of endovascular catheter biopsy such as bleeding or pulmonary infarction. In conclusion, we suggest the endovascular catheter biopsy is an effective and safe diagnostic tool for patients with PAS, when clinically indicated.
Equivalence Testing for Psychological Research: A Tutorial
Authors: Lakens Daniël , Scheel Anne M. , Isager Peder M.
Published: June 2018

Psychologists must be able to test both for the presence of an effect and for the absence of an effect. In addition to testing against zero, researchers can use the two one-sided tests (TOST) procedure to test for equivalence and reject the presence of a smallest effect size of interest (SESOI). The TOST procedure can be used to determine if an observed effect is surprisingly small, given that a true effect at least as extreme as the SESOI exists. We explain a range of approaches to determine the SESOI in psychological science and provide detailed examples of how equivalence tests should be performed and reported. Equivalence tests are an important extension of the statistical tools psychologists currently use and enable researchers to falsify predictions about the presence, and declare the absence, of meaningful effects.
Whole genome sequence revealed the fine transmission map of carbapenem-resistant Klebsiella pneumonia isolates within a nosocomial outbreak
Authors: Sui Wenjun , Zhou Haijian , Du Pengcheng , Wang Lijun , Qin Tian , Wang Mei , Ren Hongyu , Huang Yanfei , Hou Jing , Chen Chen , Lu Xinxin
Published: June 2018

Background

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of nosocomial infections worldwide. The transmission route of CRKP isolates within an outbreak is rarely described. This study aimed to reveal the molecular characteristics and transmission route of CRKP isolates within an outbreak of nosocomial infection.

Methods

Collecting case information, active screening and targeted environmental monitoring were carried out. The antibiotic susceptibility, drug-resistant genes, molecular subtype and whole genome sequence of CRKP strains were analyzed.

Results

Between October and December 2011, 26 CRKP isolates were collected from eight patients in a surgical intensive care unit and subsequent transfer wards of Beijing Tongren hospital, China. All 26 isolates harbored blaKPC-2, blaSHV-1, and blaCTX-M-15 genes, had the same or similar pulsed-field gel electrophoresis patterns, and belonged to the sequence type 11 (ST11) clone. By comprehensive consideration of genomic and epidemiological information, a putative transmission map was constructed, including identifying one case as an independent event distinct from the other seven cases, and revealing two transmissions starting from the same case.

Conclusions

This study provided the first report confirming an outbreak caused by K. pneumoniae ST11 clone co-harboring the blaKPC-2, blaCTX-M-15, and blaSHV-1 genes, and suggested that comprehensive consideration of genomic and epidemiological data can yield a fine transmission map of an outbreak and facilitate the control of nosocomial transmission.
Mood Disorders
Authors: Rakofsky Jeffrey , Rapaport Mark
Published: June 2018

PURPOSE OF REVIEW

This article discusses the prevalence of the major mood disorders (major depressive disorder and bipolar disorder) in the community and within neurologic settings, articulates the steps taken to make a diagnosis of major depressive disorder or bipolar disorder, and reviews old and newer treatment options with proven efficacy for the treatment of these two conditions.

RECENT FINDINGS

New medications are available as treatment options for major depressive disorder and bipolar disorder, such as intranasal and IV ketamine, and somatic treatments, such as deep brain stimulation and vagal nerve stimulators, are being used to target treatment-resistant depression.

Mood disorders are common in neurologic settings. They are disabling and increase morbidity and mortality. Clinicians should have a high index of suspicion if they suspect their patients seem more distressed or incapacitated than would be warranted by their neurologic disorders. If a patient does have a mood disorder, validating the patient’s experience, initiating treatment, and, if necessary, referring the patient to a primary care physician or psychiatrist are appropriate steps.
Risks and Benefits of Ultrasound, Nerve Stimulation, and Their Combination for Guiding Peripheral Nerve Blocks: A Retrospective Registry Analysis
Authors: Bomberg Hagen , Wetjen Laura , Wagenpfeil Stefan , Schöpe Jakob , Kessler Paul , Wulf Hinnerk , Wiesmann Thomas , Standl Thomas , Gottschalk André , Döffert Jens , Hering Werner , Birnbaum Jürgen , Kutter Bernd , Winckelmann Jörg , Liebl-Biereige Simone , Meissner Winfried , Vicent Oliver , Koch Thea , Bürkle Hartmut , Sessler Daniel I. , Volk Thomas
Published: June 2018

BACKGROUND:

Ultrasound, nerve stimulation, and their combination are all considered acceptable ways to guide peripheral nerve blocks. Which approach is most effective and associated with the fewest complications is unknown. We therefore used a large registry to analyze whether there are differences in vascular punctures, multiple skin punctures, and unintended paresthesia.

METHODS:

Twenty-six thousand seven hundred and thirty-three cases were extracted from the 25-center German Network for Regional Anesthesia registry between 2007 and 2016 and grouped into ultrasound-guided puncture (n = 10,380), ultrasound combined with nerve stimulation (n=8173), and nerve stimulation alone (n = 8180). The primary outcomes of vascular puncture, multiple skin punctures, and unintended paresthesia during insertion were compared with conditional logistic regression after 1:1:1 propensity score matching. Results are presented as odds ratios and 95% CIs.

RESULTS:

Propensity matching successfully paired 2508 patients with ultrasound alone (24% of 10,380 patients), 2508 patients with a combination of ultrasound/nerve stimulation (31% of 8173 patients), and 2508 patients with nerve stimulation alone (31% of 8180 patients). After matching, no variable was imbalanced (standardized differences <0.1). Compared with ultrasound guidance alone, the odds of multiple skin punctures (2.2 [1.7–2.8]; P < .001) and vascular puncture (2.7 [1.6–4.5]; P < .001) were higher with nerve stimulation alone, and the odds for unintended paresthesia were lower with nerve stimulation alone (0.3 [0.1–0.7]; P = .03). The combined use of ultrasound/nerve stimulation showed higher odds of multiple skin punctures (1.5 [1.2–1.9]; P = .001) and lower odds of unintended paresthesia (0.4 [0.2–0.8]; P = .007) compared with ultrasound alone. Comparing the combined use of ultrasound/nerve stimulation with ultrasound alone, the odds for vascular puncture (1.3 [0.7–2.2]; P = .4) did not differ significantly. Systemic toxicity of local anesthetics was not observed in any patient with ultrasound guidance alone, in 1 patient with the combined use of ultrasound and nerve stimulation, and in 1 patient with nerve stimulation alone.

CONCLUSIONS:

Use of ultrasound alone reduced the odds of vascular and multiple skin punctures. However, the sole use of ultrasound increases the odds of paresthesia.
Race/Ethnicity and Sex and Opioid Administration in the Emergency Room
Authors: Rosenbloom Julia M. , Burns Sara M. , Kim Eugene , August David A. , Ortiz Vilma E. , Houle Timothy T.
Published: June 2018

BACKGROUND:

Although racial/ethnic and sex disparities have been examined in health care generally and pain management more specifically, the combined influence of these sociodemographic factors together has not been well documented. The aim of this study was to examine the association between administration of opioid analgesics in the emergency department (ED) and interaction of race/ethnicity and sex.

METHODS:

We conducted a retrospective cohort study using 2010–2014 Center for Disease Control-National Hospital Ambulatory Medical Care Survey data for patients 12–55 years of age presenting to EDs with a primary diagnosis of appendicitis or gallbladder disease as defined by International Classification of Diseases, Ninth Revision codes. The primary outcome was the receipt of opioid analgesic medications. Secondary outcomes included: receipt of nonopioids, receipt of antiemetic medications, wait time to see a provider, and length of visit in the ED. The association between sex and analgesic receipt within Caucasian non-Hispanic and non-Caucasian groups was evaluated adjusting for pain score on presentation, patient age, emergent status, number of comorbidities, time of visit (month, day of the week, standard versus nonstandard working hours, year), and US region.

RESULTS:

After exclusions, a weighted sample of 553 ED visits was identified, representing 2,622,926 unique visits. The sample population was comprised of 1,858,035 (70.8%) females and 1,535,794 (58.6%) Caucasian non-Hispanics. No interaction was found in adjusted sampling-weighted model between sex and race/ethnicity on the odds of receiving opioids (P = .74). There was no difference in opioid administration to males as compared to females (odds ratio [OR] = 0.96, 95% CI, 0.87–1.06; P = .42) or to non-Caucasians as compared to Caucasians (OR = 0.99, 95% CI, 0.89–1.10; P = .84). In adjusted weighted models, non-Caucasian males, 123,121/239,457 (51.4%) did not differ from Caucasian non-Hispanic males, 317,427/525,434 (60.4%), on odds of receiving opioids, aOR = 0.88, 95% CI, 0.39–1.99; P = .75. Non-Caucasian females, 547,709/847,675 (64.6%) also did not differ from Caucasian females, 621,638/1,010,360 (61.5%), on odds of receiving opioids, aOR = 1.01, 95% CI, 0.53–1.90; P = .98. Across both sexes, non-Caucasians did not differ from Caucasians on receipt of nonopioid analgesics or antiemetics. Neither wait time to see a provider nor the length of the hospital visit was significantly different between sexes or race/ethnicities.

CONCLUSIONS:

Based on National Hospital Ambulatory Medical Care Survey data from 2010 to 2014, there is no statistically significant interaction between race/ethnicity and sex for administration of opioid analgesia to people presenting to the ED with appendicitis or gallbladder disease. These results suggest that the joint effect of patient race/ethnicity and sex may not manifest in disparities in opioid management.
Inhibition of Fatty Acid Amide Hydrolase Improves Depressive-Like Behaviors Independent of Its Peripheral Antinociceptive Effects in a Rat Model of Neuropathic Pain
Authors: Jiang Hai-xia , Ke Bo-wen , Liu Jin , Ma Gang , Hai Ke-rong , Gong De-ying , Yang Zheng , Zhou Cheng
Published: June 2018

BACKGROUND:

Neuropathic pain is often associated with depression. Enhancing endocannabinoids by fatty acid amide hydrolase (FAAH) inhibitors relieves neuropathic pain and stress-induced depressive-like behaviors in animal models. However, it is unclear whether FAAH inhibitor can relieve neuropathic pain–induced depression by or not by its antinociceptive effects.

METHODS:

Adult male Wistar rats with chronic constriction injury (CCI) to the sciatic nerve were treated with the systemic FAAH inhibitor URB597 (5.8 mg·kg−1·day−1, intraperitoneally) or peripherally acting FAAH inhibitor URB937 (1.6 mg·kg−1·d−1, intraperitoneally; n = 11–12). The treatment was applied from the 15th day after surgery and continued for 15 days. Mechanical withdrawal threshold was examined by Von Frey test before surgery and on the 28th day after CCI. Depressive-like behaviors were evaluated by forced swimming test (FST) and novelty-suppressed feeding (NSF) after 15-day treatment. The levels of anandamide and 2-arachidonoylglycerol in hippocampus were examined by liquid chromatography and mass spectrometry. Hippocampal neurogenesis including proliferation, differentiation, and survival of newborn cells was assessed by immunohistochemistry.

RESULTS:

After CCI injury, the rats developed significantly nociceptive and depressive-like behaviors, indicated by persistent mechanical hypersensitivity in Von Frey test, significantly prolonged immobility time in FST (sham: 84.2 ± 13.4 seconds versus CCI: 137.9 ± 18.8 seconds; P < .001), and protracted latency to feed in NSF (sham: 133.4 ± 19.4 seconds versus CCI: 234.9 ± 33.5 seconds; P < .001). For the CCI rats receiving treatment, compared to vehicle placebo group, pain threshold was increased by both URB597 (3.1 ± 1.0 vs 11.2 ± 1.2 g; P < .001) and URB937 (3.1 ± 1.0 vs 12.1 ± 1.3 g; P < .001). Immobility time of FST was reduced by URB597 (135.8 ± 16.6 vs 85.3 ± 17.2 seconds; P < .001) but not by URB937 (135.8 ± 16.6 vs 129.6 ± 17.8 seconds; P = .78). Latency to feed in NSF was also reduced by URB597 (235.9 ± 30.5 vs 131.8 ± 19.8 seconds; P < .001) but not by URB937 (235.9 ± 30.5 vs 232.2 ± 33.2 seconds; P = .72). Meanwhile, CCI decreased the number of proliferating cells and reduced survival of new mature neurons in hippocampus. URB597 but not URB937 treatment improved these cellular deficits.

CONCLUSIONS:

Inhibition of FAAH can improve depressive-like behaviors induced by neuropathic pain independent of its peripheral antinociceptive action. Enhanced neurogenesis in hippocampus might contribute to the antidepressive effects of URB597.
Indole-3-carbinol: a plant hormone combatting cancer
Authors: Katz Ella , Nisani Sophia , Chamovitz Daniel A.
Published: June 2018

A diet rich in cruciferous vegetables such as cauliflower, broccoli, and cabbage has long been considered healthy, and various epidemiological studies suggest that the consumption of cruciferous vegetables contributes to a cancer-protecting diet. While these vegetables contain a vast array of phytochemicals, the mechanism by which these vegetables counteract cancer is still largely unresolved. Numerous in situ studies have implicated indole-3-carbinol, a breakdown product of the glucosinolate indole-3-ylmethylglucosinolate, as one of the phytochemicals with anti-cancer properties. Indole-3-carbinol influences a range of cellular processes, but the mechanisms by which it acts on cancer cells are slowly being revealed. Recent studies on the role of indole-3-carbinol in Arabidopsis opens the door for cross-kingdom comparisons that can help in understanding the roles of this important phytohormone in both plant biology and combatting cancer.
Applications of IRS and INSAT Data with Specific Case Studies
Authors: Manikiam Balakrishnan
Published: June 2018

Indian satellite programme has over the past three decades achieved operational capability in the area of remote sensing. The Indian Remote Sensing (IRS) satellites are developed towards providing data for natural resources survey and management. Techniques have been developed to retrieve several parameters related to land, ocean and atmosphere. Since the launch of IRS 1A in early 80’s, the technology has improved to achieve satellite imagery with resolution of 1 meter. The Indian National satellite (INSAT) system is made up of geostationary satellites towards monitoring and study of weather over the Indian region. The INSAT data is operationally used for study of monsoon onset, cyclone prediction and forecast of severe weather conditions. The paper portrays a few unique case studies using IRS and INSAT data. The satellite data is proving to be very useful in study of the global changes and possible impacts.
Bacterial decolourization of azo dyes
Authors: Nair Amrita , Rajendhiran Nandini , Varsha R , Joseph Biljo V , Vasantha V L
Published: June 2018

Release of textile effluent into the environment is a matter of health concern. Dyes and pigments that are part of textile effluent generate hazardous wastes which are generally inorganic or organic contaminants. Among the present pollution control strategies, biodegradation of synthetic dyes by microbes is evolving as a promising approach, even more than physico-chemical methods. While both mixed cultures and pure cultures have been used to achieve efficient biodegradation, no conclusive result has been determined. This paper aims at checking the efficiency of mixed culture of sewage and pure isolates in degradation of azo dyes, both simple dyes like methyl red and methyl orange and a more complex dye like Janus green.
Effect of Inoculum Density and Different Media on the Growth of Hairy Roots and Production of Withanolide-A from Withaniasomnifera
Authors: Nagella Praveen , Murthy H N
Published: June 2018

Withaniasomnifera (L.) Dunal. (Indian ginseng) is one of the most important medicinal plants used as a crude drug for its preventive and therapeutic purposes. Among the diverse constituents of Withania, withanolides are found to be the major components responsible for their biological and pharmacological actions. The present study deals with the effect of inoculum density and different media on the growth of hairy roots and withanolide-A production from Withaniasomnifera. An inoculum size of 10 g/L FW favoured the biomass accumulation(120.42 g/L of FW and 11.98 g/L DW) and withanolide-A production(11.96 mg/g DW) inthe tested range of 2.5, 5.0, 10.0 and 20.0 g/L FW. Among different media tested [Murashige and Skoog (MS), Gamborg’s (B5), Nitsch and Nitsch (NN) and Chu’s (N6)], MS medium favoured both biomass accumulation (121.15 g/L FW and 11.96 g/L DW) and withanolide-A production (11.50 mg/g DW).
On Various Porous Scaffold Fabrication Methods
Authors: Elamparithi D , Moorthy V
Published: June 2018

Three-dimensional scaffolds can be fabricated by various methods. These scaffold constructs showed a major impact on various biomedical applications. The bioactive porous scaffolds should have an excellent three-dimensional architecture and interconnected porous structure for cells adhesion and migration to enhance the therapeutic potential. The porosity and interconnected porous structure can be optimized using various scaffold preparation methods. In this mini review, we discussed the advantages and disadvantages of various commonly used scaffold preparation techniques.
Software Stress Assessment Test: A Preliminary Invstigation
Authors: Soujanya S , Ashok H S , Sudha Bhogle
Published: June 2018

Though research on stress has been on the increase in recent years, occupational stress literature is based, to a large extent, on individual perception rather than substantiated fact. The present study was undertaken with the objective of developing a stress assessment test for the software professional. The test consists of 57 items covering four factors namely, job-related, organisational, personal and behavioural. The test was administered to 33 software specialists from a software firm in Bangalore. Based on the data, percentile norms were established. The scale was subjected to reliability test. The split half reliability is 0.816**. Work is currently on in the area and further research is required in this direction. Individual moves into a state of exhaustion, from which tissue breakdown and even death can result. In other words, continued stress can lead to bodily damage. The body manifests the stress reaction by a rise in blood pressure, increased adrenaline, changed heartbeat, more RBCs, slower digestion, and so on. However, Selye argued that a moderate amount of stress could be a positive experience while too little stress could be negative.
"The Role of Emotional Intelligence in Relation to Traits of Anxiety "
Authors: Pashang Batool , Singh Mridula
Published: June 2018

The present study examines the role of Emotional intelligence, as measured by Emotional Intelligence Scale (EIS), in relation to Traits of anxiety (Emotional instability, Suspiciousness, Guilt proneness, Low integration and Tension), as measured by Anxiety Scale (IPAT). A total of 599 adults, between the ages of 20 to 50 were asked to complete the questionnaires. The mean score on total anxiety verified that the highest level of El tolerated the lowest anxiety, which was followed by subjects with medium and low levels of El. The results of the Low self control (Q3) and Emotional Instability(C) traits, displayed that the highest level of El yielded the lowest scores on those traits. The findings reported that the trait of Suspicion was tolerated same among the groups. On the other hand both the Apprehension and Tension traits pushed up on the high level of El. In the case of medium level of El, people were engaged with all of the traits on an average but the Apprehension was increased in this group in comparison to the other traits.
"Women Empowerment through Microfinance: A Study of Slums in Bangalore City "
Authors: Kadrolkar Vilas Mohan
Published: June 2018

Women Empowerment through Microfinance: A Study of Slums in Bangalore City
Editorial
Authors: Dasgupta Pritha
Published: June 2018

The year 2002 marked the birth of our journal 'Artha' dedicated entirely to social sciences-with this a dream became a reality. Since the never losing sight of the values propounded bu our management to bring excellence in every sphere of activity, we have enthusiasm gone where very few has ventured. Artha thoroughly demonstrates this interdisciplinary nature of social sciences. Our firm belief is that research should not end up only in the annals of academia but be used as a tool to change and improve society.
"Effectiveness of Diagnosis Based Remediation on Attainment of MLL in Mathematics among V Standard Students "
Authors: K Prakash , Sharma Premalatha
Published: June 2018

Present study is aimed to assess the effectiveness of diagnosis-based remediation programme in improving the proportionate of students mastering each competency (percentage of competency mastered) by the group of V standard students in the selected (experimental) schools of Shimoga District. A total of 100 students of 4 government primary schools from Shimoga district constituted the sample for the study, of which 50 were boys and remaining 50 were girls. They were selected from both urban and rural areas of Shimoga district. This is an experimental study with pre and post test design. Among the selected100 non-mastered students, 50 were non masters and they formed control group and remaining 50 constituted the experimental group. After 2 months of intervention for the experimental group, the investigator conducted post test for both controlled and experimental groups. The controlled group students were attending regular classes whereas students from experimental group were attending the intervention class outside the class room which was taken by the investigator himself. MLL based test developed by Kashinath (2005) was adapted and used for assessing selected MLL competencies, which had 7 competencies was administered on the students selected 4 government primary schools of Shimoga district. The results showed that experimental group had gained significantly higher competencies in total scores than the control group. Further, male students of experimental group had substantial gain compared to all other groups.
"Elementary Education in Rural Karnataka - An Analysis "
Authors: D C Nanjunda , C Ramesh
Published: June 2018

To spread education in case of highly marginalized section of our society has been a colossal task to any Govt. particularly to the tribal people. The strong point of a society lies in the task of education training, development and allocation of its man power resources. It can be said that education plays an imperative complete development of individuality so that one can make an original contribution to human life according to one's best competence. Making primary or elementary education available for all rural Indian children has been one of the major challenges for the all the Government. Furthermore, the quality of elementary education in rural India has also been a major cause of concern for the any Government. This paper draws attention of the readers about the conditions and settings of the rural schools in Karnataka State, South India.
" Should We Frame Gender Questions Differently? "
Authors: Rassendren Etienne
Published: June 2018

There has been over some time now the de-disciplining of formerly traditional fields such as the Social Sciences, the Humanities and Languages, which in many significant ways have altered the categories of contemporary thought radically. This is perceived as advancement in critical thinking, but the all too facile and felicitous deployment of such ideas discredits intellectual rigor as it leaves unmarked the limits of such empowering border-crossings. While we need not mourn category-failure, we have to resist easy re-namings of certain fields such as Feminisms and Gender Studies. Yet it may also be equally simplistic not to redefine and extend the current dimensions of such knowledges to include both the re-theorizing of such fields, given the changing nature of thinking and practice in the contemporary context. Hence it is relevant to ask: Should we frame gender questions differently? But it is equally important to resist the debunking of questions of gender in favor of ambiguating even the salutary contributions of feminism and gender studies. It is precisely this contradiction, one that seeks disruption for its own sake, that I wish to investigate and respond to. True, there will be more questions than answers in this respect but it is precisely those I wish to raise in the current article.
"An Explorative Study on the Psychosocial Dimensions of Terrorism "
Authors: P K Raheemudheen
Published: June 2018

Acts of terrorism are on an increase across the globe in general and within the nation in specific. Each act of terrorism could be reckoned as the implicit index of peace and psychological status of the community in which it happens. An exploration into these psychosocial factors of one of the most dreadful manmade disasters- terrorism is logical in terms of both social urgency and academic significance. This study is an attempt to uncover various psychosocial aspects of terrorism. Sample consists of 210 adults from urban and rural area. A questionnaire consisting of closed end questions was prepared by the investigators and was used for data collection, and descriptive statistical techniques were performed for data analysis. Results of this study are under two sections; first section explains perceived causal factors of terrorism, namely perceived social injustice, antisocial behavioral patterns, traumatic childhood experiences, financial insecurity, family atmosphere, strong passion towards ones' religion or ideology and failure of country's defense system. This result also reveals that there is no prominent factor that alone can lead an individual to terrorism. The second section explains the consequences and aftermaths of terrorism. It negatively affects positive mental health of community and social relations like feeling of insecurity, over-sensitivity, hyper-alertness, fear, social withdrawal, social isolation and Psychological distress. Findings of this study demand community mental health effort and conflict resolution as protective measures in the time of terror attacks and will help the people to cope with difficulties of this attack
"An Analysis of Parental Behaviors by Adolescents "
Authors: Thomas Bino
Published: June 2018

As part of developing a parenting skill development programme, 60 couples were interviewed. The parents were selected randomly from a school in Bangalore city. Their 60 adolescents were interviewed using Parent Bonding Instrument (brief current) (Klimids 1992) to understand what they perceive about their parents' parental behaviors. The results show a trend that mothers being more controlling and fathers giving more freedom. The study throws light on the needs of having similar studies done with larger samples which will help in working for strengthening parent adolescent bond.