[Selected problems of neurofibromatosis with presentation of a case of multiple intracranial and intramedullary tumors].

PubMed

Stachura, Z; Zralek, C; Siemianowicz, S; Kiczka-Zralek, M; Zawadzki, T; Kluczewska, E; Giec-Lorenc, A

1998-01-01

A case of neurofibromatosis type II in a 19-year-old man is described with clinical and neuroimaging (MRI) findings. The diagnostic criteria of neurofibromatosis type I (NF1) and type II (NF2) and the optimal management options are still controversial. The authors suggest that this patient fulfills criteria of neurofibromatosis type II as well as partially neurofibromatosis type I. At present, without molecular analysis of DNA, this assumption can not be verified.

The Evolution of Parody from Miss Wyoming to Andrea Dworkin.

ERIC Educational Resources Information Center

Ludlum, M. P.

This paper discuses whether outrageous parodies are and should be protected under the First Amendment. After presenting a definition and a brief history of parody humor, the paper then presents a brief description of the parties to this line of legal controversies. The paper describes the rationale of a line of separate parody cases involving Miss…

LCA – Unique and Controversial Case Studies

EPA Science Inventory

This session will focus on case studies and applications that have a unique or controversial aspect. Some of the most recent topics that seem to have significant interest include: LCA-based product declarations, LCA-based standards, LCA-based labels, alternative energy, agricul...

Idiopathic Granulomatous Mastitis Associated with Corynebacterium Sp. Infection

PubMed Central

Lee, Yun Sun; Balfour, John

2011-01-01

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory condition of the breast. The etiology and treatments options of IGM remain controversial. Previous case reports have suggested that Corynebacterium sp., a gram-positive bacillus endogenous to the skin, may be associated with IGM. In the present report, we describe the first case of IGM with a positive culture for Corynebacterium sp. reported in the United States. PMID:21857740

Catnip and the alteration of human consciousness.

PubMed

Osterhoudt, K C; Lee, S K; Callahan, J M; Henretig, F M

1997-12-01

Uncertainty exists regarding the ability of catnip (Nepeta cataria) to affect human consciousness. We report a case of a toddler exhibiting central nervous system depression after consuming a large quantity of catnip. His obtundation was not attributable to another cause. We review the published literature describing the alleged psychoactive capabilities of catnip and present our case as further information for use in this ongoing controversy.

Case studies of children presenting with a history of ritualistic abuse.

PubMed

King, G F; Yorker, B

1996-01-01

Ritualistic child abuse is an alarming and controversial problem. Child psychiatric nurses need to increase their awareness of the clinical picture associated with this specific form of abuse. This article reviews the literature to date on ritualistic child abuse and addresses the controversy surrounding the phenomena. A small research project using historical data collection methods reviewed hospital records of children with a documented history of ritualistic abuse. Results are organized into clusters of linked interrelated characteristics. The symptom characteristics of these children revealed medical/somatic symptoms, distortion of self-oncept and world view, and a variety of emotional disturbances. The findings of this study are presented with implications for nurses who care for clients with a history of ritualistic abuse.

Regional Disparities in Educational Development: A Controversial Issue.

ERIC Educational Resources Information Center

Carron, Gabriel, Ed.; Chau, Ta Ngoc, Ed.

To complement a volume of case studies, these four papers and an introduction discuss the problem of regional disparities in educational development from several different perspectives. Varying points of view are presented on the relationship between regional educational disparities and socioeconomic, political, and cultural development; the…

Idiopathic granulomatous mastitis associated with risperidone-induced hyperprolactinemia

PubMed Central

2012-01-01

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease. The etiology and treatment options of IGM remain controversial. Previous case reports have suggested that hyperprolactinemia may be associated with IGM. In the present report, we describe the first case of IGM associated with risperidone-induced hyperprolactinemia. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8120093785928228 PMID:22221904

Application of non-invasive mechanical ventilation in an asthmatic pregnant woman in respiratory failure: a case report

PubMed Central

Caner, Hanife; Eryuksel, Emel; Kosar, Filiz

2013-01-01

The use of non-invasive mechanical ventilation (NIV) during an asthma attack is controversial. We report a case of a 28-year-old female patient in her 16th week of pregnancy with community-acquired pneumonia who presented during an asthma attack, which led to hypoxic respiratory failure. She was successfully treated using NIV. This case is worth discussing as it includes two clinical conditions in which NIV is often considered contraindicated. PMID:23372957

Controversies in water management: Frames and mental models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kolkman, M.J.; Department of Civil Engineering and Management, Faculty of Engineering Technology; Veen, A. van der

Controversies in decision and policy-making processes can be analysed using frame reflection and mental model mapping techniques. The purpose of the method presented in this paper is to improve the quality of the information and interpretations available to decision makers, by surfacing and juxtaposing the different frames of decision makers, experts, and special interests groups. The research provides a new method to analyse frames. It defines a frame to consist of perspectives and a mental model, which are in close interaction (through second order learning processes). The mental model acts like a 'filter' through which the problem situation is observed.more » Five major perspective types guide the construction of meaning out of the information delivered by the mental model, and determine what actors see as their interests. The perspective types are related to an actor's institutional and personal position in the decision making process. The method was applied to a case, in order to test its viability. The case concerns the decision making process and environmental impact assessment procedure for the improvement of dike ring 53 in the Netherlands, which was initiated by the Dutch 'Flood Defences Act 1996'. In this specific case the perspectives and mental models of stakeholders were elicited to explain controversies. The case was analysed with regard to the conflicts emerging between stakeholders, on an individual level. The influence of institutional embedding of individuals on the use of information and the construction of meaning, and the limits of a participatory approach were analysed within the details of controversies that emerged during the case analysis. Complicating factor appeared to be the interaction between national dike safety norms (short term) and local water management problems (long term). Revealed controversies mainly concerned disputes between an organisational and a technical perspective. But also disputes on distribution of responsibilities between different institutes, on legal and political liability, and on funding issues, involving persons of both perspectives, were found. The case reveals a lack of possibilities to search for an integrated solution which involves all levels of authority, and a lack of possibilities to discuss the additional problems that were raised by the integrated approach in the initial phase of the case project. The complex and unstructured nature of the problem situation caused the traditional substantive approach to fail to deliver a good solution. Legal, socio-economic and institutional factors ultimately dominated the decision making process.« less

Contextualized Science for Teaching Science and Technology.

ERIC Educational Resources Information Center

Koul, Ravinder; Dana, Thomas M.

1997-01-01

Discusses science education in India, arguing that a contextualized curriculum is a powerful means of improvement. The paper presents results from an analysis of the treatment of the nature of science and technology in current Indian textbooks and uses India's controversial Sadar Sarovar Hydro-Electric Project as a case example. (SM)

32 CFR 651.14 - Integration with Army planning.

Code of Federal Regulations, 2014 CFR

2014-07-01

... be controversial. In most cases, local citizens and/or existing advisory groups should assist in... reduce or eliminate discussion of minor issues to help focus analyses. Such an approach will minimize... recommendations presented in the CEQ publication entitled “The National Environmental Policy Act: A Study of Its...

32 CFR 651.14 - Integration with Army planning.

Code of Federal Regulations, 2011 CFR

2011-07-01

... be controversial. In most cases, local citizens and/or existing advisory groups should assist in... reduce or eliminate discussion of minor issues to help focus analyses. Such an approach will minimize... recommendations presented in the CEQ publication entitled “The National Environmental Policy Act: A Study of Its...

32 CFR 651.14 - Integration with Army planning.

Code of Federal Regulations, 2010 CFR

2010-07-01

... be controversial. In most cases, local citizens and/or existing advisory groups should assist in... reduce or eliminate discussion of minor issues to help focus analyses. Such an approach will minimize... recommendations presented in the CEQ publication entitled “The National Environmental Policy Act: A Study of Its...

32 CFR 651.14 - Integration with Army planning.

Code of Federal Regulations, 2012 CFR

2012-07-01

... be controversial. In most cases, local citizens and/or existing advisory groups should assist in... reduce or eliminate discussion of minor issues to help focus analyses. Such an approach will minimize... recommendations presented in the CEQ publication entitled “The National Environmental Policy Act: A Study of Its...

32 CFR 651.14 - Integration with Army planning.

Code of Federal Regulations, 2013 CFR

2013-07-01

... be controversial. In most cases, local citizens and/or existing advisory groups should assist in... reduce or eliminate discussion of minor issues to help focus analyses. Such an approach will minimize... recommendations presented in the CEQ publication entitled “The National Environmental Policy Act: A Study of Its...

A case of instantaneous rigor?

PubMed

Pirch, J; Schulz, Y; Klintschar, M

2013-09-01

The question of whether instantaneous rigor mortis (IR), the hypothetic sudden occurrence of stiffening of the muscles upon death, actually exists has been controversially debated over the last 150 years. While modern German forensic literature rejects this concept, the contemporary British literature is more willing to embrace it. We present the case of a young woman who suffered from diabetes and who was found dead in an upright standing position with back and shoulders leaned against a punchbag and a cupboard. Rigor mortis was fully established, livor mortis was strong and according to the position the body was found in. After autopsy and toxicological analysis, it was stated that death most probably occurred due to a ketoacidotic coma with markedly increased values of glucose and lactate in the cerebrospinal fluid as well as acetone in blood and urine. Whereas the position of the body is most unusual, a detailed analysis revealed that it is a stable position even without rigor mortis. Therefore, this case does not further support the controversial concept of IR.

Consensus or controversy? The classification and treatment decision-making by 491 maxillofacial surgeons from around the world in three cases of a unilateral mandibular condyle fracture.

PubMed

Kommers, Sofie C; Boffano, Paolo; Forouzanfar, Tymour

2015-12-01

Many studies are available in the literature on both classification and treatment of unilateral mandibular condyle fractures. To date however, controversy regarding the best treatment for unilateral mandibular condyle fractures remains. In this study, an attempt was made to quantify the level of agreement between a sample of maxillofacial surgeons worldwide, on the classification and treatment decisions in three different unilateral mandibular condyle fracture cases. In total, 491 of 3044 participants responded. In all three mandibular condyle fracture cases, a fairly high level of disagreement was found. Only in the case of a subcondylar fracture, assuming dysocclusion was present, more than 81% of surgeons agreed that the best treatment would be open reduction and internal fixation. Based on the study results, there is considerable variation among surgeons worldwide with regard to treatment of unilateral mandibular condyle fracture. 3D imaging in higher fractures tends to lead to more invasive treatment decisions. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Walking the line. Palliative sedation for existential distress: still a controversial issue?

PubMed

Schur, Sophie; Radbruch, Lukas; Masel, Eva K; Weixler, Dietmar; Watzke, Herbert H

2015-12-01

Adequate symptom relief is a central aspect of medical care of all patients especially in those with an incurable disease. However, as an illness progresses and the end of life approaches, physical or psychoexistential symptoms may remain uncontrollable requiring palliative sedation. Although palliative sedation has become an increasingly implemented practice in the care of terminally ill patients, sedation in the management of refractory psychological symptoms and existential distress is still a controversial issue and much debated. This case report presents a patient who received palliative sedation for the treatment of existential distress and discusses considerations that may arise from such a therapeutic approach.

A dubious defense of 'after-birth abortion': A reply to Räsänen.

PubMed

Kaczor, Christopher

2018-02-01

Scholars have offered various critiques of Alberto Giubilini and Francesca Minerva's controversial article, 'After-birth abortion: Why should the baby live?' My book The Ethics of Abortion: Women's Rights, Human Life, and the Question of Justice presents four such critiques. First, Giubilini and Minerva argue from the deeply controversial to the even more controversial. Second, they presuppose a false view of personal identity called body-self dualism. Third, their view cannot secure human equality. And fourth, their account of harm cannot account for harm found in some cases of murder. In the article, 'Pro-life arguments against infanticide and why they are not convincing', J. Räsänen examines and finds wanting these four critiques. This essay responds to Räsänen's defense of infanticide and argues that his responses to the four objections fail. © 2017 John Wiley & Sons Ltd.

Implants and Ethnocide: Learning from the Cochlear Implant Controversy

ERIC Educational Resources Information Center

Sparrow, Robert

2010-01-01

This paper uses the fictional case of the "Babel fish" to explore and illustrate the issues involved in the controversy about the use of cochlear implants in prelinguistically deaf children. Analysis of this controversy suggests that the development of genetic tests for deafness poses a serious threat to the continued flourishing of Deaf…

[Essential facial neuralgia with bilateral involvement: apropos of a case seen at the Cité Verte Hospital in Yaoundé].

PubMed

Djoumessi, A; Mendomo, E M; Onana, J; Djoumessi, S; Ndobo-Epoy, Ph

2002-09-01

Despite the fact that essential facial neuralgia is a well known clinical entity as relates to its evolution and treatment, its physiopathology is still a controversial issue. The form with bilateral evolution that we observed and that we are reporting here is extremely rare and its physiopathology is even more controversial. The case of our patient is all the more complicated in that, the pain topography is limited to the right to a sensitive region of the trigeminal nerve (superior maxillary) and to the left to the region of the mandible (inferior maxillary) A similar disease evolution is not described so far in the present literature of the disease. We have therefore seized this opportunity to out line the possible causes of faulty diagnosis in order that essential facial neuralgia should not be labelled as facial pain of tumoral, vascular or other origin.

A case of conflicting norms? Mobilizing and accountability information in newspaper coverage of the autism-vaccine controversy.

PubMed

Clarke, Christopher E

2011-09-01

When reporting health risks, the news media are often criticized for omitting "mobilizing" information that allows readers to act on existing attitudes. Using American and British newspaper coverage of the autism-vaccine controversy as a case study, this article takes a "behind the scenes" look at normative pressures that may influence whether such information appears in coverage. In particular, can holding health officials accountable for their actions potentially "crowd out" mobilizing information? A content analysis suggests that mobilizing information (at least one of four examples) was present in only 16% of articles, compared to 38% that mentioned accountability messages (at least one of two examples). US newspapers were significantly more likely to mention at least one mobilization example. Finally, although only 11% discussed both, articles were more likely to discuss certain mobilizing and accountability examples together. Implications for journalism ethics and vaccine risk communication are discussed.

Kikuchi-Fujimoto disease presenting after consumption of ‘Miracle Mineral Solution’ (sodium chlorite)

PubMed Central

Loh, John Ming Ren; Shafi, Humaira

2014-01-01

We present a case report of a 41-year-old woman of Malay ethnicity who presented with an 11-day history of fever and left-sided lymphadenopathy after consuming ‘Miracle Mineral Solution’ (sodium chlorite solution) for the first time. A diagnosis of Kikuchi-Fujimoto disease was established via lymph node biopsy after other differentials were excluded. The aetiology of Kikuchi-Fujimoto disease remains controversial, but viral, autoimmune and physicochemical causes have been suggested as possibilities. In this case, we hypothesise that oxidative injury from sodium chlorite initiated an inflammatory response, which triggered the onset of Kikuchi-Fujimoto disease. PMID:25422331

Epstein–Barr virus in the multiple sclerosis brain: a controversial issue—report on a focused workshop held in the Centre for Brain Research of the Medical University of Vienna, Austria

PubMed Central

Niedobitek, Gerald; Aloisi, Francesca; Middeldorp, Jaap M.

2011-01-01

Recent epidemiological and immunological studies provide evidence for an association between Epstein–Barr virus infection and multiple sclerosis, suggesting a role of Epstein–Barr virus infection in disease induction and pathogenesis. A key question in this context is whether Epstein–Barr virus-infected B lymphocytes are present within the central nervous system and the lesions of patients with multiple sclerosis. Previous studies on this topic provided highly controversial results, showing Epstein–Barr virus reactivity in B cells in the vast majority of multiple sclerosis cases and lesions, or only exceptional Epstein–Barr virus-positive B cells in rare cases. In an attempt to explain the reasons for these divergent results, a workshop was organized under the umbrella of the European Union FP6 NeuroproMiSe project, the outcome of which is presented here. This report summarizes the current knowledge of Epstein–Barr virus biology and shows that Epstein–Barr virus infection is highly complex. There are still major controversies, how to unequivocally identify Epstein–Barr virus infection in pathological tissues, particularly in situations other than Epstein–Barr virus-driven lymphomas or acute Epstein–Barr virus infections. It further highlights that unequivocal proof of Epstein–Barr virus infection in multiple sclerosis lesions is still lacking, due to issues related to the sensitivity and specificity of the detection methods. PMID:21846731

Tennessee to Texas: Tracing the Evolution Controversy in Public Education

ERIC Educational Resources Information Center

Armenta, Tony; Lane, Kenneth E.

2010-01-01

Darwin's Theory of Evolution has stirred controversy since its inception. Public schools in the United States, pressed by special interest groups on both sides of the controversy, have struggled with how best to teach the theory, if at all. Court cases have dealt with whether states can ban the teaching of evolutionary theory, whether Creationism…

Improving Learning by Discussing Controversies in 20th Century Physics.

ERIC Educational Resources Information Center

Niaz, Mansoor; Rodriguez, Maria A.

2002-01-01

Textbooks rarely emphasize how controversial some physics theories were at the time of their proposal. Makes the case that useful classroom debate can be generated by considering the controversy that arose over models of the atom such as Rutherford's and Bohr's, and ideas about fractional charges put forward by Millikan and arising from quark…

Angiolymphoid hyperplasia with eosinophilia versus Kimura's disease: a case report and a clinical and histopathological comparison*

PubMed Central

de Bastos, Julien Totti; da Rocha, Camila Roos Mariano; Silva, Priscila Mara Chaves e; de Freitas, Bruno Messias Pires; Cassia, Flávia de Freire; Avelleira, João Carlos Regazzi

2017-01-01

Angiolymphoid hyperplasia with eosinophilia is a rare and benign vascular tumor whose etiology remains uncertain. It clinically presents itself by angiomatous papules or nodules located on the head and neck. Many controversies in the literature are found in relation to angiolymphoid hyperplasia with eosinophilia and Kimura's disease - its main differential diagnosis - due to their clinical and histopathological similarities. However, currently, most studies agree that they are distinct diseases. The present case illustrates a characteristic description of angiolymphoid hyperplasia with eosinophilia and also highlights the main differences with Kimura's disease. PMID:29186256

Primary appendiceal lymphoma presenting as suspected perforated acute appendicitis: clinical, sonography and CT findings with pathologic correlation.

PubMed

Guo, Jingjing; Wu, Gang; Chen, Xiaojun; Li, Xiaodong

2014-01-01

The gastrointestinal tract is the most common site for extranodal involvement by non-Hodgkin's lymphoma. However, primary appendiceal lymphomas presenting as perforated acute appendicitis are very rare: they occur in only 0.015% of all gastrointestinal lymphoma cases. The management of this condition is still controversial, and a multimodality approach (e.g., surgery, radiation therapy, and chemotherapy) is the optimal treatment. In these cases, appendiceal non-Hodgkin's lymphomas typically manifest with acute symptoms in patients with no prior lymphoma history. Additionally, we treated our patient with a right hemicolectomy and postoperative multiagent chemotherapy.

History and the Culture Wars: The Case of the Smithsonian Institution's Enola Gay Exhibition.

ERIC Educational Resources Information Center

Kohn, Richard H.

1995-01-01

Presents an excellent summation of the controversy over the Smithsonian's Enola Gay exhibit. Delineates the preparation of the exhibit, nature and origins of the objections raised, subsequent revisions in the text, and the decision to cancel the exhibit. Includes textual passages from the most disputed sections of the exhibit. (MJP)

Slavery and Free Markets: Relationships between Economic Institutions

ERIC Educational Resources Information Center

Schug, Mark C.

2013-01-01

This article presents an economic perspective of the institution of slavery in the context of world and American history. Slavery has existed on all continents and in many societies. Its existence has long been controversial and, in the case of the United States, ended only as the result of a long and destructive war. Slavery as an institution was…

Do Dyslexic Individuals Present a Reduced Visual Attention Span? Evidence from Visual Recognition Tasks of Non-Verbal Multi-Character Arrays

ERIC Educational Resources Information Center

Yeari, Menahem; Isser, Michal; Schiff, Rachel

2017-01-01

A controversy has recently developed regarding the hypothesis that developmental dyslexia may be caused, in some cases, by a reduced visual attention span (VAS). To examine this hypothesis, independent of phonological abilities, researchers tested the ability of dyslexic participants to recognize arrays of unfamiliar visual characters. Employing…

Mural odontogenic epithelial proliferations within the wall of a dentigerous cyst: their significance.

PubMed

Generson, R M; Porter, J M; Stratigos, G T

1976-12-01

A case of a dentigerous cyst with proliferating odontogenic epithelium in a 5-year-old black boy is presented. A controversy exists in the histologic diagnosis and surgical treatment of this lesion. The accuracy of the pathologic diagnosis is imperative, as it will determine to a great extent the surgical modality of treatment.

[Oral squamous cell carcinoma and lichen planus vs. lichenoid lesions. Case report].

PubMed

Esquivel-Pedraza, Lilly; Fernández-Cuevas, Laura; Ruelas-Villavicencio, Ana Lilia; Guerrero-Ramos, Brenda; Hernández-Salazar, Amparo; Milke-García, María Pilar; Méndez-Flores, Silvia

2016-01-01

The development of squamous cell carcinoma from oral lichen planus is controversial. We report a case of intraoral squamous cell carcinoma, which presents together with lesions of oral lichen planus. The aim of this report was to analyze the problem to distinguish between the incipient changes of squamous cell carcinoma from the features described in oral lichen planus, in order to establish an accurate diagnosis of both entities. A 57-year old man with a history of smoking and chronic alcohol intake, who had an ulcerated tumor mass located in the tongue, and bilateral white reticular patches on buccal mucosa and borders of the tongue. The histopathological report was moderately differentiated invasive squamous cell carcinoma and lichen planus respectively. The premalignant nature of OLP is still indeterminate and controversial, this is primarily due to inconsistency in the clinical and histological diagnostic criteria used to differentiate cases of oral lichen planus from lichenoid reactions or other lesions causing intraepithelial dysplasia with high potentially malignant transformation. Oral lichenoid reactions are possibly most likely to develop malignant transformation as compared to the classic OLP lesions.

Embolization of Rectal Arteries: An Alternative Treatment for Hemorrhagic Shock Induced by Traumatic Intrarectal Hemorrhage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pichon, Nicolas, E-mail: nicolas.pichon@unilim.fr, E-mail: nicolas.pichon@chu-limoges.fr; Francois, Bruno; Pichon-Lefievre, Florence

2005-05-15

Rectal injuries caused by foreign bodies or iatrogenic insertions may lead to severe complications whose therapeutic management remains controversial. At times, both the rapid identification and treatment of subsequent active rectal bleeding may be challenging, especially when endoscopy fails to locate and control the arterial hemorrhage. We present the first two successful cases of middle rectal artery embolization in patients presenting with sustained bleeding and hemorrhagic shock.

The phrenic nerve transfer in the treatment of a septuagenarian with brachial plexus avulsion injury: a case report.

PubMed

Jiang, Ye; Lao, Jie

2018-05-01

Phrenic nerve transfer has been a well-established procedure for restoring elbow flexion function in patients with brachial plexus avulsion injury. Concerning about probably detrimental respiratory effects brought by the operation, however, stirred up quite a bit of controversy. We present a case report of the successful application of phrenic nerve as donor to reinnervate the biceps in a septuagenarian with brachial plexus avulsion injury, not accompanied with significant clinical respiratory problem.

The conservative treatment of pediatric mandibular fracture with prefabricated surgical splint: a case report.

PubMed

Kocabay, Ceyda; Ataç, Mustafa Sancar; Oner, Burak; Güngör, Nadir

2007-08-01

The use of rigid fixation in children is controversial and may cause growth retardation along cranial suture lines. Intermaxillary fixation for mandibular fractures should be used cautiously as bony ankylosis in the temporomandibular joint (TMJ) and trismus may develop. The high osteogenic potential of the pediatric mandible allows non-surgical management to be successful in younger patients with conservative approaches. In this case, successful conservative treatment of mandibular fracture of a 3-year-old patient is presented.

The right to die--ethical dilemmas in persons with spinal cord injury.

PubMed

Rundquist, Jeanine M

2002-01-01

The right to die can be a controversial topic, and health care workers in the rehabilitation setting may find themselves in the center of this heated debate. This article presents a case study of a patient with tetraplegia, Daniel, and his choices regarding life and death. The case study will be examined through the use of ethical principles as well as from a legal standpoint. Social, cultural, and economic issues are also discussed. Guidelines for possible resolution to the conflict are offered.

Microsurgical reconstruction in limb salvage due to a giant cell tumor of the distal radius. Case report.

PubMed

Sánchez-Torres, L J; de la Parra-Márquez, M L; Cruz-Escalante, A M; Ramírez-Barroso, R; Espinoza-Velazco, A

2017-01-01

The giant cell tumor of bone is one of the most controversial neoplasms due to growth patterns that may present. The case reported shows a very aggressive tumor in a classic location, but key to hand function. Rather than treat with radical surgery, was planned and performed a wide resection with an ulnar-carpus arthrodesis and microsurgical reconstruction of the defect throught an anterolateral thigh flap. The multidisciplinary approach of bone neoplasms produce a positive impact on patients.

Triazolam blood concentrations in forensic cases in Canada.

PubMed

Joynt, B P

1993-01-01

Triazolam has been a controversial drug since its appearance on world markets as a hypnotic more than ten years ago. Whole blood concentrations of triazolam as found in forensic cases are cited in several categories; that is, impaired driving: 17 cases; sexual assault: four cases; death due to drugs: 45 cases; drug-related death (drugs contributed to the death but were not the ultimate cause): 20 cases; drug-involved death (drugs were present but were not felt to be a contributing factor): six cases; miscellaneous: one case. The data was gleaned from a forensic toxicology database designed and used by the Forensic Toxicology Sections of the Royal Canadian Mounted Police (RCMP) laboratories in Canada. Triazolam concentrations from selected references are included for comparison.

Idiopathic Granulomatous Mastitis

PubMed Central

Al-Jarrah, Adil; Taranikanti, Varna; Lakhtakia, Ritu; Al-Jabri, Asma; Sawhney, Sukhpal

2013-01-01

Objectives: Idiopathic granulomatous mastitis (IGM) is a rare benign disorder of the breast whose aetiology is controversial, and is often misdiagnosed clinically and radiologically as mammary malignancy; as a result, it may be incorrectly treated. Although no standard treatment is available for this chronic disease, surgery with or without corticosteroids has been tried with controversial results. This study discusses the clinical presentation, diagnosis, management, recurrence, and follow-up data of IGM with a review of relevant literature. Methods: From 2009–2012, the Breast Unit at Sultan Qaboos University Hospital, Oman, conducted a clinical study on 20 patients with breast lumps. Their clinical and radiological examinations were indeterminate, and a diagnosis of granulomatous mastitis was established only by histopathology. Results: The majority of the patients were cases of unknown aetiology, who presented with a unilateral breast mass. A few patients had a mass with an abscess, along with axillary lymphadenopathy. A total of 4 patients were suspected of malignancy using radiology. In all patients, sterilised pus was sent for culture and sensitivity. Microscopy showed the characteristic pattern of granulomatous inflammation. All patients were treated with antibiotics for 6 weeks, and the mean follow-up period was 15 months (11–33 months). All patients had complete remission with no further recurrence. Conclusion: This single largest study of cases of IGM in Oman highlights the pitfalls in diagnosing this non-neoplastic disease of unknown aetiology and uncertain pathogenesis. It emphasises IGM’s excellent response to antibiotics, which is crucial, as IGM is a disease which is notoriously difficult and controversial to treat. PMID:23862029

The use of electroconvulsive therapy in atypical psychotic presentations: a case review.

PubMed

Montgomery, John H; Vasu, Devi

2007-10-01

Convulsive therapy and its progeny, electroconvulsive therapy (ECT), were originally used for the treatment of catatonic schizophrenia, and there is little doubt that ECT remains an effective intervention for the treatment of schizophrenia. However, current practice tends to favor the use of ECT in severe or treatment refractory affective disorders, and its use in schizophrenia and other nonaffective (atypical) psychotic disorders has become controversial.CASE REPORTS HAVE SUGGESTED A ROLE FOR ECT IN TWO SPECIFIC ATYPICAL PSYCHOTIC DISORDERS: Cotard's syndrome and cycloid psychosis. In this article, we review the atypical psychotic disorders and report a series of five case examples that signify the role of ECT in atypical psychotic presentations, particularly when the symptoms resemble those found in Cotard's syndrome and cycloid psychosis.

Treating handicapped newborns: suggestions for institutional policy.

PubMed

Thomas, E H; Andersen, K S; Franz, J E

1986-01-01

In October 1984 a conference of physicians and other health professionals, attorneys, members of the press, ethicists, and social scientists met at the State University of New York at Stony Brook to consider the medical, ethical, and social issues raised by the treatment of handicapped newborns. Presented here is a summary of guidelines for the implementation of their most important recommendation--the establishment of institutional policies concerning the internal decision making process regarding treatment and the procedures for sharing information about controversial cases with the public. The guidelines address the medical problems of diagnosis, prognosis, and clinical decision making; institutional responses to controversy within the institution and to the media and the public; and the composition and role of institutional review committees.

[In defence of the diagnosis of simple schizophrenia: reflections on a case presentation].

PubMed

Martínez Serrano, José; Medina Garrido, María L; Consuegra Sánchez, Rosario; Del Cerro Oñate, Matias; López-Mesa, José L; González Matás, Juana

2012-01-01

Since the first case descriptions of dementia praecox (Diem, 1903), the diagnosis of simple schizophrenia has continued to be controversial. The questioning of its descriptive validity and its reliability, as well as its infrequent use, has led to it being eliminated as a sub-type of schizophrenia in the DSM-III. Criteria for the diagnosis of «simple deteriorative disorder» are currently included in the DSM-IV-TR as a disorder requiring more studies for its possible inclusion. An attempt is made, using a clinical case, to perform a historical review of the concept of simple schizophrenia, and at the same what has led to the reflection on the possible reasons for the controversy, and a potential route to resolve it. Using a controversial clinical case, which meets ICD-10 clinical criteria for simple schizophrenia (and those of the DSM-IV-TR for the simple deteriorative disorder), we reflect on the symptoms and diagnostic difficulties. A literature review and update on the subjects was also performed. Our patient highlights, by the absence in the clinical picture of the most obvious positive psychotic symptoms, the tendency by psychiatrists to identify the diagnosis of schizophrenia with the presence of the same, at least at some time during its evolution. The use of neuroimaging tests was useful to assess the level of deterioration and prognosis of the patient. Considering simple schizophrenia in the differential diagnosis of other chronic deteriorative disorders could increase its recognition in the initial phases. The use of neuropsychological function tests, and looking for typical deteriorative patterns of the schizophrenia spectrum, could help to increase the reliability of the diagnosis. Copyright © 2011 SEP y SEPB. Published by Elsevier Espana. All rights reserved.

An Analysis of U.S. Foreign Direct Investment Policy and Economic Development. A.I.D. Discussion Paper No. 36.

ERIC Educational Resources Information Center

Bergsten, C. Fred; De Castro, Bruce

The purpose of the paper is to analyze U.S. policies toward financial investment in developing nations. The paper is presented in two sections. In section I, the controversial effects of direct foreign investment on development are discussed. Case studies of investment policies toward India, the Philippines, Ghana, Guatemala, and Argentina are…

Cases and Controversy: Guide to Teaching the Public Issues Series/Harvard Social Studies Project, and Supplement.

ERIC Educational Resources Information Center

Oliver, Donald W.; Newmann, Fred M.

This general guide presents an overview and explains the rationale of the teaching approach of the "Public Issues Series," units produced by the Harvard Social Studies Project to help students in grades 9-19 analyze and discuss human dilemmas related to public issues. (A detailed report on the nature, development, and evaluation of the Harvard…

Armored brain in a young girl with a syndromal hydrocephalus.

PubMed

Viozzi, Ilaria; van Baarsen, Kirsten; Grotenhuis, André

2017-01-01

The authors present a case of a young girl affected by a syndromal hydrocephalus who developed a bilateral ossified chronic subdural hematoma with the typical radiological appearance of "the armored brain". Bilateral calcified chronic subdural hematoma is a rare complication of ventriculoperitoneal shunt. There is controversy in the treatment, but most published literature discourages a surgical intervention to remove the calcifications.

Arab Civil Society and Education in Israel: The Arab Pedagogical Council as a Contentious Performance to Achieve National Recognition

ERIC Educational Resources Information Center

Agbaria, Ayman K.

2015-01-01

Focusing on recent developments in the field of education, this article grapples with the educational activism of Arab civil society in Israel. Specifically, it presents a case study of a recent initiative to establish an independent Arab Pedagogical Council (APC). I argue that this initiative, although controversial and challenging to the very…

Brown v. Board of Education: A Civil Rights Milestone and Its Troubled Legacy. Pivotal Moments in American History.

ERIC Educational Resources Information Center

Patterson, James T.

This book presents a narrative version of Brown v. Board of Education of Topeka, Kansas, which struck down state-sponsored racial segregation in America's schools. It analyzes the origins and consequences of that landmark case, illuminating the legal, political, and social implications of this decision. The book weaves many controversial issues…

Humanizing the Teaching of Physics through Storytelling: The Case of Current Electricity

ERIC Educational Resources Information Center

Hadzigeorgiou, Yannis

2006-01-01

The main purpose of this article is to discuss the potential role of storytelling in the teaching and learning of physics. I first present the main historical events concerning the discovery of current electricity by focusing on the Galvani-Volta controversy and the work of Michael Faraday. Then I outline a planning framework for teaching through…

Is there a false memory syndrome? A review of three cases.

PubMed

Kaplan, R; Manicavasagar, V

2001-01-01

The controversy over recovered memories of childhood sexual abuse (CSA) is whether such experiences can be forgotten for long periods and retrieved later in therapy or in response to cues or triggers from the environment. False memory syndrome (FMS) is caused by memories of a traumatic experience--most frequently CSA--which are objectively false, but in which the person strongly believes. Personality factors often play a role in the development of FMS. Because CSA is such a devastating experience, false accusations of sexual abuse have enormous, if not shattering, consequences for families. We present three case reports to illustrate features of the FMS. FMS should be listed for further study to establish valid criteria for making the diagnosis under the category of "factitious disorders," and a subcategory of "false memories/beliefs of abuse," with a further subdivision of "induced by therapy." The FMS controversy occurred in the context of a general moral panic about sexual abuse in the early 1980s. Psychiatrists should have a high degree of scepticism to moral panics.

Systematic assessment of the various controversies, difficulties, and current trends in the reestablishment of lost occlusal planes in edentulous patients.

PubMed

Sahoo, S; Singh, D; Raghav, D; Singh, G; Sarin, A; Kumar, P

2014-05-01

Accurate occlusal plane orientation is an essential factor in the fabrication of complete denture prosthesis. Over the years, it has received a number of methodologies by several researchers utilizing various anatomical landmarks however none of them is considered as perfect that could orient ideal occlusal plane. The presented literature review is an attempt to enlighten historical perspectives, pioneer researches, different controversies, difficulties and current trends for re-establishment of lost occlusal plane in edentulous patients. An extensive literature search was performed using Medline/PubMed interface and other scholarly research bibliographic databases using Medical Subject Headings. Studies describing research studies, case series and assorted clinical reports were retrieved and evaluated from 1963 to 2013. Most of the studies have suggest and evidence to consider Camper's plane for artificial orientation of occlusal plane however there is a substantial lack of genuine long term studies and authentic data that could recommend a single reliable landmark for perfect occlusal plane reorientation in a variety of cases.

Controversies in Persistent (Chronic) Lyme Disease

PubMed Central

2016-01-01

The Centers for Disease Control and Prevention estimates that more than 300 000 new cases of Lyme disease occur each year in the United States and that 10% to 20% of these patients will remain symptomatic despite receiving appropriate antibiotic therapy. Many elements of the disease are poorly understood and have generated considerable controversy. This paper discusses the medical controversies related to posttreatment manifestations and their potential impact on infusion nurses. PMID:27755213

The case of James A. Garfield: a historical perspective.

PubMed

Weiner, Bradley K

2003-05-15

In 1881, President James A. Garfield was shot in the back and died 79 days later. During this time, many controversies arose that had repercussions for years to come. Who was to manage the President's care? A prominent local physician took on the case, but after Garfield's death, he was highly criticized for inappropriate care and for excluding more highly qualified surgeons. Where was the bullet? Multiple opinions were given including that of Alexander Graham Bell. The correct suggestion turned out to be that of a young, unknown assistant demonstrator of anatomy. What was the proper treatment? Local wound care, removal of the bullet, and laparotomy all were considered. Many have felt that the choice of treatment may have proved to be worse than the injury itself. What did the autopsy show? Even this was controversial, with different observers claiming different results. This historical perspective reviews the case as well the controversies that surrounded it.

Death Penalty in America.

ERIC Educational Resources Information Center

Clifford, Amie L.

1997-01-01

Examines the legal and moral issues, controversies, and unique trial procedures involved with the death penalty. Discusses the 1972 landmark Supreme Court decision that resulted in many states abolishing this punishment, only to reintroduce it later with different provisions. Reviews the controversial case of Sam Sheppard. (MJP)

Treatment of Thrombotic Antiphospholipid Syndrome: The Rationale of Current Management—An Insight into Future Approaches

PubMed Central

Ubiali, Tania; Meroni, Pier Luigi

2015-01-01

Vascular thrombosis and pregnancy morbidity represent the clinical manifestations of antiphospholipid syndrome (APS), which is serologically characterized by the persistent positivity of antiphospholipid antibodies (aPL). Antiplatelet and anticoagulant agents currently provide the mainstay of APS treatment. However, the debate is still open: controversies involve the intensity and the duration of anticoagulation and the treatment of stroke and refractory cases. Unfortunately, the literature cannot provide definite answers to these controversial issues as it is flawed by many limitations, mainly due to the recruitment of patients not fulfilling laboratory and clinical criteria for APS. The recommended therapeutic management of different aPL-related clinical manifestations is hereby presented, with a critical appraisal of the evidence supporting such approaches. Cutting edge therapeutic strategies are also discussed, presenting the pioneer reports about the efficacy of novel pharmacological agents in APS. Thanks to a better understanding of aPL pathogenic mechanisms, new therapeutic targets will soon be explored. Much work is still to be done to unravel the most controversial issues about APS management: future studies are warranted to define the optimal management according to aPL risk profile and to assess the impact of a strict control of cardiovascular risk factors on disease control. PMID:26075289

Munchausen Syndrome by Proxy: A Clinical Vignette

PubMed Central

Zylstra, Robert G.; Miller, Karl E.; Stephens, Walter E.

2000-01-01

Munchausen syndrome by proxy is the act of one person fabricating or inducing an illness in another to meet his or her own emotional needs through the treatment process. The diagnosis is poorly understood and controversial. We report here the case of a 6-year-old boy who presented with possible pneumonia, nausea, vomiting, and diarrhea and whose mother was suspected of Munchausen syndrome by proxy. PMID:15014581

The Creation of Controversy: A Case Study of "And Tango Makes Three"

ERIC Educational Resources Information Center

Young, Craig A.

2010-01-01

Since the early 1980's, the number of picture books that present Queer characters and themes has grown. Correspondingly, the number of challenges to these books has also increased. "And Tango Makes Three," the true story of two male penguins who hatch and raise a chick in New York City's Central Park Zoo, is one such picture book that has received…

End-of-Life Care Decisions: Importance of Reviewing Systems and Limitations After 2 Recent North American Cases

PubMed Central

Burkle, Christopher M.; Benson, Jeffre J.

2012-01-01

Two recent and unfortunate North American cases involving end-of-life treatment highlight the difficulties surrounding medical futility conflicts. As countries have explored the greater influence that patients and their representatives may play on end-of-life treatment decisions, the benefits and struggles involved with such a movement must be appreciated. These 2 cases are used to examine the present systems existing in the United States and Canada for resolving end-of-life decisions, including the difficulty in defining medical futility, the role of medical ethics committees, and controversies involving surrogate decision making. PMID:23127734

Domesticating Biotechnology: How London's Science Museum Has Framed the Controversy.

ERIC Educational Resources Information Center

Levidow, Les

1998-01-01

Exhibits in London's Science Museum are critiqued in this discussion of the problem of balance in presenting controversial issues in museum exhibits. Science museums claim to portray controversial issues in a neutral manner, but neutrality is impossible. Asks how science museums can involve visitors in the controversy and how the museum's role can…

The scientific status of childhood dissociative identity disorder: a review of published research.

PubMed

Boysen, Guy A

2011-01-01

Dissociative identity disorder (DID) remains a controversial diagnosis due to conflicting views on its etiology. Some attribute DID to childhood trauma and others attribute it to iatrogenesis. The purpose of this article is to review the published cases of childhood DID in order to evaluate its scientific status, and to answer research questions related to the etiological models. I searched MEDLINE and PsycINFO records for studies published since 1980 on DID/multiple personality disorder in children. For each study I coded information regarding the origin of samples and diagnostic methods. The review produced a total of 255 cases of childhood DID reported as individual case studies (44) or aggregated into empirical studies (211). Nearly all cases (93%) emerged from samples of children in treatment, and multiple personalities was the presenting problem in 23% of the case studies. Four US research groups accounted for 65% of all 255 cases. Diagnostic methods typically included clinical evaluation based on Diagnostic and Statistical Manual of Mental Disorder criteria, but hypnosis, structured interviews, and multiple raters were rarely used in diagnoses. Despite continuing research on the related concepts of trauma and dissociation, childhood DID itself appears to be an extremely rare phenomenon that few researchers have studied in depth. Nearly all of the research that does exist on childhood DID is from the 1980s and 1990s and does not resolve the ongoing controversies surrounding the disorder. Copyright © 2011 S. Karger AG, Basel.

Pero Vaz de Caminha: an-interchange program for quality control between Brazil and Portugal.

PubMed

Utagawa, Maria Lúcia; di Loreto, Celso; de Freitas, Cristina; Milanezi, Fernanda; Longatto Filho, Adhemar; Pereira, Sónia Maria Miranda; Maeda, Marina Yoshiê Sakamoto; Schmitt, Fernando C

2006-01-01

To start an interexchange program for quality control in cervical cytology and discuss conceptual criteria for diagnosis. Slides were selected in the archives of the 2 institutes and included cases with unsatisfactory, negative and positive results. Sets of slides were changed between the partners every 3 months. At the end of each year a senior cytopathologist was invited to discuss the major discrepancies found in the study. A total of 1,041 cases were analyzed. Full concordance was obtained in 74.4% (774) of cases and discrepancies in 25.6% (267 cases). Full agreement was achieved in 276 (39%) of 707 cases categorized as negative. In 421 negative cases from laboratory A, this concordance represents 65.5% and 96.5% for laboratory B, which submitted 286 negative cases. The main discordance was the high number of atypical squamous cells of undetermined significance cases: 3.1% for A and 128 (33.2%) for B. Samples with discrepancies related to the quality of the material was another controversial issue: of 16 cases from laboratory A, 6 (37.5%) unsatisfactory cases were the same and 10 (62.5%) different. Laboratory B presented 20 unsatisfactory cases, and 14 (70.0%) had other diagnoses. Low grade squamous intraepithelial lesion and high grade squamous intraepithelial lesion concordance ranged from 75% to 80%, and invasive carcinoma has 4 discordances (28.5%), 3 previously screened as high grade squamous intraepithelial lesion and 1 as atypical squamous cells of undetermined significance. The kappa value obtained was 0.65, indicating substantial agreement. Our results indicated that atypical squamous cells of undetermined significance diagnoses are the crucial point of controversies and concern the quality of routine diagnosis in cytopathology.

[Critical considerations on the legal regulation of sex selection (Part I)].

PubMed

Pérez Alonso, Esteban Juan

2002-01-01

Gender selection, and particularly its regulation, is a controversial issue. The author discusses the current problems surrounding gender selection from the very beginnings, and illustrates his views with an actual and controversial case in which a woman allowed to undergo artificial insemination was given the possibility of choosing the sex of her child. The author also discusses possible solutions and the penal, administrative regulation of the issue, as well as examining the court's decision in this particular case.

Dissociative identity disorder: Medicolegal challenges.

PubMed

Farrell, Helen M

2011-01-01

Persons with dissociative identity disorder (DID) often present in the criminal justice system rather than the mental health system and perplex experts in both professions. DID is a controversial diagnosis with important medicolegal implications. Defendants have claimed that they committed serious crimes, including rape or murder, while they were in a dissociated state. Asserting that their alter personality committed the bad act, defendants have pleaded not guilty by reason of insanity (NGRI). In such instances, forensic experts are asked to assess the defendant for DID and provide testimony in court. Debate continues over whether DID truly exists, whether expert testimony should be allowed into evidence, and whether it should exculpate defendants for their criminal acts. This article reviews historical and theoretical perspectives on DID, presents cases that illustrate the legal implications and controversies of raising an insanity defense based on multiple personalities, and examines the role of forensic experts asked to comment on DID with the goal of assisting clinicians in the medicolegal assessment of DID in relation to crimes.

Politics and Didactics of Peace Education: "Securing Peace in the Nuclear Age--The Case of the Neutron Weapon". A Course for Political Instruction in Schools in Hessen.

ERIC Educational Resources Information Center

Krell, Gert

1980-01-01

Describes a course developed for the public schools of Hessen, Germany, through the cooperative efforts of army officers, peace researchers, and educators. Information is presented on goals and contents of peace education as a part of political education, learning goals, course sequence, and content related to the neutron weapons controversy. (DB)

Spouse Abuse: The Problem and a Proposal for Military Police Intervention

DTIC Science & Technology

1984-12-01

relation to law enforcement, by visiting 17 police departments9 interviewing police managers , surveying 130 police officers, and interviewing social...about presenting a lot of information, while managing to gain and hold the interest of the audience. Since spouse abuse is such a controversial subject...available for domestic violence victims and batterers. The author was also invited to attend a meeting with the Family * Advocacy Case Management Team

Percutaneous CT-Guided Treatment of Osteochondritis Dissecans of the Sacroiliac Joint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Becce, Fabio, E-mail: fabio.becce@chuv.ch; Mouhsine, Elyazid; Mosimann, Pascal John

2012-08-15

Osteochondritis dissecans (OCD) is a joint disorder that affects the articular cartilage and subchondral bone, most commonly at the knee. OCD of the sacroiliac joint is extremely rare. Management of OCD remains controversial, and surgery is often needed, especially when conservative treatment fails. We present a rare case of OCD involving the left sacroiliac joint successfully treated by percutaneous computed tomography-guided retrograde drilling and debridement.

Systematic Assessment of the Various Controversies, Difficulties, and Current Trends in the Reestablishment of Lost Occlusal Planes in Edentulous Patients

PubMed Central

Sahoo, S; Singh, D; Raghav, D; Singh, G; Sarin, A; Kumar, P

2014-01-01

Accurate occlusal plane orientation is an essential factor in the fabrication of complete denture prosthesis. Over the years, it has received a number of methodologies by several researchers utilizing various anatomical landmarks however none of them is considered as perfect that could orient ideal occlusal plane. The presented literature review is an attempt to enlighten historical perspectives, pioneer researches, different controversies, difficulties and current trends for re-establishment of lost occlusal plane in edentulous patients. An extensive literature search was performed using Medline/PubMed interface and other scholarly research bibliographic databases using Medical Subject Headings. Studies describing research studies, case series and assorted clinical reports were retrieved and evaluated from 1963 to 2013. Most of the studies have suggest and evidence to consider Camper's plane for artificial orientation of occlusal plane however there is a substantial lack of genuine long term studies and authentic data that could recommend a single reliable landmark for perfect occlusal plane reorientation in a variety of cases. PMID:24971200

Alveolar soft part sarcoma of the tongue in a 3-year-old boy: a case report

PubMed Central

2010-01-01

Introduction Alveolar soft tissue sarcoma of the tongue is a very rare and aggressive tumor which occurs in infancy with a relatively controversial histogenesis. It may mimic benign vascular neoplasms and may metastasize to the lungs, brain or bones. Case presentation We present the case of a three-year-old Caucasian boy who was admitted to our department with a history of dysphagia and two episodes of oral bleeding which had lasted for a period of six months. A thorough histological examination together with imaging techniques form the basis of a reliable diagnosis. Conclusion Alveolar soft tissue sarcoma of the tongue is a rare tumor which occurs in infancy and which is often misdiagnosed pre-operatively. It should therefore be included in the differential diagnosis of oral pediatric lesions. PMID:20459684

An evidence based review of the assessment and management of penetrating neck trauma.

PubMed

Burgess, C A; Dale, O T; Almeyda, R; Corbridge, R J

2012-02-01

Although relatively uncommon, penetrating neck trauma has the potential for serious morbidity and an estimated mortality of up to 6%. The assessment and management of patients who have sustained a penetrating neck injury has historically been an issue surrounded by significant controversy. OBJECTIVES OF REVIEW: To assess recent evidence relating to the assessment and management of penetrating neck trauma, highlighting areas of controversy with an overall aim of formulating clinical guidelines according to a care pathway format. Structured, non-systematic review of recent medical literature. An electronic literature search was performed in May 2011. The Medline database was searched using the Medical Subject Headings terms 'neck injuries' and 'wounds, penetrating' in conjunction with the terms 'assessment' or 'management'. Embase was searched with the terms 'penetrating trauma' and 'neck injury', also in conjunction with the terms 'assessment' and 'management'. Results were limited to articles published in English from 1990 to the present day. Abstracts were reviewed by the first three authors to select full-text articles for further critical appraisal. The references and citation links of these articles were hand-searched to identify further articles of relevance. 147 relevant articles were identified by the electronic literature search, comprising case series, case reports and reviews. 33 were initially selected for further evaluation. Although controversy continues to surround the management of penetrating neck trauma, the role of selective non-operative management and the utility of CT angiography to investigate potential vascular injuries appears to be increasingly accepted. © 2011 Blackwell Publishing Ltd.

Manufacturing doubt: journalists' roles and the construction of ignorance in a scientific controversy.

PubMed

Stocking, S Holly; Holstein, Lisa W

2009-01-01

In recent decades, corporate and special interests have developed a wide repertoire of methods to manufacture doubt about science that threatens their interests. In the case presented here, a trade association issued a rich assortment of rhetorical claims intended to sow public confusion about university studies that threatened to undermine its industry's activities. Journalists' use of these claims appeared to vary largely as a function of their perceptions of their journalistic roles and of their audiences, though their knowledge of science also appeared to play a role. Our findings offer insight into how and why reporters respond to rhetorical claims about scientific ignorance and uncertainty that actors use to discredit threatening science. In so doing, they contribute to growing scholarship on journalists' contributions to the social construction of ignorance in scientific controversies.

Cemento-ossifying fibroma.

PubMed

Ram, Rangila; Singhal, Anita; Singhal, Parul

2012-01-01

The cemento-ossifying fibroma is classified as a fibro-osseous lesion of the jaws. It commonly presents as a progressively growing lesion that can attain an enormous size with resultant deformity if left untreated. A case of cemento-ossifying fibroma involving the left mandible is described in a 35 year old female patient. The clinical, radiographic and histological features as well as surgical findings are presented. The cemento-ossifying fibroma is a central neoplasm of bone as well as the periodontium which has caused considerable controversy because of the confusion regarding terminology and the criteria for its diagnosis.

Cemento-ossifying fibroma

PubMed Central

Ram, Rangila; Singhal, Anita; Singhal, Parul

2012-01-01

The cemento-ossifying fibroma is classified as a fibro-osseous lesion of the jaws. It commonly presents as a progressively growing lesion that can attain an enormous size with resultant deformity if left untreated. A case of cemento-ossifying fibroma involving the left mandible is described in a 35 year old female patient. The clinical, radiographic and histological features as well as surgical findings are presented. The cemento-ossifying fibroma is a central neoplasm of bone as well as the periodontium which has caused considerable controversy because of the confusion regarding terminology and the criteria for its diagnosis. PMID:22557904

Proposed best modeling practices for assessing the effects of ecosystem restoration on fish

USGS Publications Warehouse

Rose, Kenneth A; Sable, Shaye; DeAngelis, Donald L.; Yurek, Simeon; Trexler, Joel C.; Graf, William L.; Reed, Denise J.

2015-01-01

Large-scale aquatic ecosystem restoration is increasing and is often controversial because of the economic costs involved, with the focus of the controversies gravitating to the modeling of fish responses. We present a scheme for best practices in selecting, implementing, interpreting, and reporting of fish modeling designed to assess the effects of restoration actions on fish populations and aquatic food webs. Previous best practice schemes that tended to be more general are summarized, and they form the foundation for our scheme that is specifically tailored for fish and restoration. We then present a 31-step scheme, with supporting text and narrative for each step, which goes from understanding how the results will be used through post-auditing to ensure the approach is used effectively in subsequent applications. We also describe 13 concepts that need to be considered in parallel to these best practice steps. Examples of these concepts include: life cycles and strategies; variability and uncertainty; nonequilibrium theory; biological, temporal, and spatial scaling; explicit versus implicit representation of processes; and model validation. These concepts are often not considered or not explicitly stated and casual treatment of them leads to mis-communication and mis-understandings, which in turn, often underlie the resulting controversies. We illustrate a subset of these steps, and their associated concepts, using the three case studies of Glen Canyon Dam on the Colorado River, the wetlands of coastal Louisiana, and the Everglades. Use of our proposed scheme will require investment of additional time and effort (and dollars) to be done effectively. We argue that such an investment is well worth it and will more than pay back in the long run in effective and efficient restoration actions and likely avoided controversies and legal proceedings.

Scientific Controversies in Teaching Science: The Case of Volta.

ERIC Educational Resources Information Center

Kipnis, Nahum

2001-01-01

Discusses a way of introducing a scientific controversy that emphasizes objective aspects of such issues as multiple theoretical interpretation of phenomena, choosing a theory, and insistence on the chosen theory. The goal is to give students a better insight into the workings of science and provide guidelines for building theories in their own…

The Animal Experimentation Controversy: Ethical Views of Prospective Teachers

ERIC Educational Resources Information Center

de Villiers, Rian

2012-01-01

Vivisection (live animal experimentation) is a controversial issue for many people. The purpose of this case study is to examine the attitudes of prospective teachers toward vivisection in education and research, to determine if gender has an influence on these attitudes, and to discuss the implications of these attitudes with regard to teaching…

The nature of double concomitant myxopapillary ependymoma: report of a case.

PubMed

Salomão, J Francisco; de Andrade, Cecília Vianna; Bellas, Antonio Rosa; Cervante, Tatiana Protzenko

2014-03-01

Myxopapillary ependymomas are almost exclusively seen at the conus medullaris/filum terminale/cauda equina region, usually as solitary space-occupying lesions. The authors report the case of a 14-year-old boy with double concomitant myxopapillary ependymoma, proximal and caudal on the filum terminale in which a totally gross removal was achieved in two stages. This presentation is rare and, so far, we have known just three similar cases that were previously reported in children. The true nature of these lesions is controversial, and while some argue that they are related to metastatic seeding, others consider them independent lesions developing synchronously. A review on dissemination of spinal myxopapillary ependymomas was done.

Femoral vein injury managed by in situ saphenous vein bypass : a case report.

PubMed

Coppin, Th; Kuhnle, M

2014-01-01

Injured veins of the lower limbs may cause massive haemorrhage requiring early control. Operative management of injured veins remains a controversial topic and reconstruction or ligation depends on venous and adjacent tissue damage. Nevertheless, venous reconstruction seems to reduce the complications of venous ligation. The case of a 33 year old women with a venous wound to the right groin is presented. Surgical management consisted of controlling the bleeding and venous revascularisation with an in situ saphenous vein bypass to substitute the injured femoral vein. The patient had an uneventful postoperative period without any complications. The case demonstrates this method of vascular venous repair is the preferable one. Copyright© Acta Chirurgica Belgica.

The Use of Electroconvulsive Therapy in Atypical Psychotic Presentations

PubMed Central

Vasu, Devi

2007-01-01

Convulsive therapy and its progeny, electroconvulsive therapy (ECT), were originally used for the treatment of catatonic schizophrenia, and there is little doubt that ECT remains an effective intervention for the treatment of schizophrenia. However, current practice tends to favor the use of ECT in severe or treatment refractory affective disorders, and its use in schizophrenia and other nonaffective (atypical) psychotic disorders has become controversial. Case reports have suggested a role for ECT in two specific atypical psychotic disorders: Cotard's syndrome and cycloid psychosis. In this article, we review the atypical psychotic disorders and report a series of five case examples that signify the role of ECT in atypical psychotic presentations, particularly when the symptoms resemble those found in Cotard's syndrome and cycloid psychosis. PMID:20428309

Lactic Acidosis in a Patient with Type 2 Diabetes Mellitus

PubMed Central

2015-01-01

Lactic acidosis occurs when lactate production exceeds its metabolism. There are many possible causes of lactic acidosis, and in any given patient, several causes may coexist. This Attending Rounds presents a case in point. Metformin’s role in the pathogenesis of lactic acidosis in patients with diabetes mellitus is complex, as the present case illustrates. The treatment of lactic acidosis is controversial, except for the imperative to remedy its underlying cause. The use of sodium bicarbonate to treat the often alarming metabolic derangements may be quite efficacious in that regard but is of questionable benefit to patients. Renal replacement therapies (RRTs) have particular appeal in this setting for a variety of reasons, but their effect on clinical outcomes is untested. PMID:25762524

Effective apatinib treatment of pleomorphic liposarcoma: A case report.

PubMed

Yan, Peng; Sun, Mei-Li; Sun, Yu-Ping; Liu, Chuan-Yong

2017-08-01

Pleomorphic liposarcoma (PLS) is a rare and aggressive malignant tumor, and both radiation and conventional cytotoxic chemotherapy remain controversial for metastatic or unresectable disease. We presented an 81-year-old Chinese woman with advanced PLS who received apatinib after failure chemotherapy. The patient was diagnosed as having PLS by biopsy. After a failed chemotherapy, apatinib started to be taken orally 425 mg per day. This patient achieved 3-month progression-free survival (PFS) and a higher quality of life. Meanwhile, this patient suffered grade 2 hypertension and grade 3 hand-foot syndrome (HFS). In this case, apatinib presented good efficacy and safety to treat PLS. Randomized clinical studies are required to confirm the efficacy and safety of apatinib in the treatment of PLS.

Binocular Vision

PubMed Central

Blake, Randolph; Wilson, Hugh

2010-01-01

This essay reviews major developments –empirical and theoretical –in the field of binocular vision during the last 25 years. We limit our survey primarily to work on human stereopsis, binocular rivalry and binocular contrast summation, with discussion where relevant of single-unit neurophysiology and human brain imaging. We identify several key controversies that have stimulated important work on these problems. In the case of stereopsis those controversies include position versus phase encoding of disparity, dependence of disparity limits on spatial scale, role of occlusion in binocular depth and surface perception, and motion in 3D. In the case of binocular rivalry, controversies include eye versus stimulus rivalry, role of “top-down” influences on rivalry dynamics, and the interaction of binocular rivalry and stereopsis. Concerning binocular contrast summation, the essay focuses on two representative models that highlight the evolving complexity in this field of study. PMID:20951722

Case report on vertebral artery dissection in mixed martial arts.

PubMed

Slowey, Michael; Maw, Graeme; Furyk, Jeremy

2012-04-01

A 41-year-old man presented to the ED with severe vertigo 2 days after a grappling injury while training in mixed martial arts. Imaging revealed a cerebellar infarct with complete occlusion of the right vertebral artery secondary to dissection. Management options are discussed as is the ongoing controversy regarding the safety of the sport. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Terminology of the tonsils.

PubMed

Casteleyn, C; Simoens, P; Van den Broeck, W

2011-06-01

Many terms used for referring to tonsillar structures are applied in immunological research. However, in many cases, the use of these terms is not in compliance with official veterinary anatomical nomenclature. This is partly attributable to ambiguous descriptions present in conventional anatomical textbooks. This study gives an overview of pertaining controversial terms and promotes the official anatomical terminology applicable to the tonsils, to enhance the unequivocal transfer of knowledge generated during immunological research. © 2011 Blackwell Verlag GmbH.

Mentioning race at the beginning of clinical case presentations: a survey of US medical schools.

PubMed

Nawaz, Hamayun; Brett, Allan S

2009-02-01

Medical students and doctors in the USA frequently mention the patient's race at the beginning of oral or written clinical case presentations. However, this practice is controversial. We aimed to determine whether US medical schools explicitly teach students to mention race at the beginning of case presentations, and to collect additional information on the schools' perspectives on this practice. An Internet-based questionnaire was submitted to directors of courses on history taking and physical examination at all US medical schools. The response rate was 85%. Students are taught to mention race routinely at 11% of schools and selectively at 63% of schools; this practice is discouraged at 9% of schools and not addressed at 18% of schools. Most respondents noted that resident doctors at their institutions routinely mention race at the beginning of case presentations. Even at schools in which mentioning race is discouraged or not addressed, students tend to include race during their clinical rotations. Respondents were divided on whether a standardised approach to inclusion of race should exist at US schools. Teaching about inclusion or exclusion of race in the opening statement of clinical case presentations varies across US medical schools. This variation presents an opportunity for medical educators to discuss tensions between stereotyping and cultural competence in medical education.

Teachers' Controversial Issue Decisions Related to Race, Gender, and Religion during the 2008 Presidential Election

ERIC Educational Resources Information Center

Journell, Wayne

2011-01-01

Using the 2008 Presidential Election as a case of curricular controversy, the author describes how six high school government teachers responded to the racial, gender, and religious diversity included on the presidential tickets of the two major political parties. Teachers had to decide whether the issue of Americans challenging the tradition of…

The Significance of the Origin of Physical Chemistry for Physical Chemistry Education: The Case of Electrolyte Solution Chemistry

ERIC Educational Resources Information Center

de Berg, Kevin Charles

2014-01-01

Physical Chemistry's birth was fraught with controversy, a controversy about electrolyte solution chemistry which has much to say about how scientific knowledge originates, matures, and responds to challenges. This has direct implications for the way our students are educated in physical chemistry in particular and science in general. The…

Science News of Controversy: The Case of Marijuana. Journalism Monographs No. 62.

ERIC Educational Resources Information Center

Shepherd, R. Gordon

1979-01-01

A study of news refraction was conducted to determine how well the press has functioned in popularizing scientific views and findings on a subject with direct implications for a controversial social issue. In reporting the marijuana question, the press produced a certain amount of refraction or news-slanting. For example, science articles…

The socio-legal acceptance of new technologies: a close look at artificial insemination.

PubMed

Bernstein, Gaia

2002-10-01

Heated debates often surround the introduction of an important new technology into society, as exemplified by current controversies surrounding human cloning and privacy protection on the Internet. Underlying these controversies are disruptions to central socio-legal values caused by these new technologies. Whether new technologies will eventually be accepted by society is often contingent on the reaction of the legal system. This mandates the formulation of a conceptual framework for understanding and structuring the way the law should react in cases surrounding the adoption of new technologies. By using the case study of artificial insemination this Article develops the tools for structuring the legal role in the acceptance process of new technologies. The three-century controversy surrounding the innovation of artificial insemination results from the innovations' disruption of the socio-legal value of the family. Artificial Insemination--although invented in the eighteenth-century--was rarely used until the 1930s, and only legalized in the 1960s. Its application to surrogacy and its use by unmarried women extends the controversy into the twenty-first century. The case study demonstrates the nature of the relationship among the technological, social and legal acceptance processes of new technologies, and analyzes the legal acceptance debate. The conceptual framework produced is useful in understanding and structuring the legal role in current debates surrounding the introduction and acceptance of new technologies.

History Forum Addresses Creation/Evolution Controversy.

ERIC Educational Resources Information Center

Schweinsberg, John

1997-01-01

A series of programs entitled Creationism and Evolution: The History of a Controversy was presented at the University of Alabama in Huntsville. The controversy was addressed from an historical and sociological, rather than a scientific perspective. Speakers addressed the evolution of scientific creationism, ancient texts versus sedimentary rocks…

Shouldn't Dead Be Dead?: The Search for a Uniform Definition of Death.

PubMed

Lewis, Ariane; Cahn-Fuller, Katherine; Caplan, Arthur

2017-03-01

In 1968, the definition of death in the United States was expanded to include not just death by cardiopulmonary criteria, but also death by neurologic criteria. We explore the way the definition has been modified by the medical and legal communities over the past 50 years and address the medical, legal and ethical controversies associated with the definition at present, with a particular highlight on the Supreme Court of Nevada Case of Aden Hailu.

Penetrating abdominal injuries: management controversies

PubMed Central

Butt, Muhammad U; Zacharias, Nikolaos; Velmahos, George C

2009-01-01

Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries. PMID:19374761

Understanding the Nature of Science Through a Critical and Reflective Analysis of the Controversy Between Pasteur and Liebig on Fermentation

NASA Astrophysics Data System (ADS)

García-Carmona, Antonio; Acevedo-Díaz, José Antonio

2017-03-01

This article presents a qualitative study, descriptive-interpretive in profile, of the effectiveness in learning about the nature of science (NOS) of an activity relating to the historical controversy between Pasteur and Liebig on fermentation. The activity was implemented during a course for pre-service secondary science teachers (PSSTs) specializing in physics and chemistry. The approach was explicit and reflective. Three research questions were posed: (1) What conceptions of NOS do the PSSTs show after a first reflective reading of the historical controversy?, (2) What role is played by the PSSTs' whole class critical discussion of their first reflections on the aspects of NOS dealt with in the controversy?, and (3) What changes are there in the PSSTs' conceptions of NOS after concluding the activity? The data for analysis was extracted from the PSSTs' group reports submitted at the end of the activity and the audio-recorded information from the whole class discussion. A rubric was prepared to assess this data by a process of inter-rater analysis. The results showed overall improvement in understanding the aspects of NOS involved, with there being a significant evolution in some cases (e.g., conception of scientific theory) and moderate in others (e.g., differences in scientific interpretations of the same phenomenon). This reveals that the activity has an educational utility for the education of PSSTs in NOS issues. The article concludes with an indication of some educational implications of the experience.

A review of published research on adult dissociative identity disorder: 2000-2010.

PubMed

Boysen, Guy A; VanBergen, Alexandra

2013-01-01

The purpose of this study was to assess the scientific and etiological status of dissociative identity disorder (DID) by examining cases published from 2000 to 2010. In terms of scientific status, DID is a small but ongoing field of study. The review yielded 21 case studies and 80 empirical studies, presenting data on 1171 new cases of DID. A mean of 9 articles, each containing a mean of 17 new cases of DID, emerged each year. In terms of etiological status, many of the central criticisms of the disorder's validity remain unaddressed. Most cases of DID emerged from a small number of countries and clinicians. In addition, documented cases occurring outside treatment were almost nonexistent. Finally, people simulating DID in the laboratory were mostly indistinguishable from individuals with DID. Overall, DID is still a topic of study, but the research lacks the productivity and focus needed to resolve ongoing controversies surrounding the disorder.

Vasospasm is a significant factor in cyclosporine-induced neurotoxicity: case report.

PubMed

Braakman, Hilde M H; Lodder, Jan; Postma, Alida A; Span, Lambert F R; Mess, Werner H

2010-05-11

The aetiology of central nervous system lesions observed in cerebral cyclosporine neurotoxicity remains controversial. We report a 48-year-old woman with a non-severe aplastic anaemia who presented with stroke-like episodes while on cyclosporine treatment.Transcranial Doppler ultrasound revealed severely elevated flow velocities in several cerebral vessels, consistent with vasospasm. Immediately after reducing the cyclosporine dose, the stroke-like episodes disappeared. Only after cyclosporine withdrawal the transcranial Doppler ultrasound abnormalities fully resolved. This case demonstrates a significant role of vasospasm in the pathway of cyclosporine-induced neurotoxicity. Transcranial Doppler ultrasound is an effective tool for the diagnosis and follow-up of cyclosporine-induced vasospasm.

Nerve Damage From Bone Allografts and Xenografts-A Case Series.

PubMed

Pogrel, M Anthony

2017-07-01

The concept of socket preservation by placing a particulate bone allograft or xenograft into a tooth socket or on the alveolar ridge after tooth removal remains a somewhat controversial topic. The concept is that it will preserve the ridge from resorption and such that subsequent implant insertion will be easier, with fewer complications. However, one particular issue is that these materials, although not directly neurotoxic, appear to be an irritant to the nerves if they come in contact with them. We present a case series demonstrating this complication. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Aggressive curettage of a chondroblastoma-like osteosarcoma of the proximal end of the tibia. A case report with seven-year follow-up.

PubMed

Ramos Pascua, Luis Rafael; Casas Ramos, Paula; Arias Martín, Francisco; Izquierdo García, Francisco Miguel

2018-06-01

A chondroblastoma-like osteosarcoma (CLO) in the proximal epiphysis and metaphysis of the tibia in a 30-year-old male is presented. With a wrong diagnosis of chondroblastoma, an aggressive curettage was performed. Later, the patient refused en-bloc resection. Seven years after surgery, there has been no local recurrence, and the patient is living an ordinary and active life. CLO is a very uncommon and controversial histologic subtype of osteosarcoma that can be misdiagnosed as chondroblastoma and therefore incorrectly treated. However, aggressive curettage with its functional advantages could be a reasonable option in selected cases.

Teaching about Controversial Groups in Public Schools: Critical Multiculturalism and the Case of Muslims since September 11

ERIC Educational Resources Information Center

Jackson, Elizabeth Jeanne

2009-01-01

This study explores some major challenges involved in teaching about controversial groups in U.S. public schools, discussing as an example education about Muslims since September 11, 2001 (9/11), and the need for students to develop accurate and balanced perceptions of others in a democratic society. In the first chapter, the two prominent…

Girls' Doll Play in Educational, Virtual, Ideological and Market Contexts: A Case Analysis of Controversy

ERIC Educational Resources Information Center

Reifel, Stuart

2009-01-01

The purpose of this study was to explore an example of girls' doll play in contemporary US culture, including its virtual, political, marketing, and other contextual meanings. The narrative that provoked the analysis was a brief news report about a controversial school function--a school fund-raiser fashion show featuring American Girl doll…

The Development of the Theory of Electrolytic Dissociation: A Case Study of a Scientific Controversy and the Changing Nature of Chemistry.

ERIC Educational Resources Information Center

De Berg, Kevin C.

2003-01-01

Examines the evidence proffered by Arrhenius, van't Hoff, and Ostwald in favor of the theory of electrolytic dissociation and outlines objections raised by Armstrong, Fitzgerald, and Pickering. Discusses the implication of the controversy revolving around the nature of chemistry in relation to the teaching and learning of chemistry. (KHR)

Is chronic lymphocytic leukemia a contraindication for radon and thermotherapy?--a case report.

PubMed

Falkenbach, A; Jäger, U

2001-01-15

A growing number of patients presenting for radon-thermotherapy have a history of malignant disease. The question as to whether malignancies in general are a contraindication for radon treatment or mild hyperthermia during spa therapy is still a subject of controversy. We report a patient with osteoarthritis and a frozen shoulder who repeatedly underwent speleotherapeutic radon and hyperthermia treatment in the gallery of the Gasteiner Heilstollen, Austria, despite concomitant chronic lymphocytic leukemia (B-CLL, Rai stage 0). After nine courses of radon-thermotherapy over eight years, no apparent negative impact on CLL was noted. The purpose of this case report is to encourage discussion as to whether CLL or other past or present malignancies must be considered a contraindication for spa treatment such as radon-thermotherapy.

Lactic Acidosis in a Patient with Type 2 Diabetes Mellitus.

PubMed

Weisberg, Lawrence S

2015-08-07

Lactic acidosis occurs when lactate production exceeds its metabolism. There are many possible causes of lactic acidosis, and in any given patient, several causes may coexist. This Attending Rounds presents a case in point. Metformin's role in the pathogenesis of lactic acidosis in patients with diabetes mellitus is complex, as the present case illustrates. The treatment of lactic acidosis is controversial, except for the imperative to remedy its underlying cause. The use of sodium bicarbonate to treat the often alarming metabolic derangements may be quite efficacious in that regard but is of questionable benefit to patients. Renal replacement therapies (RRTs) have particular appeal in this setting for a variety of reasons, but their effect on clinical outcomes is untested. Copyright © 2015 by the American Society of Nephrology.

Intramural Hematoma of the Thoracic Aorta as a Form of Aortic Dissection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Juszkat, Robert; Pukacki, Fryderyk; Oszkinis, Grzegorz

Intramural hematoma (IMH) of the thoracic aorta is a complication with unknown etiology and a poorly predictable prognosis. There is also considerable controversy about the management and prognosis of IMH as well as the treatment. We present two cases of endovascular treatment of IMH with stent-graft placement. On the basis of references, we discuss risks of progression of the given pathology and possible complications. Despite the lack of uniform opinion about the management of this disorder, we present our observations of and experiences with endovascular treatment of IMH of the thoracic aorta.

Therapeutic Suggestions for Chronic Subdural Hematoma Associated with Idiopathic Thrombocytopenic Purpura: A Case Report and Literature Review

PubMed Central

Takase, Hajime; Tatezuki, Junya; Ikegaya, Naoki; Yamamoto, Daisuke; Hashimoto, Mizuki; Takagi, Makoto; Mochimatsu, Yasuhiko; Kawahara, Nobutaka

2015-01-01

A 66-year-old woman who was previously diagnosed with idiopathic thrombocytopenic purpura (ITP) presented with mild right-sided hemiparesis and drowsiness. Head computed tomography (CT) imaging demonstrated a massive left chronic subdural hematoma (CSDH) with a midline shift. Because initial laboratory data showed a significantly decreased blood platelet count (0.3 × 104/mm3), medical treatments such as platelet transfusion, intravenous immunoglobulin (IVIG), and high-dose corticosteroid therapy, were initiated. She clinically and radiologically responded well to these treatments without any surgical intervention. In addition to presenting our case, we searched the PubMed and Ichushi Web databases to comprehensively illustrate clinical characteristics and treatment outcomes of similar cases. Including the present case, we found 19 reports and 23 cases of CSDH associated with ITP in the literature, and assessed 17 reports and 21 cases that were written in English and Japanese. None or mild neurological symptom were seen in 13 cases, and severe, such as coma and hemiparesis, were described in the younger 8 cases with significant difference. All except one were first treated with medical therapies. Most cases of the former group responded well to conservative therapy. On the other hand, most in the latter eventually needed surgical treatment in addition except recent two cases including the present case. CSDH associated with ITP is rarely described, and its management remains controversial. However, this report highlights multiple continuous medical treatments under strict observation and general care might be a useful alternative to avoid surgery in cases presenting with severe neurological deficits and extremely low platelet counts. PMID:28663980

Can only one person be right? The development of objectivism and social preferences regarding widely shared and controversial moral beliefs.

PubMed

Heiphetz, Larisa; Young, Liane L

2017-10-01

Prior work has established that children and adults distinguish moral norms (e.g., hitting is wrong) from conventional norms (e.g., wearing pajamas to school is wrong). Specifically, moral norms are generally perceived as universal across time and space, similar to objective facts. We examined preschoolers' and adults' perceptions of moral beliefs alongside facts and opinions by asking whether only one person could be right in the case of disagreements. We also compared perceptions of widely shared moral beliefs (e.g., whether it is better to pull someone's hair or share with someone) and controversial moral beliefs (e.g., whether it is better to help someone with a project or make cookies for someone). In Studies 1 and 2, preschoolers and adults were more likely to judge that only one person could be right in the case of widely shared versus controversial moral beliefs, treating the former as more objective or fact-like. Children were also more likely than adults to say that only one person could be right in a moral disagreement. Study 2 additionally revealed that adults were more likely than children to report preferring individuals who shared their controversial moral beliefs. Study 3 replicated these patterns using a different sample of widely shared beliefs (e.g., whether it is okay to mock a poor classmate) and controversial moral beliefs (e.g., whether it is okay to tell small, prosocial lies). While some aspects of moral cognition may depend on abundant social learning and cognitive development, the perception that disagreements about widely shared moral beliefs have only one right answer while disagreements about controversial moral beliefs do not emerges relatively early. We discuss implications for moral learning and social preferences. Copyright © 2016 Elsevier B.V. All rights reserved.

Setting the Record Straight: Interest Group Influence on Climate Policy at the Environmental Protection Agency

NASA Astrophysics Data System (ADS)

Cook, Jeffrey J.

It is clear that interest groups are involved in the rulemaking process at the Environmental Protection Agency (EPA), but it has been difficult to determine whether certain groups are more influential on outcomes. This debate persists because the literature illustrates that groups can be influential at discrete stages in the process, but the field rarely analyzes the entire rulemaking process. This uncertainty has spurred controversy regarding the EPA's recent climate change regulations. Therefore, this dissertation conducted three case studies of recent climate change regulations and addresses three questions. First, what, if any, strategies did interest groups use to influence the content of these climate change rules? Second, did these strategies translate into influence? Third, what can these climate change case studies tell us about the role of interest groups in other controversial rules at the EPA, and across the bureaucracy more broadly? Ultimately, I argue that interest group influence was generally balanced across each of the three case studies. These findings then serve as the basis to develop my Regulatory Spheres of Influence Framework. The framework illustrates that given the nature of EPA rulemakings, it is very difficult for one side either business or environmental to dominate the process in highly controversial rules. It is possible that these conclusions track to other controversial rules across the bureaucracy and I note that my framework could be applied in other contexts to test this assertion.

Indian sports nicknames/logos: affective difference between American Indian and non-Indian college students.

PubMed

LaRocque, Angela R; McDonald, J Douglas; Weatherly, Jeffrey N; Ferraro, F Richard

2011-01-01

The use of American Indian (AI) words and images in athletic teams' nicknames, logos, and mascots remains a controversial issue. This study investigated the emotional impact of the University of North Dakota's "Fighting Sioux" nickname/logo on 33 AI and 36 majority culture (MC) students enrolled at the university. Participants completed the Multiple Affect Adjective Checklist-Revised (MAACL-R) before viewing two slide presentations of Fighting Sioux-related images: one neutral (i.e., non-controversial) and one controversial. Participants completed the MAACL-R after each presentation. They also completed the Nickname and Logo Distress Scale, and AI participants completed the Northern Plains Biculturalism Inventory to assess their degree of cultural orientation. Results showed that AIs experienced higher negative affect following both slide presentations than did MC participants. MC participants' affect was only changed following the controversial slide presentation. The findings suggest AI students may experience significantly higher levels of psychological distress when viewing even neutral images of AI nicknames/logos.

Great expectations--ethics, avian flu and the value of progress.

PubMed

Evans, Nicholas G

2013-04-01

A recent controversy over the US National Science Advisory Board for Biosecurity's recommendation to censor two publications on genetically modified H5N1 avian influenza has generated concern over the threat to scientific freedom such censorship presents. In this paper, I argue that in the case of these studies, appeals to scientific freedom are not sufficient to motivate a rejection of censorship. I then use this conclusion to draw broader concerns about the ethics of dual-use research.

[Treatment of the first episode of spontaneous pneumothorax].

PubMed

Moubachir, H; Zaghba, N; Benjelloun, H; Bakhatar, A; Yassine, N

2016-11-01

The management of a first episode of spontaneous pneumothorax is controversial and the best technique to be used as an initial intervention, aspiration or intercostal drainage, is still debated. We present a retrospective case series during two and a half consecutive years describing the immediate management of spontaneous pneumothoraces, comparing aspiration versus thoracic drainage. One hundred and thirty-three clinical files from patients with spontaneous pneumothoraces were analyzed (17 primary and 116 secondary). The pneumothoraces were of varying size and different etiologies. Patients were initially treated with simple aspiration in 68 cases, with an immediate success rate of 37.5%, intercostal drainage in 49 cases, and by rest alone in 16 cases. In case of secondary pneumothorax, aspiration appeared to offer advantages as an initial strategy over intercostal drainage in terms of hospital stay (11 versus 22 days), and with significant effectiveness (37.5%). Copyright © 2016 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Case report of autogynophilia--family, ethical and surgical implications.

PubMed

Duisin, Dragana; Barisić, Jasmina; Nikolić-Balkoski, Gordana

2009-06-01

Through the case presentation of a diagnostically and therapeutically interesting gender dysphoric individual, the authors wish to address diagnostic problems associated with this controversial category, illustrate dilemmas and emphasize the importance of diagnostic procedures in differentiating between primary transsexualism and other transgender states. Many questions have been triggered by this case, mainly about whether this patient should be classified as a paraphilia (transvestite, transvestite with transsexual trend), primary transsexualism or autogynephilia and about the most adequate treatment (e.g., sex-reassignment surgery, hormone therapy as a way of partial feminisation or exclusively psychotherapy). The issue of reconstructive surgery, i.e. its justification in the case of this particular condition is specifically discussed. Before any decision is made, both medical but also ethical consequences of the treatment choice need to be considered (e.g., the client is the father of two underage children).

Paraquat. Specialized Information Service.

ERIC Educational Resources Information Center

Do It Now Foundation, Phoenix, AZ.

A collection of articles about the controversial use of paraquat (a toxic herbicide) in marijuana eradication programs is presented. Using a question-and-answer format, article 1 presents interviews with experts on all sides of the controversy, focusing on the legal, social, physiological, and ecological implications of the paraquat debate.…

Testing and the Public Interest.

ERIC Educational Resources Information Center

Educational Testing Service, Princeton, NJ.

The 1976 Educational Testing Service (ETS) Invitational Conference served as a platform for individuals who have been prominent in educational measurement and research to present their views on issues surrounding the testing controversy. The 1976 ETS "The Testing Scene: Chaos and Controversy," presents a historical review of events surrounding the…

The Problem of Catholic School Teachers Deferring to the Home on Controversial Religious Issues

ERIC Educational Resources Information Center

McDonough, Graham P.

2010-01-01

This paper observes that an ironic tension occurs in the discussion of controversial issues in some Catholic schools. One technique that teachers use in response to student disagreement with the official Church view on a controversial issue like contraception, homosexuality, or female ordination is to present Church teaching but then suggest that…

Peace and Security Education in the Federal Republic of Germany. Three Essays.

ERIC Educational Resources Information Center

Lessing, Clemens; And Others

Three essays related to peace and security education in the Federal Republic of Germany (FRG) are presented. The first essay, "An Example of Controversial Themes in Education: Peace and Security," by Clemens Lessing, uses a 1980 controversial discussion of the Committee of the Cultural Ministry as an example of controversial themes in…

The Effect of Falsely Balanced Reporting of the Autism-Vaccine Controversy on Vaccine Safety Perceptions and Behavioral Intentions

ERIC Educational Resources Information Center

Dixon, Graham; Clarke, Christopher

2013-01-01

Controversy surrounding an autism-vaccine link has elicited considerable news media attention. Despite being widely discredited, research suggests that journalists report this controversy by presenting claims both for and against a link in a relatively "balanced" fashion. To investigate how this reporting style influences judgments of vaccine…

Scientific Experts and the Controversy about Teaching Creation/Evolution in the UK Press

ERIC Educational Resources Information Center

Allgaier, Joachim

2010-01-01

The issue whether creationist accounts of the origins of life should be taught in science education alongside or even instead Darwin's theory of evolution is controversial in many countries. In 2002 there was a controversy around teaching creationism in science classes at a secondary school in England. The research presented in this paper uses…

"We Must Look at Both Sides"--But a Denial of Genocide Too?: Difficult Moments on Controversial Issues in the Classroom

ERIC Educational Resources Information Center

Kubota, Ryuko

2014-01-01

In language education, controversial issues sometimes emerge in either planned or spontaneous ways. Based on a classroom episode, this article illuminates dilemmas of approaching controversial issues for teachers who embrace critical pedagogy. A review of interdisciplinary literature demonstrates a general agreement on presenting balanced views…

The Emergence of the Controversy around the Theory of Evolution and Creationism in UK Newspaper Reports

ERIC Educational Resources Information Center

Allgaier, Joachim; Holliman, Richard

2006-01-01

The question of whether religious explanations about the origin of life should be taught alongside scientific accounts in compulsory science education has sparked controversy in several countries for decades. An important site for these controversies is media reporting. This article presents the results of a quantitative and qualitative analysis…

Controversies about sugars consumption: state of the science.

PubMed

Rippe, James M; Marcos, Ascensión

2016-11-01

Few topics in nutrition generate more controversy and debate than the putative associations between added sugars and health. With this as background, a group of researchers in the area of sugars and health gathered at the European Nutrition Conference (FENS) in 2015 to discuss these controversies and provide evidence-based science. The purpose of the current article was to provide a brief summary of some of the highlights from each of the presenters and serve as an Introduction to the supplement which contains full articles based on their presentations.

Contrasting Viewpoints about Controversial Issues: Presenting Different Views on Highly Charged Issues.

ERIC Educational Resources Information Center

Goodwin, Jeff

1993-01-01

County agricultural agents (n=258) viewed the "What's the Beef/Here's the Beef" videos, which present contrasting viewpoints on animal rights. Results suggest that well-educated people who have emotional underpinnings on a controversial issue can have their attitudes moderated by exposure to an educational program. (JOW)

The ethics of placebo-controlled trials: methodological justifications.

PubMed

Millum, Joseph; Grady, Christine

2013-11-01

The use of placebo controls in clinical trials remains controversial. Ethical analysis and international ethical guidance permit the use of placebo controls in randomized trials when scientifically indicated in four cases: (1) when there is no proven effective treatment for the condition under study; (2) when withholding treatment poses negligible risks to participants; (3) when there are compelling methodological reasons for using placebo, and withholding treatment does not pose a risk of serious harm to participants; and, more controversially, (4) when there are compelling methodological reasons for using placebo, and the research is intended to develop interventions that can be implemented in the population from which trial participants are drawn, and the trial does not require participants to forgo treatment they would otherwise receive. The concept of methodological reasons is essential to assessing the ethics of placebo controls in these controversial last two cases. This article sets out key considerations relevant to considering whether methodological reasons for a placebo control are compelling. © 2013.

Situs Inversus with Levocardia and Congenitally Corrected Transposition of Great Vessels in a 35 year old Male: A Case report

PubMed Central

Ghorbnazadeh, Atefeh; Zirak, Nahid; Fazlinezhad, Afsoon; Moenipour, Aliasghar; Manshadi, Hamid Hoseinikhah; Teshnizi, Mohammad Abbasi

2017-01-01

Situs inversus with levocardia and congenitally corrected transposition of the great arteries represents a relatively very rare congenital condition and most patients are diagnosed in infancy or early age. This case report describes a 35-year old man with congenitally corrected transposition of the great arteries which presented with a five month history of exertional dyspnea. A diagnosis was confirmed by transesophageal echocardiogram, showing situs inversus, levocardia, atrioventricular and ventriculoarterial discordance. He underwent physiologic repair, and was discharged thirty five days after the operation, in a good general condition. Although management of the corrected transposition of the great arteries patients remains controversial, the recommendation is that physiologic repair may be the procedure of choice for some patients, particularly complicated cases. PMID:28243408

Situs Inversus with Levocardia and Congenitally Corrected Transposition of Great Vessels in a 35 year old Male: A Case report.

PubMed

Ghorbnazadeh, Atefeh; Zirak, Nahid; Fazlinezhad, Afsoon; Moenipour, Aliasghar; Manshadi, Hamid Hoseinikhah; Teshnizi, Mohammad Abbasi

2017-01-01

Situs inversus with levocardia and congenitally corrected transposition of the great arteries represents a relatively very rare congenital condition and most patients are diagnosed in infancy or early age. This case report describes a 35-year old man with congenitally corrected transposition of the great arteries which presented with a five month history of exertional dyspnea. A diagnosis was confirmed by transesophageal echocardiogram, showing situs inversus, levocardia, atrioventricular and ventriculoarterial discordance. He underwent physiologic repair, and was discharged thirty five days after the operation, in a good general condition. Although management of the corrected transposition of the great arteries patients remains controversial, the recommendation is that physiologic repair may be the procedure of choice for some patients, particularly complicated cases.

Coexistence of brenner tumor and struma ovarii: case report.

PubMed

Takeuchi, K; Ohbayashi, C; Kitazawa, S; Ohara, N; Maruo, T

2005-01-01

There has been controversy regarding the histogenesis of Brenner tumors. It is generally accepted that Brenner tumors are derived directly from ovarian surface epithelium, which undergoes metaplasia to form the typical urothelial-like components, whereas some investigators assume that Brenner tumors arise from immature germ cells. We describe a well-documented case of the coexistence of struma ovarii regarded as a form of teratoma and Brenner tumor in the same ovary. Immunohistologically, not only columnar cells of thyroid follicles, but also transitional cells of Brenner nests were positive for thyroglobulin. In the present case, Brenner tumors and thyroid elements coexisted and were positive for thyroglobulin. While there is strong evidence that pure Brenner tumors originate mostly from the ovarian surface, at least Brenner tumors associated with teratomatous elements may have a germ cell origin.

Transrectal EUS-guided FNA biopsy of a presacral chordoma-report of a case and review of the literature

PubMed Central

Gottlieb, Klaus; Lin, Paul H; Liu, David M; Anders, Karl

2008-01-01

Chordomas are rare tumors which originate from the remnants of the notochord. These tumors are locally aggressive and have a predilection for the ends of the axial skeleton. An important prerequisite for optimal management of these tumors is a correct preoperative diagnosis. The present case is the first report of the use of endoscopic ultrasound to obtain transrectal fine needle aspiration biopsy of a presacral chordoma. A review of the prior computer tomography (CT) scans allowed us to calculate the tumor volume doubling time (18.3 mo). Transrectal biopsy of chordomas is controversial, however we believe that such concerns are not justified. PMID:18442211

Cemento-ossifying fibroma of mandible: An unusual case report and review of literature.

PubMed

Mohapatra, Mounabati; Banushree, C S; Nagarajan, K; Pati, Debashish

2015-01-01

The term ossifying fibroma (OF) has recently been included under fibro-osseous lesions. Cemento-OF (COF) is a benign neoplasm that arises from the periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone and fibrous tissue. These tumors occur in the third and fourth decades of life with a predilection for women. The mandible is more commonly involved than the maxilla. This lesion has caused considerable controversy regarding the use of terminology, origin and diagnostic criteria. This article describes an unusual case of COF presenting as unilocular lytic lesion of mandible in a 38-year-old male patient with review of literature.

Aggressive blood pressure treatment of hypertensive intracerebral hemorrhage may lead to global cerebral hypoperfusion: Case report and imaging perspective.

PubMed

Gavito-Higuera, Jose; Khatri, Rakesh; Qureshi, Ihtesham A; Maud, Alberto; Rodriguez, Gustavo J

2017-12-28

Hypoperfusion injury related to blood pressure decrease in acute hypertensive intracerebral hemorrhage continues to be a controversial topic. Aggressive treatment is provided with the intent to stop the ongoing bleeding. However, there may be additional factors, including autoregulation and increased intracranial pressure, that may limit this approach. We present here a case of acute hypertensive intracerebral hemorrhage, in which aggressive blood pressure management to levels within the normal range led to global cerebral ischemia within multiple border zones. Global cerebral ischemia may be of concern in the management of hypertensive hemorrhage in the presence of premorbid poorly controlled blood pressure and increased intracranial pressure.

Cemento-ossifying fibroma of mandible: An unusual case report and review of literature

PubMed Central

Mohapatra, Mounabati; Banushree, CS; Nagarajan, K; Pati, Debashish

2015-01-01

The term ossifying fibroma (OF) has recently been included under fibro-osseous lesions. Cemento-OF (COF) is a benign neoplasm that arises from the periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone and fibrous tissue. These tumors occur in the third and fourth decades of life with a predilection for women. The mandible is more commonly involved than the maxilla. This lesion has caused considerable controversy regarding the use of terminology, origin and diagnostic criteria. This article describes an unusual case of COF presenting as unilocular lytic lesion of mandible in a 38-year-old male patient with review of literature. PMID:26980975

[Large ovarian cyst associated with pregnancy. Case report].

PubMed

David, Cristina; Lupaşcu, Ivona; Socolov, Demetra; Vişan, Valeria

2008-01-01

The incidence of adnexal masses in pregnancy is rather low. The diagnosis has become more common with the routine use of ultrasonography in prenatal care. The management of adnexal masses during pregnancy remains controversial. Ultrasonography can characterise correctly the adnexal mass and avoid antepartum surgery. We present the case of a 32 years old gravida, IV gesta, I para, with an ovarian cystic tumour that enlarged during pregnancy from 7 cm to 20 cm. The tumour was correctly characterised by ultrasound exam (Sassone 3) and surgery was not indicated. The pregnancy evoluated well and the patient delivered at term by c. section and ovariectomy was also performed. The postpartum evolution was good.

[Pediatric bipolar disorder - case report of a bipolar patient with disease onset in childhood and adolescence: implications for diagnosis and therapy].

PubMed

Lackner, N; Birner, A; Bengesser, S A; Reininghaus, B; Kapfhammer, H P; Reininghaus, E

2014-11-01

In recent years, intense controversies have evolved about the existence and exact diagnostic criteria of pediatric bipolar affective disorder. The present study aims to discuss pediatric bipolar affective disorder based on the current literature focussing on the diagnostic prospects. Based on a case study, a process of bipolar disorder developed in childhood is depicted exemplarily. Because of the high comorbidity and overlapping symptoms of paediatric bipolar affective disorder and other psychiatric disorders, the major impact of the differential diagnosis has to be stressed. An early diagnosis and the treatment possibilities are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

Some Core Contested Concepts

ERIC Educational Resources Information Center

Chomsky, Noam

2015-01-01

Core concepts of language are highly contested. In some cases this is legitimate: real empirical and conceptual issues arise. In other cases, it seems that controversies are based on misunderstanding. A number of crucial cases are reviewed, and an approach to language is outlined that appears to have strong conceptual and empirical motivation, and…

Polemics in Public: Poncelet, Gergonne, Plücker, and the Duality Controversy.

PubMed

Lorenat, Jemma

2015-12-01

A plagiarism charge in 1827 sparked a public controversy centered between Jean-Victor Poncelet (1788-1867) and Joseph-Diez Gergonne (1771-1859) over the origin and applications of the principle of duality in geometry. Over the next three years and through the pages of various journals, monographs, letters, reviews, reports, and footnotes, vitriol between the antagonists increased as their potential publicity grew. While the historical literature offers valuable resources toward understanding the development, content, and applications of geometric duality, the hostile nature of the exchange seems to have deterred an in-depth textual study of the explicitly polemical writings. We argue that the necessary collective endeavor of beginning and ending this controversy constitutes a case study in the circulation of geometry. In particular, we consider how the duality controversy functioned as a medium of communicating new fundamental principles to a wider audience of practitioners.

Orthodontic treatment in cherubism: an overview and a case report.

PubMed

Abela, Stefan; Cameron, Malcolm; Bister, Dirk

2014-11-01

Cherubism is a rare hereditary disease that frequently manifests as a painless enlargement of the mandible and/or maxilla. The disease usually progresses rapidly during the first and second decades of life but it is self-limiting and often regresses. Although few orthodontic case reports describing cherubic patients exist, the timing and extent of surgical intervention is controversial. This present paper aims to review the treatment literature and provide a case report of a patient who underwent orthodontic/surgical management. The patient presented with severe cherubism in her late teenage years; her main complaint was poor facial and dental appearance. Multiple teeth were missing and those present demonstrated significant preoperative root resorption. Treatment consisted of orthodontic alignment of the upper anterior teeth and a recontouring osteotomy. Confirmed by the patient, the combination approach led to a significant improvement in facial aesthetics and better self-esteem. Tooth movement through the osseous lesions was uneventful and no further root resoption was observed. Orthodontic treatment may be undertaken in those affected by Cherubism even with pre-existing idiopathic root resorption, but patients need to be appropriately informed and consented.

Controversies in the Hydrosphere: an iBook exploring current global water issues for middle school classrooms

NASA Astrophysics Data System (ADS)

Dufoe, A.; Guertin, L. A.

2012-12-01

This project looks to help teachers utilize iPad technology in their classrooms as an instructional tool for Earth system science and connections to the Big Ideas in Earth Science. The project is part of Penn State University's National Science Foundation (NSF) Targeted Math Science Partnership grant, with one goal of the grant to help current middle school teachers across Pennsylvania engage students with significant and complex questions of Earth science. The free Apple software iBooks Author was used to create an electronic book for the iPad, focusing on a variety of controversial issues impacting the hydrosphere. The iBook includes image slideshows, embedded videos, interactive images and quizzes, and critical thinking questions along Bloom's Taxonomic Scale of Learning Objectives. Outlined in the introductory iBook chapters are the Big Ideas of Earth System Science and an overview of Earth's spheres. Since the book targets the hydrosphere, each subsequent chapter focuses on specific water issues, including glacial melts, aquifer depletion, coastal oil pollution, marine debris, and fresh-water chemical contamination. Each chapter is presented in a case study format that highlights the history of the issue, the development and current status of the issue, and some solutions that have been generated. The next section includes critical thinking questions in an open-ended discussion format that focus on the Big Ideas, proposing solutions for rectifying the situation, and/or assignments specifically targeting an idea presented in the case study chapter. Short, comprehensive multiple-choice quizzes are also in each chapter. Throughout the iBook, students are free to watch videos, explore the content and form their own opinions. As a result, this iBook fulfills the grant objective by engaging teachers and students with an innovative technological presentation that incorporates Earth system science with current case studies regarding global water issues.

Neuro-ophthalmic manifestations of cerebrovascular accidents.

PubMed

Ghannam, Alaa S Bou; Subramanian, Prem S

2017-11-01

Ocular functions can be affected in almost any type of cerebrovascular accident (CVA) creating a burden on the patient and family and limiting functionality. The present review summarizes the different ocular outcomes after stroke, divided into three categories: vision, ocular motility, and visual perception. We also discuss interventions that have been proposed to help restore vision and perception after CVA. Interventions that might help expand or compensate for visual field loss and visuospatial neglect include explorative saccade training, prisms, visual restoration therapy (VRT), and transcranial direct current stimulation (tDCS). VRT makes use of neuroplasticity, which has shown efficacy in animal models but remains controversial in human studies. CVAs can lead to decreased visual acuity, visual field loss, ocular motility abnormalities, and visuospatial perception deficits. Although ocular motility problems can be corrected with surgery, vision, and perception deficits are more difficult to overcome. Interventions to restore or compensate for visual field deficits are controversial despite theoretical underpinnings, animal model evidence, and case reports of their efficacies.

The Cretaceous/Tertiary Extinction Controversy Reconsidered.

ERIC Educational Resources Information Center

McCartney, Kevin; Nienstedt, Jeffrey

1986-01-01

Reviews varying positions taken in the Cretaceous/Tertiary (K/Y) extinction controversy. Analyzes and contests the meteoritic impact theory known as the Alvarez Model. Presents an alternative working hypothesis explaining the K/T transition. (ML)

Academic freedom, public reactions, and anonymity.

PubMed

Häyry, Matti

2014-05-01

Academic freedom can be defined as immunity against adverse reactions from the general public, designed to keep scholars unintimidated and productive even after they have published controversial ideas. Francesca Minerva claims that this notion of strict instrumental academic freedom is supported by Ronald Dworkin, and that anonymity would effectively defend the sphere of immunity implied by it. Against this, I argue that the idea defended by Minerva finds no support in the work by Dworkin referred to; that anonymity would not in most cases effectively protect the kind of immunity sought after; and that in some cases it would not even be desirable to protect scholars from public reactions to their controversial claims. © 2014 John Wiley & Sons Ltd.

The Breivik controversy: politics, terrorism and psychiatry.

PubMed

Tietze, Tad

2014-08-01

To examine and analyse the controversy over psychiatric aspects of the case of Norwegian far right mass murderer Anders Behring Breivik. Because of a basic acceptance of methodological individualism and scientific positivism, mainstream psychiatry is currently ill suited to being broadly applied to the spheres of politics and political violence. Rather than jettison psychiatric insights in such cases, the choices facing the profession are either to accept the narrowness of its utility or to work towards a theoretical framework that sees the individual psyche as socially embedded rather than as socially constitutive, and psychiatric science itself as socially constructed and hence inescapably value-laden. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Laser CO2 treatment for vulvar lymphedema secondary to gynecological cancer therapy: A report of two cases and review of the literature.

PubMed

Sopracordevole, Francesco; Mancioli, Francesca; Canzonieri, Vincenzo; Buttignol, Monica; Giorda, Giorgio; Ciavattini, Andrea

2015-04-01

Vulvar lymphedema is an uncommon and disabling side-effect of pelvic lymphadenectomy and pelvic radiotherapeutic treatment for invasive genital cancer. Lymphorrhea, a complication of lymphedema, may be extremely distressing for patients due to the requirement to wear sanitary towels and as the pain and loss of elasticity of the vulvar skin and mucosa can cause discomfort during coitus. Surgical treatments of lymphorrhea and vulvar lymphedema secondary to gynecological cancer treatments remain controversial and are not currently considered to be the standard therapy. The present study reports two cases of vulvar lymphedema complicated by vulvar lymphorrhea in females who had undergone treatment for cervical and endometrial cancer, respectively; a review of the literature is also included. In the two present cases, vulvar lymphedemas were refractory to standard treatments, including decongestive therapy, manual lymph drainage, elastic bandaging, low-stretch bandaging, exercises and skin care. Laser CO 2 excision and vaporization of the whole skin and mucosal tissue of the vulva was successfully performed to treat the lymphorrhea and improve quality of life. Thus, the present two cases indicated that laser CO 2 surgery may present an additional therapy for the treatment of genital lymphedema that is refractory to other treatments.

Acute quadriplegia following closed traction reduction of a cervical facet dislocation in the setting of ossification of the posterior longitudinal ligament: case report.

PubMed

Wimberley, David W; Vaccaro, Alexander R; Goyal, Nitin; Harrop, James S; Anderson, D Greg; Albert, Todd J; Hilibrand, Alan S

2005-08-01

A case report of acute quadriplegia resulting from closed traction reduction of traumatic bilateral cervical facet dislocation in a 54-year-old male with concomitant ossification of the posterior longitudinal ligament (OPLL). To report an unusual presentation of a spinal cord injury, examine the approach to reversal of the injury, and review the treatment and management controversies of acute cervical facet dislocations in specific patient subgroups. The treatment of acute cervical facet dislocations is an area of ongoing controversy, especially regarding the question of the necessity of advanced imaging studies before closed traction reduction of the dislocated cervical spine. The safety of an immediate closed, traction reduction of the cervical spine in awake, alert, cooperative, and appropriately select patients has been reported in several studies. To date, there have been no permanent neurologic deficits resulting from awake, closed reduction reported in the literature. A case of temporary, acute quadriplegia with complete neurologic recovery following successful closed traction reduction of a bilateral cervical facet dislocation in the setting of OPLL is presented. The clinical neurologic examination, radiographic, and advanced imaging studies before and after closed, traction reduction of a cervical facet dislocation are evaluated and discussed. A review of the literature regarding the treatment of acute cervical facet dislocations is presented. Radiographs showed approximately 50% subluxation of the fifth on the sixth cervical vertebrae, along with computerized tomography revealing extensive discontinuous OPLL. The cervical facet dislocation was successfully reduced with an awake, closed traction reduction, before magnetic resonance imaging (MRI) evaluation. The patient subsequently had acute quadriplegia develop, with the ensuing MRI study illustrating severe spinal stenosis at the C5, C6 level as a result of OPLL or a large extruded disc herniation. Following an immediate anterior decompression and a posterior stabilization procedure, the patient regained full motor and sensory function. This case report highlights the advantages and shows some safety concerns regarding immediate, closed traction reduction of cervical facet dislocation with real-time neural monitoring in an awake, alert, oriented, and appropriately select patient before MRI studies in the setting of preexisting central stenosis from OPLL.

Individual Differences in Written Corrective Feedback: A Multi-Case Study

ERIC Educational Resources Information Center

Li, Su; Li, Pengjing

2012-01-01

Written corrective feedback (WCF) has been a long time practice in L2 writing instruction. However, in many cases, the effects are not satisfactory. There have been controversies about it both theoretically and empirically. This paper reports a multi-case study exploring individual differences that impact learners' responses to WCF. Four students'…

Closely Watched Tenure Case at Columbia University Is Still Unsettled

ERIC Educational Resources Information Center

Wilson, Robin; Byrne, Richard

2008-01-01

This article reports on an unsettled tenure case at Columbia University. The high-profile and controversial tenure bid of Joseph A. Massad, a Palestinian-American professor of Arab politics, was turned down by Columbia University's provost, Alan Brinkley. Mr. Massad's case follows closely on two other high-profile tenure bids affected by the…

Evaluating Drugs and Food Additives for Public Use: A Case Studies Approach.

ERIC Educational Resources Information Center

Merritt, Sheridan V.

1980-01-01

Described is a case study used in an introductory college biology course that provides a basis for generating debate on an issue concerning the regulation of controversial food additives and prescription drugs. The case study contained within this article deals with drug screening, specifically with information related to thalidomide. (CS)

Rare esophageal ulcers related to Behçet disease: A case report.

PubMed

Jia, Ning; Tang, Yanping; Liu, Huayi; Li, Yang; Liu, Simiao; Liu, Lei

2017-11-01

The fundamental pathogenesis of Behçet disease (BD) is still unclear and controversial. Many cases of oral aphthous ulcers and genital ulcers related to BD are reported; nevertheless, idiopathic giant esophageal ulcers related to BD are rare. A rare case for esophageal ulcers related to BD is presented. In China, BD is represented with esophageal involvement which is called esophageal BD (EBD). A 56-year-old man diagnosed to the Gastroenterology Department of Integrated Traditional Chinese and Western Medicine Hospital, for multiple discrete, elliptical esophageal ulcers related to BD. The esophageal ulcers were treated with corticosteroid treatment for 12 weeks. The esophageal ulcers were cured. Our report might give further strength to avoiding the erroneous diagnosis or missed diagnosis for EBD, which is different from esophageal carcinoma, esophageal tuberculosis and esophageal Crohns disease.

Appendicitis-like clinical image elicited by Enterobius vermicularis: case report and review of the literature.

PubMed

Vleeschouwers, W; Hofman, Ph; Gillardin, J P; Meert, V; Van Slycke, S

2013-01-01

A 17-year-old female patient presented with the clinical features of an acute appendicitis. During laparoscopic exploration a macroscopically normal appendix was found. Since there were no intra-abdominal abnormalities found, the appendix was resected. Anatomopathology demonstrated Enterobius vermicularis, a pinworm infecting only humans, and mostly living in the caecum. This parasite is responsible for possibly the most common helminthic infection in the developed world. Its role in the pathogenesis of acute appendicitis is controversial, but more recent studies indicate a stronger association between enterobiasis and appendicitis. Often, enterobius mimics appendicitis by obstructing the lumen of the appendix, thereby causing appendiceal colic. This case report stresses the importance of microscopic examination of all appendectomy resection specimens. In case of enterobius infestation, systemic therapy of patient and family is necessary.

Exercise collapse associated with sickle cell trait (ECAST): case report and literature review.

PubMed

Quattrone, Richard D; Eichner, E Randy; Beutler, Anthony; Adams, W Bruce; O'Connor, Francis G

2015-01-01

Sickle cell trait (SCT) has been associated with exertional collapse (ECAST) and exercise-related sudden death in athletes and military warfighters. The mechanisms underlying ECAST remain controversial in the sports medicine community. Multiple case presentations and anecdotal reports postulate the role of extraordinary exercise intensity, but other risk factors including dehydration, heat, previous exertional rhabdomyolysis, genetic cofactors, and dietary supplements have been cited as potential contributors. Others have hypothesized some of the aforementioned factors combining in a "perfect storm" to trigger ECAST with a resultant potentially fatal "metabolic crisis." This case report provides a brief review of SCT as it pertains to exercise in warfighters and athletes, identifies known and postulated risk factors associated with ECAST, and introduces the potential mechanistic role of the "double hit" as a contributor to ECAST.

Acute suppurative appendicitis associated with Enterobius vermicularis: an incidental finding or a causative agent? A case report.

PubMed

Efared, Boubacar; Atsame-Ebang, Gabrielle; Soumana, Boubacar Marou; Tahiri, Layla; Hammas, Nawal; El Fatemi, Hinde; Chbani, Laila

2017-10-06

Histological acute appendicitis patterns associated with Enterobius vermicularis is an extremely rare finding. The exact role of this parasite in acute appendicitis is controversial as usually resected specimens show no evidence of histological inflammation. We present herein a case of a 21-year-old male Arabic patient who presented with clinical syndrome of acute appendicitis. Emergency appendectomy was performed and the histopathological examination of the resected specimen showed the presence of E. vermicularis as well as intense acute inflammatory patterns such as mucosal ulceration and suppurative necrosis. The post-operative course was uneventful and the patient was discharged with appropriate anti-helmintic drug prescription. Acute appendicitis due to E. vermicularis is a very rare occurrence. The histopathological analysis of resected specimens should pay special attention to search for this parasite for adequate post-operative treatment of patients.

Breast cancer metastatic to the pituitary gland: a case report.

PubMed

Spinelli, Gian Paolo; Lo Russo, Giuseppe; Miele, Evelina; Prinzi, Natalie; Tomao, Federica; Antonelli, Manila; Giangaspero, Felice; Stati, Valeria; Strudel, Martina; Tomao, Silverio

2012-07-09

Metastases to the pituitary gland are rare events, and usually indicate widespread malignant disease. The lung and the breast are the most common sites of primary tumors that metastasize to the pituitary gland.Metastases are more frequent in older patients and the most common symptoms at presentation are diabetes insipidus and visual alterations. 72-year-old white woman was treated for a breast carcinoma with right superoexternal quadrantectomy, radiotherapy, and hormone therapy. Twelve years later, the patient presented with bone pain, bilateral progressive visual decline, and onset of hypopituitarism. A diagnosis of secondary bone involvement and pituitary metastasis was made. This was an unusual disease course, and stresses the importance of intensive follow-up in patients with breast cancer even many years after the initial diagnosis This case emphasizes that diagnosis can be difficult and controversial when relapse occurs at uncommon sites.

Mature cystic teratoma with high proportion of solid thyroid tissue: a controversial case with unusual imaging findings.

PubMed

Gil, Rui; Cunha, Teresa Margarida; Rolim, Ines

2017-07-01

We describe a case of a mature cystic teratoma of the ovary with high proportion of solid thyroid tissue (< 50% of the entire tumor) in a childbearing woman. The patient presented with non-specific abdominal bloating. Pelvic ultrasound and magnetic resonance imaging revealed a complex cystic-solid tumor confined to the left ovary with an anterior fat-containing locus compatible with mature cystic teratoma and a posterior predominantly solid component with low signal intensity on T2-weighted images that was histopatologically diagnosed as benign thyroid tissue. Thyroglobulin levels were in normal range. Although thyroid tissue is present in up to 20% of mature cystic teratomas, with exception of struma ovarii, it is not usually macroscopically nor radiologically identified. The differential diagnosis should include T2-hypointense adnexal lesions associated with mature cystic teratoma, malignant transformation of mature teratoma, and immature teratoma.

Pituitary adenoma and unexpected sudden infant death: a case report.

PubMed

Matsuura, H; Kitazawa, Y; Tanaka, M; Morooka, K

1994-01-01

Pituitary adenomas can cause sudden death in adults, but they are quite rare during infancy. Herein we present an unusual case of sudden infant death associated with a pituitary adenoma. The clinical presentations were "quietness" complained of by the parents and probable gigantism with accelerated growth rate during the first 2 months of life. The female infants had been in good health until one day when, at the age of 3 months, she was found immobile in bed. Microscopic examination showed that the cells of the entire pituitary gland were replaced by bizarre undifferentiated tumor cells. There were no invasive lesions in the surrounding brain tissue. It was also found that the cortex of the adrenal glands was atrophic. No metastatic lesions were observed in any organ. While the mechanism leading our infant to death is both controversial and unknown, we speculated that insufficient secretion of steroid hormones might have caused cardiovascular collapse.

Discussion of the Controversy Concerning a Historical Event among Pre-Service Teachers: Contributions to Their Knowledge about Science, Their Argumentative Skills, and Reflections about Their Future Teaching Practices

ERIC Educational Resources Information Center

Justi, Rosária; Mendonça, Paula Cristina Cardoso

2016-01-01

As part of a teacher training project, 16 future chemistry teachers participated in a dramatisation activity (a mock trial of the Fritz Haber case), in which they discussed a controversy concerning an event from the history of science: the awarding of the Nobel Prize in Chemistry to Fritz Haber in 1918. Preparations for the role-play activity, the…

The effect of falsely balanced reporting of the autism-vaccine controversy on vaccine safety perceptions and behavioral intentions.

PubMed

Dixon, Graham; Clarke, Christopher

2013-04-01

Controversy surrounding an autism-vaccine link has elicited considerable news media attention. Despite being widely discredited, research suggests that journalists report this controversy by presenting claims both for and against a link in a relatively 'balanced' fashion. To investigate how this reporting style influences judgments of vaccine risk, we randomly assigned 320 undergraduate participants to read a news article presenting either claims both for/against an autism-vaccine link, link claims only, no-link claims only or non-health-related information. Participants who read the balanced article were less certain that vaccines are safe, more likely to believe experts were less certain that vaccines are safe and less likely to have their future children vaccinated. Results suggest that balancing conflicting views of the autism-vaccine controversy may lead readers to erroneously infer the state of expert knowledge regarding vaccine safety and negatively impact vaccine intentions.

When the heart rules the head: ischaemic stroke and intracerebral haemorrhage complicating infective endocarditis.

PubMed

Jiad, Estabrak; Gill, Sumanjit K; Krutikov, Maria; Turner, David; Parkinson, Michael H; Curtis, Carmel; Werring, David J

2017-01-01

Sir William Osler meticulously described the clinical manifestations of infective endocarditis in 1885, concluding that: 'few diseases present greater difficulties in the way of diagnosis … which in many cases are practically insurmountable'. Even with modern investigation techniques, diagnosing infective endocarditis can be hugely challenging, yet is critically important in patients presenting with stroke (both cerebral infarction and intracranial haemorrhage), its commonest neurological complication. In ischaemic stroke, intravenous thrombolysis carries an unacceptably high risk of intracranial haemorrhage, while in intracerebral haemorrhage, mycotic aneurysms require urgent treatment to avoid rebleeding, and in all cases, prompt treatment with antibiotics and valve surgery may be life-saving. Here, we describe typical presentations of ischaemic stroke and intracerebral haemorrhage caused by infective endocarditis. We review the diagnostic challenges, the importance of rapid diagnosis, treatment options and controversies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Nasal Septal Angiofibroma in a Post-Menopausal Woman: A Rare Entity

PubMed Central

Dayana, Farah; Fadzilah, Fazalina Mohd; Gendeh, Balwant Singh

2015-01-01

Juvenile angiofibromas (JAs) are well-characterised in literature, arising typically in the posterolateral wall of the nasal cavity of young males. Numerous theories have been proposed to explain the occurrence of this unique and rare tumour. Angiofibromas originating in other sites within the head and neck have been described but this is exceedingly rare, constituting less than 2% of all diagnosed cases. Extranasopharyngeal angiofibroma is a rare lesion, and more importantly, controversial. It is not known whether it is actually a relative of the well-known JA that is seen exclusively in adolescent males. We present the case of a post-menopausal woman with unilateral nasal obstruction who was unexpectedly diagnosed as nasal septal angiofibroma. PMID:26816925

Tension Pneumothorax During Surgery for Thoracic Spine Stabilization in Prone Position: A Case Report and Review of Literature.

PubMed

Rankin, Demicha; Mathew, Paul S; Kurnutala, Lakshmi N; Soghomonyan, Suren; Bergese, Sergio D

2014-01-01

The intraoperative progression of a simple or occult pneumothorax into a tension pneumothorax can be a devastating clinical scenario. Routine use of prophylactic thoracostomy prior to anesthesia and initiation of controlled ventilation in patients with simple or occult pneumothorax remains controversial. We report the case of a 75-year-old trauma patient with an insignificant pneumothorax on the right who developed an intraoperative tension pneumothorax on the left side while undergoing thoracic spine stabilization surgery in the prone position. Management of an intraoperative tension pneumothorax requires prompt recognition and treatment; however, the prone position presents an additional challenge of readily accessing the standard anatomic sites for pleural puncture and air drainage.

News coverage of controversial emerging technologies. Evidence for the issue attention cycle in print and online media.

PubMed

Anderson, Ashley A; Brossard, Dominique; Scheufele, Dietram A

2012-01-01

This study analyzes the issue attention cycle for print and online media coverage of a scientific publication examining the deaths of Chinese factory workers due to lung damage from chronic exposure to nanoparticles. The results of the nanoparticle study, published in 2009, embody news values that would make the study a prime candidate for press coverage, namely, novelty, negativity, controversy, and potential widespread impact. Nevertheless, mentions of the event in traditional English-language print media were nearly nonexistent. Online media, on the other hand, gave the story greater coverage. This case study exemplifies why online media may not be bound to the same issue attention cycle that print media are for controversial scientific events.

Controversies in dengue pathogenesis

PubMed Central

Halstead, Scott B

2012-01-01

Research into the pathogenesis of dengue fever has exploded over the last half-century, with issues that were considered simple becoming more complex as additional data are found. This has led to the development of a number of controversies that are being studied across the globe and debated in the literature. In this paper, the following six controversies are analysed and, where possible, resolved: the 1997 World Health Organization (WHO) case definition of dengue haemorrhagic fever (DHF) is not useful; DHF is not significantly associated with secondary dengue infection; DHF results from infection with a ‘virulent’ dengue virus; DHF is owing to abnormal T-cell responses; DHF results from auto-immune responses; and DHF results from direct infection of endothelial cells. PMID:22668442

The (sexual) politics of evolution: popular controversy in the late 20th-century United Kingdom.

PubMed

Cassidy, Angela

2007-05-01

This article outlines the major threads of controversy around the emerging subject of evolutionary psychology in the U.K. mass media during the 1990s. Much of this controversy centered on the role of evolution in shaping human gender roles and sexualities, contributing to the subject's mass appeal. This case is used to illustrate the argument that in theorizing about evolution and humans, "human nature" and "human origins" both provide a flexible resource for making arguments about how people do and should relate to one another and that such theorizing is therefore reflective of how power is held (and contested) in society. In the case of popular evolutionary psychology, shifts in the U.K. political landscape during the 1990s combined with changes in gender and sexual politics to create a situation where evolutionary theorizing about humans became more acceptable than it had been in the past. This was particularly true in left-liberal media, where a newfound compatibility between certain aspects of Darwinism and feminism created a very different space for debating gender, sexuality, and the role of human nature in today's society.

Veno-venous ECMO: a synopsis of nine key potential challenges, considerations, and controversies

PubMed Central

2014-01-01

Background Following the 2009 H1N1 Influenza pandemic, extracorporeal membrane oxygenation (ECMO) emerged as a viable alternative in selected, severe cases of ARDS. Acute Respiratory Distress Syndrome (ARDS) is a major public health problem. Average medical costs for ARDS survivors on an annual basis are multiple times those dedicated to a healthy individual. Advances in medical and ventilatory management of severe lung injury and ARDS have improved outcomes in some patients, but these advances fail to consistently “rescue” a significant proportion of those affected. Discussion Here we present a synopsis of the challenges, considerations, and potential controversies regarding veno-venous ECMO that will be of benefit to anesthesiologists, surgeons, and intensivists, especially those newly confronted with care of the ECMO patient. We outline a number of points related to ECMO, particularly regarding cannulation, pump/oxygenator design, anticoagulation, and intravascular fluid management of patients. We then address these challenges/considerations/controversies in the context of their potential future implications on clinical approaches to ECMO patients, focusing on the development and advancement of standardized ECMO clinical practices. Summary Since the 2009 H1N1 pandemic ECMO has gained a wider acceptance. There are challenges that still must be overcome. Further investigations of the benefits and effects of ECMO need to be undertaken in order to facilitate the implementation of this technology on a larger scale. PMID:25110462

A case of the corpus callosum and alien hand syndrome from a discrete paracallosal lesion.

PubMed

Faber, Raymond; Azad, Alvi; Reinsvold, Richard

2010-08-01

Here we present a patient with an isolated paracallosal brain lesion who exhibited behavioral changes associated with the corpus callosum syndrome (CCS) including features of the alien hand syndrome (AHS). The CCS is also known as the split-brain syndrome, the syndrome of hemisphere disconnection, the syndrome of brain bisection and the syndrome of the cerebral commissures. Because most reported cases of CCS were caused by tumors which extended beyond the corpus callosum (CC) and did not always induce a complete disconnection, there was much controversy about the role of the CC and the existence of a specific CCS. Aside from surgically based cases, the full complement of the CCS is infrequently clinically encountered. The patient described has a classic CCS from natural causes. This case report is unique in exhibiting a complete CCS with AHS secondary to an ischemic event affecting the left pericallosal region. To our knowledge this is the first case report of such a combination.

Management of traumatic macular holes: case report.

PubMed

Brasil, Oswaldo Ferreira Moura; Brasil, Oswaldo Moura

2008-01-01

Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months.

Histopathologic and mutational analysis of a case of blue nevus-like melanoma.

PubMed

Dai, Julia; Tetzlaff, Michael T; Schuchter, Lynn M; Elder, David E; Elenitsas, Rosalie

2016-09-01

Blue nevi are a heterogeneous group of dermal melanocytic proliferations that share a common clinical appearance but remain controversial in their histopathologic and biologic distinction. While common blue nevi and cellular blue nevi are well-defined entities that are classified without significant controversy, the distinction between atypical cellular blue nevi and blue nevus-like melanoma remains diagnostically challenging. We report a case of a 46-year-old female with recurrent blue nevus-like melanoma of the scalp with liver metastases; mutational analysis showed GNA11 Q209L and BAP1 Q393 mutations. To our knowledge, this is the first case of blue nevus-like melanoma with GNA11 and BAP1 mutations. These particular mutations and the predilection for liver metastases in our patient's case underscore a fundamental biological relationship between blue nevi and uveal melanoma and suggest the two entities may prove amenable to similar diagnostic and prognostic testing and targeted therapies. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Multidisciplinary Approaches to Educational Research: Case Studies from Europe and the Developing World. Routledge Research in Education

ERIC Educational Resources Information Center

Rizvi, Sadaf, Ed.

2011-01-01

This book provides an original perspective on a range of controversial issues in educational and social research through case studies of multi-disciplinary and mixed-method research involving children, teachers, schools and communities in Europe and the developing world. These case studies from researchers "across continents" and…

Blood tests showing nonpaternity-conclusive or rebuttable evidence? The Chaplin case revisited.

PubMed

Benson, F

1981-09-01

A defendant accused of being the father of an illegitimate child denies responsibility. Blood samples from the child, mother, and alleged father are studied and the results reveal that the alleged father is excluded. What weight, if any, should the court (if a trial is held) or the jury give to the evidence of nonpaternity? Should the evidence be treated as conclusive proof of nonpaternity or should other evidence be admitted in the trial to overcome the nonpaternity evidence? A medical expert might conclude that a controversy exists because of the court's questioned trustworthiness of the paternity blood testing, while a legal expert might conclude that the controversy arises because of burdens of proof. Both conclusions are valid. The Berry v. Chaplin case held in California in 1946 illustrates this circumstance. In refreshing our memories on this case, we can review the problem in light of today's knowledge.

Dynamics of Conflicts in Wikipedia

PubMed Central

Yasseri, Taha; Sumi, Robert; Rung, András; Kornai, András; Kertész, János

2012-01-01

In this work we study the dynamical features of editorial wars in Wikipedia (WP). Based on our previously established algorithm, we build up samples of controversial and peaceful articles and analyze the temporal characteristics of the activity in these samples. On short time scales, we show that there is a clear correspondence between conflict and burstiness of activity patterns, and that memory effects play an important role in controversies. On long time scales, we identify three distinct developmental patterns for the overall behavior of the articles. We are able to distinguish cases eventually leading to consensus from those cases where a compromise is far from achievable. Finally, we analyze discussion networks and conclude that edit wars are mainly fought by few editors only. PMID:22745683

Making Meaning of von Hagens' Body Worlds: Towards an Interdisciplinary Approach to Science Exhibitions

NASA Astrophysics Data System (ADS)

Dubek, Michelle Melodie

Body Worlds is a traveling exhibition of plastinated human cadavers that offers the general public an opportunity to experience the human body in a unique way. It has been met with controversy and awe; public reactions and responses have been mixed. This case study research explored visitor responses to this controversial science exhibition, and examined the meaning visitors made of their experience. Specifically, the following research questions directed this study: Within the context of the Body Worlds exhibition: (a) What meaning did visitors make and how did they respond to the exhibits? (b) What tensions and issues arose for visitors? and (c) What did this type of exhibition convey about the changing role of science centres and the nature of their exhibitions? The primary sources of data for this study were 46 semi-structured interviews with visitors to the exhibition, observation notes, and 10 comment books including approximately 20 000 comments. Data suggested that the personal, physical, and sociocultural contexts (Falk & Dierking, 2000) contributed to visitor meaning meaning-making. The use of plastinated human cadavers within this exhibition raised ethical and moral questions and controversies about body procurement, use of human cadavers in display, representations of the bodies, and issues related to the sanctity of life. The tensions and issues identified by visitors demonstrated that messages (intended or unintended) located within Body Worlds were critically examined by visitors and called into question. Finally, data from this study suggested that an interdisciplinary approach to the presentation of science served to enhance accessibility for the viewer. This exhibition demonstrated that visitors responded positively and made personal connections when the arts, spirituality, edutainment, issues, and a combination of historical and contemporary museum practices were used to present science.

Great Trials in History.

ERIC Educational Resources Information Center

Kratoville, Betty Lou

Designed as a supplementary resource for any classroom that incorporates global education, this workbook describes the issues and outcomes of 12 famous historical court cases. The court cases familiarize students with recurring controversial social issues. Each reading section begins with a brief outline of the time period and background of each…

Case Studies of Secondary School Teachers Designing Socioscientific Issues-Based Instruction and Their Students' Socioscientific Reasoning

NASA Astrophysics Data System (ADS)

Karahan, Engin

Addressing socioscientific issues (SSI) has been one of the main focuses in science education since the Science, Technology, and Society (STS) movement in the 1970s (Levinson, 2006); however, teaching controversial socioscientific issues has always been challenging for teachers (Dillon, 1994; Osborne, Duschl, & Fairbrother, 2002). Although teachers exhibit positive attitudes for using controversial socioscientific issues in their science classrooms, only a small percentage of them actually incorporate SSI content into their science curricula on a regular basis (Sadler, Amirshokoohi, Kazempour, & Allspaw, 2006; Lee & Witz, 2009). The literature in science education has highlighted the signi?cant relationships among teacher beliefs, teaching practices, and student learning (Bryan & Atwater, 2002; King, Shumow, & Lietz, 2001; Lederman, 1992). Despite the fact that the case studies present a relatively detailed picture of teachers' values and motivations for teaching SSI (e.g. Lee, 2006; Lee & Witz, 2009; Reis & Galvao, 2004), these studies still miss the practices of these teachers and potential outcomes for their students. Therefore, there is a great need for in-depth case studies that would focus on teachers' practices of designing and teaching SSI-based learning environments, their deeper beliefs and motivations for teaching SSI, and their students' response to these practices (Lee, 2006). This dissertation is structured as three separate, but related, studies about secondary school teachers' experiences of designing and teaching SSI-based classes and their students' understanding of science and SSI reasoning. The case studies in this dissertation seek answers for (1) teachers' practices of designing and teaching SSI-based instruction, as well as its relation to their deeper personal beliefs and motivations to teach SSI, and (2) how their students respond to their approaches of teaching SSI in terms of their science understanding and SSI reasoning. The first paper presents case studies of three secondary science teachers within three high schools located along the Minnesota River Basin. The findings of this study documented the experiences of the participant teachers, as well as the contextual influences on those experiences. The second paper presents a case study of a science teacher and a social studies teacher which describes how these two teachers collaboratively designed and taught an environmental ethics class. The results of this study documented teachers' ways of sharing responsibilities, bringing their content and pedagogical expertise, and promoting the agency of their students in the environmental ethics class. The final paper in this dissertation presents case studies of secondary school students who were the participants in the SSI-based science classes described in the first two studies. The results of this study provided evidence for participant students' understanding of science and their socioscientific reasoning, as well as how they were influenced by the instructional decisions their teachers made.

Immediate surgical resection of residual microcalcifications after a diagnosis of pure flat epithelial atypia on core biopsy: a word of caution.

PubMed

Noël, Jean-Christophe; Buxant, Frédéric; Engohan-Aloghe, Corinne

2010-12-01

The entity of pure flat epithelial atypia remains a challenge due to controversy of the surgical management of residual microcalcifications after core needle biopsies. This study aims to assess the morphological data observed in immediate surgical resection specimen of residual microcalcifications after a diagnosis of pure flat epithelial atypia on mammotome core biopsy. Sixty-two mammotome core biopsy with a diagnosis of pure flat epithelial atypia (flat epithelial atypia without associated atypical ductal hyperplasia, in situ and/or invasive carcinoma) were identified. From these 62 cases, 20 presented residual microcalcifications and underwent an immediate surgical excision after mammotome. Of the 20 patients with excised microcalcifications, 8 (40%)cases had residual pure flat epithelial atypia, 4 (20%) cases had atypical ductal hyperplasia, 4 (20%) cases had lobular in situ neoplasia, no lesions were retrieved in 4 (20%) case. None of the patients had either in situ ductal carcinoma and/or invasive carcinoma. Surgical resection of residual microcalcifications after the diagnosis of pure flat epithelial atypia on core needle biopsy remains still a debate. The present study shows no cases of in situ ductal and/or invasive carcinoma on immediate excision of residual microcalcifications after mammotome core biopsies. Copyright © 2009 Elsevier Ltd. All rights reserved.

Stereotactic neurosurgery for writer's cramp: report of two cases with an overview of the literature.

PubMed

Asahi, Takashi; Koh, Masaki; Kashiwazaki, Daina; Kuroda, Satoshi

2014-01-01

Writer's cramp is a specific movement disorder with hand muscle cramps in writing, being classified into focal and action-specific dystonia. Stereotactic surgery, such as thalamotomy and deep brain stimulation (DBS), has been reported for writer's cramp; however, the number of reported cases is still scarce and surgical procedures are also controversial. In this study, therefore, we present 2 patients who underwent thalamotomy for writer's cramp and systematically review the literature on stereotactic surgery for writer's cramp. Case reports and literature review are presented. Both patients underwent ventral oral nucleus (Vo) thalamotomy safely. Their symptoms completely disappeared after surgery and did not recur during follow-up periods. In the literature, a total of 31 cases were surgically treated for writer's cramp. Stereotactic surgery included thalamotomy in 25 cases and DBS in 6. The target included the Vo in 17 cases, the ventral intermediate nucleus (Vim) in 3, and both Vo and Vim in 7. Both procedures markedly improved or resolved the symptoms. Transient neurological deficits were observed in 16.0% of patients after thalamotomy. The Vo may be the most effective target to treat writer's cramp. Both thalamotomy and DBS are feasible and effective, but thalamotomy would be a better option, especially in younger or high-risk patients. © 2014 S. Karger AG, Basel.

[Foucault, Derrida, and the history of madness: notes on a controversy].

PubMed

Pereira Neto, A F

1998-01-01

The publication of the book Folie et Déraison. Histoire de la Folie à l'Age Classique (1961), by Michel Foucault, sparked a debate between the author and philosopher Jacques Derrida during the 1960s and 70s. Derrida criticized the methodological proposal and organization of the History of Madness presented by Foucault in the foreword to the first edition. The controversy appears to have motivated the author to withdraw this same foreword from the second edition. The purpose of this article is to analyze some current points in this controversy. It also presents a research agenda for an understanding of the reasons leading Foucault to take this stance.

The gene patent controversy on Twitter: a case study of Twitter users' responses to the CHEO lawsuit against Long QT gene patents.

PubMed

Du, Li; Kamenova, Kalina; Caulfield, Timothy

2015-08-25

The recent Canadian lawsuit on patent infringement, filed by the Children's Hospital of Eastern Ontario (CHEO), has engendered a significant public debate on whether patenting genes should be legal in Canada. In part, this public debate has involved the use of social networking sites, such as Twitter. This case provides an opportunity to examine how Twitter was used in the context of this gene patent controversy. We collected 310 English-language tweets that contained the keyword "gene patents" by using TOPSY.com and Twitter's built-in search engine. A content analysis of the messages was conducted to establish the users' perspectives on both CHEO's court challenge and the broader controversy over the patenting of human DNA. More specifically, we analyzed the users' demographics, geographic locations, and attitudes toward the CHEO position on gene patents and the patentability of human genes in principle. Our analysis has shown that messages tweeted by news media and health care organizations were re-tweeted most frequently in Twitter discussions regarding both the CHEO patent infringement lawsuit and gene patents in general. 34.8% of tweets were supportive of CHEO, with 52.8% of the supportive tweets suggesting that gene patents contravene patients' rights to health care access. 17.6% of the supportive tweets cited ethical and social concerns against gene patents. Nearly 40% of tweets clearly expressed that human genes should not be patentable, and there were no tweets that presented perspectives favourable toward the patenting of human genes. Access to healthcare and the use of genetic testing were the most important concerns raised by Twitter users in the context of the CHEO case. Our analysis of tweets reveals an expectation that the CHEO lawsuit will provide an opportunity to clear the confusion on gene patents by establishing a legal precedent on the patentability of human genes in Canada. In general, there were no tweets arguing in favour of gene patents. Given the emerging role of social media in framing the public dialogue on these issues, this sentiment could potentially have an impact on the nature and tone of the Canadian policy debate.

Spinal extradural cyst: A case report and review of literature.

PubMed

Lee, Sean Wy; Foo, Aaron; Tan, Char Loo; Tan, Thomas; Lwin, Sein; Yeo, Tseng Tsai; Nga, Vincent Dw

2018-06-02

Spinal extradural cyst (SEDC) accounts for less than 1% of spinal epidural lesions. It is commonly asymptomatic but can give rise to back pain and compressive neurological symptoms. We report the case of a 51-year-old male who presented with gait difficulties over five months associated with occasional urge incontinence. Clinical examination revealed signs suggestive of thoracic myelopathy with bilateral lower limbs spasticity, decreased proprioception and pin prick sensation. MRI showed a Thoracic (T) 7-T9 extradural cystic lesion with an area of flow void on the right side between T8 and T9. A right hemilaminotomy was initially performed, dural defect identified and repaired primarily. Unfortunately, there was a recurrence of the SEDC 2 weeks post-operation and a T7-T9 laminoplasty with complete excision was performed. Computer-tomography (CT) myelography or MRI flow study best visualises the communication between the epidural cyst and sub-arachnoid space. The ideal surgical management for SEDC remains controversial. Our case suggests that there may be higher recurrence associated with fenestration of the SEDC and closure of the dural defect, but perhaps higher complications associated with complete excision. We present a case report and literature review of the terminology, presentation, recommended investigations, management and outcomes of patients with SEDC. Copyright © 2018 Elsevier Inc. All rights reserved.

Limits of Freedom: The Ward Churchill Case

ERIC Educational Resources Information Center

O'Nell, Robert M.

2006-01-01

The University of Colorado's Ward Churchill is but the latest in a long line of professors whose volatile statements have created controversy for themselves and their universities. Specific personnel matters in the case have been meticulously addressed in Boulder, but several larger questions have been curiously neglected. One might well ask, for…

76 FR 63187 - Authority of Judgment Officers to Hear Cases

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

... COMMODITY FUTURES TRADING COMMISSION 17 CFR Part 12 Authority of Judgment Officers to Hear Cases.... Voluntary decisional proceedings are heard by a Judgment Officer without regard to the amount in controversy... Commission has raised the ceiling for claims eligible to be heard as summary proceedings, most recently from...

Introducing Students to Cases

ERIC Educational Resources Information Center

Brickman, Peggy; Glynn, Shawn; Graybeal, Geoffrey

2008-01-01

Strategically introducing students to a controversial science case--before they read it, watch it, or listen to it--motivates them to learn from it and paves the way for successful discussion and debate. A strategic introduction also provides an opportunity for the instructor to demonstrate scientific reasoning and share guidelines for the…

A Comprehensive Study of the Development of Physics in Cuba from 1959

NASA Astrophysics Data System (ADS)

Baracca, Angelo; Fajer Avila, Víctor Luis; Rodríguez Castellanos, Carlos

The present paper aims to reconstruct the main stages of the above-mentioned process from the Cuban Revolution (1959) to the present time. A general premise is necessary on the documentary sources used and the method adopted in this research. The written documents available on the development of physics in Cuba related to the early two decades are quite scarce, so that the reconstruction presented here is based mainly on oral history research. Most of the information presented in this study is sourced from interviews with Cuban colleagues who played leading roles in the events described here. This approach obviously implies drawbacks since the information obtained relies on the personal memories and views of the interviewees, and in some cases uncertain or controversial aspects arise. Despite this drawback, every effort has been made to verify the information.

Management of clinically non-functioning pituitary adenoma.

PubMed

Chanson, Philippe; Raverot, Gerald; Castinetti, Frédéric; Cortet-Rudelli, Christine; Galland, Françoise; Salenave, Sylvie

2015-07-01

Clinically NFPA is currently the preferred term for designing all the pituitary adenomas which are not hormonally active (in other words, not associated with clinical syndromes such as amenorrhea-galactorrhea in the context of prolactinomas, acromegaly, Cushing's disease or hyperthyroidism secondary to TSH-secreting adenomas). They account for 15-30% of pituitary adenomas. Diagnosis is usually made either in the context of mass effect due to a macroadenoma or, increasingly, fortuitously during imaging performed for some unrelated purpose; the latter case is known as pituitary incidentaloma. Surgery is indisputably indicated in case of tumoral syndrome, but other aspects of NFPA (hormonal work-up, follow-up, and especially postoperative follow-up, management of remnant or recurrence, the special case of incidentaloma, or apoplexy) remain controversial. The French Endocrinology Society (SFE) therefore set up an expert working group of endocrinologists, neurosurgeons, ophthalmologists, neuroradiologists, pathologists and biologists to draw up guidelines, at the 2012 SFE Congress in Toulouse, France. The present article presents the guidelines suggested by this group of French-speaking experts. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Drug-Induced Acute Pancreatitis: A Review

PubMed Central

Jones, Mark R.; Hall, Oliver Morgan; Kaye, Adam M.; Kaye, Alan David

2015-01-01

Background The majority of drug-induced pancreatitis cases are mild to moderate in severity, but severe and even fatal cases can occur. Management of drug-induced pancreatitis requires withdrawal of the offending agent and supportive care. Methods This review focuses on differential diagnosis, clinical presentation, drug-mediated effects, treatments, and mechanisms of pancreatitis, with an emphasis on drug-induced pancreatitis. Results Although only a minority of cases associated with acute pancreatitis are linked to drugs, clinical presentation and mechanisms of injury to the pancreas are not well understood by clinicians in terms of individual drug effects in the mediation or modulation of injury to the pancreas. In recent years, a large number of commonly prescribed medications has been linked to drug-induced pancreatitis pathogenesis. Although mechanisms are proposed, the exact cause of injury is either not well understood or controversial. Conclusion Future investigation into the mechanisms of pancreatitis and an appreciation by clinicians of the drugs commonly linked to the condition will help establish earlier diagnosis and quicker cessation of offending drugs in the treatment of drug-induced acute pancreatitis. PMID:25829880

Ethical dilemmas in genetic testing: examples from the Cuban program for predictive diagnosis of hereditary ataxias.

PubMed

Mariño, Tania Cruz; Armiñán, Rubén Reynaldo; Cedeño, Humberto Jorge; Mesa, José Miguel Laffita; Zaldivar, Yanetza González; Rodríguez, Raúl Aguilera; Santos, Miguel Velázquez; Mederos, Luis Enrique Almaguer; Herrera, Milena Paneque; Pérez, Luis Velázquez

2011-06-01

Predictive testing protocols are intended to help patients affected with hereditary conditions understand their condition and make informed reproductive choices. However, predictive protocols may expose clinicians and patients to ethical dilemmas that interfere with genetic counseling and the decision making process. This paper describes ethical dilemmas in a series of five cases involving predictive testing for hereditary ataxias in Cuba. The examples herein present evidence of the deeply controversial situations faced by both individuals at risk and professionals in charge of these predictive studies, suggesting a need for expanded guidelines to address such complexities.

Cosmetic tail docking: an overview of abuse and report of an interesting case.

PubMed

Eyarefe, Oghenemega David; Oguntoye, Cecilia O

2016-02-29

This paper presents an overview of the global controversies surrounding cosmetic tail docking in puppies, some observed inconsistent practices among dog breeders and Veterinarians in West Africa, and the need for the African Veterinary Profession to take a decisive position on the cosmetic docking procedure. An interesting report of observed complications associated with cosmetic tail docking in a 3 week old male Boerboel is reported alongside the management of the ensuing complications. This paper highlights the still prevalent practice of cosmetic tail docking and seeks to enlighten clinicians towards stemming its abuse in Africa.

Ethical Considerations for Psychologists Taking a Public Stance on Controversial Issues: The Balance Between Personal and Professional Life

PubMed Central

Haeny, Angela M.

2014-01-01

Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association’s (APA’s) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present paper analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present paper examines ethical issues that a) should be taken into account before psychologists take a public position on a controversial issue, and b) are in conflict with APA’s Ethics Code or current research. PMID:25342876

Ethical Considerations for Psychologists Taking a Public Stance on Controversial Issues: The Balance Between Personal and Professional Life.

PubMed

Haeny, Angela M

2014-07-01

Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association's (APA's) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present paper analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present paper examines ethical issues that a) should be taken into account before psychologists take a public position on a controversial issue, and b) are in conflict with APA's Ethics Code or current research.

Munchausen Syndrome by Proxy: An Alarming Face of Child Abuse

PubMed Central

Gehlawat, Pratibha; Gehlawat, Virender Kumar; Singh, Priti; Gupta, Rajiv

2015-01-01

Munchausen syndrome by proxy (MSBP) is emerging as a serious form of child abuse. It is an intentional production of illness in another, usually children by mothers, to assume sick role by proxy. It is poorly understood and a controversial diagnosis. Treatment is very difficult. We present a case of 9-year-old boy brought to Pt. B. D. Sharma, PGIMS, Rohtak, a tertiary care hospital in northern India by his father and paternal uncle with complaints of hematemesis since July 2012. He underwent many invasive procedures until the diagnosis of MSBP was finally considered. The examination of the blood sample confirmed the diagnosis. The child was placed under custody of his mother. The case was reported to social services, which incorporated whole family in the management. PMID:25722520

Munchausen syndrome by proxy: an alarming face of child abuse.

PubMed

Gehlawat, Pratibha; Gehlawat, Virender Kumar; Singh, Priti; Gupta, Rajiv

2015-01-01

Munchausen syndrome by proxy (MSBP) is emerging as a serious form of child abuse. It is an intentional production of illness in another, usually children by mothers, to assume sick role by proxy. It is poorly understood and a controversial diagnosis. Treatment is very difficult. We present a case of 9-year-old boy brought to Pt. B. D. Sharma, PGIMS, Rohtak, a tertiary care hospital in northern India by his father and paternal uncle with complaints of hematemesis since July 2012. He underwent many invasive procedures until the diagnosis of MSBP was finally considered. The examination of the blood sample confirmed the diagnosis. The child was placed under custody of his mother. The case was reported to social services, which incorporated whole family in the management.

Grammatical gender in German: a case for linguistic relativity?

PubMed

Bender, Andrea; Beller, Sieghard; Klauer, Karl Christoph

2011-09-01

The "principle of linguistic relativity" holds that, by way of grammatical categorization, language affects the conceptual representations of its speakers. Formal gender systems are a case in point, albeit a particularly controversial one: Previous studies obtained broadly diverging data, thus giving rise to conflicting conclusions. To a large extent, this incoherence is related to task differences and methodological problems. Here, a priming design is presented that avoids previous problems, as it prevents participants from employing gender information in a strategic manner. Four experiments with German native speakers show priming effects of the prime's grammatical gender on animate and nonanimate targets, an effect for the prime's biological gender on animate targets, but no effect for the prime's biological gender on nonanimate targets, and thus speak against an effect of language on thought for German gender.

Human Histologic Evidence of Reosseointegration Around an Implant Affected with Peri-implantitis Following Decontamination with Sterile Saline and Antiseptics: A Case History Report.

PubMed

Fletcher, Paul; Deluiz, Daniel; Tinoco, Eduardo Mb; Ricci, John L; Tarnow, Dennis P; Tinoco, Justine Monnerat

The treatment of peri-implant disease is one of the most controversial topics in implant dentistry. The multifactorial etiology and the myriad proposed techniques for managing the problem make successful decontamination of an implant surface affected by peri-implantitis one of the more unpredictable challenges dental practitioners have to face. This article presents the first known published case report demonstrating human histologic evidence of reosseointegration using a plastic curette for mechanical debridement and dilute sodium hypochlorite, hydrogen peroxide, and sterile saline for chemical detoxification. Guided bone regeneration in the infrabony component of the peri-implantitis lesion was accomplished using calcium sulfate and bovine bone as grafting materials and a porcine collagen barrier for connective tissue and epithelial exclusion.

Successful Treatment of a Drug-Resistant Epilepsy by Long-term Transcranial Direct Current Stimulation: A Case Report.

PubMed

San-Juan, Daniel; Sarmiento, Carlos Ignacio; González, Katia Márquez; Orenday Barraza, José Manuel

2018-01-01

Transcranial direct current stimulation (tDCS) is a reemerged noninvasive cerebral therapy used to treat patients with epilepsy, including focal cortical dysplasia, with controversial results. We present a case of a 28-year-old female with left frontal cortical dysplasia refractory to antiepileptic drugs, characterized by 10-15 daily right tonic hemi-body seizures. The patient received a total of seven sessions of cathodal tDCS (2 mA, 30 min). The first three sessions were applied over three consecutive days, and the remaining four sessions of tDCS were given each at 2-week intervals. At the 1-year follow-up, the patient reported to have a single seizure per month and only mild adverse events.

Successful Treatment of a Drug-Resistant Epilepsy by Long-term Transcranial Direct Current Stimulation: A Case Report

PubMed Central

San-Juan, Daniel; Sarmiento, Carlos Ignacio; González, Katia Márquez; Orenday Barraza, José Manuel

2018-01-01

Transcranial direct current stimulation (tDCS) is a reemerged noninvasive cerebral therapy used to treat patients with epilepsy, including focal cortical dysplasia, with controversial results. We present a case of a 28-year-old female with left frontal cortical dysplasia refractory to antiepileptic drugs, characterized by 10–15 daily right tonic hemi-body seizures. The patient received a total of seven sessions of cathodal tDCS (2 mA, 30 min). The first three sessions were applied over three consecutive days, and the remaining four sessions of tDCS were given each at 2-week intervals. At the 1-year follow-up, the patient reported to have a single seizure per month and only mild adverse events. PMID:29479337

Peripheral cemento-ossifying fibroma: case series literature review.

PubMed

Verma, Esha; Chakki, Arunkumar Bhimashankar; Nagaral, Sharanbasappa Chandrashekar; Ganji, Kiran Kumar

2013-01-01

THE CONCEPT OF FIBROOSSEOUS LESIONS OF BONE HAS EVOLVED OVER THE LAST SEVERAL DECADES AND NOW INCLUDES TWO MAJOR ENTITIES: fibrous dysplasia and ossifying fibroma. Peripheral cemento-ossifying fibroma is a relatively rare tumour classified between fibroosseous lesions. It predominantly affects adolescents and young adults, with peak prevalence between 10 and 19 yrs. The cemento-ossifying fibroma is a central neoplasm of bone as well as periodontium which has caused considerable controversy because of confusion regarding terminology and the criteria for its diagnosis. The cemento-ossifying fibroma is odontogenic in origin, whereas ossifying fibroma is of bony origin. Lesions histologically similar to peripheral ossifying fibroma have been given various names in existing literature. Therefore, we present and discuss in this paper a series of cases of peripheral cemento-ossifying fibroma emphasizing the differential diagnosis.

Oral findings in Rett syndrome: a systematic review of the dental literature.

PubMed

Fuertes-González, María-Cristina; Silvestre, Francisco-Javier; Almerich-Silla, José-Manuel

2011-01-01

Rett syndrome (RS) is a chromosome X-linked genetic neurological disorder characterized by developmental regression, particularly in relation to expressive language and use of the hands, together with profound mental retardation, that almost exclusively affects females. The present review describes the 35 cases of RS published in the indexed literature (Medline)--the first corresponding to 1985 and the last to the year 2007. Certain oral manifestations of the disease are derived from the drug treatment prescribed to control the disease, while others are common to other clinical conditions characterized by convulsion activity, difficulties for correct oral hygiene, walking problems and/or an excess of oral/digital-manual habits. In any case, bruxism is the oral habit most frequently associated with RS--the treatment of which remains the subject of controversy.

Endovascular Approach to Glomus Jugulare Tumors

PubMed Central

Kocur, Damian; Ślusarczyk, Wojciech; Przybyłko, Nikodem; Hofman, Mariusz; Jamróz, Tomasz; Suszyński, Krzysztof; Baron, Jan; Kwiek, Stanisław

2017-01-01

Summary Background Paragangliomas are benign neuroendocrine tumors derived from the glomus cells of the vegetative nervous system. Typically, they are located in the region of the jugular bulb and middle ear. The optimal management is controversial and can include surgical excision, stereotactic radiosurgery and embolization. Case Report We report the endovascular approach to three patients harboring glomus jugulare paragangliomas. In all cases incomplete occlusion of the lesions was achieved and recanalization in the follow-up period was revealed. Two patients presented no clinical improvement and the remaining one experienced a transient withdrawal of tinnitus. Conclusions It is technically difficult to achieve complete obliteration of glomus jugulare tumors with the use of embolization and the subtotal occlusion poses a high risk of revascularization and is not beneficial in terms of alleviating clinical symptoms. PMID:28685005

Asymptomatic Wolff–Parkinson–White syndrome: incidental ECG diagnosis and a review of literature regarding current treatment

PubMed Central

Liu, Alexander; Pusalkar, Pawan

2011-01-01

A 19-year-old male presented with periorbital cellulitis responsive to intravenous antibiotics. A routine ECG on admission showed slurred upstroke of the QRS complexes consistent with Wolff–Parkinson–White syndrome (WPW). He has never experienced any cardiac-related symptoms. Once the periorbital cellulitis resolved, he was referred to the specialist cardiology ablation clinic. He was counselled on the arrythmogenic risks of untreated WPW and the potential complications of radiofrequency catheter ablation (RFCA). He decided to go ahead with electrophysiological studies and RFCA, which took place successfully. This case highlights the importance of routine ECG in the diagnosis of asymptomatic WPW. The use of prophylactic ablation of asymptomatic WPW is controversial and should be considered on a case-specific basis. PMID:22693197

Surgery for disc-associated wobbler syndrome in the dog--an examination of the controversy.

PubMed

Jeffery, N D; McKee, W M

2001-12-01

Controversy surrounds treatment of disc-associated 'wobbler' syndrome in the dog, centring on the choice of method of surgical decompression used. In this review, details of previously published case series are summarised and critically examined in an attempt to compare success rates and complications of different types of surgery. Unequivocally accurate comparisons were difficult because of differences in methods of case recording between series. Short-term success rates were high (approximately 80 per cent), but there was a high rate of recurrence (around 20 per cent) after any surgical treatment, suggesting the possibility that the syndrome should be considered a multifocal disease of the caudal cervical region. Statistical analysis revealed no significant differences in success rates between the various reported decompressive surgical techniques

The case for vaccinating boys against human papillomavirus.

PubMed

Hull, Sarah C; Caplan, Arthur L

2009-01-01

Vaccination policy in the case of human papillomavirus (HPV) has remained a constant source of controversy ever since Gardasil, Merck's vaccine against HPV, received US Food and Drug Administration approval in the summer of 2006. This controversy has centered on the risks and benefits of vaccinating girls and women in rich and poor nations alike. However, despite all of the attention created by this important policy question, relatively little has been focused on another key public health question: should boys be vaccinated against HPV as well? If herd immunity against the most carcinogenic strains of HPV could be more rapidly and efficiently achieved by vaccinating everyone at risk for being a carrier, it logically follows that vaccine policy should expand to include boys and men. Copyright 2009 S. Karger AG, Basel.

Spontaneous gas gangrene in a patient with Crohn’s disease

PubMed Central

Vaidya, Yash P.; Vaidya, Tanvi P.

2012-01-01

Summary Background: Spontaneous gas gangrene is necrosis of muscles in the absence of trauma, causing an acutely painful and potentially fatal condition. However, the occurrence of this condition in Crohn’s disease has been very rarely documented. Case Report: In this extremely rare case we describe an occurrence of spontaneous gas gangrene, in a known case of Crohn’s disease. The patient presented with fever and pain in the left arm and abdomen. After admission and initial management with antibiotics, the patient developed crepitus in the arm and myonecrosis necessitating a fasciotomy and later an emergency amputation of his left upper limb. The pathogenesis of gas gangrene in inflammatory bowel disease is not fully understood. Management includes aggressive antibiotic administration followed by amputation of the non-salvageable limb. Conclusions: A high index of suspicion of such rare complications is a must and surgical intervention is life saving; however, the efficacy of anti-gas gangrene serum is controversial. We recommend use of a multipronged approach in such cases with high mortality rates. PMID:23569538

Relationship between Human Papilloma Virus and Subungual Keratoacanthoma: Two Case Reports and the Outcomes of Surgical Treatment.

PubMed

Göktay, Fatih; Kaynak, Emre; Güneş, Pembegül; Yaşar, Şirin; Küçükodacı, Zafer; Aytekin, Sema

2017-01-01

Subungual keratoacanthoma (SUKA) is a rare form of keratoacanthoma, with the majority of the lesions appearing as rapidly growing, painful hyperkeratotic masses located under the distal nail plate of the thumb. In some cases, SUKA causes damage to the underlying bone. The first case presented here was treated by surgical excision alone, and human papilloma virus (HPV) type 6 was detected in the tissue samples. The second case was treated by surgical excision plus curettage; however, HPV was not detected, and tumor cells were not found in the curettage material. There was near complete improvement in both the clinical appearance and the distal phalanx destruction, with no recurrence at the final follow-up in either patient (30 and 14 months, respectively). Overall, simple excision alone or in combination with curettage seemed to be sufficient in the treatment of SUKA; however, the etiopathogenetic role of HPV in SUKA remains controversial, as in its classical form.

Lessons learned from the Siting Process of an Interim Storage Facility in Spain - 12024

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lamolla, Meritxell Martell

2012-07-01

On 29 December 2009, the Spanish government launched a site selection process to host a centralised interim storage facility for spent fuel and high-level radioactive waste. It was an unprecedented call for voluntarism among Spanish municipalities to site a controversial facility. Two nuclear municipalities, amongst a total of thirteen municipalities from five different regions, presented their candidatures to host the facility in their territories. For two years the government did not make a decision. Only in November 30, 2011, the new government elected on 20 November 2011 officially selected a non-nuclear municipality, Villar de Canas, for hosting this facility. Thismore » paper focuses on analysing the factors facilitating and hindering the siting of controversial facilities, in particular the interim storage facility in Spain. It demonstrates that involving all stakeholders in the decision-making process should not be underestimated. In the case of Spain, all regional governments where there were candidate municipalities willing to host the centralised interim storage facility, publicly opposed to the siting of the facility. (author)« less

Some core contested concepts.

PubMed

Chomsky, Noam

2015-02-01

Core concepts of language are highly contested. In some cases this is legitimate: real empirical and conceptual issues arise. In other cases, it seems that controversies are based on misunderstanding. A number of crucial cases are reviewed, and an approach to language is outlined that appears to have strong conceptual and empirical motivation, and to lead to conclusions about a number of significant issues that differ from some conventional beliefs.

Students' Perceptions of a Highly Controversial yet Keystone Species, the Black-Tailed Prairie Dog: A Case Study

ERIC Educational Resources Information Center

Fox-Parrish, Lynne; Jurin, Richard R.

2008-01-01

The authors used a case-study methodology to explore the perceptions of 30 9th-grade biology students relative to black-tailed prairie dogs. The case study, which involved classroom- and field-based experiences that focused on black-tailed prairie dogs, revealed 3 major themes: apathy, egocentrism, and naive conceptions. The authors had hoped that…

Immunohistochemical analysis of P53 protein in odontogenic cysts

PubMed Central

Gaballah, Essam Taher M.A.; Tawfik, Mohamed A.

2010-01-01

The p53 is a well-known tumor suppressor gene, the mutations of which are closely related to the decreased differentiation of cells. Findings of studies on immunohistochemical P53 expression in odontogenic cysts are controversial. The present study was carried-out to investigate the immunohistochemical expression of P53 protein in odontogenic cysts. Thirty paraffin blocks of diagnosed odontogenic cysts were processed to determine the immunohistochemical expression of P53 protein. Nine of the 11 odontogenic keratocysts (81.8%) expressed P53, one of three dentigerous cyst cases expressed P53, while none of the 16 radicular cysts expressed P53 protein. The findings of the present work supported the reclassification of OKC as keratocystic odontogenic tumor. PMID:23960493

Supreme Court Review

ERIC Educational Resources Information Center

Williams, Charles F.

2008-01-01

This article looks at various cases of the Supreme Court's most recent term. In contrast to the 2006-2007 term when the Supreme Court was regularly split 5-4, during this last term, the justices have formed surprising coalitions in cases considered highly controversial. For example, it was the so-called liberal bloc's Justice Stevens who wrote the…

The Right to Live and Die. Canadian Critical Issues Series.

ERIC Educational Resources Information Center

Eisenberg, John; Bourne, Paula

One of a series adapted from the Canadian Public Issues Project, this book is designed to stimulate discussion and reflection about controversial issues through case studies. The book is based on high school units originally drawn from cases in newspapers, journals, books, legal documents, and government reports. Conflicts from issues arising over…

Case Study: Transgenic Crop Controversy in Costa Rica

ERIC Educational Resources Information Center

Hague, Steve S.

2009-01-01

Costa Rica has rich ecological resources and has been a steady political force in turbulent Central America. Most recently, it has become a battleground between pro- and anti-genetically modified organism (GMO) political forces. This case study examines the roles of U.S.-based cotton ("Gossypium hirsutum" L.) seed companies, anti-GMO…

Rights at Stake in Free-Speech Case

ERIC Educational Resources Information Center

Walsh, Mark

2007-01-01

Despite the less-than-weighty incident at its core--the display of a homemade banner emblazoned with "Bong Hits 4 Jesus"--a case that the U.S. Supreme Court will take up carries potentially far-reaching consequences for student speech, and for the legal protections of public school educators. From a sea of controversies over student…

The Vocational-Liberal Arts Controversy: Looking Backwards.

ERIC Educational Resources Information Center

Miles, Sue L.

The liberal arts-vocational education controversy is examined in this article through a series of fictitious letters based on historical facts that present the thoughts of key educational personalities regarding the community college's role in providing vocational education and liberal arts education. Part I, which takes the form of a letter and…

Eliminating Racism: Profiles in Controversy.

ERIC Educational Resources Information Center

Katz, Phyllis A., Ed.; Taylor, Dalmas A., Ed.

Dialogue and research on racism since the mid-1970s have yielded increased controversy over the theories, foundation, and continued existence of racism. The chapters presented in this book provide various divergent views of what constitutes racism and frameworks for reducing it. The following chapters (and their authors) are included: (1)…

IQ Test Controversy: Past, Present, and Future Trends.

ERIC Educational Resources Information Center

Alford, David W.

The controversies surrounding the use of intelligence quotient (IQ) tests with children are summarized. This article discusses what intelligence is and how intelligence is measured. It also examines factors which can affect measurement, including examiner training or bias, examinee age, misinterpretation of test scores, and poor tests. The…

Teaching About the Creation/Evolution Controversy. Fastback 134.

ERIC Educational Resources Information Center

Bergman, Jerry

The booklet discusses questions related to teaching engendered by the creation/evolution controversy, presents current positions of educators and textbooks, and recommends a two-model teaching approach. It is divided into six chapters. Chapter I defines and summarizes evolution and creationism as different belief structures, and outlines various…

Approaches to Education about a World Economy.

ERIC Educational Resources Information Center

Nelson, Jack L.

A rationale for skeptical and controversial teaching about world economics is presented by maintaining that the nature of economics is controversial and that ideology and nationalism are dominant obstacles in economics education. Following an introduction, the first of six sections discusses major stereotypes and perceptions in economics. The next…

The Controversy on National Standards for History.

ERIC Educational Resources Information Center

Chapin, June R.

This paper examines the controversy generated by the 1994 release of the "National Standards for United States History: Exploring the American Experience (5-12)" and "National Standards for World History: Exploring Paths to the Present (5-12)." The standards engendered protests as conservatives and others charged that it was a "politically…

Teaching Controversial Materials: Teaching about the Nuclear Issue.

ERIC Educational Resources Information Center

Wall, Joseph

1986-01-01

Describes difficulties encountered in presenting a college course on nuclear weapons and disarmament. Maintains that such courses must strive for a fuller historical account of the arms race, in addition to stressing the humanistic and ethical questions involved. Warns that controversy will arise and concludes that even blind anger is preferable…

From genotype to phenotype; clinical variability in Lesch-Nyhan disease. The role of epigenetics.

PubMed

Trigueros Genao, M; Torres, R J

2014-11-01

Lesch-Nyhan disease is a rare genetic disease characterized by a deficiency in the function of the enzyme hypoxanthine-guanine phosphoribosyltransferase (HGPRT). Patients affected by this disease experience hyperuricemia, motor disorders, mental retardation and, in the most severe cases, self-mutilation. Its clinical manifestations depend on the enzymatic activity of HGPRT, which is classically linked to the type of alteration in the HGPRT gene. More than 400 mutations of this gene have been found. At present, one of the controversial aspects of the disease is the relationship between the genotype and phenotype; cases have been described lacking a mutation, such as the patient presented in this article, as well as families who despite sharing the same genetic defect show disorders with differing severity. Epigenetic processes, which modify the genetic expression without changing the sequence of the deoxyribonucleic acid (DNA), could explain the clinical variability observed in this disease. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Posterior reversible encephalopathy syndrome in a patient with a Chiari I malformation

PubMed Central

Hansberry, David R.; Agarwal, Nitin; Tomei, Krystal L.; Goldstein, Ira M.

2013-01-01

Background: The authors describe a unique case of a patient who developed posterior reversible encephalopathy syndrome (PRES) following postoperative treatment of a Chiari I malformation. Case Decsription: A 25-year-old female presented with complaints of left upper and lower extremity paresthesias and gait disturbances. A magnetic resonance imaging (MRI) of the brain and cervical spine showed a Chiari I malformation with tonsillar descent beyond the level of the C1 lamina. She underwent a suboccipital craniectomy and C1 laminectomy with cerebellar tonsillar cauterization and duraplasty. Postoperatively, an MRI showed bilateral acute infarcts of the cerebellar vermis. She was initially treated for cerebellar ischemia with hypertensive therapy with a subsequent decline in her neurologic status and generalized tonic–clonic seizure. Further workup showed evidence of PRES. After weaning pressors, the patient had a significant progressive improvement in her mental status. Conclusion: Although the mechanism of PRES remains controversial given its diverse clinical presentation, several theories implicate hypertension and steroid use as causative agents. PMID:24232171

Actinic Prurigo Cheilitis: A Clinicopathologic Review of 75 Cases.

PubMed

Plaza, Jose A; Toussaint, Sonia; Prieto, Victor G; Mercadillo, Patricia; Diez de Medina, Juan C; Lourenco, Silvia; Batdorf, Bjorn; Sangueza, Martin

2016-06-01

Actinic prurigo (AP) is a chronic idiopathic photodermatosis that primarily affects American Indians in the United States and Mestizos in Latin American countries. Clinically, the onset of the disease is usually in the first decade of life but may appear initially in adult life, and it is characterized by symmetric involvement of sun-exposed areas of the skin, particularly areas of the face, resulting in polymorphic erythematous papules, macules, and plaques in different stages of evolution. Lower lip involvement includes swelling, scaling, fissures, hyperpigmentation, and ulcerations of the vermilion border. and in some cases could represent the only manifestation of the disease. The histopathologic features of AP have been studied; however, there is a controversy regarding whether AP cheilitis has distinct histopathologic features that could allow accurate separation from other specific and nonspecific forms of cheilitis. The diagnosis can be challenging, mainly when lip lesions are the only manifestation of the disease. In this study, the authors investigate the clinicopathologic features of 75 cases of AP cheilitis to provide further criteria for its diagnosis and classification. All 75 patients presented with lip lesions. Thirty-three cases were diagnosed as AP cheilitis with cutaneous lesions and 42 cases were diagnosed as AP cheilitis without cutaneous lesions (only lip lesions). Histologically, of the 33 cases with AP cheilitis with cutaneous lesions, 17 (52%) cases showed follicular cheilitis, and of the 42 cases that had only lip lesions, 18 (43%) cases showed follicular cheilitis. Histologically, AP cheilitis can present as follicular cheilitis; thus, supporting the diagnosis. Also, our findings confirm that lip lesions can present as the only manifestation of the disease, showing typical histological and clinical features. This form of cheilitis has not being well described in the dermatologic and dermatopathologic literature.

Clarifying Public Controversy: An Approach to Teaching Social Studies.

ERIC Educational Resources Information Center

Newmann, Fred M.; Oliver, Donald W.

This book presents a rational discussion process approach to the teaching of specific social controversies in the social studies in secondary schools. The authors provide an in-depth analysis of this approach which includes both theory and application. The introductory chapters place the discussion process framework within terms of American values…

Easy to Understand but Difficult to Decide: Information Comprehensibility and Controversiality Affect Laypeople's Science-Based Decisions

ERIC Educational Resources Information Center

Scharrer, Lisa; Britt, M. Anne; Stadtler, Marc; Bromme, Rainer

2013-01-01

Well-educated laypeople tend to rely on their own ability to evaluate scientific claims when they obtain information from texts with high comprehensibility. The present study investigated whether controversial content reduces this facilitating effect of high text comprehensibility on readers' self-reliance and whether the influence of…

B. F. Skinner: The Writer and His Definition of Verbal Behavior

ERIC Educational Resources Information Center

da F. Passos, Maria de Lourdes R.

2012-01-01

Skinner's definition of verbal behavior, with its brief and refined versions, has recently become a point of controversy among behavior analysts. Some of the arguments presented in this controversy might be based on a misreading of Skinner's (1957a) writings. An examination of Skinner's correspondence with editors of scientific journals shows his…

Improving Vocational Students' Consideration of Source Information When Deciding about Science Controversies

ERIC Educational Resources Information Center

Stadtler, Marc; Scharrer, Lisa; Macedo-Rouet, Monica; Rouet, Jean-François; Bromme, Rainer

2016-01-01

We present an empirical investigation of a classroom training fostering vocational students' consideration of source information when deciding about science-based controversies. The training was specifically aimed at raising students' awareness of the division of cognitive labor and the resulting need to take a source's competence into account…

Controversial Texts and Public Education.

ERIC Educational Resources Information Center

Smith, David L.

Because public schools are designed to serve the widest range of interests and are committed to the ideal of democracy, teachers cannot afford to avoid teaching works or presenting ideas that offend some members of communities. Students need to learn the value of controversy and of the challenges posed by a text. Richard Wright's "Native Son" and…

D. W. Griffith's Controversial Film, "The Birth of a Nation."

ERIC Educational Resources Information Center

Pitcher, Conrad

1999-01-01

Presents a lesson plan that enables students to investigate race relations during the Progressive Era by analyzing D. W. Griffith's "The Birth of a Nation" and the controversy surrounding the release of the film. Explores the pros and cons of using motion pictures as teaching tool. Includes two student handouts. (CMK)

Good Jobs or Bad Jobs? Evaluating the American Job Creation Experience.

ERIC Educational Resources Information Center

Loveman, Gary W.; Tilly, Chris

1988-01-01

The authors discuss the rate of job creation in the United States between 1973 and 1985. The controversy regarding the quality of the new jobs is emphasized. Four points of view on this controversy are reviewed. The authors also present recent research findings concerning average earnings and earnings inequality. (CH)

Tracking: Conflicts and Resolutions. Controversial Issues in Education.

ERIC Educational Resources Information Center

Lockwood, Anne Turnbaugh

The educational tracking system raises highly controversial issues. This book offers both the viewpoints of researchers who have grappled with the issue of tracking and the personal experiences of school staff who have wrestled with the issue of whether or not to track instruction. It presents summaries of interviews that were conducted with three…

Validity of Criteria-Based Content Analysis (CBCA) at Trial in Free-Narrative Interviews

ERIC Educational Resources Information Center

Roma, Paolo; San Martini, Pietro; Sabatello, Ugo; Tatarelli, Roberto; Ferracuti, Stefano

2011-01-01

Objective: The reliability of child witness testimony in sexual abuse cases is often controversial, and few tools are available. Criteria-Based Content Analysis (CBCA) is a widely used instrument for evaluating psychological credibility in cases of suspected child sexual abuse. Only few studies have evaluated CBCA scores in children suspected of…

Meta-Analysis of Single-Case Design Research: Introduction to the Special Issue

ERIC Educational Resources Information Center

Burns, Matthew K.

2012-01-01

Single-case design (SCD) research focuses on finding powerful effects, but the influence of this methodology on the evidence-based practice (EBP) movement is questionable. Meta-analytic procedures may help facilitate the role of SCD research in the EBP movement, but meta-analyses of SCDs are controversial. The current article provides an…

Teacher Evaluation and Collective Bargaining: Resolving Policy at a Local Level

ERIC Educational Resources Information Center

Paige, Mark

2013-01-01

This case study analyzes controversial teacher evaluation policies in the context of collective bargaining. Dr. Jill Abrams, a new superintendent in a struggling school district, is at the center of the case. Her school board demands a form of teacher evaluation she finds problematic because it includes value-added modeling. Moreover, the board…

Revisiting an ancient treatment for transphincteric fistula-in-ano ‘There is nothing new under the sun’ Ecclesiastes 1v9

PubMed Central

Sturgeon, G; Hargest, R

2015-01-01

Objective The history of treatments for fistula-in-ano can be traced back to ancient times. Current treatment of transphincteric fistulae is controversial, with many options available. We reviewed the history of treatment using cutting setons and present our series of transphincteric fistulae in the light of the series in the literature. Design Literature review and case series. Setting Hospital based coloproctology service Participants 140 consecutive patients presenting with fistula-in-ano were included. Main Outcome Measures The literature pertaining to treatment of transphincteric fistula was reviewed, along with the outcome of various treatment methods for this condition. Data were collected for 140 consecutive patients presenting with fistula- in-ano were assessed for fistula healing, recurrence and complications. Results A total of 140 consecutive patients with fistula-in-ano were identified, of which 111 were cryptoglandular (79.3%). Eighty-one of these 111 were transphincteric (73.0%). At a median follow-up of 35 months (range, 2–83 months), 70 transphincteric fistulae had healed (86.4%), 10 were still undergoing treatment (12.3%) and one patient was lost to follow-up prior to treatment (1.2%). Two patients in this group required a stoma (2.5%), six patients developed recurrence (7.4%); three ‘true’ recurrences (3.7%). One (1.2%) developed a chronic fissure. There were no reported cases of incontinence. Conclusions The management of transphincteric fistula-in-ano is complex and controversial, for which no clear surgical procedure has gained acceptance as the gold standard. This study demonstrates that transphincteric fistulae can be successfully treated using cutting setons. A high healing rate (86.4%), low recurrence rate (7.4%) and a low complication rate (3.7%) are shown, which compares favourably with published rates over a long follow-up. PMID:26152674

Rhinocerebral Mucor circinelloides infection in immunocompromised patient following yogurt ingestion.

PubMed

Lazar, Stephen P; Lukaszewicz, Jennifer M; Persad, Kamleish A; Reinhardt, John F

2014-08-01

The purpose of this case report is to illustrate the cause of this patient's headache and sinus pain in the setting of a unique environmental exposure: the patient ingested yogurt only days before presentation. This particular brand of yogurt caused controversy in early September 2013 when the manufacturer voluntarily recalled all flavors. The yogurt was found to be contaminated with Mucor circinelloides. The recall was triggered by the FDA, after receiving many complaints from consumers affected by temporary gastrointestinal symptoms such as abdominal cramping, diarrhea, and nausea. This patient was diagnosed with Rhinocerebral mucormycosis through fungal culture of the affected area. He was specifically colonized with Mucor circinelloides, a variant that rarely causes disease in humans. According to a literature review, only eight cases of mucormycosis in adults caused by this strain were documented before 2009.

Ectopic breast cancer: case report and review of the literature.

PubMed

Francone, Elisa; Nathan, Marco J; Murelli, Federica; Bruno, Maria Santina; Traverso, Enrico; Friedman, Daniele

2013-08-01

Ectopic breast tissue comes in two forms: supernumerary and aberrant. Despite morphologic differences, ectopic breast tissue presents characteristics analogous to orthotopic breast tissue in terms of function and, most importantly, pathologic degeneration. Data in the literature concerning its precise incidence, the probability of malignant degeneration, and its standardized management are scarce and controversial. This study selected more than 100 years of literature, and this report discusses a case of ectopic breast cancer treatment, suggesting novel therapeutic advice that could bring considerable clinical advantages, improve cosmetic results, and reduce the psychological impact on patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PubMed Central

BARBIERI, M.; MUSIZZANO, Y.; BOGGIO, M.; CARCUSCIA, C.

2011-01-01

SUMMARY Granular cell tumour is a rare soft tissue neoplasm that can virtually affect any site of the body. Its histological origin is controversial, since several studies have shown that different cells are involved. Granular cell tumour was initially described as myoblastoma, but, at present, a neural origin is supported by most Authors, due to the immunohistochemical pattern. Even if the biological behaviour of granular cell tumours is usually benign, accurate histological examination is mandatory, because in a small number of cases they can be malignant. Here, a case is described of granular cell tumour in a 14-year-old boy, which is a very rare occurrence, since these tumours typically manifest in subjects between the third and sixth decade. Histopathological features, differential diagnosis and therapeutic implications of granular cell tumour are discussed, together with a brief review of the recent literature. PMID:22058595

A nursing case history: the patient with mycotic aneurysm secondary to endocarditis.

PubMed

Leith, B; Furimsky, I

1995-03-01

Due to the advent of antibiotics, mycotic aneurysms, also known as infective aneurysms, now represent only 2.5-5% of all aneurysms. The existing research on this topic is old and scarce. It is highly probably that a neuroscience nurse will care for this type of patient at some point during his/her career. The patient with a mycotic aneurysm is usually critically ill. A 46% mortality has been noted and is related to the multiple problems of these types of patients. Currently, if and when to surgically intervene is controversial. The case of "Mr. C.", a patient at the Montreal Neurological Hospital who developed a mycotic aneurysm secondary to subacute bacterial endocarditis, will be presented. His course in hospital, the medical management and treatment as well as the nursing care and educational needs will be described.

Prostate cancer: a patient's perspective.

PubMed

Howe, R J

1994-11-01

During the last few years a tremendous amount of media attention has been focused on prostate cancer. This increased visibility has been the direct result of the prostate specific antigen test, which has led to a doubling of the number of new cases detected in just 4 years. With this visibility has come controversy about which treatment is the most effective or whether this disease should be treated aggressively at all. The formation and rapid expansion of the prostate cancer support group movement are reviewed, and the positive and negative impacts of media coverage on present and future patients are assessed. My personal case is reviewed briefly to make a specific point about the hazards of watchful waiting. Other issues, such as mass screening, Prostate Cancer Awareness Week and expenditures for prostate cancer research, are examined in some detail.

[Secondary Arterial Hypertension: Uncertainties in Diagnosis].

PubMed

Dinis, Paulo Gomes; Cachulo, Maria Carmo; Fernandes, Andreia; Paiva, Luis; Gonçalves, Lino

2017-06-30

Arterial hypertension is regarded today as a global public health problem, and the prevalence rate in Portugal is 26.9%. According to the etiology, is classified into primary or secondary arterial hypertension. In about 90% of cases it is not possible to establish a cause, so is called primary arterial hypertension. In the remaining 5 to 10%, it can be identified secondary causes, which are potentially treatable. For secondary arterial hypertension study to be cost-effective, it is essential to understand which patients investigate, and evaluate the best strategy to adopt. The main causes identified as responsible for secondary arterial hypertension are: kidney disease; endocrine and vascular diseases and obstructive sleep apnea. Among these some are consensual, and others more controversial in the literature. In this regard we present two cases of arterial hypertension, which are potentially secondary in etiology, but still focus of debate.

Peripheral Cemento-Ossifying Fibroma: Case Series Literature Review

PubMed Central

Ganji, Kiran Kumar; Chakki, ArunKumar Bhimashankar; Nagaral, Sharanbasappa Chandrashekar; Verma, Esha

2013-01-01

The concept of fibroosseous lesions of bone has evolved over the last several decades and now includes two major entities: fibrous dysplasia and ossifying fibroma. Peripheral cemento-ossifying fibroma is a relatively rare tumour classified between fibroosseous lesions. It predominantly affects adolescents and young adults, with peak prevalence between 10 and 19 yrs. The cemento-ossifying fibroma is a central neoplasm of bone as well as periodontium which has caused considerable controversy because of confusion regarding terminology and the criteria for its diagnosis. The cemento-ossifying fibroma is odontogenic in origin, whereas ossifying fibroma is of bony origin. Lesions histologically similar to peripheral ossifying fibroma have been given various names in existing literature. Therefore, we present and discuss in this paper a series of cases of peripheral cemento-ossifying fibroma emphasizing the differential diagnosis. PMID:23365762

Peripheral cemento-ossifying fibroma: A case report with review of literature

PubMed Central

Mishra, Amit Kumar; Maru, Rahul; Dhodapkar, Shrikant Vishnuprasad; Jaiswal, Gagan; Kumar, Rajesh; Punjabi, Heena

2013-01-01

Peripheral cemento-ossifying fibroma (PCOF) is a rare osteogenic neoplasm that ordinarily presents as an epulis-like growth. This is of a reactive rather than neoplastic nature and its pathogenesis is uncertain. PCOF predominantly affects adolescent and young adults with greatest prevalence around 28 years. We report here a rare clinical case of PCOF of the mandible, 1 cm mesiodistally and 1.5 cm occluso-gingivally in diameter, which caused difficulty in eating and speech, in a 42-year-old female patient. She was asymptomatic for 1 year and on follow-up for 6 mo post surgically showed gingival health and normal radioopacity of bone without any recurrence. Clinical, radiographic and histological characteristics are discussed and recommendations regarding differential diagnosis, treatment and follow up are provided. The controversial varied nomenclature and possible etiopathogenesis of PCOF are emphasized. PMID:24303483

Peripheral cemento-ossifying fibroma: A case report with review of literature.

PubMed

Mishra, Amit Kumar; Maru, Rahul; Dhodapkar, Shrikant Vishnuprasad; Jaiswal, Gagan; Kumar, Rajesh; Punjabi, Heena

2013-06-16

Peripheral cemento-ossifying fibroma (PCOF) is a rare osteogenic neoplasm that ordinarily presents as an epulis-like growth. This is of a reactive rather than neoplastic nature and its pathogenesis is uncertain. PCOF predominantly affects adolescent and young adults with greatest prevalence around 28 years. We report here a rare clinical case of PCOF of the mandible, 1 cm mesiodistally and 1.5 cm occluso-gingivally in diameter, which caused difficulty in eating and speech, in a 42-year-old female patient. She was asymptomatic for 1 year and on follow-up for 6 mo post surgically showed gingival health and normal radioopacity of bone without any recurrence. Clinical, radiographic and histological characteristics are discussed and recommendations regarding differential diagnosis, treatment and follow up are provided. The controversial varied nomenclature and possible etiopathogenesis of PCOF are emphasized.

Neonatal Sex Assignment in Disorders of Sex Development: A Philosophical Introspection

PubMed Central

Raveenthiran, V.

2017-01-01

Management of ambiguous genitalia is highly controversial. This condition was known previously as intersex and presently as disorders of sex development (DSD). There is no consensus regarding the choice, timing and method of sex assignment in neonates with DSD. Consensus conferences could not unify the views of various stakeholders and third parties. This article philosophically examines the nature and origin of such controversies. Misconception, bias and conflicting priorities are identified as the three cardinal sources of controversies. Conceptual duality of sexes, confused notion of sex and gender, bias towards penetrative intercourse, conflict between utopian ideals and reality, unwillingness to compromise are identified as perpetuators of controversies. Suggestions are made regarding sex assignment in various types of DSD based on the understanding of published literature and the author’s personal experience. PMID:28920018

Plausibility and the Theoreticians' Regress: Constructing the evolutionary fate of stars

NASA Astrophysics Data System (ADS)

Ipe, Alex Ike

2002-10-01

This project presents a case-study of a scientific controversy that occurred in theoretical astrophysics nearly seventy years ago following the conceptual discovery of a novel phenomenon relating to the evolution and structure of stellar matter, known as the limiting mass. The ensuing debate between the author of the finding, Subrahmanyan Chandrasekhar and his primary critic, Arthur Stanley Eddington, witnessed both scientists trying to convince one another, as well as the astrophysical community, that their respective positions on the issue was the correct one. Since there was no independent criterion—that is, no observational evidence—at the time of the dispute that could have been drawn upon to test the validity of the limiting mass concept, a logical, objective resolution to the controversy was not possible. In this respect, I argue that the dynamics of the Chandrasekhar-Eddington debate succinctly resonates with Kennefick's notion of the Theoreticians' Regress. However, whereas this model predicts that such a regress can be broken if both parties in a dispute come to agree on who was in error and collaborate on a calculation whose technical foundation can be agreed to, I argue that a more pragmatic path by which the Theoreticians' Regress is broken is when one side in a dispute is able to construct its argument as being more plausible than that of its opponent, and is so successful in doing so, that its opposition is subsequently forced to withdraw from the debate. In order to adequately deal with the construction of plausibility in the context of scientific controversies, I draw upon Harvey's Plausibility Model as well as Pickering's work on the role socio-cultural factors play in the resolution of intellectual disputes. It is believed that the ideas embedded in these social- relativist-constructivist perspectives provide the most parsimonious explanation as to the reasons for the genesis and ultimate closure of this particular scientific controversy.

A retrospective cohort study of patients treated with anti-tuberculous therapy for presumed ocular tuberculosis.

PubMed

Damato, Erika Marie; Dawson, Sarah; Liu, Xiaoxuan; Mukherjee, Chandoshi; Horsburgh, John; Denniston, Alastair K; Moran, Edward; Dedicoat, Martin; Murray, Philip Ian

2017-12-04

Uveitis involving the posterior segment is a significant and potentially blinding condition. The diagnosis and treatment of patients with uveitis associated with tuberculosis remains controversial, and commonly, patients are systemically well. Use of the interferon-gamma release assays has added to the controversy, as the significance of a positive test may be uncertain. We aim to report the outcomes of anti-tuberculous treatment in a cohort of patients treated in Birmingham, for presumed "ocular tuberculosis", based on clinical findings, systemic assessment and specific testing for tuberculosis. We found that in our cohort of 41 patients treated between 2010 and 2014, the majority achieved disease-free remission, even in cases where anti-tuberculous treatment was delayed. Despite controversy, this study strongly supports the use of anti-tuberculous therapy in such patients and highlights the need for formal prospective trials and treatment protocols.

Networking expertise: discursive coalitions and collaborative networks of experts in a public creationism controversy in the UK.

PubMed

Allgaier, Joachim

2012-04-01

Experts do play a particular role in public socio-scientific debates, even more so if they form heterogeneous coalition with other actors and experts. A case study about a public science education controversy surrounding the teaching of evolution/creationism in the UK press is used to investigate in detail how connections and coalitions between experts and other actors involved in the controversy emerged and played out. The research focuses on the question of what role collaborative and other networks of experts played in terms of influence, visibility, credibility, consensus and weight of argument. Issues that are considered in the research are the status of the members of the coalitions forming during the debate and how it is displayed in media representations and letters and petitions, and also how these networks and coalitions of experts perform in relation to each other.

Networking expertise: Discursive coalitions and collaborative networks of experts in a public creationism controversy in the UK

PubMed Central

Allgaier, Joachim

2012-01-01

Experts do play a particular role in public socio-scientific debates, even more so if they form heterogeneous coalition with other actors and experts. A case study about a public science education controversy surrounding the teaching of evolution/creationism in the UK press is used to investigate in detail how connections and coalitions between experts and other actors involved in the controversy emerged and played out. The research focuses on the question of what role collaborative and other networks of experts played in terms of influence, visibility, credibility, consensus and weight of argument. Issues that are considered in the research are the status of the members of the coalitions forming during the debate and how it is displayed in media representations and letters and petitions, and also how these networks and coalitions of experts perform in relation to each other. PMID:23045882

Management of Early Stage, High-Risk Endometrial Carcinoma: Preoperative and Surgical Considerations

PubMed Central

Pettigrew, Gaetan

2013-01-01

Endometrial cancer is the most common gynecologic malignancy in the developed world. Most cases are diagnosed at an early stage and have low-grade histology, portending an overall excellent prognosis. There exists a subgroup of patients with early, high-risk disease, whose management remains controversial, as current data is clouded by inclusion of early stage tumors with different high-risk features for recurrence, unstandardized protocols for surgical staging, and an evolving staging system by which we are grouping these patients. Here, we present preoperative and intraoperative considerations that should be taken into account when planning surgical management for this population of patients. PMID:23878545

Theories that narrate the world: Ronald A. Fisher's mass selection and Sewall Wright's shifting balance.

PubMed

Rosales, Alirio

2017-04-01

Theories are composed of multiple interacting components. I argue that some theories have narratives as essential components, and that narratives function as integrative devices of the mathematical components of theories. Narratives represent complex processes unfolding in time as a sequence of stages, and hold the mathematical elements together as pieces in the investigation of a given process. I present two case studies from population genetics: R. A. Fisher's "mas selection" theory, and Sewall Wright's shifting balance theory. I apply my analysis to an early episode of the "R. A. Fisher - Sewall Wright controversy." Copyright © 2017 Elsevier Ltd. All rights reserved.

High titers of autoantibodies to topoisomerase I (Scl-70) in sera from scleroderma patients.

PubMed

Shero, J H; Bordwell, B; Rothfield, N F; Earnshaw, W C

1986-02-14

Patients with rheumatic diseases often have circulating autoantibodies to nuclear components. The clinical significance of the antibodies is controversial, although in some cases they are valuable in the diagnosis of the disease. This report presents results of a study of Scl-70, an autoantigen recognized by sera of many patients with the most severe form of progressive systemic sclerosis. It was possible to show, by three independent criteria, that Scl-70 is the abundant nuclear enzyme DNA topoisomerase I. Therefore, antibody probes of high titer and high affinity are now available for the study of this important nuclear enzyme.

Treatment of singultus by sexual stimulation: Who was George T Dexter, MD (c1812-?)?

PubMed

Petroianu, Georg A

2016-05-01

This short report attempts to shed light on the interesting but controversial personality of George T Dexter (ca1812 -?), the physician who first described manipulation of the female genitalia in a hysterical impressionable girl as being associated with the termination of singultus. Although his interaction with the young female patient would not meet today's ethical standards, his medical observation was valid and contributes to our understanding of the pathophysiology of singultus. He was well ahead of his colleagues who presented hiccup therapy case reports with similar or related pathophysiology mechanisms some 150 years later. © IMechE 2014.

Palliative Sedation With Propofol for an Adolescent With a DNR Order.

PubMed

Johnson, Liza-Marie; Frader, Joel; Wolfe, Joanne; Baker, Justin N; Anghelescu, Doralina L; Lantos, John D

2017-08-01

Death from cancer is often painful. Usually, the pain can be relieved in ways that allow patients to remain awake and alert until the end. Sometimes, however, the only way to relieve pain is to sedate patients until they are unconscious. This method has been called palliative sedation therapy. Palliative sedation therapy is controversial because it can be misunderstood as euthanasia. We present a case in which an adolescent who is dying of leukemia has intractable pain. Experts in oncology, ethics, pain management, and palliative care discuss the trade-offs associated with different treatment strategies. Copyright © 2017 by the American Academy of Pediatrics.

Imaging Management of Breast Density, a Controversial Risk Factor for Breast Cancer.

PubMed

Falcon, Shannon; Williams, Angela; Weinfurtner, Jared; Drukteinis, Jennifer S

2017-04-01

Breast density is well recognized as an independent risk factor for the development of breast cancer. However, the magnitude of risk is controversial. As the public becomes increasingly aware of breast density as a risk factor, legislation and notification laws in relation to breast density have become common throughout the United States. Awareness of breast density as a risk factor for breast cancer presents new challenges for the clinician in the approach to the management and screening of women with dense breasts. The evidence and controversy surrounding breast density as a risk factor for the development of breast cancer are discussed. Common supplemental screening modalities for breast cancer are also discussed, including tomosynthesis, ultrasonography, and magnetic resonance imaging. A management strategy for screening women with dense breasts is also presented. The American College of Radiology recognizes breast density as a controversial risk factor for breast cancer, whereas the American Congress of Obstetricians and Gynecologists recognizes breast density as a modest risk factor. Neither organization recommends the routine use of supplemental screening in women with dense breasts without considering additional patient-related risk factors. Breast density is a poorly understood and controversial risk factor for the development of breast cancer. Mammography is a screening modality proven to reduce breast cancer-related mortality rates and is the single most appropriate tool for population-based screening. Use of supplemental screening modalities should be tailored to individual risk assessment.

Collective judicial management of mass toxic tort controversies: lessons and issues from the Agent Orange litigation.

PubMed

Novey, L B

1988-01-01

Viewing the Agent Orange litigation as a case study, this article explores the feasibility and desirability of strengthening the powers of the courts to manage toxic tort controversies en masse. The Agent Orange lawsuit, brought on behalf of potentially millions of Vietnam War veterans and family members, charged that herbicides used for military purposes during the war caused a wide range of health problems. This article first reviews the current national debate over how mass toxic tort controversies should be handled, including key legislative reform options, and describes how attention is increasingly focused on ways that the court system might better cope with mass toxic torts. The principal events of the Agent Orange litigation are then summarized, by which the litigation was consolidated into a massive class action, the class action was settled, and a streamlined plan for distributing the settlement fund was adopted. The article evaluates the outcome of the litigation, and discusses whether the solution there can and should be broadly applied to other mass toxic tort cases. This question depends, in part, on a series of complex legal and practical issues, but the author suggests that the question will also depend on what institutional role we expect the judiciary to play within society.

An Aristotelian Account of Minimal Chemical Life

NASA Astrophysics Data System (ADS)

Bedau, Mark A.

2010-12-01

This paper addresses the open philosophical and scientific problem of explaining and defining life. This problem is controversial, and there is nothing approaching a consensus about what life is. This raises a philosophical meta-question: Why is life so controversial and so difficult to define? This paper proposes that we can attribute a significant part of the controversy over life to use of a Cartesian approach to explaining life, which seeks necessary and sufficient conditions for being an individual living organism, out of the context of other organisms and the abiotic environment. The Cartesian approach contrasts with an Aristotelian approach to explaining life, which considers life only in the whole context in which it actually exists, looks at the characteristic phenomena involving actual life, and seeks the deepest and most unified explanation for those phenomena. The phenomena of life might be difficult to delimit precisely, but it certainly includes life's characteristic hallmarks, borderline cases, and puzzles. The Program-Metabolism-Container (PMC) model construes minimal chemical life as a functionally integrated triad of chemical systems, which are identified as the Program, Metabolism, and Container. Rasmussen diagrams precisely depict the functional definition of minimal chemical life. The PMC model illustrates the Aristotelian approach to life, because it explains eight of life's hallmarks, one of life's borderline cases (the virus), and two of life's puzzles.

An Aristotelian account of minimal chemical life.

PubMed

Bedau, Mark A

2010-12-01

This paper addresses the open philosophical and scientific problem of explaining and defining life. This problem is controversial, and there is nothing approaching a consensus about what life is. This raises a philosophical meta-question: Why is life so controversial and so difficult to define? This paper proposes that we can attribute a significant part of the controversy over life to use of a Cartesian approach to explaining life, which seeks necessary and sufficient conditions for being an individual living organism, out of the context of other organisms and the abiotic environment. The Cartesian approach contrasts with an Aristotelian approach to explaining life, which considers life only in the whole context in which it actually exists, looks at the characteristic phenomena involving actual life, and seeks the deepest and most unified explanation for those phenomena. The phenomena of life might be difficult to delimit precisely, but it certainly includes life's characteristic hallmarks, borderline cases, and puzzles. The Program-Metabolism-Container (PMC) model construes minimal chemical life as a functionally integrated triad of chemical systems, which are identified as the Program, Metabolism, and Container. Rasmussen diagrams precisely depict the functional definition of minimal chemical life. The PMC model illustrates the Aristotelian approach to life, because it explains eight of life's hallmarks, one of life's borderline cases (the virus), and two of life's puzzles.

Controversies in the Management of Asymptomatic Patients Sustaining Penetrating Thoracoabdominal Wounds

PubMed Central

Parreira, Jose Gustavo; Rasslan, Samir; Utiyama, Edivaldo M.

2008-01-01

The most challenging diagnostic issue in the management of thoracoabdominal wounds concerns the assessment of asymptomatic patients. In almost one-third of such cases, diaphragmatic injuries are present even in the absence of any clear clinical signs. The sensitivity of noninvasive diagnostic tests is very low in this situation, and acceptable methods for diagnosis are limited to videolaparoscopy or videothoracoscopy. However, these procedures are performed under general anesthesia and present real, and potentially unnecessary, risks for the patient. On the other hand, diaphragmatic hernias, which can result from unsutured diaphragmatic lesions, are associated with considerable morbidity and mortality. In this paper, the management of asymptomatic patients sustaining wounds to the lower chest is discussed, with a focus on the diagnosis of diaphragmatic injuries and the necessity of suturing them. PMID:18925332

Effective apatinib treatment of pleomorphic liposarcoma

PubMed Central

Yan, Peng; Sun, Mei-Li; Sun, Yu-Ping; Liu, Chuan-Yong

2017-01-01

Abstract Rationale: Pleomorphic liposarcoma (PLS) is a rare and aggressive malignant tumor, and both radiation and conventional cytotoxic chemotherapy remain controversial for metastatic or unresectable disease. Patient Concerns: We presented an 81-year-old Chinese woman with advanced PLS who received apatinib after failure chemotherapy. Diagnoses: The patient was diagnosed as having PLS by biopsy. Interventions: After a failed chemotherapy, apatinib started to be taken orally 425 mg per day. Outcomes: This patient achieved 3-month progression-free survival (PFS) and a higher quality of life. Meanwhile, this patient suffered grade 2 hypertension and grade 3 hand–foot syndrome (HFS). Lessons: In this case, apatinib presented good efficacy and safety to treat PLS. Randomized clinical studies are required to confirm the efficacy and safety of apatinib in the treatment of PLS. PMID:28816958

[Triple synchronous primary gynaecological tumours. A case report].

PubMed

Gutiérrez-Palomino, Laura; Romo-de Los Reyes, José María; Pareja-Megía, María Jesús; García-Mejido, José Antonio

2016-01-01

Synchronous multiple primary malignancies in the female genital tract are infrequent. From 50 to 70% of them corresponds to synchronous cancers of the endometrium and ovary. To our knowledge, this is only the third case report in the international literature of three concurrent gynaecological cancers of epithelial origin. A case is presented, as well as a literature review due to the infrequency of its diagnosis and the lack of information on the subject. A 49-year-old woman, with previous gynaecological history of ovarian endometriosis. She underwent a hysterectomy and bilateral oophorectomy, as she had been diagnosed with endometrial hyperplasia with atypia. The final histopathology reported synchronous ovarian, Fallopian tube, and endometrial cancer. An extension study and complete surgical staging was performed, both being negative. She received adjuvant treatment of chemotherapy and radiotherapy. She is currently free of disease. The aetiology is uncertain. There is controversy relating to increased susceptibility of synchronous neoplasms to pelvic endometriosis and inherited genetic syndromes. Its diagnosis needs to differentiate them from metastatic disease. Additionally, they are problematical from a clinical, diagnostic, therapeutic, and prognostic point of view. The presentation of more cases of triple synchronous cancers is necessary for a complete adjuvant and surgical treatment. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Perspectives in patent law: overview, careers, and controversies.

PubMed

Davis, Clara

2009-01-01

This paper is directed to scientists and engineers who wish to learn more about careers in patent law. It presents an overview of the patent process along with a description of the various roles of individuals and institutions involved. Finally, the paper briefly discusses a few of the more controversial issues in the patent law field today.

A 5E Nature of Science Introduction: Preparing Students to Learn about Evolution

ERIC Educational Resources Information Center

Bilica, Kimberly

2012-01-01

Teachers often struggle with controversy when teaching biological evolution in American schools. Research indicates that curriculum with a nature of science (NOS) focus quells controversy (McComas 2004; Scharmann 2005; Staver 2003). This article presents a 5E NOS series that is a first step in a NOS curriculum that situates student understanding…

Implications of the Mmory Controversy for Clinical Practice: An Overview of Treatment Recommendations and Guidelines.

ERIC Educational Resources Information Center

Courtois, Christine A.

2001-01-01

Provides an overview of the positions taken by both sides in the dispute of "false memory." Then presents major findings of several professional task forces charged with reviewing the controversy and arriving at recommendations for research, clinical practice, and forensic practice regarding delayed recall of memories for sexual abuse.…

It's Not the Distance, "It's the Niggers." Comments on the Controversy Over School Busing.

ERIC Educational Resources Information Center

National Association for the Advancement of Colored People Legal Defense and Educational Fund, New York, NY.

This paper focuses on the political nature of the present busing controversy. It is felt that the proposed moratorium on busing threatens gains which have been made in previous years through institutional and judicial enforcement of the Civil Rights Act in providing equal educational opportunities to all children. The advantages and disadvantages…

Autism Narratives in Media Coverage of the MMR Vaccine-Autism Controversy under a Crip Futurism Framework.

PubMed

Mann, Benjamin W

2018-03-09

While previous studies in health communication have examined online news media regarding autism, there is a lack of research that critically examines how such media representations may stigmatize autism and seeks to eliminate the condition, particularly in the context of the resurging measles, mumps, and rubella (MMR) vaccine-autism controversy. To address this gap in the literature, this study analyzes 153 articles that engage the MMR vaccine-autism controversy from the top 10 online news sources in the U.S. from September 2015 through July 2017. It draws from Kafer's (2013) work in Feminist, Crip, Queer, using a lens of crip futurism to interpret three major narrative themes: a death and survival narrative that purports autism as a worst-case scenario, a societal problem narrative, and a preventative narrative that seeks to eliminate the condition. These themes suggest that online news media narratives about autism surrounding the autism-MMR controversy play into stereotypes about autism, including stigmatization and prioritization of preventive behaviors and cures over supporting the lived experiences of autistic individuals. Continued research on the impact of online media portrayals of autism specifically, and disability in health contexts generally, is called for.

Spontaneous gas gangrene in a patient with Crohn's disease.

PubMed

Vaidya, Yash P; Vaidya, Tanvi P

2012-01-01

Spontaneous gas gangrene is necrosis of muscles in the absence of trauma, causing an acutely painful and potentially fatal condition. However, the occurrence of this condition in Crohn's disease has been very rarely documented. In this extremely rare case we describe an occurrence of spontaneous gas gangrene, in a known case of Crohn's disease. The patient presented with fever and pain in the left arm and abdomen. After admission and initial management with antibiotics, the patient developed crepitus in the arm and myonecrosis necessitating a fasciotomy and later an emergency amputation of his left upper limb. The pathogenesis of gas gangrene in inflammatory bowel disease is not fully understood. Management includes aggressive antibiotic administration followed by amputation of the non-salvageable limb. A high index of suspicion of such rare complications is a must and surgical intervention is life saving; however, the efficacy of anti-gas gangrene serum is controversial. We recommend use of a multipronged approach in such cases with high mortality rates.

Metastasis of osteosarcoma to the trapezius muscle: a case report

PubMed Central

2014-01-01

Metastasis of a primary osteosarcoma to the muscles is extremely rare. As there have been few reported cases, the necessity of surgical treatment for such metastatic lesions remains controversial. We present the case of a primary osteosarcoma with development of a solitary metastasis to the trapezius muscle during chemotherapy for pulmonary metastasis. The patient was a 51-year-old man diagnosed with osteosarcoma of the right tibia. After undergoing chemotherapy and femoral amputation, he developed pulmonary metastasis. Chemotherapy was reinitiated, however, after approximately 1 year a palpable tumor was identified in the patient’s right shoulder. This tumor grew and was associated with pain in the right shoulder. It was surgically removed 3 years after the re-initiation of chemotherapy. The pathological diagnosis was osteosarcoma with metastasis to the trapezius muscle. Although the patient died of respiratory failure due to pulmonary metastasis 14 months after resection of the metastatic lesion in the trapezius muscle, no new extrapulmonary metastasis was observed after the resection. PMID:24893571

Metastasis of osteosarcoma to the trapezius muscle: a case report.

PubMed

Sakamoto, Yuichiro; Yokouchi, Masahiro; Nagano, Satoshi; Shimada, Hirofumi; Nakamura, Shunsuke; Setoguchi, Takao; Kawamura, Ichiro; Ishidou, Yasuhiro; Tanimoto, Akihide; Komiya, Setsuro

2014-06-04

Metastasis of a primary osteosarcoma to the muscles is extremely rare. As there have been few reported cases, the necessity of surgical treatment for such metastatic lesions remains controversial. We present the case of a primary osteosarcoma with development of a solitary metastasis to the trapezius muscle during chemotherapy for pulmonary metastasis. The patient was a 51-year-old man diagnosed with osteosarcoma of the right tibia. After undergoing chemotherapy and femoral amputation, he developed pulmonary metastasis. Chemotherapy was reinitiated, however, after approximately 1 year a palpable tumor was identified in the patient's right shoulder. This tumor grew and was associated with pain in the right shoulder. It was surgically removed 3 years after the re-initiation of chemotherapy. The pathological diagnosis was osteosarcoma with metastasis to the trapezius muscle. Although the patient died of respiratory failure due to pulmonary metastasis 14 months after resection of the metastatic lesion in the trapezius muscle, no new extrapulmonary metastasis was observed after the resection.

Diagnosis and treatment of clear cell hidradenocarcinoma of the scalp.

PubMed

Shu, Kai; Xiao, Qungen; Büchele, Fabian; Zhang, Suojun; Jiang, Wei; Lei, Ting

2012-12-01

Clear cell hidradenocarcinoma (CCH) is an exceedingly rare and highly malignant tumor of the eccrine sweat glands. Its treatment is extremely difficult due to the characteristically aggressive clinical course including repeated local recurrence and uncontrollable distal metastasis coming along with a very poor prognosis. Most published case studies recommend a wide surgical excision followed by adjuvant conservative therapy, which is generally considered to be the standard treatment. Two cases of nodular CCH of the scalp either presenting as a singular primary lesion or at an already metastatic stage were analyzed retrospectively. Wide local excision of the tumor couldn't prevent the primary carcinoma from recurring and metastasizing. Both cases received various therapies but the results were unsatisfactory. Although most authors have recommended that early wide surgical excision of the tumor is a feasible therapeutic measurement, our results raise doubts on the efficacy of this treatment strategy. As alternative approaches (i.e. chemotherapy, radiotherapy) are similarly controversial, further studies and a wide exchange of clinical experiences are crucial.

Single-incision laparoscopic cecectomy for low-grade appendiceal mucinous neoplasm after laparoscopic rectectomy

PubMed Central

Fujino, Shiki; Miyoshi, Norikatsu; Noura, Shingo; Shingai, Tatsushi; Tomita, Yasuhiko; Ohue, Masayuki; Yano, Masahiko

2014-01-01

In this case report, we discuss single-incision laparoscopic cecectomy for low-grade appendiceal neoplasm after laparoscopic anterior resection for rectal cancer. The optimal surgical therapy for low-grade appendiceal neoplasm is controversial; currently, the options include appendectomy, cecectomy, right hemicolectomy, and open or laparoscopic surgery. Due to the risk of pseudomyxoma peritonei, complete resection without rupture is necessary. We have encountered 5 cases of low-grade appendiceal neoplasm and all 5 patients had no lymph node metastasis. We chose the appendectomy or cecectomy without lymph node dissection if preoperative imaging studies did not suspect malignancy. In the present case, we performed cecectomy without lymph node dissection by single-incision laparoscopic surgery (SILS), which is reported to be a reduced port surgery associated with decreased invasiveness and patient stress compared with conventional laparoscopic surgery. We are confident that SILS is a feasible alternative to traditional surgical procedures for borderline tumors, such as low-grade appendiceal neoplasms. PMID:24868331

Agnotology: learning from mistakes

NASA Astrophysics Data System (ADS)

Benestad, R. E.; Hygen, H. O.; van Dorland, R.; Cook, J.; Nuccitelli, D.

2013-05-01

Replication is an important part of science, and by repeating past analyses, we show that a number of papers in the scientific literature contain severe methodological flaws which can easily be identified through simple tests and demonstrations. In many cases, shortcomings are related to a lack of robustness, leading to results that are not universally valid but rather an artifact of a particular experimental set-up. Some examples presented here have ignored data that do not fit the conclusions, and in several other cases, inappropriate statistical methods have been adopted or conclusions have been based on misconceived physics. These papers may serve as educational case studies for why certain analytical approaches sometimes are unsuitable in providing reliable answers. They also highlight the merit of replication. A lack of common replication has repercussions for the quality of the scientific literature, and may be a reason why some controversial questions remain unanswered even when ignorance could be reduced. Agnotology is the study of such ignorance. A free and open-source software is provided for demonstration purposes.

Bladder transitional cell carcinoma and BK virus in a young kidney transplant recipient.

PubMed

Pino, L; Rijo, E; Nohales, G; Frances, A; Ubre, A; Arango, O

2013-02-01

Kidney transplant recipients have a heightened risk of developing neoplasms. Immunosuppressive treatments decrease the incidence of transplant rejection but increase the risk of infections, including BK virus (BKV). This infection is acquired in childhood and remains latent in the renal and urinary epithelium. In cases of immunodeficiency, BKV has been implicated as a tumor virus, but the role of BKV in cancer is a controversial topic and is difficult to determine. In the tumor cells, it is possible to detect fragments of the viral genome that could alter the control mechanisms of the cell cycle and DNA repair. We report the case of a kidney transplant recipient who developed BKV nephropathy and carcinoma of the bladder, supporting a possible role for BKV in the oncogenic pathway in this clinical setting, but the role of BKV in cancer remains a controversial topic and difficult to determine. © 2012 John Wiley & Sons A/S.

Epistemological depth in a GM crops controversy.

PubMed

Hicks, Daniel J

2015-04-01

This paper examines the scientific controversy over the yields of genetically modified [GM] crops as a case study in epistemologically deep disagreements. Appeals to "the evidence" are inadequate to resolve such disagreements; not because the interlocutors have radically different metaphysical views (as in cases of incommensurability), but instead because they assume rival epistemological frameworks and so have incompatible views about what kinds of research methods and claims count as evidence. Specifically, I show that, in the yield debate, proponents and opponents of GM crops cite two different sets of claims as evidence, which correspond to two rival epistemological frameworks, classical experimental epistemology and Nancy Cartwright's evidence for use. I go on to argue that, even if both sides of the debate accepted Cartwright's view, they might still disagree over what counts as evidence, because evidence for use ties standards of evidence to what is sometimes called the "context of application." Copyright © 2015 Elsevier Ltd. All rights reserved.

New Quality Metrics for Web Search Results

NASA Astrophysics Data System (ADS)

Metaxas, Panagiotis Takis; Ivanova, Lilia; Mustafaraj, Eni

Web search results enjoy an increasing importance in our daily lives. But what can be said about their quality, especially when querying a controversial issue? The traditional information retrieval metrics of precision and recall do not provide much insight in the case of web information retrieval. In this paper we examine new ways of evaluating quality in search results: coverage and independence. We give examples on how these new metrics can be calculated and what their values reveal regarding the two major search engines, Google and Yahoo. We have found evidence of low coverage for commercial and medical controversial queries, and high coverage for a political query that is highly contested. Given the fact that search engines are unwilling to tune their search results manually, except in a few cases that have become the source of bad publicity, low coverage and independence reveal the efforts of dedicated groups to manipulate the search results.

Innovations 'Out of Place': Controversies Over IVF Beginnings in India Between 1978 and 2005.

PubMed

Bärnreuther, Sandra

2016-01-01

In 1978, the year the first in vitro fertilization (IVF) baby was born in the United Kingdom, a research team in Kolkata reported that it too had successfully produced an IVF baby in India. However, the claim was dismissed at the time, because the experiment was conducted outside authorized institutions and recognized centers of innovation--in short, because it was an innovation 'out of place.' Tracing controversies over the case between 1978 and 2005, I show the importance of space or place in processes of knowledge production and recognition. Further, I explain the initial repudiation and subsequent partial recognition of the claim through shifts in the landscape of legitimate spaces of innovation. By discussing this specific case of the production of science and technology in the Global South, I challenge conventional narratives of diffusion that are prevalent in studies on the worldwide proliferation of reproductive technologies.

Self-Amputation in Two Non-Psychotic Patients.

PubMed

Rahmanian, Hamid; Petrou, Nikoletta A; Sarfraz, M Aamer

2015-09-01

Self-amputation, the extreme form of self-mutilation, is uncommon. The vast majority of cases are associated with psychosis, with a small number being assigned the controversial diagnosis of body identity integrity disorder. In this article, we report two cases of non-psychotic self-amputation and their similarities with a view to highlighting the risk factors and formulating an appropriate management plan.

Continuity and Discontinuity: The Case of Second Couplehood in Old Age

ERIC Educational Resources Information Center

Koren, Chaya

2011-01-01

Purpose: Continuity and discontinuity are controversial concepts in social theories on aging. The aim of this article is to explore these concepts using the experiences of older persons living in second couplehood in old age as a case in point. Design and Method: Based on a larger qualitative study on second couplehood in old age, following the…

Legal Rights of College Students: A History of Cases, Controversies and Court Decisions.

ERIC Educational Resources Information Center

Clark, Kathryn A.; Scheuermann, Tom

The legal rights of college students have changed substantially over the years, particularly during the 20th century. This paper provides a historical sketch of student rights, including a listing of significant events and cases, from the founding of Harvard College in 1636 to the bicentennial of the Constitution and the 50th anniversary of the…

The Proof Is in the PR: Five Case Studies Offer Conclusive Evidence of the Value of Strategic Communications.

ERIC Educational Resources Information Center

Schreiber, William

1993-01-01

Five case studies illustrate the value of strategic communications in school and college public relations (PR). Central issues include public scrutiny of a controversial faculty hiring policy; internal communication during retrenchment; a local education/job fair; animal rights activism; and winning public approval for a long-range campus plan.…

Using International Accreditation in Higher Education to Effect Changes in Organisational Culture: A Case Study from a Turkish University

ERIC Educational Resources Information Center

Collins, Ian

2015-01-01

International accreditation is now a significant yet controversial issue in global higher education. This case study looked at the experience of an intensive English language preparatory programme within a university in Turkey going through an accreditation by a foreign institution, and assessed to what extent the project managed to foster changes…

Controversies in the Diagnosis and Management of NAFLD and NASH.

PubMed

Rinella, Mary E; Loomba, Rohit; Caldwell, Stephen H; Kowdley, Kris; Charlton, Michael; Tetri, Brent; Harrison, Stephen A

2014-04-01

Nonalcoholic fatty liver disease (NAFLD) is recognized as the most common cause of chronic liver disease in the United States. Nonalcoholic steatohepatitis (NASH) occurs in a subset of patients with NAFLD and is characterized by the presence of hepa-tocellular injury, which is progressive in a substantial proportion of cases and can lead to cirrhosis and all of its complications. Although the diagnosis of NAFLD can be made through imaging studies or liver biopsy, the diagnosis of NASH still requires histologic confirmation. Liver biopsy should be performed in the presence of risk factors for advanced disease. Measures aimed at promoting weight loss, a healthier lifestyle, and optimization of metabolic risk factors remain the cornerstone of management of NAFLD. Therapeutic agents that are presently considered the most promising in NAFLD are effective in less than 50% of patients. Among patients with biopsy-proven NASH, treatment with pharmacologic agents should be considered; however, the role of specific agents in NASH still needs further study. Despite a wealth of research over the past 15 years, many controversies remain with respect to the diagnosis and management of NAFLD and NASH as well as the influence of alcohol on liver disease progression in these patients.

A practical approach to language complexity: a Wikipedia case study.

PubMed

Yasseri, Taha; Kornai, András; Kertész, János

2012-01-01

In this paper we present statistical analysis of English texts from Wikipedia. We try to address the issue of language complexity empirically by comparing the simple English Wikipedia (Simple) to comparable samples of the main English Wikipedia (Main). Simple is supposed to use a more simplified language with a limited vocabulary, and editors are explicitly requested to follow this guideline, yet in practice the vocabulary richness of both samples are at the same level. Detailed analysis of longer units (n-grams of words and part of speech tags) shows that the language of Simple is less complex than that of Main primarily due to the use of shorter sentences, as opposed to drastically simplified syntax or vocabulary. Comparing the two language varieties by the Gunning readability index supports this conclusion. We also report on the topical dependence of language complexity, that is, that the language is more advanced in conceptual articles compared to person-based (biographical) and object-based articles. Finally, we investigate the relation between conflict and language complexity by analyzing the content of the talk pages associated to controversial and peacefully developing articles, concluding that controversy has the effect of reducing language complexity.

Inherited pancreatic endocrine tumor syndromes: advances in molecular pathogenesis, diagnosis, management and controversies

PubMed Central

Jensen, Robert T.; Berna, Marc J.; Bingham, David B; Norton, Jeffrey A.

2008-01-01

Pancreatic endocrine tumors (PETs) can occur in as part of four inherited disorders including: Multiple Endocrine Neoplasia type 1 (MEN1), von Hippel-Lindau disease (VHL), neurofibromatosis 1(NF-1) [von Recklinghausen’s disease] and the tuberous sclerosis complex (TSC). The relative frequency with which patients with these disorders develop PETs is MEN1>VHL>NF-1>TSC. Over the last few years there have been major advances in the understanding of the genetics and molecular pathogenesis of these disorders as well in the localization, medical and surgical treatment of the PETs in these patients. The study of the PETs in these disorders has not only provided insights into the possible pathogenesis of sporadic PETs, but have also presented a number of unique management and treatment issues, some of which are applicable to patients with sporadic PETs. Therefore the study of PETs in these uncommon disorders has provided valuable insights that in many cases are applicable to the general group of patients with sporadic PETs. In this article these areas are briefly reviewed as well as the current state of knowledge of the PETs in these disorders and the controversies that exist in their management are briefly summarized and discussed. PMID:18798544

Zollinger-Ellison syndrome: classical considerations and current controversies.

PubMed

Epelboym, Irene; Mazeh, Haggi

2014-01-01

Zollinger-Ellison syndrome (ZES) is an endocrinopathy characterized by gastrin-secreting tumors, responsible for causing the formation of multiple, refractory, and recurrent peptic ulcers in the distal duodenum and proximal jejunum. Two main variants have been described, sporadic and those found in association with parathyroid and pituitary tumors, a genetic disorder known as multiple endocrine neoplasia-1 (MEN-1). Biochemical serum evaluation for elevated gastrin, followed by radiological or nuclear localization of the primary lesion, is mandated for establishing diagnosis. The mainstays of treatment include management of hypersecretory state with medical suppression of gastric acid production and surgical resection of primary tumor for the prevention of malignant transformation and metastatic complications. Medical therapy with proton pump inhibitors has virtually eliminated the need for acid-reducing surgical procedures. Surgical approach to sporadic and MEN-1-associated ZES varies based on our understanding of the natural history of the condition and the probability of cure; however, resection to a negative microscopic margin is indicated in both cases. Postoperative surveillance involves measurement of gastrin level, followed by imaging if elevation is detected. Re-excision of recurrent or resection of metastatic disease is a subject of controversy; however, at the present time aggressive cytoreductive approach is favored.

Management of pancreatic and duodenal injuries in pediatric patients.

PubMed

Plancq, M C; Villamizar, J; Ricard, J; Canarelli, J P

2000-01-01

Diagnosis of duodenal and pancreatic injuries is frequently delayed, and optimal treatment is often controversial. Fourteen children with duodenal and/or pancreatic injuries secondary to blunt trauma were treated between 1980 and 1997. The pancreas was injured in all but 1 child. An associated duodenal injury was present in 4. The preoperative diagnosis was suspected in only 6 patients based on clinical signs and ultrasonography. One patient was treated successfully conservatively; all the others required surgical management. At operation, three procedures were used: peripancreatic drainage, suture of the gland or duodenum with drainage, and primary distal pancreatic resection without splenectomy. A duodenal resection with reconstruction by duodeno-duodenostomy was performed in 1 case. The overall complication rate was 14%: 1 fistula and 1 pseudocyst. Pancreatic ductal transection was recognized 3 days after the initial laparotomy by endoscopic retrograde cholangiopancreatography (ERCP). The mortality was 7%; 1 patient died from septic and neurologic complications. When the diagnosis of pancreatic ductal injuries is a major problem, ERCP may be a useful diagnostic procedure. Pancreatic injuries without a transected duct may often be treated conservatively. The surgical or conservative management of duodenal hematomas is still controversial; other duodenal injuries often need surgical treatment.

Successful treatment of systemic juvenile xanthogranulomatosis with cytarabine and 2-chlorodeoxyadenosine: case report and review of the literature.

PubMed

Maintz, L; Wenzel, J; Irnich, M; Reinhard, H; Bieber, T

2017-02-01

The non-Langerhans cell histiocytosis (LCH) juvenile xanthogranulomatosis (JXG) is usually a benign disease limited to the skin. Only a few cases of systemic disease with at least two affected organs and lethal outcomes have been reported to date. Treatment is controversial and no standard protocol is available. We report the rare case of a 22-month-old boy presenting multiple erythematous brownish papules of the head, trunk and legs, which had developed starting from his 6th month of life. Additional symptoms were delayed psychomotor development, hydrocephalus and hepatosplenomegaly. Further diagnostics revealed a systemic JXG with involvement of the skin, central nervous system, liver and spleen. The patient did not respond to initial therapy with prednisone and vinblastine according to protocol III for LCH. However, further therapy with cytarabine and 2-chlorodeoxyadenosine followed by a consolidation phase with 2-chlorodeoxyadenosine alone was successful and the patient is in his 4th year of remission. We provide a comprehensive review of the reported cases of systemic JXG to date. © 2016 British Association of Dermatologists.

Anatomically precontoured LCP for delayed union of a medial third clavicle fracture. Case report with review of the literature.

PubMed

Siebenlist, S; Sandmann, G; Kirchhoff, C; Biberthaler, P; Neumaier, M

2013-01-01

Fractures of the medial clavicle third are rare injuries. Even in case of significant fracture displacement, their therapeutic management has been nonoperative. Recently, surgical intervention has become mandatory for displaced fractures types to prevent non-union and functional complaints, but the optimal operative strategy is being discussed controversially. We describe the case of a 63-year-old male patient with a significantly displaced medial clavicle fracture after failed conservative treatment resulting in restricted, painful shoulder function. The patient underwent open reduction and osteosynthesis with an anatomically precontoured locking compression plate (LCP). One year after surgery the patient is free of complaints and has returned to his preinjury activity level without any functional restrictions. As a not yet reported operative approach, anatomically preshaped locking plating seems to be an effective fixation method for displaced fractures of the medial clavicle third. The operative management is described in detail and discussed with the current literature. Based on the presented case, we underline the statement that displaced medial clavicle fractures should be surgically addressed to avoid late damage.

The Centers for Medicare and Medicaid Services' Nursing Home Case-Mix and Quality Demonstration: a descriptive overview.

PubMed

Reilly, Karen E; Mueller, Christine; Zimmerman, David R

2007-01-01

This paper presents the first comprehensive account of a major national demonstration designed to integrate skilled nursing facilities (SNF) prospective case-mix payment and quality of care. It describes the Centers for Medicare and Medicaid Services' Nursing Home Case-Mix and Quality (NHCMQ) Demonstration-the template for Medicare's SNF Prospective Payment System (PPS) implemented July 1998. The NHCMQ Demonstration provided the basis for one of the most significant changes in SNF reimbursement and quality monitoring policies to date. Prospective reimbursement policies created positive incentive for providers to admit Medicare residents under more equitable payment rates. However, controversy regarding unanticipated perverse provider incentives remains. The quality management system designed under the NHCMQDemonstration is currently used in over 17,000 nursing homes. Furthermore, under the NHCMQ Demonstration, one standardized assessment tool-the MDS-was used to assess a resident's clinical condition, to monitor quality, and to calculate provider reimbursement. Experiences from the NHCMQ Demonstration and continued evaluation of the current national PPS, along with state systems, provide a rich information source regarding prospective, case-mix reimbursement, and provider incentives.

A French hernia in Dubai: A case report.

PubMed

Al Abboudi, Yousif H; Busharar, Hajer A; Alozaibi, Labib S; Shah, Asnin; Ahmed, Rafya

2018-05-31

De Garengeot hernia was first described in 1731. It is rare type of hernia and there is no established mode of treatment for it to date. This work has been reported in line with the SCARE criteria (Agha et al., 2016). We present a case of a 72 years old male with a non-reducible right inguinal swelling diagnosed to be a femoral hernia with congested appendix within. There are less than 100 cases like this reported to date in the literature. Acute appendicitis within the femoral hernia is not a common problem to cross paths with. Prompt early treatment is recommended and directed at repairing the hernia after appendectomy. The method of treatment is controversial and not well established due to the scarcity of cases but open repair without mesh is the preferred approach. De Garengeot hernia is a rare hernia to encounter. Imaging modalities are a major tool in early diagnosis and early prompt surgery is crucial in preventing major complications that may lead to unnecessary morbidity and mortality. Copyright © 2018. Published by Elsevier Ltd.

Primary disorders of the lymphatic vessels--a unified concept.

PubMed

Levine, C

1989-03-01

Congenital defects of lymphatics constitute a spectrum of disorders that may manifest with a variety of clinical presentations including lymphedema, chylous effusions, lymphangiomatous malformations with cystic masses and localized gigantism, and intestinal lymphangiectasia with malabsorption. These entities constitute a relatively rare group of disorders, the origin of which remains somewhat controversial, but in some it appears to be due to early lymphatic obstruction. Five cases are described, which demonstrate the anatomical pathology of these entities. A classification and description of the defects is also presented. An attempt is made to present a unified theory of origin for this seemingly diverse group of diseases. While these entities may be challenging from a diagnostic and therapeutic standpoint, a wide variety of imaging modalities, which includes lymphography, computed tomography scanning, and ultrasound, may be used to diagnose the extent and internal structural characteristics of the abnormalities.

Case Study of the Kirkwood Call.

ERIC Educational Resources Information Center

Hall, H. L.

1991-01-01

Outlines the controversy that erupted at Kirkwood High School in Missouri when the school newspaper ran a Planned Parenthood ad. Discusses actions taken by the school principal, students, the newspaper staff, the district superintendent, the school board, and the community. (SR)

A "Bioethics" Approach to Teaching Health Law.

ERIC Educational Resources Information Center

Capron, Alexander Morgan

1988-01-01

The reasons for offering a course in bioethics to law students and some approaches to take in addressing controversial issues are examined. The use of hypothetical vs. real cases, emphasis on clinical problems, and overall course objectives are discussed. (MSE)

Reading & Listening with Purpose: Teaching Controversial Song Lyrics Using the ELA Common Core Standards in History/Social Studies

ERIC Educational Resources Information Center

Bender, Rachel A.; Sharp, Kimberlee A.

2013-01-01

This paper presents a method for social studies teachers to incorporate song lyrics into the study of controversial historical events and issues. Using the Hunt and Metcalf "Seven Problematic Areas of the Social Studies" as the rubric for selecting appropriate songs, the Teacher Candidate (TC) explains how song lyrics make viable text…

Riparian and aquatic habitats of the Pacific Northwest and southeast Alaska: ecology, management history, and potential management strategies.

Treesearch

Fred H. Everest; Gordon H. Reeves

2007-01-01

Management of riparian habitats is controversial because land use policies have historically emphasized economic values (e.g., timber production) at the expense of ecological and social values. Attempting to manage these valuable resources to attain the greatest combination of benefits has created a long-term controversy that continues to the present. Our analysis...

A Study of the Effects of Competitive Team-Based Learning and Structured Academic Controversy on the Language Proficiency of Iranian EFL College Seniors

ERIC Educational Resources Information Center

Hosseini, Seyed Mohammad Hassan

2012-01-01

This paper presents reports on an experimental study which intended to look into and compare the possible effects of this researcher's instructional innovation, Competitive Team-Based Learning (CTBL), with Structured Academic Controversy (SAC) -- the most popular method of Cooperative Learning (CL) -- on language proficiency of Iranian EFL college…

Understanding the Nature of Science through a Critical and Reflective Analysis of the Controversy between Pasteur and Liebig on Fermentation

ERIC Educational Resources Information Center

García-Carmona, Antonio; Acevedo-Díaz, José Antonio

2017-01-01

This article presents a qualitative study, descriptive-interpretive in profile, of the effectiveness in learning about the nature of science (NOS) of an activity relating to the historical controversy between Pasteur and Liebig on fermentation. The activity was implemented during a course for pre-service secondary science teachers (PSSTs)…

Expanded Endoscopic Transnasal Approach to the Chordoid Glioma of the Third Ventricle : The First Case Ever Reported.

PubMed

Zeinalizadeh, Mehdi; Sadrehosseini, Seyed Mousa; Tayebi Meybodi, Keyvan; Sharifabadi, Ali Heidari

2016-11-01

Chordoid glioma of the third ventricle is a rare and challenging tumor to surgery because of its unique anatomical location and its close juxtaposition to the neurovascular structures and hypothalamus. The authors report a case of chordoid glioma of the third ventricle in a 43-year-old woman, who presented with headache and somnolence. The tumor was approached by endoscopic transnasal technique with a favorable result. Histopathologic examination disclosed a neoplastic tissue composed of eosinophilic epithelioid cells, mucinous, periodic acid Schiff-diastase positive, extracellular matrix, and scattered lymphoplasmacytic infiltrates. The best treatment option remains controversial. Customarily, the surgical route to remove chordoid glioma is transcranial; however, the undersurface of the optic chiasm and optic nerves preclude an adequate surgical visualization. In contrast, an expanded endoscopic transnasal approach provides a direct midline corridor to this region without any brain retraction.

Cerebral aneurysms: Formation, progression and developmental chronology

PubMed Central

Etminan, Nima; Buchholz, Bruce A.; Dreier, Rita; Bruckner, Peter; Torner, James C.; Steiger, Hans-Jakob; Hänggi, Daniel; Macdonald, R. Loch

2015-01-01

The prevalence of unruptured intracranial aneurysms (UAIs) in the general population is up to 3%. Existing epidemiological data suggests that only a small fraction of UIAs progress towards rupture over the lifetime of an individual, but the surrogates for subsequent rupture and the natural history of UIAs are discussed very controversially at present. In case of rupture of an UIA, the case-fatality is up to 50%, which therefore continues to stimulate interest in the pathogenesis of cerebral aneurysm formation and progression. Actual data on the chronological development of cerebral aneurysm has been especially difficult to obtain and, until recently, the existing knowledge in this respect is mainly derived from animal or mathematical models or short-term observational studies. Here, we highlight the current data on cerebral aneurysm formation and progression as well as a novel approach to investigate the developmental chronology of cerebral aneurysms. PMID:24323717

The PECS II block as a major analgesic component for clavicle operations: A description of 7 case reports.

PubMed

Schuitemaker R, J B; Sala-Blanch, X; Rodriguez-Pérez, C L; Mayoral R, J T; López-Pantaleon, L A; Sánchez-Cohen, A P

2018-01-01

Clavicle fractures correspond to 35% of traumatic fractures of the shoulder girdle. Regional anaesthesia has shown better analgesic results than systemic treatment for perioperative management. Innervation of the clavicle is complex, at present its knowledge raises controversy. The lateral pectoral nerve through the innervating musculature predominantly participates in the lateral and anterior part of the clavicle. The following report of 7 cases describes the effective postoperative analgesia of modified PEC II block in patients with middle third clavicle fracture or acromioclavicular dislocation who underwent a modified PEC II block for postoperative pain management, in the context of a multimodal analgesia. The potential advantage of this management over other analgesic procedures should be evaluated in specific clinical trials. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Science, safety, and trust: the case of transgenic food.

PubMed

Martinelli, Lucia; Karbarz, Małgorzata; Siipi, Helena

2013-02-01

Genetically modified (GM) food is discussed as an example of the controversial relation between the intrinsic uncertainty of the scientific approach and the demand of citizen-consumers to use products of science innovation that are known to be safe. On the whole, peer-reviewed studies on GM food safety do not note significant health risks, with a few exceptions, like the most renowned "Pusztai affair" and the recent "Seralini case." These latter studies have been disregarded by the scientific community, based on incorrect experimental designs and statistic analysis. Such contradictory results show the complexity of risk evaluation, and raise concerns in the citizen-consumers against the GM food. A thoughtful consideration by scientific community and decision makers of the moral values that are present in risk evaluation and risk management should be the most trustable answer to citizen-consumers to their claim for clear and definitive answers concerning safety/un-safety of GM food.

A Gray-purple Mass on the Floor of the Mouth: Gigantic Mucogingival Pyogenic Granuloma in a Teenage Patient.

PubMed

Brunet-LLobet, Lluís; Miranda-Rius, Jaume; Lahor-Soler, Eduard; Mrina, Ombeni; Nadal, Alfons

2014-01-01

Pyogenic granuloma is defined as a benign neoplasm of vascular phenotype. This case describes the clinical and histopathological features of a gigantic mucogingival pyogenic granuloma, in a 14-year-old healthy black boy. This exophytic gray-purple mass, related to a toothpick injury, had more than twelve-month evolution on the anterior mandible involving lingual area besides to the floor of the mouth pressing the right salivary duct. Conservative excision was performed, followed by uncomplicated healing with no recurrence in two years. The histopathological examination reported a pyogenic granuloma (lobular capillary haemangioma). The authors provide a discussion of the presurgical differential diagnosis of the lesion. This case report presents an extremely uncommon location of a gigantic pyogenic granuloma, involving mucogingival complex and affecting the salivary outflow. This clinical manuscript may shed light on the controversies about possible mechanisms inducing oral pyogenic granuloma.

A Gray-purple Mass on the Floor of the Mouth: Gigantic Mucogingival Pyogenic Granuloma in a Teenage Patient

PubMed Central

Brunet-LLobet, Lluís; Miranda-Rius, Jaume; Lahor-Soler, Eduard; Mrina, Ombeni; Nadal, Alfons

2014-01-01

Pyogenic granuloma is defined as a benign neoplasm of vascular phenotype. This case describes the clinical and histopathological features of a gigantic mucogingival pyogenic granuloma, in a 14-year-old healthy black boy. This exophytic gray-purple mass, related to a toothpick injury, had more than twelve-month evolution on the anterior mandible involving lingual area besides to the floor of the mouth pressing the right salivary duct. Conservative excision was performed, followed by uncomplicated healing with no recurrence in two years. The histopathological examination reported a pyogenic granuloma (lobular capillary haemangioma). The authors provide a discussion of the presurgical differential diagnosis of the lesion. This case report presents an extremely uncommon location of a gigantic pyogenic granuloma, involving mucogingival complex and affecting the salivary outflow. This clinical manuscript may shed light on the controversies about possible mechanisms inducing oral pyogenic granuloma. PMID:24987485

Heterotopic pancreas in excluded stomach diagnosed after gastric bypass surgery

PubMed Central

2013-01-01

Background Heterotopic pancreas is defined as finding of pancreatic tissue without anatomic and vascular continuity with the normal pancreas. Heterotopic pancreas is a rare condition difficult to diagnose and with controversial clinical management. Case presentation We describe a 43 year old female patient previously submitted to laparoscopic gastric bypass for primary treatment of morbid obesity; 5 years later, the patient was discovered to have a mass in the antrum of the excluded stomach that was found to be heterotopic pancreatic tissue. Before gastric bypass surgery, the presence of the pancreatic mass in the gastric wall was unnoticed in the imagiologic records. Conclusion This is the first reported case of pancreatic heterotopy diagnosed in the excluded stomach after gastric bypass. A putative role of incretin hormones in mediating pancreatic cell hyperplasia of heterotopic pancreatic remnants should be considered an additional hypothesis that requires further research. PMID:24267291

On the history of dissociative identity disorders in Germany: the doctor Justinus Kerner and the girl from Orlach, or possession as an "exchange of the self".

PubMed

Peter, Burkhard

2011-01-01

The history of hypnosis is closely linked to the theme of possession; one such link is that the forerunner of hypnosis, animal magnetism, replaced exorcism in 1775 when Franz Anton Mesmer testified against Father Johann Joseph Gassner's exorcism. Modern authors have noted remarkable similarities between states of possession and dissociation. The treatment of possession by animal magnetism and exorcism represents the special romantic-magnetic therapy of the German medical doctor Justinus Kerner in the early 19th century. This article describes the man, his methods, and his thinking and presents one of his most famous case studies, the girl from Orlach, which, by today's standards, was a true case of dissociative identity disorder (DID). This article describes how contemporary principles of treatment were used and controversial issues about the nature and causes of DID were discussed 175 years ago.

Management of refractory anti-phospholipid syndrome.

PubMed

Scoble, Tina; Wijetilleka, Sonali; Khamashta, Munther A

2011-09-01

Anti-phospholipid syndrome (APS) is an autoimmune prothrombotic disorder characterised by the predisposition to venous and/or arterial thrombosis and obstetric morbidity. Management of APS centres on attenuating the procoagulant state whilst balancing the risks of anticoagulant therapy. Cases of recurrent thromboses and obstetric complications occur despite optimum therapy. Alternative therapies for refractory cases are subject to disparity among clinicians due to the current lack of clinical evidence present. This review aims to address the current management strategies for refractory thrombotic and obstetric cases and future therapeutic interventions. The role and current clinical evidence of using long term low molecular weight heparin (LMWH) as an alternative to warfarin therapy for refractory thromboses is evaluated. Potential alternatives for thromboses including statins, hydroxychloroquine, Rituximab are reviewed as well as the additional avenues to target in the future as the pathogenic mechanisms of APS are unveiled. The optimal management for refractory obstetric APS cases is subject to controversy. This review focuses and assesses the current evidence for the uses of low dose prednisolone, intravenous immunoglobulin and hydroxycholoroquine in obstetric cases. The treatment modalities for the management of refractory APS require further clinical evidence. Copyright © 2011 Elsevier B.V. All rights reserved.

A rare case report and appraisal of the literature on spontaneous tooth exfoliation associated with trigeminal herpes zoster.

PubMed

Kaur, Rupinder; Rani, Pooja; Malhotra, Divye; Kaur, Rajwant; Dass, Praveen Kumar

2016-09-01

Reports of post herpetic maxillofacial complications have been very rarely documented in the literature that includes periapical lesions, calcified and devitalized pulps, resorption of roots, osteonecrosis, and spontaneous exfoliation of teeth. The atypical feature of the case of concern to the dental surgeon is the rare complication of spontaneous tooth exfoliation following herpes zoster. This case reports a male patient of age 47 years who reported to the Department of Periodontology with the chief complaint of mobility in the left upper central incisor. Patient history revealed herpes zoster infection that began 11 days earlier along with underlying diabetes mellitus condition. We hereby report a known diabetic patient with history of herpes zoster infection who presented with rare complication of spontaneous tooth exfoliation involving the maxillary division of the trigeminal nerve. Limited number of cases has been reported in the literature regarding spontaneous teeth exfoliation secondary to herpes zoster. The exact pathogenesis regarding the spontaneous exfoliation of teeth in herpes zoster patient is still controversial. Thus, an oral health care provider should be aware of this rare complication while managing a case of tooth mobility with the previous history of herpes zoster of trigeminal nerve.

Exercise-associated hyponatraemia after a marathon: case series

PubMed Central

Goudie, A M; Tunstall-Pedoe, D S; Kerins, M; Terris, J

2006-01-01

Objectives To review the presentation, treatment and response of those runners from the London Marathon who presented to St Thomas' Hospital with exercise induced hyponatraemia. Design Observational case series. Setting St Thomas' Hospital, a tertiary hospital situated near the finish line of the 2003 London Marathon. Participants All runners who presented to St Thomas' Hospital on the day of the 2003 London Marathon with altered mental state whose serum sodium concentration was less than 135 mmol/L. Main outcome measures Presenting symptoms, volume and type of fluids administered and response to treatment (biochemical and clinical). Results Fourteen patients were diagnosed with exercise associated hyponatraemia with serum sodium concentrations ranging from 116 to 133 mmol/L. Eleven presented with confusion. There were long delays between the finish time and presentation time for some runners. Anecdotal descriptions suggested some runners finished the race with normal mental state then became confused. There was no correlation between running time and serum sodium level. All patients received 0.9% saline and six received 1.8% saline. Despite this, some patients demonstrated falls in serum sodium concentrations. Thirteen to fourteen patients were symptomatically well the following morning, with the remaining patient significantly improved. Conclusion Presentation of exercise associated hyponatraemia may be delayed. Optimal treatment is controversial, but the use of isotonic saline may not result in rises of serum sodium and we would suggest the early use of hypertonic fluids in symptomatic patients. PMID:16816267

Expression of aberrant CD markers in acute leukemia: a study of 100 cases with immunophenotyping by multiparameter flowcytometry.

PubMed

Sarma, Anupam; Hazarika, Munlima; Das, Debabrata; Kumar Rai, Avdhesh; Sharma, Jagannath Dev; Bhuyan, Chidananda; Kataki, Amal Chandra

2015-01-01

Acute leukemia is a heterogenous disease having diverse phenotypes. Immunophenotyping by flowcytometry is essential for diagnosis of myeloid and lymphoid subtypes. Aberrant phenotype incidence is controversial and dissimilar results have been reported by different groups. Purpose of the study was to determine the incidence of aberrant phenotypes in North East Indian patients with acute leukemia. We analysed a total of 100 cases (AML = 36, ALL = 61, MPAL = 3) by multiparametric flow cytometry using an acute panel of monoclonal antibodies (MoAbs). The MoAbs were selected to identify differentiation-associated antigens of both myeloid and lymphoid lineages. Aberrant phenotypes were found in 21 (58.3%) cases of AML, 36 (59.2%) cases of B-ALL and 6 (66.7%) cases of T-ALL. CD7 was the most frequent lymphoid associated antigen found in 33% of AML cases while CD117 was the myeloid antigen most frequently detected in ALL (54%) cases. Aberrant expression of CD 117 is highly significant by Fischer's exact test (P< 0.0001). We conclude that aberrant phenotypes are present in a great majority of acute leukemia patients of North East India. Future studies will be directed to correlate of these markers with prognosis and therapeutic response.

Are Students with Developmental Dyslexia Neurologically Different?

ERIC Educational Resources Information Center

Goldsmith-Phillips, Josephine

1994-01-01

Reviews the controversy over a biological basis for developmental dyslexia and illustrates it with two case studies of junior high school students. Reviews neurological evidence for developmental dyslexia, and proposes seven signs characteristic of reading disability that may qualify as dyslexia. (SR)

Coronary Endarterectomy: Recent Trends.

PubMed

Ghatanatti, Ravi; Teli, Anita

2017-08-01

Coronary Endarterectomy (CE) assures complete revascularization of the myocardium in case of diffusely diseased vessels and prevents residual ischemia. Recently cardiac surgeons are performing increasing number of coronary endarterectomy and it has evolved as an important adjuvant procedure in Coronary Artery Bypass Grafting (CABG). There are controversies regarding the efficiency of CE. CE is criticised for its higher rates of morbidity and mortality. At present the available evidence supports CE in Off Pump Coronary Artery Bypass surgery (OPCAB) and along with valvular procedures. Graft patency is better with open technique. Postoperative anticoagulation regimen though not uniform, the overall outcome remains the same. Therefore, it is important to focus on the current results to accept CE as a routine procedure like CABG.

Approach to a Pregnant Woman with Anti D + Anti C Reactivity Pattern: A Diagnostic Conundrum

PubMed Central

Rai, Preeti; Sharma, Geetika; Garg, Jyoti

2017-01-01

The Rhesus G antigen is present on all RBCs that are C+ and also on most D+ RBCs. Due to this co-distribution of G with either C or D antigen, it mimics a reactivity pattern of anti C + anti D on Indirect Antiglobulin Test (IAT), though the role of Anti G in causing Hemolytic Disease of Newborn (HDN) is controversial. The differentiation of anti D, anti C, and anti G is essential particularly in pregnant females. We hereby report a rare case of anti G with anti D and anti C in a pregnant woman with emphasis on approach to identify anti D+C+G and its implications. PMID:29207719

Management of scorpion envenomation at the Faya-Largeau medical post, February-June, 2014.

PubMed

Dufour-Gaume, F; Milleliri, J M

2018-05-25

Scorpion envenomation is common in northern Chad and associated with a high lethality rate. We report the management of 16 cases of scorpion envenomation in 2014 at our Faya-Largeau medical post. Our clinical experience revealed dissociated muscarinic symptoms in patients treated early in contrast to those treated later, who presented cardiogenic shock. In the absence of antivenom, patients with an isolated muscarinic syndrome received small doses of atropine, and their signs and symptoms improved afterwards. Although the use of atropine is controversial, the question here is about using it to treat muscarinic symptoms of scorpion envenomation in the absence of severe hypertension and with no signs of heart failure.

Special Medical Conditions Associated with Catatonia in the Internal Medicine Setting: Hyponatremia-Inducing Psychosis and Subsequent Catatonia

PubMed Central

Novac, Andrei A; Bota, Daniela; Witkowski, Joanne; Lipiz, Jorge; Bota, Robert G

2014-01-01

Diagnosis and treatment of catatonia in the psychiatry consultation service is not infrequent. Usually, the patient either presents to the Emergency Department or develops catatonia on the medical floor. This condition manifests with significant behavioral changes (from mildly decreased speech output to complete mutism) that interfere with the ability to communicate. After structural brain disorders are excluded, one of the diagnoses that always should be considered is catatonia. However, the causes of catatonia are numerous, ranging from psychiatric causes to a plethora of medical illnesses. Therefore, it is not surprising that there are many proposed underlying mechanisms of catatonia and that controversy persists about the etiology of specific cases. There are only 6 reports of hyponatremia-induced catatonia and psychosis in the literature. Here, we present the case of a 30-year-old woman with catatonia and psychosis induced by hyponatremia, and we use this report to exemplify the multitude of biologic causes of catatonia and to propose a new way to look at the neuroanatomical basis of processing, particularly the vertical processing systems we believe are involved in catatonia. PMID:25102520

Looking back at Love Canal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Deegan, J. Jr.

In the first part of this series (ES and T, April 1987, pp. 328-31) it was pointed out that the methods and conclusions of EPA's Love Canal Study were the subject of some controversy in the environmental community. Others defended the agency's approaches and methods. Part 2 makes no attempt to resolve the controversy; its purpose is to present the results and conclusions of the Love Canal.

Clinical characteristics and brain PET findings in 3 cases of dissociative amnesia: disproportionate retrograde deficit and posterior middle temporal gyrus hypometabolism.

PubMed

Thomas-Antérion, C; Dubas, F; Decousus, M; Jeanguillaume, C; Guedj, E

2014-10-01

Precipitated by psychological stress, dissociative amnesia occurs in the absence of identifiable brain damage. Its clinical characteristics and functional neural basis are still a matter of controversy. In the present paper, we report 3 cases of retrograde autobiographical amnesia, characterized by an acute onset concomitant with emotional/neurological precipitants. We present 2 cases of dissociative amnesia with fugue (cases 1 and 2), and one case of focal dissociative amnesia after a minor head trauma (case 3). The individual case histories and neuropsychological characteristics are reported, as well as the whole-brain voxel-based 18FDG-PET metabolic findings obtained at group-level in comparison to 15 healthy subjects. All patients suffered from autobiographical memory loss, in the absence of structural lesion. They had no significant impairment of anterograde memory or of executive function. Impairment of autobiographical memory was complete for two of the three patients, with loss of personal identity (cases 1 and 2). A clinical recovery was found for the two patients in whom follow-up was available (cases 2 and 3). Voxel-based group analysis highlighted a metabolic impairment of the right posterior middle temporal gyrus. 18FDG-PET was repeated in case 3, and showed a complete functional brain recovery. The situation of dissociative amnesia with disproportionate retrograde amnesia is clinically heterogeneous between individuals. Our findings may suggest that impairment of high-level integration of visual and/or emotional information processing involving dysfunction of the right posterior middle temporal gyrus could reduce triggering of multi-modal visual memory traces, thus impeding reactivation of aversive memories. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Restoring trust in the pharmaceutical sector on the basis of the SSRI case.

PubMed

Hernandez, Juan Francisco; van Thiel, Ghislaine J M W; Mantel-Teeuwisse, Aukje K; Raaijmakers, Jan A M; Pieters, Toine

2014-05-01

The lack of public trust in the pharmaceutical sector (i.e. industry, authorities and doctors) could compromise the future of drug development and the regulatory system. Public trust integrates two important components, namely the vulnerability of the truster and the competence of the trustee. Because trust appears to have eroded as a result of drug safety controversies, this paper analyzes the role of public trust during the selective serotonin reuptake inhibitor (SSRI) and suicidality controversy focusing on the aforementioned trust components. Because the competence component of trust is argued to be paramount in determining and maintaining public trust, the SSRI case shows that this component is a part of public trust where these institutions can build on, and might therefore be better used to substantiate and reinforce, public trust. Efforts to build trust should rely on the ethical, professional (competence) and societal commitment of institutions and individuals to protect the vulnerability of the public during controversies. Because shared values can create trust or increase its levels within a specific environment, industry, authorities and physicians ought to develop novel and cooperative strategies to highlight their shared values and motivations. Rules, regulations and settlements are indispensable tools but undue regulation is costly and can backfire on the rather sensitive trust relationships in the pharmaceutical sector. Copyright © 2013 Elsevier Ltd. All rights reserved.

The great debate series: surgical treatment of aortic valve abnormalities in children.

PubMed

d'Udekem, Yves; Tweddell, James S; Karl, Tom R

2018-05-01

This article is the latest in an EJCTS series entitled 'The Great Debates'. We have chosen the topic of aortic valve (AoV) surgery in children, with a focus on infants and neonates. The topic was selected due to the significant challenges that AoV problems in the young may present to the surgical team. There are many areas of active controversy, despite the vast accumulated world experience. We have tried to incorporate many of these issues in the questions posed, not claiming to be all-inclusive. The individuals invited to this debate are experts in paediatric valve surgery, with broad and successful clinical experiences on multiple continents. We hope that the facts and opinions presented in this debate will generate interest and discussion and perhaps prove useful in decision-making for future complex valve cases.

[Adaptation possibility of chosen aspects of pharmaceutical marketing for realization of promotion in health care].

PubMed

Syrycki, Marek

2002-01-01

Reform of health service in Poland introduced reliable economic bill and elements of competition among its subjects as well. It created a new situation both for doctors and managers of health service. Need of search for rules and ways of competition exists at present among institutions of health care. Certain solutions can be modelled on the example of pharmaceutical companies already present on the market. As an example of such activities, which they can be applied directly in this new situation may serve so called personal sale and related to it case of institutions the best direct contact between the next but more controversial form of marketing activities worth spreading. The use of direct marketing and advertisements carries most problems with itself. This latter should be easier to accept when it selects an important social aim.

Surgical management of adult type 1 split cord malformation. Report of two cases with literature review.

PubMed

Viswanathan, Vibhu K; Minnema, Amy J; Farhadi, H Francis

2018-06-01

Split cord malformation (SCM) is a rare form of spinal dysraphism wherein the spinal cord is divided longitudinally into two distinct hemicords. Surgery is usually performed in children while management in adults, who rarely manifest symptoms, remains controversial. Both expectant management and prophylactic surgery have been variously advocated. The present article describes our experience in two adult patients with predominant pain-related complaints who underwent surgical excision of type 1 SCM lesions. A comprehensive review of the literature on SCM in adults is also provided. While pain, disability, and quality of life scores improved in these two patients, further larger studies will be required to define the role of surgery in adults with type 1 SCM and a pain-dominant presentation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Dandy-Walker syndrome with severe velopharyngeal dysfunction: a contraindication for Le Fort I surgery?

PubMed

Nelke, Kamil H; Pawlak, Wojciech; Gerber, Hanna

2015-01-01

Dandy-Walker syndrome is a rare congenital brain deformation. Most symptoms are related with fourth ventricle and skull base malformations. Quite often, symptoms develop from infancy or progress rapidly. Cerebellar dysfunction, lack of muscle coordination, and skull deformities involving eye movement might be present. There are several Dandy-Walker syndrome complex types. We present a 23-year-old patient who had a severe dentofacial deformity with mandibular prognathism and extremely undeveloped maxillary bone resulting in palatopharyngeal and velopharyngeal dysfunction with complete lack of soft palate function resulting in increased speech tone and volume. Performing Le Fort I osteotomy in this case is greatly controversial and might result in even greater loss of function or even its total lack. Velopharyngeal complex is very important, and every surgeon should consider its value while planning Le Fort I osteotomies.

Endophthalmitis.

PubMed

Elder, Mark J; Morlet, Nigel

2002-12-01

Australia and New Zealand continue to be at the forefront of endophthalmitis research. In this Clinical Controversy, an ophthalmologist from each country presents different approaches to the management of a 72-year-old patient with routine endophthalmitis following cataract surgery. Mark Elder concludes that this case needs aqueous and vitreous aspirates for culture and the initial treatment of choice is intracameral vancomycin and amikacin. The evidence for intravitreal steroids is equivocal. Systemic antibiotics are indicated if there is a possibility of a bacterial biofilm present on the intraocular lens. Nigel Morlet concludes that timely intervention with appropriate antibiotics delivered in the right concentration to the vitreous cavity is the crux of successful management of endophthalmitis. Aggressive treatment of the inflammatory response is also required to further reduce the damage to the intraocular structures. Both ophthalmologists agree that vitrectomy is not necessarily the most appropriate treatment option.

Treatment of Lipoma by Injection Lipolysis

PubMed Central

Nanda, Soni

2011-01-01

Injection lipolysis or lipodissolve is the practice of injecting phosphatidyl choline/ sodium deoxycholate (PDC/DC) compounds in the subcutaneous fat. Though this practice is being used extensively for nonsurgical contouring of body and dissolving localized collections of excess fat, it's use as a treatment modality for lipomas needs further evaluation. We present a case where this technique was used for treating a lipoma, with no recurrence after 9 months of follow up. Injection lipolysis as a treatment modality for lipomas needs to be evaluated for safety and efficacy in trials on larger population. This could prove to be a very valuable adjunct to the current practice of excision, if done by a trained person in a properly selected patient. Also the side effects and the controversies regarding this procedure have been discussed in detail in the present paper. PMID:21976907

Lupus erythematosus tumidus: a series of 26 cases.

PubMed

Vieira, Vanessa; Del Pozo, Jesús; Yebra-Pimentel, Maria Teresa; Martínez, Walter; Fonseca, Eduardo

2006-05-01

To study 26 cases of lupus erythematosus tumidus (LET), a subset of chronic cutaneous lupus erythematosus (CCLE), referred to in the literature as a rare entity. A retrospective study was conducted of 26 patients diagnosed with LET between 1996 and 2002. The clinical characteristics, histopathologic and laboratory findings, response to treatment, association with other subsets of lupus, course, and diagnostic criteria were analyzed. The incidence by sex was similar. The mean age of presentation was 49.19 years. The clinical presentation usually involved erythematous, edematous plaques located on the face, chest, back, or extremities, related to sun exposure. A dermal lymphocytic infiltrate with a perivascular disposition and differing degrees of mucin deposition was observed in all cases. Minimal epidermal changes were present in 18 cases, and 11 of these also showed minimal dermal-epidermal changes. Only one case showed dermal-epidermal changes without any epidermal alteration. Direct immunofluorescence test was performed in 15 patients, and 11 were negative. All cases showed a benign course without systemic manifestations. The response to topical steroids or antimalarial treatment was excellent, but a seasonal recurrence was usually observed. Discussion No defined criteria for LET are universally accepted. The main controversies are the acceptance of LET as a separate subset of CCLE, and the histopathologic diagnostic features, mainly the presence or absence of epidermal and dermal-epidermal changes in these lesions. No inflexible histologic criteria should be employed for the diagnosis of LET. This subset of lupus erythematosus is characterized by intense photosensitivity, definite clinical lesions, a benign course, the absence of systemic disease, good response to antimalarial treatment, and a tendency to recur. More studies should be performed in order to establish the true incidence of LET because this subset of CCLE is probably underestimated.

Poison in the Halls of Ivy.

ERIC Educational Resources Information Center

Zirkel, Perry A.

1997-01-01

Discusses a California case involving a tenured professor's controversial teaching style, which focused on "obscene" topics and assignments that allegedly humiliated female students. The professor eventually prevailed in a Ninth Circuit appeal. The lesson: when attempting to eradicate sexual harassment, we cannot abandon important First…

The Black Faculty Gap.

ERIC Educational Resources Information Center

Glazer, Nathan

2003-01-01

Reviews Cole and Barber's "Increasing Faculty Diversity: The Occupational Choices of High-Achieving Minority Students," which has aroused controversy because its findings bear directly on the University of Michigan's affirmative action cases. Cole and Barber surveyed minority and white students in Ivy League, elite, and historically…

Obscenity: Three Case Studies.

ERIC Educational Resources Information Center

Kelly, Margie

The Supreme Court's controversial "community standards" ruling in "Miller v. California" (1973) states that for materials to be judged obscene, they no longer need to be "utterly without redeeming social value," but must lack serious literary, artistic, political or scientific value, and that the question of…

PubMed Central

Marchand, R.

1993-01-01

Three recent articles are examined in which research using the double-blind randomised clinical trial, the case control study, and the quasi-cohort study is described. Understanding the advantages and disadvantages of these methods makes it easier to grasp the pneumococcal vaccine controversy and make an informed choice. PMID:8499794

Tentorial dural arteriovenous fistula presenting as myelopathy: Case series and review of literature

PubMed Central

Gross, Robert; Ali, Rushna; Kole, Max; Dorbeistein, Curtis; Jayaraman, Mahesh V; Khan, Muhib

2014-01-01

Dural arteriovenous fistula (DAVF) is a rare type of cerebral arteriovenous malformation. Common presenting symptoms are related to hemorrhage. However, rarely these patients may present with myelopathy. We present two cases of DAVF presenting as rapidly progressive myelopathy. Two treatment options are available: microsurgical interruption of the fistula and endovascular embolization. These treatment options of DAVFs have improved significantly in the last decade. The optimal treatment of DAVFs remains controversial, and there is an ongoing debate as to whether primary endovascular or primary microsurgical treatment is the optimal management for these lesions. However, despite treatment a high percentage of patients are still left with severe disability. The potential for functional ambulation in patients with DAVF is related to the time of intervention. This emphasizes the important of early diagnosis and early intervention in DAVF. The eventual outcome may depend on several factors, such as the duration of symptoms, the degree of disability before treatment, and the success of the initial procedure to close the fistula. The usage of magnetic resonance imaging and selective angiography has significantly improved the ability to characterize DAVFs, however, these lesions remain inefficiently diagnosed. If intervention is delayed even prolonged time in rehabilitation does not change the grave prognosis. This review outlines the presentation, classication and management of DAVF as well as discussing patient outcomes. PMID:25516869

Climate-Conflict Research: Some Reflections on the Way Forward

DTIC Science & Technology

2015-02-18

analytical design. The conflict and massacre in Darfur in the early 2000s may represent one such case. Absent the scientific controversy around the...peaceful despite experiencing the same drought and similar challenges to land use practices—make Darfur an anomaly, rather than an illustrative case...17. Selby J. Positivist climate conflict research: a critique. Geopolitics 2014, 19:829–856. 18. Kevane M, Gray L. Darfur : rainfall and conflict

Controversies in the Management of the First Time Shoulder Dislocation

PubMed Central

Avila Lafuente, José Luis; Moros Marco, Santos; García Pequerul, José Manuel

2017-01-01

Background: Traditionally, initial management of first anterior shoulder dislocations consists of reduction of the glenohumeral joint followed by a period of immobilization and subsequent physical therapy to recover shoulder range of motion and strength. This traditional approach in management is now controversial due to the high rate of recurrence. The aim of this paper is to review and discuss the literature about the global management of patients presenting with first-time traumatic anterior glenohumeral dislocation, analyzing the factors that affect shoulder instability after the first episode of dislocation. Methods: Scientific publications about the management of first-time shoulder dislocations are reviewed. Pubmed is used for that and no limit in the year of publication are stablished. These papers and their conclusions are discussed. Results: Younger patients, patient´s activities and the kind of injury are the most important factors related to the shoulder instability after a first time traumatic dislocation. Authors that recommend surgical treatment after the first episode of dislocation argue that the possibilities of recurrence are high and therefore surgery should be performed before its occurrence. Other authors, however, argue that surgical treatment is demanding, and keep in mind that complications, such as recurrence, stiffness and pain after surgery, are still present. Conclusion: Currently, there is still no consensus in the literature with regard to the management of first episode of shoulder dislocation. It is necessary to analyze carefully every individual case to manage them more or less aggressive to obtain the best result in our practice. PMID:29430264

The case of Robert Herrlinger: a unique postwar controversy on the ethics of the anatomical use of bodies of the executed during National Socialism.

PubMed

Hildebrandt, Sabine

2013-01-01

Historical evidence shows that German anatomists used bodies of executed victims of the National Socialist (NS) regime for anatomical purposes. However, there has been little direct information on these anatomists' thoughts and motivations, and a public discussion of their activities and ethics only started in the late 1980s. The present study documents a unique postwar controversy surrounding the promotion of the anatomist and medical historian Robert Herrlinger at the university of Würzburg in the late 1950s. This intramural debate had originally been mentioned by Goetz Aly in 1987. Herrlinger's files record his career as a representative of the discipline of medical history at the university of Würzburg from 1951 to 1960. He never worked there as an active anatomist. When the university senate applied for his appointment as full professor in 1957, the internist Ernst Wollheim, the pediatrician Joseph Ströder, and the psychiatrist Heinrich Scheller strongly opposed this move in a dissenting opinion based on Herrlinger's anatomical work on bodies of executed NS-victims. They claimed that he lacked the moral prerequisites required in a teacher of medical ethics. A highly controversial debate followed and was remarkable for addressing most of the questions of the ethical and political attitudes and responsibilities of anatomists in NS-Germany that are still being discussed today and are relevant for modern anatomy. It was also significant that Wollheim, Ströder and Scheller objected to Herrlinger in his role as a medical historian, not as an anatomist. The senate finally rejected the dissenting opinion and Herrlinger was promoted. Copyright © 2012 Elsevier GmbH. All rights reserved.

Dissociative identity disorder: a controversial diagnosis.

PubMed

Gillig, Paulette Marie

2009-03-01

A brief description of the controversies surrounding the diagnosis of dissociative identity disorder is presented, followed by a discussion of the proposed similarities and differences between dissociative identity disorder and borderline personality disorder. The phenomenon of autohypnosis in the context of early childhood sexual trauma and disordered attachment is discussed, as is the meaning of alters or alternate personalities. The author describes recent neurosciences research that may relate the symptoms of dissociative identity disorder to demonstrable disordered attention and memory processes. A clinical description of a typical patient presentation is included, plus some recommendations for approaches to treatment.

Essential Features of Responsible Governance of Agricultural Biotechnology

PubMed Central

Hartley, Sarah; Wickson, Fern

2016-01-01

Agricultural biotechnology continues to generate considerable controversy. We argue that to address this controversy, serious changes to governance are needed. The new wave of genomic tools and products (e.g., CRISPR, gene drives, RNAi, synthetic biology, and genetically modified [GM] insects and fish), provide a particularly useful opportunity to reflect on and revise agricultural biotechnology governance. In response, we present five essential features to advance more socially responsible forms of governance. In presenting these, we hope to stimulate further debate and action towards improved forms of governance, particularly as these new genomic tools and products continue to emerge. PMID:27144921

Caffeine citrate - Is it a silver bullet in neonatology?

PubMed

Shrestha, Bikash; Jawa, Gaurav

2017-10-01

Caffeine citrate is one of the most prescribed drug in the present day NICU for apnea. Its efficacy, tolerability, wide therapeutic index and safety margin has made it the drug of choice among the methylxanthines. Its therapeutic uses in apnea of prematurity, mechanical ventilation, bronchopulmonary dysplasia has made it a "silver bullet" in neonatology. However, there are still controversies surrounding this drug. This review is aimed to update the reader about the basic pharmacology, current therapeutic uses, adverse effects, controversies as well as present and future research of caffeine. Copyright © 2017. Published by Elsevier B.V.

Essential Features of Responsible Governance of Agricultural Biotechnology.

PubMed

Hartley, Sarah; Gillund, Frøydis; van Hove, Lilian; Wickson, Fern

2016-05-01

Agricultural biotechnology continues to generate considerable controversy. We argue that to address this controversy, serious changes to governance are needed. The new wave of genomic tools and products (e.g., CRISPR, gene drives, RNAi, synthetic biology, and genetically modified [GM] insects and fish), provide a particularly useful opportunity to reflect on and revise agricultural biotechnology governance. In response, we present five essential features to advance more socially responsible forms of governance. In presenting these, we hope to stimulate further debate and action towards improved forms of governance, particularly as these new genomic tools and products continue to emerge.

Teaching ethics in engineering education through historical analysis.

PubMed

Billington, David P

2006-04-01

The goal of this paper is to stress the significance of ethics for engineering education and to illustrate how it can be brought into the mainstream of higher education in a natural way that is integrated with the teaching objectives of enriching the core meaning of engineering. Everyone will agree that the practicing engineer should be virtuous, should be a good colleague, and should use professional understanding for the common good. But these injunctions to virtue do not reach closely enough the ethic of the engineer as engineer, as someone acting in a uniquely engineering situation, and it is to such conditions that I wish to speak through a set of specific examples from recent history. I shall briefly refer to four controversies between engineers. Then, in some detail I shall narrate three historical cases that directly involve the actions of one engineer, and finally I would like to address some common contemporary issues. The first section, Engineering Ethics and the History of Innovation, includes four cases involving professional controversy. Each controversy sets two people against each other in disputes over who invented the telegraph, the radio, the automobile, and the airplane. In each dispute, it is possible to identify ethical and unethical behavior or ambiguous ethical behavior that serves as a basis for educational discussion. The first two historical cases described in "Crises and the Engineer" involve the primary closure dam systems in The Netherlands, each one the result of the actions of one engineer. The third tells of an American engineer who took his political boss, a big city mayor, to court over the illegal use of a watershed. The challenges these engineers faced required, in the deepest sense, a commitment to ethical behavior that is unique to engineering and instructive to our students. Finally, the cases in "Professors and Comparative Critical Analysis" illuminate the behavior of engineers in the design of structures and also how professors can make public criticisms of designs that seem wasteful.

AIDS in the workplace: current practices and possible implications.

PubMed

Nykodym, N; Miners, I A; Simonetti, J L; Patel, N S

1989-01-01

The testing of Acquired Immune Deficiency Syndrome (AIDS) remains a political factor. Questions are being raised as to an individual's right to privacy and the public's concern for safety. Despite the controversy, the law protects contagious disease sufferers from employment discrimination. Along with AIDS testing, drug testing remains a controversial issue. Mandatory drug testing remains in both the public and private sectors. Legislative activity in California continues to the present.

The Religion/Science Controversy: The Use and Abuse of Science in the Defense of Religion. Proceedings of a Conference (Westville, Indiana, October 5, 1985).

ERIC Educational Resources Information Center

Kanagy, Sherman P., II, Ed.

Science and religion have been referred to as the two strongest general forces which influence humankind. This document contains the proceedings of a conference which was held to address some of the relationships and controversies surrounding these topics. Included are the texts of the major papers presented at the conference. These are: (1)…

When general practitioners talk about alcohol: exploring facilitating and hampering factors for pragmatic case finding.

PubMed

Lid, Torgeir Gilje; Nesvåg, Sverre; Meland, Eivind

2015-03-01

The aim was to explore individual and system factors facilitating or hampering pragmatic case finding, an identification strategy based on clinical signs and targeted screening. Two focus groups with general practitioners were interviewed twice, in the context of a four-session seminar on alcohol and complex drug problems, and an additional focus group interview with general practitioners not attending the seminar. Interviews focused mainly on conditions for talking about alcohol, views on collaboration with colleagues, how they deal with complex issues, and strategies for learning and quality improvement. The participants presented many deliberate strategies for quality improvement and learning together, but there was a tendency to avoid discussing complex case stories or potentially controversial topics with colleagues. Possible barriers to change were presented. The majority of their stories on talking about alcohol coincided well with the concept of pragmatic case finding. The duality between shame and normality, time constraints and a need for structure were the most important individual barriers to an open and respectful conversation about alcohol with patients. Our study supports pragmatic case finding as a relevant and viable strategy for talking about alcohol in general practice, and as an alternative to screening and brief intervention. Quality improvement in practice is strengthened when it is adapted to the clinical setting, and builds on and stimulates the GPS' and staff's own strategies for learning and quality work. © 2015 the Nordic Societies of Public Health.

Comparative evaluation of immunohistochemistry, histopathology and conventional radiography in differentiating periapical lesions.

PubMed

Saraf, Prahlad A; Kamat, Sharad; Puranik, R S; Puranik, Surekha; Saraf, Suma P; Singh, Bhanu Pratap

2014-03-01

Periapical lesions often present differently on the radiograph resulting in a dilemma in the mind of the dentist to arrive at a final diagnosis. Although, histopathologic diagnosis has been used for confirmation of the true nature of periapical lesion, the concept of transformation of periapical granulomas containing epithelium without cystification into cyst remains controversial. The aim of this in vivo study was to evaluate the efficacy of conventional radiography and histopathology in differentiating periapical lesions in adjunct with immunohistochemical analysis. Periapical lesions often present differently on the radiograph resulting in a dilemma in the mind of the dentist to arrive at a final diagnosis. Although, histopathologic diagnosis has been used for confirmation of the true nature of periapical lesion, the concept of transformation of periapical granulomas containing epithelium without cystification into cyst remains controversial. The aim of this in vivo study was to evaluate the efficacy of conventional radiography and histopathology in differentiating periapical lesions in adjunct with immunohistochemical analysis. Thirty patients having large periapical radiolucency that do not heal successfully with routine endodontic therapy in relation to either maxillary or mandibular anterior teeth were selected for the study. Intraoral periapical radiographs were obtained and provisional diagnosis of the apical areas were made. Endodontic surgery was performed to enable histopathogical investigation. The histopathological interpretation was done to arrive at a final diagnosis and selected questionable granulomas were subjected for cytokeratin (CK-14) stain. The histopathological profile of lesions consisted of 66.66% periapical granulomas, 10% cysts, 6.67% abscess and 16.67% granulomas with cystic potential. The radiographic and histopathologic correlation was found in only 30% of these cases. Strong CK-14 expression was observed in all five cases of periapical granuloma with cystic potential. The radiographic diagnosis of periapical lesions remains inconclusive. Although histopathologic examination of periapical lesions gives true nature, the precise nature of subsets of periapical granulomas may be achieved with adjunct use of immunohistochemical markers.

Comparative evaluation of immunohistochemistry, histopathology and conventional radiography in differentiating periapical lesions

PubMed Central

Saraf, Prahlad A; Kamat, Sharad; Puranik, R S; Puranik, Surekha; Saraf, Suma P; Singh, Bhanu Pratap

2014-01-01

Background and Aim: Periapical lesions often present differently on the radiograph resulting in a dilemma in the mind of the dentist to arrive at a final diagnosis. Although, histopathologic diagnosis has been used for confirmation of the true nature of periapical lesion, the concept of transformation of periapical granulomas containing epithelium without cystification into cyst remains controversial. The aim of this in vivo study was to evaluate the efficacy of conventional radiography and histopathology in differentiating periapical lesions in adjunct with immunohistochemical analysis. Aim: Periapical lesions often present differently on the radiograph resulting in a dilemma in the mind of the dentist to arrive at a final diagnosis. Although, histopathologic diagnosis has been used for confirmation of the true nature of periapical lesion, the concept of transformation of periapical granulomas containing epithelium without cystification into cyst remains controversial. The aim of this in vivo study was to evaluate the efficacy of conventional radiography and histopathology in differentiating periapical lesions in adjunct with immunohistochemical analysis. Materials and Method: Thirty patients having large periapical radiolucency that do not heal successfully with routine endodontic therapy in relation to either maxillary or mandibular anterior teeth were selected for the study. Intraoral periapical radiographs were obtained and provisional diagnosis of the apical areas were made. Endodontic surgery was performed to enable histopathogical investigation. The histopathological interpretation was done to arrive at a final diagnosis and selected questionable granulomas were subjected for cytokeratin (CK-14) stain. Results: The histopathological profile of lesions consisted of 66.66% periapical granulomas, 10% cysts, 6.67% abscess and 16.67% granulomas with cystic potential. The radiographic and histopathologic correlation was found in only 30% of these cases. Strong CK-14 expression was observed in all five cases of periapical granuloma with cystic potential. Conclusion: The radiographic diagnosis of periapical lesions remains inconclusive. Although histopathologic examination of periapical lesions gives true nature, the precise nature of subsets of periapical granulomas may be achieved with adjunct use of immunohistochemical markers. PMID:24778515

The pearl of the 'Pro-Life' movement? Reflections on the Kermit Gosnell controversy.

PubMed

Greasley, Kate

2014-06-01

The paper comments briefly on the recent controversy surrounding the criminal prosecution and conviction of rogue abortion doctor Kermit Gosnell in the USA, for, among other things, the murder of infants born alive. Without contesting the disturbing nature of the crimes committed by Gosnell and his colleagues, it critiques a few ways in which opponents of abortion have sought to use the case as ammunition against the legal provision of abortion and against the morality of all abortion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Helmholtz and Zoellner: nineteenth-century empiricism, spiritism, and the theory of space perception.

PubMed

Stromberg, W H

1989-10-01

J. K. F. Zoellner began writing on "experimental proofs" of a fourth spatial dimension, and of the existence of spirits, in 1878. His arguments caused strong controversy, with rebuttal essays by Wilhelm Wundt and others. The author argues that Zoellner's case that these matters are experimental questions rested on arguments which Hermann von Helmholtz, inveighing against rationalist views of space and space perception, had recently published. Zoellner's use of Helmholtz's arguments to advance and defend his spiritist views occasioned strong criticism of Helmholtz, affected careers and reputations of scholars in Berlin and Leipzig, and caused enduring controversy over the credibility of Helmholtz's empiricist theory of space perception.

Environmental Education in a Region of Rapid Economic Development: The Case of Sarawak.

ERIC Educational Resources Information Center

Gough, Stephen.

1995-01-01

Discusses an innovative approach to environmental education that takes into account the interactions between cultural diversity and environmental controversy. Examines the situation in Sarawak, a State of East Malaysia, in the light of existing theoretical work. Contains 21 references. (JRH)

Effectiveness of Different Models of Case Management for Substance-Abusing Populations

PubMed Central

Vanderplasschen, Wouter; Wolf, Judith; Rapp, Richard C.; Broekaert, Eric

2007-01-01

Case management has been implemented in substance abuse treatment to improve (cost-) effectiveness, but controversy exists about its potential to realize this objective. A systematic and comprehensive review of peer-reviewed articles (n = 48) published between 1993 and 2003 is presented, focusing on the effects of different models of case management among various substance-abusing populations. Results show that several studies have reported positive effects, but only some randomized and controlled trials have demonstrated the effectiveness of case management compared with other interventions. Longitudinal effects of this intervention remain unclear. Although no compelling evidence was found for the effectiveness of case management, some evidence is available about the (differential) effectiveness of intensive case management and assertive community treatment for homeless and dually-diagnosed substance abusers. Strengths-based and generalist case management have proven to be relatively effective for substance abusers in general. Most positive effects concern reduced use of inpatient services and increased utilization of community-based services, prolonged treatment retention, improved quality of life, and high client satisfaction. Outcomes concerning drug use and psychosocial functioning are less consistent, but seem to be mediated by retention in treatment and case management. Further research is required to learn more about the extent of the effects of this intervention, how long these are sustained and what specific elements cause particular outcomes. PMID:17523588

Sex offender polygraph examination: an evidence-based case management tool for social workers.

PubMed

Levenson, Jill S

2009-10-01

This article will review the use of polygraphy in the assessment and treatment of sexual perpetrators. Such information can be utilized by social workers who are involved in the treatment and case management of child sexual abuse cases. First, the controversial literature regarding the validity and reliability of polygraph examination in general will be reviewed. Next, an emerging body of evidence supporting the utility of polygraph testing with sex offenders will be discussed. Finally, ways that social workers can incorporate this knowledge into their case management and clinical roles will be offered.

Hippocampal amnesia.

PubMed

Spiers, H J; Maguire, E A; Burgess, N

2001-01-01

This article reviews 147 cases of amnesia following damage including the hippocampus or fornix as reported in 179 publications. The aetiology, mnestic abilities and reference(s) are tabulated for each case. Consistent findings across cases include the association of bilateral hippocampal damage with a deficit in anterograde episodic memory combined with spared procedural and working memory. The limited nature of retrograde amnesia following lesions to the fornix is also noted. Less consistent and thus more controversial findings, include effects of lesion size or laterality, deficits in semantic memory or familiarity-based recognition and the extent of retrograde amnesia. The evidence concerning these issues is reviewed across cases.

The DNA database search controversy revisited: bridging the Bayesian-frequentist gap.

PubMed

Storvik, Geir; Egeland, Thore

2007-09-01

Two different quantities have been suggested for quantification of evidence in cases where a suspect is found by a search through a database of DNA profiles. The likelihood ratio, typically motivated from a Bayesian setting, is preferred by most experts in the field. The so-called np rule has been suggested through frequentist arguments and has been suggested by the American National Research Council and Stockmarr (1999, Biometrics55, 671-677). The two quantities differ substantially and have given rise to the DNA database search controversy. Although several authors have criticized the different approaches, a full explanation of why these differences appear is still lacking. In this article we show that a P-value in a frequentist hypothesis setting is approximately equal to the result of the np rule. We argue, however, that a more reasonable procedure in this case is to use conditional testing, in which case a P-value directly related to posterior probabilities and the likelihood ratio is obtained. This way of viewing the problem bridges the gap between the Bayesian and frequentist approaches. At the same time it indicates that the np rule should not be used to quantify evidence.

Sexual orientation and gender identity: review of concepts, controversies and their relation to psychopathology classification systems

PubMed Central

Moleiro, Carla; Pinto, Nuno

2015-01-01

Numerous controversies and debates have taken place throughout the history of psychopathology (and its main classification systems) with regards to sexual orientation and gender identity. These are still reflected on present reformulations of gender dysphoria in both the Diagnostic and Statistical Manual and the International Classification of Diseases, and in more or less subtle micro-aggressions experienced by lesbian, gay, bisexual and trans patients in mental health care. The present paper critically reviews this history and current controversies. It reveals that this deeply complex field contributes (i) to the reflection on the very concept of mental illness; (ii) to the focus on subjective distress and person-centered experience of psychopathology; and (iii) to the recognition of stigma and discrimination as significant intervening variables. Finally, it argues that sexual orientation and gender identity have been viewed, in the history of the field of psychopathology, between two poles: gender transgression and gender variance/fluidity. PMID:26483748

Sexual orientation and gender identity: review of concepts, controversies and their relation to psychopathology classification systems.

PubMed

Moleiro, Carla; Pinto, Nuno

2015-01-01

Numerous controversies and debates have taken place throughout the history of psychopathology (and its main classification systems) with regards to sexual orientation and gender identity. These are still reflected on present reformulations of gender dysphoria in both the Diagnostic and Statistical Manual and the International Classification of Diseases, and in more or less subtle micro-aggressions experienced by lesbian, gay, bisexual and trans patients in mental health care. The present paper critically reviews this history and current controversies. It reveals that this deeply complex field contributes (i) to the reflection on the very concept of mental illness; (ii) to the focus on subjective distress and person-centered experience of psychopathology; and (iii) to the recognition of stigma and discrimination as significant intervening variables. Finally, it argues that sexual orientation and gender identity have been viewed, in the history of the field of psychopathology, between two poles: gender transgression and gender variance/fluidity.

ESWR1-CREM Fusion in an Intracranial Myxoid Angiomatoid Fibrous Histiocytoma-Like Tumor: A Case Report and Literature Review.

PubMed

Gareton, Albane; Pierron, Gaëlle; Mokhtari, Karima; Tran, Suzanne; Tauziède-Espariat, Arnault; Pallud, Johan; Louvel, Guillaume; Meary, Eric; Capelle, Laurent; Chrétien, Fabrice; Varlet, Pascale

2018-05-19

Gene fusions of EWSR1 with members of the CREB family of transcription factors (CREB1, ATF1, and CREM) have recently been described in exceptional intracranial myxoid mesenchymal tumors. Although this is a known gene fusion found in various mesenchymal tumors, EWSR1 fusion with CREM has only been observed in 3 intracranial myxoid tumors. In this paper, we present 1 such tumor with in-depth histopathological description and long-term follow-up. There is controversy regarding whether these tumors represent a novel entity or simply an intracranial localization of the myxoid variant of angiomatoid fibrous histiocytoma, a rare soft tissue tumor of the extremities. Out of 11 cases mentioned in the literature, the 3 isolated case reports by Dunham et al, Ochalski et al, and Alshareef et al are designated as angiomatoid fibrous histiocytoma, whereas the others are defined as a novel tumoral entity called intracranial myxoid mesenchymal tumor with EWSR1-CREB fusion. We believe the vast morphological and immunohistochemical spectrum of angiomatoid fibrous histiocytoma makes it difficult to dismiss this diagnosis.

Successful vaginal birth after caesarean section in patient with Ehler-Danlos syndrome type 2.

PubMed

Maraj, Hemant; Mohajer, Michelle; Bhattacharjee, Deepannita

2011-12-01

We present the case of a 31-year-old woman with Ehler-Danlos syndrome (EDS) type 2. She had a previous caesarean section and went on to have an uncomplicated vaginal birth in her last pregnancy. To our knowledge, this is the first case of a successful vaginal birth after caesarean section in a patient with EDS. EDS is a multisystem disorder involving a genetic defect in collagen and connective-tissue synthesis and structure. It is a heterogeneous group of 11 different inherited disorders. Obstetric complications in these patients include miscarriages, stillbirths, premature rupture of the membranes, preterm labour, uterine prolapse, uterine rupture and severe postpartum haemorrhage. There has been much controversy over the appropriate mode of delivery. Abdominal deliveries are complicated by delayed wound healing and increased perioperative blood loss. Vaginal deliveries may be complicated by tissue friability causing extensive perineal tears, pelvic floor and bladder lesions. Our case highlights that in specific, controlled situations it is possible to have a vaginal delivery even after previous caesarean section in patients with EDS.

Successful vaginal birth after caesarean section in patient with Ehler-Danlos syndrome type 2

PubMed Central

Maraj, Hemant; Mohajer, Michelle; Bhattacharjee, Deepannita

2011-01-01

We present the case of a 31-year-old woman with Ehler-Danlos syndrome (EDS) type 2. She had a previous caesarean section and went on to have an uncomplicated vaginal birth in her last pregnancy. To our knowledge, this is the first case of a successful vaginal birth after caesarean section in a patient with EDS. EDS is a multisystem disorder involving a genetic defect in collagen and connective-tissue synthesis and structure. It is a heterogeneous group of 11 different inherited disorders. Obstetric complications in these patients include miscarriages, stillbirths, premature rupture of the membranes, preterm labour, uterine prolapse, uterine rupture and severe postpartum haemorrhage. There has been much controversy over the appropriate mode of delivery. Abdominal deliveries are complicated by delayed wound healing and increased perioperative blood loss. Vaginal deliveries may be complicated by tissue friability causing extensive perineal tears, pelvic floor and bladder lesions. Our case highlights that in specific, controlled situations it is possible to have a vaginal delivery even after previous caesarean section in patients with EDS. PMID:27579117

Empowerment in healthcare policy making: three domains of substantive controversy.

PubMed

Chiapperino, Luca; Tengland, Per-Anders

2015-12-01

This paper distinguishes between the uses of empowerment across different contexts in healthcare policy and health promotion, providing a model for the ethical and political scrutiny of those uses. We argue that the controversies currently engendered by empowerment are better understood by means of a historical distinction between two concepts of empowerment, namely, what we call the radical empowerment approach and the new wave of empowerment. Building on this distinction, we present a research agenda for ethicists and policy makers, highlighting three domains of controversy raised by the new wave of empowerment, namely: (1) the relationship between empowerment and paternalistic interferences on the part of professionals; (2) the evaluative commitment of empowerment strategies to the achievement of health-related goals; and (3) the problems arising from the emphasis on responsibility for health in recent uses of empowerment. Finally, we encourage the explicit theorisation of these moral controversies as a necessary step for the development and implementation of ethically legitimate empowerment processes.

Spain: Current Issues and U.S. Policy

DTIC Science & Technology

2007-03-01

taken controversial steps in other areas. He negotiated a wide- ranging autonomy statute with the Catalonia region, giving increased powers over tax...Measures in Spain,” Human Rights Watch report, January 2005. 6 Renwick McLean, “Spaniard Calls CIA Plane Case ‘Very Serious,’” New York Times...the case merited prosecution. The warrants were then withdrawn, but reissued in January 2007 after the High Court made such a ruling. Afghanistan

A rare case of palatin tonsillar metastasis from small cell lung cancer.

PubMed

D'Antonio, Chiara; Lombardini, Alberto; Onesti, Concetta Elisa; Falcone, Rosa; Romiti, Adriana; Lombardi, Marianna; Lauro, Salvatore; Marchetti, Paolo

2016-12-01

Tonsillar metastases are absolutely rare. Small cell lung cancer (SCLC) is known to be the most frequent histological type of tonsillar metastases, however the way of tumor cells spreading to tonsil remains controversial. We described a case report of 76-year-old man with SCLC and tonsillar metastases, to highlight the importance of oral cavity evaluation as a part of a clinical exam and to show the rare tumor cells spreading.

"In the Public Interest, Convenience, and Necessity"...The Broadcasting Industry Meets the People

ERIC Educational Resources Information Center

Parker, Everett C.

1972-01-01

Argues that action by community groups on the local level can help foster three concepts of better broadcasting: diversity, localism, and balance in dealing with news and controversial issues; illustrates this argument with the case of WLBT-TV, Jackson, Mississippi. (JM)

Case Studies in Censorship: William Faulkner's "Sanctuary."

ERIC Educational Resources Information Center

Loe, Mary Hong; Moore, Robert R.

1995-01-01

Faulkner's novel "Sanctuary" was controversial, and attempts to censor it came from private citizens and public officials in response to both the print version and its film adaptation. A historical background and chronology of these incidents are described in detail in a 17-item annotated bibliography. (JMV)

Investigating "Othering" in Visual Arts Spaces of Learning

ERIC Educational Resources Information Center

Biscombe, Monique; Conradie, Stephané; Costandius, Elmarie; Alexander, Neeske

2017-01-01

In the political, social, cultural and economic context of South Africa, higher education spaces provide fertile ground for social research. This case study explored "othered" identities in the Department of Visual Arts of Stellenbosch University. Interviews with students and lecturers revealed interesting and controversial aspects in…

Workforce Diversity: Status, Controversies, and an Interdisciplinary Approach.

ERIC Educational Resources Information Center

Bond, Meg A.; Pyle, Jean L.

Labor force participation rates, pay inequities, occupational segregation, positions in the hierarchy, interactions between diverse groups, and organizational culture all demonstrate that diversity in the workplace has not been fully achieved. Existing approaches to supporting workplace diversity have not worked, and, in many cases, have resulted…

Church-State Separation: Recent Trends and Developments.

ERIC Educational Resources Information Center

Sinensky, Jeffery P.; Kahn, Jill L.

1984-01-01

This report analyzes recent cases and legislation in the area of church-state separation. A brief introduction asserts that the Supreme Court's method of evaluating establishment clause controversies is undergoing pervasive changes that have permitted incursions on establishment principles. The rest of the paper, providing support for this…

From G to X: Self-Regulation or Self-Protection?

ERIC Educational Resources Information Center

De Grazia, Edward; Newman, Roger K.

1982-01-01

This discussion of movie censorship outlines federal court cases involving controversial films which led to the development of the Motion Picture Association of America Code and Rating System. The Age-Classification System and the President's Commission on Obscenity and Pornography established in 1968 are described. (EJS)

Societal acceptance of controversial facilities: The role of two public participation strategies---negotiation and risk communication

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wolfe, A.K.

Public participation in decision making about the siting of controversial facilities is viewed in contradictory ways by different groups of people. Some see public participation as an impediment, while others think it is an important mechanism in gaining societal acceptance for eventual siting. This paper discusses two strategies for obtaining societal acceptance--- negotiation and risk communication---in light of the extent to which they (1) involve members of the public; (2) focus on risk-related issues; and (3) contribute to decisions to site controversial facilities. The paper presents an integrated conceptual model for public participation in siting decisions that incorporates risk asmore » well as social, political, and historical contexts. 20 refs., 1 fig.« less

The diagnostic status of homosexuality in DSM-III: a reformulation of the issues.

PubMed

Spitzer, R L

1981-02-01

In 1973 homosexuality per se was removed from the DSM-II classification of mental disorders and replaced by the category Sexual Orientation Disturbance. This represented a compromise between the view that preferential homosexuality is invariably a mental disorder and the view that it is merely a normal sexual variant. While the 1973 DSM-II controversy was highly public, more recently a related but less public controversy involved what became the DSM-III category of Ego-dystonic Homosexuality. The author presents the DSM-III controversy and a reformulation of the issues involved in the diagnostic status of homosexuality. He argues that what is at issue is a value judgment about heterosexuality, rather than a factual dispute about homosexuality.

Ostomy or intestinal anastomosis in cases of peritonitis.

PubMed

Rasslan, S; Margutti Fonoff, A; Soldá, S C; Angelo Casaroli, A

1995-01-01

Twenty-six patients showing peritonitis due to nontraumatic acute abdomen were submitted to ostomy. Mean age was 51 years (range 25-83), being 13 males and 13 females. Bowel obstruction (BO) was the most frequent cause of peritonitis (11 cases), followed by intestinal perforation (IP) (8 cases), acute mesenteric infarction (AMI) (5 cases), and acute abdomen of inflammatory/infectious origin (AAIO) (2 cases). Brook's ileostomy was performed on 65% of the patients. Jejunostomy was performed only in 4 patients, leading to a bad evolution. Overall mortality was 54%. Primary ostomy or anastomosis in cases of peritonitis constitute a highly controversial theme. Indications and problems involving the intestinal exteriorization in emergency surgery urgency are herein discussed.

Current challenges and pitfalls in the pharmacological treatment of depression

PubMed Central

Popa-Velea, O; Gheorghe, IR; Truţescu, CI; Purcărea, VL

2015-01-01

The multifactorial etiology of depression obliges needs an individual assessment, the psychopharmacological approach involving a biopsychosocial analysis for each individual case. The rebalancing of the depressive patient, seen as a return to a normal level of psychosocial functioning and reduced risk of relapse is achieved with a prompt and constant support of specialized teams. Treatment should include psychopharmacological and psychosocial approaches, the results being interrelated and contributing to the prognosis of the disorder. Progress in clinical and pharmacological research, vivid dynamics of socio-economic environment, the complexity of diagnostic evaluation and the need for an interdisciplinary approach may cause difficulties in addressing the depressive patient and the ethical controversies. The aim of this paper is to present a brief analysis of challenges encountered in the present psychiatric practice, starting from the heterogeneity of depressive manifestations and finishing with the prioritization of interventional forms. PMID:25866576

Roundtable debate: Controversies in the management of the septic patient – desperately seeking consensus

PubMed Central

Waxman, Aaron B; Ward, Nicholas; Thompson, Taylor; Lilly, Craig M; Lisbon, Alan; Hill, Nicholas; Nasraway, Stanley A; Heard, Stephen; Corwin, Howard; Levy, Mitchell

2005-01-01

Despite continuous advances in technologic and pharmacologic management, the mortality rate from septic shock remains high. Care of patients with sepsis includes measures to support the circulatory system and treat the underlying infection. There is a substantial body of knowledge indicating that fluid resuscitation, vasopressors, and antibiotics accomplish these goals. Recent clinical trials have provided new information on the addition of individual adjuvant therapies. Consensus on how current therapies should be prescribed is lacking. We present the reasoning and preferences of a group of intensivists who met to discuss the management of an actual case. The focus is on management, with emphasis on the criteria by which treatment decisions are made. It is clear from the discussion that there are areas where there is agreement and areas where opinions diverge. This presentation is intended to show how experienced intensivists apply clinical science to their practice of critical care medicine. PMID:15693960

Diagnostic criteria for adverse health effects in the environs of wind turbines.

PubMed

McMurtry, Robert Y; Krogh, Carmen Me

2014-10-01

In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed.

On human parthenogenesis.

PubMed

Jose de Carli, Gabriel; Campos Pereira, Tiago

2017-09-01

Spontaneous parthenogenetic and androgenetic events occur in humans, but they result in tumours: the ovarian teratoma and the hydatidiform mole, respectively. However, the observation of fetiform (ovarian) teratomas, the serependious identification of several chimeric human parthenotes and androgenotes in the last two decades, along with the creation of viable bi-maternal mice in the laboratory based on minor genetic interferences, raises the question of whether natural cases of clinically healthy human parthenotes have gone unnoticed to science. Here we present a hypothesis based on three elements to support the existence of such elusive individuals: mutations affecting (i) genomic imprinting, (ii) meiosis and (iii) oocyte activation. Additionally, we suggest that the routine practice of whole genome sequencing on every single newborn worldwide will be the ultimate test to this controversial, yet astonishing hypothesis. Finally, several medical implications of such intriguing event are presented. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Chronic blepharitis: which role for Demodex folliculorum? A case report].

PubMed

Martinaud, C; Gaillard, T; Pons, S; Fournier, B; Brisou, P

2009-01-01

We present a 73-year-old woman presented to our hospital with a 2 years history of eyes itching. The ophthalmological testing was normal. Physical examination revealed blepharitis and lesions acnea-like on mouth, nose and chest. Biological testing revealed no abnormalities. Histologic study and direct immunofluorescence on a cutaneous biopsy were no contributive. The research of an allergic origine was practised by cutaneous and serological tests and negative. An examination of eyelashes was performed and yielded Demodex. Demodex folliculorum is a mite that is the most common permanent ectoparasite of humans, which is thought to be linked to blepharitis and allergic blepharoconjunctivis with rosacea, although much controversy persists. Recent studies demonstrate a high frequence of chronic blepharitis when Demodex are abundant. Several molecules can be used to treat this infestation. Parasiticide as oral ivermectine may be useful when the infestation is important.

Next generation vaccines.

PubMed

Riedmann, Eva M

2011-07-01

In February this year, about 100 delegates gathered for three days in Vienna (Austria) for the Next Generation Vaccines conference. The meeting held in the Vienna Hilton Hotel from 23rd-25th February 2011 had a strong focus on biotech and industry. The conference organizer Jacob Fleming managed to put together a versatile program ranging from the future generation of vaccines to manufacturing, vaccine distribution and delivery, to regulatory and public health issues. Carefully selected top industry experts presented first-hand experience and shared solutions for overcoming the latest challenges in the field of vaccinology. The program also included several case study presentations on novel vaccine candidates in different stages of development. An interactive pre-conference workshop as well as interactive panel discussions during the meeting allowed all delegates to gain new knowledge and become involved in lively discussions on timely, interesting and sometimes controversial topics related to vaccines.

Don’t live in a town where there are no doctors: toxic epidermal necrolysis initially misdiagnosed as oral thrush

PubMed Central

Wani, Abdul Majid; Hussain, Waleed Mohd; Fatani, Mohamad Ibrahim; Ali, Khaled Shawkat; Khoujah, Amer Mohd; Akhtar, Mubeena; Maimani, Ghassan Adnan Al; Raja, Sadeya Hanif; Basraheel, Ashraf; Fareed, Khurram

2009-01-01

Toxic epidermal necrolysis (TEN) is a rare but life threatening skin disease that is most commonly drug induced. The exact pathogenesis of TEN is still unknown and many drugs, including prednisolone, cyclosporin and intravenous immunoglobulin (IVIG), have been used in an attempt to halt the disease process. The use of IVIG in particular is controversial. Recently, the US Food and Drug Administration (FDA) has made a labelling change to the drug information for carbamazepine. Owing to recent data implicating the HLA allele B*1502 as a marker for carbamazepine induced Stevens–Johnson syndrome and TEN in Han Chinese, the FDA recommends genotyping all Asians for the allele. We present an interesting case of carbamazepine induced TEN which was confused with oral thrush, had no skin lesions on presentation, and had an excellent response to a 5 day course of methylprednisolone and high dose IVIG in combination. PMID:22207871

Diagnostic criteria for adverse health effects in the environs of wind turbines

PubMed Central

Krogh, Carmen ME

2014-01-01

Summary In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed. PMID:25383200

Prediction of sonic boom at a focus

NASA Technical Reports Server (NTRS)

Plotkin, K. J.; Cantril, J. M.

1976-01-01

The behavior of sonic boom at a focus has been reviewed for the purpose of extending present sonic boom computational methods to include focal zones. The geometry of a focal zone - whether a smooth caustic, a cusped caustic, or a perfect focus to a point - determines the character of focused signatures. The seeming contradiction of various experimental data can be resolved by noting these differences. A ray acoustic analysis has been developed for quantitative determination of caustic geometry. The only reliable theory presently available for signatures at a focus is for a smooth caustic. There has been some controversy between theoretical and experimental values of a constant in the scaling law for this case. It has been found that this discrepancy can be resolved by accounting for the finite thickness of real sonic boom shock waves. These findings have been incorporated into an existing sonic boom computer program.

Battling demons with medical authority: werewolves, physicians and rationalization.

PubMed

Metzger, Nadine

2013-09-01

Werewolves and physicians experienced their closest contact in the context of early modern witch and werewolf trials. For medical critics of the trials, melancholic diseases served as reference points for medical explanations of both individual cases and werewolf beliefs in general. This paper attempts to construct a conceptual history of werewolf beliefs and their respective medical responses. After differentiating the relevant terms, pre-modern werewolf concepts and medical lycanthropy are introduced. The early modern controversy between medical and demonological explanations forms the main part of this study. The history of werewolves and their medical explanations is then traced through to present times. An important point of discussion is to what extent the physicians' engagements with werewolves can be characterized as rationalization.

Contemporary high-profile scientists and their interactions with the community

NASA Astrophysics Data System (ADS)

Smith, Dorothy V.; Mulhall, Pamela J.; Hart, Christina E.; Gunstone, Richard F.

2016-07-01

This article presents a case study of 10 high-profile Australian research scientists. These scientists are highly committed to engaging with the public. They interact with a wide range of groups in the community, including the traditional media. They are aware that they are seen as representatives of science at a time when the authority of science and scientists is threatened in Australia by controversy around issues such as climate change and vaccination. Through their experiences of interacting with non-scientists, they have developed views about qualities, characteristics and knowledge that contribute to, or inhibit, positive interactions between scientists and non-scientists. Their experiences and insights highlight aspects of contemporary science that are not generally acknowledged in science curricula.

Battling demons with medical authority: werewolves, physicians and rationalization

PubMed Central

Metzger, Nadine

2014-01-01

Werewolves and physicians experienced their closest contact in the context of early modern witch and werewolf trials. For medical critics of the trials, melancholic diseases served as reference points for medical explanations of both individual cases and werewolf beliefs in general. This paper attempts to construct a conceptual history of werewolf beliefs and their respective medical responses. After differentiating the relevant terms, pre-modern werewolf concepts and medical lycanthropy are introduced. The early modern controversy between medical and demonological explanations forms the main part of this study. The history of werewolves and their medical explanations is then traced through to present times. An important point of discussion is to what extent the physicians’ engagements with werewolves can be characterized as rationalization. PMID:24573449

Endovascular Approach to Glomus Jugulare Tumors.

PubMed

Kocur, Damian; Ślusarczyk, Wojciech; Przybyłko, Nikodem; Hofman, Mariusz; Jamróz, Tomasz; Suszyński, Krzysztof; Baron, Jan; Kwiek, Stanisław

2017-01-01

Paragangliomas are benign neuroendocrine tumors derived from the glomus cells of the vegetative nervous system. Typically, they are located in the region of the jugular bulb and middle ear. The optimal management is controversial and can include surgical excision, stereotactic radiosurgery and embolization. We report the endovascular approach to three patients harboring glomus jugulare paragangliomas. In all cases incomplete occlusion of the lesions was achieved and recanalization in the follow-up period was revealed. Two patients presented no clinical improvement and the remaining one experienced a transient withdrawal of tinnitus. It is technically difficult to achieve complete obliteration of glomus jugulare tumors with the use of embolization and the subtotal occlusion poses a high risk of revascularization and is not beneficial in terms of alleviating clinical symptoms.

Surgical approach in treatment of translation/rotation injuries of the lower cervical spine in 21 patients.

PubMed

Llácer-Ortega, Jose L; Riesgo-Suárez, Pedro; Piquer-Belloch, Jose; Rovira-Lillo, Vicente

2012-05-01

The management of lower cervical spine injuries with a dislocation of one or both facet joints and a displacement of a vertebra over the adjacent stills generates considerable controversy. We describe our experience in surgical approach of these injuries. We present 21 cases treated between 2003-2010. Neurological status was evaluated with Frankel scale. Diagnosis was done by radiograph (XR), computed tomography (CT) and/or magnetic resonance image (MRI). Cervical traction was placed in 10 cases before surgery. Posterior and/or anterior approach was used for reduction and stabilization. The 21 cases presented were treated by surgery. Posterior approach was initially used in 17 cases and complete reduction was achieved in 13 of them. The 4 cases where we only got a partial reduction, surgery had to be delayed for different reasons. Anterior approach was initially used in 4 of the 21 cases. In 3 of them, reduction was previously obtained by traction and the fourth case anterior approach was used initially due to an important spinal cord compression. Permanent stabilization was achieved in 19 of the 21 cases. In 1 of the other 2 cases an important deformity was detected after the anterior approach. The other case had a minimal progression after a posterior approach with no increase in successive check-ups. In the first 10 cases, we used traction before surgery but reduction was achieved only in 3 of them. As the number of cases increased we rather used posterior approach in the first place, without even trying a preoperative traction. There was no case of neurological deterioration after surgery. Translation/rotation injuries of the lower cervical spine are unstable and surgical treatment must be indicated. It is our impression that posterior approach allows a better reduction and stabilization of this injuries and should be used initially without even trying a preoperative traction. Copyright © 2011 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

[On controversies around the Oedipus Complex].

PubMed

Drwiega, Marek

2002-01-01

In the article the author would like to draw the readers' attention to one of the central issues of psychoanalysis, i.e. Oedipus complex. In the development of the psychoanalysis the classical conception of Oedipus complex presented by Freud gave rise to a severe criticism both on the part of some psychoanalysts, especially women such as e.g. Melanie Klein, and on the part of ethnographers such as B. Malinowski. In the paper the author presents the main controversies concerning this interesting discussion. The fact of the matter is that the Oedipus complex is a hotly debated subject, not only from the cultural point of view but also within the psychoanalytical movement.

[Sampling in qualitative research: basic principles and some controversies].

PubMed

Martínez-Salgado, Carolina

2012-03-01

This paper presents the rationale for the choice of participants in qualitative research in contrast with that of probability sampling principles in epidemiological research. For a better understanding of the differences, concepts of nomothetic and ideographic generalizability, as well as those of transferability and reflexivity, are proposed, Fundamentals of the main types of sampling commonly used in qualitative research, and the meaning of the concept of saturation are mentioned. Finally, some reflections on the controversies that have arisen in recent years on various paradigmatic perspectives from which to conduct qualitative research, their possibilities of combination with epidemiological research, and some implications for the study of health issues are presented.

Three-dimensional wave-induced current model equations and radiation stresses

NASA Astrophysics Data System (ADS)

Xia, Hua-yong

2017-08-01

After the approach by Mellor (2003, 2008), the present paper reports on a repeated effort to derive the equations for three-dimensional wave-induced current. Via the vertical momentum equation and a proper coordinate transformation, the phase-averaged wave dynamic pressure is well treated, and a continuous and depth-dependent radiation stress tensor, rather than the controversial delta Dirac function at the surface shown in Mellor (2008), is provided. Besides, a phase-averaged vertical momentum flux over a sloping bottom is introduced. All the inconsistencies in Mellor (2003, 2008), pointed out by Ardhuin et al. (2008) and Bennis and Ardhuin (2011), are overcome in the presently revised equations. In a test case with a sloping sea bed, as shown in Ardhuin et al. (2008), the wave-driving forces derived in the present equations are in good balance, and no spurious vertical circulation occurs outside the surf zone, indicating that Airy's wave theory and the approach of Mellor (2003, 2008) are applicable for the derivation of the wave-induced current model.

Gastric necrosis secondary to strangulated giant paraesophic hiatal hernia.

PubMed

Díez Ares, José Ángel; Peris Tomás, Nuria; Estellés Vidagany, Nuria; Periáñez Gómez, Dolores

2016-08-01

Asymptomatic giant hiatal hernia comprises a relatively common disease, mostly presented in women with 50 years onwards. The therapeutic approach remains controversial in recent years. Under the latest SAGES`revision, all the symptomatic hernias must be repaired, but the symptomatic hiatal hernia definition isn`t even now established. We present the case os a A 67 - year old woman with an asymptomatic hiatal hernia, that is admitted to our hospital owing to toracic and abdominal pain. This pain was related with food intake for 6 months. The patient presents a clear worsening in the last 24 hours, with no other asociated symptomatology. Suspecting an incarcerated hiatal hernia with stomach perforation, the patient is taken to theatre for a laparotomy during the early hours. An atypic gastrectomy of the greater curvature with a gastropexy is performed with fixation to the anterior abdominal wall. The surgery is completed with a feeding jejunostomy. The Manegement of giant paraesophagic hernias, still remains as one of the challenge of the esophageal surgeons.

Sex, Kids, and Politics. Health Services in Schools.

ERIC Educational Resources Information Center

Emihovich, Catherine; Herrington, Carolyn D.

This book examines practical, cultural, and political implications of placing health service programs in public schools, detailing three cases of Florida school districts, where a controversial statewide initiative for health services in schools recently went into effect. The plan supports programs to promote the health of medically underserved…

Conflicting Expertise and Uncertainty: Quality Assurance in High-Level Radioactive Waste Management.

ERIC Educational Resources Information Center

Fitzgerald, Michael R.; McCabe, Amy Snyder

1991-01-01

Dynamics of a large, expensive, and controversial surface and underground evaluation of a radioactive waste management program at the Yucca Mountain power plant are reviewed. The use of private contractors in the quality assurance study complicates the evaluation. This case study illustrates high stakes evaluation problems. (SLD)

A Lasting Impact

ERIC Educational Resources Information Center

Dee, Thomas S.; Wyckoff, James

2017-01-01

Teachers matter--and some matter more than others. That recognition has driven a tidal wave of controversial policy reforms over the past decade, rooted in new evaluation systems that link teachers' ratings and, in some cases, their pay and advancement to evidence of classroom practice and student learning. Two out of three U.S. states overhauled…

The Serrano Problem: An Analysis of Equalization of Public School Support in California.

ERIC Educational Resources Information Center

Lindman, Erick L.

The Serrano case controversy raises the fundamental question: Do differences in school district per pupil expenditures represent cost differences incurred in providing essentially equivalent programs, or do they represent substantial differences in educational offerings? Although the answer is debatable, the California legislature increased…

Mobil's Advertorials: A Case Study in Advocacy Ads.

ERIC Educational Resources Information Center

Bowman, Camille

Mobil Oil's program of "advertorials," or company stances on controversial issues appearing in principal print media, has had several significant results since its inception in 1970. The professed reasons for this campaign were to give the company itself more visibility and to stir up discussion on issues affecting the public. The…

Preventing Youth Pregnancy: Dialogue and Deliberation in a Science Museum Exhibit

ERIC Educational Resources Information Center

Navas-Iannini, Ana Maria; Pedretti, Erminia

2017-01-01

In this article, we explore how visitors engage with a science museum exhibit that displays controversial topics. Through a case study methodology, we focus on the Brazilian exhibit "Preventing Youth Pregnancy" that delves into teen pregnancy, sexual practices, and sexually transmitted diseases. Using the lens of science communication…

Legal Challenges to Single-Sex Colleges Expected to Spread.

ERIC Educational Resources Information Center

Jaschik, Scott

1990-01-01

Court cases arising out of the current legal and political controversy over the Virginia Military Institute's policy of admitting only men are examined as they apply to the nation's three other publicly supported single-sex colleges: the Citadel (South Carolina), Mississippi University for Women, and Texas Woman's University. (DB)

Chronic Fatigue Syndrome: How Vulnerable Are Athletes?

ERIC Educational Resources Information Center

Eichner, Edward R.

1989-01-01

Discusses chronic fatigue syndrome as it affects elite athletes, noting that overtraining may mimic it. In some cases, athletes who have it perform exceedingly well in the face of debilitating fatigue. Among athletes and nonathletes, the cause and the mind-body connection are areas of controversy and research. (Author/SM)

Using Controversial Mock Trials in "Psychology and Law" Courses: Suggestions from Participants.

ERIC Educational Resources Information Center

Werth, James L., Jr.; Harvey, James; McNamara, Rebecca; Svoboda, Andrea; Gulbrandson, Raina; Hendren, Jennifer; Greedy, Tiffany; Leybold, Christie

2002-01-01

Describes a mock trial focused on Jack Kevorkian and an euthanasia case that was included in a psychology and law course. Discusses the course format, provides the reactions to the mock trial by students and consultants, and includes suggestions for improving the mock trial. (CMK)

Medicine, Rhetoric, and Euthanasia: A Case Study in the Workings of a Postmodern Discourse.

ERIC Educational Resources Information Center

Hyde, Michael J.

1993-01-01

Offers a critical reading of a controversial narrative on euthanasia that appeared in the "Journal of the American Medical Association," paying particular attention to what the narrative is doing rhetorically. Suggests the narrative is addressing topic and readers in a postmodern manner. (SR)

Just Talk? Discourses and Deinstitutionalization in School District Policy Making

ERIC Educational Resources Information Center

Spain, Angeline K.

2017-01-01

Extracurricular programs, which tend to be both highly institutionalized and popular with parents, were hard hit by cutbacks during the Great Recession. This study uses conceptual research on organizational routines and institutional processes to examine this case of controversial policy making. Observing school district policy making in two…

75 FR 53544 - Procedures for the Handling of Retaliation Complaints Under the Employee Protection Provision of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... have jurisdiction over the action without regard to the amount in controversy and that the case will be..., the agency will redact them in accordance with the Privacy Act of 1974, 5 U.S.C. 552a, et seq., and...

Curriculum and the Constitution. Issuegram 34.

ERIC Educational Resources Information Center

Lines, Patricia M.

The United States Supreme Court has to date decided four major cases dealing with curricula or the rights of students. The Court (1) declared unconstitutional a law that prohibited instruction in evolutionary theory, (2) upheld the right of students in school to express their views on controversial subjects, (3) extended protection under the…

Power, Consent, and Adolescent Sexual Harassment.

ERIC Educational Resources Information Center

Chamberlain, Elizabeth

This paper reviews the literature and case law related to the issue of sexual harassment of females and specifically focuses on the adolescent female in the public middle school setting. The controversial thesis statement the researcher explored was: "sexual harassment is a manifestation of the ubiquitous power imbalance between men and women…

"Too Asian?" On Racism, Paradox and Ethno-Nationalism

ERIC Educational Resources Information Center

Coloma, Roland Sintos

2013-01-01

This essay examines the controversial "Too Asian?" article published by Canada's premiere news magazine in 2010 as a case study of media and education in order to produce a sharper analytical grammar of race in liberal, multicultural societies. I argue that the article recycles racial stereotypes, perpetuates the normalization of…

The Legal Aspects of Student Discipline in Higher Education.

ERIC Educational Resources Information Center

Young, D. Parker

The proliferation of court cases involving student discipline testifies to controversy over administrative procedures. Generally, a college's disciplinary policy is viewed as part of the learning process. Courts in the past have ruled favorably on the contractual theory which decrees that an entering student agrees to abide by certain university…

Playful biometrics: controversial technology through the lens of play.

PubMed

Ellerbrok, Ariane

2011-01-01

This article considers the role of play in the context of technological emergence and expansion, particularly as it relates to recently emerging surveillance technologies. As a case study, I consider the trajectory of automated face recognition—a biometric technology of numerous applications, from its more controversial manifestations under the rubric of national security to a clearly emerging orientation toward play. This shift toward “playful” biometrics—or from a technology traditionally coded as “hard” to one now increasingly coded as “soft”—is critical insofar as it renders problematic the traditional modes of critique that have, up until this point, challenged the expansion of biometric systems into increasingly ubiquitous realms of everyday life. In response to this dynamic, I propose theorizing the expansion of face recognition specifically in relation to “play,” a step that allows us to broaden the critical space around newly emerging playful biometrics, as well as playful surveillance more generally. In addition, play may also have relevance for theorizing other forms of controversial technology, particularly given its potential role in processes of obfuscation, normalization, and marginalization.

[Post-traumatic stress disorder and psychological debriefing: a controversial topic].

PubMed

Debabèche, C; Ansseau, M; Pitchot, W

2012-01-01

The last decades have demonstrated the value of early interventions after a traumatic event. The purpose of these interventions is to prevent the development of psychological consequences such as post-traumatic stress disorder. Psychological debriefing is clearly the most popular intervention. However, in the literature, it is subject to a real controversy. The objective of the present paper is to define the interest of psychological debriefing, but also alternative therapeutical strategies for people exposed to traumatic events.

Juvenile Rape Victims. Hearing before the Subcommittee on Juvenile Justice of the Committee on the Judiciary. On the Problems of Juvenile Victims in Sexual Assault Cases. United States Senate, Ninety-Ninth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on the Judiciary.

This document provides witness testimonies and prepared statements from the Congressional hearing called to consider the problems of juvenile victims in sexual assault cases. Opening statements are given by Senators Arlen Specter, Paul Simon, and Mitch McConnell. The recent controversy concerning the rape conviction of Gary Dotson and the…

A rare case of palatin tonsillar metastasis from small cell lung cancer

PubMed Central

D’Antonio, Chiara; Lombardini, Alberto; Falcone, Rosa; Romiti, Adriana; Lombardi, Marianna; Lauro, Salvatore; Marchetti, Paolo

2016-01-01

Tonsillar metastases are absolutely rare. Small cell lung cancer (SCLC) is known to be the most frequent histological type of tonsillar metastases, however the way of tumor cells spreading to tonsil remains controversial. We described a case report of 76-year-old man with SCLC and tonsillar metastases, to highlight the importance of oral cavity evaluation as a part of a clinical exam and to show the rare tumor cells spreading. PMID:28149765

Effectiveness of leukocyte immunotherapy in primary recurrent spontaneous abortion (RSA).

PubMed

Gharesi-Fard, Behrouz; Zolghadri, Jaleh; Foroughinia, Leila; Tavazoo, Fahimeh; Samsami Dehaghani, Alamtaj

2007-09-01

Recurrent spontaneous abortion (RSA) is defined as three or more sequential abortions before the twentieth week of gestation. There are evidences to support an allo-immunologic mechanism for RSA. One of the methods for treatment of RSA is leukocyte therapy; however there is still controversy about effectiveness of this method. To evaluate the effectiveness of leukocyte therapy for treatment of RSA. Ninety two non-pregnant women with at least three sequential abortions (60 primary & 32 secondary aborters) recognized as RSA were referred to our Laboratory for immunotherapy. All the cases were immunized by isolated lymphocytes from their husbands. Fifty to 100 million washed and resuspended mononuclear cells were injected by I.V., S.C., and I.D. route. The result of each injection was checked by WBC cross matching between couples after four weeks of injections. Immunization was repeated in fifth week to a maximum of 3 times if needed. Eighty one age-matched non-pregnant RSA women (52 primary and 29 secondary aborters) with at least three sequential abortions were also included in this study as controls. The control group was not immunized. 67 out of 92 (72.8%) immunized cases and 44 out of 81 controls (54.3%) showed a successful outcome of pregnancy (p<0.02). Comparison of primary and secondary aborters indicated a significantly better outcome only in primary (75% vs. 42.3%. p<0.001) but not in secondary aborters (68.8% vs. 75.9%, p = 0.7). The present investigation showed the effectiveness of leukocyte therapy in primary but not in secondary RSA patients. Despite the current controversy and limitation of leukocyte therapy in RSA, the results of our investigation provide evidence supporting the use of allo-immunization in improving the outcome of pregnancy in primary RSA patients.

[Management of synchronous colorectal liver metastases].

PubMed

Dupré, Aurélien; Gagnière, Johan; Chen, Yao; Rivoire, Michel

2013-04-01

At time of diagnosis, 10 to 25% of patients with colorectal cancer present synchronous liver metastases. The treatment of such patients remains controversial without any evidence based organization. Therapeutic sequences are discussed including chemotherapy, colorectal surgery, liver resection and even radio-chemotherapy for some rectal cancers. In case of resectable liver metastases, preoperative chemotherapy offers the advantage of earlier treatment of micro-metastases as well as evaluation of tumor responsiveness, which can help shape future therapy. In this setting, different surgical strategies can be chosen (classical staged procedures with colorectal surgery followed by liver surgery, simultaneous resections or liver first approach) depending on the importance of the primary and metastatic tumors. The literature remains limited, but the results of these strategies seem identical in term of postoperative morbidity and long-term survival. Staged procedures are preferred in case of major liver resection. Location of the primary tumor on the low or mid rectum will necessitate preoperative long course chemoradiotherapy and a more complex multidisciplinary organization. For patients with extensive liver metastases, non-resectability must be assessed by experienced surgeon and radiologist before treatment and during chemotherapy. In this group of patients, improved chemotherapy regimen associated with targeted therapies and new surgical strategies (portal vein embolization, ablation, staged hepatectomies…) have improved resection rate (15 to 30-40%) and long-term survival. Treatment organization for the primary tumor remains controversial. Resection of the primary to manage symptoms such as obstruction, perforation or bleeding is advocated. For patients with asymptomatic primary a non-surgical approach permits to begin rapidly chemotherapy and obtain a better control of the disease. On the other hand, initial resection of the primary may avoid complications and the need for urgent surgical procedures. Both of these strategies are practiced without definitive evidence supporting one treatment option over the other.

A challenging case of an ectopic parathyroid adenoma.

PubMed

Panchani, Roopal; Varma, Tarun; Goyal, Ashutosh; Gupta, Nitinranjan; Saini, Ashish; Tripathi, Sudhir

2012-12-01

The occurrence of ectopic parathyroid adenomas is not uncommon (3-4% of all parathyroid adenomas). A 42-year-old female diagnosed as having GH secreting pituitary adenoma presented with an ectopic mediastinal parathyroid adenoma located between left (Lt) pulmonary artery and Lt main bronchus. The aim of presenting this case is not to appreciate the rarity of the condition but to rather discuss some of the vital practical problems faced during its management. Patient presenting in endocrine OPD with nausea, vomiting, drowsiness and chronic constipation was investigated biochemically and with various imaging modalities and accordingly managed. Patient was also investigated from the perspective of MEN 1 syndrome. Baseline routine investigations revealed hypercalcemia (corrected S. Ca- 16.9 mg/dl) due to primary hyperparathyroidism (PHP, PTH-1190 ng/L) with adenoma located between Lt main bronchus and Lt pulmonary artery. Patient was medically managed and after proper preoperative preparation, surgical excision by open thoracotomy was planned but two days before surgery she developed pulmonary embolism and was shifted to ICU where she died after 20 days. An accurate preoperative localization by various imaging procedures plays a decisive role in case of ectopic adenomas in the chest. Ectopic parathyroid adenomas are frequent cause of failed initial surgery. The best surgical approach to these ectopic adenomas is still controversial. Equally effective newer medical treatment modalities are also required in patients who are awaiting or are unfit for surgery. Lastly combination of MEN 1 with ectopic parathyroid adenoma is rare.

Sterilization as last resort in women with intellectual disabilities: protection or disservice?

PubMed

Insogna, Iris; Fiester, Autumn

2015-01-01

The legacy of the eugenics movement in the United States, including the involuntary sterilization of those deemed unfit to reproduce, has created a profound backlash against sterilization among certain populations. Particularly in treating women with intellectual disabilities, the field of obstetrics and gynecology has widely adopted an antisterilization stance. When treating women with intellectual disabilities, sterilization is generally considered a last resort. This essay revisits the issue of sterilization in women with intellectual disabilities, asking whether the field's stance of sterilization as a last resort is best viewed as a protection of this vulnerable population or one that actually does significant harm. We use a hypothetical but realistic patient case to examine the potential risks and benefits of sterilization. After reviewing the arguments against sterilization as a first-line treatment, we defend the controversial position that, in some cases, sterilization should be presented as an equally legitimate choice to reversible contraceptives. Copyright © 2015 Elsevier Inc. All rights reserved.

Vertical parasagittal hemispherotomy for Sturge-Weber syndrome in early infancy: case report and literature review.

PubMed

Liu, Xiangyu; Otsuki, Taisuke; Takahashi, Akio; Kaido, Takanobu

2016-01-01

The authors here present a rare case of a 3-month-old infant with unilateral Sturge-Weber syndrome (SWS) who had excellent seizure control and no aggravation of previous existed neurological deficits after vertical parasagittal hemispherotomy (VPH). To our knowledge, this patient with SWS was the youngest one who received VPH. The use of VPH results in a successful treatment of intractable epilepsy in a patient with seizure onset in early infancy. At follow-up, the patient's neurodevelopmental status has been improved since the surgery. It is generally accepted that early-onset seizures in children with SWS are associated with worse neurological and developmental outcomes. However, when surgical treatment should be considered and how it should be performed remain a longstanding controversy. We promote early surgery in children with SWS and early-onset epilepsy. We suggest that VPH may be a useful adjuvant in the management of SWS with refractory epilepsy in early infancy and this procedure carries low neurological risk.

A Case Study in Ethical Decision Making Regarding Remote Mitigation of Botnets

NASA Astrophysics Data System (ADS)

Dittrich, David; Leder, Felix; Werner, Tillmann

It is becoming more common for researchers to find themselves in a position of being able to take over control of a malicious botnet. If this happens, should they use this knowledge to clean up all the infected hosts? How would this affect not only the owners and operators of the zombie computers, but also other researchers, law enforcement agents serving justice, or even the criminals themselves? What dire circumstances would change the calculus about what is or is not appropriate action to take? We review two case studies of long-lived malicious botnets that present serious challenges to researchers and responders and use them to illuminate many ethical issues regarding aggressive mitigation. We make no judgments about the questions raised, instead laying out the pros and cons of possible choices and allowing workshop attendees to consider how and where they would draw lines. By this, we hope to expose where there is clear community consensus as well as where controversy or uncertainty exists.

Severe Henoch-Schönlein purpura with infliximab for ulcerative colitis.

PubMed

Song, Yang; Shi, Yan-Hong; He, Chong; Liu, Chang-Qin; Wang, Jun-Shan; Zhao, Yu-Jie; Guo, Yan-Min; Wu, Rui-Jin; Feng, Xiao-Yue; Liu, Zhan-Ju

2015-05-21

Infliximab (IFX) is an anti-tumor necrosis factor chimeric antibody that is effective for treatment of autoimmune disorders such as Crohn's disease and ulcerative colitis (UC). IFX is well tolerated with a low incidence of adverse effects such as infections, skin reactions, autoimmunity, and malignancy. Dermatological manifestations can appear as infusion reaction, vasculitis, cutaneous infections, psoriasis, eczema, and skin cancer. Here, we present an unusual case of extensive and sporadic subcutaneous ecchymosis in a 69-year-old woman with severe UC, partial colectomy and cecostomy, following her initial dose of IFX. The reaction occurred during infliximab infusion, and withdrawal of IFX led to gradual alleviation of her symptoms. We concluded that Henoch-Schönlein purpura, a kind of leukocytoclastic vasculitis, might have contributed to the development of the bruising. Although the precise mechanisms of the vasculitis are still controversial, such a case highlights the importance of subcutaneous adverse effects in the management of UC with IFX.

Anders Breivik: Extreme Beliefs Mistaken for Psychosis.

PubMed

Rahman, Tahir; Resnick, Phillip J; Harry, Bruce

2016-03-01

The case of Anders Breivik, who committed mass murder in Norway in 2011, stirred controversy among forensic mental health experts. His bizarrely composed compendium and references to himself as the "Knights Templar" raised concerns that he had a psychotic mental illness. Beliefs such as Mr. Breivik's that precede odd, unusual, or extremely violent behavior present a unique challenge to the forensic evaluator, who sometimes struggles to understand those beliefs. Psychotic disorder frequently is invoked to characterize odd, unusual, or extreme beliefs, with a classification that has evolved over time. However, the important concept of overvalued idea, largely ignored in American psychiatry, may better characterize these beliefs in some cases. We discuss the definitions of delusion and overvalued ideas in the context of Anders Breivik's rigidly held extreme beliefs. We also review the British definition of overvalued idea and discuss McHugh's construct, to introduce the term "extreme overvalued belief" as an aid in sharpening the forensic evaluator's conceptualization of these and similar beliefs. © 2016 American Academy of Psychiatry and the Law.

Adenoid Cystic Carcinoma of the Breast: A Clinical Case Report.

PubMed

Kocaay, Akin Firat; Celik, Suleyman Utku; Hesimov, Ilkin; Eker, Tevfik; Percinel, Sibel; Demirer, Seher

2016-10-01

Adenoid cystic carcinoma (ACC) is an uncommon tumor of the breast, accounting for approximately 0.1% to 1% of all breast cancers. It is characterized by rare lymph node involvement and distant metastasis, and associated with a favorable prognosis with excellent survival, despite its triple-negative status. In the current state of knowledge, results of breast-conserving treatment with postoperative radiotherapy seem to be equivalent to mastectomy alone, with respect to survival for ACC of the breast. Due to its rarity, there is no consensus on optimal treatment for patients with ACC. Otherwise, the role of chemotherapy and hormonal therapy remains controversial. Further clinical studies are required to compare treatment options for ACC. But, a long-term follow-up is very important and mandatory for affected patients, due to the late onset of local relapse and occurrence of distant metastasis. Here, we report the case of a patient who presented with a palpable breast mass in the left breast that turned out to be an ACC of the breast.

Systematic review of sensory integration therapy for individuals with disabilities: Single case design studies.

PubMed

Leong, H M; Carter, Mark; Stephenson, Jennifer

2015-12-01

Sensory integration therapy (SIT) is a controversial intervention that is widely used for people with disabilities. Systematic analysis was conducted on the outcomes of 17 single case design studies on sensory integration therapy for people with, or at-risk of, a developmental or learning disability, disorder or delay. An assessment of the quality of methodology of the studies found most used weak designs and poor methodology, with a tendency for higher quality studies to produce negative results. Based on limited comparative evidence, functional analysis-based interventions for challenging behavior were more effective that SIT. Overall the studies do not provide convincing evidence for the efficacy of sensory integration therapy. Given the findings of the present review and other recent analyses it is advised that the use of SIT be limited to experimental contexts. Issues with the studies and possible improvements for future research are discussed including the need to employ designs that allow for adequate demonstration of experimental control. Copyright © 2015 Elsevier Ltd. All rights reserved.

Primary mucosal sinonasal melanoma—Case report and review of the literature. The role of complex treatment-surgery and adjuvant radiotherapy

PubMed Central

Marinova, Lena; Yordanov, Kaloyan; Sapundgiev, Nikolay

2010-01-01

Aim The place of adjuvant radiotherapy in the treatment of sinonasal melanoma. Background Sinonasal mucosal melanoma is a rare disease with poor prognosis and requires a complex treatment. Elective neck dissection in patients with N0 and adjuvant radiotherapy has been a source of controversy. High late regional recurrence rates rise questions about elective irradiation of the neck nodes in patients with N0 stage disease. Methods We present our two years’ follow up in a case of locally advanced sinonasal melanoma and literature review of the treatment options for mucosal melanoma. Results In locally advanced sinonasal melanoma treated with surgical resection, postoperative radiotherapy and chemotherapy we had local tumor control. Two years later, a regional contralateral recurrence without distant metastasis occurred. Conclusions Literature data for frequent neck lymph nodes recurrences justify elective neck dissection. Postoperative elective neck radiotherapy for patients with locally advanced sinonasal melanoma and clinically N0 appears to decrease the rate of late regional recurrences. PMID:24376954

Fiber-reinforced resin coating for endocrown preparations: a technical report.

PubMed

Rocca, G T; Rizcalla, N; Krejci, I

2013-01-01

Coronal rehabilitation of endodontically treated posterior teeth is still a controversial issue. Although the use of classical crowns supported by radicular metal posts remains widespread in dentistry, their invasiveness has been largely criticized. New materials and therapeutic options based entirely on adhesion are available nowadays, from direct composite resins to indirect endocrowns. They allow for a more conservative, faster, and less expensive dental treatment. However, the absence of a metal or high-strength ceramic substructure as in full-crown restorations can expose this kind of restoration to a higher risk of irreversible fracture in case of crack propagation. The aim of this case report is to present a technique to reinforce the cavity of an endodontically treated tooth by incorporating a fiber-reinforced composite (FRC) layer into the resin coating of the tooth preparation, before the final impressions of the cavity. This technique allows the use of FRCs in combination with any kind of restorative material for an adhesive overlay/endocrown.

Quantifying the impact of community quarantine on SARS transmission in Ontario: estimation of secondary case count difference and number needed to quarantine.

PubMed

Bondy, Susan J; Russell, Margaret L; Laflèche, Julie Ml; Rea, Elizabeth

2009-12-24

Community quarantine is controversial, and the decision to use and prepare for it should be informed by specific quantitative evidence of benefit. Case-study reports on 2002-2004 SARS outbreaks have discussed the role of quarantine in the community in transmission. However, this literature has not yielded quantitative estimates of the reduction in secondary cases attributable to quarantine as would be seen in other areas of health policy and cost-effectiveness analysis. Using data from the 2003 Ontario, Canada, SARS outbreak, two novel expressions for the impact of quarantine are presented. Secondary Case Count Difference (SCCD) reflects reduction in the average number of transmissions arising from a SARS case in quarantine, relative to not in quarantine, at onset of symptoms. SCCD was estimated using Poisson and negative binomial regression models (with identity link function) comparing the number of secondary cases to each index case for quarantine relative to non-quarantined index cases. The inverse of this statistic is proposed as the number needed to quarantine (NNQ) to prevent one additional secondary transmission. Our estimated SCCD was 0.133 fewer secondary cases per quarantined versus non-quarantined index case; and a NNQ of 7.5 exposed individuals to be placed in community quarantine to prevent one additional case of transmission in the community. This analysis suggests quarantine can be an effective preventive measure, although these estimates lack statistical precision. Relative to other health policy areas, literature on quarantine tends to lack in quantitative expressions of effectiveness, or agreement on how best to report differences in outcomes attributable to control measure. We hope to further this discussion through presentation of means to calculate and express the impact of population control measures. The study of quarantine effectiveness presents several methodological and statistical challenges. Further research and discussion are needed to understand the costs and benefits of enacting quarantine, and this includes a discussion of how quantitative benefit should be communicated to decision-makers and the public, and evaluated.

Quantifying the impact of community quarantine on SARS transmission in Ontario: estimation of secondary case count difference and number needed to quarantine

PubMed Central

2009-01-01

Background Community quarantine is controversial, and the decision to use and prepare for it should be informed by specific quantitative evidence of benefit. Case-study reports on 2002-2004 SARS outbreaks have discussed the role of quarantine in the community in transmission. However, this literature has not yielded quantitative estimates of the reduction in secondary cases attributable to quarantine as would be seen in other areas of health policy and cost-effectiveness analysis. Methods Using data from the 2003 Ontario, Canada, SARS outbreak, two novel expressions for the impact of quarantine are presented. Secondary Case Count Difference (SCCD) reflects reduction in the average number of transmissions arising from a SARS case in quarantine, relative to not in quarantine, at onset of symptoms. SCCD was estimated using Poisson and negative binomial regression models (with identity link function) comparing the number of secondary cases to each index case for quarantine relative to non-quarantined index cases. The inverse of this statistic is proposed as the number needed to quarantine (NNQ) to prevent one additional secondary transmission. Results Our estimated SCCD was 0.133 fewer secondary cases per quarantined versus non-quarantined index case; and a NNQ of 7.5 exposed individuals to be placed in community quarantine to prevent one additional case of transmission in the community. This analysis suggests quarantine can be an effective preventive measure, although these estimates lack statistical precision. Conclusions Relative to other health policy areas, literature on quarantine tends to lack in quantitative expressions of effectiveness, or agreement on how best to report differences in outcomes attributable to control measure. We hope to further this discussion through presentation of means to calculate and express the impact of population control measures. The study of quarantine effectiveness presents several methodological and statistical challenges. Further research and discussion are needed to understand the costs and benefits of enacting quarantine, and this includes a discussion of how quantitative benefit should be communicated to decision-makers and the public, and evaluated. PMID:20034405

[Delayed neurological syndrome after CO intoxication of elderly female].

PubMed

Vander Weyden, Liesbeth; Voigt, Roxana-Maria; Boonen, Steven; Fagard, Katleen; Dejaeger, Eddy

2015-10-01

This article discusses the case history of an 87-year old woman with loss of consciousness following accidental CO intoxication. A few weeks later, the patient's cognitive abilities progressively deteriorated. This is hence a case of Delayed Neurological Symptoms after CO intoxication. This condition occurs in 40% of patients with CO intoxication and manifests itself 3-240 days after apparent recovery. Symptoms can linger for a long time and are in some cases even permanent. Treatment of CO intoxication usually consists of administering normobaric oxygen and in certain cases hyperbaric oxygen. The role of treatment with hyberbaric oxygen in delayed neurological symptoms after CO intoxication remains controversial, however.

Craniopharyngioma arising in a Rathke's cleft cyst: case report.

PubMed

Alomari, Ahmed K; Kelley, Brian J; Damisah, Eyiyemisi; Marks, Asher; Hui, Pei; DiLuna, Michael; Vortmeyer, Alexander

2015-03-01

Craniopharyngioma is one of the most common non-glial intracranial tumors of childhood. Its relation to Rathke's cleft cyst (RCC) is controversial, and both lesions have been hypothesized to lie on a continuum of cystic ectodermal lesions of the sellar region. The authors report on a 7-year-old boy who presented with decreased visual acuity, presumably of at least 2 years' duration, and was found to have a 5.2-cm sellar lesion with rim enhancement. Histological examination of the resected lesion showed a mixture of areas with simple RCC morphology with focal squamous metaplasia and areas with typical craniopharyngioma morphology. Immunohistochemical staining with CK20 and Ki 67 differentially highlighted the 2 morphological components. Testing for beta-catenin and BRAF mutations was negative in the craniopharyngioma component, precluding definitive molecular classification. Follow-up imaging showed minimal residual enhancement and the patient will be closely followed up with serial MRI. Given the clinical and histological findings in the case, a progressive transformation of the RCC to craniopharyngioma seems to be the most plausible explanation for the co-occurrence of the 2 lesion types in this patient. An extensive review of previously proposed theories of the relationship between craniopharyngioma and RCC is also presented.

Virtual Planning of a Complex Three-Part Bimaxillary Osteotomy

PubMed Central

Anghinoni, Marilena Laura

2017-01-01

In maxillofacial surgery, every patient presents special problems requiring careful evaluation. Conventional methods to study the deformities are still reliable, but the advent of tridimensional (3D) imaging, especially computed tomography (CT) scan and laser scanning of casts, created the opportunity to better understanding the skeletal support and the soft tissue structures. Nowadays, virtual technologies are increasingly employed in maxillofacial surgery and demonstrated precision and reliability. However, in complex surgical procedures, these new technologies are still controversial. Especially in the less frequent cases of three-part maxillary surgery, the experience is limited, and scientific literature cannot give a clear support. This paper presents the case of a young patient affected by a complex long face dentofacial deformity treated by a bimaxillary surgery with three-part segmentation of the maxilla. The operator performed the surgical study completely with a virtual workflow. Pre- and postoperative CT scan and optical scanning of plaster models were collected and compared. Every postoperatory maxillary piece was superimposed with the presurgical one, and the differences were examined in a color-coded map. Only mild differences were found near the osteotomy lines, when the bony surface and the teeth demonstrated an excellent coincidence. PMID:29318057

The case for physician assisted suicide: how can it possibly be proven?

PubMed Central

Dahl, E; Levy, N

2006-01-01

In her paper, The case for physician assisted suicide: not (yet) proven, Bonnie Steinbock argues that the experience with Oregon's Death with Dignity Act fails to demonstrate that the benefits of legalising physician assisted suicide outweigh its risks. Given that her verdict is based on a small number of highly controversial cases that will most likely occur under any regime of legally implemented safeguards, she renders it virtually impossible to prove the case for physician assisted suicide. In this brief paper, we suggest some ways that may enable us to weigh the risks and benefits of legalisation more fairly and, hopefully, allow us to close the case for physician assisted suicide. PMID:16731731

Effect of Periodontal Disease on Preeclampsia

PubMed Central

Sayar, F; Hoseini, M Sadat; Abbaspour, S

2011-01-01

Background: A lot of studies have shown periodontal diseases as a risk factor for adverse pregnancy outcomes. The association between periodontitis and preeclampsia has been studied recently with controversy. Considering the importance of preventing preeclampsia as a dangerous and life-threatening disease in pregnant women, the present study was carried out. Methods: Two hundred and ten pregnant women participated in this case-control study (105 controls & 105 cases) during years 2007 and 2008. Preeclamptic cases were defined as blood pressure ≥140/90mmHg and proteinuria +1. Control group were pregnant women with normal blood pressure without proteinuria. Both groups were examined during 48 hours after child delivery. Plaque Index (PLI), Pocket Depth (PD), Clinical Attachment Level (CAL), Bleeding On Probing (BOP), Gingival Recession (GR) were measured on all teeth except for third molars and recorded as periodontal examination. Data was analyzed using t-test, chi-square, and Mann-Whitney U statistical tests. Results: There was no significant difference between the two study groups for PD. CAL, GR, BOP significantly increased in the case group (P< 0.02). This study showed that preeclamptic cases were more likely to develop periodontal disease (P< 0.0001). Eighty three percent of the control group and 95% of the case group had periodontal disease (P< 0.005) which had shown that preeclamptic cases were 4.1 times more likely to have periodontal disease (OR= 4.1). Conclusion: Preeclamptic cases significantly had higher attachment loss and gingival recession than the control group. PMID:23113094

Component separation of abdominal wall with intraoperative botulinum A presents satisfactory outcomes in large incisional hernias: a case report.

PubMed

Oliveira, Lucas Torres; Essu, Felipe Futema; de Mesquita, Gustavo Heluani Antunes; Jardim, Yuri Justi; Iuamoto, Leandro Ryuchi; Suguita, Fábio Yuji; Martines, Diego Ramos; Nii, Fernanda; Waisberg, Daniel Reis; Meyer, Alberto; Andraus, Wellington; D'Albuquerque, Luiz Augusto Carneiro

2017-01-01

Transplantation patients have a series of associated risk factors that make appearance of incisional hernia (IH) more likely. A number of aspects of the closure of large defects remain controversial. In this manuscript, we present the repair of a large IH following liver transplantation through the technique of posterior components separation combined with the anterior, together with the intraoperative use of botulinum toxin A and the placement of mesh. As a secondary objective, we analyze the incidence of IH following liver transplantation in our service. Between the years 2013 and 2016, 247 patients underwent liver transplantation in the Liver Transplantation Service at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. We analyzed the incidence of IH in these patients. One of these cases operated in March 2017 presented a defect in the abdominal wall of 22×16.6×6.4cm in the median and paramedian regions. We present the details of this innovative surgical technique. The total operating time was 470min. During the postoperative phase the patient presented ileus paralysis, without systemic repercussions. Resumption of an oral diet on the fifth postoperative day, without incident. Hospital discharge occurred on the 12th postoperative day, with outpatient follow up. In our service, the incidence of incisional hernias following liver transplantation is 14.5%. We described a successful approach for selected patient group for whom there is no established standard treatment. Given the complexity of such cases, however, more studies are necessary. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

[3rd and 4th generation estroprogestatives French controversy: What effect on women's behavior?].

PubMed

Torres, Luis; Frapard, Christian; Daumas, Aurélie; Guibert, Nicolas; Lagouanelle-Simeoni, Marie-Claude; Rakoto, Jean-Claude; Villani, Patrick; Sambuc, Roland

2016-04-01

The primary objective of this study was to determine the reasons given by women who have changed or suspended their contraceptive method in 2013. What influence had the 3rd and 4th generation estroprogestatives (EP) French controversy and advices from doctors? Did they notice any consequences of the controversy on their lifestyle? Did they feel an impact on their behavior to health professionals? A study was conducted on women of childbearing age. Data collection took place between November 4 and December 16, 2013. The included subjects were between 18 and 55 years old females. Subjects were surveyed through an anonymous self-administered questionnaire distributed through pharmacies. The protocol called for the construction of clusters of subjects by having heard about, or not, of the controversy. Patients reporting having heard about the controversy have formed the "exposed" group while the others have formed the "unexposed" group. We compared two parameters between these two groups: the rate of subjects who reported having modified or suspended their contraceptive method in 2013 on one hand, and the rate of subjects who reported having made a change in their contraceptive method without or against advices from a doctor on the other hand. The sample included 988 subjects. The average age was 34 years. The level of exposure to media debates was 86.5%. Of the respondents, 19.8% were under 3rd or 4th generation EP in 2012, thus directly involved in the discussions and affected by health recommendations. Of the patients, 38.5% reported having changed their contraception in 2013. In these women, when they confirmed having heard about the controversy, 40.1% of them claimed to have conducted this process without or against advices from a doctor. This number dropped to 18.2% for those who had not heard of it. Media coverage of the 3rd and 4th generation EP vascular risk was not mentioned more by patients who suspended all medical contraceptive method than it was by patients who simply changed their method. In all, 52.1% of women who completely stopped their contraception indicated that this choice was at least partly due to a change in their sexuality or reproductive life. This reason was evoked only in 19.0% of women who have simply made a change of contraceptive method. Among the views of women, the EP controversy was one of the reasons for a change of contraception method in 41.8% of cases, while advices from a doctor did play a role in 19.9% of cases. One has seen a decline of 11.0% of oral contraception between 2012 and 2013, almost superimposed on that of oral 3rd and 4th generation EP (10.6%). However, the use of 1st and 2nd generation EP stagnated: their increase was 0.4%. Beyond any change of contraceptive method, 66.9% of women expressed the absence of any impact of the controversy on their behavior. Of the women, 6.1% showed a loss of confidence in health professionals. We have shown how patients who stopped or modified their contraception method during 2013 placed the controversy influence in the forefront of the reasons for their decision. Although a medical reason has been widely quoted, only one in five felt that the advice of her doctor had clearly contributed to her choice. The influence of the media seemed to encroach on the doctor-patient relationship, which is fundamental to the quality of healthcare in the long term. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

HYPNOSIS IN THE TREATMENT OF MORGELLONS DISEASE: A Case Study1

PubMed Central

Gartner, Ashley M.; Dolan, Sara L.; Stanford, Matthew S.; Elkins, Gary R.

2014-01-01

Morgellons Disease is a condition involving painful skin lesions, fibrous growths protruding from the skin, and subcutaneous stinging and burning sensations, along with symptoms of anxiety, depression, fatigue, and memory and attention deficits. The etiological and physiological bases of these symptoms are unclear, making the diagnosis controversial and challenging to treat. There are currently no established treatments for Morgellons Disease. The following case example depicts treatment of a woman with Morgellons Disease using hypnotherapy. Data from this case example suggest that hypnotherapy is a promising intervention for the physical and psychological symptoms associated with Morgellons Disease. PMID:21390982

Hypnosis in the treatment of Morgellons disease: a case study.

PubMed

Gartner, Ashley M; Dolan, Sara L; Stanford, Matthew S; Elkins, Gary R

2011-04-01

Morgellons Disease is a condition involving painful skin lesions, fibrous growths protruding from the skin, and subcutaneous stinging and burning sensations, along with symptoms of anxiety, depression, fatigue, and memory and attention deficits. The etiological and physiological bases of these symptoms are unclear, making the diagnosis controversial and challenging to treat. There are currently no established treatments for Morgellons Disease. The following case example depicts treatment of a woman with Morgellons Disease using hypnotherapy. Data from this case example suggest that hypnotherapy is a promising intervention for the physical and psychological symptoms associated with Morgellons Disease.

[Myocardial infarction after conduction electrical weapon shock].

PubMed

Ben Ahmed, H; Bouzouita, K; Selmi, K; Chelli, M; Mokaddem, A; Ben Ameur, Y; Boujnah, M R

2013-04-01

Controversy persists over the safety of conducted electrical weapons, which are increasingly used by law enforcement agencies around the world. We report a case of 33-year-old man who had an acute inferior myocardial infarction after he was shot in the chest with an electrical weapon. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Co-Occurrence of ADHD and High IQ: A Case Series Empirical Study

ERIC Educational Resources Information Center

Cordeiro, Mara L.; Farias, Antonio C.; Cunha, Alexandre; Benko, Cassia R.; Farias, Lucilene G.; Costa, Maria T.; Martins, Leandra F.; McCracken, James T.

2011-01-01

Objective: The validity of a diagnosis of ADHD in children with a high intelligence quotient (IQ) remains controversial. Using a multidisciplinary approach, rigorous diagnostic criteria, and worldwide-validated psychometric instruments, we identified a group of children attending public schools in southern Brazil for co-occurrence of high IQ and…

Science Education and Controversial Issues: A Case Study.

ERIC Educational Resources Information Center

Matricardi, Giorgio; Muratori, Rosanna; Porro, Rita; Pirola, Elisabetta; Capozza, Angela

A constructivistic learning process was used with primary and secondary students in Genoa, Italy, to approach the problem of the diffusion of the alloctonous algae Caulerpa taxifolia in the northwestern Mediterranean Sea. Because of the lack of a continuous research program in Italy, the media played a heavy role in the transfer of information to…

Notoriety Yields Tragedy in Iowa Sexual-Harassment Cases

ERIC Educational Resources Information Center

Wilson, Robin

2009-01-01

Sexual harassment broke into the national consciousness in 1991, when Anita Hill accused Clarence Thomas--then a nominee to the U.S. Supreme Court--of having made sexually inappropriate comments to her. The controversy spawned a flood of charges nationwide, including on college campuses. Since then colleges have tried to stem harassment with…

Attention-deficit/hyperactive disorder: making a case for multidisciplinary management.

PubMed

Ramanathan, G; White, G E

2001-01-01

Attention Deficit/Hyperactivity Disorder (AD/HD) is characterized by a cluster of age-inappropriate behavioral abnormalities comprising inattentivity, hyperactivity and impulsivity. The definition is controversial and without an accurate diagnosis. Therefore, it seems prudent that a multidisciplinary treatment protocol should begin with non-drug psychological and behavioral strategies plus nutritional intervention.

RETROSPECTIVE LANDSCAPE ANALYSIS, AN APPROACH FOR EVALUATION LAND COVER CHANGE: SAN PEDRO RIVER CASE STUDY

EPA Science Inventory

Vegetation change in the American West has been the subject of much concern and controversy throughout the twentieth century. Over the years, a considerable number and variety of 'claims have been made regarding cause related to changes in land cover. The evidence for vegetat...

RIT-CIA Case Study: Classified Research in a University Context.

ERIC Educational Resources Information Center

Carl, W. John, III

A controversy at the Rochester Institute of Technology (RIT) in New York State over that institution's involvement with classified research for the Central Intelligence Agency (CIA) raised issues regarding classified research and institutional leadership. In 1991 M. Richard Rose, then president of RIT, took a 4-month sabbatical to work for the…

Who Are Members of the University Community?

ERIC Educational Resources Information Center

Lunsford, Terry F.

1968-01-01

The relationship between the ideal of a university and its reality in the experience of its members has become a major issue of controversy. The courts, however, rarely discuss the university in terms of a community. Most cases concerning student-institutional relationships that reach court are decided ad hoc, for the law leaves student rights and…

The Possible Influence of Curriculum Statements and Textbooks on Misconceptions: The Case of Evolution

ERIC Educational Resources Information Center

Sanders, Martie; Makotsa, Dennis

2016-01-01

Curriculum statements and textbooks are considered to be vital support tools for teachers, particularly during times of curriculum innovation. A recent change in South Africa was the controversial inclusion of evolution in the school curriculum, raising serious concerns amongst biology teachers regarding the adequacy of their content and…

Why Parents Matter: Parental Investment and Child Outcomes.

ERIC Educational Resources Information Center

Barber, Nigel

There has been a recent academic controversy over whether parental child-rearing has any real effect on how offspring turn out. This book is a comprehensive collection of the experimental evidence establishing that parental treatment does affect child outcomes. Also included are natural experiments, as in the case of children raised in…

Educating Professionals--Perceptions of the Research--Teaching Nexus in Accounting: A Case Study

ERIC Educational Resources Information Center

Lubbe, Ilse

2015-01-01

The teaching-research "nexus" has been an area of historic and ongoing controversy within universities and discussions into the nexus between teaching and research continues to expand. Within the accounting discipline, where new knowledge is perceived to be located "outside" the university, academics struggle to describe and…

Welcoming Taye: How His English Teacher Embraced an African American Transfer Student in an Affluent Suburb

ERIC Educational Resources Information Center

Hill, K. Dara

2014-01-01

This case study narrative examines the circumstances underlying problems of residency in an affluent Midwest suburb experiencing an unexpected influx of working class African American students. Dilemmas engender a cultural mismatch between teachers and students and discomfort with African-American males. In a controversial climate where students…

Developing Black and Minority Ethnic Leaders: The Case for Customized Programmes

ERIC Educational Resources Information Center

Ogunbawo, Dolapo

2012-01-01

The provision of customized black and minority ethnic (BME) leadership courses and programmes is one of the measures being employed to address the under-representation of teachers and school leaders from minority ethnic backgrounds. This strategy has always attracted controversy as opinions have been divided about its value and benefits. Yet there…

School Openness, Parent Participation and Satisfaction: An Exploration of Causal Models.

ERIC Educational Resources Information Center

Spivak, Harriet

This case study in policy research was prompted by: (1) concern about a methodological issue: how useful are cross-sectional, non-experimental data for answering policy questions?--and, (2) interest in some policy issues raised by the school decentralization/community control controversies and participatory reforms of the 1960s--are participatory…

Successful Surgical Excision of a Large Cardiac Fibroma in an Asymptomatic Child.

PubMed

Borodinova, Olga; Ostras, Oleksii; Raad, Tammo; Yemets, Illya

2017-03-01

Cardiac fibroma is a rare disease, and the management of asymptomatic patients is controversial. We report a case of successful surgical excision of a large cardiac fibroma in an asymptomatic child. Surgery should be considered for such a patient, as sudden cardiac death may occur in the absence of premonitory symptoms.

Evidence-Based Practice for Teachers of Children with Autism: A Dynamic Approach

ERIC Educational Resources Information Center

Lubas, Margaret; Mitchell, Jennifer; De Leo, Gianluca

2016-01-01

Evidence-based practice related to autism research is a controversial topic. Governmental entities and national agencies are defining evidence-based practice as a specific set of interventions that educators should implement; however, large-scale efforts to generalize autism research, which are often single-subject case designs, may be a setback…

Renewing Aristotelian Theory: The Cold Fusion Controversy as a Test Case.

ERIC Educational Resources Information Center

Gross, Alan G.

1995-01-01

Exhibits the strength and flexibility of science as a rhetorical enterprise via a rhetorical analysis of cold fusion which reveals science under considerable stress. Assumes the continuing viability of classical rhetoric as an explanation for the persuasiveness of texts, while acknowledging the need to reexamine its central concepts. (SR)

The Skagit Valley Controversy: A Case History in Environmental Politics

ERIC Educational Resources Information Center

Perry, Thomas I., Jr.

1975-01-01

Citizens of the Skagit Valley became concerned when that area was to be flooded to produce energy for the United States. Through political citizen action, they saved this area from ecological destruction and set a precedent for further environmental policy decisions. The importance of environmental impact assessment became evident. (MA)

Legal Developments in New York State Regarding the Sealed Adoption Record Controversy.

ERIC Educational Resources Information Center

Newborg, Donald L.

1979-01-01

Provides information on recent decisions in New York courts in cases involving the right of adult adoptees to inspect sealed adoption records. The effect of these decisions is that any change in the right of access to records must be brought about through legislation, not through the courts. (Author/SS)

Employee Rights Versus the First Amendment.

ERIC Educational Resources Information Center

Walker, Lois; Teaster, Gale; Kelley, Gloria

1998-01-01

Illustrates a case of a student art exhibit in the Winthrop University, South Carolina Library, where freedom of expression interfered with employee rights in the workplace. The Dean of Libraries stated that the library could not act as a censor, and that they were obligated to defend the First Amendment; the controversial statue remained, but…

Good and Just Teaching: The Case for Social Justice in Teacher Education

ERIC Educational Resources Information Center

Cochran-Smith, Marilyn; Shakman, Karen; Jong, Cindy; Terrell, Dianna G.; Barnatt, Joan; McQuillan, Patrick

2009-01-01

A particularly controversial aspect of teacher preparation is the increasing number of teacher preparation programs that emphasize "social justice" as part of the curriculum. This article examines how students in a program with a social justice agenda understood the concept and how their understandings played out in practice. Using interviews and…

Disciplinary Sanctions for Students with Special Needs.

ERIC Educational Resources Information Center

Osborne, Allen G., Jr.

One of the more controversial issues that has come before the courts since the implementation of the Individuals with Disabilities Act (IDEA) concerns the imposition of disciplinary sanctions on students with disabilities. Because this issue is not directly addressed by the act, school administrators must turn to case law for guidance. This paper…

A Case Study of Student Achievement in a Secondary Charter School

ERIC Educational Resources Information Center

Hung, Li-Ching; Badejo, Folashade; Bennett, Jo

2014-01-01

The quality of student learning and achievement in public schools has become a matter of public discourse and policy, thus led to the establishment of charter school concept. However, there are controversial reports on the academic performances of charter schools, inadequate information on their instructional practices, and the learning…

Autonomy-Facilitation or Autonomy-Promotion? The Case of Sex Education

ERIC Educational Resources Information Center

Corngold, Josh

2012-01-01

This article offers a critique of Harry Brighouse's "autonomy-facilitating education", which aims to enable students to reflect critically on their lives and society without disposing them to do so. Because it is "character-neutral", this kind of education purportedly avoids some of the controversy surrounding autonomy-promotion. At the same time,…

Objectivity and Its Discontents: Knowledge Advocacy in the Sally Hemings Controversy

ERIC Educational Resources Information Center

Whooley, Owen

2008-01-01

The sociology of knowledge, derived from research on the hard sciences, overlooks the potential for outsiders to determine the content of knowledge within professional disciplines. Using the case of the Sally Hemings affair, I introduce the concept of "knowledge advocacy" to analyze how outside groups shape historical knowledge. The Hemings…

Desegregating Conversations about Race and Identity in Culturally Specific Museums

ERIC Educational Resources Information Center

Brown, Lovisa; Gutierrez, Caren; Okmin, Janine; McCullough, Susan

2017-01-01

Recent years have witnessed a surge in field-wide discussion about how to talk openly about race and culture within museum education. This article provides an analysis, using case studies from three culturally specific museums to explore how these identity-driven institutions navigate challenging, and often controversial, approaches to discussing…

Stuttering in Preschool Children: Direct versus Indirect Treatment

ERIC Educational Resources Information Center

Nippold, Marilyn A.

2018-01-01

Purpose: The purpose of this article is to discuss the controversial topic of stuttering in preschool children and how to evaluate the options for treatment, emphasizing the role of external research evidence. Method: A hypothetical but realistic case study of a 3-year-old boy who stutters is described. Two contrasting approaches to treatment are…

The Case for Pedagogical Action Research in Psychology Learning and Teaching

ERIC Educational Resources Information Center

Norton, Lin

2014-01-01

It is just over 12 years since "Psychology Teaching Review"'s first Special Issue on action research psychology. In the guest editorial for that issue Lin Norton suggested that pedagogical action research can be controversial, and that for some academic psychologists it appears to be more than curriculum development rather than…

The business of human embryonic stem cell research and an international analysis of relevant laws.

PubMed

De Trizio, Ella; Brennan, Christopher S

2004-01-01

Few sciences have held out such therapeutic promise and correspondingly stirred so much controversy in countries throughout the world as the developing science surrounding human embryonic stem cells. Since the first reported development of several lines of human embryonic stem cells in 1988, many governments around the world have attempted to address the thorny ethical issues raised by human embryonic stem cell research by the passage of laws. In some cases these laws have directly regulated governmental funding of the science; in other cases they have created a legal environment that has either encouraged or discouraged both governmental and private funding of the science. This article first differentiates human embryonic stem cells from other types of stem cells and frames the ethical controversy surrounding human embryonic stem cell research, then surveys laws governing human embryonic stem cell research in various scientifically advanced countries located throughout the Pacific Rim, Europe and North America and explains the impact these laws have had on governmental and private funding of human embryonic stem cell research.

The Case for Reasonable Accommodation of Conscientious Objections to Declarations of Brain Death.

PubMed

Johnson, L Syd M

2016-03-01

Since its inception in 1968, the concept of whole-brain death has been contentious, and four decades on, controversy concerning the validity and coherence of whole-brain death continues unabated. Although whole-brain death is legally recognized and medically entrenched in the United States and elsewhere, there is reasonable disagreement among physicians, philosophers, and the public concerning whether brain death is really equivalent to death as it has been traditionally understood. A handful of states have acknowledged this plurality of viewpoints and enacted "conscience clauses" that require "reasonable accommodation" of religious and moral objections to the determination of death by neurological criteria. This paper argues for the universal adoption of "reasonable accommodation" policies using the New Jersey statute as a model, in light of both the ongoing controversy and the recent case of Jahi McMath, a child whose family raised religious objections to a declaration of brain death. Public policies that accommodate reasonable, divergent viewpoints concerning death provide a practical and compassionate way to resolve those conflicts that are the most urgent, painful, and difficult to reconcile.

Modifying the food supply at a community swimming pool: a case study.

PubMed

Lloyd, Beverley; Dumbrell, Susan

2011-04-01

We report on a process evaluation of a project that aimed to replace energy-dense, nutrient-poor (EDNP) items at a community swimming pool kiosk. The analytic framework was the Analysis Grid for Environments Linked to Obesity (ANGELO). To contribute to health promotion practice in recreational settings, the process evaluation sought to determine the extent to which project'controversies' modified project objectives and strategies. The case study method captured the project narrative. The primary data were interviews with key project participants, supplemented with project records and media articles.These were analysed thematically. The socio-cultural and political environments, particularly the capacity to exercise choice in relation to ENDP products, had considerable influence on the project. In the face of two controversies -"I thought everyone was signed up to it"and "We can't deny the kiddies their ice-cream" it was necessary for the project partners to modify the objectives and strategies and substantially change the target. The setting is highly responsive to both the micro and macro socio-cultural and political aspects of the environment.

Just a drop of cement: a case of cervical spine bone aneurysmal cyst successfully treated by percutaneous injection of a small amount of polymethyl-methacrylate cement

PubMed Central

Fahed, Robert; Clarençon, Frédéric; Riouallon, Guillaume; Cormier, Evelyne; Bonaccorsi, Raphael; Pascal-Mousselard, Hugues; Chiras, Jacques

2014-01-01

Aneurysmal bone cyst (ABC) is a benign hemorrhagic tumor, commonly revealed by local pain. The best treatment for this lesion is still controversial. We report the case of a patient with chronic neck pain revealing an ABC of the third cervical vertebra. After percutaneous injection of a small amount of polymethyl-methacrylate bone cement, the patient experienced significant clinical and radiological improvement. PMID:25498806

Reflections upon an "Atheist Epic": Madalyn Murray O'Hair and "Baltimore Sun" Reporters Comment about Coverage of the First Incidents Leading to the Supreme Court's Banning of Compulsory Prayer in Public Schools.

ERIC Educational Resources Information Center

Bowman, Jim; Kahan, Bob

In 1960 a teenage boy, Bill Murray, refused to participate in Bible reading, and the result was a series of court cases that culminated in the 1963 United States Supreme Court decision banning compulsory prayer in public schools. To gain insight into the dynamics of journalism practiced during controversy, a case study attempts to examine the…

Just a drop of cement: a case of cervical spine bone aneurysmal cyst successfully treated by percutaneous injection of a small amount of polymethyl-methacrylate cement.

PubMed

Fahed, Robert; Clarençon, Frédéric; Riouallon, Guillaume; Cormier, Evelyne; Bonaccorsi, Raphael; Pascal-Mousselard, Hugues; Chiras, Jacques

2014-12-12

Aneurysmal bone cyst (ABC) is a benign hemorrhagic tumor, commonly revealed by local pain. The best treatment for this lesion is still controversial. We report the case of a patient with chronic neck pain revealing an ABC of the third cervical vertebra. After percutaneous injection of a small amount of polymethyl-methacrylate bone cement, the patient experienced significant clinical and radiological improvement. 2014 BMJ Publishing Group Ltd.

Fibre-optic awake intubation for caesarean section in a parturient with predicted difficult airway.

PubMed

Trevisan, P

2002-10-01

Anaesthetic management of a parturient with predicted difficult airway presenting for caesarean section (CS) is not a straightforward decision: general anaesthesia should be avoided because intubation can be impossible and a "cannot intubate, cannot ventilate" scenario might ensue, on the other hand regional techniques can be unsuccessful or, though rarely, have complications that require emergency intubation. The case is presented of a primigravida admitted to hospital at 37 weeks' gestation with hypertension, intrauterine growth retardation and oligohydramnios. After a few days' observation, it was decided to proceed with an elective CS. The preoperative airway examination revealed a poor mouth opening with an interdental distance of 20 mm and a Mallampati class IV. The patient was classified as a case of difficult intubation and the following anaesthetic options were considered: epidural anaesthesia, spinal anaesthesia and awake fibreoptic intubation followed by general anaesthesia. The pros and the cons of these techniques were explained to the patient and it was suggested that awake fibreoptic intubation was the safest option. The patient gave her consent, so an uneventful nasal awake fibreoptic intubation was carried out under local anaesthesia. This case report offers the opportunity to underline the risk to perform a central blockade in a parturient with predicted difficult intubation, arguing that the safest course of action is an awake fibrescopic intubation, besides some controversial points to safely perform awake fibreoptic intubation in obstetric patients are discussed.

Evolving Perspectives on Lyme Borreliosis in Canada

PubMed Central

Sperling, JLH; Middelveen, MJ; Klein, D; Sperling, FAH

2012-01-01

With cases now documented in every province, Lyme borreliosis (LB) is emerging as a serious public health risk in Canada. Controversy over the contribution of LB to the burden of chronic disease is maintained by difficulty in capturing accurate Canadian statistics, especially early clinical cases of LB. The use of dogs as sentinel species demon-strates that potential contact with Borrelia burgdorferi spirochetes, as detected by C6 peptide, extends across the country. Dissemination of infected ticks by migratory birds and rapid establishment of significant levels of infection have been well described. Canadian public health response has focused on identification of established populations of the tick vectors, Ixodes scapularis and I. pacificus, on the assumption that these are the only important vectors of the disease across Canada. Strains of B. burgdorferi circulating in Canada and the full range of their reservoir species and coinfections remain to be explored. Ongoing surveys and historical records demonstrate that Borrelia-positive Ixodes species are regu-larly present in regions of Canada that have previously been considered to be outside of the ranges of these species in re-cent modeling efforts. We present data demonstrating that human cases of LB are found across the nation. Consequently, physician education and better early diagnoses are needed to prevent long term sequelae. An international perspective will be paramount for developing improved Canadian guidelines that recognize the complexity and diversity of Lyme borreliosis. PMID:23091570

Upper and lower extremity nerve injuries in pediatric missile wounds: a selective approach to management.

PubMed

Stoebner, Andrew A; Sachanandani, Neil S; Borschel, Gregory H

2011-06-01

Nerve injuries from missile and gunshot wounds often produce significant disability, and their management is controversial. The role of the surgeon in cases of missile wounds with neurologic deficits is not well defined. Enhancing the trauma team's ability to recognize treatable nerve injuries will lead to improved outcomes. Further, raising awareness of the time-sensitive nature of these injuries will also improve results in these cases. We reviewed a consecutive series of 17 pediatric patients with peripheral nerve injuries caused by missile and gunshot wounds in a tertiary care children's hospital. We examined the indications for surgery, presence of associated injuries, mechanisms of injury, demographic characteristics and clinical outcomes. Urban victims were significantly more likely to have been intentionally assaulted than rural or suburban victims and they were also less likely to have completed follow-up care. High-energy weapons were more likely to require surgery compared with low-energy weapons. Patients presenting with tendon injuries were more likely to have a high-grade nerve injury requiring surgery. Patients presenting with tendon lacerations or high-energy mechanisms were significantly more likely to require surgery. Early exploration should be undertaken in cases where transection is likely to have occurred. Early decompression of common entrapment sites distal to repairs or injuries should be performed. Because follow-up is poor in this population, treatment should be prompt and thorough.

Affective psychosis following Accutane (isotretinoin) treatment.

PubMed

Barak, Yoram; Wohl, Yonit; Greenberg, Yifa; Bar Dayan, Yosefa; Friedman, Tali; Shoval, Gideon; Knobler, Haim Y

2005-01-01

Isotretinoin (Accutane) ranks in the top 10 of the US Food and Drug Administration's database of drugs associated with reports of depression and suicide attempts. However, this association is still controversial because up to 5.6% of patients with moderate acne may have pre-existing suicidal ideations, improvement of acne often reduces associated depression, and isotretinoin users are reportedly no more likely than those taking antibiotics for acne to have depression or commit suicide. We describe a series of cases of manic psychosis that developed in a 1-year period (2003) in association with isotretinoin treatment and resulted in suicidality and progression to long-standing psychosis. Cases were drawn from 500 soldiers who had been evaluated in a military specialists dermatology clinic for severe acne. Data were summarized from medical records of five severe acne patients treated by isotretinion during their compulsory military service. Data from their draft board examinations and service records, as well as repeated clinical assessments by certified psychiatrists at the Israel Defense Forces (IDF) Mental Health Department clinic, were evaluated. Five young adults developed manic psychosis within a mean of 7.6 months of exposure to isotretinoin. In three cases, this was accompanied by a suicide attempt, and in three cases, psychosis lasted for longer than 6 months. Either a personal history of obsessive-compulsive disorder, neurological insult or family history of a major psychiatric illness were present in all cases. The present case-series is suggestive of an increase in the likelihood of an association between exposure to isotretinion and manic psychosis. Associated risk factors were both family and personal history of psychiatric morbidity. Further studies are needed to establish our findings.

A systemic approach for modeling biological evolution using Parallel DEVS.

PubMed

Heredia, Daniel; Sanz, Victorino; Urquia, Alfonso; Sandín, Máximo

2015-08-01

A new model for studying the evolution of living organisms is proposed in this manuscript. The proposed model is based on a non-neodarwinian systemic approach. The model is focused on considering several controversies and open discussions about modern evolutionary biology. Additionally, a simplification of the proposed model, named EvoDEVS, has been mathematically described using the Parallel DEVS formalism and implemented as a computer program using the DEVSLib Modelica library. EvoDEVS serves as an experimental platform to study different conditions and scenarios by means of computer simulations. Two preliminary case studies are presented to illustrate the behavior of the model and validate its results. EvoDEVS is freely available at http://www.euclides.dia.uned.es. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Autoantibodies in chronic hepatitis C: A clinical perspective

PubMed Central

Narciso-Schiavon, Janaína Luz; Schiavon, Leonardo de Lucca

2015-01-01

Non-organ-specific autoantibodies and thyroid autoantibodies have been frequently found in chronic carriers of hepatitis C virus (HCV). With respect to endomysial antibodies and tissue transglutaminase, it is controversial whether the prevalence of gluten-related seromarkers is higher in patients with HCV. In such cases, in addition to acknowledging any currently existing autoimmune disease, recognizing the risk of the patient developing an autoimmune disease during interferon (IFN)-based treatment must be a principle concern. From a clinical point-of-view, the presence of autoantibodies arouses suspicion that an autoimmune disease may be present or may be precipitated by IFN-based HCV treatment. In this paper, we review the prevalence of autoantibodies in individuals with hepatitis C, the clinical significance of these autoantibodies, and the approach recommended for such situations. PMID:26052396

Non Locality Proofs in Quantum Mechanics Analyzed by Ordinary Mathematical Logic

NASA Astrophysics Data System (ADS)

Nisticò, Giuseppe

2014-10-01

The so-called non-locality theorems aim to show that Quantum Mechanics is not consistent with the Locality Principle. Their proofs require, besides the standard postulates of Quantum Theory, further conditions, as for instance the Criterion of Reality, which cannot be formulated in the language of Standard Quantum Theory; this difficulty makes the proofs not verifiable according to usual logico-mathematical methods, and therefore it is a source of the controversial debate about the real implications of these theorems. The present work addresses this difficulty for Bell-type and Stapp's arguments of non-locality. We supplement the formalism of Quantum Mechanics with formal statements inferred from the further conditions in the two different cases. Then an analysis of the two arguments is performed according to ordinary mathematical logic.

[Management of hypothyroidism and hyperthyroidism].

PubMed

Jiskra, Jan

2015-10-01

Functional thyropathies present significant health risks for patients. Advanced functional thyropathies are always treated while indications for therapy of subclinical thyropathies are individual and often controversial. It is widely agreed that these disorders should be diagnosed and individuals should be followed. The drug of choice in substitution therapy of hypothyroidism is levothyroxine, in the treatment of hyperthyroidism it is methimazole. Administration of propylthiouracil should be limited to the first trimester of pregnancy, because its serious hepatotoxicity has been described. Hyperthyroidism based on thyroid nodules and immunogenic hyperthyroidism not reaching long-term remission, need to be treated radically: by surgery or radioiodine treatment. When radiation protection requirements are met, radioiodine can also be administered on an outpatient basis. Exceptionally, small doses of methimazole can be administered over an extended period of time in individual cases.

Thyrotoxic periodic paralysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ferreiro, J.E.; Arguelles, D.J.; Rams, H. Jr.

1986-01-01

A case of thyrotoxic periodic paralysis is reported in a Hispanic man with an unusual recurrence six weeks after radioactive iodine treatment. Thyrotoxic periodic paralysis has now been well characterized in the literature: it occurs primarily in Orientals with an overwhelming male preponderance and a higher association of specific HLA antigens. Clinical manifestations include onset after high carbohydrate ingestion or heavy exertion, with progressive symmetric weakness leading to flaccid paralysis of the extremities and other muscle groups, lasting several hours. If hypokalemia is present, potassium administration may help abort the attack. Although propranolol can be efficacious in preventing further episodes,more » the only definitive treatment is establishing a euthyroid state. The pathophysiology is still controversial, but reflects altered potassium and calcium dynamics as well as certain morphologic characteristics within the muscle unit itself.« less

Current Management of Urethral Stricture

PubMed Central

Lee, Young Ju

2013-01-01

The surgical treatment of urethral stricture diseases is continually evolving. Although various surgical techniques are available for the treatment of anterior urethral stricture, no one technique has been identified as the method of choice. This article provides a brief updated review of the surgical options for the management of different sites and different types of anterior urethral stricture. This review also covers present controversies in urethral reconstruction. Among the various procedures available for treating urethral stricture, one-stage buccal mucosal graft urethroplasty is currently widely used. The choice of technique for urethroplasty for an individual case largely depends on the expertise of the surgeon. Therefore, urologists working in this field should keep themselves updated on the numerous surgical techniques to deal with any condition of the urethra that might surface at the time of surgery. PMID:24044088

Endemic tropical sprue in Rhodesia.

PubMed

Thomas, G; Clain, D J

1976-11-01

The existence of tropical sprue in Africa is controversial. In this paper we present 31 cases seen in Rhodesia over a 15 month period. They have the clinical features, small intestinal morphology, malabsorption pattern, and treatment response of tropical sprue. Other causes of malabsorption, and primary malnutrition, have been excluded. The severity of the clinical state and intestinal malabsorption distinguish these patients from those we have described with tropical enteropathy. The previous work on tropical sprue in Africa is reviewed and it is apparent that, when it has been adequately looked for, it has been found. It is clear that the question of tropical sprue in Africa must be re-examined and that it existence may have hitherto been concealed by the assumption that primary malnutrition is responsible for the high prevalence of deficiency states.

[Inferior hemiarthroplasty of the temporo-mandibular joint with articulated condylar prosthesis type Stryker].

PubMed

Bucur, A; Dincă, O; Totan, C; Ghită, V

2007-01-01

The optimal reconstruction of the mandible and of the temporo-mandibular joint after mandibular hemi-resection with disarticulation is still controversial in literature. This paperwork presents our experience on four cases in the reconstruction of the mandible together with the inferior arthroplasty of the temporo-mandibular joint, after the resection of extended benign tumors of the mandible, based on fibular free vascularized grafts having attached a Stryker titanium condylar prosthesis reconstructing the inferior segment of the temporo-mandibular joint. Our results for the this technique were excellent, with a functional rehabilitation very close to normal. After reviewing the various techniques and their arguments in literature, with accent on the TMJ reconstruction, we consider this method to be optimal for the reconstruction of mandibular defects in patients with neoplastic conditions.

What would Mary Douglas do? A commentary on Kahan et al., "Cultural cognition and public policy: the case of outpatient commitment laws".

PubMed

Swanson, Jeffrey

2010-06-01

Involuntary outpatient commitment is a highly controversial issue in mental health law. Strong supporters of outpatient commitment see it as a form of access to community-based mental health care and a less restrictive alternative to hospitalization for people with severe mental illness; vocal opponents see it as an instrument of social control and an unwarranted deprivation of individual liberty. Kahan and colleagues apply the theory of "cultural cognition" in an empirical study of how cultural worldviews influence support for outpatient commitment laws among the general public and shape perceptions of evidence for these laws' effectiveness. This article critiques Kahan et al. and offers an alternative perspective on the controversy, emphasizing particular social facts underlying stakeholders' positions on outpatient commitment laws.

Trazodone Addition to Paroxetine and Mirtazapine in a Patient with Treatment-Resistant Depression: The Pros and Cons of Combining Three Antidepressants

PubMed Central

Alves, José Carlos; Rego, Raquel Garcia

2016-01-01

Dual antidepressant combination for treatment-resistant depression is a strategy well supported by literature and accepted in clinical practice. Rather, the usefulness of the combination of more than two antidepressants is controversial. This may be related to the possibility of higher side-effect burden and to doubts about its pharmacological effectiveness and therapeutic advantage compared to other standard treatment options. We report a relapse of moderate-to-severe depressive symptoms with insomnia that successfully remitted after the addition of trazodone to a dual combination of paroxetine and mirtazapine (in standard effective doses) in a patient with treatment-resistant depression. We also review the literature and discuss the utility of triple antidepressant combination in treatment-resistant depression. This clinical case highlights the utility of combining trazodone as a third antidepressant for the relapse of depressive symptoms after the failure of a dual antidepressant combination. Trazodone may be advantageous in patients presenting recurrence of moderate-to-severe depressive symptoms that include sleep problems and/or insomnia and may be particularly useful when benzodiazepines are not recommended. Although its use may be controversial and associated with higher risk of side-effects, more investigation is needed to determine the efficacy and safety for triple antidepressant combinations as reliable strategies for treatment-resistant depression in clinical practice. PMID:27807450

Papillary urothelial carcinoma with squamous differentiation in association with human papilloma virus: case report and literature review.

PubMed

Guma, Sergei; Maglantay, Remegio; Lau, Ryan; Wieczorek, Rosemary; Melamed, Jonathan; Deng, Fang-Ming; Zhou, Ming; Makarov, Danil; Lee, Peng; Pincus, Matthew R; Pei, Zhi-Heng

2016-01-01

The human papilloma virus (HPV) is a carcinogen known for its strong association with cervical cancers and cervical lesions. It is also known to be associated with a variety of squamous cell carcinomas in other areas, such as the penis, vulva, anus and head and neck. However, the association with urothelial carcinoma remains controversial. Here, we report a case of urothelial carcinoma with squamous differentiation associated with HPV-6/HPV-11. This is a case of a 70 year old man who presented with nocturia and pressure during urination. During the TURP procedure for what was clinically thought to be benign prostate hyperplasia with pathologic diagnosis as prostate carcinoma, a 2 cm papillary mass was found in the distal penile urethra. The papillary mass was found to be a high grade urothelial carcinoma positive for GATA 3 expression, with focal areas of squamous differentiation. The areas with squamous differentiation demonstrated koilocytic differentiation, which were positive for strong p16 expression. The tumor was found to harbor low risk HPV 6/11 by in situ hybridization. This study case demonstrates HPV infection with a low risk subtype (HPV 6/11) associated with an urothelial carcinoma with squamous differentiation and condylomatous features.

Retrospective multicenter evaluation of the "fly-catching syndrome" in 24 dogs: EEG, BAER, MRI, CSF findings and response to antiepileptic and antidepressant treatment.

PubMed

Wrzosek, Marcin; Płonek, Marta; Nicpoń, Józef; Cizinauskas, Sigitas; Pakozdy, Akos

2015-12-01

The fly-catching syndrome (FCS) is a rare canine condition of sudden, occasional, or constant episodes of biting the air. It may be accompanied by jumping, licking, and swallowing. The etiology of FCS is unknown and controversial. Various explanations for its occurrence have included epileptoid disorders such as visual cortex epileptiform disturbances and simple and complex partial seizures as well as compulsive disorders, hallucinatory behavior, and stereotypy. A retrospective multicenter analysis of 24 dogs with clinical symptoms of FCS is presented. Clinical signs at the time of presentation, the mean age at onset of the disease, the response to treatment, and the clinical outcome were recorded and analyzed in all patients. All dogs underwent clinical, neurological, and otoscopic examinations. Complete blood cell counts (CBCs) and serum chemistry panels were obtained from each dog. Diagnostic testing included MRI and EEG examinations in 21 cases, BAER in 19 cases, and CSF analysis in 20 cases. The EEG revealed spike activity in 8 (38%) of the 21 cases, 7 of which had activity in the occipital lobes. The brainstem auditory evoked response (BAER) revealed three cases of bilateral deafness. The MRI revealed six cases of Chiari malformation (CM), one case of syringohydromyelia (SM), and one case of a falx cerebri meningioma. The dogs were divided into groups according to their treatment protocol. Group A included dogs treated with phenobarbital (PB), and group B consisted of dogs treated with fluoxetine (FLX). Thirty-six percent of the dogs in group A responded to PB, while 100% of the dogs in group B responded to FLX. The results suggest that FCS is more responsive to FLX than PB. However, the etiology of this behavior remains unclear in most cases. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

West Nile virus transmission through organ transplantation in north-eastern Italy: a case report and implications for pre-procurement screening.

PubMed

Inojosa, W O; Scotton, P G; Fuser, R; Giobbia, M; Paolin, A; Maresca, M C; Brunello, A; Nascimben, E; Sorbara, C; Rigoli, R; Berti, R; Gajo, G B; Giometto, B

2012-10-01

West Nile virus (WNV) transmission through organ transplantation occurs rarely and screening of organ donors for WNV infection remains controversial. This report describes the case of WNV encephalitis in a kidney recipient and the case of asymptomatic WNV infection in the organ donor, both observed at Treviso Hospital, northeastern Italy. After briefly reviewing the literature, we discuss the implications for WNV screening. We reviewed medical, laboratory and epidemiological records at our hospital, and the literature concerning cases of organ-transmitted WNV infections and WNV screening of organ donors in Italy and worldwide. The kidney recipient was the first confirmed case of WNV infection notified in northeastern Italy in 2011, and the first case of WNV infection in a cluster of four transplant recipients who acquired the infection from a common organ donor. The organ donor, whose WNV infection was only retrospectively diagnosed by IgM detection, represents the index case of a WNV outbreak in the Treviso Province. Screening of her blood prior to organ recovery did not show detectable levels of WNV nucleic acid with the use of quantitative real-time polymerase chain reaction. This report emphasizes that transplant-acquired WNV neuroinvasive disease can be particularly severe. We suggest that pre-procurement screening of organ donors by testing blood with both WNV IgM capture ELISA and a sensitive nucleic acid testing should be adopted during the transmission season in the present Italian epidemiological setting.

[Management of intramedullary spinal cord tumors: surgical considerations and results in 45 cases].

PubMed

Berhouma, M; Bahri, K; Houissa, S; Zemmel, I; Khouja, N; Aouidj, L; Jemel, H; Khaldi, M

2009-06-01

Intramedullary spinal cord tumors (IMSCT) are relatively rare neoplasms, accounting for less than 5% of all central nervous system tumors. The optimum management of these tumors still remains controversial. Many decades ago, partial surgical resection followed by radiotherapy was the conventional management for IMSCT. Nowadays, maximal surgical resection of IMSCT without adjuvant therapy is the rule. We discuss the management of our cohort of 45 patients and review retrospectively the surgical outcome and survival. We reviewed the charts of 45 patients who underwent surgery for IMSCT in our institution since 1990. The study included 23 female and 22 male with a mean age of 28.7 years (range: 18 months-64 years). In 40 patients, the final diagnosis was based on the results of MR imaging. The cervical location of the tumor was the most common (20 cases). Surgical procedures included a gross-total resection in 31 cases, subtotal resection in six cases, partial resection in five cases and a biopsy in three cases. The large majority of patients had histologically-proven low-grade tumors composed essentially of astrocytomas (44,4%) and ependymomas (28,8%). There was no mortality related to surgery. Concerning the functional outcome at six months, we noted that 22.2% of our patients deteriorated, 47.3% stayed the same and 30.5% improved. We found that patients with mild or no preoperative deficits were exceptionally damaged by the surgical procedure. The gold-standard treatment of IMSCT remains maximal microsurgical resection without adjuvant therapy. For malignant or rapidly recurrent IMSCT, the optimum management is still controversial. Determinant predictors for a good outcome after surgery of IMSCT are histological type of lesion, total removal of the tumor and a satisfactory neurological status before surgery.

Comparison of US EPA and European emission standards for combustion and incineration technologies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Licata, A.; Hartenstein, H.U.; Terracciano, L.

1997-12-01

There has been considerable debate, misunderstanding, and controversy when comparing emission standards used in Europe and the United States. One of the first questions you hear whenever U.S. EPA publishes a new emission standard is, {open_quotes}Is it as restrictive or is it the same as the German standard{close_quotes}. Although both systems of regulation call for the use of CEMS for compliance, there are substantial differences in how emission standards are structured in Europe and in the U.S. They include reference points, averaging times, sampling methods, and technology. Generally, the European standards tend to be more restrictive, due in part tomore » the fact that the facilities are of necessity sited in close proximity to residential areas. In Germany, for example, regulations in general are comprehensive and include both design standards and emission limits while U.S. EPA`s rules are source specific and, in most cases, limited to numerical emission standards. In some cases, comparisons can be made between emission standards and, in some cases, comparisons can only be made with restrictive caveats. The paper will present a comprehensive overview of the emission standards and how they are applied.« less

Keratocyst of the buccal mucosa: is it odontogenic?

PubMed

Ide, Fumio; Kikuchi, Kentaro; Miyazaki, Yuji; Mishima, Kenji; Saito, Ichiro; Kusama, Kaoru

2010-11-01

Odontogenic keratocyst (OKC) of the buccal mucosa, the diagnosis of which is based on subjective histologic evaluation, is a controversial entity of questionable existence. This report describes 2 rare cases of parakeratinized cyst arising from the buccal mucosa. Case 1 was a 60-year-old man with a 3-cm cyst and case 2 was a 16-year-old boy with a microcyst incidentally discovered on histology. Both lesions were essentially identical in histologic appearance and immunophenotype to intraosseous and gingival OKC, but they were clearly different from orthokeratinized odontogenic cysts and buccal mucosal epidermoid cysts. Step sections failed to reveal any kind of odontogenic tissue or skin adnexa in the cyst wall. These microscopic characteristics reflexively lead to the diagnosis of OKC, if the extragingival occurrence in the buccal mucosa cannot be considered. An alternative nonodontogenic origin includes a keratocyst of the skin, ie, an unusual mucosal presentation of cutaneous keratocyst. Because its true nature, either odontogenic or epidermal, cannot be conclusively proven at this time, we propose a more descriptive and noncommittal term, "mucosal keratocyst," for a particular cyst in a buccal location that is morphologically indistinguishable from OKC. Copyright © 2010 Mosby, Inc. All rights reserved.

A forgotten retained drain inside a knee for 10 years: A case report.

PubMed

Koaban, Saeed; Alatassi, Raheef; Alogayyel, Nawaf

2018-05-29

Surgical drains are inserted into the wound after an arthroscopic knee procedure mainly to decrease fluid collection after the operation. The use of postoperative surgical drains remains controversial. This report presents a rare case of a forgotten retained drain that was accidentally found inside a knee 10 years after an arthroscopic procedure. The drain was removed without any complications. A retained and broken drain during removal is a very rare and preventable complication that can be stressful for both the patient and surgeon. Most of the literature supports that retained drains in the soft tissues do not affect long-term outcomes, but if the drain fragment is in the intra-articular area, it might cause complications. Furthermore, there are several preventive measures to avoid retained surgical drains. By reporting this case of a forgotten drain retained inside a knee for approximately 10 years, we aim to illustrate the potential risk of leaving a drain inside the joint following an arthroscopic procedure. Furthermore, we advise that surgeons maintain a high index of suspicion for iatrogenic complications when a patient continues to complain about unexplained pain at the surgical site. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Sudden perinatal death due to rupture of congenital cardiac diverticulum. Pathological findings and medico-legal investigations in malpractice charge.

PubMed

Marchesi, Matteo; Boracchi, Michele; Gentile, Guendalina; Maghin, Francesca; Zoja, Riccardo

2017-09-01

Congenital diverticula of the left ventricle, very rare malformations, are determined by an abnormal embryonic development of the ventricular wall and can be isolated or associated to other cardiac anomalies. In most of the cases, these pathologies are not symptomatic and in some patients can be associated to ventricular arrhythmia, cardiac rupture with tamponade and sudden death. Authors are presenting the case of a sudden death in an 8-weeks-old newborn due to rupture of a cardiac congenital diverticulum of the left ventricle, discovered only at the moment of the autopsic examination. The parents of the victim pressed charges against the medical staff that was appointed to the cares, blaming them with malpractice. The missed diagnosis of a cardiac congenital diverticulum of the left ventricle, a rare pathology, reflects the trickiness of the medical management that can lead to medico-legal controversies and, even though such rare conditions must be always taken into consideration when investigating possible dysfunction causing the death, diagnostic difficulties, in the case in exam, justify the missed diagnosis intra-vitam of cardiac ventricular diverticulum. Copyright © 2017 Elsevier B.V. All rights reserved.

Social Interest in The Polish Doctrine of Monument Preservation

NASA Astrophysics Data System (ADS)

Antoszczyszyn, Marek

2017-10-01

The paper discusses a controversy surrounding the latest amendment to the text of the Polish Parliament Act Conservation and the Care of Monuments (2015). It is a common dictum that any edifice cannot exist without good foundations. In this particular case of the mentioned above Act, definition of monument appears to be such a basis. A social interest is one of the constituent elements of the definition mentioned above. In the first part of the paper the notion of the social interest expression has been discussed, particularly from national and international points of view. The second part of the paper comprises some examples from the Polish monument preservation experience with the use of comparison method supported by case study. Only three big Polish cities: Warsaw, Wroclaw and Szczecin are involved in the presented case study but it must be emphasized that many other places on Polish territory experienced the same. Basing on the faith of these cities, the results and discussion chapter proves fundamental discrepancy in social interest notion between national and international scopes using some analytical methods. Finally, in the discussion chapter some proposals for the future amendment of monument definition in the Act of Conservation and the Care of Monuments have been provided.

Euthanasia and physician-assisted suicide not meeting due care criteria in the Netherlands: a qualitative review of review committee judgements.

PubMed

Miller, David Gibbes; Kim, Scott Y H

2017-10-25

ObjectivesTo assess how Dutch regional euthanasia review committees (RTE) apply the euthanasia and physician-assisted suicide (EAS) due care criteria in cases where the criteria are judged not to have been met ('due care not met' (DCNM)) and to evaluate how the criteria function to set limits in Dutch EAS practice. A qualitative review using directed content analysis of DCNM cases in the Netherlands from 2012 to 2016 published on the RTE website (https://www.euthanasiecommissie.nl/) as of 31 January 2017. Of 33 DCNM cases identified (occurring 2012-2016), 32 cases (97%) were published online and included in the analysis. 22 cases (69%) violated only procedural criteria, relating to improper medication administration or inadequate physician consultation. 10 cases (31%) failed to meet substantive criteria, with the most common violation involving the no reasonable alternative (to EAS) criterion (seven cases). Most substantive cases involved controversial elements, such as EAS for psychiatric disorders or 'tired of life', in incapacitated patients or by physicians from advocacy organisations. Even in substantive criteria cases, the RTE's focus was procedural. The cases were more about unorthodox, unprofessional or overconfident physician behaviours and not whether patients should have received EAS. However, in some cases, physicians knowingly pushed the limits of EAS law. Physicians from euthanasia advocacy organisations were over-represented in substantive criteria cases. Trained EAS consultants tended to agree with or facilitate EAS in DCNM cases. Physicians and families had difficulty applying ambiguous advance directives of incapacitated patients. As a retrospective review of physician self-reported data, the Dutch RTEs do not focus on whether patients should have received EAS, but instead primarily gauge whether doctors conducted EAS in a thorough, professional manner. To what extent this constitutes enforcement of strict safeguards, especially when cases contain controversial features, is not clear. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Fetus-in-fetu: parasite or neoplasm? A study of two cases.

PubMed

Saito, Keisuke; Katsumata, Yusuke; Hirabuki, Tomoo; Kato, Keisuke; Yamanaka, Michiko

2007-01-01

Fetus-in-fetu is a rare congenital fetiform mass whose etiology is still controversial. We report two cases of fetus-in-fetu. CASE 1: A fetal retroperitoneal cystic tumor including two masses was detected by ultrasonography at 26 gestational weeks. The masses showed distinctive structures resembling a vertebral axis and were prenatally diagnosed as fetus-in-fetu. A resected specimen revealed two fetiform masses. CASE 2: An intracranial tumor with hydrocephalus was detected by ultrasonography at 19 gestational weeks. The pregnancy was terminated, and a postmortem examination revealed six fetiform masses with immature teratoma. The tumors may possibly consist of parasitic monozygotic diamniotic twins or highly differentiated teratomas. Copyright 2007 S. Karger AG, Basel.

One shot of carbon-ion radiotherapy cured a 6-cm chemo-resistant metastatic liver tumor: a case of breast cancer.

PubMed

Harada, Mayumi; Karasawa, Kumiko; Yasuda, Shigeo; Kamada, Tadashi; Nemoto, Kenji

2015-09-01

The standard treatment for metastatic liver tumor from breast cancer is systemic medical treatment, and there is controversy regarding the value of local treatment. However, there are some exceptional cases that do benefit from local therapy. We describe the case of a 54-year-old woman with systemic therapy-resistant liver metastasis from breast cancer successfully treated with a single shot of 36-GyE carbon-ion radiotherapy and surviving more than 8 years without local recurrence. This case represents a good example of the usefulness and safety of carbon-ion radiotherapy, and who might benefit from local therapy.

Psychological counseling and accuracy of memory for child sexual abuse.

PubMed

Goodman, Gail S; Goldfarb, Deborah; Quas, Jodi A; Lyon, Alexandra

2017-12-01

Tens of thousands of child sexual abuse (CSA) cases are reported to authorities annually. Although some of the child victims obtain psychological counseling or therapy, controversy exists about the potential consequences for the accuracy of victims' memory of CSA, both in childhood and adulthood. Yet, delaying needed therapeutic intervention may have detrimental effects on the victims' well-being and recovery. To address this controversy, this study examined whether psychological counseling during a CSA prosecution predicts accuracy or inaccuracy of long-term memory for CSA. Participants (N = 71) were CSA victims who took part in a longitudinal study of memory and legal involvement. Data regarding participants' counseling attendance during the prosecution and details of their CSA cases were gathered throughout legal involvement and shortly thereafter (Time 1). Ten to 16 years later (Time 2), participants were questioned about a range of topics, including the alleged abuse. Time 1 counseling attendance significantly predicted more correct answers to abuse-related questions and (for corroborated cases) fewer overreporting responses at Time 2. Counseling was unrelated to underreporting responses. These results held even with other potential influences, such as abuse severity, victim-defendant relationship, posttraumatic stress disorder criteria met, testifying in the case, and delay, were statistically controlled. Although further research is needed, this study provides evidence that psychological counseling received by CSA victims during or shortly after prosecutions may improve later memory for abuse-related information. (PsycINFO Database Record (c) 2017 APA, all rights reserved).